Objective:Dual-track teaching mode in higher colleges and universities of Chinese medicine in clinical pathology teaching reform and practice, so as to change the phenomenon of university students of traditional Chinese medicine western medicine foundation weak, and improve the teaching quality of clinical pathology.Methods: We use the traditional teaching method (LBL) and teaching method of the problem-based learning (PBL) to make double-track recess internship teaching model in clinical pathology, and in practice use the access type, interactive type and potential mining methods to motivate the students’ learning.Results: The dual-track teaching model realizes complementary teaching effect of a variety of teaching methods, makes the teaching quality enhance unceasingly. It not only exercises the students’ ability of autonomous learning, cultivate the students’ clinical thinking, but also stimulates students’ imagination and improves the students’ ability to analyze and solve practical problems.Conclusion: The dual-track teaching mode is worth popularizing in the higher colleges and universities of traditional Chinese medicine, and it can improve the students’ comprehensive quality and innovation and make it better from students to the role of the doctor.

Objective:To observe the clinical efficacy of Shenfu Injection for the most gastric resection.Methods: ASA II-III patients undergoing elective surgery for 60 patients with subtotal gastrectomy, were divided into experimental group, control group randomly. The experimental group was divided into Shenfu group (A), the control group treated with dopamine (B). In the A group before induction of anesthesia with intravenous injection of 0.8ml/kg of Shenfu injection,and group B received balanced salt to maintain anesthesia, the disposal of the same. Patients were given dopamine, atropine and other vasoactive drugs, there were recorded before anesthesia(T0), immediately after tracheal intubation (T1), 30min after intubation (T2), 1h after intubation(T3) hemodynamics.Results: Compared with the control group, the experimental group canachieve hemodynamic stability time earlier, smaller influence on the fluctuation of blood pressure.Conclusion: Shenfu Injection on patients with coronary heart disease underwentsubtotal gastrectomy to improve the stability of circulation system.

0.05).The differences between NSCLC and SCLC reached the statistical signifcance,P

Objective To investigate the effect of ultrasound-guided percutaneous tube drainage in early acute pancreatitis of closed abdominal injury. Methods The clinical data about fifteen ca.ses of acute pancreatitis of closed abdominal injury in our hospital were reviewed retrospectively. Results By ultrasound-guided percutaneous tube drainage, 11 cases were cured, 2 cases were drainaged by open operation with the complication of pancreatic pseudocyst, 2 eases were transfered to superior hospital with state of an illness sharpened. Conclusion Ultrasoundguided percutaneous tube drainage was effective treatment in early acute pancreatitis of dosed abdominal injury,and avoided open operation.

Objective To evaluate the role of fetal brainstem-vermis (BV) and brainstem-tentorium (BT) angles in differential diagnosis of fetal cereballar vermis anomalies by three-dimensional ultrasonography. Methods A total of 335 normally developed fetuses at 18-34 gestational weeks were examined prospectively in Prenatal Ultrasound Center of Suzhou Municipal Hospital from July 2013 to July 2014 by three-dimensional ultrasonography scanning. The BV angles and BT angles were measured at the mid-sagittal sections of fetal heads which were obtained by three-dimensional ultrasonography. Sixteen fetuses with abnormal cerebellar vermis were selected. The BV angles and BT angles were measured and compared with the measurements of normal group. Results In normal fetuses, the mean of BV angles was (3.3±1.7)° , ranging from1.0 to 10.0°;the mean BT angle was (31.5±6.9)° , and ranging from 16.6 to 57.8° . In 16 cases of abnormal cerebellar vermis, 4 cases of Dandy-Walker Malformation (DWM) showed significantly upward rotated cerebellar vermises, the BV angles increased significantly (88.9±18.1)° , the cerebellar tentoriums were superior displaced, the BT angles increased remarkably (89.0±12.8) ° ;6 cases of Dandy-Walker variant (DWV) showed upward rotated cerebellar vermises, with increased BV angles (23.7±5.2) ° , and slightly increased BT angles (54.5±12.0)°;6 cases of Blake′s pouch cyst (BPC) showed upward rotated cerebellar vermises were, mildly increased BV angles (16.7±1.8)° , and slightly increased BT angles (50.3±8.2)° . The comparison results showed:BV angles increased with increasing severity of the condition in BPC, DWV and DWM;BT angles increased significantly in DWM. Conclusions The measurements of BV angles and BT angles are valuable in the differential diagnosis of fetal cereballar vermis anomalies. From 19 gestational weeks, a BV angle>60° is strongly suggestive of a Dandy-Walker malformation, while a measurement>10.0° and<20° favors the diagnosis of Blake′s pouch cyst.

Objective To observe the effects of A2a adenosine receptor antagonist SCH442416 and ZM241385 on the expression of glutamine synthetase(GS) and L-Glutamate/L-Aspartate Transporter(GLAST) in rat retina under chronic ocular hypertension model.Methods Rat chronic ocular hypertension models were induced in the right eye of 12 male Sprague Dawley rats by blocking three episcleral veins,the left eye as control one.Intraocular pressure (IOP) was measured and compared at postoperative 1 week,2 weeks and 3 weeks.54 male chronic ocular hypertension rats were divided into 3 groups randomly,topically applying A2a adenosine receptor antagonist SCH442416,ZM241385 and carrier,respectively,three times a day for three weeks.At three weeks,mRNA and protein expression of GS and GLAST in rat retina were analyzed by RealTime-PCR and Western-blot.Results The average IOP of the modeling eyes at postoperative 1 week,2 weeks and 3 weeks were higher than that of the control eyes (all P ＜ 0.05).The mRNA and protein expression of GS and GLAST in the retina of SCH442416 and ZM241385 groups increased significantly compared to the carrier group (all P ＜ 0.05).However,the differences of mRNA and protein expression of GS and GLAST between SCH442416 and ZM241385 groups was not significant(all P ＞ 0.05).Conclusion Rat chronic ocular hypertension model can be induced by blocking three episceral veins successfully and effectively.A2a adenosine receptor antagonist SCH442416 and ZM241385 increase the expression of GS and GLAST.There seems no difference between the effects of these two drugs.

