Objective This study aimed to accurately understand medical teaching design research status and development trend to provide practical basis for the future of the medical teaching practice.Methods CNKI academic journal articles from January 1,2000 to December 30,2013 were retrieved,using search item for the subject,the retrieval word for instructional system design or instructional design,and the retrieval subject for medicine,and matches are precise retrieval way,and a total of 298 articles were retrieved.The common word analysis method was used to compare the high frequency keywords,analyze the key words in the article,and study the high frequency keywords clustering.Results In the two stages from 2000 to 2006 and from 2006 to 2013,research on medical teaching design of the courseware,distance education and other traditional E-learning-frequency gradually reduced,and vocabulary frequency related to education informationization of new situation such as cooperative learning,teacher education and constructionism and so on increased.In addition,in the second stage,some fresh words related to new technologies and new media appeared,such as interactive electronic whiteboard,virtual reality technology and so on.According to the correlation of keywords in 2007-2013,we found that the current medical teaching design research mainly gathered in three aspects such as classroom teaching,information technology supporting the reform of medical teaching and the training of medical teaching practitioners.Conclusion The research concluded that today and the future of medical teaching design research will mainly focus on three aspects such as effective teaching,the diversification of teaching supported by information technology and open medical education research under the Internet environment.

Objective To investigate the clinical efficacy of B-Lynch suture in the treatment of massive hemorrhage during cesarean section. Methods Thirty-six patients with massive hemorrhage during cesarean section were applied with B-Lynch suture when bleeding was not controlled through conventional treatment. Results The bleeding of 36 cases were all controlled effectively when treated with B-Lynch suture,no one was operated again because of poor blood circulation or rebleeding, avoided hysterectomy, no postoperative complications occurred, there was no abnormal of uterine involution and the menstrual time.Conclusions The operation of B-Lynch suture is easy, hemostasis rapidly,reliable,persistently,and with high success rate. It can reserve the uterus maximumly, reserve the fertility function of the patient. It is the effective surgical hemostasis in the treatment of massive hemorrhage during cesarean section, and without special equipment, suitable for primary hospital use when emergency,worthing promotion.

OBJECTIVE:To establish a method for dissolution determination of Erythromycin ethylsuccinate granules.METHODS:Paddle method was adopted and 0.1 mol?L-1 HCl solution was used as dissolution medium at rotation rate of 50 r?min-1.UV spectrophotometry was used to detect at wavelength of 482 nm.Dissolution rate was calculated.RESULTS:The linear range of erythromycin ethylsuccinate were 4～40 mg?L-1(r=0.999 0,n=5)with an average recovery of 99.19%(RSD=0.56%).Dissolution rate of erythromycin ethylsuccinate was more than 80% within 30 min.CONCLUSION:The method is rapid,simple and accurate for the quality control of Erythromycin ethylsuccinate granules.

Resveratrol has several neuroprotective effects in cerebral ischemia, including reductions of oxidative stress, inflammatory responses and apoptosis. Recent studies have shown that these neuroprotective effects of resveratrol may be involved in activation of silent information regulator 1.

Objective To evaluate the value of liver acquisition with volume acceleration(LAVA) in the diagnosis of hepatic outflow abnormalities.Methods LAVA was performed in 78 patients with suspected hepatic outflow abnormalities,thrombosis,stenosis,occlusion,or compression,including 71 hepatocellular carcinomas and 7 Budd-Chiari syndrome.Image quality and the presence of venous abnormalities and collaterals were evaluated.Results LAVA images were of diagnostic quality and without artifact in all patients.LAVA clearly showed the vascular anatomy and various disorders.The site,extent,cause of venous obstruction,and collateral pathways were well depicted.Conclusion LAVA is simple to perform and accurate in detecting hepatic outflow abnormalities.

Objective To explore the curative effect of dissection steel plate treatment in humerus near end bone fracture curative effect.Methods From June 2000 to March 2006,dissection steel plate treatment was used in 31 cases of humerus near end bone fracture and Constant-Murley scores was used to evaluate the curative effect.Results All patients were made a follow-up for 10 to 24 months,the average 16.5 months.31 examples surgeries patient only superior 16 examples,good 10 examples,may 2 examples,difficult 3 examples.Conclusion Center 3 and 4 humeruses near ends bone fracture uses the dissection steel plate treatment to Neer dividing will be possible to obtain the good clinical effect.

