The practical teaching of clinical medicine is in progress on the last stage of the 5-year university life,so it has the feature of the employment preparation and is influenced by a lot of factors.To make the practical teaching of clinical medicine take the right turning and get a satisfactory result,we should not only lay stress on the construction of teachers'contingents,but also bring the students'initiative to play and tighten up the management.

OBJECTIVE:To study the pharmacokinetics and relative bioavailability of metformin hydrochloride enteric-coated tablets and validate the bioequivalence between the domestic and the imported metformin hydrochloride enteric-coated tablets.METHODS:An oral single dose(1 000 mg)of domestic or imported metformin hydrochloride enteric-coated tablets was given to 26 healthy volunteers in a randomized crossover study.The time-concentrations of metformin hydrochloride were determined by HPLC.The pharmacokinetic parameters as well as relative bioavailability of the domestic tablets were computed.RESULTS:The concentration-time curves of the two kinds of metformin hydrochloride enteric-coated tablets were in line with one-compartment model.The main pharmacokinetic parameters of the domestic vs.the imported metformin hydrochloride enteric-coated tablets were as follows:Cmax(84.9?16.4)?g?L-1 vs.(84.5?13.8)?g?L-1;tmax(0.67?0.07)h vs.(0.77?0.08)h;t1/2 Ke(1.90?0.17)h vs.(1.79?0.19)h;AUC0～t(161.9?16.8)?g?h?L-1 vs.(157.2?19.7)?g?h?L-1;AUC0～∞(179.7?18.2)?g?h?L-1 vs.(173.4?19.2)?g?h?L-1.The relative bioavailability of the domestic enteric-coated tablets was(109.0?7.2)% as against the imported enteric-coated tablets.CONCLUSION:The two kinds of tablets were bioequivalent.

Objective:To investigate the relationship between some common risk factors of the cerebralvascular diseases and PD.Methods:Case-control study was carried out.Blood glucose,low density lipoprotein cholesterol(LDL-C)and homocysteic acid(Hcy) levels were detected by routine methods.The intima-media thickness(IMT)of carotid artery was measured by color Doppler ultrasound.The PD patients were graded by Unified Parkinson's Disease Rating Scale(UPDRS).Results:The blood glucose and Hcy in PD patients were higher than that in control group,and the LDL-C,IMT of carotid artery in PD were lower than that in control group.The Hcy was positively related to risk of PD,while IMT of carotid artery and LDL-C were negatively related to risk of PD by Spearman analysis.Conclusion:The Hcy level is a risk factor of PD.The LDL-C and IMT of carotid artery in PD patients were lower than that in control group,which suggests that the probability of PD patients who suffer from atherosclerosis is small.

To improve the quality education of medical students,we should attach importance to the construction of teaching staff,improve learning environment,strengthen selected course construction and arrange for students to take social practice.

A total of 78 pelvic abscess cases were confirmed by operation retrospectively.Group A underwent celiotomy ( n =30 ) while group B laparoscopic surgery ( n =48 ).Medical history , clinical symptoms and outcomes were analyzed.Operative durations of groups A and B were ( 90 ±21 ) and ( 70 ± 14) min, the amount of hemorrhage (70 ±24) and (46 ±24) ml and wound dehiscence rate 20% and 0 respectively.There was significant inter-group difference.And the efficacy of group B was better than that of group A.The postoperative recurrence rate was 13% and 4% and there was no significant difference.Laparoscopic surgery is suitable for treating pelvic abscess.It is mini-invasive, has a quick recovery and does not increase operative complications.

To analyze the clinical characteristics of postmenopausal ovarian tumors and explore the predict indicators and treatment for ovarian benign and malignant tumors.A retrospective analysis was performed for clinical data and pathological results of 125 patients with postmenopausal ovarian tumors from January 2008 to January 2013.The symptoms of malignant patients included abdominal pain (n =30),bloating (n =11) and weight loss (n =5).It had significant difference compared with benign tumors (P ＜0.05).Ultrasound showed that there was 44 cystic and solid tumors with 22 malignancies and 57 cystic tumors with 5 malignancies.There was significant difference in morbidity of malignant ovarian tumors between them (P ＜ 0.05).The incidence of malignant tumor in 5-10 cm group was 56％.There were significant differences compared with the ＜ 5 cm group (P ＜ 0.05).The specificity of ultrasound plus a combined detection of CA125 for malignant epithelial tumor of ovary was 91％ with a sensitivity of 93％.Thirty-one cases of malignant tumor were accurately diagnosed with preoperative ultrasound.Ultrasound plus CA125 could help distinguish the characteristic of tumors.

