This paper discusses the meaning of the tutorial system on clinical practice;the qualifications,tasks and a responsibility of the tutors,expounds the role of tutors,and discusses the main problems of tutorial system of the undergraduate.

Objective To optimize the processing conditions of Manchuiran Dutchmanspipe Stem with alkali. Methods The combination of radial basis function ( RBF) and response surface methodology ( RSM) was used to investigate the influence of NaHCO3 , concentration, duration and cycles of processing on the content of aristolochic acid. Results The optimal process was achieved when Manchuiran Dutchmanspipe Stem was soaked for 3 cycles in 0. 05 mol·L-1 NaHCO3 solution, for 24 hours in each cycle. The removal rate of total aristolochic acid approached to 83. 74%. Conclusion The combination of RBF and RSM provided a new method and good guidance for further toxicity attenuation for Manchuiran Dutchmanspipe Stem.

Objective To sum up the experience of a large-scale aero transportation of mass casualties away from the quake-hit region to distant cities,and to provide reference for medical transportation of mass casualties.Method The study analyzed the aero medical transportation of 3 482 casualties from quake-hit region treated in West China Hospital of Siehuan University and other seven hospitals in Sichuan Province to other provinces from 22 May 2008 to 3 June 2008.The influencing factors of aero medical transportation were discussed,including selection standard of patients,preparation of staff and mcterials before transportation,management during transportation.The selection standards were:patients with stable condition after orthopedic operation and craniocerebral operation,and patients with passage of gas by anus after abdominal operation 5 days.Results Total of 3 482 casualties were transported in 99 times to 19 cities including Guangzhou,Shanghai,Shenyang,only 8 victims felt a little bit uncomfortable during flight,and recovered soon after management.Conclusions Total of 3 482 patients were safely transported.Strict selection of patients,comprehensive planning and monitoring,and psychotherapy are important for aero medical transfer.

BACKGROUND: The problem of the high rate of acute restenosis at an early and advanced stage has been a hot spot, while the stent with paclitaxel (poly-L-lactide, PLLA/polyglycolic acid, PGA) degradable material will resolve it. OBJECTIVE: To seek an ideal biologic degradable material used in biologic degradable stent. DESIGN, TIME AND SETTING: The comparative cytological study was performed at the Laboratory of Toxicology, Institute of Public Health, Jilin University (Key Laboratory of Radiobiology of Ministry of Public Health of China, Key Laboratory of Toxicology of Jilin Province) from July 2003 to July 2005. MATERIALS: Paclitaxel degradable material (PLLA/PGA) (PLLA:PGA= 9: l ) were offered by Changchun Applied Chemistry Institute of Chinese Academy of Science). Human umbilical arterial smooth muscle cells (SMCs) were purchased from Boster, Wuhan, China. METHODS: The sixth passage of SMCs were digested by 0.25% Trypsin under ambient temperature for 3 minutes, incubated in 10 mL 10% ox serum BMEM, and made into SMC suspension. The materials kept in hypothermal disinfectant Co60 were heated to 37 ℃ by waterbath after surface treatment, and then placed in a 6-well culture plate. SMC suspension was added into the middle of the materials. The density of cells was about 5×106/cm2. Cell suspension diffused around the materials gradually. At last, 10% ox serum BMEM culture solution was added into it, and cultivated in a 5% CO2 incubator at 37 ℃. The growth of cells in and surrounding the materials was observed by inverted microscope everyday. MAIN OUCOME MEASURES: The materials were obtained after culture for 3, 6, 12, 19, 26, 34 days and vacuum dehydration, and were weighed. The weight loss of materials was compared before and after culture. The average degradable rate of materials was calculated.RESULTS: Degradable material had no influence on the development of SMCs. The average degradation rate ex vivo was 0.45% per day. CONCLUSION: PLLA/PGA with good cellular compatibility could be applied to intravascular stents.

