ObjectiveThis paper aims to probe into the effect of working and studying combined teaching reform of chnical medicine major.MethodsTwo classes containing 46 students respectively were selected at random as observation group and control group,from the six classes of Grade Two majoring in clinical medicine.The two groups of students were trained by adopting working and studying combined teaching model and traditional teaching model respectively,after which they were evaluated in terms of clinical theory,practical skills and operations,and exercitation achievement.ResultsThe observation group does better in practical skills and exercitation achievement than the control group,while they have no difference in clinical theory.ConclusionWorking and studying combined teaching model can improve students' clinical analytical ability,strengthen their awareness of medical morals,and help them achieve more in exercitation.

Chlorella pyrenoidosa No.2 was screened from five species of microalga Chlorella sp. for its higher lipid yield. Effects of medium components and culture conditions on cell growth as well as lipid ac-cumulation of C. pyrenoidosa No.2 were investigated and the results showed that the optimum medium rec-ipe was 20.0 g/L glucose,0.08 g/L glycine,1.0 g/L K2HPO4?3H2O,0.4 g/L MgSO4?7H2O and 0.004 g/L FeSO4?7H2O. The optimum culture temperature,initial pH,shaking rate and light intensity were 28℃,6.0,130 r/min and 650 Lux,respectively. Biomass and lipid content increased from 3.73 g/L and 40.15% to 6.56 g/L and 59.90% when Chlorella pyrenoidosa No.2 was cultivated under the above optimal conditions for 7 days,with lipid yield raised by 162%. Chlorella pyrenoidosa No.2 could produce lipid with xylose as carbon source,and so is potential for lipid production from renewable materials such as lignocellulose. GC analysis demonstrated that the fatty acid composition of the lipid was similar to that of vegetable oil and its unsaturated fatty acid content reached around 71%,thus it is a promising material for biodiesel production.

A complete aniline dioxygenase gene cluster cloned from an Acinetobacter sp. strain, which could utilize aniline as the sole carbon, nitrogen and energy, was sequenced. Sequence analysis showed that the gene cluster had six intact ORFs, and the whole sequence had high similarity with that of Acinetobacter sp. YAA at amino acid level. A recombinant strain was formed with the gene cluster ligated to vector pLAFR6 and transferred to E.coli. After optimizing the fermentation conditions of this strain for producing catechol, LB was confirmed as the final medium, pH7.0, aniline concentration 0.5mg/ml, E.coli DH5?as the host, incubation temperature 37℃, amount of inoculum 3%. Under above conditions, the yield of catechol could get to 0.546mg/ml, and the converting rate of substrate at molecule level could get to 92.4%.

Objective: To observe the alteration of type-　 Ⅰ collagen protein gene expression after arterial injury and investigate its effect on the development of restenosis. Methods: Firstly, thee xperimental carotid arterial injury rabbit model was constructed. Then, Norther n blot, in situ hybridization and histomorphometric analysis were used to de tect the expression of procollagen mRNA and the accumulation of collagen protein 1,2,4 weeks after injury. Results: Type-　Ⅰ collag en mRNA increased 1 week after injury, peaked 2 weeks later and decreased 4 week s later. The deposition of the collagen protein account for a high percentage o f space in neointima on histomorphometric analysis. Conclusion: Collagen protein may play an important role in the development of neointima and restenosis.

Objective To study the feasibility and curative effect of laparoscopic radical resection of rectal carcinoma. Methods Sixty-two cases were enrolled in this study between Feb 2003 and Mar 2005, including 32 cases undergoing laparoscopic radical resection (19 Dixon and 13 Miles) , and 30 cases undergoing open radical resection (22 Dixons and 8 Miles). Results The mean operation time of laparoscopic group was 195 min, and open group was 156 min (P 0. 05 ). The GI and urination function of laparoscopic group recovered faster than open group ( evacuated was 2. 7 days vs. 3. 7 days, P

Objective To evaluate the significance of myocardial bridge and find a reasonable diagnosis and treatment strategy.Methods Sixty-three myocardial bridge patients and sixty-three patients with negative results of coronary artery angiography were reviewed.The clinical data of symptoms,electrocardiogram,exercise tests,coronary artery angiography,therapeutics and the serum levels of C-reactive protein(CRP)were analyzed.Results The symptoms of chest distress and chest pain were found in myocardial bridge patients.Myocardial consumption of oxygen augmentation causes the symptoms of aggravation.Positive results of electrocardiogram and exercise tests in many of myocardial bridge patients were examined.There were no relationship with severity of myocardial bridge artery stenosis.Most of myocardial bridge were discovered in anterior descending branch.At present,the main treatment of myocardial bridge was drug therapeutics.After treatment,the serum levels of CRP was significantly decreased.Conclusion Myocardial bridge was anatomy abnormality with important clinical significance.The serum levels of CRP can be used to evalue the therapeutic efficacy of myocardial bridge.

