The key to the management of clinical colleges is to improve teaching-administering bodies and construct the faculty of diagnostics.Factors that ensure teaching quality include formulating a syllabus corresponding to training objectives,compiling teaching material with essential contents and good operability,adopting teaching method capable of best developing students′ abilities to learn and practice,and using information technology.

Clinical exercise is an important stage to combine theory and practice,and an essential process for medical student to become a doctor.The quality of clinical exercise directly influences the practicing ability of graduated medical students and the achievement of medical education.This article analyzes factors that influence the quality of clinical exercise by collecting and sorting relative data,and presents some countermeasures thereby.

Resident or specialist training plays a very important role in developing qualified clinicians and improving medical quality.In combination with the status quo of resident or specialist training in our country , brief analysis has been made on the characteristicsof military resident or specialist training .As a result, the 3 +X +militarymode has been put forward in military resident orspecialist training.According to Specialist Training Standards by National Health and Family Planning Commission , training criteria upto military requirements have been established in order to achieve systematic military residency , develop medical support capability andpromote military health development.

OBJECTIVE To inspect and analyze the cleaning efficacy on surgical instrument after cleaning cycle and maintenance procedures.METHODS The medical instrument was collected from each department based on the weekly usages.Focus on the timing of the cleaning after use and the efficacy of the cleaning methods.Use naked eyes to inspect the cleanness of the medical instrument after each cleaning cycle.RESULTS The combination of the machine washing and manual washing immediately after the surgical procedures provided better cleaning efficacy.It was more difficult to clean the instrument once the dried bio-burden on it or after soaking in the chlorine disinfectant.CONCLUSIONS The correct cleaning methods and instrument care procedures guarantee the cleaning efficacy,disinfections,and the sterilization for the medical instrument.

[Objective]To investigate the clinical treatments of perioperative complications in patients with cervical cord injury.[Method]Totally 155 cases of cervical cord injury associated with fracture of the cervical spine were enrolled in this study from January 1997 to December 2007.Eighty-five cases were treated with anterior internal fixation,66 with expansive open-door laminoplasty of the cervical spine,and 4 with one stage anterior and posterior approach operations.[Result]Forty-five cases were complicated with hyperpyrexia,31 with respiratory dysfunction,43 with pulmonary infection,70 with hyponatremia,25 with urinary system infection,3 with stress ulcer,10 with deep venous thrombosis,5 with palsy of the C5 nerve root,3 with injury of superior laryngeal nerve or recurrent nerve,1 with leakage of cerebrospinal fluid,2 with cervical hematoma,1 with loosening of interal fixation,1 with esophageal fislula,and 10 died.[Conclusion]There are many perioperative complications from cervical cord injury.To pay attention to the treatments of perioperative complications will bring a satisfactory clinical effect.

Objective:To evaluate construct validity of China residents health literacy questionnaire and explore the application of confirmative factor analysis(CFA)in health literacy measurements.Methods:CFA was performed on dimension of basic healthy skills in the questionnaire.Latent variable scores and comprehensive score based on factor variance weight were calculated.Comparison among the latent variable scores,comprehensive scores and proportion of knowing was conducted via GLM or Logistic model.Results:Two factors named general capacity and emergency capacity were well fitted(?2=12.12,P=0.356,IFI=0.998,TLI=0.996,RMSEA=0.007).According to comprehensive score the sample qualification rate of basic health literacy was 38.5%(785/2 040),much similar to 38.2%(780/2 040)which is calculated by original item scores.Latent variable score or comprehensive score has more statistical power than that of proportion of knowing in multivariate analysis.Conclusion:CFA is a useful tool and valuable for applying in the field of health literacy measurement and analysis.

Objective To develop multimedia network testing system on"three-primary" Training.Methods Java was used to develop the application program,MySQL was used to establish database of test questions.The stable communication protocol(SOAP,Web service,etc.) and link were applied.Results With this system,random test questions and choices are provided;questions are answered by human-computer interaction;answer time is restricted;the paper is automatically scored;database of test questions is managed openly;test paper is automatically set.Conclusion This testing system is highly automatic,secure,impersonal,extensible,stable,open and efficient.

Objective To analyze the characteristic of auditory brainstem responses (ABR) evoked by chirp in normal hearing subjects .Methods Fifteen cases (30 ears) with normal hearing young people were recorded ABR by stimulation with two kinds of sounds :chirp and click .The data were compared .Results The response threshold of chirp-ABR were lower than that of click -ABR .The average difference was 8 .59 dB .At 90 dB nHL ,the wave V amplitude yield no significant difference between chirp -ABR and click-ABR .The wave V amplitude had a signifi-cant difference between chirp -ABR and click-ABR at 60 dB nHL .At 90 and 60 dB nHL ,the wave V amplitude of chirp-ABR had not a significant difference .The occurence rate was 40% for the wave I of chirp -ABR ,obvi-ously less than that of click -ABR .At 90 dB nHL ,the wave V latency of chirp -ABR was shorter than that of click-ABR .Conclusion The wave V response threshold of chirp -ABR is less than that of the click -ABR .The chirp-ABR is more advantageous than the click -ABR for assessing hearing threshold .

Metastasis is the leading cause of death in patients with lung cancer .Circulating tumor cells (CTCs)play a key role in the process of distant metastasis .In recent years,research results have shown that CTCs may become a emerging marker and new target in the treatment of lung cancer .In this article,we elaborate the clinical significance of CTCs in lung cancer from the way of diagnosis and clinical staging ,metastasis and recur-rence,individual treatment and prognosis and so on ,so that we can provide a new direction for the treatment of lung cancer .

Objective As there are difficult problems in surgical puncture needle cleaning and cleaning effect monitoring,we are aiming at finding some reliable solutions through relevant comparative tests. Methods Lumbar puncture needle,bone puncture needle and anesthe-sia spinal needle after clinical use,80 of each kind,were randomly collected and equally divided into the experimental group and the control group. The control group was given traditional lumen surgical instruments cleaning procedure,and the experimental group was given newly cre-ated small lumen instruments manual cleaning procedures. Magnifying glass,self-made instruments monitoring and ATP bioluminescence mo-nitoring were respectively used to verify the cleaning effect. Results All needles were monitored with magnifying glass,self-made instruments monitoring and ATP bioluminescence monitoring after cleaning,and the qualified rate were 98. 33%,97. 00% and 93. 33% respectively in the experimental group while 95. 00%,83. 33% and 78. 33% respectively in the control group. Results of self-made instruments monitoring and ATP bioluminescence monitoring showed that there was no difference between the two kinds of detection methods. Conclusion Newly created small lumen instruments manual cleaning procedures and self-made instruments monitoring were of reliable effect and strong operabili-ty in terms of puncture needle cleaning and cleaning effect monitoring,and they were worthy of further research and application.