The emphasis and basic target of medical education is to cultivate medical students with high qualities. The qualities of medical students include professional ethics, self-cultivation, medical knowledge and physical-psychological quality, which is critical to the medical education. It has been proven that the teaching of Clinical Pathway is one of the most important factors to promote the improvement of comprehensive qualities of medical students.

Ophthalmology is a clinical course which requires students to have practical skills. The traditional clinical teaching method lacks varied means resulting in unsatisfactory teaching effects. Application of multimedia technology not only changes the teaching model, enriches the teaching contents but also improves the quality of ophthalmology teaching. By analyzing the advantages and disadvantages of multimedia application in clinical teaching based on our practice, the paper raises some methods for improvment in order to achieve the best teaching effects.

Cysts ; congenital ; Humans ; Infant ; Laryngeal Diseases ; congenital ; Male

Objective To systematically review the influence of propofol orsevoflurane on postoperative cognitive dysfunction(POCD) in elderly patients undergoing non-cardiac surgery.Methods Eight databases including Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, Pubmed, CNKI, VIP, CBM and Wanfang Database were searched for randomized controlled trials (RCT) about the influence of propofol orsevoflurane on POCD in elderly patients from the time of database establishment to June, 2016.At the same time, the reference materials of included literature were retrieved manually.All data were selected and evaluated by three independent reviewers according to the inclusion and exclusion criterions.RevMan 5.1 was used for the data analysis.Results A total 14 trials were discovered involving 790 elderly patients undergoing non-cardiac surgery.The results of Meta-analysis showed that the eye opening time and extubation time in the propofol group were significant shorter than sevoflurane group[SMDeye opening=-0.83,95%CI(-1.05,-0.61),P<0.05;SMDextubation=-0.85,95%CI(-1.09,-0.62),P<0.05].The MMSE scores at 1,3 and 6 h respectivelyafter the operation were obviously higher than those of sevoflurane group[SMD1h =0.84,95%CI(0.61,1.08),P<0.05;SMD3 h=1.12,95%CI(0.86,1.38),P<0.05;SMD6h=0.61,95%CI(0.40,0.82),P<0.05].One day after the operation,the difference was not significant[SMD1d=0.14,95%CI(-0.03,0.31),P>0.05].Three days after the operation, the values returned to normal levels, and was still higher in propofol group than in sevoflurane group[SMD3d=-0.32,95%CI(-0.56,-0.07),P<0.05] until 7 d [SMD7d=-0.18,95%CI(-0.51,0.15),P>0.05].The odds ratio of POCD incidence between propofol and sevoflurane groups was 0.35 [95%CI(0.21,0.58),P<0.05].Conclusion Propofol may lead to shorter eye opening time and extubation time compared to sevoflurane in elderly patients undergoing non-cardiac surgery.Both groups may lead to POCD, while propofol is a better choice for elderly patients when choosing general anesthesia.

Objective To investigate roles of superoxide dismutase-1(SOD1),phosphatidylinositol 3-kinase (PI3K) /serine/ threonine protein kinase (AKT) signal transduction pathway in protection of propofol on spinal cord ischemic reperfusion injury (SCIRI) in rabbit model before and after ischemia. Methods Sixty Japanese male rabbits were randomly divided into 3 groups (n=20),namely sham-operation group (Group S),ischemia-reperfusion group (Group I/ R) and ischemia-reperfusion group with propofol treatment (Group P). Abdominal aorta of the rabbits in group I/ R and group P were blocked by clamp for 40 min and then the clamp was removed. Propofol (30 mg·kg-1 ) was intravenously infused 10 min before blocking the aorta and at the time of reperfusion. Normal saline was intravenously infused at the same time points in the other two groups. Four rabbits of each group were randomly executed 1,2,3,5,7 days after surgery. Spinal cord tissues at L3-L4 levles were harvested. Bioactivity of SOD1 was detected by ELISA and mRNA expression levels of SOD1,PI3K and AKT were detected by RT-PCR. Results On the 1st day after the surgery,the bioactivity of SOD1 increased significantly in Group I/ R and Group P as compared with that in Group S (P<0. 05). On the 2nd day,compared with Group S,the bioactivity of SOD1 increased significantly in Group P (P<0. 05),but there was no change in Group I/ R (P>0. 05). On the 3rd,the 5th and the 7th day,compared with Group S,the bioactivity of SOD1 decreased significantly in Group I/ R (P<0. 05),but there was no change in Group P (P>0. 05). Linear regression analysis indicated that there was a positive correlation between the changes of SOD1 activity and the mRNA expression of SOD1,PI3K and AKT respectively in spinal cord tissues. Conclusion Pre- and post-ischemic conditioning with propofol shows potent protective effects against SCIRI in the rabbit model. The mechanisms may be related to increased expression of SOD1 in the spinal cord tissues by activating PI3K/ AKT signal transduction pathway.

Objective To explore the relationship between respiratory viruses infection and the episode of steroid responsive simple nephrotic syndrome(SRSNS).Methods Thirty-eight children with SRSNS were selected,including the active stage group(n=28)and the remission group(n=10).The urine from 18 cases of nephritic nephrosis,16 cases of bronchiolitis,15 cases of secondary glomerular diseases and 15 cases of healthy children were served as controls.By using the method of reverse transcriptase-polymerase chain reaction(RT-PCR)and alkaline phosphoesterase-anti alkaline phosphoesterase enzyme-linked assay(APAAP),viral genes and antigens in urine were assayed,respectively.Results The positive rate of detecting viruses in the active stage group of SRSNS children was higher than that in the remission group and the other control groups(Pa

Objective:To compare the sedative effect and safety of different doses of dexmedetomidine in the patients undergoing total abdominal hyserectomy. Methods:A total of 120 patients undergoing total abdominal hysterectomy were randomly divided into four groups, different doses of dexmedetomidine groups(D1 group, D2 group and D3 group)and midazolam group(M group) with 30 pa-tients in each. Dexmedetomidine groups received intravenous pump infusion of dexmedetomidine (0. 5 μg·kg-1 ) 10 minutes before the operation, and then the different dexmedetomidine groups were received continuous infusion of dexmedetomine of different doses:D1 group of 0. 4μg·(kg·h) -1, D2 group with 0. 6μg·(kg·h) -1 and D3 group with 0. 8μg·(kg·h) -1;M group received in-travenous pump infusion of midazolam (0. 06 mg·kg-1) 10 minutes before the operation, and then with 0. 04 mg·(kg·h) -1 con-tinuous infusion. The mean arterial pressure( MAP) , heart rate( HR) , respiratory rate( RR) , oxyhemoglobin saturation( SpO2 ) were recorded at the following time points:the moment of entering the operating room(T0), the block effect of epidural anesthesia was satis-fied (T1),10 min(T2),20 min(T3)and 40 min(T4)after the drug infusion, and the end of the operation(T5), and the duration of the medicine use and the whole operation were recorded as well. The sedation degrees were evaluated with Ramsay scale, and the am-nesic scores, adverse drug reactions and patient satisfaction were recorded after the operation. Results:Compared with that of the other groups, HR of D3 group was obviously lower after T3 (P<0. 05);and after T2, HR was significantly lower than that at T0 (P<0. 05 or P<0. 01). Compared with the other groups, RR of M group was obviously lower at T3 and T4 (P<0. 05). Compared with those at T0 , the sedative effects of all the groups were much remarkable(P<0. 05 or P<0. 01);and the Ramsay score of D3 group at T3 and T4 was higher than that in D1 group or M group(P<0. 05). There were no obvious adverse reactions in the four groups. Conclusion:The use of dexmedetomidine in the patients undergoing total abdominal hyserectomy might not lead to the risk of respiratory depression as the use of midazolam, while the dose of dexmedetomidine should be less than 0. 8 μg·(kg·h) -1.

Objective To observe the regulation of sry-related high-mobility-group box-containing 2 (Sox2) on epidermal growth factor receptor(EGFR)and on the sphere formation rate of glioma stem cells .Methods Promoter reporter plasmids of epidermal growth factor homologous receptor ErbB2 ,ErbB3 ,ErbB4 were respectively constructed .Sox2 expression plasmid was co-transfected together with the reporter plasmid into U251 cells .Then the luciferase activity was analyzed by dual-luciferase reporter assay sys-tem to test the regulation of Sox2 on ErbB2 ,ErbB3 ,ErbB4 promoters .Sphere formation assay was used to observe selfrenew of the cancer stem cells after transfection of Sox 2 .The expression of EGFR and ErbB2 proteins in the spheres was examined by Western blot .Results Sox2 could dose-dependently increase the ErbB2 ,ErbB3 ,ErbB4 promoter drived luciferase activity .Sox2 promotes the sphere-forming rate of U251 cells and upregulates the expression of EGFR and ErbB2 in the spheres .Conclusion Sox2 could up-regulate the expression of EGFR and promote selfrenew of glioma stem cells .

Objective To investigate the expression and significance of signal pathway Wnt/β-catenin in prostate cancer stem cells.Methods Prostate cancer tissues,hyperplasia prostate tissues and normal prostate tissues were collected,then prostate cancer stem cells were selected from cell suspension in the culture system of serum-free medium by magnetic activated cell sorting system.Immunohistochemical SP test,RT-PCR and Western blot were applied to test the expression of Wnt and β-Catenin mRNA or protein in prostate cancer stem cells,hyperplasia prostate tissues and normal prostate tissues.Results The protein expression of Wnt and β-Catenin was higher in prostate cancer tissues compared with that in hyperplasia prostate tissues and normal prostate tissues;mRNA expression of Wnt and β-Catenin was higher in prostate cancer stem cells (4.57±0.83,3.93±0.78) than in hyperplasia prostate tissues (1.32±0.35,1.48±0.44) and normal prostate tissues (1.00±0.12,1.00±0.11),and the difference was statistically significant (F＝13.287,12.648,P＝0.000).Protein expression of Wnt and β-Catenin was higher in prostate cancer stem cells(0.87±0.10,1.12±0.23) than in hyperplasia prostate tissues(0.39±0.08,0.64±±0.11) and normal prostate tissues (0.33±0.09,0.45±0.10),and the difference was statistically significant (F＝16.625,14.417,P＝0.000).Conclusion Signal pathway Wnt/β-catenin is stimulated abnormally in prostate cancer stem cells,causing the occurrence of prostate cancer,providing a new research direction for treatment of prostate cancer.

Objective To observe the effects of strabismus surgery for treatment of concomitant exotropia and analyze the influential factors. Methods From 2000 to 2004, 95 patients hospitalized in our department underwent strabismus surgery and followed up for one week to 3 years. We retrospectively analyzed the deviation and superior sensory outcome at week 1 (95 cases) and week 6 (58 cases) after surgery. Results Seventy-four cases (82.11%) were completely corrected in one-week follow-up, and 46 cases (79.31%) in six-week follow-up. Nineteen cases (32.76%) recovered superior sensory. Conclusion Timely surgery of concomitant exotropia can improve not only the appearance but also the function of the eyes.