Resident doctor standardization training program is the necessary and important part of medical education after graduation.The Hainan branch of PLA General Hospital combines scientific and practical medical conditions and discipline characteristics of Hainan to scientifically plan the standardized treatment of cancer pain in training.This model combines lecture-based learning (LBL) teaching method and virtual demonstration for theoretical training.In practical training,we conduct problem-based learning (PBL) teaching method,situational teaching and standardized examination to systemically improve resident doctors' skill for cancer pain management.This combined teaching strategy can help resident doctors to establish correct and standard concept in future clinical practice,and enable them to establish a correct concept of treatment,and adopt two-way evaluation to continuously improve teaching quality before the end of training.

Objective To discuss the impact of zedoary turmerie oil(ZTO) injection over oncosis index and Bcl-2 expression of human ovarian cancer SKOV3 cell.Methods After ZTO injection acted on human ovarian cancer SKOV3 cells,the changes in the nucleus were observed by fluorescence microscope,oncosis index was counted by projection electron microscope,the situation of cell DNA breakage was observed by agarose gel electrophoresis,and cell Bcl-2 gene expression was observed by immunohistochemical method.Results After treated by ZTO injection for 48 hours,human ovarian cancer SKOV3 cells shows that oncosis cell was swelling in fluorescence microscope,the volume increased,the membrane area narrowed,the nuclear chromatin expansed.The oncosis index increased with dose-effect relationship,DNA electrophoresis showed diffuse type and Bcl-2 gene expression was down-regulated.Conclusion ZTO injection can increase oncosis index of human ovarian cancer SKOV3 cell with the concentration,and lower Bcl-2 gene expression,which may be one of the mechanisms of ZTO injection caused oncosis of SKOV3 cell.

Cell Culture Techniques ; Endothelial Cells ; cytology ; Humans ; Lymphangiogenesis ; physiology ; Lymphatic Metastasis ; Lymphatic Vessels ; pathology ; Neoplasms ; blood supply ; metabolism ; physiopathology ; Vascular Endothelial Growth Factor C ; metabolism ; physiology ; Vascular Endothelial Growth Factor Receptor-3 ; metabolism

Objective To observe the effects of passive movement on the functional outcome after occlusion of the middle artery in the brain and reperfusion, and to explore the molecular mechanisms involved. Methods Cerebral infarction models were established in rats using left middle cerebral artery occlusion ( MCAO). The survivors were randomly divided into a passive movement group and a natural recovery group. There was also a sham-operated group and a normal group. Passive movement treatment (twice a day, twenty min per time) was started at different times after reperfusion. The expression of brain-derived neurotrophic factor (BDNF) and B cell lymphoma/leukemia-2 gene (Bcl-2) were determined using real-time PCRs. Results Expression of BDNF and Bcl-2 was detected a-round the infarction area in both groups. The expression of BDNF and Bcl-2 was highest in the sub-groups where passive movement was begun 24 or 48 h after the operation. Conclusions The expression of BDNF and Bcl-2 in the brain peaks when daily, moderate intensity passive movement is administered beginning 24 to 48 h after reperfusion. Passive movement might have a protective and rehabilitative effect after cerebral infarction.

Objective:To investigate the number and distribution of macrophages (Mφ) and natural killer(NK) cells in hepatocellular carcinoma (HCC), paraneoplastic,cirrhosis and normal liver tissues and their relationship with the prognosis of HCC patients.　Methods:Surgical specimens from 60 cases of HCC, 62 cases of cirrhosis and 23 cases of normal liver tissues were investigated by immunohistochemical staining of CD68 and CD57 with a streptavidin-horseradish peroxidase detective system.The correlation of the number of Mφ and NK cells in different tissues with the clinical tumor parameters was also studied.　Results:①The order of the number of Mφ from the highest to the lowest was:paraneoplastic,cirrhosis, normal, HCC(P<0.05)；and the number of NK cells from the highest to the lowest was:HCC, paraneoplastic, normal, cirrhosis(P<0.05).②The number of Mφ decreased successively with the decrease of the HCC differentiation(P<0.05)；There was no relationship between the number of NK cells in HCC and histological grade. ③There was no relationship between the number of Mφ in HCC and clinical TNM stage ；The number of NK cells in HCC had degressive tendency with the clinical TNM stage(P<0.05). ④The number of Mφ and NK cells in HCC in the cases with metastasis in 15 months was significantly lower than that without metastasis(P<0.05, 0.01）.⑤There was a linear positive correlation between the number of Mφ and NK cells in HCC (r＝0.344, P<0.05).　Conclusion:The number of Mφ and NK cells in HCC in the cases with metastasis is significantly lower than that without metastasis；The number of Mφ has a close correlation with the HCC differentiation, and positive correlation with the number of NK cells；The number of Mφ and NK cells might be important markers to estimate the immune status and useful factors to predict the prognosis of HCC patients.

