Objective To investigate the teaching effects of Sandwich teaching mode applied in clinical oncology teaching.Methods Totally 72 clinical medicine undergraduates were divided into two groups randomly:Sandwich teaching group and traditional teaching group.Sandwich teaching mode was introduced to Sandwich teaching group while traditional teaching mode was carried out in traditional teaching group.Questionnaires and test paper were analyzed between the two groups and two teaching modes were evaluated.Examination results were statistically analyzed by t test.Results According to the questionnaires,more than 80 percent of the students thought that the initiative and enthusiasm were fully mobilized by the Sandwich teaching mode.Studying efficiency was improved significantly and skills of independent thinking,comprehensive analysis and problem-solving were trained,meanwhile,Sandwich teaching mode can improve the ability of expression and communication.Test score of students in Sandwich teaching group was higher than those in traditional teaching group (P＜0.05).Conclusions Sandwich teaching mode has obvious advantages in improving teaching quality of clinical oncology and it may help to cultivate high quality oncology specialists.

Objective To explore the clinical features,diagnosis and treatment of solid-pseudopapillary tumor(SPT)of pancreas.Methods The clinical data of 19 patients with SPT treated in 8 years were studied retrospectively,included 3 males and 16 females.Results The type of operation was decided by the size and location of tumor.Pancreatic leakage was a familiar complication,there were 9 cases.Patients were followed up from 3 to 70 months,and no recurrence or metastsis was found.Conclusion Pancreas SPT is a rare type neoplasm of pancreas.Pancreas SPT is affecting primarily young women,complete resection results in excellent prognosis.

Objective To design and formulate price evaluation indexes for medical services and develop a framework of indexes for the comprehensive evaluation of price formulation and implementation for medical services so as to provide government departments with management and decision-making tools with regard to prices for medical services.Methods The theories and methods of the sciences of medicine,economics,statistics,prices,and evidence-based medicine were used to develop by means of the Delphi method an evaluation model and a framework of price evaluation indexes for medical services.Results The framework developed could well evaluate the following items in price formulation and implementation for medical services: the management goals of the government,the quality of medical services in the hospital,work efficiency,cost control,economic benefits,and the involvement and satisfaction of the citizens.Conclusion It is absolutely necessary to develop a framework of price evaluation indexes for medical services.The framework developed in the present study is able to meet the current needs of price evaluation for medical services.

Objective:To explore and evaluate the application of flipped classroom in the integrated curriculum of pathology and pathophysiology overview.Methods:This study included in 172 students from the 8-year program of clinical medicine of Batch 2016 (observation group), and 142 students of Batch 2014 (control group). The observation group adopted traditional classroom teaching combined with flipped classroom teaching, and the control group used only traditional classroom teaching. In the observation group, the teaching contents were redesigned in the form of flipped classroom. The relevant knowledge points were provided before class. Group discussions and in-class presentations were used in the teaching. And the cultivation of students' learning autonomy, interaction and innovation were emphasized. The teaching evaluation was obtained from the questionnaire survey and final exam performance of the two groups of students. SPSS 21.0 was used for t test. Results:Students in the observation group had high satisfaction with flipped classroom which was helpful to improve students' independent learning ability, oral expression ability and innovative thinking ability. However, there was no significant difference in the final exam scores between the two groups ( P=0.306). Conclusion:Flipped classroom teaching can improve students' interest in learning and stimulate their independent learning and innovation. However, the teaching effect evaluated only by the final performance can't reflect the superiority of flipped classroom, which should be assessed by more evaluation indexes.

An evaluation scale of medical services quality was developed on the basis of "patients' experience". The questionnaires were developed by, among others, searching relevant literature, collecting well-established assessment scales, measuring patients' experience and satisfaction, brain-storming, literature analysis. Delphi method was adopted for expert consultation. Scale items were screened and revised. The key indexes were converted. Field surveys were conducted for testing the reliability and validity of the scale. Our modified evaluation scale for measuring medical services quality based on "patients' experience" included 6 dimensions (tangibility, reliability, responsiveness, assurance, empathy and continuity), and 50 items. The novel scale based on "patients' experience" may better serve the purpose of assessing medical services quality.

Objective To explore the correlation factors for surgical treatment in lumbar spinal tuberculosis.Methods A total of 46 patients with lumbar spinal tuberculosis who underwent surgical treatment were analyzed.The possible correlation between the clinicopathologic features and clinical outcome were analyzed by Logistic regression analysis.Results Nine patients failed in surgical treatment.Multiple analysis showed that the number of infected vertebrae (OR =6.44,95％ CI:2.47-19.92) and internal fixation (OR =10.76,95％ CI:3.50-18.74) had significant correlation with the clinical outcome.Conclusions Surgical treatment for lumbar spinal tuberculosis has a favorable outcome in patients.The number of infected vertebrae and internal fixation are significant risk factors for poor outcome.

