The emphasis and basic target of medical education is to cultivate medical students with high qualities. The qualities of medical students include professional ethics, self-cultivation, medical knowledge and physical-psychological quality, which is critical to the medical education. It has been proven that the teaching of Clinical Pathway is one of the most important factors to promote the improvement of comprehensive qualities of medical students.

Ophthalmology is a clinical course which requires students to have practical skills. The traditional clinical teaching method lacks varied means resulting in unsatisfactory teaching effects. Application of multimedia technology not only changes the teaching model, enriches the teaching contents but also improves the quality of ophthalmology teaching. By analyzing the advantages and disadvantages of multimedia application in clinical teaching based on our practice, the paper raises some methods for improvment in order to achieve the best teaching effects.

3) in control group (χ2=5.42,P=0.02).Conclusions Gemcitabine chemotherapy combined with HIFU treatment was more effective for pancreatic tumor growth control and pain relief without more adverse events,which was effective and safe.

Adolescent ; Adult ; Aged ; Calcaneus ; injuries ; surgery ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; adverse effects ; Fractures, Bone ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Postoperative Complications ; pathology ; physiopathology ; Recovery of Function ; Retrospective Studies ; Young Adult

Cor pulmonale is a common disease. The intervention varies and the effectiveness remains unsatisfactory. The vasodilators have been studied intensively in recent years and their application in treating the disease has been developing quickly. In this paper, the advances of research on the vasodilators in treatment of pulmonary hypertension in the last 5 years is reviewed, the advantages and disadvantages of the drugs presented, and a discussion on the trend of treatment of pulmonary hypertension made.

Objective To investigate roles of superoxide dismutase-1(SOD1),phosphatidylinositol 3-kinase (PI3K) /serine/ threonine protein kinase (AKT) signal transduction pathway in protection of propofol on spinal cord ischemic reperfusion injury (SCIRI) in rabbit model before and after ischemia. Methods Sixty Japanese male rabbits were randomly divided into 3 groups (n=20),namely sham-operation group (Group S),ischemia-reperfusion group (Group I/ R) and ischemia-reperfusion group with propofol treatment (Group P). Abdominal aorta of the rabbits in group I/ R and group P were blocked by clamp for 40 min and then the clamp was removed. Propofol (30 mg·kg-1 ) was intravenously infused 10 min before blocking the aorta and at the time of reperfusion. Normal saline was intravenously infused at the same time points in the other two groups. Four rabbits of each group were randomly executed 1,2,3,5,7 days after surgery. Spinal cord tissues at L3-L4 levles were harvested. Bioactivity of SOD1 was detected by ELISA and mRNA expression levels of SOD1,PI3K and AKT were detected by RT-PCR. Results On the 1st day after the surgery,the bioactivity of SOD1 increased significantly in Group I/ R and Group P as compared with that in Group S (P<0. 05). On the 2nd day,compared with Group S,the bioactivity of SOD1 increased significantly in Group P (P<0. 05),but there was no change in Group I/ R (P>0. 05). On the 3rd,the 5th and the 7th day,compared with Group S,the bioactivity of SOD1 decreased significantly in Group I/ R (P<0. 05),but there was no change in Group P (P>0. 05). Linear regression analysis indicated that there was a positive correlation between the changes of SOD1 activity and the mRNA expression of SOD1,PI3K and AKT respectively in spinal cord tissues. Conclusion Pre- and post-ischemic conditioning with propofol shows potent protective effects against SCIRI in the rabbit model. The mechanisms may be related to increased expression of SOD1 in the spinal cord tissues by activating PI3K/ AKT signal transduction pathway.

