Compared with the traditional teaching methods,multimedia teaching has specific advantages and has been widely used. Meanwhile,the defects in multimedia teaching must be attached great importance to. This paper focuses on some problems widely existing in the multimedia teaching and sets forth several proposals of promotion in the use of multimedia teaching.

The esophagus carcinoma is one of the most common cancers in China. The therapy modes for esopha-gus carcinoma include surgery, radiotherapy and chemotherapy. Platinum-based combined chemotherapy has always been used in the treatment for esophagus carcinoma. In this article, we reviewed the application of platinum-based chemo-therapy in esophageal cancer in recent years. The efficacy of cisplatin in treating esophageal cancer has been proved. Cis-platin is used in neoadjuvant chemotherapy, adjuvant chemotherapy, concurrent chemo-radiotherapy and salvage chemo-therapy for esophageal cancer. Combined chemotherapy with 5-fluorouracil (5-FU) and cisplatin is regarded as the stan-dard regimen for esophageal cancer in concurrent chemoradiotherapy and salvage chemotherapy. Compared with cisplat-in, carboplatin causes lower rate of nephrotoxicity, reactions in the digestive tract and ototoxicity. But carboplatin does not have better effect. Patients with esopohageal adenocarcinoma show good clinical response to oxaliplatin and relatively sat-isfactory median survival. The rate of nephrotoxicity and reactions of digestive tract caused by cisplatin is lower. Oxaliplatin can lead to serious neurotoxicity. The therapeutic efficacy of nedaplatin is as good as that of cisplatin. Nedaplatin is used in concurrent chemoradiotherapy and salvage chemotherapy for esophageal squamous cell carcinoma. Compared with cispla-tin, nedaplatin can result in myelosuppression. Further research is warranted to explore whether nedaplatin can take place of cisplatin as the standard regimen. Lobaplatin combined with 5-fluorouracil (5-Fu) and leucovorin (CF) is effective and well tolerated for advanced esophagus carcinoma. The major toxicities noted are reversible bone marrow suppression and gastrointestinal tract reaction.

Taking the basic theory of Chinese medicine as the instruction, through the bidirectional features of clinical manifestations, the relative etiology and pathology, acupoints and treatments, the bifunctional law in acupuncture theory is discussed. And it is held that after the confirmation of bidirectional symptoms of some diseases or syndromes, acupoints which have special functions in the bifunctional theory of acupuncture with a narrow meaning can be taken as major acupoints. And at the same time, other proper acupoints and flexible treating methods can be selected under the instruction of the bifunctional law of the broad meaning, so as to get the best therapeutic effect.
Acupuncture Points ; Acupuncture Therapy ; Humans ; Medicine in Literature ; Meridians

Objective To investigate the clinical characteristics,surgical resection extent and prognosis influencing factors of pri-mary high-risk gastrointestinal stromal tumors(GIST).Methods The clinicopathological and follow-up data of 48 patients with pri-mary resectable high-risk GIST in this hospital from January 2005 to January 2013 were retrospectively analyzed.The influence of three kinds of different surgical resection methods on the prognosis of GIST was analyzed.Results 34 cases were treated by R0 re-section(70.83%),6 cases by R1 resection(11.50%)and 8 cases by R2 resection(16.67%).All cases were given the postoperative adjuvant therapy of imatinib mesylate.The average medication time was(26.5±13.6)months.The occurrence rate of adverse drug reactions was 100%,and the main symptoms were swelling and leukopenia.The 5-year survival rates in 3 kinds of resection modes were 97.06%,66.67% and 25.00% respectively.The univariate and multivariate prognostic analysis showed that the surgical re-section extent and the tumor rupture were the independent prognostic factors in the high-risk GIST patients.Conclusion The intact operative resection and preventing the tumor rupture are the keys to increase the postoperative survival rate of GIST patients.

Air Pollutants, Occupational ; analysis ; Cyanamide ; analysis ; Spectrophotometry ; Workplace

Objective:To study the association between rs2235371,rs2013162,rs2235377 SNPs in interferon regulatory factor 6 (IRF6)gene and non-syndromic cleft lip with or without cleft palate(NSCL/P)in Xinjiang Uyghur population.Methods:100 Uyghur NSCL/P patients from Xinjiang were included in the case group and 60 Uyghur inpatients with upper respiratory tract infection were se-lected in the control group.Next,generation sequencing was used,DNA sequencing results were compared with the information on the genome database and genetic analysis were made.Results:There were no significant differences in the frequency distribution of both genotypes and alles when the cases were campared with the controls at the rs2235371,rs2013162 and rs2235377 loci(P >0.05). Above three loci were located in the same block,rs2235371 and rs2235377 loci presents the strong linkage disequilibrium(r2 =0.949, D'=0.974).Possible haplotypes were:CCT >CAT >TAC,and there was no significant difference between the cases and controls in haplotype distribution(P >0.05).Conclusion:Polymorphisms of rs2235371,rs2013162 and rs2235377 in IRF6 gene may be associ-ated with NSCL/P in Xinjiang Uygur people.

