Wuhan University built up a new modular integrated curriculum in clinical medicine oriented for post competence,by learning from the successful international experience and the course of vertical and horizontal integration.The curriculum focused on five modules (including humanities and vocational course,courses of integrated medicine,clinical practice and thinking,innovation awareness and ability,prevention and health promotion program) and the eight integrated curriculum (including human structure,organization and function,cell,molecule and gene,reaction,nerve injury science,pathogen biology,CPPT,clinical skills).During the curriculum implementation,Wuhan University vigorously promoted the group discussion teaching,cultivated high-quality core teaching team,and effectively carried out curriculum construction and teaching evaluation,which effectively improved the level and quality of medical personnel training.

Objective To assess the association between interleukin-10-1082 (IL-10-1082) gene polymorphisms and susceptibility of gastric cancer in the Chinese population.Methods Cochrane systematic evaluation was adopted for the analysis.Articles published in Medline,Embase,Cochrane library,CBM,CJFD and CSJD from 1966 to 2012 were retrieved.Case control studies on the correlation between the 1L-10-1082 polymorphism and gastric cancer in Chinese population were collected.Gastric cancer patients were in the gastric cancer group,and healthy individuals were in the control group.Two researchers extracted data and evaluated the quality of literatures independently.Meta analysis was performed to detect whether there were differences between the gastric cancer group and the control group about the distribution of genotypes of IL-10-1082 gene (GG,AA,AG,AA,alleles G and A).The heterogeneity was analyzed using the Q test or I2 test.Fixed effect model or random effect model was adopted,and the results of the meta analysis were presented with odds ratio (OR) and 95％ confidence interval (95％ CI).Results Thirteen literatures including 5252 patients were included in the analysis.There were 2077 patients in the gastric cancer group and 3175 patients in the control group.The results of meta analysis showed that population with the genotypes GG and AG have higher risk of having gastric cancer when compared with population with the genotype AA (OR =1.76,95％ CI 1.33-2.33 ; OR =2.08,95％ CI 1.62-2.66,P ＜0.05).Population with the allele G have higher risk of having gastric cancer when compared with population with allele A (OR =1.67,95％ CI 1.31-2.13,P ＜ 0.05).Conclusion The genotypes GG,AG and the allele G of IL-10-1082 gcne of the Chincse population are significantly associated with the increased risk of gastric cancer.

Objective To define the value of DCE and DWI in assessing malignant and benign lesion in periamapullary regions . Methods The data of dynamic contrast enhancement magnetic resonance imaging (DCE‐MRI) and diffusion‐weighted imaging(DWI) of 43 patients (32 malignant and 11 benign lesions) were analyzed retrospectively ,who have been diagnosed as biliary strictures in ampullary regions .One radiologist compared the signal intensity of DCE‐MRI and DWI of malignant and benign periamapullary le‐sions .Two other radiologists assessed data of DCE‐MRI and data of combined DCE‐MRI and DWI from those periamapullary lesions respectively .And then we compared the diagnostic sensitivity and specificity of each type of data by receiver operating characteristic (ROC) curve analysis .Results Malignant and benign periamapullary lesions showed no statistically significant difference on DCE‐MRI;Malignant periampullary lesion were more frequently appeared hyperintense than benign lesions on DWI ,and hypointense on ADC (P<0 .001) .Diagnostic accuracy improved from 84 .4% to 96 .9% and 87 .7% to 96 .6% for both reviewers after adding DWI on diagno‐sis of malignant periampuullary lesions .Conclusion The combination of DCE‐MRI and DWI can improve the diagnostic accuracy for differentiating malignant from benign strictures in the periampullary region .

Objective To investigate MRI characteristics of subacute combined degeneration(SCD)with secondary spinal canal stenosis.Methods The clinical and MRI imaging data of 56 patients with SCD were collected to analyze the performance characteristics between spinal cord lesions and spinal canal stenosis,which depended on the synergism of lumbar disc bluge or herniation,degenerative thickening of the ligament flavum and posterior longitudinal ligament.Results Among 56 SCD cases underwent MRI scan,45 cases were combined with spinal cord lesions which showed typical signs of SCD.37 patients were secondary spinal canal stenosis with typical signs,but 2 showed no typical signs.8 patients were no secondary spinal canal stenosis and showed typical.9 cases showed neither spinal cord lesions nor secondary spinal canal stenosis.There was significant difference (P <0.05)between relative secondary spinal canal stenosis and spinal anomaly signal.The course of 1 5 cases were shortened after treated by physical in 37 cases of SCD with secondary spinal canal. Conclusion The secondary spinal canal stenosis can cause microcirculation dysfunction of the spinal cord,which is a key factor contributing to the imaging manifestation.

OBJECTIVETo analyze the correlation between mitral regurgitation grading and left ventricular ejection fraction in elderly patients (>60 years of age) in a 2-year follow-up.

METHODSA total of 455 patients with the diagnosis of at least mild mitral regurgitation by echocardiography were divided into ischemic mitral regurgitation (IMR) group and non-ischemic regurgitation (NIMR) group. The patients were followed up with echocardiography every 6 months and the data were analyzed at the end of 24 months.

RESULTSMitral regurgitation grade was inversely correlated with left ventricular ejection fraction (LVEF). Patients with moderate and severe IMR had a lower LVEF than those with NIMR (P<0.05). After adjustment for age, sex, body mass index, high blood pressure, diabetes, atrial fibrillation and cardiomyopathy, the mean LVEF at 2 years was lowered by 2.7% (1.4%-4.1%), 2.7% (1.3%-4.0%), and 5.2% (3.5%-6.9%) in mild, moderate and severe IMR patients, respectively (P<0.04), and by 3.2% (1.6%-4.8%), and 3.0% (1.4%-4.5%), and 1.7%(-0.5%-3.9%) in mild, moderate and severe NIMR patients (P=0.30).

CONCLUSIONThe mean LVEF in IMR patients is significantly lowered compared to that in NIMR patients. The grade of mitral regurgitation is inversely correlated with the regurgitation area in IMR patients. Stratified management might help improve LVEF in severe IMR patients.

Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Male ; Mitral Valve Insufficiency ; Stroke Volume ; Ventricular Dysfunction, Left ; physiopathology