Teaching hospital plays a central role in training excellent doctor.Clinical teaching secretaries act as the advisor,coordinator,logistics people and supervisor in hospital clinical teaching management.Their duties include helping leader form and fulfill teaching plan,collect and arrange teaching records.To better accomplish the teaching secretarial job,a clinical teaching secretary should keep improving professional quality and personal comprehensive ability,ameliorating working methods and enhancing innovative thinking in a sound managing and evaluating system.

Clinics are a main institutional form for doctors to open personal business in China .The develop-ment process of clinic reflects the situation of medical staff free practice .This study summarized the supervision poli-cies on clinic in China since the founding of China and got three conclusions .The first one was the attitude of the practice of the clinic has changed significantly .The change include four stages which were authorization ( 1949—1957 ) , limitations ( 1958—1977 ) , re-authorization ( 1978—1996 ) , promotion and encourage ( 1997—) along with macroeconomic system reform and the changes of government's governance ideas on health sector .The second conclu-sion was that the government gradually raised awareness of the status and role of the clinic institutions in the health system over the past several decades .The third conclusion was the supervision policies became more meticulous .In the future , clinical institutions can be a useful supplement to public medical institutions in China for its development process and characteristics .

Objective To explore an effective method for enhancing basic clinical skill of students.Methods Selective course of basic clinical skill was launched for the fourth grade clinical medicine students by using simulation-based medical education (SBME).Elective courses have 21 class hours,involving 15 items of basic clinical skills in internal medicine,surgery and nursing.Training methods include preparation,explanation,demonstration,operation,group competition,examination and questionnaire.Selective course examination includes class activation and final examination,accounting for 20％ and 80％ of the final scores,respectively.Scores were classified into A (excellent),B (good) and C (moderate) levels.Scores and questionnaire data were processed by Microsoft Office Excel 2007 software and percentages of score and questionnaire feedback were calculated.Results Results suggested that the scores of 70％ students were more than 90.Results of questionnaire indicated that the basic clinical skills of 76.6％ of the students were improved a lot.79.2％ considered that it was useful for their clinical practices.Conclusion Clinical-skill course based on SBME is conducive to enhancing basic clinical skills of students.

ObjectiveTo investigate the expression levels of the type Ⅰ IFN system in muscle and lung of experimental autoimmune myositis (EAM) model and to evaluate whether the type Ⅰ IFN system associates with the pathogenesis of the EAM model in rats.MethodsThe EAM model was established to determine creatine kinase (CK) in blood serum.The pathology of muscle and lung tissue was examined by hematoxylin-eosin staining.The concentration of type Ⅰ IFN system mRNA in muscle and lung tissue was detected by real-time PCR.ResultsThe concentration of CK in model group [(209.17 ±91.95) IU/L]was significantly higher than that of two control groups(P ＜0.05).The scores of muscle and lung in EAM model were significantly higher than that of control groups (all P ＜ 0.05).The expression levels of the type Ⅰ IFN system in muscle of EAM model were significantly higher than that of control groups(all P ＜0.05).The expression levels of the type Ⅰ IFN system in muscle with EAM model were positively correlated with CK and the scores of muscle (all P ＜ 0.05).The expression levels of IFNα, IFNβ, IFNαR1, signal transducer and activator of transcription 1 (STAT1), myxovirus resistance protein 1 (MX1) in lung of EAM model were significantly higher than those of control groups(P ＜ 0.05), but not seen in INF-induced protein with tetratricopetide repeats 1 (IFIT1) and IFN-stimulated gene 15 (ISG15).The expression levels of IFNα, IFNβ, IFNαR1, STAT1 and MX1 in lung with EAM model were positively correlated with the scores of lung pathology (all P ＜ 0.05).ConclusionThe type Ⅰ IFN system probably played a crucial role in the pathogenesis and the pathology of muscle and lung of EAM modeL

Objective To study the function and effect of Oleanolic acid to cholestasis on regulating bile acids transporters. Methods A total of 45 rats were divided into 9 groups,5 rats in each group. The Sham group,Bile duct ligation group and Oleanolic acid group were treated with saline or Oleanolic acid for 3 days,7 days and 14 days. Then the liver and tested bile acids transporters in mRNA and protein lev-els were collected. Results The expression of bile acids transporter OSTβ with Oleanolic acid was increased after 3 days. The expression of OSTβ and BESP in Oleanolic acid group after 7 days were increased than those in Sham group. Fourteen days later,the increasing tendency of OSTα,OSTβ and BSEP were sensiable. Conclusion Oleanolic acid can stimulates the expression of bile acids transporters OSTalpha-beta and BSEP in bile duct-ligation rats.

Objective To investigate the application effects of cardiac resynchronization therapy(CRT)of[left bundle optimization(LOT)]and biventricular pacing(BiV)in the patients with chronic heart failure complicating left bundle branch block.Methods The single center,prospective and non-randomized controlled study method was used.Forty-two patients with heart failure meeting CRT in this center from April 2020 to April 2022 were consecutively included.Among them,32 cases adopted the BiV-CRT(BiV-CRT group)and 10 cases adopted LOT-CRT(LOT-CRT group).The pacing-making parameters,quality of life scale(SF-36)score,6-min walk test(6-MWT),ECG QRS width(QRSd),left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF)and New York cardiac function grade(NYHA)situation were collected before surgery,after surgery immediately and in postoperative 3,6,12 months.Their complica-tions and clinical outcomes were evaluated.Results The pacing threshold value in the LOT-CRT group was stable and lower than that in the BiV-CRT group(P＜0.05);QRSd in postoperative 12 months in the LOT-CRT group was shorter than that in the BiV-CRT group[(115.0±14.3)ms vs.(133.0±14.0)ms,P＜0.05]and 6-MWT was longer than that in the BiV-CRT group[(327.0±52.8)m vs.(274.0±52.8)m,P＜0.05],and the differences were statistically significant(P＜0.05);LVEF,LVEDD,NYHA cardiac grade and SF-36 score in postoperative 12 months were improved compared with those before implantation.The rehospitaliza-tion rate of heart failure in the LOT-CRT group was lower.Conclusion LOT-CRT could obtain a narrower QRS wave and longer 6-MWT than BiV-CRT.