With the increasingly tense doctor-patient relationship,the practice teaching of laboratory medicine has obviously been affected.For example,the practice teachings systems do not adapt to the updated situations,and practice teaching has been simplified and communication training ignored.In order to deal with these problems and ensure the goals of practice teaching,various measures have been taken in training hospitals.Firstly,the practice system has been further improved and implemented effectively by strengthening mobilization and adopting qualification licensing before practice and interaction practice between teachers and students and regular communication between school and training hospital during practice and strict assessment after practice.Secondly,medical ethics educations and laboratory biological safety have been strengthened.Thirdly,the modem automation and classic morphology should be integrated.Finally,the ability of communication between medical laboratory and doctor and patients should be cultivated,and so on.These measures are to ensure the effect of the practice teaching and cultivate excellent students.

Environmental safety technologies of dry cleaning and risk assessment of solvent residue control embody the green consumption's social environmental beneficiary. The safety assurance of dry cleaning with the combination of life cycle analysis and clean production offer dry cleaning industries an efficient way to get rid of health, environmental and social problems from hazardous solvent on the basis of pollution prevention and treatment during production and consumption period.

Objectives: To assess the feasibility and stability of right ventricular outflow tract (ROVT) pacing under current technology by comparing the results of ROVT pacing with the traditional right ventricular apex (RVA) pacing. Methods: A total of 42 patients (at mean age of 63.5±10.4 years) without structural heart disease were randomly divided into two groups. RVA pacing group (n=14),and RVOT pacing group(n=28). An active fixation lead was implanted in all patients whose pacemaker could automatically measure the pacing threshold every day. The operation time,X-ray exposure time and lead parameters detected during the operation were collected to evaluate the feasibility of RVOT pacing. The complications related to lead and implantation procedure and the trend of threshold change during the follow-up time were used to assess the stability of RVOT pacing.Results: There were no statistic differences between RVA pacing group and RVOT pacing group in terms of operation time,X-ray exposure time and lead parameters. In RVOT group,the change of threshold during acute period was similar to those in RVA group (P=0.23). Chronic pacing threshold was also comparable between two groups,mean threshold at 6 months follow-up time was 0.55±0.11V and 0.54±0.09V at 0.4 pulse width in RVA group and RVOT group respectively (P=0.787).Conclusion: RVOT pacing was feasible and stable in operation time and lead characteristics compared with the conventional RVA pacing under current pacing technology.

The epidemic situation of influenza A(H1N1) throughout the world had evoked close attention of the World Health Organization(WHO).WHO director-general pointed out that the pandemic alert level had been set at 3,which was then raised by WHO from 3 to 4 and from 4 to 5 two days later.The present paper focused on the finding of influenza virus,the influenza prevalence in history,and introduced the scientific countermeasures for influenza A(H1N1),including the spreading of influenza virus,the clinical features,treatment,main measures of prevention and control,etc.

OBJECTIVE To reinforce the administration in the management of reusable medical appliances,and to ensure the quality of sterile.METHODS Every step of the integral sterilization were monitored.RESULTS The quality of every link in the course and the end quality of the reusable medical appliances were assured.All the pass-rates of routine examination and sample examination of our hospital and CDC in Zhuhai were 100%.CONCLUSIONS The process of integral sterilization in the management of reusable medical appliances can ensure the quality of sterile materials,and can prevent the nosocomial infections and guarantee the safety of patients.

In order to provide the maximum benefit of cardiac resynchronization therapy (CRT), we tried to use an echocardiography method to optimize the atrioventricular and interventricular delay. Methods The study included 6 patients who underwent implantation of biventricular pacemakers for drug-resistant heart failure. Two-dimensional echocardiography and tissue Doppler imaging were carried out before and after the pacemaker implantation. The optimal AV delay was defined as the AV delay resulting in maximum timevelocity integral (TVI) of transmitral filling flow, the longest left ventricular filling time (LVFT) and the minimum mitral regurgitation(MR). The optimal VV delay was defined as the VV delay producing the maximum LV synchrony and the largest aortic TVI. Results CRT was successfully performed in all patients. After pacemaker implantation, an acute improvement in left ventricular ejection fraction (LVEF) was observed from 26.5% to 35%. Meanwhile, the QRS duration decreased from 170ms to 150ms. The optimal AV delay was programmed at 130, 120, 120, 120, 150 and 110ms respectively with heart rate corrected, LVFT significantly lengthened and TVI of MR decreased (non-optimal vs optimal AV delay: LVFT: 469ms vs 523ms; TVI of MR: 16.43cm vs 13.06cm, P＜0.05). The optimal VV delay was programmed at 4, 4, 4, 8, 12 and 8ms with LV preactivation respectively. Programming the optimal VV delay increased the aortic TVI from 17.33cm up to 21.42cm (P＜0.05). In the septal and lateral wall, peak systolic velocities improved from2.70cm/s to 3.02cm/s (P＞0.05) and froml.31cm/s to 2.50cm/s (P＜0.05) respectively. The septal-to-lateral delay in peak velocity improved from 56.4ms to 13.3ms after CRT (P＜0.01). Conclusions Optimization of AV and VV delays may further enhance the efficacy of CRT. However, there was interindividual variability of optimal values, warranting individual patient examination.

