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.

Fluorescent technology is widely used in many fields due to its high sensitivity. However, the direct quantification of one target analyte in complex system is still difficult to be achieved when using the traditional fluorescent method without any pretreatment separation procedure. This is due to the fact that serious overlapping of fluorescence spectra often occurs, mainly originating from natural interferences in complex sample backgrounds, or the interferents with similar structures to a target analyte, particularly in the simultaneous analysis of multi-components samples. The rapid development of modern analytical instruments and three-way data collection techniques has led to a resurgence of interest in the development of chemomet-rics-based analytical strategies, which might light a new avenue to simple experimentation using“mathematical separation” as a replacement or enhancement of“physical or chemical separation” of uncalibrated background or interferents. These methods can offer a highly attractive property, called“second-order advantage”, which allows for the direct and rapid determination of a single target component or simultaneous determination of multiple target components in complex samples, even in the presence of uncalibrated interferences. The property has been a hotspot in the current chemometric domain, and was successfully employed for many applications, such as pharmaceuticals, biological, food, environmental analysis and so on.

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.

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.

A new terpenoid, lucidone D (1), has been isolated from Ganoderma lucidum. Its structure was determined to be 7beta, 15alpha-dihydroxy-4, 4, 14alpha-trimethyl-3, 11, 20-trioxo-5alpha-pregn-8-en on the basis of 1D and 2D-NMR spectral analysis.

Objective: To establish a method for determination of isofraxidin in Xiaoerkaiwei Oral Liquid (Radix Acanthopanacis Senticosi, Endothelium Corneum Gigeriae Galli, Semen Alpiniae Katsumadai, Semen Pharbitidis, etc.) by RP HPLC. Methods: The HPLC system consisted of Symmetry C 18 column(3.9m?150mm, 5?m), methanol water (0.1% formic acid) (30∶70) mixture as a mobile phase, detection wavelength at 342nm, 0.8mL?min -1 of flow rate and column temperature at 30℃.Results: The calibration curves of the isofraxidin were linear ( r =0.9993). The precision were perfect ( RSD =1.87). The samples were stable in 6 h. The average recovery of Xiaoerkaiwei Oral Liquid was 102.4% with RSD of 1.76%.Conclusion: This method is simple, quick and specific, suitable for the quality control.

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.

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.

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.