Case based learning(CBL)is one of the teaching modes in clinic education and it is important to explore its teaching methods and qualities.This article discussed on how to use debate in CBL in neurology teaching for seven-year-program students including its organization,topic choosing,rules and specific process in order to provide references for teaching reform.

Taking Web of Science database as the data source,the paper visually analyzes the literatures about medical knowledge data using the visualization software,such as Citespace,SATI and Ucinet,reveals the research power,core journals,core authors,situation of the literature referred and hot topics in this field.

Objective To investigate the clinical effect of mifepristone in treatment of perimenopausal dysfunctional uterine bleeding.Methods 80 cases of patients with perimenopausal dysfunctional uterine bleeding were selected and randomly divided into control group and research group,with 40 cases in each group.The control group was in the diagnosis of curettage after 10 days of oral provera 10mg every night before going to bed,stopped drug application in 14 days,15 days to retreat hemorrhages oral provera 10mg/day,stayed for 10 days,repeated drug use 5 months.The research group was treated with oral mifepristone every night before going to bed since cleaning up the uterus,12.5mg,for 6 months.Outpatient follow -up for 6 months,the recent curative effect,long -term curative effect,hormone level changes,anemia and adverse drug reactions were observed.Results The total effective rate of the research group was 95.0%,which of the control group was 82.5%,there was statistically significant difference(χ2 =7.82, P =0.005);The recurrence rate of the research group was 5.0%,which of the control group was 15.0%,there was statistically significant difference(χ2 =5.56,P =0.018).The FSH,LH,E2 and P of the two groups were decreased, but which of the research group were lower significantly than those of control group,the differences were statistically significant (all P <0.05).The decreased degree of endometrium in the research group was larger than that of the control group,the difference was statistically significant(P =0.0001).Conclusion Treatment of mifepristone perimenopausal dysfunctional uterine bleeding is significant,safe and convenient,which is worthy of clinical application.

Background and purpose:Single photonemisson computed tomography(PET) is recently available in many cities. It has been extensively used for the diagnosis of pulmonary lesions,especially in the differential diagnose of solitary pulmonary nodules(SPN) with PET.We retrospectively analysed 20 lung tumour patients with multifical lesions to investigate the value of PET scanning. Methods:20 cases with lung tumour patients who had multifical lesions were analyzed , the patients were treated from August 2004 to June 2005 in Shanghai Chest Hospital. All patients were examined with PET,X-ray,CT(computerized tomography) and SPECT(single photonemisson computed tomography). Some of them were detected with MRI because they were suspected to have spinal metastases. 14 cases were pathologically proved as lung cancer.Results:All(100%) of the primary lesions were positively detected by PET scanning. In addition to 100% sensitivity to the primary lesions, 6 cases of the metastatic lesions were confirmed by PET,in which 2 of them were pulmonary nodules (all bigger than 1cm in size),3 were mediastinal lymph nodes,and the other was a secondary tumor of the spine. 14 cases were negative on the PET image, 4 of 14 cases were false negative, 2 of them had pulmonary nodules (all smaller than 1cm), the other 2 were either mediastinal lymph nodes or a secondary tumors of the spine.Conclusions:PET scanning has high value in terms of improving diagnosis of the primary and metastatic pulmonary lesions, it is useful to define stage of tumor and chose proper treatment for the patients. PET scanning may not be a efficient tool when the size of nodules is smaller than 1 cm. Some of the secondary tumors of the spine maybe be PET negative.

Infection rate of HBV in the high-risk population, such as dentists and the patients undertaking hemodialysis, was not higher than those in general population. The occurrence of the subclinical infection state might be resulted from hypo-responsiveness of humoral and cellular immunity to HBsAg. Of 257 cases of liver biopsy, 44% of them were diagnosed as chronic hepatitis of various categories. No relationship was found between the expression patterns of viral antigens and the inflammatory activity in the liver. The infection state was quite stable. HBeAg/anti-HBe seroconversion was not a turning point from replicative to nonreplicative phase of the virus. The individuals with intrahepatic integrated HBV DNA might be the genome carriers with sero-negative HBsAg. The above results illustrate the characteristics of hyporesponsive HBV infection in hyperendemic area in China.

