The teaching location of literature retrieval course for medical students has been discussed from teaching time,teaching hours,teaching contents,teaching deapth and textbooks.

Objective To study the effect of mosapride citrate in the treatment of gastroesophageal reflux disease and its effect on gastrin .Methods 86 patients with gastroesophageal reflux disease admitted in our hospital from August 2013 to August 2016, those patients were divided into observation group and control group according to the order of admission,43 cases in each group.The control group was treated with esomeprazole on the basis of basal therapy, and the observation group was treated with mosapride citrate on the basis of control group.The clinical curative effect and adverse reaction were analyzed,visual analogue scale(VAS), gastrin and motilin were compared before and after treatment between the two groups.Results After treatment, the total effective rate in the observation group was significantly higher than the control group [90.70% (39/43) vs.65.12% (28/43)](P<0.05). The VAS score in the observation group was significantly lower than the control group [(2.43 ±0.25) vs.(4.02 ±0.41)](P<0.05).The levels of gastrin and motilin in the observation group were significantly higher than the control group[ (55.87 ±4.82) pg/mL, (308.43 ±19.31) pg/mL vs. (44.12 ±3.86) pg/mL,(243.12 ±15.76) pg/mL](P<0.05).There was no significant difference in adverse reaction rate between two groups. Conclusion Mosapride citrate tablets can be used in gastroesophageal reflux disease , can effectively improve the patient's gastrin levels and clinical symptoms, clinical efficacy is good, and with low rate of adverse reactions.

Objective To investigate the specimen source and drug resistance in the strains of Acinetobacter baumannii isolated from the submitted samples in the neurosurgery wards of our hospital during 2011-2014 in order to provide the reference for clini‐cal treatment and nosocomial infection control .Methods A retrospective analysis was performed on the clinical data of clinical dis‐tribution and antibacterial drugs sensitivity in 404 non‐repeated strains of Acinetobacter baumannii isolated from the samples of neurosurgical patients .Results The mainly specimen source of Acinetobacter baumannii isolated from neurosurgical patients was sputum and cerebrospinal fluid ,accounting for 89 .1% and 7 .9% respectively .Acinetobacter baumannii isolates showed the lowest resistance rates to minocycline and cefoperazone/sulbactam (28 .6% and 31 .8% respectively) .The resistance rates to imipenem and meropenem were 79 .4% and 83 .2% respectively ;the resistance rate to other antibacterial drugs exceeded 69 .0% .Conclusion Acinetobacter baumanii strains isolated from the neurosurgery department have higher resistance rates to many kinds of antibacteri‐al agents ,minocycline and cefoperazone/sulbactam still has good in vitro antibacterial activity against Acinetobacter baumanii .Clinic should strengthen the management of antibacterial agents ,increases the rate of drug susceptibility test and rationally uses the anti‐bacterial drugs .

Objective:To analyze the correlation of serum lipoprotein-associated phospholipase A2(Lp-PLA2)and nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)levels with the severity of coronary heart disease in elderly patients.Methods:Clinical data of 200 elderly patients with coronary heart disease in the hospital from January 2017 to July 2019 were retrospectively collected.Data of 80 healthy elderly patients undergoing regular physical examinations in our hospital during the same period were collected and used as the healthy control group.All patients received laboratory tests using relevant parameters and coronary angiography on admission, with complete records of examination results for analysis.Based on SYNTAX scores from angiography of coronary artery lesions, all 200 elderly patients with coronary heart disease were further divided into a low-risk lesion subgroup, an intermediate-risk lesion subgroup and a high-risk lesion subgroup.The correlation of serum Lp-PLA2 and NLRP3 levels with the severity of coronary lesions was analyzed in elderly patients with coronary heart disease.Results:The mean SYNTAX score was 27.6±10.1.There were 60 cases with low-risk lesions, 68 cases with intermediate-risk lesions and 72 cases with high-risk lesions, accounting for 30.0%, 34.0% and 36.0%, respectively.The control group had the lowest serum levels of Lp-PLA2 and NLRP3, followed by the low-risk lesion, intermediate-risk lesion and high-risk lesion subgroups( F=305.026, 9.173 and 582.029, all P<0.001). Bivariate Pearson correlation analysis showed that serum levels of Lp-PLA2 and NLRP3 were positively correlated to the Syntax score in elderly patients with coronary heart disease( r=0.545 and 0.689, all P<0.001). Conclusions:Serum levels of Lp-PLA2 and NLRP3 are correlated to the severity of coronary artery disease in elderly patients with coronary heart disease.Overexpression of these two markers may indicate growing severity of coronary artery disease.Testing for serum Lp-PLA2 and NLRP3 levels in elderly patients with coronary heart disease can be considered to evaluate coronary lesions and treatment options in the future.

AIM: To investigate the effects of prenatal stress (PS) on neurons and neuronal ultrastructure of hippocampus in offspring rats, and to explore the role of the overproduction of oxidants. METHODS: One month male offspring rats were obtained to observe the neuronal number, neuronal ultrastructure and the number of nNOS -positive cell in hippocampus. RESULTS: The neuronal number of CA1 and CA4 subregions in late gestation stress (LS) offspring decreases significantly. The neuronal ultrastructure of CA1 subregion in MS (stress in 7-13 days of gestation) and LS offspring appeared bulgy mitochondria, unclear membrane and irregular electron density. Lipofuscin pigments increased; The number of nNOS-positive cell in CA1, CA2, CA3 subregions and DG of MS group and the whole hippocampus of LS group increased significantly. CONCLUSION: PS damaged the neurons and neuronal ultrastructure of hippocampus of offspring rats. The damages were associated with the overproduction of oxidants.

