There are many defects in traditional clinical medical education,Socratic method has been used in law and commerce education,and we find it has the feasibility and operation to use the method in clinical medical education.

China′s economy has moved into a new normal stage.It features slower GDP growth, relaxed macro-control,economic structure upgrading,new powerhouses for economic growth.In such a situation,it is imperative for the society to realize,comply with and encourage the new normal for all fields of work.As for the healthcare sector,reform of public hospitals as a top priority has entered a crucial period of system reconstruction and effective operation.In the perspective of auditing governance mechanism as a key role in public hospital′s supervision and management system,this article tried to explore how to enable public hospitals′auditing to comply with the economic new normal.This paper puts forwards that public hospital auditing should reconstruct its system as follows:Auditing entity framework should strengthen the development of functionality and linkage among national auditing,internal auditing and social auditing,and public hospitals should try to set up their auditing committee system when necessary;Auditing contents should emphasize the multiple development and innovation of public welfare auditing,economic responsibility auditing,governance performance auditing,policy implementation effect auditing and more innovative auditing services.

AIM: To understand the formation of portal hypertension through the change of portal hemodynamics on experiment cirrhosis. METHODS: Carbon tetrachloride was subcutaneously injected in the rat. The changes of the portal hemodynamics in the pathological process of liver tissue were observed. RESULTS: The liver underwent degeneration, necrosis of hepatocytes, and the normal architecture of the liver lobules was replaced by pseudolobule, which consist of regenerative hepatocytes and fibrous septa. The diameter, the blood flow velocity and the blood flow quantity of portal were significantly higher than that in former group (P0 05). CONCLUSION: The changes in hemodynamics of the portal are in accordance with the changes in pathology of liver in the formation of liver cirrhosis.

Objective To observe the TCM syndrome changes of lung cancer patients before and after chemotherapy and the effect of Shengxuetang on dealing with side and toxic effects caused by chemotherapy and patient’s immune function. Method Phase III and IV lung cancer patients were randomly divided into two groups, treatment group and control group. Patients in the treatment group were given the combination of chemotherapy and Shengxuetang, while those in the control group were given the combination of chemotherapy and berbamine. Peripheral WBC count, HGB level, platelet count, T-cell count, and NK cell activity were measured, and other toxic effects were observed before and after chemotherapy. Results Before chemotherapy, there were two syndrome types, one is the deficiency of Qi and Yin, and the other is phlegm-damp due to deficiency of Qi accompanied with blood stasis. During the treatment, these two syndrome gradually transformed to the deficiency of both Qi and Yin and coagulation of phlegm and blood stasis. The chance for patients to develop myelosuppression had no difference between two groups, however, most patients in the treatment group developed grade I myelosuppression, while in the control group, most patients developed grade II myelosuppression. G-CSF was prescribed more in the control group than in the treatment group (P

Objective To investigate the expression and the roles of Angiopoietin 1(ang-1) and Angiopoietin 2(ang-2) in the endometrium of women with abnormal bleeding after medical abortion. Methods Analyzing endometrial pathological change of 1087 patients with abnormal bleeding after medical abortion in early pregnancy,and the endometrial specimens from 40 patients were randomly chosen for the study. The endometrial specimens from 20 women without abnormal bleeding after medical abortion were used as control group.Immunohistochemistry was used to detect the levels of Ang-1 and Ang-2 proteins in endometria. Results The percentage of patients with both the residul decidua and villus was 80.5%; positive immunoreactive signals of Ang-1 and Ang-2 were found in the endometrial glandular epithelium, stromal cells and the endothelial cells of vessels; the expression rate of Ang-1 and Ang-2 in the patients with abnormal bleeding were higher than that in the control group(P

Objective To analyse clinical characteristics and preventive methods of pregnancy-induced hypertensive severe pre-eclampsia with ascites.Methods 184 cases of patients with severe pre-eclampsia complicated with ascite were divided into two groups and the clinical characteristics were compared(severe pre-eclampsia complicated with ascite group,n=36;Severe pre-eclampsia group,n=148 cases).Results The average time of the termination of pregnancy was (34±4) weeks in severe pre-eclampsia complicated with ascites group,and (36±3) weeks in severe pre-eclampsia group (t=2.71,P＜0.01).There were 6 cases of intrauterine stillborn (16.67%),14 cases of neonatal mortality (38.89%);22 cases of premature labor (61.11%) in severe pre-eclampsia complicated with aacites group;There were 4 cases of intrauterine stillborn (2.7%);16 cases of neonatal mortality (10.81%);and 35 cases of premature labor (23.65%) in severe pre-eclampsia group (X~2=10.99,16.73,19.01,P＜0.001).There were differences in the total protein,albumin,white/ball ratio,lactic acid dehydregenase,serum creatinine,24-hour urinary protein between the two groups [total protein:(51.68±6.08) g/L vs (59.34±8.28)g/L,albumin:(24.32±4.06) g/L vs (32.16±5.63) g/L,white/ball ratio:(0.92±0.26) vs (1.16±0.26),lactic acid dehydrogenase:(495.87±312.56) U/L vs (323.81±185.00) U /L,serum creatinine:(131.62±95.34) μmol/L vs (91.52±86.83) μmol/L,24 h urinary protein(4.21±3.51)g/24 h vs (2.38±2.57)g/24h,t=6.17,8.77,5.50,4.79,2.72,3.98,P＜0.05 or ＜0.01].Conclusion Tbe condition of severe pre-eclampsia with ascites is extremely serious,so pregnancy should be timely terminated.The aacites can be dissipated after delivery.Early,systematic and regular prenatal care can prevent severe pre-eclampsia and complications in time.

