Objective To examine the application effect of intelligent simulator(SimMan) in comprehensive skill training among doctors and nurses.Methods Totally 168 doctors and nurses were chosen as the training object,6 people (4 doctors and 2 nurses) formed a work team.Comprehensive training course was in accordance with 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care science.Real clinical situation was designed by using the third generation SimMan of Norway laerdal company.Trainees were administered two tests before and after training,in which there were two parts containing specialized operation ability and non-technical ability.Overall qualification rate,average mark and treatment time of qualified teams were compared before and after the training.SPSS 16.0 software was used to analyze the data and P ＜0.05 signifies statistically significance.Results Overall qualification rate,average mark and treatment time of qualified teams were 71.43％,(84.70 ± 3.15),and (449.25 ± 77.0) s respectively before training while 100％,(93.55 ± 3.86) and (323.71 ± 42.26) s after training.There were significant differences in results of two groups before and after training (P =0.002,0.000,0.000).Conclusions Application of the third generation intelligent simulator (SimMan) in comprehensive training will obviously improve training effectiveness and cultivate the non-technical ability.

Objective To understand the influencing factors of the post competency of health technical personnel in township hospitals in a prov-ince,so as to provide scientific reference for improving health professionals'post competency. Methods Using stratified cluster random sam-pling,1242 health professionals from township health centers and village clinics of 14 cities were extracted and then surveyed with questionnaire. Results The average score of the respondents'post competency was 3.43,which meant they could afford most of the work. Multiple linear re-gression analysis showed that the main influencing factors of the professionals'post competency included gender,age,specialty,and training. The female,senior,nursing and health-care professionals with training exhibited a better post competency. Conclusion To realize the further develop-ment of professionals'post competency,medical students should not only be early clinical and more clinical,but also actively participate in the training and continue the education after entering the clinic. On the other hand ,the government should define the function orientation of the town-ship healthy centers and explore human resource management mode based on the post competency.

Early small hepatocellular carcinoma (SHCC) can be cured by surgery and interventional operation to improve the survival rate of paitents,so the accurate diagnosis of SHCC is of great significance.Presently,the dynamic contrast-enhanced MR scan could only obtain single arterial phase imaging by single breath hold,and it had breathing motion artifact because of the long scanning time.The early arterial transient enhancement of SHCC was easy to be misdiagnosed.The CAIPIRINHA-Dixon-TWIST-VIBE (CDT-VIBE) sequence couldobtain high-quality multiple arterial phases images and hepatic arterial dominant (HAD) images in short-time scanning.And it could not only detect small focal lesions which were difficult to find by other imaging examination,but also find the start enhanced difference between lesions which were relevant to lesions property and blood supplement.The CDT-VIBE has a high clinical value in diagnosis and treatment of SHCC.The research progresses of CDT-VIBE in diagnosis of SHCC was reviewed in this article.

Objective To investigate the relationship between the single nucleotide polymorphism (SNP)of KCNJ1 1 (inwardly rectifying potassium channel,subfamily J,member 1 1)gene and essential hypertension (EH)in Xinjiang Kazak population.Methods The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP ) method was used to detect genotypes of rs2285676 polymorphism of KCNJ1 1, including 126 hypertensives (EH group)and 126 normotensives (NT group)in Xinjiang Kazak population.Multiple-factor unconditional Logistic regression analysis was used to evaluate the risk factors for hypertension in Xinjiang Kazak. Results Logistic regression analysis showed that KCNJ1 1-rs2285676 genotypes,sex,weight,total cholesterol and triglyceride were not associated with hypertension;body mass index (BMI)and high-density lipoprotein (HDL) were protective factors affecting hypertension while low-density lipoprotein (LDL ) was a risk factor for hypertension.Genotypes (TT,CT and CC)and allele frequencies (T and C)of the SNP of rs2285676 in KCNJ1 1 gene were 50.00%,48.41%,1.59%,74.21% and 25.79% in EH group,respectively.The differences between EH and normal control were not significant (P >0.05).Conclusion The rs2285676 polymorphism of KCNJ1 1 is not associated with EH in Xinjiang Kazak population.

