conduction of institutionalized and stanardized education for rural doctors is one of the specific measures that can be taken to put into effectt the gist of the documents issued by the State Council, realize healthcare for all people in the rural areas of China by the year 2000, and imprvove the quality of medical services in the rural areas. The steps taken by Yun County include: ①strengthening leadership so as to guarantee the smooth conduction of the work; ②establishing training hases so as to provide the necessary environment; ③working out policies so as to create the right circumstances; and ④consolidating measures so as to bring into ply the ndhative of rural doctors in participating in the education. As a result of the above steps, health stations have ho set up in all the 396 administrative villages throughout the county, with the average number of rural doctors in each village being 1.47. 86. 1% of these rural doctors have participated in the education, with the newly employed 29 ed doctors all having received technical secondary education in health. Yet the construchon of the contingent of ed doctors is still confronted with some problems needing prompt solution.

Objective To investigate the effects of cochlear implantation combined with subtotal resection of temporal bone in treatment of nasopharyngeal carcinoma after radiotherapy of temporal bone necrosis. Methods A prospective study method was used, and 76 cases of nasopharyngeal carcinoma after radiotherapy of temporal bone necrosis from February 2013 to October 2015 in our hospital for diagnosis and treatment were selected. According to the open control paired principle,the patients were equally divided into observation group and control group, each of 38 cases. Both groups received subtotal temporal bone resection in the treatment, and the observation group received cochlear implant therapy. The surgical effect and hearing improvement of two groups were observed. Results All patients successfully completed surgery. In the observation group, the patients showed normal reactions to intraoperative electrode detection and postoperative electrode impedance, without electrode slippage. There were no statistical differences between the two groups in postoperative pneumothorax and other complication (P>0.05). The sound intensity level of hearing test in postoperative 1 month in the observation group and control group were (21.23±5.22) dB and (28.42±4.19) dB, which was significantly lower than that in the preoperative 1d [(38.24 ±4.98) dB and (38.12 ±5.00) dB], with significantly statistical difference (P<0.05). The postoperative 1 month of hearing and speech score in the observation group were (87.24 ±2.98) points and (82.10 ±3.91) points respectively, which were significantly higher than those in the control group [(73.02 ±5.30) points and (71.84 ±3.11) points] (P<0.05). The two groups of postoperative 1 months of hearing and speech scores were also significantly higher than those in the preoperative 1 d [observation group: (34.29±3.49) points and (32.10±5.30) points; control group: (33.20±4.14) points and (31.98±4.92) points] (P<0.05). Conclusion Cochlear implantation combined with subtotal resection of temporal bone in treatment of nasopharyngeal carcinoma after radiotherapy of temporal bone necrosis shows high safety and success rate, which can promote the improvement of hearing and speech ability, and be widely used in clinic.

Objective To explore the clinical value of serum tumor markers including CEA,AFP,CA199,CA125,CK19,CA242 and CA724 in diagnosis of pancreatic adenocarcinoma in the elderly.Methods Totally 158 elderly and 102 middle-aged patients with pancreatic adenocarcinoma were selected.Pancreatic adenocarcinoma in all patients were confirmed by pathological examination,cytological examination and CT.100 elderly and 100 middle-aged patients with benign diseases were selected as control groups.The levels of serum tumor markers were detected and their sensitivities and specificities were calculated and compared between groups.Results The levels of serum CEA,CA199,CA125,CK19,CA242 and CA724 were higher in elderly patients with pancreatic adenocarcinoma than in the elderly control group [(70.9±11.4) g/L vs.(1.6±0.4) g/L,(158.9±19.1)U/mlvs.(12.6±3.2)U/ml,(53.9±15.4)U/mlvs.(11.6±1.1)U/ml,(70.2±16.3)U/ml vs.(1.4±0.2)U/ml,(96.4±18.5)U/ml vs.(7.9±2.2)U/ml,(57.6±13.6)U/ml vs.(4.4± 0.6)U/ml,t=26.13,31.63,17.57,19.03,20.95,15.59,respectively,all P＜0.05].The sensitivities of serum CEA,AFP,CA199,CA125,and CA242 were higher in the elderly patients than in the middle aged patients (61.72％ vs.48.69％,19.56％ vs.4.13％,80.31％ vs.69.55％,70.21％ vs.46.77％,75.24％ vs.59.44％,x2=4.28,12.63,3.94,14.32,7.23,respectively,all P＜0.05).The specificities of serum CEA,AFP,CA199,CA125,and CA242 had no significant differences between the elderly and middle aged patients (all P＞0.05).Conclusions Serum tumor markers may provide effective reference for the clinical diagnosis of pancreatic adenocarcinoma in the elderly,which has important value for pancreatic adenocarcinoma control and reversal.

