Simulated teaching method is a necessary complement to theoretical teaching of health law,which meets the practical-oriented reform need and cultivates students with the literacy as a legal professional.The teaching method demands more requirements on teachers,students,teaching materials,organizational management,and more attention on contextual design,preparation details,implementation activities and evaluation of teaching.

Constructivism educational theory can provide a useful guidelines for health law education,this article finds the association of constructivist theory for health law education reform,and combined the with application of relevant theories on teaching practice experience,it also discusses how to provide a real promotion for the"students'first"concept.

Objective To use the flow cytometry to detect the platelet vasodilator-stimulated phosphoprotein(VASP)phospho-rylation level and to evaluate the clopidogrel curative effect after PCI.Methods 17 cases in the control group without any drug in-tervention and 26 cases of acute coronary syndrome(ACS)after PCI operation with clopidogrel were selected.Platelet VASP phos-phorylation levels at being selecting and on 7 d after anti-platelet therapy were detected by the flow cytometry and the platelet reac-tivity index (PRI)was calculated.Results The PRI after anti-platelet therapy in the ACS group was decreased significantly,the difference between before treatment and after treatment had statistical significance (P <0.05 ).Conclusion The platelet VASP phosphorylation level detected by the flow cytometry can specifically evaluate the effect of clopidogrel.

The thickness of the soft tissue at 34 points on the head the and the face were measured. 28 out of 30 cadavers were fixed with 10% formalin about 1 year and 2 fresh. 14 measuring points were on the middle line, while 20 points on the lateral line. The width of palpebral fissure, the position of eye-ball in the orbital cavity, the thickness as well as the heght and the width of the auricle, the thickness of supper and lower lip, the width of mouth-slit, the length of external nose, the width of inferior aspect of the nose, the heght of the epex of noselip, and the diameter of nares were measured to provide some anatomicaleata data for the restoration and reconstraction of the head and the face of the dead when they are injured.

Objective To compare the blood-saving effect when acute hypervolemic hemodilution (AHH) was performed with hydroxyethyl starch (HES) 130/0.4 dissolved in electrolyte injection (HES-E) and HES 130/0.4 in sodium chloride injection (HES-NaCl).Methods Thirty patients of both sexes,aged 18-60 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,with body mass index of 18-25 kg/m2,hemoglobin (Hb) ＞100 g/L,hematocrit (Hct) ＞ 35％,scheduled for elective abdominal operations under general anesthesia,were randomly divided into HES-E group and HES-NaCl group using a random number table,with 15 patients in each group.AHH was performed after induction of anesthesia.In HES-E and HES-NaCl groups,HES-E and HES-NaCl 15 ml/kg were intravenously infused over 30 min,respectively,and the infusion was conpleted before skin incision.Immediately after onset of AHH (T1),at 2 h after the end of AHH (T2),and at the end of operation (T3),arterial blood samples were collected for blood gas analysis and blood routine test,and pH value,base excess,HCO3-,K+,Na+,Cl-,Ca2+,Hb and Hct were recorded.Venous blood samples were collected at T1 and T2 for measurement of blood coagulation parameters including prothrombin time,activated partial thromboplastin time and fibrinogen and thrombelastography parameters.The volume of liquid intake and output and requirement for allogeneic blood transfusion were recorded,and the blood volume expansion rate was calculated.Results Compared with group HES-NaCl,no significant changes were found in the total volume of liquid infused,requirement for allogeneic blood transfusion,blood volume expansion rate,blood coagulation parameters at each time point,Hb and Hct (P＞0.05),pH value,base excess,HCO3 and K+ were significantly increased,and Na+ and Cl-were significantly decreased in group HES-E (P＜0.01).Conclusion There is no significant difference in the blood-saving effect between AHH with HES-E and HES-NaCl clinically,but HES-E can maintain homeostasis better.

OBJECTIVETo investigate the injury stress responses caused by ischemia reperfusion and its effects on the salivary secretory function of rat submandibular glands.

METHODSAn in situ ischemia reperfusion experimental model of rat submandibular glands was developed. The rat submandibular glands were subjected to 90 min of ischemia without denervation followed by reperfusion for 1, 12, 24, and 72 h. Salivary secretion, histological changes, reactive oxygen species (ROS) levels, and cellular apoptosis of the involved submandibular glands were detected after reperfusion.

RESULTSThe secretory function of the glands decreased at 1 and 12 h, and the saliva secretion gradually had the same value as that of the control sample 72 h after reperfusion. Increasing inflammatory cells infiltration, cellular atrophy, and tissue edema were observed especially after reperfusion for 12 h. The level of ROS and the number of apoptotic cells exhibited the same tendency, and higher ROS levels and more apoptosis cells 1 and 12 h after reperfusion were observed.

CONCLUSIONOur study suggests that ischemia reperfusion can cause a series of injury stress responses in submandibular glands, which might have an important function in the early phase dysfunction of transplanted submandibular glands.

