With the rapid development of high science and technology,new teaching methods related to computer and electronic message techniques,have been applied to the recent medical education.Classical pathological teaching model has been gradually replaced by the modern way.This paper reports our teaching reformed practice by using the new technology and form the current educational theory.

Aged ; CA-125 Antigen ; metabolism ; Carcinoembryonic Antigen ; metabolism ; Cystadenocarcinoma, Papillary ; metabolism ; pathology ; surgery ; Female ; Humans ; Keratin-7 ; metabolism ; Ki-67 Antigen ; metabolism ; Membrane Proteins ; metabolism ; Uterine Neoplasms ; metabolism ; pathology ; surgery

Calmodulin-Binding Proteins ; metabolism ; Female ; Humans ; Hysterectomy ; Leiomyosarcoma ; metabolism ; pathology ; secondary ; surgery ; Lymph Node Excision ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Middle Aged ; Neprilysin ; metabolism ; Ovarian Neoplasms ; secondary ; Uterine Neoplasms ; metabolism ; pathology ; surgery

Dietary essential amino acids are extracted in the first-pass metabolism by the small intestine.Besides incorporation into mucosal protein,they are also the fuels for the utilization by small intestinal mucosal cells and the precursors for intestinal synthesis of new amino acids and enormous biological important molecules such as glutathione,polyamines,etc.Thus,their gut metabolism is not only crucial for the maintenance of the integrity and function of intestinal mucosa,but also important for the regulation of whole body metabolism.

Objective To investigate the effects of different ventilation modes on PaCO 2 and PaO 2 during laparoscopic surgery in the Trendelenburg position.Methods Forty cases of laparoscopic resection of rectal cancer were randomly divided into group A (n =20)and group B (n =20).Under general anesthesia,all the cases were in volume-controlled ventilation mode (VCV,tidal volume=10 ml/kg)before pneumoperitoneum.After ventilating in VCV mode for 20 minutes with a lower tidal volume (8 ml/kg),group A was converted to PCV mode for 20 minutes and then back to the VCV mode for 20 minutes again.Next we switched to PCV combined with PEEP (5 cm H 2 O)mode (PCV+PEEP)for 20 minutes.In group B,we only alternated PCV with PCV combined with PEEP.Arte-rial blood-gas analysis was obtained at each time when ventilating mode changed.Results In both group A and B,PaO 2 in VCV mode was less than that in PCV mode and PCV+PEEP mode (P <0.05),PaO 2 in PCV mode was also less than that in mode PCV+PEEP mode (P <0.05).PaCO 2 in PCV and PCV combined with PEEP mode was less than that in VCV mode (P <0.05 ),and there was no difference of PaCO 2 in PCV mode and PCV+PEEP mode.The pH value in VCV mode was less than that in PCV mode and PCV+PEEP mode (P < 0.05).There was no difference in pH value between PCV mode and PCV+PEEP mode.Conclusion PCV combined PEEP mode is beneficial ei-ther in increasing or decreasing of PaCO 2 during laparoscopic surgery in the Trendelenburg position comparing with single VCV mode or PCV mode.

Objective To analyze the implementation of national continuing medical education (CME) programme in Chinese Center for Disease Control and Prevention during 2007-2012,in order to improve quality of CME.Methods According to the data from national CME system,Excel 2007 was used to analyze the authorized and executed programme data to calculate implementation rate; to calculate constituent ratio of different project hosting days; analyzing the tide of a technical post data to calculate constituent ratio of different professional ride; analyzing different types of lecture to calculate percentage of theory class hours and experiment class hours; calculating constituent ratio of different professional title about students,using SPSS 13.0 to conduct x2 test for constituent ratio of different professional tide about students in different years.Excel 2007 was used to analyze training effect data,calculating constituent ratio of degree of effect satisfaction.Results 361 projects were approved,52 projects of which were conducted during 2007-2012 with the execution rate of 69.81％.Most hosting days were 3-6 d.Teachers who have senior professional tides gain 80.25％(1 170/1 458).The majority (70.85％,20 642/29 136) of students have junior and intermediate technical tides; Students in different years Tide Distribution is not exacdy the same,junior and intermediate technical tides gain the most proportion(X2=2 215.79,P=0.000).Students are satisfied with the progressiveness of training content.Conclusions Implementation of projects are overall good.In the future,it is needed to expand the scale,and enhance surveillance and evaluation to improve project quality according to the characteristic of project.