The article explored the cause of recovery failure by adopting advanced simu-lation system(ECS) in the teaching of ‘recoveing of neonatal asphyxia’and put forward some improvement methods and counter measures.Marking full use of the advantages of ECS,designing the training course with specifit roles and objectives,paying attention to the guidance of organiza-tion and exchange as well as the training of cooperative team are the key to improve the skills of neonatal asphyxia recovery in obstetrical pediatric and the teaching quality.

Objective:We aimed to explore the clinical features, computed tomography (CT) findings, treatment, and prognosis of bronchopulmonary carcinoid. Methods:Clinical data of 31 patients with primary carcinoid tumor of the lung were retrospectively re-viewed. The prognostic factors were analyzed via Cox univariate and multivariate analyses. Results: Clinical symptoms included coughing or expectoration in 17 of the 31 cases, hemoptysis or blood-stained sputum in 7 cases, and chest pains or shortness of breath in 8 cases. Six cases were asymptomatic. The CT scans showed round or oval nodules with clear boundaries, and enhancement CT scans indicated mild, homogeneous enhancement. Immunohistochemistry results revealed the positive expression rates of synaptophy-sin (Syn), chromogranin A (CgA), and neuron-specific enolase (NSE) were 90.3%(28/31), 87.1%(27/31), and 90.3%(28/31), respec-tively. Therapy and prognosis results were as follows:28 of the total number of patients underwent surgery, among which 3 underwent postoperative adjuvant therapy, 2 received chemotherapy; and only 1 refused treatment. The 1-year overall survival rates were 100%(18/18) and 92.3%(12/13), whereas the 3-year survival rates were 94.4%(17/18) and 69.2%(9/13) in the typical and atypical carcinoid cases, respectively. Cox univariate analysis results revealed that lymphatic metastasis (P=0.02), tissue types (P=0.017), TNM stage (P=0.005), and therapies (P=0.01) were the prognostic factors. Cox multivariate analysis results showed that lymphatic metastasis (P=0.032) and tissue types (P=0.002) were the independent prognostic factors. Conclusion:Compared with other lung cancers, the bron-chopulmonary lung carcinoid has no special clinical manifestation in clinical and radiographic images. The diagnosis was mainly based on histopathology results. Surgery was the main and effective treatment, whereas chemotherapy and radiotherapy showed unsatisfactory results. The overall prognosis was satisfactory. However, the atypical carcinoid was inferior to the typical carcinoid in terms of progno-sis. Pathological typing and lymph node metastasis were significant prognostic factors.

Objective To observe the effect of WeChat -based health education on young patients with initial treatment of pulmonary tuberculosis(TB).Methods A total of 180 TB patients were randomly divided into control group and observation group,90 cases in each group.All patients received health education for six months under the guidance of specialist nurses and physicians,but WeChat-based health education for the observation group and telephone health education for control group.Patients of the two groups were evaluated with TB cognitive level and compliance at 6 months after discharge.Results The pulmonary tuberculosis knowledge level of the observer group was significantly higher than that of the control group (89.8%vs 73.3%),the difference was statistically significant (χ2 =11.07,P<0.01);And after 6 months of follow-up,in the observation group,the compliances of patients taking medicine on time(97.8%vs 80.0%,χ2 =15.59,P<0.01),reasonable diet(95.5%vs 81.1%,χ2 =23.24, P<0.01),moderate exercise(97.8%vs 83.4%,χ2 =36.51,P<0.01) and timely referral(96.7% vs 82.2%,χ2 =20.63,P<0.01) were higher than those in the control group,the differences were statistically significant (all P<0.01).Conclusion WeChat -based health education is effective for improving TB cognitive level and the compliance of the patients.Since WeChat has been widely used,WeChat-based health education can be promoted.

Objective To observe the efficacy and safety of cetuximab chemotherapy combined with irinotecan in the treatment of advanced colorectal in the elderly.Methods 40 irinotecanresistant patients with K-Ras wild type were randomized to cetuximab weekly combined with irinotecan group (group A) and cetuximab biweekly combined with irinotecan group (group B).In group A,cetuximab was given at an initial dose of 400 mg/m2,followed by weekly 250 mg/m2.In group B,cetuximah and irinotecan were given at 500 mg/m2 and 180 mg/m2 respectively every two weeks.Time to progression (TTP),overall survival (OS) and toxicity were compared between the two groups.Results There were no significant differences in objective response rate (RR),disease control rate (DOC),TTP and OS between goup A and group B (30.0％ vs.25.0％,60.0％ vs.55.0％,5.8 months vs.5.6 months,9.8 months vs.9.5 months,respectively,all P＞0.05).Grade 3 or more toxicities including hematological toxicity,gastrointestinal reactions and skin toxicity were found in 2 cases,2 cases and 1 case respectively in group A and 3 cases,1 case and 2 cases respectively in group B.The two groups had no significant differences in toxicities (all P＞0.05).Conclusions Cetuximab combined with irinotecan therapy is effective in the treatment of advanced colorectal cancer in elderly irinotecan resistant patients.Cetuximab biweekly regimen is more convenient but has the same efficacy and toxicity as compared with cetuximab weekly regimen.