Objective To explore the preliminary practice of Clinical Scenario Mode in the teaching of surgery. Methods Clinical Scenario Mode was stimulated or rebuilt by the cooperation of teachers and Standardized Patients (SP) to introduce relative theories and raise discussions in the surgery lectures of five-year clinical medicine students in grade 2004 and grade 2005. Results Lectures with the application of Clinical Scenario Mode were reported positively by students from the survey. It improved students’learning motivation,enhanced teaching quality,and optimized the allocation of resources. Discussion With the combination of the advantages of lecture based learning (LBL) and problem based learning (PBL),Clinical Scenario Mode can be considered as the linkage to the widespread use of PBL,and should be widely applied in the medical teaching practice.

Objective To study the effective treatment for severe hypertensive cerebral hemorrhage. Methods 102 cases of severe hypertensive cerebral hemorrhage were randomly divided into two groups: One group with minimally invasive surgery and intravenous drip of wintermine started 1 ～ 5 days after operation, another only with minimally invasive surgery. The 55 subjects with conservative treatment were selected as control group. Results The quality of life in the survival group was better than in group B and C (P < 0.05, or P < 0.01), the mortality of group A was also significantly lower than the other two groups (P < 0.05, or P < 0.01). Conclusion Minimally invasive surgery combined with intravenous drip of wintermine can be a safe and effective method for severe hypertensive cerebral hemorrhage.

Objective To assess volume state precisely and rapidly by ultrasonography of internal jugular vein (IJV) in healthy blood donor.Methods The values of the sonographic IJV collapse index and corrected IJV longitudinal length (cIJVLL) of 46 healthy blood donors were compared before and after blood donation.The correlations between IJV collapse index and cIJV LL were analyzed.Results The value of cIJV LLs before and after blood donation were significantly difference (6.56 ± 0.32 vs.6.11 ± 0.41,P ＜ 0.01).IJV collapse index before blood donation was not differently significant after blood donation (33.12 ± 2.21 vs.39.01 ± 3.83,P＞ 0.05).There was correlation between the value of cIJV LLs before and after blood donation (r =0.81).The value of IJV collapse index before and after blood donation,as well as cIJVLL was not well correlated (r =0.24,r =0.13,respectively).Conclusion The IJV collapse index is not a useful parameter for evaluation of hypovolemia,cIJV LL is more valuable marker for the detection of blood loss in emergency.

Objective: To modify the structure of podophyllotoxin derivatives and evaluate the antitumor activities of the derivatives. Methods: The target compounds were synthesized by multi-step reaction with podophyllotoxin and aldehyde compound as starting material.. MTT assay was used to test antitumor activity of all the target compounds on Hela cells, K562 cells, and K562/A02 cell. Results: Eleven novel derivatives were synthesized which had not been reported in any literature and the structures were characterized by 1H-NMR, 13C-NMR, HR-ESI-MS and melting point determination analysis. The antitumor activity screening results showed that all the target compounds had different degrees of cytotoxic activity in vitro. Most of the compounds had significant anti-MDR activity in vitro. Conclusion: Through structural modification of podophyllotoxin derivatives, the antineoplastic activities are enhanced.

OBJECTIVE: To synthesize 5-substituted indole-3-deoxypodophyllotoxin derivatives and study their antitumor activity. METHODS: The target compounds were synthesized through a series of reactions and their anti-tumor activity in vitro were evaluated against Hela, K562 and K562/A02 cell lines by MTT as assay. RESULTS: Ten target compounds were synthesized and confirmed by 1H-NMR, 13C-NMR, and HR-ESI-MS. All the target compounds had different degrees of cytotoxic activity in vitro. Most of the compounds had significant anti-MDR activity in vitro. CONCLUSION: 5-Substituted indole-3-deoxypodophyllotoxin derivatives have good antitumor activity and worth of further study.

Objective The study was to provide evidence for the development of local community health services through the analysis of patiems' expectations for community health services. Methods The expectations were indirectly evaluated by investigating the patients in the willingness-to-pay. Results The patients had a generally high expectation for health community services and they would be highly disappointed once their expectations fall short. Conclusions Those expectations that could be realized with short-term efforts ought to attract high attention of community health service providers and made important goals to achieve in the near future.

OBJECTIVE:To provide reference for rational use of anticoagulant drugs in the clinic. METHODS:Medical or-ders of anticoagulant drugs were collected from hospital information system of our hospital during 2013-2015. Those medical orders were analyzed in respects of consumption sum,DDDs,DDC and drug utilization. RESULTS:During 2013-2015,the sum tatio of Low-molecular-weight heparins calcium injection(6000 AXaIU),Enoxaparin sodium injection(6000 AXaIU),Dalteparin sodium injection(5000 IU) and Rivaroxaban tablets(10 mg)were on the rise,while those of Nadroparin calcium infection(6150,4100 AXaIU)and Fondaparinux sodium injection(2.5 mg)were in the decline. DDDs of Nadroparin calcium injection(4100 AXaIU), Dalteparin sodium injection(5000 IU)and Enoxaparin sodium injection(6000 AXaIU)took up the first 3 places. DDC of Rivar-oxaban tablets was the highest,being 167.60-180.25 yuan. The utilization of Nadroparin calcium injection(6150,4100 AXaIU), Low-molecular-weight heparins calcium injection (6000 AXaIU),Fondaparinux sodium injection(2.5 mg) and Warfarin sodium tablets(3 mg)showed good synchronization within 3 years,and the values of B/A ranged 0.50-1.50. Both consumption sum and utili-zation rate of rivaroxaban took up the first place in vascular surgery department. CONCLUSIONS:Based on the spectrum of diseases, the features of drugs and ADR,the utilization of anticoagulant drugs in our hospital is rational during recent 3 years. However,the uti-lization of anticoagulant drugs should be still used as routine pharmaceutical monitoring content.

OBJECTIVE:To compare the quality of domperidone tablets produced by 3 different factories METHODS:The quality of different products was investigated according to the standards of Ministry of Public Health and manufacture factories,including dissolubility,uniformity of dosage units,related substances and seals of blister packaging RESULTS:In 3 batches of products manufactured by Y,W and L,the contents of domperidone were 98 23%～99 74%,96 92%～98 31% and 97 42%～98 72%,and content uniformity A+1 8S was 2 11～3 38,3 97～5 25 and 5 49～7 47 respectively,which were in keeping with the Chinese pharmacopoeia;impurity R061668 was not found,and contents of impurity R052211 were 0 004%～0 024%,0 029%～0 072% and 0 003%～0 056%;the total impurity substances were 0 030%～0 095%,0 102%～0 128% and 0 232%～0 489%;the dissolubity(45min) was 95 09%～95 77%,91 25%～96 43% and 95 48%～96 58% respectively In experimental condition,no leakage was found from blister package of Y and W products,however,the leak rate of L product reached more than 38% CONCLUSION:According to this survey,the quality of product Y is the best,W is better

Objective To improve the recognition of nervous system symptoms of inborn errors.Methods Five patients with organic acidemias were screened by urine organic acid analysis(gas chromotography-mass spectrometry,GC/MS),3 cases of methylmalolic acidemias(MMA) and 2 cases of propionic acidemias(PA) were confirmed.They were treated with special diet and medicine after diagnosis.Result The improvement of mental development was observed after treatment.Conclusions Most of organic acidemias involve nervous systems,causing non-specific symptoms of nervous system as lethergy,seizures,mental retardation.Inborn errors of metabolism shall be kept in mind when causes of the symtoms of acidosis,seisures,mental retardation and lethergy are investigated.GC/MS is a very important method in diagnosis of organic acidemias.Early diagnosis and early treatment can improve the mental prognosis.

AIM:Changes of rat renal aquaporin (AQP1) and AQP2 mRNA expression after partially ligating left renal vein were observed to explore molecular mechanism of renal tubular reabsorption decrease resulted by increasing renal vein pressure.METHODS:Adult male rats were randomly divided into left renal vein partial ligation group(ie. VCG, varicocele group ) and sham operation group (SOG), left renal mRNA expression was analyed by Northen blot two months later.RESULTS:Intensity of left renal AQP1 mRNA expression in VCG was weaker than that in SOG, there was not any difference in left renal AQP2 mRNA expression between two groups, no hybridization signal was found in testes.CONCLUSION:Decrease of renal tubular reabsorption resulted by partially ligating renal vein might be related to decrease of AQP1 mRNA expression; “hormone escape" might occur in collecting tubules.