Objective To understand the effects of reform on clinical teaching taking patient's symptoms as the starting point and to investigate students' recognition degree towards this reform and their information feedback.Methods Totally 42 clinical students of the second clinical medical college (the second class) of China Three Gorges University were enrolled in the study and clinical teaching taking patient's symptoms as the starting point was conducted.Thirty-nine clinical students of the second clinical medical college (the fourth class) were enrolled as control group and traditional method was conducted.Effects of clinical teaching were evaluated by examination score and students' recognition degree towards this reform was investigated by self-made questionnaire and information feedback.Data were processed using SPSS 13.0 statistical software; t tests were used to compare students' scores of theoretical test and skill test; P ＜ 0.05 signifies that the difference is statistically significant.Results There was no statistical difference in theoretical test score between experiment group and control group (P ＞ 0.05).Skill test scores were higher in experiment group than in control group (P＜0.01).Students highly admitted this teaching mode and they thought that this mode can improve their self-study ability,clinical practice skill and clinical thinking ability without influencing their theoretical learning.Conclusions Practice of clinical teaching taking patient's symptoms as the starting point is feasible,which can increase scores of skill test significantly without influencing scores of theoretical test.

Objective To establish an HPLC method for the simultaneous determination of CTX and DDP and to research their pharmacokinetics in rat. Methods The separation was performed on a Hypersil-CTX. Results Retention time of CTX was 5.15 min. The linearity range of calibration curve was 0.5-10 μg/ml (r =0.9999), the average recovery was 97.4 %(RSD＜5 %). The detection limit was 0.1 μg/ml(S/N＞3). For DDP the retention time was 9.26 min and the linearity range of calibration curve was 0.1-2.0 μg/ml (r =0.9998).The average recovery was 98.1%(RSD＜5 %). The detection limit was 0.1 μg/ml (S/N＞3). Conclusion The method is effective for determination of CTX and DDP. It also provides the method eligible for pharmacokinetics of CTX and DDP. Drug combination make eliminating rate decrease and eliminating half life prolong, have effect on each other.

Based on the analysis of Medical Independent Colleges,this article is trying to discuss how to set up majors innovatively,reform curriculum and teaching plans effectively By doing this,it aims to set up a bettor education model of Medical Independent Colleges with characteristics of the running of such Medical Independent Colleges.Wishing it can serve as an talent training model for the colleges of the same kind

Objective:The purpose of this study was to assess the outcome of intestine fistula patients treated with home enteral nutrition(HEN) support before definitive operation.Methods:Fifty-eighty patients were divided into HEN support group and hospital enteral nutrition support group when their illness were stable and total enteral nutrition(TEN) were full resumed.All the patients were supervised by the members of nutrition support team.Days of TEN and hospital stay and medical cost was recorded.Plasma protein,body weight and body mass index were measured on the first day of full enteral nutriton and the day enteral nutrition was stop for operation preparation.Results:Nutritional status of the patients improved.There was no significant difference between two groups in nutritional status,complications and duration of TEN.The time patients in HEN group stayed at home was(61.11?27.71) d and in hospital(60.79?17.11) d.The cost in HEN group was less than that in hospital EN support group(140.21?61.2 vs 189.2?72.2 thousand Chinese dollar).Conclusion:Under the close supervise of nutrition support team,HEN is of the same safety and effect and can reduce the time of hospital-stay and medical cost when compared hospital EN.

By using a self-developed IF power and a ASTM contact material experimental system of small-capacity and variable frequency, the value of arcing characteristics and the welding force of the silver-based contact material are acquired under low voltage, resistive load and small current at 400 Hz and 50 Hz. By means of an electricity-ray analytical balance, SEM and EDAX, the weighing values of the contact materials and the changes of AgCdO, AgNi, AgC and AgW contact material surface profile and micro-area constituent are obtained and analyzed. The arc erosion causes of silver-based alloy contact materials at 400 Hz and 50 Hz are also discussed.

Objective To assess the risk factors for pneumonia in patients with acute stroke. Methods Three hundred and forty patients with acute stroke were studied, and risk factors for pneumonia such as demographics, history of hypertension, diabetes and smoking, initial blood pressure, body temperature, fasting plasma glucose level, C-reactive protein, National Institutes of Health Stroke Scale ( NIHSS) scores, degree of dysphagia and mechanical ventilation were evaluated. Besides, the correlation between incidence of pneumonia and pneumonia scores in patients with acute stroke was studied. Results Pneumonia was developed in 63 patients (18.5%). Logistic regression analysis revealed that age, gender, initial NIHSS scores, dysphagia and mechanical ventilation were independent predictors for pneumonia (P <0.05). The incidence of pneumonia gradually increased with the pneumonia scores. Conclusion The occurrence of pneumonia after acute stroke is associated with older age, male gender, high NIHSS scores, dysphagia and mechanical ventilation. The pneumonia scores can be adopted to identify the risks of pneumonia after acute stroke.

