Experiment teaching is an important component of teaching in medical college and university, a key step to foster students practical ability and innovation ability and a guarantee to achieve the goal of medical talent training. The quality and level of experiment teaching is directly related to the college talent training quality and the college overall development. According to the requirement of quality engineering, our college strengthens the connotation construction from the aspects of experiment teaching management, teaching staff training and quality monitoring and improves experiment teaching quality.

Objective To investigate the efficacy of laparoscopy for the treatment of rectovaginal septum endometriosis. Methods A totalof 13 patients with rectovaginal septum endometriosis underwent open (5 cases) or laparoscopic (8 cases) operations in our hospital between January 2001 and May 2006.Results In the open surgery group,the operation time ranged from 130 to 200 minutes (mean,187 minutes) ,and the mean intraoperative blood loss was 189 ml (170 to 280).After the operation,the menstrual pain was relieved in 5 cases at 1 month,4 at 3 months,3 at 6 months,and 2 at 12 months.Whereas,in the laparoscopy group,the operation time ranged from 120 to 185 minutes (mean,155 minutes),and the mean blood loss was 135 ml(100 to 190 ml).The menstrual pain was relieved in 8 cases at month 1,8 cases at month 3,7 cases at month 6,and 5 cases at month 12.Conclusions Laparoscopic surgery is effective and safe for patients with rectovaginal septum endometriosis.

As an essential technique involved in complicated liver surgery,portal vein reconstruction results in eradication of macro- or microscopic tumor residual on surgical margins when combined with precise hepatectomy,improving both the living quality and the survival rate of patients.The application of this reconstruction technique needs precise evaluation of pre-operational image data,clearly dissection of portal vessels and tremendous amount of collaborative effort by the surgery team. Other techniques performed during the surgical procedure include intra-operative ultrasound scan,revitalizing the cryopreserved vessels,and angioplasty.

Objective To explore the value of virtual touch tissue quantification (VTQ) elastography and its influencing factors in identifying benign and malignant thyroid nodules.Methods A retrospective analysis was conducted in 210 cases of 240 thyroid nodules.Their images,including 2D ultrasound,color Doppler flow imaging (CDFI) and VTQ elastography,were reviewed,and the scanning view,the maximum diameter of the nodule,inside blood flow,calcifications and its depth beneath the skin were recorded.The value of shear wave velocity(SWV) in identifying benign and malignant thyroid nodules was calculated using receiver operating characteristic (ROC) curve.The influences of the maximum diameter of the nodules,calcifications,internal blood flow,the depth beneath skin and scanning views as well as type of pathology on the value of SWV were analyzed using multiple linear regressions (MLR).Results The sensitivity and specificity of VTQ in differential diagnosis of benign and malignant thyroid nodules was 74.8％ and 73.4％,respectively,and the area under ROC curve was 0.799.MLR indicated that the maximum diameter of the nodule,the type of pathology and internal blood flow were correlated with the SWV value (P ＜0.05),of which,the type of pathology was the important factor (standardized coefficient was-0.312).Microcalcifications,the depth of the nodules located and the scanning surface were not significantly related to SWV value (P ＞0.05).Conclusions VTQ can quantitatively provide the information on the hardness of thyroid tissue,which is of a definite value in the differential diagnosis of the nodules.The pathology of the nodule,its internal blood flow and maximum diameter are the factors that affect the value of SWV,and not its depth,scanning views and microcalcifications.

