Objective Toanalyze and evaluate the value ofthe method ofmedical simulation technique combined with PBL pattern in the training before clinical practice. Methods 80 students were divided into two groups:the experimental group and the control group. The PBL method was used in the experimental group,while the control group was taught by traditional method. Results The students in experimental group had a significant higher score than those in control group. Conclu-sion It means that the method of medical simulation combined with PBL teaching is an effective leaning method and should be widely used in the training before clinical practice.

MicroRNA are endogenous non-coding small RNA composed of approximately 18 - 23 nucleotides, mainly participating in post-transcription gene regulation. More and more data show that miR-21 is over-expressed in many human cancer cells and it was involved in cell differentiation, proliferation and apoptosis, closely related to tumorigenesis and the development of carcinoma as oncogene. Here, we will make a review about miR-21' s target gene, biosynthesis and regulation and clinical significance in order to provide a valued data for the future study and clinical application.

Objective To explore the effects of chlamydia and mycoplasma infections on the healing of wounds after surgical operation for haemorrhoids,fistula and anoschisis.Methods Sixty-two patients with haemorrhoids,fistula and anoschisis undergoing the surgical operation during 2000.1 to 2008.10 were collected,and wounds did not heal 40 days after operation and the wound's surface infection occurred after postoperative anti-inflammatory therapy and dressing change.All patients were positive at least for laboratory Ct or Uu,and those with infections caused by other fungi,bacteria,viruses and the other systemic diseases were excluded.The correlation between the infections in 62 cases and sex,surgical types was analyzed.Results In 62 patients,there were 30 cases (48.4%) positive for both Ct and Uu,22 cases for single Ct (35.5%),and 10 cases for single Uu (16.1%),respectively.The infection rate in females was higher than in males (P<0.01).The surgical types included:surgery for 8 cases of haemorrhoids (12.9%),for 18 cases of fistula(29.0%),and for 36 cases of anoschisis(58.1%).respectively.Conclusion There is the possibility of chlamydia and mycoplasma infections in the patients with delayed healing of wounds following the surgical treatment on the anal region.Early diagnosis,early treatment,avoidance of ineffective medicines and repeatedly management of the wounds can shorten the healing period.

Objective To stuey effects of coloprotectomy under colonoscopy combined with laparoscope on exfoliated tumor cells in abdominal cavity.Methods 42 cases of colorectal cancer proved by pathologic histology were devided into two groups randomly: Laparoscope Group(laparoscopic surgery) and Combined Group(colonoscopy combined with laparoscope surgery).Operation time,the positive rate of exfoliated tumor cells in abdominal cavity after and before operation,the positive rate of residual tumor cells in resection of operation specimen and postoperative complications between 2 groups were compared.Results Operation time of the Combined Group was shorter than that of the Laparoscope Group [(160.5?12.6) min vs.(201.2?18.4) min,t=-8.363,P=0.000].The positive rate of exfoliated cells in abdominal cavity before operation had no significant difference between the 2 groups[9.5%(2/21) vs.19.0%(4/21),?2=0.194,P=0.659],but the postoperative positive rate of exfoliated cells in the Combined Group was significantly lower than that in the Laparoscope Group[14.3%(3/21) vs.42.9%(9/21),?2=4.200,P=0.040].There were no residual tumor cells in resection of operation specimen of 2 groups.No infection of incisional wound and lung occurred.A follow-up for 6-24 months in the Laparoscope Group showed abdominal metastasis in 1 case.Conclusions Coloprotectomy for colorectal cancer under colonoscopy combined with laparoscope can decrease exfoliated tumor cells in abdominal cavity and shorten operation time.

Objective To investigate the feasibility of laparoscopic repair for ingunal hernia after peritoneal dialysis. Methods Laparoscopic repair of inguinal hernia was conducted in 26 patients with chronic renal insufficiency who had received peritoneal dialysis for a long time. For indirect inguinal hernia, a piece of mesh was placed in the abdominal cavity and the internal ring was sutured and ligated under laparoscope. For direct inguinal hernia, the hernia sac was high suspended and then the mesh onlay was placed under laparoscope. Results The laparoscopy was successfully performed in all the 26 patients, without conversions to open surgery. No postoperative hematoma of scrotum or refractory neuralgia was observed. Follow-up examinations for 6~12 months (mean, 9 months) showed no recurrence. Conclusions Laparoscopic herniorrhaphy for inguinal hernia after peritoneal dialysis is feasible, effective, and safe.

