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.

Objective To explore the relationship between respiratory viruses infection and the episode of steroid responsive simple nephrotic syndrome(SRSNS).Methods Thirty-eight children with SRSNS were selected,including the active stage group(n=28)and the remission group(n=10).The urine from 18 cases of nephritic nephrosis,16 cases of bronchiolitis,15 cases of secondary glomerular diseases and 15 cases of healthy children were served as controls.By using the method of reverse transcriptase-polymerase chain reaction(RT-PCR)and alkaline phosphoesterase-anti alkaline phosphoesterase enzyme-linked assay(APAAP),viral genes and antigens in urine were assayed,respectively.Results The positive rate of detecting viruses in the active stage group of SRSNS children was higher than that in the remission group and the other control groups(Pa

Cysts ; congenital ; Humans ; Infant ; Laryngeal Diseases ; congenital ; Male

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 systematically review the influence of propofol orsevoflurane on postoperative cognitive dysfunction(POCD) in elderly patients undergoing non-cardiac surgery.Methods Eight databases including Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, Pubmed, CNKI, VIP, CBM and Wanfang Database were searched for randomized controlled trials (RCT) about the influence of propofol orsevoflurane on POCD in elderly patients from the time of database establishment to June, 2016.At the same time, the reference materials of included literature were retrieved manually.All data were selected and evaluated by three independent reviewers according to the inclusion and exclusion criterions.RevMan 5.1 was used for the data analysis.Results A total 14 trials were discovered involving 790 elderly patients undergoing non-cardiac surgery.The results of Meta-analysis showed that the eye opening time and extubation time in the propofol group were significant shorter than sevoflurane group[SMDeye opening=-0.83,95%CI(-1.05,-0.61),P<0.05;SMDextubation=-0.85,95%CI(-1.09,-0.62),P<0.05].The MMSE scores at 1,3 and 6 h respectivelyafter the operation were obviously higher than those of sevoflurane group[SMD1h =0.84,95%CI(0.61,1.08),P<0.05;SMD3 h=1.12,95%CI(0.86,1.38),P<0.05;SMD6h=0.61,95%CI(0.40,0.82),P<0.05].One day after the operation,the difference was not significant[SMD1d=0.14,95%CI(-0.03,0.31),P>0.05].Three days after the operation, the values returned to normal levels, and was still higher in propofol group than in sevoflurane group[SMD3d=-0.32,95%CI(-0.56,-0.07),P<0.05] until 7 d [SMD7d=-0.18,95%CI(-0.51,0.15),P>0.05].The odds ratio of POCD incidence between propofol and sevoflurane groups was 0.35 [95%CI(0.21,0.58),P<0.05].Conclusion Propofol may lead to shorter eye opening time and extubation time compared to sevoflurane in elderly patients undergoing non-cardiac surgery.Both groups may lead to POCD, while propofol is a better choice for elderly patients when choosing general anesthesia.

Objective To explore the effects of chronic fluorosis on neurons in the cerebral cortex of rats,and to provide some morphological evidence of damage in the central nervous system induced by chronic fluorosis.Methods Male Wistar rats 40 days after birth were fed with high fluoride contented water(100 mg/L)for inducing chronic fluorosis.Immunocytochemistry and in situ hybridization were used to detect c-fos and Caspase 8 at cerebral cortical neurons respectively.Results c-fos positive cells rate and gray scale in the cerebral cortex of chronic fluorosis were 35.8%and 0.2756±0.0241,respectively,and that of control group were 32.1%and 0.2774±0.0331with statistical difference(χ2=0.305,t=0.826,P＞0.05).Caspase 8 positive cells rates of fluorosis group and control group were 18.7%and 14.1%,respectively,the difference being statistically significant(χ2=0.419,P＞0.05).The gray scale of fluorosis group and control group were 0.3874±0.0329 and 0.3884±0.0323,respectively,the difference being statistically significant(t=0.641,P＞0.05).Conclusion Chronic fluorosis had no significant influence on apoptosis of cerebral cortical neurons.

