The current paper, pivoting on an analytical survey of the teaching contents and curriculum system of post-education for rural medical personnel, pinpoints the problems existing therein, and explores the various approaches for reforming the teaching contents and curriculum system.

Teachers of pathology have long been concerned with highlighting professional characteristics and nursing features in addition to stressing clinical application in their teaching.Based on extensive investigation and comparative analysis,the authors of the current paper make a reform of pathology teaching in aspects of teaching contents and methods to better adapt pathology teaching to professional characteristics of nursing specialties,in a bid to lay a solid foundation for subsequent teaching of professional courses and clinical application.

Objective To explore the clinical feature and prognosis of multiple myeloma with heart failure as initial manifestations.Methods 12 patients of multiple myeloma with heart failure as initial manifestations were analyzed and followed up.Results Twelve patients,9 men and 3 women,with mean age of 48～69(58.4?5.2)years older were enrolled.The first symptoms of the patients were almost the same,with different degree of dyspnea and tachypnea.Anaemia and proteinuria were 83.3% and 75% respectively in 12 patients.ECG showed that 8 patients had low voltage in the limb leads,with present poor R wave progression in the precordial leads and ST-T changes in 6 patients.UCG showed that 10 patients had enlarged left atrium(41.6?4.2)mm,8 patients had increased thickness of the interventricular septums and left ventricular walls as well as diffuse weakness of the wall motion.Followed up for(4.0?3.7)months,all of the patients(100%)died.Conclusion Multiple myeloma with heart failure as initial manifestations is rare clinically,but has fast aggravation and bad prognosis.Pro-brain natriuretic peptide(Pro-BNP)and cardiac troponin are subtile markers for judging the prognosis of patients with multiple myeloma.

The status quo of American informatics nurses investigated 4 times by US HIMSS from 2004 to 2014 was analyzed.The following characteristics of American informatics nurses were summarized in terms of their educa-tion level, income, qualification authentication, occupation satisfaction, work experience and duties, including high education level and interdisciplinary background, high income and occupation satisfaction, necessary clinical background, and systematic professional development, which may provide reference for nursing staff in China to have a better understanding of informatics nurse.

Objective To discuss the early stage treatment of reduction and the curative effect in coxa dislo- cation with acetabular fracture. Methods According to the different type of coxa dislocation with aeetsbular frac- ture,22 patients were given the distinctive operation and drawn reduction. As to 22 cases combination with acetabu- lar fracture and basis of difference type of the fracture were selected the method of suitable operative entrance or in- ner fixation. In this gronp,22 patients were followed up about 6 month to 3 years(average 15.3 months) after opera- tion. According to the standard of America orthopedic surgery study were commented on curative effect. Results Excellent 15 cases,well 4 casea,pass 2 cases,bad 1 case. Total fine rate were 86% .Conclusion Each kinds type of the hip dislocation cases should needed emergency reduction. The operation treatments were selected first method to settlement the bone shatter displacement in acetabular fracture or unsuitable joint and unsteady joint.

[Objective]To explore the mechanism of nucleoplasty combined with oxygen-ozone for the treatment of lumbar disc herniation，and to evaluate its therapeutic effects.[Method]From June 2005 to June 2006，62 patients with lumbar disc herniation were treated by nueleoplasty combined with oxygen-ozone，34 were male and 28 were female，ranging in age from 32 to 76 years，with an average of 53.4 years.The course of this disease ranged from 3 to 56 months，meanly 1.3 years.Thirteen patients had the herniation at L4.5 and L3，4，thirty two patients at L4、5，eight patients at L4、5 and L5S1，and nine patients at L5S1.The curative effect was assessed by using a modified MacNab method.[Result]After 25～35 months'follow-up，there were no servious complications in all 62 cases.According to modified MacNab assessment，50 cases(80.7%)achieved excellent outcomes，8 cases(12.9%)good，2 cases(3.2%)fair and 2 cases(3.2%)poor.The excellent and good rate was 93.5%.[Conclusion]The micro-invasive technique of nueleoplasty combined with oxygen-ozone is effective in the treatment of lumbar disc herniation，and it has maximized the clinical effect and minimized the local damage：it also expanded adaptive cases with lumbar disc herniation and enlarged the applicable scope of minimally invasive technique in treating lumbar disc hemiation.

