This paper introduced the teaching reform in the integrated course of introduction to clinical medicine in China medical university.According to the capacity and quality in the global minimum essential requirements in medical education (GMER) proposed by the Institute for International Medical Education (IIME),we carried out the teaching reform of ‘early exposure to clinic’ in the integrated course of introduction to clinical medicine based on the theory of competency-based education (CBE) and took capacity-building as the teaching objective.We achieved good teaching effect and appraisal by students.

Objective: To explore the guiding significance of transpulmonary thermodilution pulse-indicated continuous cardiac output (PiCCO) in treatment for patients with acute inferior wall myocardial infarction (AIMI). Methods: A total of 26 AIMI patients in intensive care unit of cardiology department in our hospital from Jul 2012 to Jan 2014 received PiCCO and ultrasonic cardiography (UCG) to monitor cardiac output (CO) and cardiac index (CI), and their correlation analysis. Results: When PiCCO placement and after placement 72h， PiCCO monitoring CI were （2.77±0.77）L•min-1•m-2, (3.17±0.39) L•min-1•m-2 respectively, there was significant difference（P＜0.01）, UCG measured CI were (2.49±0.64）L•min-1•m-2, (2.63±0.24) L•min-1•m-2, there was no significant difference（P＞0.05）; PiCCO monitoring CO were（4.78±1.06）L/min, (5.08±1.53) L/min respectively, there was significant difference（P＜0.05）, UCG measured CO were（4.51± 0.86）L/min, (4.57±0.91) L/min, there was no significant difference（P＞0.05）; and CI，CO measured by PiCCO were significantly higher than those of UCG group (P＜0.01 both) after PiCCO placement 72h. Conclusion: Pulse-indicated continuous cardiac output can offer more sensitive hemodynamic indexes compared with UCG, which possesses important treatment guiding significance in patients with acute inferior wall myocardial infarction and unstable hemodynamics.

Nationally and internationally,there is an growing emphasis on formative assessment for medical education.Teachers are enabled to apply the reflective teaching methods in their classes through careful theoretical trainings and practical guidance.By the application,shortcomings of students are found effectively,so that teachers can adjust their teaching plans and reach a higher teaching quality.

Objective:To evaluate the safety of dental treatment in pediatric patients with leukemia. Methods:Eighty-nine patients were included and dental treatment was conducted under the condition of neutrophil counts ranging from 3.0?109/L to 10?109/L and platelet counts of more than 50?109/L. Supportive medical care was continued, the patients were monitored for at least one month after dental treatment for bleeding,pain,local and/or systemic infection,fever and other complications. Results:Dental treatments were performed successfully.All patients, except one with delayed wound healing after tooth extraction, recovered uneventfully. Conclusions:As long as the hematological values are within the suggested range, preoperative preparation and supportive medical care are well conducted,dental treatment can be safely performed in pediatric patients with leukemia.

The distribution of journals, cooperated papers, authors and their affiliated institutions, fund-supported papers, and subjects in 305 papers published in 17 core journals of stomatology since their establishment with their citation frequencies ≤40 were analyzed in an attempt to provide reference for the editorial departments of journals in their topic selection , manuscripts review and solicitation .

Objective To study the effect of antagonist of excitatory amino acid receptor DL2-amino-5-phosphonovalerate(D-AP 5) on peripheral nerve regeneration.Methods The models of regeneration chamber after sciatic nerve injury were made by cutting 6 mm of left sciatic nerve which was connected subsequently using silicage channel. 10 ?l sterile normal saline was injected into regeneration chamber. In the treatment group, 10 ?l of different concentration of D-AP 5(2 ?mol/L used as low dosage group, 20 ?mol/L used as moderate dosage group and 200 ?mol/L used as high dosage group) was administered intrathecally while the same quantity of normal saline was used in the control group. The rats were sacrificed at 12 weeks and studied by electrophysialogy, electron microscope, microscope and image analysis.Results The nerve conduction velocity, diameter and number of regenerated myelinated nerve fiber in high dosage group were superior to those in the control group and other dosage groups(all P

Objective To present the diagnosis and treatment of functional bladder outlet obstruction and to assess the results of transurethral bladder neck incision and alpha-blockers with regard to symptoms and urodynamic findings. Methods From October 1995 to October 2002,39 male patients (age range from 24 to 48 years,with a mean of 37 years) who had dysuria and underwent urodynamic examination,cystourethrography and urethral exploration were diagnosed with functional bladder outlet obstruction.The mean IPSS was 22.5.The mean maximum urinary flow rate was 10.2 ml/s and the mean residual volume was 124 ml.All the patients were treated with transurethral incision of bladder neck and alpha blockers. Results The mean operative duration was 15 min;mean blood loss was 50 ml;mean postoperative hospital stay was 3.5 d.During 1-year follow-up,most of the patients were satisfied with the treatment results.Subjective assessment showed a statistically significant reduction of the voiding complaints.The mean IPSS was 10.1 .The mean maximum urinary flow rate was 22.1 ml/s (range,12.7 to 42.1 ml/s) and the mean residual volume was 49 ml (range,0 to 84 ml). Conclusions Urodynamic examination,voiding cystourethrography and urethral exploration with dilator facilitate the diagnosis of functional bladder outlet obstruction.Treatments with transurethral incision of the bladder neck and alpha-blockers are effective and safe for functional bladder outlet obstruction.

Objective To construct an oral recombinant DNA vaccine of Helicobacter pylori(H. pylori) neutrophil activating protein (Hp-NAP), and to evaluate its immunotherapeutic effects. Methods The napA gene (encoding Hp-NAP) was amplified by poly mera se chain reaction(PCR) and cloned into TA cloning vector pBT. After nucleotide s equencing and sequence analysis, the target sequence was subcloned into an eukar yot ic expression vector pIRES. Then the identified recombinant plasmid, pIRES-napA , was transformed into a live attenuated Salmonella typhimurium(S. typhimurium ) strain SL7207, and lavaged into a long-term(30 weeks) model of BALB/c mice infected by Sydney strain(SS1) of H. pylori. Results A 435 bp target gene of napA was amplified by PCR. Seq uenci ng and BLAST analysis showed that most of the cloned napA sequence was homologou s with that of SS1 strain of H. pylori. provided by GenBank, and the homolog y of neucleotide and protein was over 98%, respectively. PCR and restriction enzyme digestion id entification indicated that a recombinant live attenuated S. typhimurium DNA vaccine strain carrying Hp-napA gene was successfully constructed. After 4 wee ks of oral immunization, 75% of mice treated with DNA vaccine were rapid urease test negative, while those with vacant plasmid or normal saline alone were all p ositive (P= 0.0476). The titer of serum Hp-NAP antibody was signific antly elevated in treatment group. Conclusions The successful construction of an effective oral recom binant DNA vaccine of Hp-NAP may be helpful for the further development of polyvalent DNA vaccine against H. pylori infection.

Transpulmonary thermodilution pulse-indicated continuous cardiac output (PiCCO) monitoring only needs a central venous catheter and an artery catheter ,so is a minimally invasive ,simple ,accurate and continuous cardiac output monitor technique used at home and abroad now .It combines transpulmonary thermodilution and analysis technique of arterial pulse wave area under curve (AUC) .It helps to better evaluate ,guide and improve treatment in critically ill patients .