Although the humanity had already developed the numerous teaching design theory,under the social background of information explosion,it is necessary for instructional technologists to continue developing comprehensive guidelines to support new areas of human learning and development.The new theory includes the instructional values,preconditions for how to facilitating SDL.

Taking the modern occupation education concept as the guide,oriented by adapting to the demand of occupation post,we established a new open education mechanism of medical occupation education to promote the reform of personnel training mode,curriculum and teaching content to explore the effective way of the sustainable development of local medical occupation education.

As a new technology for rehabilitation training for function disorders, exoskeletons and orthoses are more concerned than before.This article discussed the classification of exoskeletons and orthoses and their application in rehabilitation training, as well as current research status and prospects.

[Objective] To evaluate the influence of dexmedetomidine on median effective target effect-site concentration(EC50)of sufentanil-inhibiting urethroscope insertion response in patients undergoing transurethral resection of prostate(TURP).[Methods] Forty patients with ASA grading Ⅰ-Ⅱ who accepted selective TURP were divided by random digits table method into two groups with 20 cases each.The patients in dexmedetomidine group were treated with 0.6 μ g/kg dexmedetomidine intravenous infusion for more than 10 min,while control group were treated with equivalent capacity of 0.9％ sodium chloride.At 5 min after stopping injection,target-controlled infusion of propofol was started and the plasma target concentration was 3.0 μ g/ml.At 10 min after infusion,target-controlled infusion of sufentanil began and the plasma target concentration was 0.20 ng/ml.The target concentration of sufentanil of the next patient accorded to the patient with or without the urethroscope insertion response and the adjacent rate of the target concentration was 1.1.The EC50 and 95％ confidence interval(CI)of sufentanil were calculated.[Results] There were 20 cases in dexmedetomidine group ultimately selected and 19 cases in control group.There was no statistical significance in absolute value of ST segment of intraoperative electrocardiogram,systolic blood pressure,heart rate,pulse oxygen saturation and bispecual index between two groups(P＞0.05).EC5o of sufentanil-inhibiting urethroscope insertion response in dexmedetomidine group was 0.1148 ng/ml(95％ CI 0.1055-0.1249 ng/ml),which was significantly lower than that in control group[0.1454 ng/ml(95％ CI 0.1339-0.1580 ng/ml)](P＜0.05).[Conclusions] 0.6 μg/kg dexmedetomidine intravenous infusion before operation can reduce the EC50 of sufentanil-inhibiting urethroscope insertion response in patients undergoing TURP.

Objective To improve and innovate the dispensing equipment in oncology.Methods Plexiglass plate was used in the counter in order to give an isolate space for preparation of chemotherapy drugs.Through the ventilation hole,the air polluted by chemotherapy drugs was sent out of door.The operator put on special protective gloves before preparation of chemotherapy drugs.Results There was a decrease of dispensing errors and confusion,when the counter was used to separate the conventional dosage from chemotherapy dosage.The counter effectively prevented the skin and respiratory tract damage to the operator during the preparation of chemotherapy drugs.Conclusion It is practical,cheap,easily operated and produced,which is worth promoting.

Objective To explore the image features of multilocular cystic nephroma and its correlative differential diagnosis. Methods Eight cases of multilocular cystic nephroma were retrospectively analyzed by comparing the imaging findings with surgical and pathological results. Results In all 8 cases, multilocular cystic nephromas were unilateral and circumscribed by thick capsules. These lesions ranged in diameter from 2. 5 cm to 7. 5 cm. The lesions were entirely composed of locules and septa without solid nodules. These locules did not communicate with each other. The septa of these lesions were clear in 2 cases, partly clear in 4 cases, and not very clear in 2 cases. All lesions were better detected on enhanced scans than on non-enhanced ones. Four of 8 cases also underwent MR scan, which presented low signal intensity on T1WI and high signal intensity on T2WI. The Interlocular septa was demonstrated much better with MM than with CT. Histopathology proved that the capsule and septa of the lesions were lined by cuboidal or flattened epithelial cells. Conclusion Multilocular cystic nephroma is a rare disease of the kidney. CT and MRI scanning are valuable in the diagnosis of multilocular cystic nephroma, but the imaging features are not specific enough to differentiate benign multilocular cystic nephroma from multilocular cystic renal cell carcinoma.

Objective To study the main infectious bacteria and their drug-resistance after liver tra nsplantation. Methods K-B method was used to detect the susceptibility of agents of the main bacteria after liver transplantation. ESBLs and AmpC ?-lactamase among the main negati ve bacillus were detected by three-dimensional tests. ?-lactamase and Van gen e among Enterococcus were dectected by standard agar dilution susceptibility tes ts and Nitrocefin respectively. Results Among the main Gram-negative bacteria in 55 cases of infection following liver transplantation, the ratio of resistance to 4 or more antibiotic were all beyond 40% . The detectable rate of ESBLs and AmpC ?-lactamases in Enterobacter cloacae and Escherichia coli was 32.4% and 36.8% , and 33.8% and 10.5% re spectively. Moreover, the detectable rate of both ESBLs and AmpC ?-lactamases in Enterobacter cloacae and Escherich ia coli was 24.3% and 7.0% repectively. 8.8% and 11.1% produced ?-lactamases in Enterococcus faec alis and Enterococcusfaecium, with the ratio of resistance to Vancomycin being 11.2% and 18.5% respectively. Conclusions The primary pathogens have the high and multiple resistance to antimicrobial aft er liver transplantation. ESBLs and AmpC ?-lactamases were the main two factor s of drug-resistance among Gram-negative bacillus. we should pay much attentio n to the high detectble rate of Enterococcus which are resistant to Vancomycin a fter liver transplantation.

Objective To investigate the characteristics of serum lipids levels in young women with paraplegia in sedantary lifestyles.Methods 183 female paraplegics who admitted in China Rehabilitation Research Centre (CRRC) from Jan 2004 to Dec 2009 were investigated.Lipid profiles included triglyceride (TG), total cholesterol (TC), low density lipoprotein (LDL), and high-density lipoprotein (HDL).Results Female paraplegics showed higher mean TG and TC levels than mean levels of Chinese females (TG 1.44 mmol/L vs. 1.24 mmol/L; TC 4.45 mmol/L vs. 4.30 mmol/L). But no difference was found in HDL and LDL levels. TG, TC and LDL levels were correlated positively to age (r=0.158, P<0.05; r=0.271, P<0.01; r=0.207, P<0.01, respectively), but HDL showed no correlation to age. Prevalence of dislipidemia was 60%, including low HDL(33%), high TC(25%), high TG(24%), and high LDL(21%). Conclusion Lack of exercise may result in some dyslipidemia and increase cardiovascular risks in women who are under estrogen protection.

Objective To study the CT symptom and diagnosis value of pancreatic trauma. Methods Retro-spectively analyzed the CT and clinical data of 11 pancreatic trauma. Results Bleeding,edema in pancreas parenehy-ma, uprightness low density lines appear along long axis of pancreas when enhancement were performed ,which werethe direct symptom of pancreatic trauma and rupture; hematoeele, hydrops around pancreas, front fascia of left kidney broaden, pancreatic pseudoeyst pneumatosis in bile duet, which were the indirect symptom of pancreatic trauma. Con-clusion CT is the first choice in the diagnosis of pancreatic trauma. Master the CT symptom and make right diag-nosis, which were important to clinical operation.