Choosing a suitable textbook is the most important part to ensure the quality of in-ternational students' education. By comparing the advantages and disadvantages of English textbooks, domestic publishing textbooks and institutions self-made teaching materials, and combining with inter-national students' textbooks usage and investigation, we fine problems such as students' lower satisfac-tion of textbooks and better evaluation in original English textbooks than the domestic publishing text-books and college self-made teaching materials, so we advocate that we should select a good textbook, strengthen the construction of teachers and teaching materials, offer special medicine courses, establish an effective network teaching platform and attach importance to students' feedback.

Objective To analyze and evaluate the efficacy of intramedullary interlocking nail in the treatment of long bone fractures.Methods From July 1997 to October 1999,100 cases of long bone fractures were treated intramedullary interlocking nail,including 25 fractures of tibia and fibula at middle site tibia,35 at middle-lower,31 middle femoral,9 middle-lower of femoral.Results The period from 3 to 19 months with an average of 13 months for followed-up.The average fracture healing time was 14 weeks.According to Johnenand-Wruh evaluation method,98 of 100 patients(98%) were excellent osteosythesis,one case was good and only one case was bad.Conclusions The treatment of long bone fractures with intramedullary interlocking nail is a good way.It has high healing rate,and pathologic rigidity of joint movement is fewer.But the method has some limits for operative indication and its special complications also to be explored further.

Objective To investigate the expression level and clinical significance of serum IL-18 and MCP-1 in patients with Chronic Obstructive Pulmonary Disease(COPD).Methods Serum IL-18 and MCP-1 levels were measured in healthy people( control group,30 cases) and in patients with COPD (acute stage group and stable stage group,30 cases in each group).At the same time,the level of serum CRP and forced expiratory volume in one second ( FEV1 ),the forced expiratory volume in one second/forced vital capacity ( FEV1/FVC％ ) were tested in the three groups.The variation.of the level of serum IL-18 and MCP-1 and the correlation between these index with lung function and CRP were analyzed.Results The levels of serum IL-18 and MCP-1 in acute stage group ( IL-18 [ 69.29 ± 16.14 ] ng/L,MCP-1 [ 123.95 ± 32.06 ] ng/L) were significantly higher than those in stable stage group ( IL-18 [ 53.15 ± 14.74 ] ng/L,MCP-1 [ 96.46 ± 18.24 ] ng/L) ( F =10.975,P ＜0.01 ),and also significantly higher than those in control group ( IL-18 [ 37.53 ± 14.55 ] ng/L,MCP-1 [60.86 ± 17.26] ng/L) ( F =18.101,P ＜ 0.01 ).In acute stage group,positive correlations were obtained among the level of serum IL-18,MCP-1 and CRP ( r =0.688,P ＜ 0.05 ; r =0.663,P ＜ 0.05 ; r =0.825,P ＜0.01 ),and they were correlated negatively with FEV1 and FEV1/FVC％ ( r =- 0.732,P ＜ 0.01 ;r =- 0.586,P ＜0.05 ).In stable stage group,the level of serum MCP-1 was correlated positively with the level of IL-18( r =0.674,P ＜ 0.05 ) and with the level of CRP ( r =0.719,P ＜ 0.05 ),but it was correlated negatively with FEV1 and FEV1/FVC％ ( r =-0.512,P ＜ 0.05 ;r =-0.557,P ＜ 0.05 ).Conclusion The serum IL-18 and MCP-1may be one of the inflammation markers in patients with COPD and may be associated with airway inflammation and limited airflow.

Objective To investigate the ideal methods for correction of lower eyelid retraction by lateral canthal anchoring.Methods The authors retrospectively reviewed the records of 126 patients(207 eyelids) operated on between June 1999 and 2005 by one senior surgeon.The age of the patients ranged from 28 to 72 years(mean,46 years).Transcanrhal canthopexy was used in 20 patients(33 eyes);The 3 mm tarsal strip procedure was used in 35 patients(57 eyes);Transcanrhal canthopexy combined with Hamra's lower blepharoplasty was used in 26 patients(45 eyes).The tarsal strip procedure combined with Hamra's procedure was used in 45 patients(72 eyes).75 patients(123 eyes) were followed up for 6～12 months.Mean follow-up time was 8 months. Results Of them,125 patients were uniformly satisfied with their cosmetic and functional outcome at last follow-up;one patient had undercorrection of retraction.There were no major complications and only one minor complications(corneal irritation from graft sutures),which resolved in the early follow-up period.Conclusions The lateral canthal anchoring is an effective,aesthetic,and functional treatment for moderate to severe lower eyelid retraction resulting from multiple causes.This procedure is associated with predictable results,a low morbidity rate,and high patient satisfaction.

