The scientific research was integrated with medical statistics experiments in view of the experimental teaching practice of medical statistics.The experimental teaching system and evaluation methods of medical statistics were formed,characterized with research task-oriented,a combination of theory,practice and scientific research to guide the students to study medical statistics systematically,such as project design,collecting data,sorting data and analyzing data.The teaching method boosts the students' enthusiasm,and cultivates students' ability to solve practical problems by using statistical principles.

In order to improve the quality of nursing dissertations,we combined the teaching of nursing research with clinical internship to teach nursing dissertation writing,following the process of program input-situation experience-clinical internship-problem study-dissertation writing.Taking problem study as the leading role,students as subject,self experience as the main access and tutors as whole-process instructors,we taught and evaluated nursing dissertations at different stages.Students'interests in scientific research,enthusiasm for participation and quality of dissertations were improved effectively.95.78％ of the students showed positive attitude to this teaching method.

To solve the problems in traditional experiment teaching,we transform the static,purely verifying experiments into dynamic ones that both reflect the substance changes and verify theories.These reforms in experiments are intended to arouse the students' interest,inspire their creative thinking,cultivate their research skills and improve experiment teaching quality.

The article,taking the experience and the lesson in constructing demonstration center of experiment teaching as a clue,has discussed the idea,the method and the ownership of experimental teaching reform,has demonstrated the relations among teachers' teaching idea and teaching reality and students' studying effect,has analyzed some trends and quality of experimental teaching reform and has concluded some feasible reform idea of experiment teaching.

The functional experimental teaching reform plays a very important role in raising the teaching resources,consummating the experimental teaching management system,enhancing the student to practice the ability and so on and has obtained the good effect.But it also faces some problems waiting urgently to be solved and further perfected,to which this article has made the analysis and the discussion from the management science angle.The goal lies in deepening the educational reform in functional experiment unceasingly to provide the model.

To improve the clinical teaching work, the objective structured clinical examination (OSCE) was first introduced into the periodontal clinical assessment held by Departments of Periodon-titis and Mucosal Disease. With the OSCE exam station and item pool established, standardized pa-tients tralned, the examination form reformed, the knowledge, skill, and attitude of the examinee were assessed comprehensively. Compared with traditional exam,the OSCE evaluated the examinee's skills on clinical admissions, history collection, treatment plan development better. Most examinee have got satisfactory result (pass rate: 86.4 %, 19/22; good rate: 36.4%, 8/22; excellent rate: 9.1%, 2/22). The feedback of the following questionnalre also showed that most of the candidates thought the OSCE helpful to promoting the learning of theoretical knowledge (87.5%, 14/16) and good for converting the learned knowledge and skills into occupation ability (87.5%, 14/16).

Objective To explore the distinctive ultrasonographic characters of enthesitis in patients with spondyloarthritis (SpA) and evaluate the diagnostic value of ultrasonography in SpA by comparing ultrasonography of enthesis in the lower limbs of patients with SpA,rheumatoid arthritis (RA) and osteoarthritis(OA).Methods Entheses in the lower limbs (quadriceps tendon,proximal patellar ligament,distal patellar ligament,achilles tendon and plantar aponeurosis) were detected in SpA,RA,OA patients and health controls by ultrasonographic examination.Results A total of 46 SpA,23 RA and 12 OA patients were enrolled in this study,with 26 SpA and 7 RA patients complaining of heel pain(P ＜0.05).There were 126 enthesal sites(126/460,27.2％) were detected abnormal in SpA group,compared with 54 of 230 (23.5 ％) sites in RA group and 27 of 120 (22.5 ％) sites in OA group (P ＞ 0.05).Sixty five (70.7 ％) sites of the distal patellar ligaments were abnormal in SpA group,while that were 19(41.3％)in RA group(P ＜ 0.05)and 13 (54.2％)in OA group.Twenty six sites of tendon thickness and 22 sites of bone erosion in the distal patellar ligaments were found in SpA group,while only one site of each in RA group(P ＜ 0.05) and 4 sites of tendon thickness in OA group (P ＜ 0.05) were found.Tendon thickness,bursal synovitis and bone erosion coexisting in one distal patellar ligament indicated SpA,the sensitivity,specificity and the area under the curve (AUC) of which were 70.7％,65.5％ and 0.740,respectively.Conclusion Tendon thickness and bone erosion of entheses were more likely the distinctive ultrasonographic characters of enthesitis in SpA patients.Tendon thickness,bursal synovitis and bone erosion in the distal patellar ligament could be an ideal tool for SpA diagnosis.

