The higher medical education systemin China has experienced six significant curricular program changes within the last century. And these changes seem to run in a circle:from the pluralistic to the singleness,and then back to the pluralistic.The process repeated itself.These changes in history could provide some valuable insights into the future reform of the higher medical education system in China.

Objective Celloidin sections of temporal bone were used to develop a serial stereo anatomical atlas of temporal bone by computer aided three dimensional(3-D) reconstruction and stereology. Methods Fifty sets of serial celloidin sections of temporal bone with reference points were prepared and 3-D morphology of structures in temporal bone was restored systemically by the technique of computer aided 3-D reconstruction. A system of stereo anatomical atlas of temporal bone with stereoscope was established. Results Totally 48 cases of reconstruction were accomplished for bony and membranous labyrinth, ossicles, tendons, facial nerve and its canal, round window membrane and niche, posterior ampullary nerve, endolymphatic sac, cochlear aqueduct, VII and VIIIth cranial nerve. The stereo picture pairs of these structures with the best representation were selected as the stereo anatomical atlas of temporal bone which showed the fine spatial morphology and relationship of the above structures. The stereo anatomical atlas was applied to guide ear surgery and to assist anatomic training of temporal bone. Conclusion The stereo anatomic atlas of temporal bone is an innovative powerful anatomic tool and has tremendous application futures in otology, or even in the whole medical science.

Objective To verify and evaluate the efficacy and safety of PEG-4000 electrolyte lavage solution in endoscopy preparation. Methods A multicenter open randomized controlled clinical study of 211 patients taking PEG-4000 electrolyte or mannitol in colonoendoscopy preparation. The overall evaluation of colonic preparation was the primary efficacy criterion. The investigator recorded any adverse event to assess the safety. Results The total effective rate of overall colonic preparation of study group was 92. 45% (98/ 106) , that of mannitol group was 80% (84/105). The study group showed more effective than control group with statistical significance (P = 0.016). The adverse event incidence of study group was 8.49%. There were 6 patients complained of nausea and vomiting, 3 patients showed abnormal laboratory results after administration. All the events relieved in short period and have no influence on examination. There was no serious adverse event in this group. The incidence of adverse event in mannitol group was 14. 29% (15/105 ). Four patients showed gastrointestinal symptoms and 1 showed chest suppression. Abnormal laboratory results were found in 10 patients. There was 1 serious adverse event occurred in control group. The difference between 2 groups had no statistical significance. Conclusion PEG-4000 electrolyte is a safe and effective drug in colonic preparation before clinical colonic examination or surgery.

Brain computer interface is a control system between brain and outside devices by transforming electroencephalogram (EEG) signal. The brain computer interface system does not depend on the normal output pathways, such as peripheral nerve and muscle tissue, so it can provide a new way of the communication control for paralysis or nerve muscle damaged disabled persons. Steady state visual evoked potential (SSVEP) is one of non-invasive EEG signals, and it has been widely used in research in recent years. SSVEP is a kind of rhythmic brain activity simulated by continuous visual stimuli. SSVEP frequency is composed of a fixed visual stimulation frequency and its harmonic frequencies. The two-dimensional ensemble empirical mode decomposition (2D-EEMD) is an improved algorithm of the classical empirical mode decomposition (EMD) algorithm which extended the decomposition to two-dimensional direction. 2D-EEMD has been widely used in ocean hurricane, nuclear magnetic resonance imaging (MRI), Lena image and other related image processing fields. The present study shown in this paper initiatively applies 2D-EEMD to SSVEP. The decomposition, the 2-D picture of intrinsic mode function (IMF), can show the SSVEP frequency clearly. The SSVEP IMFs which had filtered noise and artifacts were mapped into the head picture to reflect the time changing trend of brain responding visual stimuli, and to reflect responding intension based on different brain regions. The results showed that the occipital region had the strongest response. Finally, this study used short-time Fourier transform (STFT) to detect SSVEP frequency of the 2D-EEMD reconstructed signal, and the accuracy rate increased by 16%.
Algorithms ; Brain ; physiology ; Brain Mapping ; Brain-Computer Interfaces ; Electroencephalography ; Evoked Potentials, Visual ; Humans ; Neural Pathways

Objective To analyze the molecular cytogenetic abnormalities and pathogenesis of pediatric Burkitt lymphoma (BL) by array comparative genomic hybridization (aCGH).Methods First,immunophenotype,molecular genetics and EB virus (EBV) infection status were detected using immunohistochemistry and fluorescence in situ hybridization in 21 pediatric BL patients.Second,in addition to detecting genome-wide genetic gain/deletion status,aCGH results with EBV infection status were also correlated.Results aCGH results showed genetic alterations in 19 cases (90.5 ％).Generally,frequency of chromosomal gain was higher than chromosomal deletion.The regions of frequently-occurring small DNA genomic fragment gains (≥40 ％ cases) were 3q21.1,5p13.2,19q13.32,12q23.1,14q32.33,6q27,20p13 and 20p11.21.Large DNA fragment gains and deletions could be detected in 42.9 ％ (9/21) cases in the 14q24.2 and 14q32.33 regions.There was no significant difference in genetic alterations between EBV (+) and EBV (-) BL cases (P≥0.05).Conclusion aCGH results show that BL cases have complex genetic alterations,which have no significant difference between EBV(+) and EBV(-) cases.Most BL cases show large DNA segment deletion or acquisition of 14q,indicating that 14q gene alteration plays an important role in the pathogenesis of BL.

