The role-experience teaching method,including writing medical record,doctor-patient and doctor-nurse communications,preoperative anesthetic interview and theory teaching,was close to clinical practice and had strong operability,which was helpful to switching the role from medical student to clinical doctor successfully.This artical explores the application and experience of this teaching method in clinical practice of Respiratory Medicine.

Today,improving teaching quality and cultivating thinking innovation are the emphasis and difficulties in clinic teaching and will directly affect the ability of medical team and medical occupation in the future.This article begins with analyzing the disturbances of culturing innovation ability,discusses the change of medical teaching mode and induction of thinking innovation in order to provide theoretical foundation and practical reference for solving this teaching difficulty.

Gastrectomy ; Humans ; MicroRNAs ; analysis ; Statistics as Topic ; Stomach Neoplasms ; genetics ; metabolism

sers should offer good care in mental, physical, social aspects to improve their comfortable state.

Objective To explore the nursing intervention on the pregnant women with syphilis during pregnancy so as to reduce the harm to maternal and baby.Methods Many information such as age,occupation,dwelling environment,marriage and sexual life,curing during pregnancy,pregnant and perinatal infant outcome from medical records were reviewed. Gestational syphilis women of 847 cases were randomly divided into nursing intervention group with 427 cases and control group with 420 cases.Nursing intervention group received one-by-one psychological care and health education,got cooperation from families,and received routine blood test and cure cooperation,while control group only received routine blood test and curing cooperation.Patients were followed up for seven days.Results The rate of adherence to treatment in nursing intervention group was 98.1％ which was significantly higher than 61.7％ in control group ( x2 =176.2,P ＜ 0.01 ),and the rate of accepting standard treatment between early and late pregnancy,middle and late pregnancy were significantly higher than that in control group ( x2 =17.8,P ＜ 0.01 ).The week was shorter for receiving nursing intervention and the patients' compliance was better ( P ＜ 0.01 ). Only 23 syphilis infection babies in the nursing intervention group were born,but 149 babies in control group were infected by syphilis,and the difference was significantly different( x2 =123.2,P ＜ 0.01 ).Conclusions Nursing intervention can effectively increase the compliance of pregnant women with syphilis and improve the outcome of pregnancy and perinatal infant.

Objective To evaluate a new system,Vitek 2 Compact,for identification of bacteria and yeasts.Methods 185 clinical isolates of Peking Union Medical College Hospital,including 69 gram- positive strains,66 gram-negative strains and 50 yeasts,and 50 reference strains in our laboratory,including 25 gram-positive and gram-negative strains respectively,were studied.All the strains were identified by Vitek 2 Compact with GP,GN or YST identification cards.The API method was used as the reference method.Results Among the 93 gram-positive strains,85 strains(91.40%)were correctly identified, including 5 low discrimination identified strains,and 8 strains(8.60%)were correctly identified to the genus level,but misidentified to the species level.About 90% of gram-positive strains were identified within 7 h.Out of 91 gram-negative strains,90 strains(98.90%)were correctly identified,with 5 low discrimination identified strains,only 1 strain(1.1%)was correctly identified to the genus level,but misidentified to the species level.Above 90% of Enterobacteriaceae were identified within 5 h,and over 90% of nonfermenting bacteria were identified within 10 h.In the 50 strains of yeasts,46 strains(92%) were correctly identified,including 8 low discrimination identified strains,and 4 strains(8%)were correctly identified to the genus level,but misidentified to the species level.In all the yeasts,45 strains (90%)were identified in 18.25 h,and another 5 strains(10%)were identified in 18.50 h.Conclusions As Vitek 2 Compact system can give us reliable identification results of clinically relevant bacteria and yeasts,together with its significant reduction of handling time,it will definitely become a powerful tool in clinical microbiology laboratory.