Objective:To survey the status quo of ADR occurred in our hospital. Methods:Totally 277 ADR reports were collect-ed and analyzed statistically in our hospital from January 2010 to June 2013. Results:Among the ADR cases,the ratio of male to fe-male was 1∶1. 565, and 59. 93% of ADR occurred in the people over 50 years old. Totally 240 ADR cases (86. 64%) were induced by intravenous administration and 32 ADR cases (11. 87%) were induced by oral administration. Totally 167 ADR cases were caused by antibiotics (60. 29%), among them, 54 cases wero by cephalosporins (32. 34%), 47 cases by quinolones (28. 14%) and 32 ca-ses by cephamycins (19. 16%). Totally 42 ADR cases were caused by traditional Chinese medicine injections (15. 16%), and 18 ca-ses were caused by cardiovascular system drugs (6. 5%). The main clinical manifestations were lesion of skin and its appendant organr and digestive system injury with 162 cases (58. 48%) and 62 cases (22. 38%), respectively. Conclusion: It is necessary to strengthen clinical ADR monitoring, rationally use antibiotics and emphasize the importance of safe medication of traditional Chinese medicine injections.

OBJECTIVE:To introduce the Fair PharmaCare program of BC Canada for the reference of the reform of China's medical insurance system.METHODS:The running procedure of Fair PharmaCare program of BC Canada was introduced in detail and its characteristics were analyzed.RESULTS & CONCLUSIONS:Fair PharmaCare program covers all BC residents and protects them against economic difficulties in pharmacare.The program serves as a reference for the reform of China's medical insurance system.

Objective To investigate the effects of autologous blood transfusion on serum neopterin and IL-2 concentrations after radical gastrectomy. Methods Sixty ASA Ⅰ or Ⅱ patients of both sexes (33 male, 27 female) aged 40-65 yrs weighing 51-70 kg undergoing radical gastrectomy for stomach cancer were randomly divided into 2 groups (n = 30 each):homologous blood transfusion group (H) and autologous blood transfusion group (A). The patients were premedicated with intramuscular diazepam 10 mg and atropine 0.5 mg. Anesthesia was induced with midazolam 0.1 mg?kg-1, fentanyl 5 ?g?kg-1, propofol 1 mg?kg-1 and vecuronium 0.12 mg? kg-1 and maintained with isoflurane inhalation (1 % -2 %) and intermittent i. v. boluses of fentanyl and vecuronium. In group H homologous blood 400 ml was infused during gastro-intestinal anastomosis. In group A 400 ml of blood was removed from radial artery after induction of anesthesia, before surgery. Blood volume was maintained by simultaneous infusion of succinylated gelatin 500 ml. The 400 ml autologous blood was infused also during gastrointestinal anastomosis. Venous blood samples were taken before operation (baseline) , at the end of operation and on the 5th postoperative day for determination of serum concentrations of neopterin and IL-2 (ELISA) Results The two groups were comparable with regard to sex (M/F ratio), age, body weight, duration of operation and total blood loss. The serum concentrations of neopterin and IL-2 were significantly decreased after operation compared to the baseline values before operation in group H (P

Objective To detection the carrying situation of Clostridium difficile toxin gene A/B in stool specimens of the pa-tients with ulcerative colitis (UC) and persons undergoing physical examination and to research the relationship between Clostridium difficile toxin gene carrying and UC.Methods The stool specimens were collected from 53 cases of UC(32 cases of active stage and 21 cases of resting stage) and 45 persons undergoing physical examination.Total DNA was extracted from stool specimens.The Clostridium difficile toxin gene cdtA and cdtB were detected by real-time PCR ,then the PCR products were amplified and performed the agarose gel electrophoresis and gene sequencing for conducting the amplification products verification.Results 7 cases of cdtA and 4 cases of cdtB were checked out in the UC group ,in which 5 cases of cdtA and 2 cases of cdtB were in the UC active stage group ,2 cases of cdtA and 2 cases of cdtB were in the UC resting stage group.In the healthy control group ,5 cases of cdtA and 2 cases of cdtB were checked out.The detection rate of cdtA and cdtB had no statistically significant difference between the UC group and healthy control group(P>0.05).There was no statistically significant difference between UC active group and inactive group (P>0.05).Conclusion There is no appearant correlation between the carrying situation of cdtA and cdtB in stool with UC onset and UC stage.

Objective To investigate the teaching effects for students of seven-year program.Method Symposiums were hold among 3 batches for seven-years program and questionnaire collected.Results We need to further modify the curriculum and improve clinical teaching skills,and students also need to have more research ideas.Conclusion We should modify current teaching content,curriculum,and skills.Clinical skills and humanization management should be highlighted.This is the key to ensure that teaching effects and teaching quality can be improved effectively.