Objective: To observe the efficacy of needling the Xi-Cleft points of yang meridians plus topical surrounding needling and pregabalin in treating postherpetic neuralgia (PHN) affecting the head and face and its influence on quality of life (QOL). Methods: Eighty patients with PHN affecting the head and face were randomized into an acupuncture-medication group and a Western medication group by their visiting sequence, with 40 cases in each group. The Western medication group took pregabalin capsules orally, 75 mg each time, twice a day. The dosage could increase to 150 mg each time and twice a day within 1 week based on the efficacy and tolerance. The treatment lasted for 5 weeks. The acupuncture-medication group was given additional surrounding needling at the herpes zoster on the head and face, and Xi-Cleft points of yang meridians were chosen according to the affected area for acupuncture, once every other day, for 5 weeks in total. Results: Prior to treatment, there were no significant differences in the visual analog scale (VAS) and QOL scores between the two groups (both P>0.05). After treatment, VAS and QOL scores dropped significantly in both groups (all P<0.01), and were significantly lower in the acupuncture-medication group than in the Western medication group (both P<0.01). The total effective rate was 67.5％ in the Western medication group, versus 92.5％ in the acupuncture-medication group, and the between-group difference was statistically significant (P<0.05). Conclusion: Based on oral administration of pregabalin, needling the Xi-Cleft points of yang meridians and topical surrounding needling can reduce PHN, notably improve patients' QOL, and produce more significant efficacy than oral administration of pregabalin alone.

Objective To investigate the risk factors of gallbladder carcinoma,so as to provide theoretical base for the prevention of gallbladder carcinoma.Methods The clinical data of 153 patients with gallbladder carcinoma (gallbladder carcinoma group) who were admitted to the Peking Union Medical College Hospital from January 2000 to December 2010 were retrospectively analyzed. A total of 300 patients with cholecystolithiasis (cholecystolithiasis group) and 300 patients without gallbladder carcinoma or cholecystolithiasis (control group)were collected and matched at the ratio of 1∶2 to conduct the controlled study.Data were statistically analyzed by the Chi-square test and conditional Logistric regression.Results Univariate analysis showed significant difference in age,history of cholecystolithiasis,postmenopausal age,accumulated menstrual period,giving birth or not and number of birth between gallbladder carcinoma group and control group ( x2 =58.22,180.14,9.59,24.30,18.66,15.17,P ＜0.05).Age,history of cholecystolithiasis,accumulated menstrual period and number of birth were the independent risk factors of gallbladder carcinoma (x2 =55.76,180.95,24.30,8.54,P ＜ 0.05).The risk of having gallbladder carcinoma in patients who had a history of cholecystolithiasis was 34 times higher than those who did not have the history of cholecystolithiasis (OR =34.22).Late postmenopausal age (51 -55 years old),longer accumulated menstrual period ( ≥30 years),and the number of birth ( 3 times) were associated with higher risk of gallbladder carcinoma (OR =3.96,9.68,3.51 ). Age,course of cholecystolithiasis and accumulated menstrual period and number of birth were the risk factors of gallbladder carcinoma when comparing patients who have history of cholecystolithiasis in the gallbladder carcinoma group with those in the cholecystolithiasis group (x2 =70.66,16.66,11.59,4.69,P ＜ 0.05 ).Age,course of cholecystolithiasis and accumulated menstrual period were the independent risk factors of gallbladder carcinoma ( x2 =64.29,8.82,5.58,P ＜ 0.05).The risk of gallbladder carcinoma increased as the increase of age and course of cholecystolithiasis. The accumulated menstrual period ≥ 30 years was also a risk factor of gallbladder carcinoma. Conclusions Age,history of cholecystolithiasis,course of cholecystolithiasis,accumulated menstrual period and number of birth may be the risk factors of gallbladder carcinoma.For patients with age above 60 years and course of cholecystolithiasis above 3 years,cholecystectomy should be conducted to reduce the incidence of gallbladder carcinoma,and great importance should be attached to female patients with indications mentioned above.

According to the investigation about the current ability of military hospitals to cope with bioterrorism , we suggest that military hospitals improve the capability for bioterrorism response based on the research above by satisfying mission requirements , combining peacetime with wartime , carrying out crisis management , classifying response and cooperating with local sectors .