Objective To explore the antibacterial active components of Flos Caryophylii. Methods The components were distilled by extraction and big - hole colophony. The minimum antibacterial concentration of components was detected. Results and conclusion The and - staphylococcus aureus active components of of Flos Caryophylii. include fat - soluble ingredients and water - soluble ingredients.

Aiming at the existing problem of inequality and being unscientific in the evaluation of comprehensive quality of medical students, through literature research and expert opinion method, and from multi angles , the author constructed the evaluation index system of comprehensive quality of scientific medicine, using AHP to determine the weights of evaluation indexes, and established a fuzzy evaluation model of the comprehensive quality of medical students, and on this basis, improved the calculation method of fuzzy evaluation and the maximal subjection degree of the evaluation result. The specific examples of the evaluation results showed that the method was effective and could reflect the comprehensive quality of med-ical students in a comprehensive and objective way, and it had great significance to the comprehensive quality evaluation of medical students.

Objective Due to the problem of individual matching, exclusivity and loose with pure mechanical fixation for artificial hemi-knee joints made by traditional method, a new manufacturing process based on rapid prototyping technique and custom-made concept is presented.MethodsRapid prototyping was processed to rapidly and accurately shape the prototype of an artificial implant almost with the same shape as the hemi-knee joint of the patient, and the process based on Titanium alloy centrifugal casting technology and biomaterial sintering molding technology was used to fabricate the artificial hemi-knee joint and bioactive proximal tibia artificial bone, respectively.Results and ConclusionThe custom-made knee joint prosthesis has been fabricated and put into clinical use successfully. In comparison with the traditional implants, this system can realize the well matching movement between the artificial hemi-knee joint and its opposite. Meanwhile,the design of functional holes and tibial nails realizes the combination of biological fixation with mechanical fixation for the artificial implant,and the use of bioactive artificial bone promotes bone growth and minimizes the exclusive reaction.

BACKGROUND:In recent years, many manufacturing techniques have been recently developed for soft tissue engineering scaffolds. Especialy additive manufacturing with a unique material accumulated forming principle can be feasible and reliable to manufacture the highly precise scaffolds with gradient structures and multi-materials for large soft tissue defect repairing.
OBJECTIVE:To summarize scaffolds manufacturing technologies in the soft tissue engineering applications developed in recent years and to predict the direction of development.
METHODS: A retrieval was performed for the literature about the manufacturing methods of soft tissue scaffolds using key words of “additive manufacturing, microfabrication, vascular tissue engineering, muscle tissue engineering, cartilage tissue engineering, stereolithography, 3D printing, biodegradable hydrogel” in English and Chinese, which were published between January 2010 and September 2013 in PubMed Database and China National Knowledge Infrastructure (CNKI) Database.
RESULTS AND CONCLUSION:For large soft tissue defects repairing, structure design of the scaffolds has been shifted from a simple planar structure to a more complex three-dimensional structure, and integration of scaffold structure, materials and cels, and growth factors during the manufacturing procedure can be used to obtain the resolution of vascularization. Additive manufacturings become one of the most promising approaches for the ideal soft tissue scaffolds with gradient and complex structure and multi-materials. In particular, the hydrogel/cellcomposite scaffolds fabrication, a hot but promising approach to develop the soft tissue engineering wil be made progress by the accurate principles and processes of the hydrogel additive manufacturing combined with the introduction of living cels and growth factors.

Objective To evaluate the extremity function of patients with intracerebral hemorrhage (ICH)using short-latency somatosensory evoked potentials (SEPs) and a modified intracerebral hemorrhage (MICH) scale.Methods On admission, SEP was applied in the examination of 61 patients with ICH. P40 latency and the amplitude of posterior tibial nerve potentials in both the healthy and affected extremities were measured. Abnormalities were classified based on the margin of lower extremity SEP latency and the main waveform changes. MICH was measured simultaneously to prepare a prognosis. The modified Rankin scale (MRS) score was assessed 3 months after the attack as well.Results Compared with the healthy side, there were significant differences in posterior tibial nerve P40 latency and amplitude on the affected side among patients with ICH. P40 latency and MRS scores on the affected side 3 months after the attack were positively correlated. On the unaffected side, P40 amplitude and the MRS score 3 months after the attack were negatively correlated. The MICH score on admission and the MRS score 3 months after the attack were positively correlated. Based on MRS scores (MRS≥4 indicating a poor prognosis), the predictive sensitivities for a poor prognosis of SEP and the MICH scale in patients with ICH were 80.77% and 84.61% respectively, while the specificities were 62.68% and 88.57% respectively, and the accordance rates were 70.5% and 86.9% respectively. Conclusions SEP and the MICH scale are closely correlated with the prognosis for extremity function in patients with ICH.The combination of SEP with the MICH scale might be helpful in predicting the prognosis of the patients with ICH.