OBJECTIVE:To optimize the extraction technology of chlorogenic acid in Prunus armeniaca flos,and compare the contents in P. armeniaca flos from different origins and varieties. METHODS:HPLC was conducted to determine the content of chlorogenic acid in P. armeniaca flos;using the volume fraction of ethanol,the ratio of material to liquid,ultrasonic extraction times and time as factor,the content of chlorogenic acid as index,single factor and orthogonal test were designed to optimize the extraction technology,and verification tests were carried out. The optimized extraction technology was used to extract and compare the contents of chlorogenic acid in Armeniaca sibirica from 7 origins of P. armeniaca flos and 3 origins of Armeniaca sibirica flos. RESULTS:The optimized extraction technology was extracting twice with 12-fold 75% ethanol,30 min each time. Under the con-ditions,the content of chlorogenic acid can reach 77.38 mg/g(RSD=0.58%,n=3);the contents of chlorogenic acid in A. sibiri-ca flos and P. armeniaca flos were 77.38-83.33 mg/g and 63.12-70.22 mg/g,respectively. CONCLUSIONS:The established extrac-tion technology is reasonable,stable and feasible. The contents of chlorogenic acid in A. sibirica are higher than that in P. armenia-ca flos;the contents have no obvious differences in the same variety of A. sibirica from different origins.

Objective To investigate the incidence of needle stick injuries of nursing students in different stages of clinical practice and occupational protective education to provide evidence for developing education strategies. Methods One hundred and forty-one nursing students were surveyed retrospectively by a self-designed questionnaire. Results A total of 75.9%(107/141) nursing students had been injured in clinical practice. The incidence of needle stick injuries varied in different stages of clinical practice. Compared with the middle and late stage of clinical practice, the incidence of needle stick injuries was highest in the early stage of clinical practice:53.9%(76/141) vs. 38.3%(54/141),7.8%(11/141),and there was significant difference, χ2=216.14, P<0.05.About 64.2%(88/141)-78.0%(110/141) nursing students had not received protective education on the needle stick injuries. Only 48.9%(69/141)-55.3%(78/141) of nursing students were given protective training on needle stick injuries in their practice hospitals. Before clinical practice, 63.1%(89/141) nursing students had not been vaccinated to prevent infective diseases. Conclusions To reduce the incidence of needle stick injuries and related potential risks of infection caused by injuries, it is necessary to strengthen pre-practice education on occupational protection among nursing students. Perfect supervision system should also be established in practice hospitals and clinic wards.

To analyze the test results of five serum markers of hepatitis B virus (HBV) among university freshmen from 2007 to 2012.Among a total of 10 827 freshmen,there were 5 021 freshmen from 2007 to 2009 with all five serum markers.The overall ratio of HBsAg positive was 4.5％,4.8％,4.8％ and 4.0％ for each year.And it had no statistically significant difference.The overall ratio of single-HBsAb positive was 34.8％,37.4％,29.0％ and 37.9％ for each year and the figure of 2008 was lower than those of 2007 and 2009 (P ＜ 0.01).The overall ratio of five markers all negative were 58.3％,55.4％,63.9％ and 55.8％ for each year and the figure of 2008 was higher than those of 2007 and 2009 (P ＜ 0.01).And 34.5％ of HBsAg positive freshmen were HBsAg(+),HBeAg (+),HBcAb (+) and 44.2％ HBsAg(+),HBeAb(+),HBcAb(+).The prevalence ratio of HBsAg for males was higher than that for females (5.1％ vs.3.2％,P ＜0.01).Among 5 806 freshmen tested during 2010-2012,522(9.0％) had a serum level of alanine transaminase (ALT) ＞ 40 U/L,including HBsAg positive (n =12),single anti-HBs positive (n =213) and five negatives (n =288).Approximate 50％ university freshmen have no anti-HBs indicating a low level of immunity.And the students should acquire the knowledge of hepatitis B,improve the ratio of vaccination,strengthen the monitoring and prevent its spread through concerted measures.