To study the application of simulated-patient teaching in practice teaching and assessment of obstetrics and gynecology,the two groups of students were taught by simulated-patient teaching and discussed cases teaching respectively,and then they were assessed by using simulated patients for clinical skills.The result shows that simulated-patient teaching is effective in improving students' clinical skills,can act as a worthy tool of clinical teaching and assessment.

Objective To investigate the effects of propofol on lipopolysaccharide (LPS)-induced brain injury in rats.Methods Fifty-four pathogen-free SD rats of both sexes, aged 6 weeks, weighing 200-250 g, were randomly divided into 3 groups: control group (group C, n = 6) ; LPS group (group L, n = 24) ; propofol group (group P, n = 24) . Brain injury was produced by injection of LPS 1 mg/kg via the left internal carotid artery in L and P groups. Propofol 100 mg/kg was injected intraperitonealry immediately after the LPS administration in group P, while the equal volume of normal saline was given instead of propofol in group L. The equal volume of normal saline was given instead of LPS and propofol in group C. Six rats in each group were sacrificed and the brain tissues were immediately removed at 24 h after intraperitoneal administration in group C, and at 6, 24, 48 and 72 h after intraperitoneal administration in L and P groups for determination of brain water content, high-mobility group box 1 ( HMGB1) expression and NF-κB activity, and microscopic examination. Results The brain water content and NF-kB activity were significantly increased, and HMGB1 expression was up-regulated in group L as compared to group C (P ＜ 0.05) . The brain water content, expression of HMGB1 and NF-kB activity were significantly lower in group P than in group L ( P ＜ 0.05) . The microscopic examination showed that brain injury was attenuated in group P compared with group L. The brain water content was positively correlated with the HMGB1 expression and NF- κB activity (r = 0.692 and 0.769 respectively, P ＜ 0.05). Conclusion Propofol can reduce the LPS- induced brain injury by reducing inflammatory response of the brain tissues.

Objective To explore the capacity of hematopoietic cells from human umbilical cord blood (UCB) induced by hematopoietic growth fators (HGFS) to differentiate committedly to granulocyte in vitro . Methods Suspension culture of isolated mononuclear cells from fresh UCB samples were conducted for 5 weeks in IMDM medium containing UCB serum and HGFS. The expansion folds of nucleated cells, the changes of CD34+antigen by immunofluorometry, and the colony forming unit granulocyte macrophage(CFU GM) by progenitor clonogenic assay were observed. Results Culture of mononuclear cells with the combination of granulocyte colony stimulating factor(G CSF), granulocyte macrophage colony stimulating factor (GM CSF), stem cell factor(SCF), interluekin 3(IL 3) and interleukin 6(IL 6) for 3 weeks markedly increased the total count of nucleated cells and CFU GM, being 58.3 and 12.2 folds of the pre cultured, and the cultured cells were mainly neutrophils. However, CD34+ cells in nucleated cells declined from 0.97% to 0.05%. According to the culture condition, a single portion of fresh UCB could increase nucleated cells by (5.1?2.3) fold and CFU GM by (2.2?0.95) fold. Conclusion Hematopoietic cells of UCB may be induced to differentiate committedely to granulocyte lineage by this culture system in vitro to result in the increase of granulocytes and CFU GM in single portion of cord blood.

Objective:To investigate the biological basis of phlegm syndrome (Tan Zheng) and blood stasis syndrome (Xue-Yu Zheng) in traditional Chinese medicine(TCM) through the dynamic observation of the changes of blood lipid hemorheology and vessel endothelium impairment. Methods: SD rats were divided into fi ve groups randomly: the control group fed by normal diet, four model groups fed by 2-, 4-, 8- and 16-week high cholesterol diet, respectively. The indices of blood lipid hemorheology the level of plasma endothelin (ET) and serum nitric oxide (NO) were detected. Results: Compared with normal control group, serum total cholesterol (TC) and LDL-C levels raised signif icantly after being given hypercholesterol diet for 2 weeks, and this changes lasted till 16 weeks(P