Both the lecture based learning mode and problem based learning mode have their advantages and disadvantages in imparting knowledge and cultivating students'ability.Therefore according to the characteristics of clinical education,two kinds of methods should be used together to complement each other in clinical education of surgery so that knowledge can be systematically imparted to students through lecture based learning,and the abilities such as self-study,oral expression,cooperate and innovation can be cultivated through problem based learning to improve the quality of education.

Objective To study the CT characteristics of rare renal malignant tumors.Methods 7 cases with rare renal malignant tumors confirmed by operation and pathology were reviewed and their CT manifestations were analyzed retrospectively.In clinical, all cases had abdomen pain,6 cases had macroscopic haematuria,and 1 case had asymptomatic by chance.Results Of 7 cases,3 ca-ses were sarcomatoid carcinoma,1 case was carcinosarcoma,1 case was malignant mesenchymal tumor,1 case was lymphoma,and 1 case was neuroendocrine carcinoma.The diameter was about 4.0-12.3 cm.1 case had uniform density,6 cases uneven,and the boundary was not clear.Conclusion The rare renal malignant tumors are misdiagnosed easily.Combined clinical data with imaging performance are helpful to make comprehensive analysis,and to improve accuracy rate for diagnosis,definite diagnosis still depends on pathological examination.

"3+2" educational model was performed in our clinical medical college as a reformation based on traditional "4+1" model.After 5 years teaching practice,it obtained some good results as we prospected,however,there still exists some problems.This article analyzes the problems around the aspect of the teachers,the students,the teaching administration and arrangements,and proposes the corresponded measure to improve it.

Objective To test the effect of different flexion angles of knee joint on the myoelectric activity and torque of quadriceps femoris and hamstring muscle when these muscles contracting.MethodsElectromyographic activities and isometric torque measurements were performed on 10 healthy subjects at 30°, 60° and 90° of knee joint flexion.ResultsThe results indicated that the greatest maximal voluntary isometric contracture-torque of quadriceps femoris occurred during knee extension at 60° of knee flexion ( P<0.01). However, no significant relationship of maximal voluntary isometric contracture-electromyography and maximal voluntary isometric contracture-torque of quadriceps femoris were found in 10 subjects. But when knee joint was at 90° flexion, hamstring muscle had a greatest neuro-myoelectric activity.ConclusionThe exercise of maximal voluntary isometric contraction of quadriceps femoris and hamstrings muscles at certain knee joint angle can help to maintain the stability of knee joint.

AIM: To explore the characters of fibroblast-like (F-L) cells cultured from granunocyte clony stimunating factor (G-CSF)-mobilized peripheral blood cell (PBC) harvests. METHODS: The adherent cells in the PBC harvests were cultured for 2 week in the mediums of RPMI-1640/L-DMEM/G-CSF or interleukin-3 (IL-3) plus RPMI-1640, the cultured F-L cells were analyzed by flow cytometry (FC). RESULTS: The adherent non-confluent F-L cells obtained from the four groups were similar in their phenotypes: CD33+, CD11c+, CD64+, CD14+, CD45+, HLA-DR+, CD86+, CD34-, CD38-, CD3-, CD19-, CD56-, CD29-, CD44-, CD105-. The F-L cells are similar to monocytes except CD38-and were distinct from dendritic cells (DC) or mesenchymal stem cells (MSC). CONCLUSION: The cultured F-L cells are macrophages rather than DC or MSC. G-CSF, rhIL-3 enhances their numbers.

Objective To establish methods of measuring the eye lens dose to interventional staff,to obtain relevant dose data and to provide a scientific basis for reducing eye lens dose.Methods Two kinds of dosimeters,thermoluminescent dosimeter (TLD) and optically stimulated luminescence dosimeter (OSLD),were selected to measure the personal dose equivalent HP (3) to eye lens of occupational staff in several kinds of interventional procedures,including cardiovascular interventional procedures,cerebrovascular interventional procedures etc.Five types of Digital Subtraction Angiography (DSA) equipment were chosen in the study,including single tube equipment and double tube equipment.Results The eye lens dose HP (3) to interventional staff varied significantly with different interventional procedures.The lowest dose is shown in the coronary angiography procedure,while the highest dose shown in the cerebral stenting procedure.For the same type of interventional procedure,the eye lens dose to the primary interventionist was the highest.For same interventionist,the dose to the left eye was obviously higher than that to the right eye.In addition,the measured results of OSLD were apparently higher than that of TLD.Conclusions Both TLD and OSLD could be used to measure eye lens dose,and the ways of calibrating TLD to evaluate personal dose equivalent HP (3) were feasible.The reason of significant difference between the measured results of TLD and OSLD needs further research.

Objective:To explore therapeutic effect and prognosis of thrombus suction in patients with acute ST seg-ment elevation myocardial infarction (STEMI)during percutaneous coronary intervention (PCI).Methods:A total of 105 STEMI patients were enrolled and divided into thrombus suction + PCI group (n=34,received thrombus suction + PCI therapy)and routine PCI group (n=71,received routine PCI treatment).Postoperative TIMI flow, cardiac function during hospitalization,incidence of major adverse cardiovascular events (MACE)and rehospitaliza-tion within one-year follow-up after PCI were compared between two groups.Results:Compared with routine PCI group,there were significant reductions in peak values of creatine kinase isoenzyme [CK-MB,(236.62± 133.00) ng/ml vs.(186.47±69.20)ng/ml]and creatine kinase [CK,(2833.39± 198.70)ng/ml vs.(2129.59± 199.40) ng/ml],peak time of CK-MB [(12.38±6.70)h vs.(9.65±3.90)h]and CK [(12.80±8.10)h vs.(9.68± 3.50)h]after blood flow recovery,P < 0.05 all in thrombus suction + PCI group;there were downtrend of MACE (19.7% vs.8.8%)and rehospitalization rate (66.2% vs.50.0%)in thrombus suction + PCI group,but no significant difference between routine PCI group and thrombus suction + PCI group during one-year follow-up,P >0.05. Conclusion:Thrombus suction is help for improving patients condition,reducing enzymology level may be effect improving prognosis.

