[Objective To evaluate the teaching effects and advantages of problem-based learning (PBL) teaching mode based on network in the clinical practice of obstetrics and gynecology. Methods 2007 grade intern students in department of obstetrics and gynecology in Beijing Tongren Hospital of Capital Medical University were divided into 2 groups:control group (18 seven-year program and 11 five-year program)and experiment group (17 seven-year program and 10 five-year program). Traditional teaching was conducted in control group:interns and teacher completed teaching ward round several times according to the teaching requirement. PBL based on network was conducted in experiment group:tea-chers asking questions-data collection-learning and discussing-demonstrating and arguing-discussing and summarizing teaching process. Then the effects of different teaching methods were evaluated by clinical practice skill and theoretical test. SSPS13.0 statistical software was used for data analysis and measurement data were expressed as x±s. T test was conducted among groups. Results As for clinical practice skills, scores in PBL group (seven-year program and five-year program )were higher than those of traditional group [seven-year program:(190.47±2.30)vs (87.42±2.93);five-year program:(92.95±2.20)vs (90 . 09 ± 2 . 70 )] . There was no difference between the two groups in scores of theoretical test . In clinical practice skills,scores of general skill and clinic case analysis showed significant differences be-tween PBL group and traditional group. Conclusions PBL tea-ching mode based on network can improve the quality and effectiveness of the clinical practice of obstetrics and gynecology, especially in the social, technical,and knowledge dimension.

OBJECTIVE:To compare the efficacy and safety of gio combined with oxaliplatin (SOX) versus 5-fluorouracil (5-FU)combined with calcium folinate and oxaliplatin(mFOLFOX6)in the treatment of diffuse advanced gastric cancer. METH-ODS:The data of 128 patients with diffuse advanced gastric cancer was retrospectively analyzed and patients were divided into SOX group(66 cases)and mFOLFOX6 group(62 cases)by different medication. SOX group received Gio capsule after breakfast and dinner,which was <1.25 m2,40 mg,1.25-1.5 m2,50 mg,>1.5 m2,60 mg,d1-14+130 mg/m2 Oxaliplatin for injection,intrave-nously,d1;3-week was regarded as a treatment course,the efficacy was evaluated every 2 courses,and it lasted a maximum of 8 courses but a minimum of 2 courses. mFOLFOX6 group received 85 mg/m2 Oxaliplatin for injection,intravenously,d1+200 mg/m2 calcium folinate,intravenously,d1+400 mg/m2 5-FU for injection by rapid intravenous injection,d1,then 2 400 mg/m2 5-FU,main-taining 46 h by continuous infusion. 2-week was regarded as a treatment course,the efficacy was evaluated every 3 courses,and chemotherapy was conducted in a maximum of 12 courses but a minimum of 3 courses. Clinical efficacy,time to progression,sur-vival time and incidence of toxicities in 2 groups were observed. RESULTS:The objective response rate,time to progression and median survival time in SOX group was significantly higher than mFOLFOX6 group,the difference was statistically significant (P<0.05 or P<0.01). There was no significant difference in the disease control rate and incidence of toxicities in 2 groups(P>0.05). CONCLUSIONS:The efficacy of SOX is superior to mFOLFOX6 in the treatment of diffuse advanced gastric cancer,it can prolong the survival time,with similar safety.

Objective To observe the effect of body-weight supported treadmill training (BWSTT) on the lower limb motor function of elderly hemiplegia patients with acute cerebral infarction using semi-quantitative analysis of regional cerebral blood flow (rCBF) through single photon emission computed tomography (SPECT). Methods Seven patients with cerebral infarction were given comprehensive rehabilitation therapy for 10 weeks in three stages: a baseline period of 2 weeks ( conventional rehabilitation therapy), an intervention period of 6 weeks ( conventional rehabilitation therapy plus BWSTT) and a withdrawal period of 2 weeks (conventional rehabilitation therapy). During the intervention period the exercise duration increased gradually from 15 to 30 minutes, once a day, 5 times a week,for 6 consecutive weeks. Dynamic changes in rCBF in the cortex were observed with SPECT before and after treat ment. Results During the baseline period there was no significant change in average MWS (maximum walking speed) or BBS ( Berg balance scale) scores. During the intervention period both scores improved significantly. During the withdrawal period there were some changes in MWS and BBS scores, but they were not significant. There was a significant change in average rCBF in the cortex after treatment compared with before. Conclusions BWSTT is effective for improving the walking speed and balance of elderly patients with acute cerebral infarction. There is a positive correlation between the recovery of lower limb motor function and changes in rCBF in the cortex.

Clinical data were retrospectively reviewed for one case of penicillium marneffei infection after renal transplantation (RT) to explore a proper management of peniciliosis marneffei (PSM)transplantation.This case had a history of pulmonary tuberculosis and underwent RT due to uremia.After discharging, postoperative recovery was excellent.Recurrent cough occurred at Month 7 post-operation.Fiberoptic bronchoscopy and pulmonary CT indicated a possibility of pulmonary tuberculosis.However, a definite diagnosis of PSM was confirmed by next generation sequencing (NGS) and pathogenic bacteria culture of alveolar lavage fluid.After adjusting immunosuppressive agents and regular antifungal treatment with voriconazole, respiratory symptoms improved and pulmonary CT hinted at a resorption of lesion.Features of pulmonary CT and bronchoscopic examination were nearly similar to those of tuberculosis.Thus early bacterium culture and NGS may aid an definite diagnosis.Voriconazole is an effective treatment of the disease.