Spread into regional lymph node is the major route of metastasis in cervical cancer.Although lymph node status is not involved in the International Federation of Gynecology and Obstetrics stagingsystem of uterine cervical cancer,the presence or absence of lymph node metastasis provides important information for prognosis and treatment.In this review,we have attempted to focus on the incidence and patterns of lymph node metastasis,and the issues surrounding surgical assessment of lymph nodes.In addition,the preoperative prediction of lymph node status,as well as the intraoperative assessment by sentinel nodes will be reviewed.Finally,lymph node micrometastasis also will be discussed.

Objective To investigate perinatal outcomes of twin pregnancy.Methods Perinatal outcomes of 658 pregnancies with twins hospitalized and born at Beijing Obstetrics and Gynecology Hospital during 2002 to 2005 were retrospective analyzed to compare the influence of type of twin,delivery mode, gestational week,birth time interval between twins,as well as specific complications of twin pregnancies on their outcomes.Results Pefinatal fatality of monzygous twins was 53.69 per thousand(16/298),higher than that of dizygous twins(27.11 per thousand,9/332),with U=2.35,P0.05.Perinatal fatality was higher in twins with different development (birth weight).Perinatal fatality in dizygous twins(12.5 percent,2/16)was lower than that in monozygous ones(14.3 percent,6/42),and that in twins with different development(birth weight)(0.6 percent, 2/316)was lower than that with same development(1.2 percent,3/256),with ?~2=16.944,P

The subject of clinical medicine contains abundant humanism educational material.When students start the clinic learning and contact with the patients for the first time,clinical teacher should endeavor to cultivate medical students' humanistic spirit in clinical practice.The paper discussed how to merge humanistic spirit into medical clinic teaching by illustrating the gynecology and obstetrics teaching.

Adult ; Body Composition ; Exercise ; physiology ; Female ; Humans ; Lipids ; blood ; Obesity ; blood ; Young Adult

Objective To investigate the extubated timing in acute severe organophosphorus pesticide poisoning patients.Methods Seventy-five patients with mechanical ventilation for acute severe organophosphorus pesticide poisoning were divided into early group (34 cases) and late group (41 cases) by extubation time.Mechanical ventilation time,ICU retention time,tracheal intubation time,ventilator-associated pneumonia (VAP) incidence and extubation success rate of both groups were observed.Results The mechanical ventilation time,ICU retention time between two groups showed no significant difference [(110.66±28.59)h vs.(114.47±34.21)h,(140.63±28.52)h vs.(138.44±34.74) h,P＞0.05].The tracheal intubation time in late group was significantly longer than that in early group [(135.27 ± 28.84) h vs.(119.03 ± 35.05) h,P ＜ 0.05],but the VAP incidence was nostatistically significant difference between two groups [29.27％ (12/41) vs.20.59％ (7/34),P ＞ 0.05].The success rate of extubation in late group was significantly higher than that in early group [97.56％ (40/41) vs.79.41％ (27/34),P ＜ 0.05].Conclusion Delayed extubation can significantly improve the chances of successful extubation,and no increase in VAP risk and more secure in acute severe organophosphorus pesticide poisoning patients.

BACKGROUND:At present, the development of reprogramming technology provides a wide prospect for stem cellresearch. Through the ectopic co-expression of reprogramming factors, the somatic cells can be reprogrammed to a pluripotent state, termed as induced pluripotent stem cells, which can avoid the ethical controversy faced in the research and application of embryonic stem cells. Also, we can generate patient-specific and disease-specific induced pluripotent stem cells, which significantly decrease immuno-rejection. However, reprogramming technology faces some chal enges, such as low efficiency and safety.
OBJECTIVE:Based on the characteristics of induced pluripotent stem cells and the principles of reprogramming, to detail the progress in reprogramming technology from five aspects, including cellresources, carriers, transcription factors, microRNA and signal transduction pathway. 
METHODS:A computer-based online retrieval was performed to search papers published form January 1990 to April 2013 in VIP periodical ful-text database, Wanfang periodical ful-text database, CNKI periodical ful-text database, PubMed database and Springer database with key words of“reprogramming, induced pluripotent stem cell, signal transduction pathway, epigenetics, microRNA, transcription factor, vector, somatic cell, smal molecule compound, safety”both in Chinese and English. After excluding objective-independent papers, 67 papers were included for further analysis.
RESULTS AND CONCLUSION:By exploring different cellresources, different carriers, various combination of transcription factors, microRNAs or inhibition of the signal transduction pathways, the reprogramming efficiency and safety have been improved greatly. However, currently, induced pluripotent stem cells stil could not meet the requirement of clinical application. To achieve the clinical application of induced pluripotent stem cells, it is urgent to explore the mechanism of reprogramming, and to optimize the programming strategy.