The training of clinical thinking ability is the key point of obstetrical teaching to medical students in eight-year program.Obstetrical department of the third affiliated hospital of Sun Yat-sen university has put forward specific methods of SP inquiring and PBL case analysis teaching.The well-designed teaching methods have an active role in the training of case history collecting ability,diagnosing and treating ability to medical students in eight-year program.

Objective To evaluate the efficacy and safety of radioactive 125 I seed implantation combined with paclitaxel (PTX) for treating senile non‐small cell lung cancer(NSCLC) .Methods The clinical data in 35 patients with NSCLC in our hospi‐tal from June 2013 to August 2014 were retrospectively analyzed ,including 12 cases receiving the lung tumor radioactive 125 I seed implantation therapy(group A) ,10 cases treated with PTX combined with cisplatin (TP scheme)after receiving radioactive 125I seed implantation therapy(group B) and 13 cases only conducted TP scheme(group C) .The 21 d chemotherapy was a evaluation cycle . The adverse reactions were evaluated after 1 cycle and the curative efficacy was evaluated after 2 cycles .Results Thirty‐five cases were followed up for 6 months .The adverse reactions could be evaluated in all the cases .The short‐term efficacy could be evaluated in 34 cases .The group A had no obvious adverse reactions ,the main adverse reactions in the group B and C were bone marrow sup‐pression and digestive tract reactions without statistically significant differences (P> 0 .05) .The effective rates after 4 cycles of chemotherapy in the group A and B were 66 .7% and 80 .0% ,the clinical benefit rates were 83 .3% and 90 .0% respectively ,which were higher than 23 .1% and 53 .8% in the group C respectively ,the differences were statistically significant ( P< 0 .05 ) . Conclusion Radioactive125 I seed implantation therapy and PTX combined with radioactive 125 I seed implantation for treating senile early NSCLC are superior to the simple PTX chemotherapy ,which have high effective rate and benefit rate ,safety ,mini‐invasion and mild adverse reactions ,and can increase the patient′s living quality .

Objective: To determine the effects of intravenous anesthetics (fentanyl,midazolam and propofol )on inflammatory responses. Method: We employed carrageenan-sensitized endotoxemic rabbit model. Thirty-two New Zealand rabbits were randomly assigned to one of four groups,control group(no anesthetic was used), fentanyl group, midazolam group and propofol group. Different anesthetics were used intravenously for anesthesia induction and maintenance according to the group classification. Meanwhile, all animals were mechanically ventilated, then, 2?g?kg~(-1) lipopolysaccharide(LPS) were injected for endotoxin challenge. Result:In all groups, serum tumor necrosis factor (TNF)activity began to increase at 30 min,reached its maximal level at 60 min,and tended to decrease at 120 min after (LPS) challenge,and the significant increase of TNF activity was associated with development of hypotension. Meanwhile,serum phospholipase A_2(PLA_2)activity began to increase at 60 min and persisted in going up within 2h. Those animals,with continuous infusion of these three different anesthetics and mechanical ventilation,had much lower peak level of TNF and higher mean arterial pressure (MAP)than control levels, but their changes of serum PLA_2 activity had no significant difference from control level. Conclusion: With mechanical ventilation, intravenous infusion of these anesthetics can reduce LPS induced injury in the acute phase of endotoxemia, probably by the inhibition of TNF production.

We treated 40 cases of stubborn constipation by puncturing Zhongwan (CV 12),Qihai (CV 6), Tianshu (ST 25, bilateral), Daheng (SP 15, bilateral). After 20 times of treatment, 16 cases were cured(accounting for 45%) ,18 cases were significantly improved(accounting for 45%),4 case were improved(accounting for 10%),2 cases were ineffective(accounting for 5%).The total effective rate was 95%.

Objective To analyze CT portal venography (CTPV) manifestations of portal collateral circulation in patients with cirrhosis by using a 16-detector row spiral CT scanner. Methods CTPV was performed in 36 patients with portal hypertension due to cirrhosis, the diagnosis was proved by clinical data, hepatic function findings and imaging signs. By using post-processing reconstruction technique, 3D images of portal venous system and portal collateral circulation were obtained. Results CTPV images displayed the portal venous system and its collateral circulation stereoscopically. Of 36 patients, left gastric varices were seen in 29 (80.6%), lower esophageal varices in 18 (50.0%), short gastric or posterior gastric varices in 15 (41.7%),paraesophageal varices in 9 (25.0%), gastro-renal or splenorenal shunts in 8 (22.2%), sponge-like transformation of portal vein in 7 (19.4%), paraumbilical and abdominal wall varices in 6 (16.7%), congenital cavernous in 6 (16. 7%) and paravertebral venous shunts in 4 (11.1%). Conclusion CTPV can well display the site, extent and severity of the portal collateral circulation in patients with portal hypertension due to cirrhosis, which is of great clinical importance for judging the patient's condition, for selecting therapeutic protocols and for estimating prognosis.

