Case based study emphasizes on the training of students' practical clinical ability. With the development of computer technology, picture archiving and communication system was widely applied, providing bases for case based study. According to the characteristics of radiology, appli-cation of case based study in medical imaging practice teaching was believed to stimulate students' learning interest, improve their analytical ability and thinking capacity, make them combine theory with practice better and develop their clinical thinking ability.

To improve the quality of practice teaching in medical imaging,we explored the teaching methods on the basis of quality-oriented education,combining the special nature of the medical imaging and the clinical medicine program.

Comparative imaging can be used to analyse and compare diseases in different respects,which can not only conduce to students’transversal contrast of knowledge they have learned, but also improve the teaching effect of medical imaging and the students’clinical skills,and at the same time,lay a solid foundation of the research for future.

Objective To explore the effectiveness of remediation of antimicrobials in a third-grade class-A hospital .Methods Using retrospective analysis to analyze the clinical application of antimicrobials related data during July .2011 to Nov .2011(before remediation) and July .2012 to Nov .2012(after remediation) .Results The ratio of antimicrobial cost ,the proportion of outpatient antimicrobial prescribing ,inpatient antimicrobial usage and AUD fell respectively from 13 .73% ,16 .97% ,59 .93% and 72 .71 DDDs/100 persons day before remediation to 7 .37% ,13 .83% ,44 .88% and 40 .08 DDDs/100 persons day after remediation ;indica-tors of antibacterial use in clean surgery improved greatly ;the structure of antibacterials changed significantly .Conclusion After extensive antimicrobial special rectification ,the clinical use of antimicrobials is rationalized ,a number of indicators are in line with the Ministry of Health ,its management experience is worth using for reference .But there are still some problems which call for at-tention .

Objective To study atrioventricular conduction during right coronary artery infarction and its correlation with sympathetic nerve.Method AIMI model by ligating the fight coronary artery of denervated autonomic nervous cats was used.The A,H and V-wave were measured from the His electrode by template matching.The AA,AH,HV intervals with and without sympathetic nerve stimulation were measured respectivelv.Results The decreased percentage of AH intervals was (7±5)% vs.(14±5)% (without pacing) and (12±2)% vs.(23±7)% (with pacing) respectively in ischemia and normal after sympathetic nerve stimulation,and the decreasing amplitude were 50% and 48% respectively.Conclusion The regulating function of sympathetic nerve on atrioventricular conduction decreased after ischemia related to the right coronary artery.This decrease may be one of the mechanisms that lead to atrioventficular block after acute inferior myocardial infarction.

Objective To explore the early coal pneumoconiosis patients with HRCT staging and pulmonary function abnormali-ties indicators ,provide an objective basis for clinical diagnosis and treatment early pneumoconiosis .Methods Strict control of the inclusion criteria :no smoking ,no pneumonia ,no tuberculosis ,no lung cancer and no lung surgery ,as a result ,total 33 early coal pneumoconiosis patients were chosen in the study .All of them were underwent paired CT obtained at full inspiratory position .High kv chest radiography ,and pulmonary function tests at the same day .Reference to the chest X-ray pneumoconiosis classification method as pneumoconiosis HRCT staging .Analyzed the correlation between early coal pneumoconiosis with HRCT staging and the parameters ,including Forced vital capacity (FVC) ,Forced expiratory volume in 1 second(FEV1) ,FEV1/FVC ,Maximum midexpi-ratory flow(MMEF) ,Peak expiratory flow(PEF) ,FEF75 ,FEF50 ,FEF25 ,Total lung capacity(TLC) ,Residual volume(RV) ,Carbon monoxide diffusion capacity(DLco) ,KCO and so on .Results HRCT could be more accurately display the shape ,size and distribu-tion of coal pneumoconiosis small nodules .There were significant correlation with MMEF ,PEF ,FEF75 ,FEF50 and FEF25 in different HRCT staging .Conclusion HRCT can early detection and validation early coal workers pneumoconiosis .Early coal worker′s pneu-moconiosis small airway flow rate decline caused by inhalation coal dust .