Objective To investigate the effects of hypothermia combined with sevoflurane on myocardial monophasic action potential (MAP) and transmural dispersion of repolarization (TDR) of the left ventricle in rabbits in vitro. Methods Adult rabbits weighing 1.5-2.0 kg were sacrificed after heparinized and anesthetized.The hearts were immediately removed and perfused with K-H soluation saturated with 95%O2-5%CO2 at 37℃ in a Langendorff apparatus. Forty-eight isolated hearts were randomly divided into 6 groups ( n = 8 each): Ⅰ control group (group C), Ⅱ low concentration sevoflurane group ( group S1 ), Ⅲ high concentration sevoflurane group (group S2 ), Ⅳ hypothermia group (group H), Ⅴ hypothermia + low concentration sevoflurane (group HS1 ) and Ⅵ hypothermia + high concentraion sevoflurane (group HS2 ).Group C received continous perfusion. Group S1and S2 received perfusion with K-H solution saturated with 2.4% and 4.8% sevoflurane at 37 ℃ for 30 min respectively. Group H received perfusion with K-H solution at 30℃ for 30 min. Group HS1 and HS2 received perfusion with K-H solution saturated with 2.4% and 4.8% sevoflurane at 30℃ respectively.MAPs of epicardium, mid-myocardium and endocardium of the left ventricle were recorded. MAP duration at 90%repolarization(MAPD90)and TDR were calculated. Early after-depolarization,delayed after-depolarization and arrhythmia were also recorded. Results Compared with group C, MAPD90 of the 3 layers of ventricle was significandy prolonged, the incidence of arrhythmia increased in group H (P＜0.05). There was no significant difference in TDR among all groups ( P＞0.05). There was no interaction between sevoflurane and hypothermia (P＞0.05), and it only showed that MAPD90 was prolonged by hypothermia (P ＜0.05 ). Conclusion Hypothermia combined with sevoflurane exerts no significant effects on myocardial MAP and TDR of ventricles in rabbits, and sevoflurane decreases the incidence of hypothermia-induced arrhythmia through inhibiting the prolongation of MAPD90.

B-type ultrasound images have important applications in medical diagnosis. However, the widely spread intensity inhomogeneity, low-scale contrast, constructed defect, noise and blurred edges all make it difficult to implement automatic segmentation of lesion in the images. Based on region level set method, a subordinate degree region level set model was proposed, in which subordinate degree probability of each pixel was defined to reflect the pixel subjection grade to target and background respectively. Pixels were classified to either target or background by calculation of their subordinate degree probabilities, and edge contour was obtained by region level set iterations. In this paper, lesion segmentation is regarded as local segmentation of specific area, and the calculation is restrained to the local sphere abide by the contour, which greatly reduce the calculation complexity. Experiments on B-type ultrasound images showed improved results of the proposed method compared to those of some popular level set methods.
Algorithms ; Diagnostic Imaging ; Humans ; Models, Theoretical ; Probability ; Signal Processing, Computer-Assisted ; Ultrasonography

Objective To understand the occurrence and risk factors of healthcare-associated infection(HAI) in a neonatal intensive care unit(NICU).Methods Neonates who were admitted to the NICU of a hospital from January 2012 to December 2014 were investigated retrospectively,risk factors for HAI were performed univariate analysis.Results A total of 760 neonates were included in the investigation,198 neonates developed 259 times of HAI,incidence of HAI was 26.05％,case incidence of HAI was 34.08％,incidence of HAI per 1 000 patient days was 9.50‰;the main infection site was lower respiratory tract (n =92,35.52％);among 259 cases of HAI,172 strains of pathogenic bacteria were isolated,the major pathogen was Acinetobacter spp.(n =40,23.26％);incidence of HAI was high in neonates with gestational age ≤32 weeks,birth weight≤1 500 g,length of hospital stay ≥10 days,duration of antimicrobial use≥10 days,mechanical ventilation,deep venous catheterization,and feeding intolerance,difference was statistically significant (all P＜0.001).Conclusion Incidence of HAI in NICU is high,effective prevention and control measures should be formulated according to its risk factors,so as to reduce the occurrence of HAI in neonates.

To study the expression of human telomerase RNA(hTR) in different grades of bladder transitional cell carcinoma and its relation to its prognosis. With in situ hybridization, the expression of hTR was observed in 67 cases of bladder transitional cell carcinoma specimens, to be compared with specimens of 10 normal bladder tissue and 10 benign lesions. The RNA probe used in hybridization was telomerase reverse transcript (TERT), and the marker was digoxin. There was a significent correlation between the expression of hTR and grading and prognosis. hTR is considered as an important and independent prognostic factor in this carcinoma.