Objective: To explore current status of antithrombotic therapy in patients with non-valvular atrial ifbrillation (NVAF) at Macau area of china via clinical data analysis.
Methods: A total of 472 NVAF patients treated in Centro Hospitalar Conde de S?o Januário (CHCSJ) from 2014-01 to 2041-12 were enrolled. The patients were at the age of (73.0±10.9) years including 197 (41.7%) female and 244 (51.7%)≥75 years. The baseline condition, clinical characteristics and antithrombotic therapy were analyzed; relevant scores were calculated, CHA2DS2-VASc score≥2 was deifned as high risk of stroke and HAS-BLED score≥3 was deifned as high risk of bleeding.
Results: The average CHA2DS2-VASc score was (3.4±1.8) and 389/472 (82.4%) patients with CHA2DS2-VASc scor≥2; the mean HAS-BLED score was (1.96±1.03) and 132 (28.0%) patients with HAS-BLED score≥3. There were 184 (38.9%) patients received antiplatelet therapy, 101 (21.4%) received warfarin, 156 (33.1%) received new oral anticoagulant drug and 22 patients taken both antiplatelet and anticoagulant treatments simultaneously; 53 (11.2%) patients had no antithrombotic therapy. The patients with high risk of stroke had the higher rate of anticoagulant therapy (215/472, 55.3%) and the application rate of new anticoagulant drug was higher than warfarin.
Conclusion: NVAF patients had the higher risk of stroke as more than 80% with CHA2DS2-VASc score≥2 and most patients received anticoagulant therapy in Macau area. The application rate of new anticoagulant drug was higher than warfarin.

Background The data on the prognostic values of high sensitivity C-reactive protein (hsCRP) levels in patients with advanced symp-tomatic heart failure (HF) receiving cardiac resynchronization therapy (CRT) are scarce. The aim of present study was to investigate the association of serum hsCRP levels with left ventricle reverse remodeling after six months of CRT as well as long-term outcome. Methods A total of 232 CRT patients were included. The assessment of hsCRP values, clinical status and echocardiographic data were performed at baseline and after six months of CRT. Long-term follow-up included all-cause mortality and hospitalizations for HF. Results During the mean follow-up periods of 31.3 ± 31.5 months, elevated hsCRP (>3 mg/L) prior to CRT was associated with a significant 2.39-fold increase (P=0.006) in the risk of death or HF hospitalizations. At 6-month follow-up, patients who responded to CRT showed significant reductions or maintained low in hsCRP levels (–0.5 ± 4.1 mg/L reduction) compared with non-responders (1.7 ± 6.1 mg/L increase, P=0.018). Com-pared with patients in whom 6-month hsCRP levels were reduced or remained low, patients in whom 6-month hsCRP levels were increased or maintained high experienced a significantly higher risk of subsequent death or HF hospitalizations (Log-rank P<0.001). The echocardio-graphic improvement was also better among patients in whom 6-month hsCRP levels were reduced or remained low compared to those in whom 6-month hsCRP levels were raised or maintained high. Conclusions Our findings demonstrated that measurement of baseline and follow-up hsCRP levels may be useful as prognostic markers for timely potential risk stratification and subsequent appropriate treatment strategies in patients with advanced HF undergoing CRT.

Objective To explore the relationship between the abnormal expression of anti-oncogene PTEN in gastric carcinoma and the clinicopathological characteristics. Methods Mythylation specific PCR was applied to detect the expression of PTEN methylation in gastric carcinoma and their normal tissues from 45 patients. Results The methylation took place in 40.0 percent in gastric carcinoma and 2.2 percent in their normal tissues, and the difference was significant(P<0.05). The methylation rate in poorly differentiated adenocarcinoma was 60.0 percent ,while 15.0 percent in highly-moderately differentiated group, the difference was significant (P<0.05). In the 24 cases with lymph node metastasis, mythylation was observed in 13 cases, and the difference was significant (P<0.05). Conclusion The methylation of PTEN gene was associated with gastric carcinoma, it may play an important role in the development of the disease.

Objective To study the factors influencing the outcome of patients suffering from in-hospital ventricular fibriUation (IHVF), as there have been few studies focusing on this topic. Methods Patients with IHVF collected in a single cardiac center were classified into a successful group and a failure group. Data relevant to the predicting factors of the two groups were compared. Results There were 206 events in the analysis. The most common underlining disease was coronary artery disease (CAD), especially acute myocardial infarction (AMI). On multiple logistic regression analysis, it was shown that the independent predictors for failure of defebriUation were higher NYHA class (OR 1.7, 95% CI 1.3-2. 2,P <0.001), higher blood potassium level (OR 2.9, 95% CI 1.9-4.3, P =0.007) and adrenaline usage (OR 25.0, 95% CI 11.5-55. 1, P <0.001). In a AMI sub-group, 56. 9% of the IHVF events occurred within the first day of AMI, and the occurrence descended with time going on within 2 weeks. Before the occurrence of IHVF, the patients with right coronary artery as the infarction related artery (IRA) often suffered from(8/9, 88.9%) bradycardia (R-R interval > 1 s), but those with left anterior descending artery as IRA often showed (8/12, 66.7%) tachycardia (RR interval < 0.6 s). Conclusions The common disease causing IHVF is CAD. The worse the heart function, the higher the rate of IHVF and the worse theprognosis. It IHVF not induced by hypokalemia and use of adrenaline in resuscitation predict lower successful defibrillation rate.