Methods:188 students majorting in clinical medicine were randomly divided into two groups:the experimental group with evidence based medicine(EBM)teaching method and the control group with traditional teaching method.Results:The experimental group was better than the control group in results of theory examination and skill test,writing medical record,analyzing condition of patients and the level of student's satisfaction.Conclusions:EBM thinking training is practicable in clinical teaching.

Objective Improving the hospital operation management , preparing for the establishment of the digital operation room and achieving the fine management goal .Methods Based on the actual medical and clinical demand, combined with the standard of the operation management , designed and analyzed the management rules and processes of the perioperative information management system .Results Straightened out the information management rules and procedures of the operation room , strengthened the communication , feedback and sharing of the periopera-tive medical information , and improved the work efficiency , the operation quality and the utilization rate of the opera-tion room.Conclusion The smooth management process and the efficient use of information are the keys to promote the hospital management by means of informationization .

The article has studied the application and the student-centered teaching mode in clinic medicine teaching and discussed how to cultivate students' self-learning ability and life-time learning skills by means of internet teaching,problem-base learning,case-studying and question-discussion.It has also pointed out that compared with the traditional teaching mode this teaching mode has advantages in cultivating innovative,pioneering and practical medical talents.

Objective To investigate the clinical effect of Orem self-care nursing for patients with liver cirrhosis according to the comprehensive evaluation software system of organ function.Methods 80 patients with hepatitis B cirrhosis in our hospital were enrolled.The patients' condition was evaluated with comprehensive evaluation software system of organ function.According to the severity of the disease,Orem self-care option was taken.Chronic liver disease questionnaire(CLDQ) was used to evaluate the quality of life if the patients' condition permitted.Liver health knowledge questionnaire was used to evaluate the awareness rate of liver disease.1 month after discharge,the patients' quality of life and health knowledge were measured.Results Patients were discharged after 1 month in the average quality of life score of abdominal symptoms,systemic symptoms,fatigue,activity ability,emotion and anxiety respectively (5.74±1.52)points,(5.47±1.36) points,(5.83±1.57) points,(5.90±1.22) points,(5.79±1.67)points and (5.10±1.23)points,which were significantly higher than the first score (4.52±1.31)points,(4.17±1.48)points,(4.18±1.75)points,(4.26±0.98)points,(4.40±1.32)points and (4.35±1.08)points,the differences were statistically significant(t=-3.107,-3.527,-4.875,-4.963,-3.670,-2.805,all P<0.05).Patients were discharged from the hospital 1 month after liver disease knowledge rate was evaluated for the first time increased significantly(all P<0.05).Conclusion On the basis of patients' Organ function evaluation carried out for patients with liver cirrhosis Orem self-care care,the clinical effect is good,it is worthy of promotion.

SWNTs are a mixture of 1/3 metallic SWNTs (m-SWNTs) and 2/3 semiconducting SWNTs (s-SWNTs). It is desirable to separate the metallic SWNTs from the semi-conducting ones. In this study m-SWNTs was separated by using a poly[(m-phenylenevinylene)-alt-(p-phenylenevinylene)] (PmPV) derivative and used as photo-thermal media instead of SWNTs. The separation effects of m-SWNTs were evaluated by Raman spectra, molecular modeling and TEM images. The effects of m-SWNTs on MCF-7 cell proliferation and apoptosis were evaluated with MTT assay and flow cytometry, respectively. m-SWNTs were separated with high purity. A strong inhibition of MCF-7 cell growth was observed with the m-SWNTs under near-infrared (NIR) light irradiation. Our results will be helpful for the potential applications of m-SWNTs in clinical photothermal cancer therapy.

Objective To evaluate the safety and efficacy of Prolift pelvic reconstructive surgery for advanced pelvic organ prolapse in elderly patients,and to investigate its impact on pelvic floor function and sexual function.Methods Totally 42 patients aged 60-79 years with advanced pelvic organ prolapse [Pelvic Organ Prolapse Quantification (POP-Q) stage Ⅲ,n=30; POP-Q Ⅳ,n=12)were selected in this study.All patients underwent total Prolift procedure,and were followed up at month 1 and 6 after operation.Operation time,bleeding volume and postoperative complications were recorded.The impact of total Prolift procedure on pelvic floor function in patients were assessed by pelvic floor distress inventory short form 20 (PFDI-20),the pelvic floor incontinence questionnaire 7 (PFIQ-7) and the pelvic organ prolapsed and incontinence sexual quality questionnaire 31 (PISQ-31).Results The operative time was (35-78) minutes[mean time:(42±25) minutes].Bleeding volume was (50 300) ml [mean volume:(137±58) ml].No bladder injury,rectum injury and postoperative complications were observed.All patients were cured,and no one recurred.The scores of PFDI-20 and PFIQ-7 were decreased in patients after sugery at 1 and 6-month follow-up as compared with beforesugery (4.5±1.4,0 vs.47.9±12.2; 7.8±4.3,0 vs.76.3±17.9,respectively,all P＜0.01).There were no significant differences in scores of PFIQ-7 between before and after sugery at 1-and 6-months follow-up (52.3±4.3 vs.49.8±6.3,51.1±6.5,P＞0.05).Conclusions Prolift pelvic reconstructive surgery is an safe and effective treatment for advanced pelvic organ prolapse,which can significantly improve quality of life in elderly patients.

