Objective This study discusses the role of case-based learning (CBL) in the development of common competency in medical students.Methods One hundred and twenty-one students of Grade 2013 and Grade 2014 majoring in clinical medicine were divided into study (Grade 2014:63 students) and control (Grade 2013:58 students) groups.The study group was composed of 5 teams,with 12 or 13 students in each team.CBL and traditional lecture-based learning (LBL) were applied to the study and the control groups respectively.After the courses,a questionnaire with 10 indicators of medical students' common competency was scored by the students.The scores were entered into SPSS 19.0 for two independent-samples t-test.Results The effective questionnaire recovery rates for the study and the control groups were 92.1％ and 98.3％ respectively.For the medical students' post competency index,students in the study group scored significantly higher than those in the control,with knowledge mastery,study interest,learning initiative,independent learning,problem analyzing,problem solving showing the following scores,respectively:(5.57 ± 0.77),(5.28 ± 1.01),(5.16 ± 0.91),(5.05 ± 1.05),(5.10 ± 0.89),and (5.09 ± 1.01),compared to those in the control showing the following scores,respectively:(5.14 ± 0.99),(4.82 ± 1.12),(4.75 ± 1.07),(4.46 ± 1.09),(4.70 ± 1.03),and (4.68 ± 0.97),and the differences were statistically significant (P＜ 0.05).Besides,students in the study group performed much better in communication,collaboration,information collection,or critical thinking than those of the control (P＜0.05),with scores in the study group showing (4.97 ± 1.08),(5.33 ± 0.94),(5.21 ± 0.97),and (4.98 ± 0.96),respectively and those in the control (3.93 ± 1.16),(1.95 ± 0.85),(2.21 ± 0.98) and (2.12 ± 0.91),respectively,and the differences had statistical significance.Conclusion CBL can promote the early development of medical students' common competency during basic medical education and compared to the traditional LBL,teaching in smaller teams is much better in ability training.

Background choroidal neovascularization (CNV) is the common reason of visual acuity impairment in high myopia patients,which usually leads to irreversible central visual impairment.Objective This study was to evaluate the clinical efficacy and safety of conbercept intravitreal injection for CNV in high myopia.Methods Fifteen high myopia patients with macular CNV diagnosed by OCT and fluorescein fundus angiography (FFA) from July 2014 to July 2015 were retrospectively analyzed.All patients were performed with intravitreal injection of conbercept 0.5 mg (0.05 ml).The best corrected visual acuity (BCVA) and central macular thickness (CMT) were examined 1 day,l week,4,8 and 12 weeks after injection.The ocular and systemic complications relating to drug were also observed.Results Fifteen eyes of 15 patients totally received 45 times of conbercept intravitreal injection.Among the total,1 eye only received 1 time of treatment,2 eyes received 2 times of treatment,12 eyes received 3 times of treatment and 1 eye received 4 times of treatments.After 12 weeks of treatment,FFA showed that fluorescein leakage disappeared in 10 eyes;fluorescein leakage area decreased in 4 eyes;fluorescein leakage was continued in 1 eye.The BCVA before treatment and at 4,8 and 12 weeks after treatment were 0.61 ±0.46,0.60±0.43,0.41±0.53 and 0.41±0.51,with significant difference among them (F=7.862,P＜0.001).The CMT before treatment and at 4,8 and 12 weeks after treatment were (280.33±14.40),(269.00±10.10),(261.93±7.80) and (259.53±6.30) μm respectively,with significant difference among them (F =32.520,P＜0.001).None of the patients conducted anterior chamber puncture because of elevated intraocular pressure,and no intraocular inflammation,vitreous hemorrhage,retinal detachment and cardiovascular disease or other serious complications occurred.Conclusions Intravitreal injection of conbercept can relieve macular edema and improve the vision.It is an effective method for the treatment of CNV associated with high myopia,but long-term follow-up observation still need to perform.

Clinical division of stages in 289 cases of chronic myelogenous leukemia (CML) and reviewing investigating survey analysis were made for its relationship with TCM syndromes. And then relative problems of clinical syndromes, names of diseases and syndromes were researched respectively according to the analytic results. It is indicated that the disease is characterized mainly by clinical changes of the 4 stages, i. e. pathogenic factor falling while body resistence excessive: pathogenic factor accumulating while body resistence prevailing; pathogenic factor advancing while body resistence weakened: pathogenic factor excess while body resistence deficience. And it is firstly put forward that Sui Du is served as name of disease and syndrome of CML.