Objective To make clear the patients in minimally invasive surgery through explo-ring effects of pneumoperitoneum and pulmonary infection on the airway pressure of patients with dif-ferent body mass index (BMI)under general anesthesia.Methods A total of 849 cases of patients with trachea cannula in pneumoperitoneum surgery inr general anesthesia under different position were studied.To observe the changes of airway pressure and the ratio of pulmonary infection within one week of patients in general anesthesia.Propofol,Remifentanil and Atracrium were used in general an-esthesia.BIS and TOF were used to detect the degree of muscle relaxation.Results The airway pres-sure was increased obviously in patients of Head-down Tilt under same pneumoperitoneum pressure(P<0.05);the airway pressure was increased in patients with BMI>30 kg/m2 (P <0.05).There was no obvious increase in pulmonary infection rate in all patients.Conclusion Pneumoperitoneum could increase airway pressure and pulmonary infection of patients with low head position and BMI > 30 kg/m2 under same pneumoperitoneum pressure.Therefore,shorten the operation time and decreased pneumoperitoneum pressure could be used to prevent pulmonary infection.

Objective To investigate the relationship between the incidence of dysphagia and the location of brain lesions in patients with acute stroke.Methods Swallowing function was assessed by Watin drinking water test within 48 hours after admission in 226 cases with acute stroke.The location of the brain lesions was identified by CT and / or MRI.According to the US National Institutes of Health Stroke Scale (NIHSS),evaluation of nerve functions was evaluated within 24 hours after admission in stroke patients.Results The incidence of dysphagia was 50.4％ (114 /226) in 226 patients in acute stage.The degree of neurological deficit of stroke patients on admission was significantly correlated with the occurrence of dysphagia (x2 =13.35,P=0.02).The incidence of dysphagia caused by lesions in internal carotid artery trunk (hemisphere in combination with basal ganglia/internal capsule) was more common in anterior circulating territory(internal carotid artery system),dysphagia with internal carotid arterg(ICA) trunk occlusion (hemisphere in combination with basal ganglia/internal capsule) was more common than that caused by cortex branches occlusion (hemisphere-cortex) or penetrating ICA injuries (basal ganglia/internal capsule) and cortex branches occlusion (hemisphere-cortex),respectively(x2 =8.228,P＜0.05).The incidences of dysphagia induced by brain lesions of different cortex lobes had no statistic differences(x2 =0.312,P＞0.05).In posterior circulating territory (vertebro-basilar system),the incidence of swallowing disorders was significantly higher in brain stem group than in the thalamus and cerebellum (x2 =27.292,P＜0.001).The incidence of the dysphagia caused by lesions in cerebral hemispheres,combined basal ganglia / internal capsule and brain stem lesions were significantly higher than those caused by other lesions(x2 =35.639,P＜0.000).Conclusions Brain lesions of hemisphere combined basal ganglia/internal capsule and brain stem are significantly associated with the occurrence of dysphagia after acute stroke.

To lay a foundation for the type selection of the ambulance helicopter. The type selection was explored from the aspects of platform selection, rescue environment and service requirements, analyzing the rescue in the helicopter and the tendency of the ambulance helicopter in foreign countries and China. The types of the am-bulance helicopter were determined as the specific and modified ambulances, with the considerations such as operation environment, flight performance, cabin structure, onboard equipment, cabin configuration, fixation device and protection. Specific ambulance helicopter is supposed to be based on small- or mediate-sized platform, while the modi-fied ambulance helicopter is supposed to be based on large or heavy platform.

Objective To observe the expression of aggrecanase 2 and a tissue inhibitor of metalloproteinase 3 (TIMP-3) in degenerate human lumbar intervertebral discs and their role in degeneration of the nucleus pulposus.Methods Pfirrmann classification was used to class degenerate intervertebral discs observed through MRI.They were divided into three groups:a control group (Pfirrmann grade Ⅰ-Ⅱ),a degeneration group (Pfirrmann grade Ⅲ-Ⅳ),and a severe degeneration group (Pfirrmann grade Ⅴ).A total of 45 cases accepted lumbar spine surgery for removing nucleus pulposus specimens.Each group contained 15 cases.After formalin-fixation and paraffin embedding,immunohistochemistry was used to detect aggrecanase 2 and TIMP-3 expression in the nucleus pulposus cells.Results The percentages of cells positive for aggrecanase 2 were (13.58 ± 7.76) ％,(33.48 ± 13.95) ％ and (56.00 ± 18.39) ％ in the control,degeneration and severe degeneration groups respectively.These differences had statistical significance.The percentages of cells positive for TIMP-3 were (34.78 ± 13.80) ％,(46.77 ± 10.98) ％ and (50.65 ± 16.45) ％,and these differences were again statistically significant.The aggrecanase 2/TIMP-3 ratios were also significantly different.Conclusion As the degree of degeneration of the nucleus pulposus increased,the expression of aggrecanase 2 and TIMP-3 rose,which indicates that both changes were closely connected with the degeneration.Their ratio was correlated with the degree of degeneration of the nucleus pulposus.