AIM:To investigate the correlation between chronic dry eye and refractive regression after laser in situ keratomileusis (LASIK)for myopia.METHODS:Two hundred and twenty-five eyes of 225 patients were enrolled in this study.Examinations including Schirmer test,tear break-up time(BUT),corneal sensation,and ocular surface staining were performed before and 6 months after LASIK.Dry eye symptoms were assessed using the McMonnies Dry Eye Symptom Survey.Data were analyzed on history and treatment response.RESULTS:Refractive regression after LASIK was related to chronic dry eye.It occurred in 8(25.0%)of 32 patients with chronic dry eye and in 18(9.3%)of 193 patients without dry eye(P＜0.01).CONCLUSION:The risk of refractive regression was increased in patients with chronic dry eye.

OBJECTIVEEstablished with amphotericin B perforated patch-clamp technique, to study the electrophysiological properties of calyx synapses.

METHODSIn the present experiments, we studied the application of perforated patch clamp technique on the calyx synapses of mice with Amphotericin B.

RESULTSThe use of Amphotericin B significantly slowed down the decay of channel currents and the optimum concentration was 400 microg/ml.

CONCLUSIONThe syudy developed a stable of perforated patch clamp whole cell recording technique, could be more effecitve, more real reaction neurons electrophysiological characteristics of the channel current. Our work might provide the basic information to future users studying the signal transmission and regulation of auditory system of rodents.

Objective To study the mechanism of lidocaine injection in the alleviation of pains of propofol injection. Methods 430 patients, who underwent elective gastrointestinal endoscopy under general anesthesia , were randomly assigned into 3 groups: group A received 2 mL NS intravenous injection on the right dorsal hand;group B received 40 mg Lidocaine intravenous injection on the right dorsal hand and group C received 40 mg lidocaine intravenous injection on the left dorsal hand. All groups received 2 mg/kg Propofol intravenous injectionon the right dorsal hand at the rate of 20 mL/min. The injection pains were evaluated while the dosage reached 1/4 of the total (2 mg/kg). The left dosage of Propofol and 50 μg Fentanil were pumped after evaluation. Propofol dosage was added when needed. Mean arterial pressure (MAP) and heart rate (HR ) were recorded before Propofol injection and 1, 3, 5 minutes after Propofol injection. Results VRS comparisons: Tthe rate of pain incidence of group B was significantly lower than those of group A and C. MAP were declined dramatically at the time points of 1 minute, 3 minutes and 5 minutes after propofol injection, as compared to before propofol injection. The HR was declined dramatically 5 minutes after propofol injection. Conclusion Intravenous Lidocaine of 40 mgcould reduce Propofol-induced injection pain of the same vein. Local effect of Lidocaine but not its systemic function may play an important role in reducing Propofol-induced injection pain.

Objective: To study the effect of arginine (Arg) on serum NO, NOS activities and thymus T cells in mice under heat stress. Method: NIH-mice were randomly divided into 3 groups and given water L-Arg 1.5 mg/g bw and L-Arg 2.5 mg/g bw for 14 d respectively. There were 42 mice in each group and were under heat stress (41?0.5)℃ for 120 min except 6 mice not stressed as control. Blood was taken at 0, 2, 4, 8, 12, 24 h after heat stress from 6 mice each time. The quantity of NO, activities of NOS and the change of thymus T cells in serum were measured. Results: At normal temperature or under heat stress, the quantity of NO, activities of NOS, the concentration of CD3+, CD4+ cells and CD4+/CD8+ of the groups with L-Arg were higher than those of the groups without L-Arg, but the concentration of CD8+ was contrary. The difference between two groups with L-Arg was not significant . Conclusion: The immunity of mice was destroyed under heat stress for 4-8 h. The quantity of NO, activities of NOS, and the number of T cells and CD4+/CD8+in serum could be improved after given L-Arg.

This paper elaborates the creative thoughts on the medical Higher Mathematics from the following three aspects: the teaching idea,course system and cultivation of students' abilities.