To analyze and summarize the connotation,elements,procedure and efficacy of cooperative learning in European medical education and provide reference to innovate our medical education.

Objective To study the therapeutic methods of cholecystic duct stones. Methods A retrospective analysis of the clinical data of 158 cases of cholecystic duct stones treated in the recent 6 years was made. Results 97 of the 158 cases of cholecystic duct stones were removed by open surgical operation and 61 cases by laparoscopic cholecystectomy(LC).In 49 of the 61 cases treated with LC,the cholecystic duct stones were removed together with removal of the gallbladder, and 12 by duodenoscopy after LC. Conclusions One should strive to extract the cholecystic duct stones while removing the gallbladder. If the stones or stone fragments escape into the common bile duct, they could be removed through a choledochotomy at the time of the open operation ,or by postoparative duodenoscopy in cases undergoing LC. The latter method of treatment is associated with minor trauma, quick recovery and definite therapeutic results.

Objective To investigate the correlation between indexes of thrombelastogram (TEG) and hemorrhagic transformation (HT) after acute ischemic stroke.Methods The cases of acute ischemic stroke but not receiving early reperfusion therapy were recruited in our hospital from January to November 2016,and were divided into HT group and non-HT group.Their general clinical characteristics and TEG indexes were retrospectively analyzed,and comparison between two groups and multivariate Logistic regression analysis were performed.Results A total of 71 cases were enrolled and 11 of them were divided into HT group.The percentages of massive cerebral infarction and cardio-embolic stroke were significantly higher in HT group than those in non-HT group (P<0.05),whereas the levels of CI in HT group were significantly lower than thoes in non-HT group(P<0.05).Multivariate Logistic regression analysis showed that massive cerebral infarction (OR=13.172,95%CI:1.414-122.671) and CI(OR=0.554,95%CI:0.321-0.956) were independently correlated with HT(P<0.05).Conclusion CI is independently correlated with HT after acute ischemic stroke,and may be a potential predictor of HT.

Three Modules and Three Stages proposed by guidelines on college English teaching that will be issued by the Ministry of Education gives direction for college English teaching.Through the investigation of the students' cognition and learning of English curriculum,combined with the teaching experiment,the new system of English curriculum,which reflects the characteristics of medical colleges and universities,has been preliminarily established,aiming at cultivating medical students' comprehensive English abilities in medical study and career development.Considering students' language abilities in different stages,college English curriculum can be designed in three modules,that is,English for general purpose (EGP),English for academic purpose (EAP) and intercultural communication,in three stages,that is,the basic stage,the improvement stage,and the development stage.The practice shows that the new curriculum system can promote the interaction,reform and development of teachers,teaching teams and Foreign Language Department.

Objective To evaluate retrospectively ECG -gating for the coronary angiography with MSCT. Methods 15 patients were studied with a multislice spiral CT on retrospective ECG -gating,0.5s rotation, and cardial segment reconstruction algorithm. Nine phases were chosen to reconstruct images of coronary arteries. Results In the 230 coronary artery segments,213 (91%)were best visualized at 70%. And 15 (6.4%), 9 (3.8%), and 3 (1.3%) were optimal at 80%, 40% , and 5% of the cycle respectively. Conclusion The coronary arteries usually are best visualized at 70% image reconstruction window of the cardial cycle.

OBJECTIVE To determine the association between phenotype and genotype of biofilm in Staphylococcus.METHODS All 156 clinical isolates of coagulase negative Staphylococcus(CNS) and 90 S.aureus(SAU) strains isolating from clinical specimens from Mar 2005 to Jul 2008,as well as 12 CNS strains from nasal swabs of healthy carriers from hospital staff,were collected.Congo red technique was performed to examine slime production.The presence of the intercellular adhesion genes(icaA and icaD) was determined by the polymerase chain reaction method.The phenotype and genotype of biofilm were analyzed.RESULTS Thirty-two out of 168 CNS isolates were biofilm producers(19.0%) while 32 out of 90 SAU isolates were producers(35.6%).All strains positive for icaA positive were also positive for icaD.The 16 strains(10 CNS isolates and 6 SAU isolates) were icaA and icaD positive but do not produced slime.CONCLUSIONS For SAU,the percentage of slime-production strains(35.6%) is higher than that found in CNS(19.0%).The characteristic of biofilm-negative variants having the ica loci might contribute to the dissemination.For clinical isolates of S.epidermidis,ica locus may not be a significant marker discriminating between invasive and contaminating isolates.

