The application of the multimedia combined with the PBL teaching model to the teaching of Gynaecology and Obstetrics is an open teaching model.It emphasizes that the class-teaching will be problem-based,and it can improve the students' initiative greatly and their enthusiasm as well.In this way,it can urge their desire to participate in the class-room activities and acquire knowledge.The method combined multimedia with PBL can also improve the teachers' teaching skills and their over-all clinical working abilities.

Objective To investigate effect of irinotecan combined with cisplatin on level of Bcl-2 and MACC1 protein in serum in patients with cervical cancer.Methods 92 cases of patients with cervical cancer surgery from department of gynaecology and obstetrics,the third People’s hospital of Nanchang were randomly divided into control group and treatment group.Control group was treated with paclitaxel therapy chemotherapy, treatment group were treated with irinotecan combined with cisplatin.Bcl-2 and MACC1 protein in serum were compared before and after the treatment. Results The level of Bcl-2 and MACC1 in both groups were not statistically significant pre-treatment;After treatment, the levels of Bcl-2 and MACC1protein in serum were decreased (P<0.05).Compared with control group post-treatment, the level of Bcl-2 and MACC1 protein in serum were lower in treatment group (P<0.05).During follow-up, death cases of treatment group and control group were 5 cases and 6 cases respectively, the survival rate of 89.13% and 86.96% respectively within the past six months(χ2 =0.103,P>0.05).Death cases of treatment group and control group were 4 cases and 12 cases respectively. the survival rate of 91.30% and 73.91% respectively within one year (χ2 =4.84, P <0.05 ) Conclusion Irinotecan combined with cisplatin in the treatment of cervical cancer in one year survival rate is higher, which may be related to the decrease of serum levels of Bcl-2 and MACC1 protein content.

"Seven kinds of prescriptions" and "Ten formulas of materia medica" were important classifications of prescription. According to textual research, the title of"Seven kinds of prescriptions" appeared fi rst in XU Shu-wei’s Shang han jiu shi lun (Ninety Essays on Cold Pathogenic Diseases), which was applied in medical education in the Song Dynasty. The title of "Ten formulas of materia medica" was beginning from CHEN Cang-qi’s ten kinds of "general drugs", and its concept was expanded from "kind" of drugs into "prescription" in Sheng ji jing (Classic of Holy Universal Relief) of the Song Dynasty. These two classif ications had great influence on classif ication of prescription based on functions in later time. The development of "Seven kinds of prescriptions" and "Ten formulas of materia medica" in the Song Dynasty was discussed, and the reasons was analyzed in this paper.

Interventional radiology has lot of advantages in dealing with various emergencies. The technique is minimally-invasive,highly-effective and immediately-efficient,moreover,it integrates the diagnosis with the therapy perfectly. Besides,the interventional techniques applied in emergency medicine include not only the vascular interventions,such as embolization,embolectomy,etc,but also the nonvascular interventions,such as tracheal stent implantation,percutaneous vertebroplasty and so forth. However,importance has not been attached to the clinical use of interventional therapy in emergency medicine so far. It is imperative for us to promote the acceptance of interventional therapy in emergency medicine as well as to popularize the technique in clinical practice.

This article is about how to set up the equipment and reservation mechanism of emergency supplies in small and medium-sized hospitals.A full-time emergency management agency is set up to coordinate the work of emergency medical support;Regular education and publicity mobilization about emergency support are carried out to lay a solid foundation in mind for officers and soldiers;the emergency reservation is fulfilled in aspects of medicines,equipment,apparatus,and emergency support groceries;General and professional personnel training are enhanced;The training of full-time staff is strengthened to maintain,use and develop the equipment;the staff-equipment combination of medical support staff is highlighted.All the methods above are used to address the reservation and supply issue of the emergency medical support goods,thereby improving the medical support capacity of small and medium-sized hospitals for diverse military tasks.

