The key to the management of clinical colleges is to improve teaching-administering bodies and construct the faculty of diagnostics.Factors that ensure teaching quality include formulating a syllabus corresponding to training objectives,compiling teaching material with essential contents and good operability,adopting teaching method capable of best developing students′ abilities to learn and practice,and using information technology.

Clinical exercise is an important stage to combine theory and practice,and an essential process for medical student to become a doctor.The quality of clinical exercise directly influences the practicing ability of graduated medical students and the achievement of medical education.This article analyzes factors that influence the quality of clinical exercise by collecting and sorting relative data,and presents some countermeasures thereby.

Resident or specialist training plays a very important role in developing qualified clinicians and improving medical quality.In combination with the status quo of resident or specialist training in our country , brief analysis has been made on the characteristicsof military resident or specialist training .As a result, the 3 +X +militarymode has been put forward in military resident orspecialist training.According to Specialist Training Standards by National Health and Family Planning Commission , training criteria upto military requirements have been established in order to achieve systematic military residency , develop medical support capability andpromote military health development.

Objective:To evaluate construct validity of China residents health literacy questionnaire and explore the application of confirmative factor analysis(CFA)in health literacy measurements.Methods:CFA was performed on dimension of basic healthy skills in the questionnaire.Latent variable scores and comprehensive score based on factor variance weight were calculated.Comparison among the latent variable scores,comprehensive scores and proportion of knowing was conducted via GLM or Logistic model.Results:Two factors named general capacity and emergency capacity were well fitted(?2=12.12,P=0.356,IFI=0.998,TLI=0.996,RMSEA=0.007).According to comprehensive score the sample qualification rate of basic health literacy was 38.5%(785/2 040),much similar to 38.2%(780/2 040)which is calculated by original item scores.Latent variable score or comprehensive score has more statistical power than that of proportion of knowing in multivariate analysis.Conclusion:CFA is a useful tool and valuable for applying in the field of health literacy measurement and analysis.

[Objective]To investigate the clinical treatments of perioperative complications in patients with cervical cord injury.[Method]Totally 155 cases of cervical cord injury associated with fracture of the cervical spine were enrolled in this study from January 1997 to December 2007.Eighty-five cases were treated with anterior internal fixation,66 with expansive open-door laminoplasty of the cervical spine,and 4 with one stage anterior and posterior approach operations.[Result]Forty-five cases were complicated with hyperpyrexia,31 with respiratory dysfunction,43 with pulmonary infection,70 with hyponatremia,25 with urinary system infection,3 with stress ulcer,10 with deep venous thrombosis,5 with palsy of the C5 nerve root,3 with injury of superior laryngeal nerve or recurrent nerve,1 with leakage of cerebrospinal fluid,2 with cervical hematoma,1 with loosening of interal fixation,1 with esophageal fislula,and 10 died.[Conclusion]There are many perioperative complications from cervical cord injury.To pay attention to the treatments of perioperative complications will bring a satisfactory clinical effect.

OBJECTIVE To inspect and analyze the cleaning efficacy on surgical instrument after cleaning cycle and maintenance procedures.METHODS The medical instrument was collected from each department based on the weekly usages.Focus on the timing of the cleaning after use and the efficacy of the cleaning methods.Use naked eyes to inspect the cleanness of the medical instrument after each cleaning cycle.RESULTS The combination of the machine washing and manual washing immediately after the surgical procedures provided better cleaning efficacy.It was more difficult to clean the instrument once the dried bio-burden on it or after soaking in the chlorine disinfectant.CONCLUSIONS The correct cleaning methods and instrument care procedures guarantee the cleaning efficacy,disinfections,and the sterilization for the medical instrument.

Objective To develop multimedia network testing system on"three-primary" Training.Methods Java was used to develop the application program,MySQL was used to establish database of test questions.The stable communication protocol(SOAP,Web service,etc.) and link were applied.Results With this system,random test questions and choices are provided;questions are answered by human-computer interaction;answer time is restricted;the paper is automatically scored;database of test questions is managed openly;test paper is automatically set.Conclusion This testing system is highly automatic,secure,impersonal,extensible,stable,open and efficient.