Objective To observe the level of serum hepcidin and the relationship of hepcidin with renal anemia and micro-inflammation state in peritoneal dialysis(PD) patients.Methods Serum hepcidin,interleukin-6(IL-6),soluble transferrin receptor (sTfR) and erythropoietin (EPO) were measured in 50 PD patients with anemia,30 PD patients without anemia and 40 cases of normal control by ELISA.The indexes of blood routine examination,biochemistry and iron metabolism were also detected at the same time.Results The level of hepcidin in PD patients was significantly higher than that in normal control[(103.65±43.6) μg/L vs (56.39±35.7) μg/L,P ＜ 0.05].Furthermore,the level of hepcidin in PD patients with anemia was higher than that in PD patients without anemia [(122.67±36.6) μg/L vs (83.65±26.4) μg/L,P ＜ 0.05].The results of correlation analysis showed that serum IL-6,sTfR,EPO and ferritin were positively correlated with hepcidin(R =0.821,0.742,0.711,0.531,all P ＜ 0.05),while creatinine clearance of residual kidney in 24 hours and hemoglobin were negatively correlated with hepcidin(R =-0.533,-0.685,all P ＜ 0.05).Conclusions The higher level of hepcidin in PD patients is related with the residual renal function and the micro-inflammatory state.The higher level of hepcidin may induce the iron metabolism imbalance,and then influence the state of renal anemia.The adjustment of hepcidin may provide clinical research value of improving renal anemia and micro-inflammatory state in PD patients.

Objective To find out the changes of the soft tissue profile in Guangdong women with Angle's I teeth uncovered by lips after extraction of 4 first bicuspid teeth and to evaluate its significance. Methods Fifteen cases of adult Guangdong women with Angle's I teeth uncovered by lips were enrolled in this retrospective study. The X-ray film of lateral cephalometry was used to analyze the soft tissue profile in pre- and post- corrective tooth extraction. The paired t-test was statistically applied for comparison between the changes of lip tissue in pre- and post- correction. Results The changes occurred obviously in the angles of nose vs. lip and upper vs. lower lips, angle Z, and the length, thickness, esthetical plane distance and convex distance of upper and lower lips, but not in the angles of face and facial convex, basic angle of upper vs. lower lips and chin thickness. Conclusilons The facial dislocation and figure of these women have been positively improved after extraction of 4 first bicuspid teeth in spite of the larger thickness of lips than before correction, the just partly shortened distance between lips and the upper and front teeth still exposed and uncovered by lips to some extent. Further improvement depends on functional exercise of lip muscles.

Objective To study the schizophrenia and depression recognition rate in the mental health literacy.Methods Search and select the published questionnaire survey studies literature about mental health literacy.Those studies were analyzed by software RevMan 5.2.Results 10 researches entered accorded with the including criteria,a total of 27 275 samples,12 791 of the respondents recognized schizophrenia.10 499 respondents recognized depression.Meta-analysis results showed that the sum of people with schizophrenia recognition rate was 47％ (95％ CI 24％-69％).The sum of people with schizophrenia recognition rate was 45％ (95％CI 31％-59％).Conclusions People from different areas have a higher recognition rate than that of depression.

Objective To study the clinical effect of Qiliqiangxin capsule (QC) in patients with chronic congestive heart failure (CHF). Methods According to random number table,64 CHF patients were randomly assigned into therapy group (n=33) and control group (n=31).During the treatment,sweat secretion,heart function improved rate,6 min walking distance,the side-effect and compliance were observed.The levels of serum Na+ and K+ of patients were measured on the 2nd,8th and 15th hospital day.Results Compared with control group,the remission rate of sweat secretion in therapy group was higher after treatment (P0.05);compared with control group,the improved rates of heart function and 6 min walking distance in therapy group were higher after two weeks (P0.05);on the 15th day,the level of serum Na+ in therapy group was higher than that in control group (P0.05).During treatment,33 patients had not any uncomfortable complain about this drug and nobody stopped using this capsule;while there was no complain from the patients of control group.Conclusion The effect of QC about releasing hyperidrosis in a short time is conspicuous.QC can improve heart function,but it plays this role gradually.QC can keep the level of serum Na+ to some extent.There is no influence on the level of serum K+.The tolerance of this capsule is well.