Objective To evaluate a new system,Vitek 2 Compact,for antimicrobial susceptibility testing(AST)of gram-negative and gram-positive bacteria.Methods Eighty-nine clinical isolates of Peking Union Medical College Hospital,including 48 gram-negative strains and 41 gram-positive strains,and 66 reference strains kept in our laboratory,including 41 gram-negative strains and 25 gram-positive strains, were studied.The antimicrobial susceptibility of these strains were tested by Vitek 2 Compact with AST- GN09(for gram-negative bacteria),AST-P536(for Staphylococci),AST-P534(for Enterococci and S.agalactiae),and AST-P533(for S.pneumoniae)susceptibility cards.The Etest was used as the reference method for comparision.Thirty-two ESBL-producing strains assessed with the confirmatory tests for ESBLs of CLSI(16 strains of them had been confirmed by PCR amplified and sequencing)were detected for ESBLs by Vitek 2 Compact.Results According to the breakpoints of Clinical and Laboratory Standards Institute (CLSI),for the 1 626 microorganism-antibiotic combinations,Vitek 2 Compact gave 90.83% strains with category agreement(CA),4.91% strains with very major errors(VME),2.09% strains with major errors (ME),6.40% minor errors(MIE).The AST for more than 90% of Enterobacteriaceae,nonfermenting bacteria,micrococci and streptococci were completed within 11h,13h,11h and 12h,respectively.The ESBLs tests for thirty-two strains by V-itek 2 Compact are all positive.Conclusions Vitek 2 Compact system can give rapid,reliable and reproducible result with high sensitivity and specificity in assessment of antimicrobial susceptibility testing for clinically relevant gram-negative and gram-positive bacteria,and would become a powerful tool in clinical microbiology laboratory.

AlM:To compare the differences of tilt and decentration of two aspheric posterior chamber intraocular lens ( PC-lOL) implantation by ultrasonic biomicroscope ( UBM) .METHODS:Thirty-seven patients ( 45 eyes ) underwent cataract surgery were distributed to two groups randomly. Group A was implanted with Akreos AO ( Bausch &Lomb; four-haptic ) while group B implanted with ZCB00 ( Abbott Medical Optics, lnc. AMO; two-haptic) . All eyes underwent standard phacoemulsification with intraocular lens implantation. Diameter of capsulotomy was recorded. One month postoperatively, vision, best-corrected visual acuity ( BCVA) assessment, slit lamp examination, and anterior chamber depth ( ACD ) measured by UBM were performed. Tilt and decentration were measured horizontally and vertically, and total tilt and decentration were calculated by geometry method.
RESULTS:No statistical difference was found in BCVA and diameter of capsulotomy between two groups ( P>0. 05). The mean ACD of group A and group B were 3. 86mm ± 0. 31mm and 4. 14mm ± 0. 31mm respectively, which showed it had statistically significant difference ( P<0. 05). Horizontal decentration, vertical decentration and total decentration of group A were 0. 15mm ± 0. 09mm, 0. 15mm ± 0. 12mm and 0. 22mm ± 0. 12mm respectively, while it were 0. 22mm ± 0. 21mm, 0. 14mm ± 0. 15mm, 0. 29mm±0. 22mm for group B. Horizontal tilt, vertical tilt and total tilt of group A were 0. 63°±0. 62°, 0. 89°±0. 85°and 1.22°±0.76°, while it were 1.36°±1.48°, 1.46°±1.62° and 2. 21°±1. 97° for group B. No statistically significance was found in tilt and decentration between group A and group B, no matter horizontally or vertically or totally (P>0. 05).CONCLUSlON:Two-haptic lOL shows no difference in tilt and decentration with four-haptic lOL postoperatively.

Glaucoma is a group of diseases which can threaten and damage the optic nerve and its visual pathway, leading to visual impairment as a result. Glaucomatous optic neuropathy is a chronic disease accompanied by apoptosis of retinal ganglion cells ( RGCs ) , visual field defect and cupping of optic nerve head. The gold standard in functional glaucoma evaluation is standard automated perimetry ( SAP) , but it is often limited to the subjective feelings of the patients. Still, visual electrophysiological techniques cannot replace the conventional inspection, but with its rapid development, it has provided a new strategy for the early diagnosis of glaucoma as a supplement because it can show changes in amplitude and latency before visual field defect. Here we review three special electroretinograms and multifocal focal visually evoked potentials in the early diagnosis of glaucoma.

Aim To investigate the cardiotoxicity of propofol and thiopental. Methods 4day-old contracting neonatal primary myocardial cells obtained from 2-to 3-day-oldWistar rats were divided into 5 groups, with normal contrast group, and the cellcultures in groups PL, PH, TL and TH, were treated with propofol(3 ? 10-5 and3 ? 10-4 mol? L) and thiopental (1 ? 10-5 and 1 ? 10-4 mol?L) for 8 h.The con-tractility and morphology of the cells were observed and the cytoplasmic enzyme(LDH, AST, CK and ALP) release content of myocardial cell and the concentrationof electrolytes (K +, Na +, Cl - and Ca2+ ) in the medium were measured 8 h afterintravenous anesthetics administration. Results In groupPH and TL decreasedsignificantly (P