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.

3) in control group (χ2=5.42,P=0.02).Conclusions Gemcitabine chemotherapy combined with HIFU treatment was more effective for pancreatic tumor growth control and pain relief without more adverse events,which was effective and safe.

Adolescent ; Adult ; Aged ; Calcaneus ; injuries ; surgery ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; adverse effects ; Fractures, Bone ; physiopathology ; surgery ; Humans ; Male ; Middle Aged ; Postoperative Complications ; pathology ; physiopathology ; Recovery of Function ; Retrospective Studies ; Young Adult

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 investigate the effects of hypothermia combined with sevoflurane on expression of myocardial gap junction protein connexin 43 (Cx43) in isolated rabbit hearts.Methods Healthy adult rabbits of both sexes,weighing 1.5-2.0 kg,were sacrificed after anesthetization.The hearts were rapidly excised and perfused in a langendorff apparatus with K-H solution saturated with 95％ O2-5％ CO2 at 37 ℃ in a langendorff apparatus.Forty isolated hearts were randomly divided into 4 groups (n =10 each):control group (group C),hypothermia group (group H) and hypothermia combined with sevoflurane group (group HS).At 15 min of equilibration,the perfusion with K-H solution was continued at 37 ℃ in group C,K-H solution saturated with 2.4％ sevoflurane was perfused at 37 ℃ in group S,K-H solution was perfused at 30 ℃ in group H,and K-H solution saturated with 2.4％ sevoflurane was perfused at 30 ℃ in group HS.At 30 min of perfusion,myocardial specimens were obtained from the anterior wall of the left ventricle for detection of the expression of Cx43 in myocardial cells (by immunohistochemistry and Western blot).Results Compared with group C,Cx43 expression was downregualted in group H (P ＜ 0.05),and no significant change was found in Cx43 expression in S and HS groups (P ＞ 0.05).Cx43 levels distributed mainly in the intercalated disc in S and HS groups,and in H group the distribution of Cx43 levels in the intercalated disc was less,but the percentages of lateralized Cx43 were increased.Conclusion Sevofurane can inhibit hypothermia-induced down-regulation and distribution disturbance of myocardial Cx43 expression,which may be the mechanism by which sevofurane inhibits hypothermia-induced arrhythmia.

Objective To investigate the influence of health care workers’(HCWs)hand hygiene intervention in healthcare-associated infection(HAI)in an intensive care unit(ICU).Methods Intervention measures of hand hygiene were adopted,effective supervision and management systems were established,hand hygiene compliance and HAI rate be-fore intervention(January-December 2012)and after intervention (the first stage:January-June 2013;the second stage:Ju-ly-December 2013)were compared.Results A total of 4 066 patients were surveyed,HCWs’hand hygiene compliance rate before intervention was 50.03%,the first and second stage after intervention was 61.80% and 64.57% respectively,there was increasing trend (rs=1.00,P<0.001).HAI before intervention was 5.48%,the first and second stage after inter-vention was 3.86% and 3.30% respectively,there was decreasing trend (rs=-1.00,P<0.001).Significant decreasing trends were found in rates of catheter-related bloodstream infection(CRBSI),catheter-associated urinary tract infection (CAUTI)and ventilator-associated pneumonia(VAP)(rs=-1.00,P<0.001).There were negative correlations between hand hygiene compliance rate and the infection rate of ICU,infection rate of CRBSI,CAUTI and VAP (P<0.05 ). Conclusion The improvement of hand hygiene compliance can effectively reduce the incidence of HAI in ICU ward.

To study the expression of human telomerase RNA(hTR) in different grades of bladder transitional cell carcinoma and its relation to its prognosis. With in situ hybridization, the expression of hTR was observed in 67 cases of bladder transitional cell carcinoma specimens, to be compared with specimens of 10 normal bladder tissue and 10 benign lesions. The RNA probe used in hybridization was telomerase reverse transcript (TERT), and the marker was digoxin. There was a significent correlation between the expression of hTR and grading and prognosis. hTR is considered as an important and independent prognostic factor in this carcinoma.

The precise measurement in lens thickness in vivo, provides great application value for intraocular accommodation and ametropia development mechanism research.And it has great clinical significance for the diagnosis and treatment of glaucoma and cataract.Currently, many ultrasonic methods and optical methods are used in measuring lens thickness.The measurement principles, advantages, disadvantages and the accuracy of the instruments are summarized in this paper.Among these methods, Orbscan II, Pentacam, Lenstar and AS-OCT can be used to measure lens thickness instead of A-scan.More important is the fact that UL-OCT can dynamically monitor the change of the lens thickness with intraocular accommodation.Choosing an instrument with higher measuring accuracy to examine the lens thickness, can provide more accurate and convincing lens thickness data for clinical and scientific research.

Objective To study the risk factors for catheter-related bloodstream infection (CRBSI)in an intensive care unit (ICU),and provide scientific evidence for CRBSI prevention and control.Methods 1 677 ICU patients with central venous catheterization (CVC)for>48 hours between January 2008 and December 2012 were divided in-to CRBSI group and non-CRBSI group,risk factors for CRBSI were analyzed.Results The utilization rate of CVC was 92.88% (21 041 d);86 (5.13%)patients developed CRBSI,the incidence of CRBSI per 1 000 catheterization-day was 4.02,the mortality of CRBSI group was significantly higher than non-CRBSI group (58.14% [50/86]vs 36.83%[586/1 591])(χ2 =15.74,P <0.01 ).Multivariate logistic regression analysis showed that the risk factors for CRBSI in-cluded length of stay in ICU>5 days,CVC>5 days,the episode of CVC>1 (P <0.01).Conclusion Realizing the occur-rence status and risk factors of CRBSI in ICU patients can provide reference for further targeted monitor and implementation of zero tolerance goal of the CRBSI.