Starting from the characteristics of medical targeted-area student,the cultivation should not only strengthen the general medical knowledge,but also the ethics education.Based on this,this paper pointed out the dilemma of the students in the educational subject,educational object and educational process.Also,it put forward the countermeasures:enhancing the cognition,perfecting the curriculum system,intensifying the resources of teachers,optimizing the content of courses and innovating the teaching methods.

Objective To study the effects of cryopreservation and two different cooling rates on rat hepatocytes. Methods Perfusion with collagenase digestion was used to isolate rat hepatocytes. Hepatocytes were incubated with a freezing medium consisting of RPMI 1640 with 20% calf serum and 10% DMSO. Two different freezing protocols were applied using a computer controlled freezer to freeze the medium to -80℃ before hepatocytes were plunged into liquid nitrogen and stored. The viability, morphology, and protein synthesis were measured at Day 3, Day 15, Day 30, respectively after thawing. Results Both viability and protein synthesis ability of group B and group C decreased significantly as compared with that of Group A ( P 0.05). Electron microscopy showed ultrastructural changes between fresh and thawed rat hepatocytes including injury of cell membrane, loss of cell content, alteration of nucleolus. The degree of injury in Group B is slighter than in Group C. Conclusion Cooling rate of cryopreservation correlates with the quality of thawed hepatocytes. The cryopreservation and thawing procedures are key factors to affect the quantity and quality of hepatocytes. The viability and protein synthesis ability are not influenced by the storage period in liquid nitrogen.

Environmental endocrine disrupting chemicals (EDC) may interfere with thyroid function by affecting the synthesis,release,transport,metabolism,and clearance of thyroid hormone as well as its receptor binding,etc.Thyroid hormones are essential for normal fctal brain development and for many aspects of normal adult physiology.This paper is to provide a brief overview of recent findings on thyroid disruptionly EDC.It would contribute to the development of new strategies against thyroid dysfuction.

A total of 184 teeth obtained from 102 cases(27 males and 75 females aged 17-64 years)were selected from Department of Tooth and Dental Pulp.DalJan Stomatology Hospital from June to Septembet 2007.All the teeth with deep caries which resulted from caries showed no pulp.Ninety-two teeth obtained from 54 cases were regarded as Vitrebond group which were used by light-cured glass to cover pulp;while,the other 92 teeth obtained from 48 cases were regarded as dycal group which were cured by dycal calcium hydroxide.Finally,3MZ250 resin was used in this study.A half-year following up showed that the filling shed and loose were observed in the Vitrebond group(n=1)and the dycal group(n=3)(P>0.05).There were significant differenoe in color between Vitrebond group(n=1)and dycal group(n=8)(P<0.05),suggesting 3M Vitrebond light-cured glass Was superior to dycal calcium hydroxide in decreasing dental pulp stimulation and improving dental appearance.

Objective To observe the clinical effect of small endoscopic sphincterectomy (SES) combined with endoscopic papillary balloon dilation (EPBD) in the treatment of large common bile duct stones.Methods The patients were randomly divided into 3 groups:normal endoscopic sphincterotomy(EST),EPBD,SES combined with EPBD.The incidence of pancreatitis at 1 week after operation and the recurrence rate of inner duct stone within 15 months after operation were statistically analyzed.Results At 1 week after treatment,the incidence of pancreatitis was lower in group EST and group SES combind with EPBD than in group EPBD [3.3％ (1/30),3.3％ (1/30) vs.20.0％ (6/30),both P＜0.05].After 15 months of treatment,the recurrence rate of inner duct stone were lower in group B and group C than in group A 3.3％ (1/30),3.3％ (1/30) vs.23.3％(7/30),both P＜0.05).Conclusions In the treatment of large common bile duct stones,SES combined with EPBD can reduce the incidence of postoperative acute pancreatitis and the longterm recurrence rate of common bile duct stones.

Objective To discuss the correlation between the distribution of TCM constitutional types and carotid artery intima-media thickness (CIMT) in patients with subclinical hypothyroidism;To select the biased constitution type with high risk factors for atherosclerosis;To provide theoretical basis for preventing this disease from the perspective of TCM physique. Methods Totally 120 patients with subclinical hypothyroidism and 50 cases of normal healthy subjects were selected. TCM constitutional types of two groups were distinguished by KY3H TCM physique recognition software. CIMT was determined, and the correlation between the distribution of TCM constitutional types and CIMT in patients with subclinical hypothyroidism was analyzed. Results In 120 cases of subclinical hypothyroidism, there were 3 cases of gentleness type (2.50%), 30 cases of qi-depression type (25.00%), 28 cases of qi-deficiency type (23.33%), 25 cases of yang-deficiency type (20.83%), 13 cases of phlegm-damp type (10.84%), 9 cases of yin-deficiency type (7.50%), 6 cases of blood stasis type (5.00%), 5 cases of dampness heat type (4.17%), 1 case of particular type (0.83%). The main TCM constitutional types of subclinical hypothyroidism were qi-depression type, qi-deficiency type, yang-deficiency type and phlegm-damp type. The morbidity of atherosclerosis in patients with qi-depression type and qi-deficiency type were higher than other constitutional types. Conclusion The main TCM constitutional types of subclinical hypothyroidism were qi-depression type, qi-deficiency type, yang-deficiency type and phlegm-damp type.

