Clinical education for undergraduates in China can be divided into three phases:preclinical phase,clinical clerkship phase,clinical practice phase,and each phase has its own features and different teaching tasks.Currently there are four teaching methods mostly applied in clinical education:lecture-based Learning (LBL),team-based learning (TBL),case-based learning (CBL) and problem-based learning (PBL).LBL is a teacher-centered.teaching method,which focuses on making knowledge accurate,systematic and comprehensive;TBL,CBL and PBL are student-centered teaching methods,which can improve students' enthusiasm and subject initiative.Each teaching method has advantages and dis-advantages.According to the different characteristics of three stages of medical education,this paper analyzes the reasonable application of different medical teaching methods in three stages of undergraduate medical education:in preclinical stage,combining LBL with TBL teaching methods;in clinical clerkship phase,combining the teaching methods of LBL,TBL and CBL;in clinical practice stage,combining CBL with PBL teaching methods.

A 52-year-old female presented with unexplained thrombocytopenia for 29 years and a prunosus plaque on the right cheek for 9 years.She had ever been treated with glucocorticoids,which resulted in a slight improvement of the condition,but the platelet count remained below the normal range.During glucocorticoid tapering,she had administrated traditional Chinese medicines for a long peroid.Recently,the plaque on the cheek became swollen and painful with a progressive decrease in platelet count.Routine blood test showed that the count of white blood cells and platelets was 3.0 × 109/L and 2 × 109/L respectively,and the concentration of hemoglobin was 85 g/L.Computed tomography (CT) scan revealed multiple liver hemangiomas,one of which in the left liver lobe measured 14 cm × 5.7 cm in size.After medical treatment,the giant hemangioma in the left lobe was resected.Thereafter,the platelet count increased to 120 × 109/L with the subsidence of swelling of the right cheek.Postoperative pathological examination confirmed a diagnosis of giant cavernous hemangioma of the liver with extensive intravascular thrombosis and thrombus organization.Based on these findings,the case was diagnosed as adult Kasabach-Merritt syndrome.

By sorting out the literature on circling acupuncture manipulation in past dynasties’ acupuncture books and famous doctors’ treatises and selecting representative doctors and works, this article summarizes, sorts out and analyzes the definition, performance, action and application of circling acupuncture manipulation and explores its essence in order to promote the inheritance of circling acupuncture manipulation as old and very effective therapy and better its clinical application.

Objective To evaluate the bedside index for severity in acute pancreatitis (BISAP) and harmless acute pancreatitis (HAP) scoring system in predicting prognosis of acute pancreatitis (AP).Methods A total of 442 AP patients,who were admitted to The First Affiliated Hospital of Sun Yat-sen University from January 2003 to December 2010,were retrospectively studied.BISAP and HAP scores were evaluated respectively.The value of BISAP and HAP scores in predicting severity,local complications,organ failure and mortality were measured by the area under the curve (AUC) of receiver operator characteristic curve (ROC),and it was compared with that of traditional Ranson's score.Results Among 442 patients,73 patients (16.5％) were diagnosed to have severe acute pancreatitis (SAP).AUC for BISAP score in predicting SAP,local complications,organ failure and mortality were 0.90 (95％ CI:0.86 ～ 0.93),0.82(95％ CI:0.76 ～ 0.89),0.93 (95％ CI:0.89 ～ 0.96),0.93 (95％ CI:0.87 ～ 0.98).There were no statistically significant differences in AUCs of the four prognostic parameters between BISAP and Ranson's score.The specificity,positive predictive value (PPV),and AUC of HAP score in predicting mild AP were 85％,95％ and 0.73 (95％ CI:0.67 ～ 0.79).The risk of dismal prognosis increased when both BISAP and HAP score were abnormal.Conclusions BISAP and Ranson's score have comparable ability in predicting prognosis of patients with AP.However,BISAP score is simpler.HAP score is a simple and accurate method for predicting prognosis of patients with mild AP.Combination of BISAP score with HAP score can better help predict the prognosis of AP patients.

High resolution melting (HRM), based on melting curve analysis, requires not only saturating dyes that fluoresce in the presence of double-stranded DNA, but also higher resolution detection equipment. The melting curve is a novel method for sequence matching, genotyping and mutation scanning. The technology is simple, accurate, rapid, closed-tube, low-cost, and high-throughput, which make it gain more and more applications. This review article presents the basic principles, key factors and both the advantage and limitations of HRM. The potential application is discussed in the study of molecular identity of traditional Chinese medicine.
DNA Mutational Analysis ; methods ; Drugs, Chinese Herbal ; classification ; Genotyping Techniques ; methods ; Medicine, Chinese Traditional ; Nucleic Acid Denaturation