Objective To investigate the effects of ropivavaine on gamma -aminobutyric acid(GABA)-activated membrane cur-rents in isolated dorsal root ganglion(DRG) neurons of the rats with ischiadic nerve chronic constriction injury (CCI) and to discuss the possible analgesia mechanism of ropivacaine .Methods The whole-cell patch clamp technique was used to record and compare the changes of GABA receptor activation currents of acute isolated DRG neurons after 30 s of ropivacaine preperfusion in the oper-ating side and the operative opposite side of the CCI model rats and the sham-operation group .Results (1)Compared with the oper-ative opposite side ,the sham-operation group and the control group ,the thermal withdrawal latency in the operative side group of the CCI model rats was notablely shortened(P<0 .05);(2)the amplitude of GABA-activated currents with different concentration GABA(0 .1-1 000μmol/L) in the operative opposite side group of the CCI operation was significantly greater than that of the op-erative side group and the sham-opeartion group ;(3)DRG neurons after ropivacaine preperfusion (0 .1-1 000μmol /L) showed va-rying degrees of enhancement effect on the 100 μmol/L GABA-activated currents ,the enhancement amplitude in the CCI operative opposite side group was significantly greater than that in the operative side group and the sham-operation group ;(4)The dose-re-sponse curve of DRG neurons GABA (0 .1-1 000μmol/L) activated current in the operative side group of the CCI rats after ropiva-caine pre-perfusion (100 μmol/L) was shifted to the left ,the difference between two EC50 had no statistical significance (P>0 .05) .Conclusion Ropivacaine has the enhancement effect on GABA activated currents in the DRG neurons of the CCI model rats , which could be one of reasons for ropivacaine producing the anesthetic and analgesic effect .

Objective To investigate the effects of midazolam on GABAA receptor-activated currents in isolated dorsal root ganglion (DRG) neurons in rats.Methods Sprague-Dawley rats of both sexes,weighing 200-250 g,aged 4 weeks,were used in the study.The DRG neurons were isolated and GABAA receptor-activated currents were recorded using the whole-cell patch-clamp technique.GABAA receptor-activated currents were recorded after administration of the mixture of midazolam 3.00 μmol/L (final concentration)and the different final concentrations (0.03,0.10,1.00,10.00,100.00 and 1000.00 μmol/L) of GABA,after different concentrations of midazolam (0.03,0.10,1.00,3.00,10.00 and 100.00 μmol/L) was given,after administration of the mixture of different final concentrations(0.03,0.10,1.00,3.00,10.00 and 100.00 μmol/L) of midazolam and GABA 100.00 μmol/L (final concentration),and after administration of the mixture of midazolam 1.00μmol/L (final concentration) and GABA 100.00 μmol/L (final concentration)at the preset time points of perfusion with different concentrations of midazolam (0,20,40,60 and 120 s of perfusion).The enhancement rate of the currents was calculated.Results No change in the membrane currents was found after midazolam was perfused in the neurons sensitive to GABA.GABAA receptor-activated currents were enhanced after administration of the mixture of different concentrations of GABA and midazolam.GABAA receptor-activated currents were enhanced after different concentrations of midazolam were given compared with that before administration,and the enhancement rate of the GABAA receptoractivated currents was gradually increased with the increase in the concentration of midazolam and reached the peak at the concentration of 3.00 μmol/L.The enhancement rate of the GABAA receptor-activated currents was gradually increased with the prolongation of perfusion time and peaked at 40 s of perfusion.Conclusion Midazolam can enhance the GABAA receptor-activated currents in rat dorsal root ganglion neurons,indicating that midazolam increases the role of GABA through increasing the activity of GABAA receptors and has analgesic effect at the spinal cord level.

Objective To investigate the effects of propofol on mesenteric artery in SD rats and to observe whether the effect of propofol on the mesenteric artery relaxation is related to the gap. Methods Pressure myograph was used to examine the effect of 18β-GA and 2-APB on the relaxation induced by propofol 1×10 -7 ,3×10 -7 ,1×10 -6 ,3×10 -6 ,1 ×10 -5 ,3 ×10 -5 ,1 ×10 -4 and 3 ×10 -4 mol/L in acutely separated mesenteric arterioles of SD rat.Results The diameter of mesenteric arteri-oles were increased from (208.6±13.4)to (213.5±13.6),(21 9.7±13.2),(226.4±12.5),(234.9 ±12.3),(245.5±13.0),(267.4±1 5.2),(336.2±18.3)and (385.9 ±14.2)μm after application of 1×10 -7 ,3×10 -7 ,1 × 10 -6 ,3 × 10 -6 ,1 × 10 -5 ,3 × 10 -5 ,1 × 10 -4 and 3 × 10 -4 mol/L propofol,re-spectively.Propofol induced dilation of the rat mesenteric arterioles in a concentration-dependent man-ner (P < 0.01 ).After pretreatment with 18β-GA and 2-APB,1 × 10 -4 mol/L propofol induced dilation was absolutely decreased (P <0.01).Conclusion These results suggest that propofol relaxes mesenteric arterioles via gap junction.

