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 evaluate the effect of continuous spinal anesthesia with a "catheter-over-needle" system which diminished the leakage of CSF through the hole in the dura alongside the inserted catheter and minimizes the risk of post-dura-puncture headache. Methods Sixty ASA Ⅰ - Ⅱ patients aged over 60 yr, scheduled for transurethral prostatectomy, were randomly divided into two groups of 30 patients in each group: group I continuous spinal anesthesia (CSA); group Ⅱ continuous epidural anesthesia(CEA) . Catheter was placed at L2-3 or L3-4. Both groups received 0.5% bupivacaine for surgery. A loading dose of 1.5-2.5 ml (groupⅠ ) or 8-13 ml (group Ⅱ) was given. If the surgery exceeded 2 h a third of the loading dose was injected. For postoperative analgesia a mixture of 0.125% bupivacaine + 0.0006% fentanyl was used. In group I the PCA setting was loading dose 0.5ml, background infusion at 0.5 ml/h, bolus dose 0.5 ml and lock-out interval 8 min. In group Ⅱ the loading dose was 2 ml followed by background infusion at 2 ml/h and bolus dose was 2 ml with lock-out interval of 15 min. Onset time and level of analgesia were recorded during surgery and VAS pain score and movement of lower extremities (modified Bromage score) were assessed. Postoperative PCA was maintained for 50 h. Results The demographic data including age, height and body weight were comparable between the two groups. There was no significant difference in the duration of surgery between the two groups. The onset of block was significantly faster in group I (3.5 ?2.3) min than that in the group Ⅱ (9.5 ?3.4) min. Motor blockade was less intense in group Ⅱ as assessed by modified Bromage score. Analgesia was more satisfactory in group I as less patients received fentanyl and droperidol iv during surgery in group I . Thetotal amount of bupivacaine used during postoperative analgesia was significantly less in group I , only about one-fifth of the total amount used in group Ⅱ. Two patients complained of headache in group I but in group Ⅱ there was also one patient complaining of headache. Conclusion Continuous spinal anesthesia has the advantage of faster onset of block, better analgesia, more intense motor block with less local anesthetic.

In order to meet the modern needs in medical talent education and bring up highly qualitfied medical talent,Medical College of Shantou University has aggressively and effectively conducted exploration and practice on high medical education,and developed a new teaching model for bringing up medical talent under with high quality the strategies of "Reform of Course System" and "Innovation of Teaching Model".The new teaching model is designed to bring up excellent clinicians with innovative spirit and proficient basic skills.It keeps up with the global ideal of high medical education,and it is an originated teaching model in China with Chinese characteristics and a unique style of Medical College of Shantou University,which will make a positive and significant impact on Chinese high medical education.

Guangdong Province,with its rapid economic development,is one of the fastest provinces of china in the progress of urbanization,while its rural development is relatively laged.The main reason of this phenomenon is: the government paid too much attention to the city,but the investment in human capital to the rural areas is insufficient.In this paper,the reason for the phenomenon is briefly analyzed.

To test the clinical skills of medical students by applying the innovative types of clinical skills examination in medical quality education.

Ongoing and rapid development in medical science makes the improvement of English language abilities crucial for students. The paper sets out now to:develop excellent teaching methods, form a qualified and dedicated teaching faculty, focus on individual teaching methods, make English interesting and popular among students, and manage the process to maximize the value of the investment.

This article summarizes the virtual reality(VR) technology's bases and characters and discusses the application scope of VR in modern medicine thoroughly.For example,the application of VR in digitized virtual human,the simulation of surgical operation,long-distance medical diagnosis,virtual hospital,higher medical education technology and so on.It also covers the existing problems and prospect of VR.

It is necessary to pay attention to the quality of mass higher education.We should adapt the evaluation system of higher education to the needs of its managerial system reform and healthy development.The cognition of that can help us to build higher education evaluation system with Chinese characteristics,which not only fits the national condition but also reflects the general rules of this system.

Innovative education on business venturing at medical colleges and universities is a need of both the time of knowledge economy and the socialization of medicine.Innovative venturing education is a new model to cultiv ate high-caliber medical talents with wide social perspective,profound knowledge,creativity and entrepreneurship.Approaches to implementing such education in the transition of educational model may include enhancing cultural and sociological education,promulgating venturing practices in medical field,establishing favorable at mosphere for innovative venturing education,fostering English language skills in the whole process,emphasizing clinical practices,setting up effective competency assessment system and establishing a high-caliber faculty team.

Classic problem-based learning ( PBL ) was applied in a medical microbiology course.The results of questionnaire survey showed most of the students were satisfied with the whole learning program.They thought the case was appropriate,and the discussing could increase their understanding of the knowledge.Based on the problems faced during the application and the students' feedback,the duty of the tutors,summary of the learning topic,arrangement of the course,application of different teaching methods,and selection of the tutors were discussed in detail.