The authors analyzed the current problems about clinical postgraduate cultivation in the medical colleges or institutes or hospitals in China,and proposed some solving ideas for discussion,including raising the applicative qualification for enrolling postgraduate,reinforcing construction of the soft and hardware condition,guaranteeing enrolling number of postgraduate for key colleges and institutes.

Objective To investigate the risk factors related with the recurrence of multifocal papillary thyroid microcarcinoma(PTMC).Methods The data of 126 patients undergoing surgery from Jan.2001 to Jun.2011 proved to be multifocal PTMC by pathology were rctrospcctively analyzed.Logistic multifactor regression analysis was used to analyze the clinicopathological factors that may influence the recurrence of PTMC.Results The median age of the 126 patients was 46 years(ranging from 15 to 78 years old).The recurrence rate was 14.3％ (18/126) and the overall survival rate was 98.4％ with the medium follow-up of 75 months (ranging from 24 to 150 months).Multivariate analysis showed that extra-thyoidal extension,neck lymph node metastasis and non-total(or near total)thyroidectomy were the independent risk factors for the recurrence of multifocal PTMC (P =0.008,0.027,0.022 respectively).Conclusions Extension beyond the thyroid and metastatic neck lymph node predict a high risk of recurrence.Total or near total thyroidectomy can reduce the risk of recurrence.

Objective To investigate the effects of the serum from chronic renal failure (CRF) rats on endoplasmic reticulum stress (ERS) and activation of activating transcription factor 4 (ATF4) of rat arterial smooth muscle cells (ASMCs) cultured in vitro and explore the possible mechanism. Methods The rat model of CRF was established by 5/6 nephrectomy. ASMCs were incubated in the media with 10% or 20% serum of CRF rats cultured in vitro. ATF4 nuclear translocation were analyzed by immunofluorescence. GRP78 (glucose regulated protein 78), p-PERK (pancreatic ER kinase) and ATF4 proteins in response to the CRF serum in ASMCs were determined by Western blot. The ATF4-DNA binding activity was analyzed by electrophoretic mobility shift assay (EMSA). Results The CRF serum could significantly promote the expression of GRP78 of ASMCs in dose-dependent manner. Under the stimulation of 20% CRF serum, nuclear translocation of ATF4 in ASMCs was found. Compared with control serum group, the expression of ATF4 and p-PERK of CRF serum group was increased significantly (P<0.01). The CRF serum could increase the ATF4-DNA binding activity. Conclusion The CRF rat serum can effectively induce ERS of ASMCs and activate the pathway of PERK-ATF4.

Surface lubricity is one of the important performance criteria for interventional guide wire. In this paper, a review of the methods of surface hydrophilicity and lubrication modification of interventional guide wire is presented, including their fundamental principles, effects and some relative applications. These methods all have their own advantages and disadvantages, therefore, limitations of experimental conditions need to be taken into account.
Catheterization ; Hydrophobic and Hydrophilic Interactions ; Lubrication

Objective:To define doctors professional risk connotation , the scientific judgment doctors profes-sional risk fact , seek medical professional risk guard against and dissolve the long -term mechanism , maintaining safety and legitimate rights and interests of the doctor′s body and mind .Methods:Using doctor -patient relation-ship as the research background , adopts the questionnaire survey , through the survey data analysis of the correla-tion between the doctor-patient relationship and the doctor professional risk , on the basis of the young workers , for example , the empirical research doctors professional risk existing conditions and the reality .Results:The doctor-patient relationship nervous career anxiety and unease , doctor of job burnout and the harm done by the profession itself, complicated medical environment cannot effectively solve the doctor occupational safety crisis , institutional arrangements and the prevention and control mechanism is not reasonable career crisis .Conclusion:The govern-ment should strengthen the professional risk management system design and the prevention and control institutions and hospitals to strengthen the construction of professional risk management and prevention and control system , the doctor should promote occupational consciousness of risk prevention and control and doctor -patient communication ability, the society should strengthen professional risk management and the prevention and control of environmental regulation .