Although the humanity had already developed the numerous teaching design theory,under the social background of information explosion,it is necessary for instructional technologists to continue developing comprehensive guidelines to support new areas of human learning and development.The new theory includes the instructional values,preconditions for how to facilitating SDL.

[Objective] To evaluate the influence of dexmedetomidine on median effective target effect-site concentration(EC50)of sufentanil-inhibiting urethroscope insertion response in patients undergoing transurethral resection of prostate(TURP).[Methods] Forty patients with ASA grading Ⅰ-Ⅱ who accepted selective TURP were divided by random digits table method into two groups with 20 cases each.The patients in dexmedetomidine group were treated with 0.6 μ g/kg dexmedetomidine intravenous infusion for more than 10 min,while control group were treated with equivalent capacity of 0.9％ sodium chloride.At 5 min after stopping injection,target-controlled infusion of propofol was started and the plasma target concentration was 3.0 μ g/ml.At 10 min after infusion,target-controlled infusion of sufentanil began and the plasma target concentration was 0.20 ng/ml.The target concentration of sufentanil of the next patient accorded to the patient with or without the urethroscope insertion response and the adjacent rate of the target concentration was 1.1.The EC50 and 95％ confidence interval(CI)of sufentanil were calculated.[Results] There were 20 cases in dexmedetomidine group ultimately selected and 19 cases in control group.There was no statistical significance in absolute value of ST segment of intraoperative electrocardiogram,systolic blood pressure,heart rate,pulse oxygen saturation and bispecual index between two groups(P＞0.05).EC5o of sufentanil-inhibiting urethroscope insertion response in dexmedetomidine group was 0.1148 ng/ml(95％ CI 0.1055-0.1249 ng/ml),which was significantly lower than that in control group[0.1454 ng/ml(95％ CI 0.1339-0.1580 ng/ml)](P＜0.05).[Conclusions] 0.6 μg/kg dexmedetomidine intravenous infusion before operation can reduce the EC50 of sufentanil-inhibiting urethroscope insertion response in patients undergoing TURP.

Taking the modern occupation education concept as the guide,oriented by adapting to the demand of occupation post,we established a new open education mechanism of medical occupation education to promote the reform of personnel training mode,curriculum and teaching content to explore the effective way of the sustainable development of local medical occupation education.

As a new technology for rehabilitation training for function disorders, exoskeletons and orthoses are more concerned than before.This article discussed the classification of exoskeletons and orthoses and their application in rehabilitation training, as well as current research status and prospects.

Objective To explore the image features of multilocular cystic nephroma and its correlative differential diagnosis. Methods Eight cases of multilocular cystic nephroma were retrospectively analyzed by comparing the imaging findings with surgical and pathological results. Results In all 8 cases, multilocular cystic nephromas were unilateral and circumscribed by thick capsules. These lesions ranged in diameter from 2. 5 cm to 7. 5 cm. The lesions were entirely composed of locules and septa without solid nodules. These locules did not communicate with each other. The septa of these lesions were clear in 2 cases, partly clear in 4 cases, and not very clear in 2 cases. All lesions were better detected on enhanced scans than on non-enhanced ones. Four of 8 cases also underwent MR scan, which presented low signal intensity on T1WI and high signal intensity on T2WI. The Interlocular septa was demonstrated much better with MM than with CT. Histopathology proved that the capsule and septa of the lesions were lined by cuboidal or flattened epithelial cells. Conclusion Multilocular cystic nephroma is a rare disease of the kidney. CT and MRI scanning are valuable in the diagnosis of multilocular cystic nephroma, but the imaging features are not specific enough to differentiate benign multilocular cystic nephroma from multilocular cystic renal cell carcinoma.

Objective To improve and innovate the dispensing equipment in oncology.Methods Plexiglass plate was used in the counter in order to give an isolate space for preparation of chemotherapy drugs.Through the ventilation hole,the air polluted by chemotherapy drugs was sent out of door.The operator put on special protective gloves before preparation of chemotherapy drugs.Results There was a decrease of dispensing errors and confusion,when the counter was used to separate the conventional dosage from chemotherapy dosage.The counter effectively prevented the skin and respiratory tract damage to the operator during the preparation of chemotherapy drugs.Conclusion It is practical,cheap,easily operated and produced,which is worth promoting.

Objective To study the CT symptom and diagnosis value of pancreatic trauma. Methods Retro-spectively analyzed the CT and clinical data of 11 pancreatic trauma. Results Bleeding,edema in pancreas parenehy-ma, uprightness low density lines appear along long axis of pancreas when enhancement were performed ,which werethe direct symptom of pancreatic trauma and rupture; hematoeele, hydrops around pancreas, front fascia of left kidney broaden, pancreatic pseudoeyst pneumatosis in bile duet, which were the indirect symptom of pancreatic trauma. Con-clusion CT is the first choice in the diagnosis of pancreatic trauma. Master the CT symptom and make right diag-nosis, which were important to clinical operation.

Objective The status quo of multidimensional life satisfaction of college medical students understanding and its influ‐ence on mental health and to provide the scientific basis for the implementation of school mental health education .Methods 810 medical science college level students were measured with satisfaction status and mental health survey with self‐designed question‐naire and life satisfaction scale (MSLSS) ,mental health assessment scale (SCL‐90);Use SPSS19 .0 to establish a database for t test ,variance analysis ,correlation analysis and regression analysis ,descriptive etc .Results College level medical students in differ‐ent gender ,native place (birthplace) ,parents′educational level ,family economic status ,and whether the only child ,whether there are differences in the student cadre ,whether or not to participate in social practice life have different satisfaction score ;life satisfac‐tion scores and symptom self evaluation scale (SCL‐90) score of each factor were negatively related (P<0 .01) .Conclusion The current status of life satisfaction of medical students directly affect their psychological health .The intervention of medical students life satisfaction is an important means to promote mental health .

Objective To evaluate the value of high-frequency ultrasound for diagnosing Duchenne muscular dystrophy.Methods Eighty-one cases with Duchenne muscualr dystrophy were divided into four groups according to their age,age 3-7(13 cases),age 7-10 (30 cases), age 10-13 (30 cases),age 13-14 (8 cases). Twenty cases of healthy children, aged from 1 to 11 were chosed as controls. In all groups' buttock muscle,thigh and leg muscle were observed by high-frequency ultrasound longitudinally and horizontally.Results Gluteus atrophy and subcutaneous fat thickening were seen in age 3 patients,progressive subcutaneous fat thickening and progressive muscular atrophy of buttock,thigh and leg with age were proved.There were significantly differences among groups ( P

Objective:To explore the Th1/Th2 type cytokines expression and its clinical significance in various clinical behaviors of HBV-infected individuals.Methods:The production of IFN-? and IL-4 by CD3+CD8+?CD3+CD8-cells in peripheral blood from normal donor and patients with hepatitis B virus infection were assessed by a four-color flow cytometry.Results:Compared with the healthy control,the percentage of Tc1 cells in AHB group was higher,whereas the percentage of Th1 and Tc1 cells in CHB group were lower,and lower than that of the AHB,but they increased significantly with the chronic hepatic inflammation activity.Conclusion:T-helper 1 type cytokines are predominant in peripheral blood cell of AHB and CHB,but the different percentage of Th1 type cytokines may be one reason of the final outcome of the HBV-infected individuals.