The article summarizes the questions of clinical practicing in obstetrics and gynecology through clinical teaching in person,and find out some measures to improve teaching quality of clinical practicing.

Objective:To analyze and compare pharmacology cognizing between five-year and three-year systems students in medicine to provide materials for teaching innovation.Method:To gather feedbacks from the students and to analyze and induce the cases by EXCEL software.Results:The effectiveness of medicament is the focus.But five-year and three-year systems students concern different problems.57.1% questions raised by three-year system students are about the effectiveness and the effective factors of medicament,while 53.2% by five-year system students are about the effectiveness and the mechanism of medicament.Conclusion: There have been certain differences of pharmacology cognizing between five-year and three-year systems students.

Objective　To assess the CT manifestations and diagnostic value in the pancreatic tuberculosis(PTB)with review of the literatures. Methods　All cases of PTB proved by surgery or biopsy were examined with plain and enhanced CT scans. Results　The CT findings in one case with multiple-nodular type of PTB were diffuse enlargement of the pancreas with multiple, nodular, and low-density lesions; The nodular lesions had peripheral enhancement. 7 cases of local type of PTB encroached on pancreatic head. 4 cases showed local soft tissue masses with multiple flecked calcifications in 2 cases and mild enhancement in one case; Cystic masses was found in 2 cases, with mural calcification in 1 case and multiloculated cystic mass in 1 case, respectively; Massive pancreatic head calcification was demonstrated in one case. In these 8 cases of PTB, the lesion extended out of pancreas in 4 cases, including abdominal tuberculous lymph nodes, tuberculous peritonitis, and hepatosplenic tuberculosis. Conclusion　CT findings of PTB were various but had some characteristics. Pancreatic masses with multiple flecked calcification or mild enhancement could suggest the diagnosis. Abdominal tuberculosis accompanied with the pancreatic lesion, especially tuberculous lymph nodes, was highly suggestive of the diagnosis of PTB.

Objective To make recommendations on the development of private hospitals,by means of investigation and analysis of their business operations.Methods Quantitative and descriptive analysis were used to study business operation data from 2011 to 2013 of the 172 private hospitals,in order to learn their present status and development trends.These data were compared with public hospitals in average to identify problems.Results The revenue and expenditure of theses private hospitals increased at a fast pace,with a revenue growth rate of 22.0% and an expenditure growth rate of 15.7% in 2013.Number of visits gradually improved,with an increase of 12.9%.But the rate of bed occupancy was only 68.1%,lower than the average of public hospitals.Conclusions In view of the low resource utilization,the authors recommend such hospitals to improve hospital management systems,and uphold the integrity of business,so as to compete with public hospitals differentially.

Objective To investigate the correlation between tetramine poisoning and hypocalcemia in children.Methods According to different severe cases grade,tetramine poisoning children were divided into critical group(70-90 score),extremely critical group(

Objective To investigate the effects of vascular endothelial growth factor receptor-1(VEGFR-1) in the invasion and metastasis of hepatocellular carcinoma(HCC)by detecting the expression of VEGFR-1 in HCC tissues.Methods Paraffin-embedded tissue which containing HCC tissues and adjacent tissues were prepared from patients(n=82)with HCC,then were analyzed by immunohistochemical technique for the expression of VEGFR-1,epithelial marker E-cadherin and mesenchymal marker Vimentin.The relationship between the expression of VEGFR-1 and pathological parameters,and the correlation between VEGFR-1 and E-cadherin,VEGFR-1 and Vimentin were analyzed.Results The expression rates of VEGFR-1 in HCC tissues and adjacent tissues were 89%(73/82)and 0,respectively.The difference of VEGFR-1 expression in portal vein tumor thrombus,tumor capsule,stage,size and differentiation grade of tumor had statistical significance(x2=22.192,15.934,16.751,20.154,6.487,P＜0.05).The expression of VEGFR-1 had effect on the 1-,2-year recurrence rate and 2-year survival rate (x2=0.983,0.958,0.847,P＜0.05),but not on 1-year survival rate(x2=0.359,P＞0.05).The expression of VEGFR-1 was negatively correlated with that of E-cadherin(r=0.765,P＜0.01)but positively with that of Vimentin (r=1.469,P＞0.05).Conclusions VEGFR-1 may play an important role in invasion and metastasis of HCC.Epithelial-mesenehymal transition that induced by VEGFR-1 may contribute to the invasion and metastasis of HCC.