Objective To study the relationship between gene polymorphism of apolipoprotein E (apolipoproteinE,ApoE)of peripheral blood and Mycoplasma pneumoniae infection in children.Methods Collected 236 cases serum of inpatient and outpatient screening in children with Mycoplasma pneumoniae infection and healthy children between March 2011 and March 2014 in the First Affiliated Hospital of Xi’an Medical University and Xi’an Children’s Hospital,at the age of 3~8 years old,divided into two groups:110 cases of control group and 126 cases of Mycoplasma pneumoniae infection in chil-dren.Used multiple allele-specific PCR (multi-AS PCR)to detect gene polymorphism of ApoE in each group.Results ApoE gene was polymorphic and 6 genotypes:3 homozygous (ε2/2,ε3/3,ε4/4)and 3 heterozygote (ε3/2,ε3/4,ε4/2).Theε3/2 had four bands,ε3/3,ε3/4 and 4/2 had three bands,ε2/2 andε4/4 had two bands.ε3/3 of ApoE genotype distribution in two groups was the most common,control group was 66.7%,infection group was 46.4%.Allele frequencies ofε3 and genotype frequencies ofε3/3 inMycoplasmapneumoniae infection of children were lower than those in control group (P<0.05).But allele frequencies ofε4 and genotype frequency ofε4/4 in Mycoplasma pneumoniae infection of children were increased, which were compared with those in control group (P<0.05).Conclusion There were an association between ApoE gene polymorphism and the incidence of Mycoplasma pneumoniae infection in children.Allelesε3 seems to be a protective factor and allelesε4 may contribute to the development of Mycoplasma pneumoniae infection of children.

Para-neoplastic neurological syndrome (PNS) is a series of rare illnesses affecting the nervous system and associated with several malignant tumors. PNS is manifested by various clinical symptoms, which conventionally precede the diagnosis of tumors in months or even years. Although anti-neuronal antibodies can indicate the presence of cancer, numerous false positive and false nega-tive cases are detected. Therefore, the clinical diagnosis of PNS has become a challenge. Position emission tomography/computed to-mography (PET/CT) is an image-fusion method containing anatomical and functional information and can be used to obtain whole-body images by a single scan. Fluoro-deoxy-glucose (FDG) PET/CT imaging can reveal potential malignant lesions in the whole body and diagnose specific types of cancer. This technology can also be applied to assess functional abnormality in the brain and moni-tor its response to treatment. Furthermore, the mechanism, clinical manifestation, and diagnosis of PNS are introduced in this study. Re-cent applications of FDG PET/CT in the diagnosis of PNS are reviewed to improve diagnostic accuracy.

Chemical investigation of fruits of Mours alba L. lead to the isolation of fifteen compounds by various chromatographies such as silica gel, Sephadex LH-20, RP-C18 column chromatography. Their structures were determined to be: 1-[5-(2-formlfuryl) methyl] dihydrogen 2-hydroxypropane-1, 2, 3-tricarboxylate 2, 3-diethyl ester (1), 1-[2-(furan-2-yl)-2-oxoethyl] pyrrolidin-2-one (2), divaricataester A (3), methyl 1-[2-(furan-2-yl)-2-oxoethyl]-5-oxopyrrolidine-2-carboxylate (4), 1-[2-(furan-2-yl)-2-oxoethyl]-5-oxopyrrolidine-2-carboxylic acid (5), L-pyroglutamic acid (6), L-pyroglutamic acid ethyl ester (7), 3-O-caffeoylquinic acid methyl ester (8), 3-O-caffeoylquinic acid ethyl ester (9), 5-O-caffeoylquinic acid methyl ester (10), 5-O-caffeoylquinic acid ethyl ester (11), 4-O-caffeoylquinic acid methyl ester (12), 4-O-caffeoylquinic acid methyl ester (13), 4-O-caffeoylquinic acid (14), 3-O-caffeoylquinic acid (15), respectively, based on the spectral analysis such as NMR, MS etc. Compounds 1-14 were isolated from this genus for the first time, among which 1 was a new compound.

High resolution melting (HRM), based on melting curve analysis, requires not only saturating dyes that fluoresce in the presence of double-stranded DNA, but also higher resolution detection equipment. The melting curve is a novel method for sequence matching, genotyping and mutation scanning. The technology is simple, accurate, rapid, closed-tube, low-cost, and high-throughput, which make it gain more and more applications. This review article presents the basic principles, key factors and both the advantage and limitations of HRM. The potential application is discussed in the study of molecular identity of traditional Chinese medicine.

This article made a summarization and analysis on acupuncture related empirical and clinical research literature in Science Citation Index (SCI) periodicals in 2009.Authors used acupuncture respectively as the key word to retrieve in SCI periodicals in 2009 through Web of Science and got 630 articles.The articles were summarized and analyzed on experimental design, experimental research content, disease category, acupuncture accident and systematic review of clinical effect from native and abroad.