Objective To investigate oxycodone hydrochloride injectio in treatment of postoperative laparoscopic cholecystectomy and its effects on analgesia and levels of 5-hydroxytryptamine(5-HT),nitric oxide(NO),substance P(SP).Methods 90 patients of underwent laparoscopic cholecystectomy who received therapy from August 2013 to August 2016 in Hangzhou Tvaditional chinese Medical hospital were selected and randomly divided into observation group and control group,45 cases in each group.Before incision,the observation group were gived intravenous oxycodone hydrochloride injection 0.1mg/kg,the control group were gived intravenous sufentanil 0.2μg/kg.The changes of anesthesia,postoperative pain,adverse reactions and 5-HT,NO and SP after operation were compared between the two groups.ResultsThere was no significant difference in the anesthesia time,operation time,spontaneous breathing recovery time,wake up of time between two groups,after postoperative two,four,24 h,the scores of incision pain,visceral pain in the observation group were lower than the control group,the difference was statistically significant(P<0.05).After the operation,the levels of 5-HT,NO,SP of two groups were changed,the difference was statistically significant(P<0.05),but the results in observation group were lower than the control group,the difference was statistically significant(P<0.05),the total incidence of postoperative adverse reactions in observation group were lower than the control group,the difference was statistically significant(P<0.05).Conclusion Oxycodone hydrochloride injection is well for laparoscopic cholecystectomy,which can effectively reduce the release of 5-HT,NO,SP,relief of postoperative pain,high security.

BACKGROUND:PA6 cells are bone marrow stromal stem cells from the mouse skul , and scientists have found that PA6 cells co-cultured with some kinds of stem cells have shown neural differentiation, based on which, PA6 cells can be used for repair of nerve injury. Therefore, researchers give more and more attentions to PA6, but few studies have addressed isolation and culture methods of bone marrow stromal stem cells from the skul . OBJECTIVE:To isolate and culture bone marrow stromal stem cells from the skul of Sprague-Dawley rats and to observe cellular morpholopy in vitro and perform immunofluorescence identification. METHODS:Under sterile conditions, newborn Sprague-Dawley rat’s skul was cut into pieces. Smal skul pieces were washed using Dulbecco’s modified Eagle’s medium containing 10%fetal bovine serum. Single cellsuspension was made, and placed in culture flask. The culture medium was changed many times for cellpurification. The second passage of cells was obtained for morphology observation under an inverted microscope. cellsurface markers were detected by using immunofluorescence staining. RESULTS AND CONCLUSION:After the primary culture for 24 hours, cells exhibited adherent growth;after 3 days, cells were increased in number, and presented with irregular shapes, such as polygon, triangle, spindle and flat shape. After passage, cells were uniform in morphology, arranged in radial and bunch patterns, and exhibited strong adherent ability. Some cells grew in cluster, and proliferated faster than primary cells. Immunofluorescence staining showed that cells were positive for CD105, CD73, CD44, CD90, but negative for CD45, D34,CD14, HLA-DR. Results indicate that this method can obtain bone marrow stromal stem cells.

131 I-metabolizing genes are markers for differentiation of thyroid carcinoma.The loss or down-regulation of these genes represents progression of dedifferentiation,which results in low 131 I uptake and suggests a poor prognosis.The mechanism of dedifferentiation of DTC is important for treatment.This article reviews the mechanism of dedifferentiation from 131I radiation damage,gene mutation,tumor markers and protein.

Purpose:To investigate effect on bcl-2 and bax expression in apoptic PGCl_(3) cells and to study the mechanism of apoptosis of PGCl_(3) cells induced by death associated protein kinase(DAPK).Methods:Eukaryotic express vector pcDNA3.1-DAPK was tranfected into High-metastasis Non-small Lung Cancer Cell PGCl_(3).Changes of bcl2 and bax expression were detected with RT-PCR.Phospharation of Bcl-2 was examined with Westernblotting.Results:It was demonstrated that bcl-2 expression was down regulated,but bax expression did not change in apoptosis of PGCl_(3) cells induced by DAPK.Level of Phospharation of Bcl-2 increased.Conclusions:Apoptosis of PGCl_(3) cells induced by over-expression of DAPK may be associated with down regulating of bcl-2 expressio and increase of phospharation of Bcl-2.