Objective:To investigate the number of CD+68 cells in hepatocellular carcinoma (HCC),paraneoplastic tissues,cirrhosis tissues and normal liver tissues and their clinical significance.Methods:Surgical specimens from 60 cases of HCC,62 cases of cirrhosis and 23 cases of normal liver were investigated by immunohistochemical staining of CD+68with streptavidin-horseradish peroxidase detective system.Results:(1)The order of the mean number of CD+68cells in the tissues from the highest to the lowest was:paraneoplastic,cirrhosis,normal liver and HCC tissues(P〈0.01);(2)The number of CD+68cells in the tissues decreased successively with the decrease of HCC differentiation (P〈0.05);(3)There was no relationship between the number of CD+68cells in HCC and its clinical TNM stage;(4)The number of CD+68cells in the cases with metastasis within 15 months was significantly lower than that without metastasis (P〈0.05).Conclusion:The number of CD+68cells might be an important marker to estimate the immune status and a useful factor to predict the prognosis of HCC patients.

Objective To investigate the risk factors for postoperative nausea and vomiting (PONV) in spinal anesthesia patients.Methods A total of 841 patients received spinal anesthesia were visited after operation.Data were analyzed using univariate analysis and multivariate Logistic regression to identify risk factors related to PONV.Results PONV occurred in 94 patients (11.2％,94/841).Univariate analysis showed that PONV was unrelated with gender,age,ASA classification,anesthesia mode (P ＞ 0.05),related with operation department (P =0.026),body mass index (P =0.020),education level (P =0.000),history of previous surgery anesthesia (P =0.005),history of PONV (P =0.000),history of kinesia (P =0.002),smoke (P =0.019),intraoperative using of tramadol (P =0.018).Multivariate analysis showed that operation department (OR =4.039,95％ CI 1.331-12.259,P=0.048),education level (OR =3.504,95％ CI 1486-8.260,P=0.015),history of PONV (OR =5.113,95％ CI 1.790-14.606,P =0.002),intraoperative using of tramadol (OR =5.316,95％ CI 1.091-25.908,P =0.039) were identified as independent risk factors for PONV.Conclusions The independent factors associated with PONV following spinal anesthesia include operation department,education level,history of PONV,intraoperative using of tramadol.Identifying patients who are at high risk for PONV will enable the formation of more timely management project.

OBJECTIVE:To provide electronic drug directions for hospital staffs.METHODS:Based on the military hospital information system,a system that can provide electronic drug directions was developed by establishing the database,collecting and sorting drug directions.RESULTS&CONCLUSION:This system is characterized by friend user interface,convenient input,quick inquiry,easy maintenance and widespread service,which can help hospital staffs to get the drug di?rections quickly and exactly and hence to better serve patients.

The progress of objective and digital diagnosis of Traditional Chinese Medicine (TCM) is not optimistic.There is no denying that there are a lot of research ideas and methods,on the other hand,the understanding of TCM is very one-sided,fuzzy and even wrong.This paper attempts to absorb the quintessence of TCM in clinical medical information detection and treatment ideas from the measurement science and modem information detection and processing point of view.Ideas and means of clinical medical information detection and treatment in TCM not only coincide with,but also improve that of modem information detection and processing way and means,which have high reference value.The way of thinking and means,not only for medical information detection and processing,but also provide a valuable reference for other areas of information detection and processing.

Objective: To establish the quality control standards of two intermediate products of Xingshen Nasal Drops:musk aromatic water and volatile oil of Acorus tatarinowii Schott so that the content of main components and composition of the different batches of ultimate products remained stable.Methods: The content limit of muskone of musk aromatic water was ascertained by GC-MS. And the characteristic finger print of volatile oil of Acorus tatarinowii Schott was established. Results: The content of muskone of musk aromatic water should be controlled at the range of 0.166～0.202mg/mL. RSD of muskone content of 3 batches of ultimate products was 4.49%, not larger than 10%. The characteristic finger point of volatile oil of Acorus tatarinowii Schott was composed of 6 main component peaks: Methyleugenol, cis-Methylisoeugenol, trans-Methylisoeugenol, Elemicin, ?-Asarone and ?-Asarone. This characteristiz finger print could be repeated when the ultimate product was determined. Conclusion: The establishment of quality control standard of intermediate product can raise the product quality of compound preparations. And GC-MS is one of effective determination methods.