Objective To improve the understanding of the clinical features, differential diagnosis and prognosis of pachydermodactyly. Methods The clinical data of 20 patients with pachydermo dactyly and follow-up data of 6 patient were analyzed. Results Seventeen out of 20 patients were male. The average onset age was (15±2) years. All of them had asymptomatic, firm swellings which developed insidiously on both sides of the proximal interphalangeal (PIP) joints. All the patients indicated that they were in the compulsive habit of interlacing their fingers and squeezing them. For all patients, biochemical examinations were normal and there was no rheumatoid factor or antinuclear antibodies. X-ray and MRI showed that the thickening of soft tissue around PIP joints without changes in bones or joints structure. Histopathologic findings from the swellings reveMed marked hyperkeratosis, with slight epidermal hyperplasia, and a markedly thickened dermis with whorled, densely aggregated bundles of coarse collagen. Even though 8 patients in the group had gotten rid of the aforesaid habit for 3 to 22 years, the swellings of their PIP joints did not resolve. Conclusion Pachy-dermodactyly is a benign digital fibromatosis which usually involves the PIP joints. It can be distinguished from juvenile rheumatoid arthritis and knuckle pad.

Objective To compare the changes of 11 cytokines in ankylosing spondylitis(AS)before and after treatment with a loading regimen of infliximab and to evaluate the potential AS related discriminating cytokines and explore their value in diseases activity evaluation and possible association with therapeutic response.Methods This was an open-labeled,phase Ⅱ clinical trial conducted in 2 medical centers.All AS patients were infused with infliximab at week 0,2,6.The dosage was 5 mg/kg.Disease activity parameters were assessed at week 0,2,6 and 10.Eleven serum cytokines were detected using protein chip technique,then,serum IL-6 level wag measured by sandwich enzyme-linked immunosorbent assay(ELISA).Results IL-6 was detected by EHSA.Compared with healthy controls.IL-6 level incregsed markediy in AS(P<0.01).After treated with infliximab,IL-6 level decreased at week 2(P<0.01)and maintained at low level until week 10.Baseline serum IL-6 level was positively associated with AS disease activity index(night pain scores、ESRand CRP)(P<0.01).Conclusion Serum IL-6 level is associated with AS disease activity and may become a useful parameter for monitoring the clinical response of infliximab in AS patients.IL-6 is an important cytokine involved in the pathogenesis of AS.

Objective To evaluate the efficacy and safety of single intra-articular etanercept injection in patients with rheumatoid arthritis (RA) and spondyloarthropathy (SpA) who had knee arthritis.Methods This was a randomized, single-blind, parallel, controlled clinical trial. The subjects were the RA or SpA patients with the knee arthritis without deformity, moderate or severe bone erosion and obvious joint space narrowing in radiography in the target knees, who had taken at least 6-week therapy with routine dosage of disease modifying anti-rheumatic drugs (DMARDs) before the study. The subjects were randomized in 2:1 ratio to receive either single intra-articular 25 mg etanercept injection or 2 ml compound betamethasone to the target knees joint after their synovial fluid being drawn away at baseline. They were followed up four weeks after injection. The primary end-point was the 4-week change in the modified Hospital for Special Surgery (HSS) knee score for the target knee. Results Forty-seven subjects in the experimental group and twenty-three subjects in the controlled group were included in the trial. The modified HSS knee score for the experimental group was baseline mean 65.6 ± 14.0, follow-up 84.3 ±11.1 (P ＜0.0001 ), the controlled group baseline mean 68.2 ± 11.4, follow-up 79.4 ± 15.5(P =0.0015). A mean (34.9 ±38.9)% improvement on the modified HSS knee score was achieved in the experimental group, while ( 17.9 ±24.5)% improvement on the modified HSS knee score was achieved in the controlled group (P =0.0467). Adverse events were observed in eight patients (19.0% ) in the experimental group and eight patients (44.4%) in the controlled group. No serious adverse event had been observed. Conclusions Single intra-articular 25 mg etanercept injection had a better efficacy than 2 ml compound betamethasone. It was an effective and safe therapeutic option for SpA and RA patients who had knee arthritis without obvious change in radiography.