Objective To study the effect of indomethacin preventing post-ERCP pancreatitis ( PEP ) on the patients younger than 50 years undergoing small endoscopic sphincterotomy (sEST) combined with endoscopic papillary balloon dilation(EPBD) in the treatment of choledocholithiasis. Methods 202 patients younger than 50 years with choledocholithiasis were divided into two groups, 101 patients in treatment group before surgery were rectal administrated with indometacin, 101 patients in control group were administered with placebo, all patients underwent sEST combined with EPBD in the treatment of choledocholithiasis.After operation,the abdominal pain NRS score, amylase, incidence of pancreatitis and hospitalization time were recorded, and the rates of heartburn, rash, gastrointestinal bleeding were recorded.Results In the treatment group, pain NRS score 24 hours after operation was(0.327 ±0.763), amylase 24 hours after operation was (116.87 ±113.97) U/L, there were 3 cases of postoperative pancreatitis (2.97%) in the treatment group,and the postoperative hospitalization time was (6.42 ±2.11) days.In the control group, pain NRS score 24 hours after operation was ( 0.634 ±1.027 ) , amylase 24 hours after operation was ( 185.38 ±160.60 ) U/L, there were 11 cases of postoperative pancreatitis (10.89%) in the control group, and the postoperative hospitalization time were (7.29 ±2.71) days.The differences of NRS pain score, amylase, incidence of pancreatitis, postoperative hospitalization time between these two groups were statistically significant ( P<0.05 ) .The differences of the rates of postoperative heartburn, rash, gastrointestinal bleeding between these two groups were not statistically significant.Conclusion Indomethacin rectal administration can prevent post-ERCP pancreatitis ( PEP ) on the patients who undergoing sEST combined with EPBD in the treatment of choledocholithiasis,and this administration is quite security.

Objective To investigate the effect of early goal lactate clearance rate therapy in patients with severe sepsis or septic shock.Methods Articles were retrieved from PubMed,Embase,Cochrane Library,Wanfang and CNKI before March 5,2016.Inclusion criteria included the subjects concerning patients with severe sepsis or septic shock reported as randomized controlled trial (RCT),which endpoints were the mortality,the length of ICU stay and hospital stay.RevMan 5.3 software was used for Meta analysis.Results There were 5 RCTs meeting inclusive criteria including 860 patients.It was shown by Meta analysis that early goal lactate clearance rate therapy was associated with decrease in the 28-day mortality(RR =0.73,95％ CI:0.60-0.88,P ＜ 0.01),shorten the length of ICU stay (WMD =-2.41,95％ CI:-4.68--0.14,P ＜ 0.05),but not associated with decrease of the length of hospital stay(WMD =-0.13,95 ％ CI:-4.58-4.31,P =0.95).Conclusion Early goal lactate clearance rate therapy was associated with significant improvement in 28-day mortality and the length of ICU stay but not with the length of hospital stay in patients with severe sepsis or septic shock.

Objective To observe the level of urinary microalbumin(MAU) and carotid artery intima-media thickness(CIMT) in patients with subclinical hypothyroidism,and to explore the relationship between subclinical hypothyroidism and MAU,arteriosclerosis.Methods 70 patients with subclinical hypothyroidism were randomly divided into the two groups according to the level of CIMT.33 patients were selected as the arteriosclerosis group and 37 patients were selected as the non-arteriosclerosis group,and 30 healthy people were selected as the control group.The levels of FT3,FT4,TSH,blood fat,MAU,CIMT observed.Results Compared with the healthy controls,the levels of TC,TG,LDL-C,CIMT were significantly higher in the arteriosclerosis group (P =0.008,0.007,0.009,0.006),the level of HDL-C was significantly lower in the arteriosclerosis group(P =0.006).The levels of TC,TG,LDL-C,CIMT were significantly higher in the non-arteriosclerosis group (P =0.042,0.037,0.008,0.035),the level of HDL-C was significantly lower in the non-arteriosclerosis group(P =0.038).The levels of TC,TG,LDL-C,CIMT in arteriosclerosis group were significantly higher than those in the non-arteriosclerosis group (P =0.032,0.041,0.039,0.007).The level of HDL-C in the arteriosclerosis group was significantly lower than the non-arteriosclerosis group(P =0.044).The level of MAU had no significant difference among the three groups(P =0.052,0.087,0.092).TSH had no relationship with MAU (r =0.195,P ＞ 0.05),TSH had positive correlation with CIMT(r =0.578,P ＜ 0.01).Conclusion The patients with subclinical hypothyroidism have lipid metabolism disorder and CIMT incrassation,which can increase the risk of arteriosclerosis.

OBJECTIVE:To provide baseline data of safe and rational drug use in pediatrics. METHODS:The pediatrics outpatient prescriptions were randomly selected from pediatric department of The Second Affiliated Hospital of Xinjiang Medi-cal University during Mar. 2014-Feb. 2015. The behavior of off-label drug use was determined according to the content of drug instruction. The type of off-label drug use,the relationship of different age groups with various drugs were analyzed. RE-SULTS:A total of 2400 outpatient prescriptions were collected from pediatric department,5115 medication records were ana-lyzed,involving 171 kinds of drugs. By the number of prescriptions,medication records and drug types,the incidence of off-la-bel drug use were 59.08%,40.87% and 80.70%,respectively. The main categories of drug off-label use were off-label dosing frequency(43.03%),off-label dosage(29.55%)and off-label indication(18.83%). The incidence of off-label drug use in in-fants and adolescents ranked the top 2 places,being 67.58%,63.01%. The top-four drugs in the list of the incidence of off-la-bel drug use were drugs for external use(55.56%),drugs for nerve system(54.12%),drugs for respiratory system(48.95%) and nutritional agents(48.09%). CONCLUSIONS:The phenomenon of drug off-label use is widespread in pediatric outpatient prescriptions.