With the extensive use of information technology and the development of big data technology, the traditional treatment methods for cancer are not meeting our needs.The application of medical large data has now changed our tumor treatment model profoundly, but also brings a deeply cognition to the nature of malignant tumor.Development of medical big data analysis and management technologies are driving malignancy treatment model fromindividual treatment era into the precision medicine era, which allows us to change the prediction, diagnosis, treatment and monitor of malignancy.There are also a variety of challenges to resolve.

Objective To investigate the safety and medium-and long-term effects of endovascular stenting,axilloaxillary bypass (AAB),carotid-subclavian bypass (CSB) in patients of subclavian arterial occlusion.Method From 2001 to 2013,311 consecutive patients with subclavian arteriosclerosis obliterans were treated with endovascular stenting (n =191),axilloaxillary bypass (n =96) or carotidsubclavian bypass(n =32).We collected patients' medical data,calculated patency of the graft or stent with life-table method and compared patency between three approaches with Log-rank.Results The incidence of perioperative complications was 4.1％ in the stenting group vs.11.5％ in AAB group vs.18.7％ in CSB group.There was significant statistical differences between the stenting group and bypass group about the incidence of perioperative complications.The primary patency rates at 1,3 and 5 years were 90.3％,84％,81.6％ in stenting group vs.95.3％,92.6％,88.9％ for AAB group vs.100％,96.4％,96.4％ for CSB group.There was significant statistical differences between the stenting group and bypass group about the primary patency rates.Conclusions Both endovascular stenting and extrathoracic surgical bypass are safe and effective treatments for subclavian arteriosclerosis obliterans.However,effect of extrathoracic surgical bypass is more durable in the medium-and long-term.

Objective To evaluate clinical efficacy and survival outcomes of neoadjuvant treatment on early stage bulky cervical carcinoma.Methods A total of 155 cases with bulky stage Ⅰ b2 or Ⅱ a2 cervical carcinoma in Affiliated Tumor Hospital of Shantou University Medical College from Nov.2010 to Feb.2015 was reviewed and divided into two groups according to pre-operative treatment 108 cases in the neoadjuvant treatment group and 47 cases in the control group who underwent radical surgery directly.The clinical,pathologic,and follow-up data were analyzed retrospectively.Results The total response rate of neoadjuvant treatment was 75.0％.Histological grade in neoadjuvant treatment group was better than the other group and the rate of deep myometrial infiltration was tend to low in neoadjuvant treatment group.There was no difference in pathological type,parametrial involvement,lymph node metastasis,and lymph vascular space invasion between two groups.The rate of postoperative treatment was similar (92.6％ vs 87.2％,P ＞ 0.05).The overall survival rate of neoadjuvant treatment group was 96.4％ and the other group was 88.9％ (P =0.069).Conclusions Neoadjuvant treatment was effective for early stage bulky cervical carcinoma.It might reduce tumor histological grade and maybe improve the overall survival of patients.

Objective To explore the value of serum CA125 level to the prognosis of epithelial ovarian cancer.Methods The clinicopathologic data and serum CA125 level of 76 patients with epithelial ovarian cancer from Jan.2003 to Dec.2009 were analyzed retrospectively, and the outcomes of patients were followed up.Results No relationship was found between CA125 concentration before therapy with prognosis and cytoreductive condition for epithelial ovarian cancer.The normal or abnormal CA125 concentration after 3 courses of treatment meant different prognosis, with the 5-year survival rates of 63.8 ％ and 25.0 ％, and the median survival time of 57 months and 28 months, respectively (x2 =19.951, P =0.000).The 5-year survival rates of patients with CA125 concentration≤ 10.0 U/ml and＞10.0 U/ml after therapy were 72.7 ％ and 42.8 ％, respectively (x2 =7.266, P =0.007).According to multivariate Cox proportional-hazard model, two independent factors , operative pathological staging and CA125 concentration after 3 courses, were related significantly to the prognosis of epithelial ovarian cancer (P ＜ 0.05).Conclusion Serum CA125 level, especially after 3 courses and therapy, plays an important role in the prognosis of epithelial ovarian cancer.