[Objective] To determine the effects and possible mechanism of the thrombin antagonist r-RGD-Hirudin (HIR) on ventricular arrhythmia(VA) after acute myocardial infarction (AMI). [Methods] Seventy adult male Sprague-Dawley rats were randomly subjected to the 10 groups according to duration of left coronary occlusion: HIR 0 min, HIR 5 rain, HIR 10 min, HIR 20 min, HIR 30 min, and normal saline(NS) 0 min, NS 5 min, NS 10 min, NS 20 min, NS 30 min; and the average of every group is 7 rats. Acute myocardial infarction was produced by the occlusion of the left anterior descending coronary artery, then the measurements of arrhythmia and infarction sizing by Evans blue were assessed as well as the expression of three isoforms of inositol 1,4,5-trisphosphate receptors (IP3Rs) mRNA in isehemic myocardium by reverse transeriptase polymerase chain reactions (RT-PCR). [Results] Compared with NS groups, the measurements of VA in HIR were reduced significantly in 5 to 20 minutes after AMI (P<0.05). The incidence of VA was all positive related to the expression of three isoforms of IP3Rs mRNA (P<0.01). Compared with NS groups, the expression of type2,inositol 1,4,5-trisphosphate receptor (IP3R2) mRNA at 10 min and type3, inositol 1,4,5-trisphosphate receptor mRNA (IP3R3) at 10 min and 20 min after AMI were significant decreased (P<0.05) in HIR groups. [Conclusion] The thrombin antagonist r-RGD-Hirudin exerts its myocardial protection against ventricular arrhythmia after acute myocardial infarction possible through IP3R2 and IP3R3 and not typel, inositol 1,4,5-trisphosphate receptor (IP3R1).

Objective To analyze the characteristics and risk factors of preoperative deep vein thrombosis in patients with hip fracture,and provide a theoretical basis for clinical treatment and intervention.Methods 470 patients with hip fracture were chosen as the objects of study.The clinical data of the patients were retrospectively analyzed,including age,gender,injury,combined with other systemic diseases,fracture type (whether old fractures),two D-dimer level.All the patients with deep venous thrombosis of lower extremity were divided into DVT group and nonDVT group.There were 83 cases in DVT group,387 cases in non-DVT group.The factors like aboves as independent variables,presence of deep vein thrombosis as dependent variable,,preoperative deep venous thrombosis of the characteristics and risk factors were analyzed.Results 83 patients had DVT,the incidence rate was 17.7％.There were significant difference in age (40/83 vs 268/387),combined with other system diseases (57/83 vs 283/387),prevention measures (58/83 vs 196/387),D-thrombosis two dimer level (16/83 vs 122/387) of the two groups (x2 =13.712,14.836,9.876,5.313,all P ＜ 0.05).3 age ≥ 40 years,with other system diseases and injury,did not take to prevent the formation of thrombus measures were independent risk factors influencing the occurrence of DVT.Conclusion Age ≥40 years,combined with other system diseases and injury,don't take to prevent the formation of thrombus measures are independent risk factors influencing the occurrence of DVT.

Objective To investigate the clinical effectiveness of dynamic hip screw (DHS) internal fixation and proximal femoral nail (PFN) internal fixation for intertrochanteric femoral fractures.Methods One hundred and sixty-five patients with intertrochanteric femoral fractures were randomly divided into 2 groups,85 patients were in DHS group and 80 patients were in PFN group.The clinical effectiveness,index in operative procedure and complications were compared between two groups.Results The fine rate of DHS group and PFN group was 75.3％(64/85 ) and 83.8％( 67/80 ) (P ＞ 0.05 ).The indexes of function recover time,fracture healing time,amount of bleeding in operation,operation time in PFN group were significant lower than those in DHS group [(54.3 ± 11.7 ) d vs.(92.6 ± 10.5 ) d,(63.8 ± 12.2) d vs.(71.3 ± 10.6) d,(453.3 ± 50.7) ml vs.(627.5 ± 46.8) ml,(77.9 ± 25.2) min vs.( 115.7 ± 32.8) min](P＜0.05 ).The rate of short-term complications was 16.2％ (13/80) in PFN group,and 12.9 ％ ( 11/85 ) in DHS group(P ＞ 0.05 ).The rate of long-term complications was 1.2％( 1/80 ) in PEN group and 4.7％(4/85 ) in plts group (P ＜ 0.05).Conclusions As the treatment of intertrochanteric femoral fractures,PFN internal fixation has less bleeding and better efficacy,and can improve function recovery.PFN internal fixation is a better method for unstable femoral fracture.

Purpose To investigate the effect of anti-HER-2 engineered antibody chA21 on the angiogenesis in nude mice xenografts of human ovarian cancer SKOV3 cells that overexpresses HER-2.Methods An animal model with SKOV3 cells involved in nude mice was established and the mice were randomized into control group and chA21 group;chA21 was administrated via caudal vein for 5 weeks, meanwhile the same volume of chA21 buffer was injected in control group.The mice were terminated after 5 weeks and the xenografts dislodged,VEGF and DLL4 expression in two groups were quantitatively analyzed by immunohistochemistry on tissue microarray sections combined with a micro-image analyzing system, and microvessel density (MVD) values were compared between the two groups by immunohistochemical staining of CD31.Results The expression of VEGF, DLL4 and MVD values in chA21 group were lower than those in control group (P<0.05).Conclusion chA21 inhibits the angiogenesis of transplantations of human ovarian cancer SKOV3 cells effectively.