BACKGROUND: Serum levels of high-sensitivity C-reactive protein (hs-CRP) can be used to predict cardiovascular injury.OBJECTIVE: To investigate the serum levels of hs-CRP in a rabbit model of atherosclerosis following repeated long-termexposure to positive acceleration and to predict the risk of cardiovascular injury.METHODS: Twenty-four New Zealand purebred rabbits were randomly divided into a positive acceleration group and a controlgroup. Rabbits in the positive acceleration group were exposed to +4 g rotation for 20 seconds with an acceleration of 1 g/s. Therotation interval was 5 minutes and totally three rotations were daily performed for 3 days per week. 0.5 g rotation was addedevery week, and by week 4, +6 g rotation was added, and the exposure lasted for 40 seconds.RESULTS AND CONCLUSION: Exposure to positive acceleration yielded significant effects on serum level of hs-CRP in rabbitswith atherosclerosis compared with before exposure (P < 0.01), but exposure time did not produce effects on serum level ofhs-CRP (P > 0.05). The interaction between exposure to positive acceleration and exposure time also did not produce significanteffects on serum level of hs-CRP (P > 0.05). Hyperplastic foam cells in the aortic tunica intima and the superficial layer of mediaincreased with the prolongation of exposure to positive acceleration. Repeated long-term exposure to positive acceleration maylead to a long-term high serum level of hs-CRP in rabbits.

Exertional heat stroke (EHS) is an emergency with a high mortality rate, characterized by acute onset and identification difficulties. EHS prevention focuses on evaluating the environment by professionals, making preventive measures in advance, identifying internal and external risk factors for the onset of disease, carrying out prior heat adaptation and endurance training, monitoring the status of high risk persons in real time. After occurrence of EHS, the key to success treatment is on-site accurate identification and diagnosis and rapid implementation of effective cooling measures, thus winning time of EHS patients transferred to the hospital for the treatment. This article reviews the current status of EHS prevention and treatment in domestic and foreign from the scene to the hospital. Summarizing the recognition, diagnosis, cooling measures, treatment concepts and principles of EHS, we hope to provide a reference for the rescue of EHS in hospital and outside.

Objective To find out whether inpatients with acute ischaemic stroke and atrial fibrillation (AF) have higher rate of renal dysfunction than without AF,and analyze risk factors associated with renal dysfunction.Method 374 patients with acute ischaemic stroke and AF were enrolled,which cases have complete data.500 patients were randomly selected as the non-AF group.To compare the prevalence of renal dysfunction [eGFR ＜ 60 mL/(min· 1.73 m2)] of two groups.Non-conditional Logistic regression analysis was used to detemmine the factors associated with renal dysfunction.Results 374 patients in AF group,114 (30.5％) were renal dysfunction;500 patients in non-AF group,75 (15％) were renal dysfunction (P =0.000,OR =2.485).The eGFR of AF and non-AF group was (77.75 ± 39.89) mL/(min· 1.73 m2) and (96.93±39.14) mL/(min · 1.73 m2).In Logis tic regression analysis,heart dysfunction (OR =2.057),hypertension (OR =1.826),diabetes (OR =1.897),hypevuricemia (OR =3.161) were found to be associated with renal dysfunction.Conclusions Adult patients with acute ischaemic stroke and AF have a higher rate of renal dysfunction than acute ischaemic stroke without AF.Heart dysfunction,hypertension,diabetes,hyperuricemia were factors associated with renal dysfunction.

Surface-enhanced laser desorption ionization spectrometry (SELDI),as a new type of proteinchip technique,could easily and quickly acquire the information of proteins in all kinds of body fluid and tissue. It could be used in selecting new tumor markers,early diagnosis and evaluating the risk of tumors. This article introduces the principium of this ProteinChip technique,its application in clinic detection,and the outline of its future.