Objective To understand the effects of reform on clinical teaching taking patient's symptoms as the starting point and to investigate students' recognition degree towards this reform and their information feedback.Methods Totally 42 clinical students of the second clinical medical college (the second class) of China Three Gorges University were enrolled in the study and clinical teaching taking patient's symptoms as the starting point was conducted.Thirty-nine clinical students of the second clinical medical college (the fourth class) were enrolled as control group and traditional method was conducted.Effects of clinical teaching were evaluated by examination score and students' recognition degree towards this reform was investigated by self-made questionnaire and information feedback.Data were processed using SPSS 13.0 statistical software; t tests were used to compare students' scores of theoretical test and skill test; P ＜ 0.05 signifies that the difference is statistically significant.Results There was no statistical difference in theoretical test score between experiment group and control group (P ＞ 0.05).Skill test scores were higher in experiment group than in control group (P＜0.01).Students highly admitted this teaching mode and they thought that this mode can improve their self-study ability,clinical practice skill and clinical thinking ability without influencing their theoretical learning.Conclusions Practice of clinical teaching taking patient's symptoms as the starting point is feasible,which can increase scores of skill test significantly without influencing scores of theoretical test.

The glucose metabolism pathways including glycolysis and oxidative phosphorylation in vivo.The metabolism of tumor cells depends on glycolysis,which enhances the adaptability of tumor cells to the microenvironment and promotes the proliferation of tumor cells,which is called Warburg effect.Arsenic is one of the chemical pollutants,which is widely distributed in natural environment.International agency for research on cancer (IARC) has made it clear that arsenic and its compounds are carcinogens.However,the mechanism of carcinogenesis induced by arsenic still remains obscure.Recently,researchers have found that Warburg effect plays an important role in the process of arsenic carcinogenesis.In this paper,we have reviewed the definition and function of glycolysis,its relationship with inflammation and tumorigenesis,and the role of Warburg effect in arsenic carcinogenesis.

The criterion of injury severity is an important part of evaluation,which can affect the treatment for closed fracture.The reaction in soft tissue healing process contains microvascular responses and inflammation.Take soft tissue with low immunity as a incision will lead to wound dehiscence and deep infection.Therefore,realization of injury severity lays a foundation for effective treating with closed fracture.Many treatment methods,such as splint fixation,cryotherapy,compression or delayed operation,can prevent soft tissue from a second injury,and promote self-repair ability prior to operation.The newly development surgical tech-nique can improve efficacy of therapy,meantime,decrease the incidence of complications.

Objective To prove the existence of dry eye in children and to learn the clinical characteristics of them. Design Prospective observational case series. Participants 38 cases(76 eyes) of suspected children of dry eye diagnosed by adult standard and 38 normal children subjects. Methods 38 suspected child patients were studied who were diagnosed clinically with dry eye by adult standard, and were followed up 6 months. The control group consisted of 38 normal children with no significant difference in age. Dry eye examinations including Schirmer test, break-up time(BUT) and fluorescein staining were performed on these two groups. Following items were recorded in 38 suspected children of dry eye, including symptoms and causations. Main Outcome Measures Symptoms, Schirmer test, BUT and fluorescein staining. Results In the 38 suspected patients, frequent blinking was the most common symptom in 21 cases(55.26%), followed by dryness (15 cases, 39.47%), redness (14 cases, 36.84%) and photosensitivity (14 cases, 36.84%). The Schirmer test and BUT were decreased remarkably in the suspected patients compared to those of normal subjects (P=0.0000). In both groups, right eyes were correlated with left eyes in both Schirmer test and BUT. Between these two groups, Schirmer test was nol correlated with BUT. In the suspected patients, the results of BUT and fluorescein staining were improved (P

Objective To investigate colonization of multidrug-resistant organisms (MDROs)in neonatal intensive care unit (NICU)newborns on admission.Methods From April to November 2013,293 newborns who admitted to NICU of a hospital were screened for methicillin-resistant Staphylococcus aureus (MRSA)by nasal and throat swabs and for extended-spectrumβ-lactamases (ESBLs)bacteria and vancomycin-resistant Enterococcus (VRE)by anal swabs.Results Of 293 newborns,61 were detected MDROs (20.82%).The positive rate of MDROs screening in newborns aged <3 days(5.92%)was lower than those aged <3-6 days(37.74%)and 7-28 days (43.66%), the difference was significant (P =0.000).The major colonized MDROs were ESBLs-producing bacteria(83.60%), the major colonized site was anus(88.52%).Conclusion Neonatal anus and stool are important sources of MDROs in NICU;more attention should be paid to colonization screening for MDROs by anal swabs in newborns aged >3 days,and appropriate isolation measures should be taken for positive screening patients to prevent the transmission of MDROs.