According to the Rules for the Implementation of the Standards for Review of Level 3 General Hospital (2011) of Formor Ministry of Health,the paper analyzes the requirements of review of level 3 general hospital for decision support,and takes the Sixth Affiliated Hospital of Sun Yat-sen University as an example to introduce the decision support solution and the application of Decision Support System (DSS).

Objective To investigate the protection effects of recombinant human tumor necrosis factor-α receptor Ⅱ :IgG Fc fusion protein for injection (rhTNFR:Fc) on rats with collagen-induced arthritis (CIA) and analyze osteopontin (OPN) changes following therapy in order to understand its primary mechanism of action. Methods CIA was induced by bovine Ⅱ collagen (B Ⅱ C) injection. Rats were treated with rhTNFR:Fc from the 13th day after the first injection of B Ⅱ C till the 36th day. The anterior-posterior diameters of ankle joints and weight were measured weekly. The pathological score was evaluated by HE staining and toluidine blue staining. The blood plasma TNF-α and OPN levels were measured by ELISA and the histology expression was evaluated by immuno-histochemistry. Comparisons between groups were performed with one-way ANOVA. Results Quantitative analysis showed pathological score in the model group and treatment group was significantly reduced in joint pathology (8.2±1.0 vs 4.8±1.4, P<0.05). The mean plasma levels of TNF-α and OPN values were (713±146) pg/ml, (4.3±0.6) ng/ml respectively in the model group,but those of the treatment group were (68±20) pg/ml, (4.2±0.6) ng/ml. Serum TNF-α values were significantly different (P<0.05) between the two groups, while no significant difference was found in the value of plasma OPN (P=0.688) between the two groups. rhTNFR:Fc could reduce the cells OPN expression in the interface layer of the synovium and cartilage (P<0.05). Conclusion Pathology scores and ELISA results haveshown that rhTNFR:Fc has good therapeutic efficacy. It can significantly reduce the bone and cartilage damage of CIA mouse model, and can significantly reduce the expression of OPN in the sliding joints, thereby delay disease progression. However, it can not reduce the expression of OPN in the peripheral blood plasma.OPN may be involved in bone destruction and resorption rather than in inflammatory process.

Objective To investigate the safety,effectiveness and prognosis of percutaneous microwave ablation (MWA) combined with synchronous transarterial chemoembolization (TACE) to treat of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) with liver metastases (LMs).Methods This retrospective study included 19 cases of GEP-NENs with LMs patients who received percutaneous MWA combined with synchronous TACE treatment from 2013 to 2016.The mRECIST standard was selected to assess the curative effect.SPSS 21.0 software was applied in the statistical analysis of overall survival (OS),progression-free survival (PFS) and factors related to prognosis.Results All patients were capable of curative effect evaluation,including 1 case of complete remission (CR),3 cases of partial remission (PR),7 cases of progressive disease (PD) and 8 cases of stable disease (SD) respectively accounting for 5 ％,16 ％,37 ％,42 ％,which exhibited 21％ of response rate (RR) and 63％ disease control rate (DCR).In the present study,the median OS and median PFS was respectively 25 months and 34 months,and the one-year survival and three-year survival was respectively 95％ and 84％.Serum CA199,the WHO classification of LMs and the tumor burden of LMs were the major risk factors of prognosis through single factor analysis of survival,which showed that G3 of the WHO classification of LMs predicted a poor OS (P＜0.05) and tumor burden of LMs was negatively related to PFS (P＜0.05).It was obviously observed that serum CgA was decreased by the therapy of percutaneous MWA with synchronous TACEfor GEP-NENs (P＜0.05).Conclusions Percutaneous MWA combined with synchronous TACE is a safe and effective method to treat GEP-NENs with LMs.

Objective To explore the relationship between MspⅠpolymorphism of CYP1A1 gene and susceptibility to breast cancer in Yi nationality in Yunnan province. Methods The gene polymorphism of restriction enzyme of 3′-terminal of CYP1A1 was detected by PCR-RFLP in 60 healthy Yi women , 51 Yi women with breast cancer, 235 healthy Han women, and 250 Han women with breast cancer. Results The distribution frequency of CYP1A1-MspⅠgenotypes was significantly higher in Yi women with breast cancer (51.0%) than in the healthy Yi women (33.3%) (P < 0.05), an the allele C had a higher frequency in women with breast cancer than in healthy controls (P < 0.05). Significant differences of frequencies were found in genotypes TT, TC and CC between women with breast cancer and healthy controls (P < 0.05). The risks of TC and CC for breast cancer were 1.19 and 1.95 folds respectively to TT genotype. But as compared with Yi women , the distribution frequency of CYP1A1-MspⅠ genotypes did not differ between Han women with breast cancer and in the healthy control (P > 0.05), and there were no differences in three genotype frequencies (P > 0.05). Conclusions Gene polymorphism of CYP1A1 genotypes may be associated with the risk of breast cancer in Yi nationality but not in Han nationality in Yunnan. The mutation of CYP1A1 gene may increase the incidence of breast cancer in Yi nationality.