Objective To investigate the expression of miR-133b in the brain of methamphetamine(MA) dependent rats and its regulatory effects on neuronal toxic injury.MethodsThrough continuous intraperitoneal injection to rats with MA(10 mg/kg),the conditioned place preference(CPP) rats model was established,and the expression of miR-133b in the cerebral cortex of model rats was detected by real-time fluorescence quantitative PCR(RT-PCR).PC12 cells were cultured in vitro and treated with MA(800 μmol/L),and then miR-133b expression in cultured neurons was detected.miR-133b mimics and inhibitor were transfected to PC12 cells respectively to observe the effect of miR-133b on the mitochondrial membrane potential(MMP) of cultured neurons.ResultsAfter continuous intraperitoneal injection with MA for 14 days,the residence time of rats in the box with medicine((620.20±44.80)s) was significantly longer compared with the control group((341.80±25.12)s,P<0.01),which showed that MA dependent rats model was successfully established.The RT-PCR detection results showed that the expression of miR-133b in the cerebral cortex of model rats(0.36±0.05) significantly decreased compared with the control group(0.99±0.08,P<0.01).In the in vitro model,most of the neuronal cell bodies became round and the neuorites were withdrawn after MA treatment.Compared with the control group(1.00±0.02),the RT-PCR detection results showed that the expression of miR-133b in MA group(0.74±0.05) decreased(P<0.05).The JC-1 detection results showed that the MMP of the MA group(109.85±7.03) decreased significantly contrast to the control group(36.49±3.89,P<0.01),the MMP of the miR-133b mimics group(58.97±6.56) increased significantly contrast to the mimics control group(135.46±15.04,P<0.01) and the MMP of the miR-133b inhibitor group(162.84±14.15) decreased contrast to the inhibitor control group(139.81±12.26,P<0.05).ConclusionsThe expression of miR-133b in the cerebral cortex of MA dependent rats and in vitro neuron model treated with MA are significantly downregulated.By regulating the expression of miR-133b,the MMP damage of cultured neurons treated with MA is changed,indicating that miR-133b is not only involved in the nerve injury induced by MA,but also possiblely as a molecular target for intervention.

Objective To explore the normal range of the caudate nucleus' volume in Chinese adults of the Han nationality and provide morphological data for the construction of database for Chinese Standard Brain.Methods This was a clinical multi-center study.One thousand Chinese healthy volunteers (age range=18 to 70)recruited from 16 hospitals were divided into 5 groups,i.e.,Group A(age range=18 to 30),B(age range=31 to 40),C(age range=41 to 50),D(age range=51 to 60),and E(age range=61 to 70).Each group contained 100 males and 100 females.All of the volunteers were scanned by MR using T1 weighted three-dimensional magnetization prepared rapid acquisition gradient echo sequence.The volume of eaudate was measured manually using 3D volume analysis software.The difierence of volumes of the eaudate between male and female were analyzed by independent sample t-test,and among age groups by ANOVA.Pearson's correlation coefficient was used to characterize the relationship between volunles and age.The differences of measurements between left and right caudate nucleus were analyzed by paired t test.Results (1)rnle mean volume of bilateral caudate nucleus in healthy Chinese adults wag(10.973±1.647)cm3.The mean volume of the the male's left and right caudate nucleus were(5.656±0.860)and (5.671±0.855)cm3 respectively,no significant differences were found between the volume of left and right eaudate nucleus(t=1.230.P>0.05).The mean volume of the the female's left and right eaudate nucleus were(5.287±0.774)and(5.331±0.766)cm3 respectively,and the right's wag larger than the left's with significant differences(t=3.999,P<0.01);(2)Pearson correlation analysis showed a significant negative correlation between the nucleus volume and age(male and female's,left and fight)(r=-0.561,-0.568,-0.548,-0.552,P<0.05).Conclusion With high-resolution MRI and 3D volumetric analytic software(Midob),the volume of the caudate nucleus can be accurately measured,so as to provide the basic data for establishing Chinese adults' standard digital brain.and provide nomad control standards for caudate nucleus volume-related diseases.

On the basis of analysis of the current status and future tendency of development of the health services industry in Shanghai,the authors identified key problems and bottlenecks.Thus they made clear the target positioning and principles of the industry,and proposed the basic ideas and pattern of the industry in the 13 th five-year plan period,focusing on such fields as private and high-end healthcare services,traditional Chinese medicine services,public health services,commercial health insurance,and other related industries.In the end,corresponding supporting polices were proposed.