Based on the survey of the learning preference of Kunming Medical College students,we analyze relationship between students’learning style and personalities.In order to match different learning style,teachers must find some strategies in their English teaching.

Objective To investigate the effect of the increased pulse pressure on cerebrovascular hemodynamic index.Methods From January 2014 to October 2016,the application of the method of cross-sectional study,6 006 consecutive health subjects examined and detected with ultrasound noninvasive cerebral hemodynamic index (CVHI) at the Physical Examination Center,Pu′er People′s Hospital,Yunnan Province were enrolled.In order to control the influence of age and gender on the results,according to age and gender in the increased pulse pressure group (≥60 mmHg),and the same sex and age difference of not more than 1 years old were selected as the inclusion criteria in the normal pulse pressure group (60 mmHg).Finally,1 115 subjects were enrolled as a control group for comparative analysis.The study population was divided into an increased pulse pressure group (n=590) and a normal pulse pressure group (n=1 115) in a mixed manner.The differences of CVHI index and its integral score of both groups were compared.The correlation of the increased pulse pressure level and changes of cerebrovascular hemodynamic accumulative scores were analyzed.Results The minimum velocity,mean velocity,and critical pressure in the increased pulse pressure group were significantly lower than those in the normal pulse pressure group (P<0.05),while the differences of the peripheral vascular resistance,characteristic impedance,pulse wave velocity,dynamic resistance,diastolic blood pressure,and critical pressure were significant higher than those in the normal pulse pressure group.There were significant differences (P<0.01).The integral values of cerebral hemodynamics in the increased pulse pressure group and the normal pulse pressure group were 76±22 and 88±19 respectively.There was significant difference (P<0.01).The proportion of the integral value <75 was 34.4% (203/590) and 15.6% respectively (174/1 115,P<0.01).With the increase of pulse pressure level,the integral value of cerebral hemodynamics showed a significant downward trend,there was a significant negative correlation between the two (r=-0.312,P<0.01).Conclusion The increased pulse pressure may result in the changes of cerebral hemodynamic indexes and its integral values.There is a significant negative correlation between the pulse pressure level and the integral value of cerebral hemodynamics.

0.05). Conclusions: There exists an abnormal reduction of neural viability and function on bilateral hippocampus of patients with first-episode MDD.

By complexation reaction with water-soluble carboxymethyl chitosan and Ca 2+ ?Fe 2+ ?Zn 2+ in solution,the metal complexes of Ca 2+ ?Fe 2+ ?Zn 2+ were preparated.The effects of various factors:reaction time,etmperature,substitution degree of carboxymethyl group,ionic strength and pH value on the reaction were investigated.The results showed that the optimum reaction condition was pH 5~7,time 10 min,the complex capacity of CMCS for metal ions increasing with the substitution degree of carboxymethyl group,decreasing with the ionic strength of solution.

Objective To study the significance of repeated washing in reducing the positive rate of intra-abdominal exfoliated cancer cells. Methods Sequential intraoperative peritoneal lavages were performed in each of the 160 patients with gastric cancer one time before tumor resection,three times after excision.Four sub-peritoneal washing fluid was assayed for cytology smears with routine pathology.The results were then compared. Results Exfoliated tumor cells were positive in the intraoperative peritoneal lavages of 56 patients before resention.Exfoliated tumor cells were positive in the first three intraoperative peritoneal lavages of 64 patients before resention,42 at the second,3 at the third.Tumor cells positive and forward setting lotion shed after the first time,with the number of detected cases increased but had no significant statistical significance.Compaving the positive result of the 3rd exfoliated cancer cells with the first 1,we found that the difference was statistically significant. Conclusion Sequential intraoperative peritoneal lavages is an useful method in reducing the positive rate of peritoneal exfoliated tumor cells in patients with gastric cancer.

Objective To observe the distribution of sentinel nodes(SN) in gastric cancer,and investigate their clinical significance.Methods The extent and features of intraoperatively stained sentinel nodes in 288 cases of gastric cancer were analyzed retrospectively.Methylene blue was injected intraoperatively into the(subseral) muscle and submucosa of the normal gastric wall adjacent to the neoplasms,then lymphadenography was performed,and the nodes were resected for histopathological examination.Results The pathological(diagnosis) of the 288 cases with gastric cancer was T_1 in 102 cases,T_2 106 cases and T_3 60 cases.Stained nodes were detectable in 270 cases(success rate: 93.8%).One hundred and two cases were found to have lymph node metastasis;66 cases had metastasis in both SNs and non-SNs;18 cases in SNs alone;and 18 cases in non-SNs alone.Conclusions Sentinel lymph nodes can accurately predict the lymph node metastatic status of gastric cancer patients during operation.Intraoperative sentinal lymph node mapping can avoid routine lymph node dissection in patients with gastric cancer with negative lymph node metastasis.