Child ; Humans ; Urolithiasis ; diagnosis ; therapy

Objective To assess the imaging characters and clinical applications of triphasie spiral computer tomography (CT) scanning in ureteral lesions. Methods We analyzed of 76 eonseeutive eases of elinieaUy evidenced ureteral lesions using the cross - sec-fional images and CTU derived from triphaaie spiral CT scanning retrospectively. Results Twetny - four cases of 76 ureteral lesions pa-tients were diagnosed as ureteral tumor, resulting in severe urinary tract obstruction. The shape, size, number, regional ureter wall in-flammatory infiltration of visible mass were verified as well. Twetny- six cases were caused by ureteral stones. The "edge" sign was shown clearly. Ten cases were ureteral inflammation, characterized by different ureteral wall thickening and enhancement feature. Eight cases were ureteral tuberculosis that secondary to renal tuberculosis. Uneven ureteral wall thickening, stiffness and mild to moderate densi-ty were shown in CT scanning. Ureteral congenital malformations were found in 3 patients. The other five cases were caused by exogenous factors. CT scanning could identify the mass general profile. Conclusion Triphasic spiral CT scanning plays an important role in ureteral lesions diagnosis and differentiation from other similar diseases.

ObjectiveTo investigate the prevention and management of the hemorrhage during laparoscopic cholecystectomy( LC), and improve success ratio. MethodsThe medical data of 420 cases with LC from May 2003 to 2009, September were analyzed retrospectively, including total number, hemorrhage site and ways of prevention and management. Results417 cases experienced successful C,with success ratio 99.3%. 49 cases ( 11.7% ) had hemorrhage, and in 46 cases(93. 9% ), it was stopped by laparoscope or hemostasis by compression,3 cases were rescued by operation. All hemorrhage sites included 15 cases(30. 6% ) in triangle de Calot,26 cases(53. 1% ) in gallbladder bed, and 8 cases ( 16.3% ) in incision. ConclusionA reliable opetration and appropriate hemostasis are critical of the successful operation and prevention of complications after LC.

Objective To investigate the role of RhoA and Rho kinase system in the onset of labor. Methods Forty term pregnant women, who delivered through cesarean section at the Xiangya Second Hospital of Central South University from February 2007 to November 2007, were selected and divided into 2 groups: 20 in labor group and 20 in non-labor group. Another 20 non-pregnant women undergoing hysterectomy due to cervical intraepithelial neoplasia were chosen as the control. Real-time fluorescence quantitative RT-PCR and western blot were applied to detect the expression RhoA and ROCKⅠ mRNA and protein in uterine smooth muscle tissue and the correlation between the mRNA and protein expression of RhoA and ROCKⅠ were analyzed. Results (1) The mRNA expressions of both RhoA and ROCKⅠ were detected in all groups, and higher levels were found in the labor group than in the non-labor group and the control [RhoA mRNA: (3.51±0.56)×10-3 vs. (2.75±0.52)×10-3 and (2.11±0.54)×10-3; ROCKⅠ mRNA: (4.07±0.66)×10-3 vs. (2.71±0.52)×10-3 and(2.01±0.23)×10-3, P<0.01]. (2) RhoA and ROCKⅠ proteins were also identified in all three groups, and the expressions in the labor and non-labor group were higher than those of the control (RhoA protein: 0.72±0.23 and 0.64±0.17 vs. 0.46±0.15; ROCKⅠ protein: 0.56±0.14 and 0.42±0.16 vs. 0.29±0.08, P<0.01). (3) The expression of RhoA mRNA and ROCKⅠ mRNA were positively correlated in each of the three groups (r=0.73,P<0.01), and the same was found in the expression of RhoA protein and ROCKⅠ protein (r=0.37,P<0.01). Conclusion The increased expression of RhoA and Rho kinase may play an important role in the initiation of labor.