Objective To observe the effects of propofol intervention on renal ischemia-reperfusion injury on the expression of Cx43 in rat renal interlobar artery.Methods Male SD rats were randomly divided into control 4h and 24h groups (control), sham operation 4h and 24h groups (sham), ischemia reperfusion 4h and 24h groups (I/R), propofol 4h and 24h groups (propofol), and fat emulsion 4h and 24h groups (intralipid).Ischemia/reperfusion model was prepared by resection of right kidney and noninvasive arterial occlusion of left kidney, with renal ischemia for 45min and reperfusion for 4h or 24h depending on different group.Serum urea nitrogen (BUN) and creatinine (Cr) were detected by automatic biochemical analyzer.HE staining was used to observe the pathological changes of renal tissue.The changes of renal artery systolic and diastolic lobes were examined by pressure myographic technique.The expression of Cx43 protein in renal interlobar artery was analyzed by Western blot.Results The concentrations of serum BUN and Cr in sham group did not differ significantly from those in the blank control group.Renal HE staining showed no significant lesions;the pressure myogram of motor renal interlobar artery contraction rate showed no significant difference.The expression of Cx43 protein did not change significantly.Compared with sham operation group, the concentrations of serum BUN and Cr in ischemia-reperfusiongroup were significantly increased.HE slices kidney showed that the pathological changes of renal tissue became obvious;pressure motor indicated renal interlobar artery contraction rate was decreased;the expression of Cx43 protein was increased significantly (P<0.05).Compared with ischemia-reperfusion group, the concentrations of serum BUN and Cr in propofol group were decreased;renal HE slices showed reduced renal tissue lesions, increased renal interlobar artery contraction rate, and decreased expression of Cx43 protein (P<0.05).Conclusion Propofol can change renal ischemia-reperfusion injury by reducing the expression of Cx43 protein in vasomotor in renal interlobar artery.

‘Student-centered’ teaching model is the needs of higher medical education.In the process of education,we carried out comprehensive and systematic reforms by satisfying students' needs and improving students' ability as the main line.These reforms included change of teaching methods (the basic theory combined with clinical knowledge),increase of innovative experiments and change of evaluation system.These results showed that students were interested in these reforms,the innovation abilities of students were improved and students could pay more attention to the process of learning.

Objective To investigate the clinical significance of Notch-1 expression in small cell lung cancer(SCLC) and non-small cell lung cancer(NSCLC),and analyze the role of it in prognosis.Methods SP immunohistochemistry was used to detect the expression of Notch-1 antibody in 43 of SCLC and 40 of NSCLC tissues.Further analysis was carried out to interpret the association of Notch-1 antibody expression with clinicopathological features,lymph node metastasis and prognosis in SCLC.Results The positive rate of Notch-1 expression was 20.93％ ( 9/43 ) in SCLC,while 65.00％ ( 26/40 ) in NSCLC.The expression of Notch-1 antibody was associated with clinical stage and lymph node metastasis ( x2 =5.42,P ＜ 0.05 ; x2 =4.88,P ＜ 0.05respectively),but was not associated with age,sex,tumor location,tumor size ( Ps ＞ 0.05 ).Compared with NSCLC,the expression rates of Notch-1 antibody were significantly higher in SCLC ( x2 =16.50,P ＜ 0.05 ).Kaplan-Meier survival analysis indicated that the survival time of patients with positive Notch-1 expression was significantly longer than that of patients with negative staining( x2 =19.87,P ＜ 0.05 ).Cox regression analysis showed that Notch-1 antibody could significantly reduce the risk of death in patients with SCLC.Conclusion The positive expressions of Notch-1 were significantly different in SCLC and NSCLC,which linked to the clinicalstage,lymph node metastasis and poor prognosis.Accordingly,the expression of Notch-1 may have good value in diagnosis and prognosis.