AIM: To study protective effects and mechanism of heat shock response (HSR) on cardiovascular system in rats after heat exposure. METHODS: The study was divided into 2 experiments: ① Protective effects of HSR on cardiovascular system in rats after heat exposure. SD rats randomly allocated into 2 groups: heat shock group (HS group), sham control group (SC group). HS group were treated with heat shock, but SC group weren't. After recovering for 20 h at room temperature, two groups exposed to death in thermal environment, and blood pressure and electrocardiogram were measured continuously. Through Chart software mean arterial pressure(MAP), existent time etc were acquired. ② SD male rats randomly allocated into 3 groups: HS group, SC group and normal temperature control group (NC group). NC group weren't treated. The treatment in HS and SC group was identical with in the first experiment, but it would be terminated at 73 min after heat exposure, meanwhile content of MDA of myocardium were measured. RESULTS: ① Existent time in HS group was longer than that in SC group and shock arrived later; ② During earlier period after heat exposure MAP had no significant changes between HS and SC group, but after 60 mins MAP in HS group were higher than that in SC group; ③ Compared with NC group, content of MDA in myocardium in SC group was higher significantly at 73 min after heat exposure. Howerer, content of MDA in HS group was lower than in SC group, and had no significant changes with NC group. CONCLUSION:Through decreasing production of MDA in myocardium, HSR has a protective effect on cardiovascular system in rats after heat exposure.

Objective To elucidate the significances of health education in the prevention and treatment of gout and hyperuricemia.Method Health education scientific knowledg was done through approaches of specific proclamation in clinic out patients,screening the directly-related members of patient family,training medical staffs and popular vehicle propaganda etc.Results Health education improved the diet structure and life mode of patients,promoted early diagnosis and treatment of patients.It also had favourness in timely detection of other patients in directly-related members of ones family.Conclusion Health education combined with conventional pharmacological therapy could produce a better efficacy than that of single pharmacological ones.

BACKGROUND:Interbody fusion is widely used in spine surgeries. Failed fusion may cause many complications, so it is very important to evaluate fusion before surgery. Imaging methods are commonly used to evaluate fusion, including X ray, CT and MRI. Above methods have their own specific methods and characteristics, which cause their differences in sensibility and specificity. OBJECTIVE:To review the research progress of imaging methods in interbody fusion. METHODS:The English key words were“lambar fusion, cervical fusion, interbody fusion, evaluation method”in the PubMed database. The literatures with detailed description of interbody fusion were selected for further review, including comparative study on a variety of evaluation methods of imaging means. RESULTS AND CONCLUSION:According to the inclusion criteria and exclusion criteria, a total of 40 papers were included. X-ray and CT are the most commonly used methods, while CT is more reliable. MRI, bone scan and other methods cannot correctly and directly evaluate spinal fusion. Overal judgment of symptoms, signs and different kinds of image data are more reasonable fusion evaluation strategies.

In order to assess colonic motility of chronic constipation, colonic transit test was carried out in 34 patients with chronic constipation and in 20 healthy subjects. 20 radiopaque markers are ingested at 8 am before the day test, and plain abdominal films were obtained at 24 h, 48 h and 72 h. The normal value of colonic transit test was 16(80%), or more markers passed after 72 h. By means of transit time study, 34 constipated patients were classified into 2 groups: 12 normal transit patients and 22 slow transit patients. There was no difference in colonic transit time between normal transit patients and controls (P＞0.05). Patients with slow transit had more markers left in right colon, left colon and rectosigmoid colon at 48 h (P＜0.01, respectively) and 72 h (P＜0.01, respectively). According to the transit index, 22 slow transit patients were divided into 3 types: 10 cases colonic stasis, 8 cases outlet obstruction and 4 cases colorectal stasis. The study suggests that chronic constipated patients have abnormalbilities of colonic transit.