Objective To investigate the value of the application of evidence-based medicine combining problem-based learning (EBM-PBL) in hematology internal teaching.Methods All the interns (n=112),who studied in hematology department from Mar.2013 to Feb.2014,were divided into two groups by parallel.One group received the traditional classroom oriented learning model (n=57),the other was trained how to obtain the most effective and correct evidence and autonomous learning (EBM-PBL,n=55).After two weeks learning,the different effectiveness was evaluated by comparing the oral and written tests holding instantly and annual final exam.Further,feedbacks were anonymously collected from the teachers and students in EBM-PBL group.Results The test scores of oral and written test in EBM-PBL are both significantly higher than those in control group (P=0.000),especially the oral exam.Compared with the instant test,the scores in later oral (P=0.054) and written (P=0.023) examinations were slightly decreased in EBM-PBL group,while they both dramatically dropped in control group (P=0.000).The performance of eight-and seven-year students was generally better than those of five-year students,however,five-year students seemed to get more benefits from EBM-PBL teaching.Feedbacks showed that most of the teachers and students agreed that they all made progress from the practice of EBM-PBL teaching.Conclusion It showed that EBM-PBL helps to cultivate students' self updating of medical knowledge and clinical skills,which ensuring them to follow the development in major field.Thereby,they could transform into excellent clinicians from the students.In addition,it also promoted the teachers to renew their knowledge system and the ability of teaching.

In constructing the system of medical functional teaching and enhancing the quality and ability of students,we adjust the content and method of teaching in practice,and try to find students'problems in study through questionnaire survey and promote teaching reform and disciplines construction.

Objective To observe the efficacy and safety of albumin-bound paclitaxel on the patients with advanced malignance in more than the third-lines (including the third-lines).Methods 34 patients with advanced malignance diagnosed by pathological evidence accepted more than the third-lines (including the third-lines) chemotherapy containing albumin-bound paclitaxel after failure of chemotherapy.The efficacy and safety were observed.Results Totally 110 cycles chemotherapy were completed,with a mean of 3.24 cycles in each of the 34 patients.No CR patients,12 cases of PR,9 cases of SD and 13 cases of PD were found.The response rate (RR) was 35.29 ％ (12/34) and the disease control rate (DCR) was 61.76 ％ (21/34).The main toxicity was hematologic toxicity,including neutropenia in 26 cases (76.47 ％),anemia in 14 cases (41.18 ％) and thrombocytopenia in 3 cases (8.82 ％).Other common adverse reactions included alopecia in 27 patients (79.41％) and muscle and joint pain in 15 cases (44.18 ％).Conclusions The albumin-bound paclitaxel is effective and tolerable in patients with advanced malignance in more than the third-lines (include the thirdlines) chemotherapy.

This paper analyzed international acupuncture and moxibustion literature cited in SCIE of web of science from 1970-2013,using bibliometric methods and visualization analysis tools,according to categories:publication years,countries,organization,authors,subjects and keywords,to explore the topic evolution process and development directions of acupuncture and moxibustion research.

Objective We try to find the current situation of Hangzhou health research.Methods Using established evaluation index system to evaluate 8 medical service.Results Scientific research development level of 8 medical service is unbalanced,but input-output is balance.Conclusions According to the appraisal results,we suggest reduce the gap among the scientific level of medical service,train high-level personnel,strengthen the construction of key discipline and specialties,create the atmosphere of project application,and establish scientific research incentive system.

Service for key subjects is important for medical information institutions nowadays.This paper discusses the necessity of providing subject-oriented service,and proposes three service modes:information transmission mode,information analysis mode and information navigation mode.In addition,the guarantee measures are also discussed,including constructing a security system for subject literature,training high-quality services team,and promoting subject information service brand.

To reveal the scientific research situation of general hospitals in recent years in　china,the authors retrieved papers included in CBM、CCD and ISI Web of Knowledge,and compared　the production of papers from the general hospital in 15 sub-provincial cities during the period of 2000　-2009.Also the citation frequency of all papers and the average citation frequency were compared.