[Objective] To explore the techniques of hand-assisted laparoscopic splenectomy plus portozygos disconnection procedure. [Methods] 18 patients with portal hypertension were operated by hand-assisted laparoscopic splenectomy plus portozygos disconnection. [Results] The operations were completed successfully. The mean operative time was 180(150～260) minutes, the mean blood loss estimated was 540(200～2 000) mL, the mean weight of spleen was 910 (500～2000) g and the mean length of hospital stay was 9.7 (8～18) days after operation. All patients had recovered rapidly and suffered less pain and only 5 patients needed analgesic. The mean recovery time of the bowel function was 52(24～74) hours. The hand incisions healed well, and only one occurred complications and another suffered death. [ Conclusions ] Hand-assisted laparoscopic splenectomy plus portozygos disconnection procedure is to be feasible and safe, and has the merits of minimally invasive surgery.

ObjectiveTo evaluate magnesium sulfate and compound polyethylene glycol electrolyte in bowel preparation before capsule endoscopy.MethodsA total of 81 patients were randomly divided into two groups.Group A (n =41 ) received compound polyethylene glycol electrolyte,and group B (n =40) received magnesium sulfate combined with compound polyethylene glycol electrolyte. Positive detection rate,intestinal preparation score,the incidence of capsule retention and solution quality,liver and kidney function were compared between those two groups.ResultsThe positive detection rates of capsule endoscopy were 65.9％ (27/41) in group A and 62.5％ (25/40) in group B,which were nonsignificantly different (x2 =0.099,P ＞ 0.05).The intestinal preparation scores of 19 patients in group A were ≤4 and those of 22 patients were ≥6,while those of 28 patients in group B were ≤4 and of 12 patients were ≥6,which were significantly different (x2 =4.653,P ＜ 0.05). The rates of capsule retention of group A and B were 2.4％( 1/41 ) and 5.0％ (2/40) respectively,which were not significantly different (x2 =0.372,P ＞ 0.05 ).Obvious abdominal pain,nausea or vomitting occurred in no patients of the two groups.There was no difference in electrolyte level or liver and kidney function between those two groups (P ＞ 0.05 ).ConclusionMagnesium sulfate combined with compound polyethylene glycol electrolyte is applicable for the bowel preparation before capsule endoscopy.

Objective To observe curative effects of augmentation fixation technique injected with PMMA through lateral holes of dynamical hip screw (DHS) in treatment of unstable intertrochanteric fracture of senile osteoporotic patients. Methods From January 2006 to December 2007,15 senile osteoporotic inpatients with unstable femoral intertrochanteric fracture were treated with augmentation technique injected with PMMA to the femoral head through central channel and lateral holes of DHS. Clinical data about function of hip joint and complications early after operation were observed. All patients were followed up till fractures were healed, when the hip joint function was evaluated according to Harris standarch. Results Surgical trauma indices such as operation time and bleeding volume of augmentation technique were the same as those of merely DHS fixation. All the patients could safely do hip flexion and extension exercises in the bed and completely sit up by bedside 2-3 days after operation. Six patients could do walking exercise with aid one week after operation, with no complications relating to staying in bed or to PMMA during per-operation period. All fractures were healed 3-6 months after operation, without complications like fixation loosening, cut or destruction of femoral head during postoperative follow-up period. Six months after operation, 14 patients recovered viability to normal. According to Harris standards, the results were excellent in four patients, good in 10 and fair in one, with average Harris score of 83 points. Conclusions The augmentation fixation technique injected with PMMA through lateral holes of DHS has advantages of better DHS anchoring ability in femoral heads, less surgical trauma, reliable fixation and early functional exercise and is suitable for senile osteoporotic patients with unstable intertrochanteric fractures.

Objectives:To investigate the influence of PN via portal vein on insulin and glucagon in liver regeneration. Methods:The rabbits were randomly devided into control group( n =5),PN via portal vein group(group Ⅰ, n =10) and PN via central vein group(group Ⅱ, n =10).The PN was performed for 6 days after partial hepatectomy.The concentration of serum insulin and glucagon in portal and perpheral vein were analysed with radioimmunoassay. Results:The concentration of serum insulin was increased in group Ⅰ and group Ⅱ,and it was increased significantly( P 0.05),but it was increased significantly in portal vein blood in group Ⅰ( P