Objective:To retrospectively analyze the early mortality and related risk factors in adult patients with maintenance hemodialysis (MHD).Methods:Adult MHD patients from 2008 to 2018 were enrolled and divided into training data group and validation data group. In training data group, multivariate logistic regression was used to analyze the risk factors of early death within 120 days after hemodialysis and establish a prediction model. The receiver operating characteristic (ROC) curve was applied to evaluate the prediction ability of the model.Results:A total of 4 885 patients were included. The cumulative mortality within 120 days was 20.97/100 person years, and that within 365 days was 12.25/100 person years. A total of 3 603 patients in the training data group were analyzed. The following risk factors were correlated with early mortality (all P<0.05), including age at start of dialysis over 60 years old ( OR=1.792), non-chronic glomerulonephritis ( OR=2.214), cardio-cerebrovascular disease ( OR=2.695), plasma albumin less than 35 g/L ( OR=1.358), platelet count less than 120×10 9/L ( OR=2.194), serum creatinine less than 600 μmol/L ( OR=1.652), blood urea nitrogen over 30 mmol/L ( OR=1.887), blood phosphorus less than 1.13 mmol/L ( OR=1.783), pulse pressure over 55 mmHg(1 mmHg=0.133 kPa) ( OR=1.656), low density lipoprotein less than 1.5 mmol/L ( OR=1.873), and blood calcium over 2.5 mmol/L ( OR=1.876). Risk prediction model was established. The other 1 282 cases in the validation data group were verified. The area under ROC curve was 0.810, with sensitivity 85.7%, and specificity 62.5%. Conclusion:The mortality rate of adult MHD patients within 120 days after dialysis is high. The established prediction model can effectively predict the risk of early death.

Objective:To explore the relationship between end-dialysis over-weight (edOW) in initial stage of hemodialysis and long-term prognosis in maintenance hemodialysis patients.Methods:The data of initial uremia patients receiving hemodialysis in the First Affiliated Hospital, College of Medicine, Zhejiang University from January 1, 2008 to April 30, 2017 were retrospectively analyzed. The end point of follow-up was death or until April 30, 2018. The general data including age, gender, body mass index, primary disease, complications and laboratory indicators of the patients and the related parameters of dialysis from four to twelve months were collected. Kaplan-Meier method was used to analyze survival rate. Cox multivariate regression was used to analyze the relationship between edOW and all-cause mortality and cardiovascular disease (CVD) mortality.Results:A total of 469 patients (300 males, 64.0%) were enrolled, with age of (56.9±17.1)years old. During the follow-up period of (4.1±2.4) years (1.0-10.3 years), 102 patients died. The main cause of death was cardiovascular and cerebrovascular events, accounting for 44.1% (45/102). The value of edOW was (0.28±0.02) kg. The patients were divided into edOW<0.28 kg group ( n=292) and edOW≥0.28 kg group ( n=177) according to the mean value of edOW. Kaplan-Meier survival analysis showed that the long-term survival rate in edOW<0.28 kg group was higher than that in edOW≥0.28 kg group (Log-rank χ2=4.134, P=0.043), and the CVD mortality in edOW≥0.28 kg group was significantly higher than that in edOW<0.28 kg group (Log-rank χ2=11.136, P=0.001). Cox multivariate regression analysis showed that high edOW was an independent influencing factor for all-cause death and CVD death in hemodialysis patients ( HR=1.541, 95% CI 1.057-2.249, P=0.025; HR=1.930, 95% CI 1.198-3.107, P=0.007). Conclusion:High edOW in early phase is an independent influencing factor of all-cause and CVD death in hemodialysis patients.

Aim To investigate effects of tetramethylpyrazine (TMP) on neuropathic pain induced by P2X_3 receptor. Methods Chronic constriction injury (CCI) model was adopted. Mechanical withdrawal threshold and thermal withdrawal latency were measured and P2X_3 immunoreactivity in L_4/L_5 spinal cord was detected by immunohistochemistry. Results At day 14 after operation, the mechanical withdrawal threshold and thermal withdrawal latency in group Ⅴ(CCI group) were lower than those in groupⅠ(NS group),Ⅱ(TMP group),Ⅲ(sham group) and Ⅳ (CCI+ TMP group)(P0.05). The expression of P2X_3 receptor in L_4/L_5 spinal cord of group Ⅳ was lower than that of group Ⅴ (P