Objective:To study the clinical significance of tumor tissue of patients with liver metastasis of colorectal cancer CD44,CD166 expression.Methods:Retrospective analysis clinical data in our hospital from Octobor 2008 to October 2013,these data from 76 patients with rectal cancer was divided into the test group ( liver metastasis group, n=40 ) and control group ( without liver metastases group, n=36 ) .All of specimens were identified with qualitative immunohistochemical analysis.Observation the positive expression of CD166/CD44, age, sex, clinical stage, invasion depth, lymph node metastasis, Dukes staging, pathological tissue differentiation parameter correlation and the survival rate.Results: In test group,the positive expression of CD44,CD166 groups were respectively 72.50%,85%;in the control group,the positive expression rates of CD44 and CD166 were 36.11%,41.67%.The two groups have significant difference(P<0.05).In test group,expression of CD44,CD166 has no significant difference(P>0.05) with age,gender, histological differentiation.However it showed significant difference with the depth of invasion, Dukes ( P<0.05 ) .In addition,the survival ratio of the test group was significant lower than control group(P<0.05).Conclusion: In rectal cancer,CD166 and CD44 are a hallmark of liver metastasis,rectal cancer,which could determine the process of development.To explore the expression of CD44 and CD166 is helpful to early diagnosis and treatment scheme of rectal cancer.

Objective To identify factors that might affect establishing pregnancy following conservative treatment by medroxyprogesterone acetate ( MPA)for well -differentiated endometrioid adenocarcinoma ( EC) or a-typical endometrial hyperplasia(AEH).Methods A retrospective study of 65 patients with EC/AEH were divid-ed into a pregnancy group ( n=34 ) and a non -pregnancy group ( n=31 ) .The influent factors on establishing pregnancy were detected by statistical analysis .Results There was no significant difference in clinical character-istics between pregnancy group and non -pregnancy group .There were significantly different between pregnancy group and non-pregnancy in the duration of MPA administration ,the time to disappearance of lesions ,the age of pregnancy permission ,the number of D&C procedures performed ,and endometrial thickness during ovulation ( P<0.05).The multivariate logistic regression analysis identified that the recurrence (OR=2.323,P=0.015),endo-metrial thickness during ovulation (OR=0.283,P <0.001),and age of pregnancy permission (OR=2.524,P=0.039) were significant factors affecting pregnancy outcomes .Conclusion Recurrence, endometrial thickness during ovulation ,and the age of the pregnancy permission were considered to affect pregnant establishment follow -ing conservative treatment with MPA .Assisted reproductive technology immediately after achieving tumor disap-pearance by MPA would therefore be beneficial for patients with disease recurrence ,thin endometrium ,or a higher age of pregnancy permission .

OBJECTIVE:To study the situation of anemia in newly diagnosed ovarian cancer and breast cancer patients treated with 7 kinds of chemotherapy regimes. METHODS:110 cases of newly diagnosed ovarian cancer and breast cancer from May 2008 to Feb. 2009 in People’s Hospital of Peking University were analyzed retrospectively. The level of hemoglobin in patients treated with different chemotherapy regimes were evaluated and analyzed with SPSS software. RESULTS:Of total 110 patients, class Ⅰ anemia occurred 194 times and class Ⅱ anemia occurred 55 times. High incidence of anemia appeared in chemotherapy regimes with platinum as base. Low incidence of anemia occurred in TA chemotherapy regime. The older patient is,the more easily anemia occurred. CONCLUSION:The incidence of anemia after chemotherapy is related to type of cancer,chemotherapy regime, chemotherapy cycle and patient’s age.

Objective To investigate if mitochondrial KATP channels are involved in the cardioprotective effects of astragalus membranaceus in immature rabbit hearts. Methods Twenty-four New Zealand white rabbits of both sexes aged 14-21 days weighing 300-350 g were anesthetized and heparinized. The hearts were rapidly removed after thoracotomy and mounted on a Langendorff apparatus via ascending aorta and perfused with oxygenated (95% O2-5% CO2) Krebs-Hensleit buffer (KHB) solution at 60 cm H2O (perfusion pressure) and 38 ℃ . A fluid-filled latex balloon was inserted into left ventricle via left atrium for measurement of left ventricular developed pressure ( LVDP) , Global myocardial ischemia was induced by suspension of perfusion for 30 min followed by 45 min reperfusion. The animals were randomly divided into 3 groups with 8 animals in each group : group A control;group B astragalus and group C astragalus +- 5-HD (a selective inhibitor of the mitochondrial KATP channel). In group B the hearts were perfused with astragalus 40 g? L-1 for 15 min before ischemia. In group C the hearts were perfused with 5-HD 100?mol?L-1 for 5 min followed by 10 min astragalus perfusion before ischemia. In control group the hearts were perfused with only KHB before ischemia. Coronary flow (CF), HR, LVDP and ? dp/dtmax, were measured at 5, 10, 15, 30 and 45 min of reperfusion and recorded. Coronary effluent was collected at 10 min of reperfusion for determination of CK-MB, LDH and CK levels . At the end of 45 min reperfusion the isolated heart was removed for determination of myocardial ATP and iNOS levels and electron microscopic examination.Results In astragalus group (B) LVDP ? dp/dtmax and CF recovered significantly better and myocardial ATP content was significantly higher as compared with group A and C (P