Objective To establish the methods for measuring the dose to occupational staff's eye lens in interventional procedures with direct-reading dosimeters,and to realize the real-time monitoring of eye lens dose and warning for high dose rate,thus providing the scientific basis of the staff radiological protection in interventional procedures.Methods Direct-reading dosimeters were calibrated with personal dose equivalent HP (3).The eye lens doses for occupational staff in different kinds of interventional procedures were measured by the devices with both single-and double X-ray tubes.The data obtained fromthe direct-reading dosimeters was compared to those obtained from TLDs.Results Direct-reading dosimeters showed good linear fitting with the calibration of HP (3),and the coefficients of variation were lower than 5％.The average eye lens HP (3) for the main operator in coronary arteriography and stent implantation in brain obtained by direct-reading dosimeters were 12.0 and 24.5 μSv,respectively,whereas those obtained by TLDs were 11.9 and 22.7 μSv,respectively.The direct-reading dosimeters gave similar t~nds as TLDs do so.The direct-reading dosimeters were able to provide eye lens HP (3) in each individual interventional procedure,and to monitor the real-time dose rate as well.Conclusions The calibration of HP (3) and the data gained by direct-reading dosimeters are reliable.Therefore,the methods for real-time measurement of eye lens dose for occupational staff in interventional procedures are successfully established.

Objective To investigate the effect of the side of cerebral lesion on the outcome in patients with ischemic stroke.Methods A total of 407 consecutive anterior circulation ischemic stroke patients within 14 days after symptom onset were recruited prospectively.The basic data ofthe e,~ISes were collected,such as the National Institutes ofHealth Stroke Scale (NU-ISS)and the side ofcerebral lesion.The modified Rankin Scale(mRS)was used to evaluate the prognosis of the patients at 6 raomhs.Results Of the 407 patients recruited,230 patients (56.5%)Were left hemisphere stroke,177(43.5%)were fight hemisphere stroke.After multivariable logistic recession analysis,the age(odds ratio[OR]1.022,95% confidence interval[CI]1.001-1.043,P=0.040),the side of lesion(OR 1.999.95%CI1.179.3.389.P=0.010),the time from onset to admission(OR1.006,95%(7/1.002-1.010,P=0.007),the outcome of the anterior circulation ischcmic stroke at 6 months aftel"onset.The outcome of the right hemisphere stroke Was significantly worse than that of the left hemisphere stroke.The onset-admission time in patients with right hemisphere stroke(median 12 h,median 39.61 h)was significantly delayed compared to the patients with left hemisphere stroke(median 12 h,median 22.72 h;Z=-2.962,P=0.003).Condusions The outcome of the left hemisphere stroke at 6 months after onset is superior to the right hemisphere stroke,and it mau be associated with the delayed admission.

Objective To evaluate the effects of electromagnetic irradiation of 2000 μW/cm2 exposure on mRNA and protein expression levels of immunoreactive protein and mRNA of NMDAR1 in rats hippocampal,and to explore the impaired mechanism of electromagnetic irradiation on learning and memory.Methods Rats were randomly divided into normal control group, sham-radiated group, and 1 h/d, 2 h/d, and 3 h/d radiation groups.The rats in the radiation groups were fixed and recieved microwave exposure of 2000 μW/cm2, then their learning and memory abilities were tested by Morris water maze experiment, the change of NR1 protein in hippocampal neurons of each group of rats was measured with immunohistochmistry and western blot techniques, and the expression of NR1 mRNA in hippocampus was determined by RT-PCR.Results In the water maze test,compared with the normal control group (8.8 ± 1.66 ), the escape latency of three radiated groups rats ( 1 h/d ( 12.29 ±1.36) s,2 h/d ( 17.99 ±2.25) s,and 3 h/d (24.66 ±5.56) s) were significantly longer (P＜0.05).In the radiation group,the hippocampal neurons of rats showed evident reduction in the ratio of NR1 positive cells,irregular,and arrayed in disorder.Moreover,compared with the normal control group ( (0.70 ±0.11 ), (0.68 ±0.11 ) ) ,the expession of NR1 protein ( 1 h/d (0.122 ±0.026) ,2 h/d (0.102 ±0.023) ,and 3 h/d (0.060 ± 0.009) ) and its mRNA ( 1 h/d (0.46 ±0.07) ,2 h/d (0.35 ±0.05) ,and 3 h/d (0.12 ±0.02) ) in hippocampal neurons was significantly decreased (P＜0.05).Among the indicators, there was no significant difference between sham-radiated group and normal control group.Conclusions Electromagnetic irradiation of 2000 μW/cm2 exposure can impair the learning and memory abilities of rats possibly through a mechanism correlated with the lower expression of NR1 protein and its mRNA in hippocampus.