Objective To study the prevalent situation of the traffic illegal behaviors ,characteristics of high occurrence and its related risk factors among the residents in Yunnan during 2010 to offer the scientific basis for making the related strategy and countermeasure of road traffic injury prevention and control .Methods By adopting the multistage stratified proportion random cluster sampling method ,the permanent residents aged over 18 years old were randomly sampled from each family for conducting the survey during 2010 .Then the prevalent situation and characteristics of unsafe traffic behaviors were analyzed .Results the oc‐currence rate of unsafe traffic behaviors was 59 .09% .The helmet wearing rate was 40 .45% ,the wearing rate of safe belt in drivers was 46 .75% ;the drunk driving rate was 18 .05% ;The fatigue driving rate was 29 .06% ;the rate of driving without license was 16 .25% .The populations of having high traffic illegal behaviors were male ,ethic minorities ,unmarried people and blue‐collar work‐ers .Conclusion The unsafe traffic behaviors of Yunnan residents is still serious .

Objective To assess the regional left ventricular (LV) rotation motion in the patients with rheumatic mitral stenosis (MS) with velocity vector imaging (VVI).Methods This study included 38 patients with isolated MS (mild,moderate and severe) and 55 healthy control subjects.Short-axis parasternal views at the basal and apical level of LV were taken.Peak value of rotation angle and rotation velocity,as well as time to peak value were measured by VVI workplace offline respectively.Results ①In the healthy control subjects LV rotates clockwisely at the base and counterclockwisely at the apex,the same as the patients with MS.② In th patients with MS,rotaion angle and rotation velocity were significantly reduced at the apical level(P ＜0.001),rotation velocity were significantly reduced at some segments of basal level (anterior,lateral,septal) (P ＜ 0.05).③Compared with the healthy control,the difference of time to peak roation angle between base and apex was significantly longer in patients with MS (P ＜0.05).④ There were no significant differences among mild,moderate and severe MS (P ＞0.05).Conclusions The patients with MS may suffer from systolic dysfunctin even in the early stage identified by the alteration of LV rotation motion,which is independent of the hemodynamic severity of MS.

To explore the value of local anesthesia under ultrasonic guidance for establishing puncture path of superficial tumor.A total of 144 patients with superficial tumor received local pre-puncture anesthesia under ultrasonic guidance so that all lesions were targeted.Transient aggregation of narcotics was applied for raised (n =12) or superficial (n =15) skin lesions.The clarity of scanning acoustic window was enhanced,the puncture distance of tumor broadened and the mass of axial changed to obtain a longer lymph node cortex.The damage of blood vessels occurred easily due to tumor closeness to large blood vessel or shortened puncture path in 17 cases.Anesthetic drug was injected between tumor and blood vessels to enlarge the thickness for visualizing the puncture needle tract clearly.And puncture was accomplished under the guidance of color Doppler.Therefore a puncture path can be created effectively with local anesthesia by ultrasonic guidance.

BACKGROUND:Previous studies have found that the basement membrane matrix can induced the chondrogenic differentiation of bone marrow mesenchymal stem cels, but there is a wide gap between its mechanical properties and practical application, and further research is needed. OBJECTIVE:To prepare a suitable matrigel/chitosan scaffold that has appropriate mechanical properties and remarkable bioactivity for cartilage repair. METHODS: We selected genipin as cross-linking agent, and mixed Matrigel with cross-linked chitosan at different ratios (2:1, 1:1, 1:3). Then rat bone marrow mesenchymal stem cels were seeded on different scaffolds and cultured for 14 days. The mechanical properties of materials were measured by DMA. Cel counting kit-8, FDA staining, ELISA kits and Alcian blue staining were used to measure the bioactivity of materials. RESULTS AND CONCLUSION:The storage modulus of scaffolds was raised from 0.48 kPa to 1.78 kPa with increase ratio of chitosan. Cels spread wel in the early period on al scaffolds, and then the cels on the chitosan scaffold showed reduced chondrogenic activity, but cels on the scaffolds with matrigel could maintain chondrogenic differentiation. The matrigel/chitosan scaffold at a ratio of 1:1 had appropriate mechanical properties and higher levels of colagen II and colagen X at 14 days. The prepared matrigel/chitosan scaffold with decent mechanical performance can promote the differentiation of bone marrow mesenchymal stem cels into chondrogenic lineages, which can be used in cartilage tissue engineering.