Objective To investigate the relation between hepatic function of mothers and prognosis of fetuses in intrahepatic cholestasis of pregnancy(ICP).Methods 166 patients with ICP were retrospectively studied.Results The incidences of meconium passage and fetal distress were perfectly high in mothers of high serum transaminase and bilirubin.The birth weight and Apgar scores of neonate were related to the levels of bilirubin and we could predict the fetal prognosis by analysis of mother's serum bilirubin level.The serum total bile acid(TBA) levels and other hepatic indexes were not related to the incidences of meconium passage and fetal distress.Conclusions The fetal prognosis of mothers with high-level serum transaminase and bilirubin is bad,so they must be taken great aware of.The prognosis of fetuses can be bettered by cesarean section at proper time.

Objectives To investigate HPV infection and its correlati on with the expression of matrix metalloproteinase-9 (MMP-9) and tissue inhibito r of metalloproteinase-1 (TIMP-1) in vulvar squamous cell carcinoma (VSCC). Meth ods HPV6/11 and 16/18 DNA were detected using in situ hybridization in 26 case s of VSCC, 21 cases of vulvar intraepithelial neoplasia (VIN) and 10 specimens o f normal skin. The expression of MMP-9 and TIMP-1 was measured by immunohistoche mical method in these three groups. Results The infection rates of HPV6/11 and 16/18 in VSCC and VIN were 69.23% (18/26) and 38.46% (10/26), 42.86% (9/21) and 28.57% (6/21) respectively, and no HPV6/11 or 16/18 DNA was discovered in norma l skin epidermis. The expression rates of MMP-9 and TIMP-1 in VSCC, VIN and norm al skin epidermis were 92.31%(24/26) and 76.92% (20/26), 90.45% (19/21) and 80.9 5% (17/21), and 80.00% (8/10) and 50.00% (5/10) respectively. MMP-9 expression in HPV positive lesions was higher than that in HPV negative lesions, but no sig nificant difference of TIMP-1 expression was observed in HPV positive and negati ve lesions. Conclusions HPV infection may play a role in the development of VS CC. The higher expression of MMP-9 comparing with that of TIMP-1 may be an early marker of tumor progression in VSCC, and HPV infection may facilitate the invas ion and metastasis of VSCC.

Objective To study the effects of flavone compound α-NF on CYP1B1 gene in transplanted nude mice tumor with human paclitaxel resistance ovarian cancer cell. Methods Using 24 nude models of orthotopic transplantation of human ovarian cancer, they were divided randomly into four groups: control group, α-NF group, paclitaxel group and combined group. RT-PCR and Western blotting method were used to detect CYP1B1 mRNA and protein expression. Results There was no significant difference in CYP1B1 mRNA expression between α-NF group, combined group and control group(P >0.05). Compared with control group, CYP1B1 protein expression was distinctly lower in α-NF and combined group (P<0.01). Conclusion α-NF has no effect on CYPIB1 gene in mRNA level, whereas α-NF down-regnlate, CYP1B1 expression of transplanted A2780TS nude mice tumor in protein level, thus α-NF has the effect on reversing paclitaxel resistance of A2780TS cell.

Objective To explore the effect of hyperbaric oxygen combined with acupuncture and moxibustion on traumatic peripheral facial nerve injury, and the results of electromyography. Methods From January, 2007 to January, 2013, a total of 160 patients with traumat-ic peripheral facial nerve injury were divided into treatment group (n=80) and control group (n=80). Both groups received routine drug treat-ment. Hyperbaric oxygen combined with acupuncture and moxibustion was applied to treatment group in addition. The clinical efficacy and the results of electromyography were analyzed before and 36 days after treatment. Results After treatment, the cure rate and total efficiency was significantly higher (χ2>7.657, P<0.001), the motor latency of facial nerve was shorter (t>2.214, P<0.05), the M wave amplitude of fa-cial nerve was significantly higher (t>3.116, P<0.01), the number of recruitment potential was more (χ2=9.76, P<0.05), and the motor unit potential voltage was significantly higher (t>5.45, P<0.001) in the treatment group than in the control group. Conclusion Hyperbaric oxy-gen combined with acupuncture and moxibustion is more effective on traumatic peripheral facial nerve injury than routine.