Objective To compare the efficacy and safety of novorapid and novolin R in the treatment of patients with gestational diabetes.Methods From September 2014 to October 2015,the clinical data of 58 patients with gestational diabetes in our hospital were retrospectively analyzed.According to the drug used,the patients were divided into two groups.The observation group was given novorapid,and the control group was given novolin R.Before and after treatment,the total effective rate,fasting blood glucose (FBG),2h postprandial blood glucose (2hPBG),average blood glucose control time,body mass index (BMI),alanine transaminase (ALT),aspartate aminotransferase (AST),serum creatinine (SCr),urea nitrogen (BUN) and the frequency of hypoglycaemia,insulin dosage,the pregnancy outcome were compared between the two groups.Results After treatment,the FBG [(5.14±0.39)mmol/L],2hPBG[(7.06±1.25)mmol/L] of the observation group were significantly lower than those of the control group (t=11.72,5.67,all P＜0.05).ALT[(25.27±8.71)U/L],AST[(27.98±8.53)U/L],SCr[(69.92±11.39)μmol/L],BUN[(5.23±5.75)mmol/L] of the observation group had no obvious differences compared with the control group (t=0.14,0.07,0.04,0.30,all P＞0.05).The total effective rate (93.10％),average blood glucose control time (3.06±0.43)d,insulin dosage (36.15±4.72)U/d of the observation group were significantly better than those of the control group (χ2=4.35,t=14.30,4.92,all P＜0.05).The incidence rates of pregnancy-induced hypertension (3.45％),amniotic fluid (6.90％),cesarean delivery (17.24％),macrosomia(3.45％),high blood bilirubin(3.45％) of the observation group were significantly lower than those of the control group(χ2=5.22,5.50,4.08,9.09,7.73,all P＜0.05).Body weight [(70.6±3.09)g],BMI[(23.9±0.28)kg/m2] of the observation group were better than those of the control group(t=2.20,12.19,all P＜0.05).The incidence rate of hypoglycemic events in observation group(17.24％) was significantly lower than that of the control group(χ2=5.47,P＜0.05).Conclusion Compare with novolin R,the treatment effect of novorapid for gestational diabetes is remarkable and has high security,it is worthy of clinical implementation.

Objective To analyze the CT contrast enhanced features of the extra-organic primary tumors in pelvis and to evaluate anatomic bases of these imaging characteristics.Methods CT findings in 14 patients with pathologically proved extra-organic primary tumors in pelvis were reviewed retrospectively for tumor size,density,margins,contrast enhanced characteristics,location and relationship of the lesions with surrounding organs and tissues.Results There were benign tumors (n=3) and malignant tumors(n=11) in this study.There were 6 lesions in peritoneal cavity and 6 in retroperitoneal space of pelvis respectively,and two other masses were in both peritoneal cavity and retroperitoneal space of pelvis.CT scan revealed that there were 6 solid masses and 8 cystic-solid masses.The enhanced characteristics of lesions were homogeneous and heterogeneous in 3 and 11 patients respectively.The fatty space surrounding the lesion was invasive in 7 cases and all of them were malignant tumor.The fatty space surrounding lesion was clear in other 7 cases including 3 benign tumors and 4 malignant tumors.CT revealed calcification in 4 lesions including benign teratoma (n=2) , malignant teratoma (n=1), and carcinoid (n=1).Conclusion In the diagnosis of extra-organic primary tumors in pelvis,CT enhancement scan can reveal the anatomic location and relationships of the lesions with surrounding organs and tissues and can differentiate benign and malignant tumor to some degree.