Objective To study the clinical value of serum N-terminal pro-brain natriuretic peptide (NT-ProBNP) and cardiac troponin I (cTnI) levels in children with severe pneumonia. Methods A total of 72 children with severe pneumonia in pediatric intensive care unit were divided into heart failure (HF) group and non-HF group according to the occurrence of heart failure, and 30 healthy children were selected as control group. Serum NT-ProBNP and cTnI levels were detected and analyzed. Results Compared with control group, NT-ProBNP and cTnI levels were signiifcantly higher (P<0.01) in HF and non-HF group. The levels of NT-ProBNP and cTnI in HFgroup were both signiifcantly higher (P<0.01) than that in non-HFgroup. Serum NT-ProBNP level was positively related to the level of cTnI(P=0.000) in children with severe pneumonia. The abnormal rate of cTnI in HF group was significantly higher (P=0.037) than that in non-HFgroup. The difference of the abnormal rate of NT-ProBNP between the two groups was not signiifcant (P=0.375), however, the abnormal rate of NT-ProBNP was signiifcantly higher (P=0.036) than that of cTnI in non-HF group. Conclusions There was obvious myocardial damage in children with severe pneumonia. NT-ProBNP and cTnI could be important serological markers to assist diagnosis of myocardial damage and its severity.

Objective To study the change and clinical significance of coagulation and fibrinolytic function in neonatal sepsis. Methods 86 neonates inpatients in the neonatology department of our hospital were selected and divided into the ordinary infection group(30 cases)and the sepsis group(56 cases),and 30 healthy neonates were selected as the normal control group.Plasma AT-Ⅲactivity,DD level and PLT count were detected immediately after admission and the detection results were analyzed.Results Com-pared with the control group and the ordinary infection group,the AT-Ⅲ activity and the PLT count in the sepsis group were sig-nificantly decreased,while the DD level was significantly increase,the difference had statistical significance(P <0.01).The differ-ences of the three indexes had no statistical significance between the normal control group and the ordinary infection group(P >0.05);however,the AT-Ⅲ activity and the PLT count in the DIC group were significantly decreased and the DD level was signifi-cantly increased(P <0.01),the occurrence rate of abnormal three indexes was 83.33%(15/18)in the DIC group,which was signifi-cantly higher than that in the non-DIC group(χ2 =17.75,P =0.00).Conclusion The obvious dysfunction of coagulation and fibri-nolysis exists in neonatal sepsis,which is related with the severity degree of disease.The joint detection of AT-Ⅲ activity,DD level and PLT count is helpful for the early diagnosis of DIC in neonatal sepsis.

Objective To investigate the prevalence and trends of human papillomavirus (HPV)infections in gynecology outpatients in Zhejiang province.Methods Samples of cervical exfoliated cells were collected from gynecology outpatients in 11 sentinel hospitals in Zhejiang Province from January 2011 to December 2013.Twenty one HPV subtypes were detected by flow-through hybridization technique.Chisquare test was performed to analyze the prevalence rates of HPV infections in different years and in different age groups.Results A total of 14 569 patients were enrolled in the study,among whom 3 552 (24.38％)were positive for HPV.HPV-16 (5.77％,840/14 569),HPV-52 (4.71％,686/14 569) and HPV-58 (4.52％,659/14 569) were the most prevalent subtypes.Among all patients,2 244 (15.40％) were infected with a single high-risk subtype,426 (2.92％) were infected with a single low-risk subtype,and 882 (6.05％) were infected with multiple subtypes.The rate of multiple infection was on the rise during 2011 and 2013 (x2 =23.65,P ＜0.01).The positive rates of HPV in patients with 15-24 y age group and ＞54 y age group were 27.91％ (211/756) and 27.73％ (439/1 583) respectively,which were higher than those in other age groups (x2 =18.664,P ＜ 0.01).Conclusion HPV infection is popular in gynecology outpatients in Zhejiang province,especially in patients aged 15-24 y and ＞ 54 y,and a certain proportion of patients are infected with multiple subtypes.

10.3969/j.issn.1000-3606.2013.06.009

Objective To investigate the professional attitudes and occupational values of undergraduate students and to compare the differences between the first-year and fourth-year students? Method A scale concerning the professional attitude and a questionnaire concerning the occupational values were used to investigate the occpational values in 196 first-year and fourth year college nursing students? Results The professional attitude score of the first-year students was(6?7±1?3),which was significantly higher than that of the fourth students(5?3±1?1,P = 0?027)? The occupational value on the hygiene factor of the first-year students was significantly higher than that of the fourth-year students(P < 0?001)? The occupational value of reputation and social status,development between the students of the two grades achieved no significant difference? Conclusions The professional attitude and occupational value of students from different grades are different? The professional attitude and occupational value of the senior students tend to be rational?