Objective:To explore the optimal design for education and teaching mode of general medical students.Methods: 60 general medical students of 2013 grade of ChengduMedical College were divided into experiment group and 60 general medical students of 2013 grade of the Second Affiliated Hospital of Chengdu Medical College were divided into control group. The students of experiment group received the interactive teaching mode of whole teaching process, while students of control group received conventional theory teaching. And then the general medical curriculum assessment, examination results and teaching effects of the two groups were statistically analyzed.Results: The understanding degrees of general medical basic theory, overview of community health services, general medical education of the experimental group were significantly higher than that of control group (P<0.05). The series of indicators, such as health care which was human centered, family as a unit, community as basis and prevention as precursor, and the general medical service of health and fitness in women, children and old people, and physician patient relations and communication in general medicine, and the establishing ability of general medical treatment and health archive of chronic disease, of experiment group were significantly higher than that of control group. After a phase, the examination results of experiment group was significantly higher than that of control group (t=4.303,P<0.05), and the ratios of cultivating vocational interest, stabling vocation belief, establishing occupational planning of experiment group were significantly higher than that of control group (x2=12.83,x2=11.14,x2=9.35,P<0.05).Conclusion: In the teaching for general medical student, the interactive mode of tutor and student in whole teaching process was better than conventional mode of theory teaching.

Objective To investigate the epidemiological characteristics of three common susceptive gene retared hearing loss in the patients with the congenital deafness in Liuzhou.Methods 161 patients with congenital hearing loss were diagnosed with audiologic evolutions,including newborns and outpatients.The blood samples of all patients were taken for the extraction of DNA which was amplified by PCR.The common mutationsl hot spots of the mitochondrial DNA 12SrRNA,GJB2 and SLC26A4 were examined by restricted enzyme and directed sequencing.Results 1 case(0.62%)was found to carry mitoehondrial DNA 12SrRNA A1555G and 4 patients(2.48%)carried heterozygotes or homozygotes pathologic mutations of GJB2.10 patients(6.21%)were heterozygous carriers with pathologic mutations,IVS7-2 A>G,in the SLC26A4 gene.The detection rate of GJB2,mitochondrial DNA A1555G and SLC26A4 mutations in 161 patients were 9.31%.Conclusion The patients with congenital hearing loss distributed different minority groups in liuzhou zone.The mutational frequencies of the three common gene related hearing loss in the patients of Liuzhou were noticeably lower than the data reported in other regions in China.The gene screening for deafness was very important for early diagnosis and treatment.

Objective To improve the quality of the clinical hematologic examination laboratories in national free preconception health examination project by using randomized blind sample test in the external quality assessment (EQA ) schemes .Methods Blind samples for clinical hematologic examination were prepared as higher ,middle ,lower three levels .Samples were dispensed in u‐nified way which included 4 times conventional EQA and in random way which included 1 time blind sample test .Samples will be tested by Clinical hematologic examination laboratories in national free preconception health examination project .The feedback re‐sults were summarized and analyzed by EQA organizer .Results In 4 times of conventional EQA ,the rates of accepted score of 134 laboratories were 72 .4% ,97 .8% ,97 .0% and 98 .5% respectively .The rates of accepted score in last three times were statistically significant higher than that in the first time(P<0 .05) .However ,the rates of accepted score (84 .3% ) in randomized blind sample test were significant lower than that(97 .0% ) in conventional EQA which was conducted at the same time(P<0 .05) .Conclusion The use of randomized blind sample test may help the EQA organizer to find the problems in laboratories participated EQA and find effective way to improve the quality of the laboratories .

Objective To discuss the value of digital tomosynthesis for detection of pulmonary nodules. Methods Thirty patients suspected of having pulmonary nodules underwent chest radiography, digital tomosynthesis and CT examination. Above image data were transferred to postprocessing work station and were reviewed by 2 radiologists with 3 years of chest-radiology diagnosis experience in a double-blind method. The number, location and size of nodules were recorded. Then, 2 radiologists reviewed the all images once more, and discuss in consensus. The sensitivities of chest radiography and digital tomosynthesis for detection of pulmonary nodules were respectively calculated according to the CT results. Chi-square test was used for radiography, digital tomosynthesis and CT examination. Results Of 30 patients, 21 were detected having pulmonary nodules by X-ray radiography and 9 were negative, the total number of 40 nodules was detected, while 89 nodules in 26 patients were detected by digital tomosynthesis, and only 4 patients were negative. CT demonstrated 102 nodules in 27 patients, and 3 patients were negative. Taking CT as "gold standard", the sensitivities of X-ray radiography and digital tomosynthesis were 27.4%(28/102)and 87.2%(89/102), X~2=4.35, P<0.05, respectively. Conclusion Digital tomosynthesis has a high sensitivity for detection of pulmonary nodules compared with X-ray radiography, and could be an excellent and necessary supplementary technique of X-ray radiography.

