Based on the discussion of the present English teaching in medical colleges and universities in China,this paper clarifies the mission and task of English teaching in medical colleges and universities and proposes that medical colleges and universities should attach importance to the education goals and needs of the department,major and students in the information age.It is believed that a scientific,reasonable and perfect English curriculum can be achieved by integrating IT into English curriculum,applying individualized teaching mode and expanding course connotation.

This paper first explains the contextual theory,then it analyses the contextual characteristics under network environment with multimedia.At last,according to systematic functional linguistics,it discusses the implications of how to take advantage of the contextual characteristics in College English teaching and learning.

Objective To understand the related analysis of the cause of atrial fibrillation and atrial size.Methods Among 133 cases of inpatients suffened atrial fibrillation,the 12 lead electrocardiogram(ECG) was recorded to analyze atrial fibrillation,and the echocardiography was used to measure the atrium size.Results The diameter of left atrium was obviously enlarged along with the age,but the variety of right atrium was unobvious.The left atrium enlargement was present in 68% with atrial fibrillation,among which the left atrium enlargement were present in 40.46% with hypertension heart disease(54 cases),in 35.33% with coronary heart disease(47 cases),and in 14.28% with valve disease(19 cases).Conclusion The left atrium enlargement is related to atrial fibrillation.We infer that atrial fibrillation could enlarge the left atrium,rather than that is induced by the left atrium enlargement.

Objective To investigate the comparison of clinical curative effect and inflammation factors between irbesartan hydrochlorothiazide and candesartan cilexetil in the treatment of patients with hypertension.Methods A total of 86 patients with hypertension in our hospital from June 2014 to October 2015 were collected and randomly divided into two groups, 43 cases in the control group were treated by candesartan cilexetil,43 cases in the experimental group were treated by irbesartan hydrochlorothiazide.The blood pressure, CRP, IL-6 and NO indexes were detected in the two groups and the clinical curative effect of the two groups was compared.Results The systolic pressure and diastolic pressure levels in the experimental group were significantly lower than the control group ( P <0.05 ); the serum CRP, IL -6 levels in experimental group were significantly lower than the control group, the NO level was significantly higher than the control group (P<0.05).Conclusion Irbesartan hydrochlorothiazide in the treatment of patients with hypertension has a better clinical curative effect, and higher security.

Objective:To investigate the effect of gegenqinlian on serum TNF-αlevel in rats with chronic periodontitis and athero-sclerotic.Methods:40 healthy male Wistar rats were randomly divided into control group(N,n =10)and model group(D,n =30).After model establishment and identfication the rats in model group were divided into D1,D2,D3,D4 and D5 groups(n =5) and were administered with saline,metronidazole,atorvastatin,metronidazole combined with atorvastatin and gegenqinlian respec-tively for 4 weeks.Periodontal indexes(PD and AL)were measured,the maximum intima-media thickness of abdominal aorta(IMT) was pathologically examined,TNF-αlevel was detected by ELISA.Results:After treatment PD,AL and serum TNF-αlevels in D2,D3,D4 and D5 groups were significantly lower than those in D1 group(P <0.05),There was no difference of lipid and TNF-αlevels between D4 and D5 groups(P >0.05).Conclusion:Gegenqinlian can reduce serum level of TNF-αin rats,suggesting that the drug is effective in the treatment of periodontitis with atherosclerosis.

Objective to investigate the efficacy of functional electrical stimulation(FES)on the postoperative treatment of lumbar disc hernia-tion. Methods Informed consents were obtained from all the subjects before the study. totally 60 patients who had remnant nervous lesion after sur-gery of lumbar disc herniation were divided into two groups:FES group and Control group. FES group received treatment since the first day after sur-gery. the parameters of therapeutic apparatus were as follows:35 Hz,0.28 ms,1 time daily and 30 min each time. the intensity of the treatment was the maximum tolerated that the patients can take. the course was 4 weeks. the control group during the study did not receive any stimulation. the myodynamia of hallux dorsiflexion and JOA score of patients were recorded and analyzed. Results After 2 weeks treatment,the myodynamia of FES group was 15.10±5.03,which was significantly larger than that of the control group at 12.03±6.30(P < 0.05). After 4 weeks treatment,the myody-namia of FES group was 20.43±5.73,which was significantly larger than that of the control group at 14.57±7.17(P < 0.05). After 4 weeks of treat-ment,the JOA score of FES group was 24.63±1.91,which was significantly higher than that of the control group at 19.87±2.33(P < 0.05). Conclu-sion After 2-4 weeks of functional electrical stimulation therapy,myodynamia of hallux dorsiflexion in FES group was significantly improved. And at the 4th week after operation,JOA score was more higher than that of the control group. Functional electrical stimulation in the treatment of remnant nervous lesion after postoperative of lumbar disc herniation has exact curative effect,which is worthy of popularization.

Objective To study the curative efficacy of different doses of atorvastatin combined with fenofibrate in treatment of mixed type hyperlipidemia and its effects on blood lipid and prognosis.Methods 120 patients of mixed type hyperlipidemia who received therapy were selected as research subjects.According to random number table,the patients were divided into A group (n=60) and B group (n=60).The two groups were treated with atorvastatin and fenofibrate,the dose of atorvastatin in A group was 10mg,which in B group was 20mg,fenofibrate dose was 200mg.After 4 weeks of treatment,the therapeutic effect was compared.Results After treatment,the blood lipids of the two groups were improved(P<0.05),but total cholesterol (TC),triglyceride (TG),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C) in A group were better than those in B group[(5.20±0.31)mmol/L vs.(5.87±0.46)mmol/L,(2.61±0.29)mmol/L vs.(3.85±0.34)mmol/L,(1.12±0.17)mmol/L vs.(0.93±0.13)mmol/L,(3.03±0.32)mmol/L vs.(3.48±0.41)mmol/L](t=9.355,21.493,6.877,6.702,all P<0.05).There was no significant difference in the total effective rate between the two groups[96.67%(58/60) vs.91.67%(55/60)](x2=1.365,P>0.05).The incidence rate of adverse reactions in A group was lower than that in B group[96.67%(58/60) vs.76.67%(46/60)](x2=6.171,P<0.05).Conclusion Low dose (10 mg) of atorvastatin combined with fenofibrate for mixed type hyperlipidemia has good lipid regulating effect,and adverse reaction is low,has little effect on the liver function of patients,which can effectively improve the prognosis,it is worthy of application and promotion.

Objective:To explore the predictive value of computed tomography (CT) texture analysis for the recurrence in children with acute pancreatitis (AP).Methods:The clinical diagnostic test was conducted. The clinical data of 56 children with primary AP who were admitted to Wuhan Fourth Hospital from January 2016 to January 2018 were collected. There were 13 males and 43 females, aged from 3.5 to 13.0 years, with a median age of 5.5 years. Based on follow-up in other hospitals, 20 children with recurrence of AP were allocated into recurrence group, and 36 children without recurrence were allocated into non-recurrence group. All the 56 children underwent abdomen plain and enhanced CT scan within 24 hours after first admission. Observation indicators: (1) comparison of clinicopathological features between two groups of children with AP. (2) comparison of CT texture parameters between two groups of children with AP. (3) diagnostic efficacy of clinical features and CT texture parameters. Follow-up using outpatient reexamination and telephone interview was conducted to detect recurrence of AP up to February 2020. The duration of follow-up required more than or equal to 24 months. The Shapiro Wilk test was used to analyze normality of measurement data. Measurement data with normal distribution were repre-sented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M (range) or M ( P25, P75), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was analyzed using the chi-square test. Comparison of ordinal data was conducted using the Mann-Whitney U test. Clinical parameters and CT texture parameters with statistical differences were multivariate analyzed using the Logistic regression model. Receiver operating characteristic curve (ROC) analysis was used to evaluate the predictive efficacy of parameters for recurrence of AP. Results:(1) Comparison of clinicopatholo-gical features between two groups of children with AP: cases with or without complications were 14 and 6 for the recurrence group, versus 7 and 29 for the non-recurrence group, showing a significant difference between the two groups ( χ2=14.021, P<0.05). Cases with minimal, moderately severe or severe disease (severity of disease) were 2, 5, 13 for the recurrence group, versus 19, 11, 6 for the non-recurrence group, showing a significant difference between the two groups ( Z=5.414, P<0.05). (2) Comparison of CT texture parameters between two groups of children with AP: the energy value in the arterial phase on CT examination was 0.186(0.174,0.206)for the recurrence group and 0.413(0.405,0.425) for the non-recurrence group, showing a significant difference between the two groups ( Z=9.413, P<0.05). The energy value and entropy value in the venous phase on CT examination were 0.084(0.078,0.092) and 0.961(0.210,1.720) for the recurrence group, versus 0.135(0.124,0.156) and 0.372(0.210,0.535) for the non-recurrence group, showing significant differences between the two groups ( Z=4.763, 7.243, P<0.05). (3) Diagnostic efficacy of clinical parameters and CT texture parameters: results of multivariate analysis showed the complications, severity of disease, energy value in the arterial phase on CT examination were related factors for recurrence in children with AP, energy value and entropy value in the venous phase on CT examination were related factor for recurrence in children with AP ( odds ratio=0.874, 0.765, 0.837, 0.902, 0.813, 95% confidence interval as 0.802?0.985, 0.581?0.914, 0.753?0.897, 0.862?0.948, 0.765?0.873, P<0.05). Results of ROC analysis showed that that areas under curve (AUC) of complications, severity of disease in the clinical parameters were 0.734 and 0.832, the AUC of single CT texture parameter was 0.811?0.867, the AUC of clinico-pathological parameters combined with CT texture parameters was 0.882. Conclusion:CT texture analysis can early and non-invasively predict the recurrence of AP in children, and the combination of clinicopathological parameters with CT texture parameter has a better predictive efficacy.