Objective To evaluate the effect of the urinary reservoir constructed with ileocecum-appendix in the elderly with bladder cancer. Methods From March 2002 to June 2008, 12 cases were treated using ileocecum-appendix as the reservoir after radical cystectomy. They all received the imaging urodynamics examination and were followed up for 1 year. Results The 11 of 12 patients had urinary continence completely. Only 1 case had incontinence and 3 cases had incontinentia urinae at night. Times of uresis were 8-10/day and 3-5/night within 3 months after surgery, and 4-6/day and 0-2/night 6 months after surgery. The urinary output was 150-350 ml/time. Urodynamics showed that mean urinary flow rate was 10.5 ml/s, mean initial bladder pressure was 27 cm H2O, the maximum filling pressure was 35 cm H2O. The average reservoir capacity was 152 ml and 420 ml, respectively. The out let pressure of posterior urethra was 52 cm H2O. The volume of residual urine was 0-65 ml. No evidence of ureteral reflux occurred, no hyperchloremic acidosis was observed. Conclusions Orthotopic bladder reconstruction is considered as an ideal form of urinary diversion characterized by low pressure, larger capacity and continence.

Objective To assess the change of CEA in the peritoneal lavage fluit at pre-,post-laparoscopy-assisted radical gastrectomy, and after hyperthermic perfusion chemotherapy, and to investigate the influence of laparoscopy-assisted radical gastrectomy on drop off of cancer cells, the efficiency of hyperthermic perfusion chemotherapy. To investigate whether CEA in the peritoneal lavage fluit detected by flow cytometry (FCM) is an effective predictor of intraperitoneal free cancer cells and peritoneal metastasis. Methods Peritoneal washings of 40 patients with gastric carcinoma were collected to detect CEA using FCM. The peritoneal lavage cytology examinations ( PLC)were detected by H-E staining. Results Laparoscopic surgery in patients with gastric cancer,before resection of gastric cancer the peritoneal washing CEA positive rate 35. 0% (14/40) ,and after operation, the positive rate was 40. 0% ( 16/40) .which was not significantly higher than that before operation ( P > 0. 05 ). After intraperitoneal hyperthermic perfusion chemotherapy the CEA positive rate was 7. 5% (3/40) ,which was significantly lower than that pre-operation(P<0. 05). Before operation there were 4 cases of positive PLC in the peritoneal lavage fluid, 14 CEA-positive detected by flow cytometry, and there was significant difference ( P < 0. 05 ) . All PLC-positive cases were positive for CEA, whereas 10 PLC-negative cases showed CEA-positive. None of CEA-negative cases showed PLC-positive. Conclusions Laparoscopic radical gastrectomy does not increase the intra-abdominal gastric cancer cell shedding. Intraoperative hyperthermic perfusion chemotherapy is simple and feasible approach with high efficiency.Peritoneal washing CEA detected by flow cytometry is an effective index to predictor for intraperitoneal free cancer cells and prediction of peritoneal metastasis.

Objective To adjust the layout of secondary medicine shelves in hospital pharmacy for outpatient services and optimize the varieties of automated equipment to improve working process and promote human-machine cooperation.Methods This article discussed the adjustment of the layout of secondary medicine shelves in hospital pharmacy for outpatient services and the optimization of varieties of automated equipment for storing by analyzing actual problems in automated system and clinical drug uses and the requirements of the automated equipment for drug storage respectively to improve working process and to adapt to the operation of outpatient pharmacy automated system.Results Dispensing efficiency of outpatient pharmacy automated system was improved, patients′ waiting time was significantly shortened, and the workload of pharmacists was decreased.Conclusion Optimization of hospital pharmacy drug delivery system and its operation can obviously improve work efficiency, shorten patients′ waiting time and reduce dispensing error, thus ensuring the safety of medication.