Objective To investigate the probability of verifying the X-knife treatment plan by the radiotherapy simulator,and to analyze and report the errors of the X-knife treatment plan for reference.Methods The radiation fields of the X-knife treatment plan were observed in the whole simulating treatment process by the radiotherapy simulator.Results The error rate of X-knife treatment plan were in the simulating treatment process was 5.9%(22/372).Among the errors,3 cases of X-knife plans were found in the simulating treatment process,and the errors of isocenter in Z direction were 10cm.Conclusion This is a special error of X-knife TPS,which deserves more attention in stereotactic radiotherapy.

OBJECTIVE This study aimed at identifying inner ear malformation underlying molecular determinant(s) using a large five-generation Chinese family with multiple familial cases. METHODS Model-based genetic linkage analyses were performed with the use of microsatellite polymorphisms to determine the disease locus. Mutation screening was performed with the family and unrelated population-based controls to establish molecular evidence that caused the specific X-linked inheritance pattern in the family. RESULTS Clinical investigations of the pedigree demonstrated the extremely high penetrance in the male members, but no penetrance in the female members. Linkage analyses mapped the disease to the chromosomal region Xq13.1-Xq23 (maximum X-linkage LOD score = 3.27). Mutation screening of the candidate genes in the linkage region by direct sequencing revealed a de novo missense substitution (925T→C) in the well-known deaf gene POU3F4. Direct sequencing on 110 unrelated controls did not detect any mutation. CONCLUSION a novel mutation of POU3F4 gene was identified to be the causative reason for the hearing loss in family with inner ear malformation.

OBJECTIVE To investigate whether the KCNN4 gene and KPTN gene contribute to a Chinese non-syndromic hearing loss pedigree linked to DFNA4 with positional candidate approach. METHODS The complete coding region of the two genes were amplified with polymerase chain reaction (PCR), and bidirectional sequencing of the PCR products was subsequently applied in the 36 family members to identify the possible mutations or polymorphisms in the candidate genes. RESULTS Sequence analysis of coding regions and splice sites of the two candidate genes in 36 members including 12 hearing-impaired individuals in family Z002 failed to demonstrate any deafness-causing mutations of KCNN4 gene. There was one heterozygous mutation identified in exon10 coding sequence (942C/T) of KPTN gene, which did not result in amino acid change (P302P) as a repoerted synonymous SNP site (rs2293424). This SNP site did not cosegregate with the phenotype of family Z002. CONCLUSION Our study excluded the two candidates, KCNN4 and KPTN , as the causative genes involved in this Chinese DFNA4 pedigree.

OBJECTIVE To investigate the contribution of the GJB6 gene [encoding connexin 30 (C?30)] mutations in Chinese population with sporadic non-syndromic hearing impairment. METHODS PCR reactions were performed with two pair of primers for the coding sequence of GJB6 gene and for the deletion of GJB6. PCR products bidirectional sequencing was subsequently applied in 214 patients with hearing loss and 86 normal controls. RESULTS A novel heterozygous mutation-233(C→A) was found, which results in amino acid change, A78D. This mutation wasn't detected in the control subjects. The altered valine residue lies within the second conserved transmembrane domain. The large deletion△(GJB6/ D13S1830)] of GJB6 was not found in this group. CONCLUSION The large deletion of GJB6 was not found in the Chinese deafness population. A novel heterozygous mutation of GJB6 was found. These results indicated GJB6 mutations are not a major cause of hearing loss in the Chinese population.

Objective To evaluate the feasibility and value of dual-energy perfusion imaging (DEPI) of dual-source CT(DSCT) in the diagnosis of acute experimental pulmonary embolism. Methods Acute pulmonary embolism ( PE ) model was made in 8 New Zealand rabbits, and non-enhanced and enhanced DSCT scans were performed before and after embelization. Postprocessing of image data was made on the workstation, and CT pulmonary angiography ( CTPA ), DEal and fusion images were obtained. The location and number of the emboli were recorded. The rabbits were killed immediately after DSCT scan, the location and number of the lung lobes with pulmonary emboli were evaluated pathologically. Based on the pathological results, the sensitivity, specificity, positive predictive value ( PPV), and negative predictive value (NPV) of CTA, DEal and fusion images for the diagnosis of PE were calculated. Weighted Kappa values were calculated to evaluate the consistency between CTPA and DEal. