Objective:To explore the effect of SimMan 3G simulator based scenario simulation teaching method and case-based learning (CBL) in emergency medicine teaching.Methods:Sixty students from Batch 2013 eight-year program of clinical medicine were selected as subjects. They were randomly divided into an experimental group and a control group, with 30 students in each group. In the teaching of emergency medicine, the experimental group used the combination of scenario simulation with CBL teaching methods, and the control group used classic teaching methods. The test scores and the questionnaires satisfaction of the two groups were compared to evaluate the teaching effects. SPSS 17.0 was used for the statistical analysis, measurement data were compared between the groups by t test, and counting data were compared between groups by chi-square test.Results:The scores of the experimental group (94.24±1.13) were better than those of the control group (90.6±0.59), with significant differences ( t=12.85, P<0.05). The results of the questionnaires showed that the students of experimental group were more satisfied with the learning experience than those of the control group. Conclusion:The teaching method can improve the teaching effects, the students' emergency clinical thinking, skills, comprehensive analysis and judgment ability, team cooperation consciousness and leadership ability.

Fetal cystic lymphangioma is a developmental anomaly of the lymphatic system, which can occur in any part of the body, but most commonly in the neck and armpit. A case of fetal cystic lymphangioma located at the chest wall under the right armpit with a size of 21 mm×18 mm×16 mm is reported here. The mass was initially diagnosed by routine ultrasound examination at 21 gestational weeks. After the diagnosis, ultrasound was repeated every 4 weeks till 37 +4 gestational weeks. Over this period, the mass increased progressively to 101 mm×110 mm×95 mm. Ultrasound-guided intrauterine fetal cystic mass puncture and aspiration was performed 38 +4 weekss, and Bleomycin was injected into the cyst after operation and on day 42 after birth. During a follow-up to 10 months after birth, no obvious cystic mass was found at the right axillary chest wall of the child.

Objective To investigate the relationship between QRS wave terminal distortion with coronary arterial lesion and serum high-sensitivity cardiac troponin I (hs-cTnI) in early stage of acute ST-segment elevation myocardial infarction (STEMI).Methods One hundred and twenty patients with STEMI were classified into the QRS wave distortion positive group(QRS+,n=81) and non-QRS wave distortion group(QRS-group,n=39) according to EKG on admission.The two groups all conducted the coronary angiography and hs-cTnI detection.The coronary arterial lesion occurrence situation and hs-cTnI level were compared between the two groups.Results (1) In the QRS+ group:68 cases (83.59％) were male and 13 cases (16.05％) were females;in the QRS-group:27 cases(69.23％) were male and 12 cases (30.77％) were female.The sex difference had statistical significance (P＜0.05).(2) The occurrence rate of left anterior descending artery (LAD) lesion in the QRS+ group was higher than that in the QRS-group,the difference was statistically significant (P＜0.05).But the occurrence rate of left circumflex coronary artery (LCX) lesion in the QRS-group was higher than that in the QRS+ group,the difference was statistically significant (P＜0.01).(3) The hs-cTnI level in the QRS+ group was higher than that in the QRS-group,the difference was statistically significant (P ＜0.01).Conclusion The patients with QRS wave distortion positive have a higher occurrence rate of LAD lesion,while the patients with out QRS wave distortion negative have higher occurrence rate of LCX lesion;the QRS wave terminal distortion has relationship with serum hs-cTnI level.