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 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.

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.

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 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?

Objective To understand the relationship among junior college students' anxious status in testing and studying behaviors and studying result. Methods TAS anxiety scale was used for the evaluation of anxious status, and data were analyzed by SPSS software. Results Statistical significance was observed among different specialties. Sex, socioeconomic status and living environment did not affect TAS score. The higher the anxious status was, the worse the studying results will be. The anxious status was associated with some studying behaviors. Conclusions Anxiety was correlated with specialities and studying behaviors, and affected studying result.

Objective To study the diagnostic value of serum α-L-fueosidase (AFU), transforming growth factor alpha(TGF-α)and ferritin (Fer) in primary hepatic carcinoma (PHC). Methods AFU and Fer in the serum were studied in 36 patients with benign hepatism and 56 patients with low concentration AFP of PHC hepatic carcinoma by automatic biochemistry analyzer Roche Modular. ELISA was used to assay the degree of TGF-α The sensitivity and specificity of AFU, TGF-α and Fer for low expression AFP of PHC were evaluated by ROC curve. Results The serum AFU, Fer and TGF-α levels were all significant difference in the patients than those in controls (P <0.05). The area under ROC curve of these indexes in descending order was AFU (0.707), TGF-α (0.677) and Fer (0.592). The diagnostic sensitivity of Fer was lower than AFU and TGF-α in diagnosis of AFP lowly expression PHC. The ratio showed AFU better than TGF-α The diagnostic specificity of AFU (64 %) was higher than that of TGF-α (61%) when TGF-α and AFU was at the same diagnostic sensitivity (64 %). Conclusion AFU is more valuable than Fer and TGF-α for negative or AFP lowly expression PHC, meanwhile it has much more accuracy.

Objective To determine the relationship between the aggravation of CAAS and coronary atherosclerosis (CAS) ;and to summarize the pathologic character of CAAS of the patients with various coronary artery disease. Methods Review the result of coronary angiography and carotid artery ultrasonography and the related risk factors of the patients who were diagnosed as CAD through coronary angiography ( CAG). The patients were divided into the scleratheroma group and the non scleratheroma group. The patients were divided into stable angina pectoris( AP) group, unstable angina pectoris(UAP) group and acute myocardial infarction (AMI) group according to the criterion of coronary artery disease of WHO. The patients were divided into group A (coronary artery of single vessel lession) ,group B( coronary artery of double vessel lession ) , group C( coronary artery of triple vessel lession )and group D(left main vessel lession ).The aggravation of CAAS was graded. Results There were 198 patients with various CAAS among 228 patients with coronary artery disease ( 86. 8%). CAAS was much related with hypertension and non-related with age, sex, BMI, smoking, drinking, hyperlipoidemia, hyperuricosuria and diabetes mellitus. The aggravation of CAAS much graver with much graver CAS. But only the plaque number of Group A was more than Group D( P ＜0. 05). The grading integral and Crouse integral of CAAS of AP group was not remarkable less than UAP group. The grading integral of CAAS of AP group was less than AMI group and the Crouse integral of AP group was more. But there was no remarkable difference. The number of all plaque,plaque and plaque of AP group was not remarkable less than UAP group and AMI group. There was the plaque among the three group. Conclusion Carotid artery atherosclerosis (CAAS) is relative to coronary artery disease ( CAD).