Objective To investigate the therapeutic effects of atorvastatin on pulmonary fibrosis of rats induced by Bleomycin (BLM). Methods Fourty-two female Wistar rats were randomly divided into 7 groups: the control group(group C) , the model group which was furtherly divided into group 2-week (M2) , 4-week (M4) , 6-week (M6) , and atorvastatin-treatment group which was furtherly divided into group 2-week (A2) , 4-week (A4) , 6-week(A6). Group M and A were induced to pulmonary fibrosis by the method of BLM endotracheal injection, while group C was injected with saline. On 2nd day, group A were given orally atorvastatin by 10 mg/kg · d. Rats were seperately killed on 2nd, 4th and 6th week. After intratracheal injection of BLM, alveolitis and pulmonary fi-brosis were evaluated by pathology, hydroxyproline concentration and PaO_2. Results The lung coefficient of group M2, M4, A2 and A4 was significantly higher than that of group C. The degree of pulmonary fibrosis in group A4 and A6 was improved as compared with group M4, M6. Alveolitis and pulmonary fibrosis in group A were improved compared with those in group M. Hydroxyproline concentration in group A and M were significantly higher than that in group C. While A4 was lower than M4 (P <0. 01). There was a decrease in PaO_2 after exposure to BLM, espe-cially in group M2 (P <0. 01). Improvement in PaO_2 was documented in groups A, compared with M. Conclusion Atorvastatin has centtain efficacy in treatment of pulmonary fibrosis of rats. The effect was significant on 6th week after treatment, which suggest that the effect is correlated positively to the carly treatment.

Objective To study the pathological,ultrastructural and immunohistochemical features of kidney oncocytoma (RO). Methods The clinical and histological features of 13 patients (5 men and 8 women;mean age,58 years,age 44 -78 years) with RO were observed.Immunohistochemical staining was performed on paraffin-embedded tissues with a panel of antibodies including vimentin,EMA,ckpan,CK7,CK18,E-cadherin,CD10,RCC,CD117,34βE12,HMB45,s-100 and Ki-67.Of the 13 cases,10were found incidentally during a health examination while the other three cases presented with lumbago and discomfort of the lumber.Four cases were analyzed by electron microscopy.Eleven were treated with radical nephrectomy and 2 with partial nephrectomy. Results Histologically,the tumor cells were mainly arranged in closely packed nests,aciniform or tubule with an occasional microcystic pattern in loose edematous hypocellular fibrous stroma.Tumor cells had moderate to abundant granular eosinophilic cytoplasm with a small,round and uniform nucleus containing finely and evenly dispersed chromati.However,focal nuclear atypia were observed with no mitotic activity.Immunohistochemically,all cases were diffusely positive for CK18 and showed variable immunoreactivity for E-cadherin,CD117,CD10 and CK7.Twelve cases were positive for EMA. All cases were negative for vimentin,34βE12,HMB45 and s-100.The proliferative index (Ki-67) was very low in all cases,with less than 1％ of the nuclei labeled.Electronic microscopy showed the cytoplasm had abundant mitochondria with lamellar cristae.Follow-up on 10 patients ( range from 2 to 67months) showed no recurrence or metastasis. Conclusions Tumor cells arranged in nests with loose hypocellu]ar and edematous stroma is the most important histological feature of RO.The immunohistochemical features could be helpful for both diagnosis and differential diagnosis.