Objective To investigate the effect of dexmedetomidine (Dex)on long-term cogni-tive function after partial hepatectomy (PH)in mice.Methods Forty adult male C57BL/6J mice were randomly divided into control group (group C),group PH,normal saline group (group NS)and group Dex,10 mice per each group.At 2 days after PH,the mice of group C and group PH under-went Morris water maze test,four times per day and a total of 4 days.The mice were euthanized and hippocampi tissue was immediately excised for determination of wet hippocampi weight to dry hipp-ocampi weight (W/D)and total hippocampi water content (TWC).The expression levels of cycteinyl aspirate-specific protease 12 (caspase-12)mRNA and protein of hippocampi tissue were detected re-spectively by reverse transcription-polymerase chain reaction (RT-PCR)and Western blot.Apoptosis index (AI)of hippocampi tissue was determined by terminal-deoxynucleoitidyl transferase mediated nick end labeling (TUNEL)assay.After the mice regained consciousness after operation,animals re-ceived intraperitoneally Dex at a dose of 25 μg·kg-1 ·d-1 for 30 consecutive days in group Dex.Ani-mals of group NS were given intraperitoneally with the same volume of normal saline.After treatment for 30 consecutive days,the mice of group Dex and group NS underwent Morris water maze test,four times per day and a total of 4 days.The mice were euthanized and hippocampi tissue was immediately excised for determination of W/D and TWC.The expression levels of caspase-12 mRNA and protein of hippocampi tissue were detected respectively by RT-PCR and Western blot.AI of hippocampi tissue was determined by TUNEL assay.Results Compared with the first day,the escape latency at the third day,the fourth day and swimming distance were shortened in groups C,NS and Dex (P <0.05);Compared with group C,the escape latency at the third day,the fourth day and swimming distance were prolonged (P < 0.05 ), W/D,TWC and AI were higher (P < 0.05 ), and the expression levels of caspase-12 mRNA and protein of hippocampi tissue were significantly higher (P<0.05)in group PH.Compared with group NS,the escape latency at the third day,the fourth day and swimming distance were shortened (P <0.05),W/D,TWC and AI were lower (P <0.05)and the expression levels of caspase-12 mRNA and protein of hippocampi tissue were significantly lower (P <0.05)in group Dex.Conclusion The treatment of Dex could improve the long-term cognitive function after PH in mice,and the mechanism may be to lighten apoptosis mediated by caspase-12 in hippocampi tissue.

Objective One of the characteristics of rheumatoid arthritis was multiple joints involved symmetrically. The purpose was to study the method of early diagnosis and treatment for the atypical rheumatoid arthritis involving solitary joint. Methods From April 1997 to December 2002, 5 cases which were 1 male and 4 female patients with an average age of 36.8 years (range, 23 to 47 years), suffered from the swelling and pain of knee joint, and were diagnosed as early rheumatoid arthritis. The interval of the onset to surgical treatment ranged from 2 months to 3 years with a mean of 16.2 months. The patients were evaluated with serum test, joint fluids examination and radiological imaging. They were treated by the synovectomy under the arthroscopy, while the appearances of the joint under arthroscopy were recorded, and the synovial tissue was sent to the pathological examination. The improvements of the joints symptoms and the range of motion were assessed at final follow up. Results During the operation, the light green and little muddy joint fluids were found in all patients. ESR of the patients ranged from 29 to 51 mm/1h with an average of 32.2 mm/1h, all of which were higher than normal value, whereas, 3 cases had positive rheumatoid factor and 4 cases showed significant higher ?2-MG. The radiographic findings were osteoporosis in 3 cases, soft tissue swelling in 4 cases and narrowed joint space in 1 case. The synovium were proliferated and enlarged in dark violet, there were creeping pannus and necrosis fibrin deposition in the cartilage. All of the patients were diagnosed as rheumatoid arthritis confirmed by pathological changes of the synovium. The patients were followed up from 4 months to 5 years (mean, 18.7 months). Pain released in 5 cases, swelling reduced in 3 cases, the range of motion improved by 19 degrees. Unfortunately, all of the patients developed later into typical rheumatoid arthritis after the mean interval of 10.9 months (range, 3 to 25 months), the symptoms were consistent with the criteria of American Rheumatoid Association . Conclusion Solitary joint with rheumatoid arthritis is rare and may be the early status of rheumatoid arthritis. The specific appearance under the arthroscopy prompt the early diagnosis of the knee rheumatoid arthritis, and synovectomy by arthroscopy may be benificial to release the symptoms of rheumatoid arthritis.