Objective To investigate the ED50 and ED9 5 of subarachnoid 0.375% bupivacaine in elderly patients undergoing elective total hip arthroplasty (THA ) in high altitude area. Methods Twenty-three elderly patients,aged 73-99 years old,ASA Ⅱ or Ⅲ,selected for total hip ar-throplasty (THA)under combined spinal-epidural (CSE)anesthesia were enrolled in this study and predose of 3.0 mg,0.375% (m/v)bupivacaine administered in subarachnoid,following dosage in-creased by ratio of 0.8.Calculate the ED50 and ED9 5 of subarachnoid 0.375% bupivacaine and 95%CI.Results Twenty of 23 underwent the test completely.The ED50 (95%CI)and ED9 5 (95%CI)of 0.375% (m/v)bupivacaine were 4.81 mg (3.98-5.81 )and 7.29 mg (6.03-8.81 ),respectively. Conclusion Subarachnoid 0.375% bupivacaine (7.5 mg)can be used effectively and safely in elderly patients undergoing total hip arthroplasty in high altitudes area.

Objective To investigate smoking status,knowledge of smoking hazards,attitude of tobacco control and skill of assisting smoking cessation of the staff in a teaching hospital in Chongqing and to provide references for the further construction of‘smoking-free hospital’. Methods General investi-gation was taken on the staff in a teaching hospital in Chongqing with a self-designed questionnaire. Main contents of questionnaire include:social demographic information,smoking status,awareness of tobacco hazard,willingness and methods of tobacco control,etc. All the data were inputted with software Epidata 3.1 and were analyzed with SPSS 13.0. Results The total smoking rate was 9.65%,with 30.49%for male, 2.75%for female and 12.50%for clinician. The age distribution of smoking staff was described as follow-ing:91.97% being under 50 year-old and more than 50.00% being 20-35 year-old. 52.43% of the surveyed did not know Framework Convention of Tobacco Control of WHO . Relatively ,most of the surveyed only knew well the relationship between respiratory diseases and tobacco use and the relation-ship between fetal abnormalities and tobacco use. 84.99%of the surveyed agreed with outdoor-smoking policy;83.56%of the surveyed claimed that they had discouraged smoking behaviors in public at various extents,14.20%of the surveyed agreed that assisting the public in smoking cessation was one of the aims of constructing‘smoking-free hospital’;70.00%clinicians claimed routinely inquiring and noting smok-ing status of patients, which was better than nurses and medical technicians;almost 30.00%clinic staff did not know quitting smoking drugs at all,approximately 70.00%clinic staff claimed a lack of confidence in smoking control and approximately 70.00% clinicians and nurses did not recommend pro-fessional methods of smoking cessation in practice. Conclusions Smoking staff in the teaching hospital are almost younger people,which is an alarm of the urgent need for tobacco control education. Most staff reach a consensus on keeping smoking-free environment in hospital,but they do not sufficiently acknowledge their social responsibility for tobacco control,and also there is a distance before they can serve as a smok-ing cessation assistant. Tobacco control must be incorporated in long-term mechanism of hospital con-struction. There are three steps in the construction of smoking-free hospital:①creating a smoking-free en-vironment in hospital;②encouraging patients to quit smoking and providing professional service of smoking cessation;③making a positive effort on social tobacco control and advocating smoking cessation in public.

Objective To explore the clinical value of the monitoring of electronic cardiac index (CI) in the evaluation of neonatal congenital heart disease complicated with heart failure. Methods Sixty neonates with congenital heart disease treated in neonatal department from March 1, 2016 to December 30, 2016 were selected, and divided into severe group (n=11), moderate group (n=15), mild group (n=34), and no heart failure group (n=10) according to the modified Ross heart failure score. CI was measured by electronic force measurement. Left ventricular ejection fraction (LVEF) and pulmonary arterial pressure (PAP) were measured by echocardiography. Venous blood sampling was collected to detect the N-terminal type B brain natriuretic peptide (NT-proBNP). Results The neonates in the severe group were mainly under 2-week-old, while those in the mild group and the moderate group were more than 2-week-old. The differences of CI, LVEF, NT-proBNP, and PAP among the groups were statistically different. The CI and LVEF values were lowest in the severe group, followed by moderate group and mild group, and the highest in no heart failure group. The NT-proBNP and PAP values were the highest in the severe group, followed by moderate group and mild group, and the lowest in no heart failure group. Correlation analysis showed that CI was positively correlated with LVEF (r=0.845, P<0.001), and negatively correlated with NT-proBNP (r=-0.886, P<0.001); CI and PAP were weakly negatively correlated (r=-0.595, P<0.001). Conclusions CI reflects the degree of heart failure to some extent and has some clinical value.