Objective To establish a scientific evaluation index system for medical service scientific research competitiveness for government assessment.Methods The evaluation indexes and their weights were determined after two rounds Delphi consultation.Results Construct a hierachical index system composed of three groups,namely investment,output and effects,including three first class index,13 second ones and 50 third ones after two rounds Delphi consultation.Conclusions The index system has reasonable structure and comprehensive contents,reflecting the core idea of scientific research competitiveness evaluation.

Objective To evaluate the effect of continuous adenosine infusion on mesentery microcirculation during cardiopulmonary resuscitation in rats with asphyxia. Methods Rat model of asphyxia was established in 22 healthy Wistar rats. The animals were then randomly divided into normal saline group (group A, n=10), epinephrine group (group B, n=6) and epinephrine plus adenosine group (group C, n=6). After a 3-min asphyxia without intervention, cardiopulmonary resuscitation (CPR) was started. The cardiac compression was carried out with an electric cardio-pulmonary resuscitation machine (200 times/min). Respiration was restored and maintained with a ventilator with tidal volume of 4ml, breathing rate 50times/min and FiO2 100%. After a 4-min CPR, rats in group A and group B were given normal saline and epinephrine (bolus of 90?g/kg) respectively, and in group C epinephrine (bolus of 90?g/kg) plus 70?g/kg adenosine were given. Electric defibrillation would be initiated if there was ventricular fibrillation. The reperfusion rate of mesentery arterioles and venules, diameter of blood vessels and relative blood velocity were observed. Results The reperfusion rate of mesentery arterioles and venules was significantly higher in group C than in group B (P

ObjectiveTo identify the presence of side population (SP) cells in human ovarian cancer cell line OVCAR-3 and to investigate whether SP cells have the characteristics of cancer stem cells.MethodsSP and non-SP (NSP) cells from OVCAR-3 were isolated by fluorescence-activated cell sorting after being stained by DNA-binding dye Hoechst 33342.Limiting dilution transplantation assay,realtime PCR,and drug sensitivity assay were performed to compare the tumorigenic ability,differentiation ability in vivo,the mRNA expressiou of stemness marker (Oct-4,Klf4,and Nanog) and ATP-binding cassette (ABC) transporter (ABCG2,ABCB1,and ABCC2),and response to multiple drugs (cisplatin,paclitaxel,doxorubicin,and mitoxantrone )between SP and NSP cells.ResultsA few of SP cells [ ( 1.13 ±0.39) ％ ] which were sensitive to reserpine were identified in OVCAR-3 cells.The injection of as few as 102 SP cells initiated tumors in two of five mice.Tumor latency was 52 -61 days.However,the NSP cells did not generate any tumors in mice until 104 NSP cells were injected (two of five mice).Tumor latency was 64 - 98 days.Tumorigenicity of SP cells was enhanced by at least 100-fold than that of NSP cells.The SP cells regenerated both SP [ ( 2.09 ± 0.73 ) ％ ] and NSP populations in vivo with a fraction size that was comparable to the original population.The mRNA expression ofstemness genes Oct-4,Klf4 and ABC transporters ABCG2,ABCC2 genes were elevated in SP cells compared to NSP cells,the fold changes were 1.95±0.41 (P＜0.05),4.26 ±0.63 (P＜0.01),3.22±0.36 (P＜0.01),and 1.76±0.26 (P＜0.01 ),respectively.The relative activity of SP and NSP cells were 0.757 ± 0.105 versus 0.474 ± 0.035 (P＜0.01),0.521 ±0.092 versus 0.384 ±0.073 (P＜0.05),0.742 ±0.051 versus 0.526 ±0.088 (P ＜0.01 ),and 0.690 ± 0.096 versus 0.466 ± 0.112 ( P ＜ 0.01 ) when they exposed to 0.25 μg/ml cisplatin, 0.01μmol/Lpaclitaxel, 0.25μmol/Ldoxorubicin, and0.05μg/mlmitoxantrone,respectively.ConclusionsSP cells from OVCAR-3 have enhanced self-renewal,differentiation,and tumorinitiating capacity compared to NSP cells.The mRNA expression of stemness genes and ABC transporters are markedly elevated in SP cells,which showed resistance to multiple chemotherapeutic drugs and have characteristics of cancer stem-like cells.Therefore,SP phenotype could be used as a marker to isolate the cancer stem-like cells in ovarian cancer.