To determine the role of biopterin in acute lung injury in scald rats with infection, and to observe the therapeutic effect of GTP-cyclohydrolase I(GTP-CHI) inhibitor on postburn sepsis, 56 male Wistar rats were randomly divided into four groups: normal controls (n=10), scald control group(n=10), postburn sepsis group(n=20) and 2,4-diamino-6-hydroxy-pyrimidine (DAHP) treatment group (n=16). Tissue samples from lungs were collected to determine GTP-CHI and inducible nitric oxide synthase (iNOS) mRNA expression, meanwhile biopterin, nitric oxide (NO), tumor necrosis factor-?(TNF-?) and interferon-? (IFN-?) levels in lungs were also measured. The results showed that after scald injury followed by Staphylococcus aureus challenge, GTP-CHI gene expression and biopterin levels significantly elevated in lungs, so did the values of iNOS mRNA expression and NO induction (P

To compare the growth factors mRNA expressions in human skin fibroblasts cultured in two (2D) or three dimensional systems (3D). Human skin fibroblasts were isolated and cultured in collagen jelly (3D) or the regular culture plates (2D). After 72 hours, the total RNA of fibroblasts were extracted. Specific oligonucleotide primers for the growth factor VEGF and bFGF were synthesized and reverse transcriptase polymerase chain reaction (RT PCR) was utilized to amplify the mRNA of those growth factors. RT PCR productions were separated by electrophoresis in 1% wt/vol agarose gels and photographed. Semi quantitative data were statistically analyzed. Although the morphology of fibroblasts in 3D culture was different from that in 2D culture, the RT PCR analysis revealed the same expression and concentration of VEGF mRNA and bFGF mRNA in human skin fibroblasts cultured in different systems.

Over the past years efforts have been made by the government to improve the management of clinical laboratories.The government activities such as networking of quality assurance, development and implementation of clinical laboratory standards, and establishment of external quality control mechanisms have facilitated the improvement of clinical laboratory quality.Further definition and integration of clinical laboratory services, introduction of clinical laboratory pathologists and consultation and establishment of a permission mechanism are needed for improving the effectiveness of clinical laboratory services.Government regulations will continue to play an essential role in the clinical improvement process.

Objective:To observe the clinical efficacy of chemotherapy for esophageal cancer in the elderly. Methods: A total of 74 patients diagnosed with esophageal cancer in our hospital were randomly divided into the observation group and the control group. The control group was treated with radiotherapy alone, while the observation group was treated with concurrent chemoradiotherapy. The efficacy, adverse reactions and 1 and 2-year survival were observed. Results:The recently response rate was 86.5% in the observation group, while the control group was 62.2% (x2=5.37, P<0.05). The disease control rate was 100.0% in the observation group, while it was 3.8% in the control group. The differences were significant (x2=4.53,P<0.05). The adverse reactions in the two groups were not significantly different. With 34 patients in the observation group followed up, the 1-year survival rate was 73.5%, 2-year survival rate was 55.9%, while it was 40.0% and 25.9% in 35 patients that followed up in the control group. The differences were statistically significant (x2=6.58,x2=5.32;P<0.05).Conclusion: Concurrent chemotherapy for esophageal cancer in the elderly has a significant effect. Compared with radiotherapy alone, it can significantly increase the 1, 2-year survival rate, and does not significantly increase the adverse reactions.

Transformers are required to demonstrate the ability to withstand short circuit currents. Over currents caused by short circuit can give rise to windings deformation. In this paper, a novel method is proposed to monitor the state of transformer windings, which is achieved through on-line detecting the leakage inductance of the windings. Specifically, the mathematical model is established for on-line identifying the leakage inductance of the windings by applying least square algorithm (LSA) to the equivalent circuit equations. The effect of measurement and model inaccuracy on the identification error is analyzed, and the corrected model is also given to decrease these adverse effect on the results. Finally, dynamic test is carried out to verify our method. The test results clearly show that our method is very accurate even under the fluctuation of load or power factor. Therefore, our method can be effectively used to on-line detect the windings deformation.