Objective To investigate the auxiliary effects of huaier granule on hepatoeellular carcinoma (HCC)patients after liver transplantation.Methods Sixty HCC patients who had undergone liver transplantation from Julv 2004 to June 2006 and met the standard of UCSF were involved in this study.All patients were divided into huaier granule group(n=20),chemotherapy group(n=15),huaier granule+chemotherapy group (n=15)and control group(n=10).The white blood cell count,liver function,cell immunity and immunologieal reiection were detected.The 1-year tumor recurrence rate wag calculated.Results The white blood cell counts in chemotherapy group 1,3,and 6 months after treatment were significantly lower than that before treatment (F=62.053,58.472,49.807,P＜0.05).The changes of white blood cell counts of the other 3 groups before and aftertreatment were small.The difference on the white blood cell counts of the 4 groups had no statistical 8ignincanee(F=102.361,113.412,87.572,P＜0.05).The NK activity,CD4+/CD8+ ratio,IL-2 level in huaier granule group and huaier granule+chemotherapy group 1,3,6 months after treatment were significantly higher than those before treatment,and were significantly higher than those in chemotherapy group and control group(P＜0.05).No immunological rejection occurred in all the groups.Two patients in each group had recurrence and metastasis of HCC within 1 year after the treatment.and the incidence in control group was higher than the other 3 groups(P＜0.05). Conclusions Humer granule can increase the white blood cell count which is decreased after chemotherapy,impmve cellular immunity,and effectively suppress the recurrence and metastasis of HCC at the first year after operation.

ObjectiveTo compare the accelerating effect of topical recombinant human epidermal growth factor (rhEGF) and recombinant bovine basic fibroblast growth factor (rb-bFGF) on wound healing after fractional CO2 laser therapy.MethodsTwenty male guinea pigs were included in this study.After hair removal and irradiation with fractional CO2 laser,the back of each guinea pig was divided into 4 regions to be topically treated with rhEGF of 10 μg/cm2 (rhEGF group),rb-bFGF of 262.51 IU/cm2 (rb-bFGF group),the combination of rhEGF and rb-bFGF (combination group),or normal saline (control group),twice daily until the healing of wound.Skin physiology parameters including elasticity index and melanin index were detected before the irradiation,7,14 and 28 days after the irradiation,and compared between the 4 groups by analysis of variance.Tissue specimens were obtained from 4 mice at the above time points and subjected to pathological examination for the observation of collagen fibers and quantification of fibroblasts.ResultsAfter fractional CO2 laser therapy,the crusts fall off completely in growth factor-treated regions,while partly in the control regions,within 3 to 7 days; the wounds healed completely in 14 to 28 days in all the groups,with the regenerating tissue being more tender and redder compared with the surrounding unirradiated tissue.The wound surface was smaller in area and redder in color in the 3 growth factor-treated groups than in the control group.At 28 days after the irradiation,the elasticity index was 262.29 ± 62.40 in the combination group,202.00 ± 65.62 in the rhEGF group,188.86 ± 35.02 in the rb-bFGF group,167.14 ± 42.49 in the control group.Statistical difference was observed in elasticity index,but not in skin melanin index among the 4 groups.Pathological examination showed a dense and organized arrangement of collagen fibers in the combination group but a sparse and disorganized arrangement of collagen fibers in the control group.ConclusionThe combined application of rhEGF and rbbFGF can accelerate the healing of wound and increase the elasticity of regenerating tissue after fractional CO2 laser therapy.

Objective To discuss the diagnosis and management of metastatic adrenal carcinoma. Methods Forty-seven cases with metastatic tumor in the adrenal glands were analyzed retrospectively from December 1996 to April 2010. Lung was the most common primary tumor site (51.1 %, 24 cases), followed by the renal cell carcinoma (12.8%, 6 cases), liver cancer (10.6%,5 cases), breast cancer (8.5%, 4 cases), melanoma (4.2%, 2 cases), and other carcinoma (12.8%,6 cases). Most patients with metastatic adrenal carcinoma had no special clinic manifestation. Lesions of 36 cases were surgically removed and 11 cases gave up operation. Results The mean survival time were 33.8±4.5 months for 31 cases underwent adrenalectomy and 6.3±2.7 months for 6 cases without operation. Patients with surgically removed adrenal metastases had better survival than those without surgical resection. Conclusions Adrenal gland is a common site of metastatic carcinoma.Ultrasonographic and CT scans are important diagnosis methods for metastatic adrenal carcinoma. Operation is still effective and long-term survival may be achieved for those well selected patients, but surgical indication must be strictly monitored.

Objective To systematically review the effect of telephone intervention on colostomy patients.Methods The randomized controlled trials (RCTs) of telephone intervention on colostomy patients were searched in CBM,VIP,CNKI and Wanfang database and analyzed by RevMan5.2 software.Results Nine RCTs were included.Results of systematic evaluation showed that there were statistical difference in the self-care status,obeying doctors' order,satisfaction degree,self management ability,quality of life.Conclusions The effect of telephone intervention on colostomy patients was better than that of the traditional intervention.