OBJECTIVE: To observe the effects of Feiji Formula, a compound traditional Chinese herbal medicine, on lung cancer metastasis in mice. METHODS: The lung cancer metastasis model of mice was established in this experiment study. Twenty-four mice were randomly divided into three groups: untreated group, cisplatin group and Feiji Formula group. Mice in the Feiji Formula group were treated with Feiji Formula decoction; in cisplatin group, with cisplatin by intraperitoneal injection; and in the untreated group, with normal saline (NS). After twenty-day treatment, the body and tumor weights as well as the number of metastatic tumors in both lungs of each mouse were measured. RESULTS: The body weight of mice in cisplatin group was significantly less than that of Feiji Formula group and untreated group (P<0.01); the tumor weight of mice in cisplatin group and Feiji Formula group was markedly lower than that of untreated group (P<0.01); and the number of metastatic tumors in cisplatin group and Feiji Formula group was markedly lower than that of the untreated group (P<0.01), no significant difference between the Feiji Formula group and cisplatin group in terms of the weights and the numbers of metastatic tumors in bilateral lungs. CONCLUSION: Feiji Formula can suppress tumor growth and decrease the number of lung metastatic tumors in the mice, and maintain the body weight of the mice.

Objective To analyze the characteristic of auditory brainstem responses (ABR) evoked by chirp in normal hearing subjects .Methods Fifteen cases (30 ears) with normal hearing young people were recorded ABR by stimulation with two kinds of sounds :chirp and click .The data were compared .Results The response threshold of chirp-ABR were lower than that of click -ABR .The average difference was 8 .59 dB .At 90 dB nHL ,the wave V amplitude yield no significant difference between chirp -ABR and click-ABR .The wave V amplitude had a signifi-cant difference between chirp -ABR and click-ABR at 60 dB nHL .At 90 and 60 dB nHL ,the wave V amplitude of chirp-ABR had not a significant difference .The occurence rate was 40% for the wave I of chirp -ABR ,obvi-ously less than that of click -ABR .At 90 dB nHL ,the wave V latency of chirp -ABR was shorter than that of click-ABR .Conclusion The wave V response threshold of chirp -ABR is less than that of the click -ABR .The chirp-ABR is more advantageous than the click -ABR for assessing hearing threshold .

Objective To evaluate the effect of different sevoflurane postconditioning on myocardial injury in patients undergoing coronary artery bypass grafting (CABG ) with cardiopulmonary bypass (CPB ) .Methods Seventy-five NYHA class Ⅰ or Ⅱ patients ,aged 46-72 yr ,weighing 57-90 kg ,scheduled for elective CABG with CPB ,were randomly divided into 5 groups ( n=15 each) using a random number table :control group (groupⅠ) , postconditioning with continuous administration of 1.7% sevoflurane group (groupⅡ a ) , postconditioning with continuous administration of 3.4% sevoflurane group (group Ⅲa) ,postconditioning with interrupted administration of 1.7% sevoflurane group (Ⅱb) and postconditioning with interrupted administration of 3.4% sevoflurane group (group Ⅲb) .Sevoflurane was not given in group Ⅰ .In Ⅱa group ,after the anastomotic stomas of the internal mammary artery to anterior descending artery were released ,the patients continuously inhaled 1.7% sevoflurane for 15 min .In Ⅱb group ,after the anastomotic stomas were released .In Ⅲa group ,after the anastomotic stomas were released , the patients continuously inhaled 3.4% sevoflurane for 15 min , the patients inhaled 1.7%sevoflurane for 5 min first ,inhalation was interrupted for 5 min ,and then inhalation was recovered lasting for 5 min ,and it was 15 min in total .In Ⅲb group ,after the anastomotic stomas were released ,the patients inhaled 3.4% sevoflurane for 5 min first ,inhalation was interrupted for 5 min ,and then inhalation was recovered lasting for 5 min ,and it was 15 min in total .Venous blood samples were taken for determination of the plasma creatine kinase ,creatine kinase isoenzyme-MB , lactic dehydrogenase , and cardiac troponin I concentrations before CPB and at 6 and 24 h after operation .Myocardial specimens were obtained from the right auricle before CPB and after termination of CPB for microscopic examination of the ultrastructure .Results Compared with group Ⅰ , the concentration of cardiac troponin Ⅰ was significantly decreased at 6 and 24 h after operation ( P<0.05) ,and no significant changes were found in the other parameters in Ⅱb group ( P>0.05 ) .The pathological changes were significantly attenuated in sevoflurane postconditioning groups as compared with group Ⅰ ,especially in Ⅱb group . Conclusion Postconditioning with continuous administration of 3.4% sevoflurane for 15 min can attenuate myocardial damage in patients undergoing CABG with CPB .