[Abatract] In order to improve the result of clinical practice for undergraduate students of clinical medicine, combined with the professional characteristics of hematology and teaching syllabus, Hematology Department in the First Affiliated Hospital of Dalian Medical University developed practi-cal teaching content and tried using a variety of teaching methods and teaching means such as multi-media aided teaching, case teaching and simulation teaching method and so on. Besides, multiple station examination was established; teaching feedback and supervision were strengthened. The prac-tice proved that the reform measures were conducive to the cultivation of medical students' practical skills and clinical thinking, which helped to speed up the transformation from the students to the role of doctors.

Objective To analyze the effectiveness of chronic disease management among suburb residents to secure an optimal health management model. Methods Since 2002, physical examinations had been conducted for rural residents aged≥40. Hypertensive patients detected on health check received medical evaluation and risk factor intervention. Results The incidence of high blood pressure decreased from 26.57% in 2002 to 11.99% in 2007-2008. The mortality of cerebrovascular disease declined from 68.00% to 5.26%. The incidence, disability rate, and death rate of hypertension related-stroke were also significantly reduced. Conclusion Primary healthcare center-based chronic disease screening, along with the health management network, can largely decrease the incidence, disability rate, and mortality of stroke associated with high blood pressure.

Objective To investigate the combined inhibition effect and the potential mechanism of rapamycin (mammalian target of rapamycin inhibitor) and PD98059 (mitogen-activated protein kinase/extracellular signal-regulated kinase kinase (MEK) inhibitor) on mouse colorectal cancer (CRC). Methods S-ICR mice were subcutaneously injected with 20 mg/kg of 1,2-dimethylhydrazine dihydrochloride in the nape for 20 weeks to induce CRC. From the 16th week, the mice were treated with alone or combined injection with 0.25 mg/kg rapamycin and 2.5 mg/kg PD98059. The drugs were administered for 8 weeks. Subsequently, the animals were sacrificed and dissected, the tumor sizes were measured, and the tumors were harvested for pathological assay. Furthermore, the phosphorylation of mTOR, p70S6K, and 4E-BPl proteins was detected by using immunohistoehemistry. Results The mice treated with rapamycin (44. 44 %) or PD 98059 (either alone (38.89%) or combination treatment (6.67%) were significantly less likely to develop cancer compared with mice receiving none of them (77.78%, P<0. 05). The average size of tumors was (6.15±2. 192), (8.85±3. 983), (2.917±0. 191), (16.36±6.855) mm3 respectively (P<0.05).The anti-cancer effect of the combination treatment was substantially significant. The proteins of phospho-mTOR, phospho-p70s6K and phospho-4E-BPl were significantly down-regulated after treatments (all P values < ,0.05). Conclusions Combined treatment was more effective than single-drug treatments of rapamycin or PD98059 alone for the prevention and treatment of mouse CRC. The mTOR signal pathway might be involved in the inhibitory mechanism.

0.05),PaO2,PaCO2 of patient and to shorten the number of application days in intensified group were better than in routine group.The improvement of nutritional status in intensified group was also superior to routine group.There was significant difference between 2 groups (P

Objective To observe the efficacy and adverse events of L-asparaginasum plus DICE regimen in the treatment of relapsed and refractory non-Hodgkin's lymphoma (NHL). Methods Thirty-one patients with relapsed and refractory NHL were treated with L-asparaginasum plus DICE regimen. Each patient was scheduled to receive 2 to 6 cycles.Results Among the 31 assessable patients,11 (35.5 ％) achieved a complete remission (CR),14(45.2 ％) got a partial remission (PR),2 were stable,4 were progressive.The overall response (CR + PR) rate was 80.7 ％.The median survival was 8 months (rang:2-38 months).The 1-year survival rate was 43.3 ％,the 2-year survival rate was 32.5 ％.The main adverse events were myelosuppression,digestive tract reaction,allergy and edema.No treatment-related death was observed.Conclusion The L-asparaginasum plus DICE regimen is effective and safe for the relapsed and refractory NHL.

Objective To investigate the imaging features in CT/MR of pancreatic neuroendocrine tumors(PNETs) with multiple lesions and further deepen the understanding of this disease .Methods A retrospective review of 12 PNETs patients′radiological data with pancreatic tumors′numbers≥2 and confirmed by surgery or fine needle aspiration biopsy in Changhai Hospital were conducted .Five cases underwent pancreatic CT plain and enhanced scan , 2 cases underwent MRI plain and enhanced scan , and 5 cases underwent both CT and MRI scan .Results There were totally 46 lesions in 12 patients.There were 29 (63.0%) lesions located in the pancreatic head and neck , and 17(37.0%) lesions located in body and tail of pancreas.The sizes of the lesions ranged from 0.8 to 9.5 cm,and the median size was 2.9 cm.Forty-four (95.7%) of the tumors was round or oval , and 2 ( 4.3%) was lobulated;44 ( 95.7%) mass solid and 2 (4.3%) was cystic.CT plain scan detected punctate , crescent or nodular calcification in 8(17.4%) lesions;enhanced scan found 42 lesions(91.4%) were markedly enhanced in the arterial phase , 2 lesions (4.3%) were markedly enhanced in the pancreatic phase;2 lesions (4.3%) were slightly enhanced and the degree of enhancement was lower than that of the normal pancreas .Four cases (33.3%) had dilatation of pancreatic duct and/or the bile duct, 4 cases (33.3%) had distant organ metastasis, 2 cases (16.7%) had lymph node metastasis, and 3 cases (25.0%) had vascular invasion .Conclusions PNETs can be multiple and vary in the size.Most of the lesions are round or oval solid lesions and the malignant signs for organ metastasis can be found occasionally .In dynamic enhanced scanning , the obvious enhancement of the solid portion in the tumor and the higher enhancement degree than that of normal pancreas is the main characteristic .