AIM:To explore the characteristics of hepatitis B virus S gene mutation in the vertical transmission after active and passive vaccination .METHODS:Fifteen cases of immunoprophylaxis failure were enrolled in the study . HBV S gene (including pres-S and S) from the mothers, newborns before active and passive vaccination and 7-month-old infants with immunoprophylaxis failure were detected by PCR amplification .The characteristics of HBV S gene mutation were compared among the 3 groups.RESULTS: The genotype of HBV in the newborns and the infants was the same as that in the mothers .The frequencies of mutation in the 2 fragments of the HBV S gene had no significant difference between the 3 groups.The homology tree model based on HBV S gene was analyzed in the 3 groups, in which every group had their own cluster.There were 15 different mutation sites between 7 pairs of mothers and newborns .There were 3 different muta-tion sites between 3 pairs of newborns and infants (nt273A→A/G, nt512C→C/T and nt1139C→A), among which the first 2 were located in the S gene region but not in the “a” determinant , and the latter was located in the overlap region of S and X genes .There were 25 different mutation sites between 9 pairs of mothers and infants , but only 1 case had a differ-ent mutation site between the mother , newborn and infant .CONCLUSION: The HBV species in newborns and infants with immunoprophylaxis failure were transmitted from the mothers .The mutations in the HBV S gene with immunoprophy-laxis failure happened before and after active and passive vaccination , mainly before vaccination .The relationship between HBV S gene mutations and immunoprophylaxis failure should be further explored .

Objective:To study the concentrations of fine particulate matters and ultrafine particles and influenced factors during winter in an area of Beijing .Methods:Real-time monitoring of particles ’ mass and number concentrations were conducted in an area of Beijing from February 7th to 27th , 2013.At the same time, the meteorological data were also collected from the Beijing meteorological website .Differences of the particles ’ mass and number concentrations during different periods were analyzed using Mann -Whitney U test.Meanwhile, the influenced factors were also analyzed .Results: The mean concentra-tions of fine particulate matters and ultrafine particles were ( 157.2 ±142.8 ) μg/m3 and (25 018 ± 9 309) particles/cm3, respectively.The particles’ number and mass concentrations in haze days were 1.27 times and 2.91 times higher than those in non-haze days, respectively.The mass concentrations of fine particulate matters in the self-monitoring site were higher than those in the nearest central monitoring sites, and the hourly-average concentrations of particles were significantly consistent with those at the commuter times.Meanwhile, the setting off of fireworks/firecrackers during the Spring Festival could lead to short-term increases of the particles ’ number and mass concentrations .When the wind speed was low and the related humidity was high , the concentrations of particulate matters were relatively high , and the mass concentrations of fine particulate matters were lagged about 1-2 d.Conclusion: The level of the particulate matters in this area was high .Heavy traffic , setting off of fireworks/firecrackers and meteoro-logical factors may be some of the main factors affecting the concentrations of the particulate matters in this area.Among those factors, the effect of setting off of fireworks/firecrackers didn’t last long and the effect of the meteorological factors had a hysteresis effect .

Objective:To compare the hemodynamic responses to orotracheal intubation between TruviewTM EVO2 optic laryngoscope and Macintosh direct laryngoscope.Methods: Eighty adult patients(ASA physical status Ⅰ-Ⅱ,aged 18-65 years) scheduled for elective surgery under general anesthesia requiring orotracheal intubation were randomly divided into 2 groups(n=40 each):T group and M group.After standard intravenous anesthetic induction,orotracheal intubation was performed with TruviewTM EVO2 optic laryngoscope or Macintosh direct laryngoscope.Non-invasive heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP) and SpO2 were recorded before(T0) and after anesthetic induction(T1),at intubation(T2),1 minutes(T3),3 minutes(T4) and 5 minute after intubation(T5).The laryngeal exposure period and intubation period were also recorded.Statistical analysis was performed using the Statistical Package for Social Sciences(SPSS) Version 13.0.Results: Except for HR at intubation(T2),there was no significant difference in the hemodynamic data at any other time points between the two groups.There was no significant difference in the laryngeal exposure period between the two groups.The intubation time in the T group was significantly longer than that in the M group(P

BACKGROUND:Hip’s anatomy structure is complex, and the traditional two-dimensional imaging, such as X-ray film or CT scan, is susceptible to image overlap and other soft tissue. As a result, there are some limitations in the diagnosis of hip disease. The digital model is built based on reverse engineering and rapid prototyping. It is comprehensive, intuitive and accurate of the stereo configuration of the hip and the spatial relations of other parts’ anatomical structures. This study has a broad application prospect. OBJECTIVE:To reconstruct the personalized three-dimensional entity model of the hip bone with computer aided technology. METHODS: The human hips were scanned with a portable three-dimensional laser scanner, and then the point cloud data of the hips were gotten. The point cloud was processed and the three-dimensional model reconstruction was carried out by using the engineering software Geomagic and the computer aided software CimatronE. Three-dimensional print of hip was completed and the model was gotten, which was consistent with the geometry of hip bone, through the rapid prototyping machine. RESULTS AND CONCLUSION:A model with good geometric similarity and biomechanical characteristics was built by digital modeling method based on reverse engineering and rapid prototyping. This way of digital modeling provided the basis for digital manufacturing of artificial hip, virtual assembly, stress analysis and surgical simulation.

Objective To certify whether 99mTc-HL91 can be trapped in ischemic myocardium prominently for clinical imaging. Methods The model of myocardial ischemia in rabbits was prepared and the distribution of 99mTc-HL91 was observed. The distribution of 99mTc-HL91 in the whole body was also observed. Results The myocardium of the left ventricle supplied by LCX was ischemic according to the change of electrical physiology and the results of NBT dying. The radioactivity in the myocardium of left ventricle supplied by LCX was higher than that supplied by LAD. LCX/LAD: 120 min, 2.57; 180 min, 3.45. 99mTc-HL91 was mostly distributed in the liver and kidney, next, the stomach and intestine. It was excreted through urination and defecation. There was little radioactivity in the heart and lungs and it eliminated quickly. 99mTc-HL91 was eliminated quickly from blood, too. Conclusion Ischemic myocardium can trap 99mTc-HL91 more significantly and relatively prominently at 180 minutes of post-injection. 99mTc-HL91 can be used in myocardial hypoxia imaging.