Objective To establish the method of content determination of Berberine in Zhenjing San. Method The analysis was carried out on C18 column (4.6 mm?250 mm, 5 ?m) by HPLC. The mobile please was acetonitrile-0.033 mol/L KH2PO4 (22∶78), the flow rate was 0.800 mL/min and detective wave length was 345 nm. Result The cabibration curves showed good linearity in the range of 12.012～600.600 ?g. The average recovery was 98.85% (RSD=1.09%). Conclusion The method is good sensitive, accurate and reliable.

Esophageal squamous cell carcinoma (ESCC) accounts for more than 90% of the confirmed cases of esophageal cancer in Asia, and the degree of malignancy is high. There is a growing number of research on ESCC immunotherapy, particularly programmed death-1 (PD-1) and programmed death-ligand 1 (PD-L1). Among them, the most studied PD-1/PD-L1 inhibitors in ESCC are nivolumab, pembrolizumab, camrelizumab, toripalimab, tislelizumab, atozolizumab, SHR-1316 and durvalumab. Some of the clinical trials of these drugs are still in progress, and some have initially shown good results.

Objective:To explore the efficacy of nimodipine combined with ganglioside in the treatment of cerebral hemorrhage and its effect on the expression of serum resistin and oxidized low-density lipoprotein (ox-LDL).Methods:According to the random number table method, 100 patients with cerebral hemorrhage admitted in Central Hospital of Zibo from February 2018 to February 2020 were divided into the single treatment group and the combined treatment group, with 50 cases in each group. In addition to conventional treatment, the single treatment group was additionally treated with nimodipine, and the combined group was additionally treated with nimodipine combined with ganglioside. After 2 weeks of intervention, the efficacy of the two groups was evaluated, and the National Institutes of Health Stroke Scale (NIHSS) scores, Ability of Daily Living (ADL) scores, serum inflammatory factors, resistin and ox-LDL levels were evaluated and recorded between the two groups before and after treatment.Results:The total effective rate of treatment in the combined treatment group was higher than that in the single treatment group: 90.0%(45/50) vs. 74.0%(37/50), and the difference was statistically difference ( P<0.05). After 2 weeks′ treatment, the scores of NIHSS was decreased and the scores of ADL was increased in two groups, and the scores of NIHSS in combined treatment group was lower than that in the single treatment group: (9.41 ± 1.27) scores vs. (12.10 ± 1.65) scores; the scores of ADL in the combined treatment group was higher than that in the single treatment group: (67.82 ± 9.04) scores vs. (59.10 ± 8.75) scores, and the differences were statistically differences ( P<0.05). After 2 weeks′ treatment, the levels of serum high-sensitivity C-reactive protein (hs-CRP), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α), resistin and ox-LDL in the two groups were decreased, and the levels of above index in the combined treatment group were lower than those in the single treatment group: (4.81 ± 1.03) mg/L vs. (6.10 ± 1.73) mg/L, (40.96 ± 9.21) μg/L vs. (56.74 ± 8.93) μg/L, (33.20 ± 7.96) μg/L vs. (44.76 ± 8.43) μg/L, (0.29 ± 0.09) μg/L vs. (0.45 ± 0.13) μg/L, (336.25 ± 69.74) mg/L vs. (372.18 ± 68.52) mg/L, and the differences were statistically differences ( P<0.05). There was no significant difference in adverse reactions between the two groups ( P<0.05). Conclusions:Nimodipine combined with ganglioside has a clear efficacy in the treatment of cerebral hemorrhage. It can effectively inhibit inflammation indicators, reduce serum resistin and ox-LDL levels, promote the recovery of nerve defects, and improve their living ability.

Cerebral edema and hemorrhagic transformation(HT) are the common complications of ischemic stroke. Ischemic cerebral edema is the primary cause of death in patients w ith large infarction. The sulfonylurea receptor 1 (Sur1) transient receptor potential M4 (Trpm4) channel plays an important role in focal cerebral ischemia. Both animal experiment and clinical studies have show n that the Sur1 selective inhibitor glibenclamide provides neuroprotection for ischemic stroke, including infarct volume reduction and improvement of neurological function, especial y in attenuating cerebral edema and reducing the incidence of HT. This article review s the advances in research on glibenclamide for the prevention of cerebral edema and HT in patients w ith ischemic stroke.