Objective: To observe the cholagogic effect of Danning Tablet. Methods: We determined the gallbladder contractibility, the bile flow volume and the tensity of Oddis sphincte of rabbit. Results: Danning Tablet could increase the frequence and extent of the gallbladder contractibility and the bile flow volume, it also relaxed Oddis sphincte ( P

A strain named as WJ44 with capability of producing branched-chain aminotransferase was isolated from the soil, the enzyme activity is especially high when used leucine as a substrate. According to the physiological characteristics, biochemical characteristics and 16S rRNA sequence of WJ44, the strain was identified as Bacillus cereus. The optimal carbon source and nitrogen source were also determined as 20 g/L glucose, 15 g/L tryptone and 5 g/L beef extract, respectively. The optimal proportion of other component in the medium is corn steep liquor 15 g/L, KH2PO4 3 g/L, MgSO4?7H2O 0.5 g/L. The optimum original pH value is 7.0, the cultural temperature is 37℃, liquid volume is 20 mL/250 mL, the shaker’s rotating speed is 200 r/min. The highest leucine transferase activity of 45.787 U/mL was achieved after 10 h under the opti- mal condition, and the dry weight of cell is 8.643 g/L, increased by 54% and 10% respectively. This result shows that WJ44 is a branched-chain aminotransferase-production strain with fine capability.

Objective:To discuss the effect of pharmacist intervention on the use of antimicrobial agents in the clinical pathway of community-acquired pneumonia ( CAP) in our hospital to standardize the rational medication and promote the rational use of antimicro-bial agents. Methods:Totally 100 bacterial CAP patients in 2013 ( before the intervention) and 2014 ( after the intervention) in the pneumology department were studied. The antibacterial drug cost, total hospitalization cost, use intensity of antimicrobial drugs, hospi-talization time, therapeutic effects and so on in the two groups were observed during the treatment. Results: There were significant differences between the two groups in antibacterial drug cost, total hospitalization cost, use intensity of antimicrobial drugs, hospitaliza-tion time and so on, whereas there was no significant difference in the curative effect. Conclusion:After the pharmacist intervention, the application of antibiotics is more rational, the antibiotics use density and per capita cost are reduced, the hospitalization day is shortened and the value of pharmacists is also improved.

Objective To explore the effect of adriamycin, bleomyein, vincristine and dacarbazinum (ABVD) chemotherapy scheme executed at day I and day 8 for primary Hodgkin's lymphomas (HL). Methods 62 patients with primary HL in stages Ⅱ-Ⅳ treated in our department from October 2005 to October 2006 were divided into group A and B at random with 31 patients in each group. The patients in group A received ABVD chemotherapy scheme executed at day 1 and day 8 for 6-8 cycles. The patients in group B received ABVD chemotherapy scheme executed at day 1 and day 15 for 6-8 cycles. The patients of the groups received radiotherapy by the same doctor after chemotherapy according to the patients condition and the radiotherapy regimens were not affected by the grouping. Results The complete remission rate (CR)in group A after chemotherapy was 90. 3% (28/31);the one-year and two-year disease free survival (DFS) rates were 87. 1% (27/31) and 80.0% (20/25)respectively. The CR rate in group B after chemotherapy was 83.9% (26/31);the one-year and two-year DFS rates were 80. 6% (25/31)and 72. 0% (18/25) respectively. The discrepancy of CR rates and the one-year and two-year DFS rates between the two groups was not significant (P>0.05). The incidences of therapeutic side effecte such as myocardial iscnemia grade Ⅲ-Ⅳ liver function impair-ment,pulmonary fibrosis and serious marrow inhibition between the two groups were not significant too (P > 0.05). Average chemotherapy period for the patients in group A was 159 days; it was 69 days shorter than that in group B. Conclusion The CR rate,1-year DFS rate and 2-year DFS rate of ABVD chemotherapy scheme executed at day 1 and 8 are similar to those of ABVD chemotherapy scheme executed at day Ⅰ and 15 for primary HL in stages Ⅱ-Ⅳ. The side-effects of chemoterapy between group A and B are similar too. The chemotherapy period in group A is shortened significantly.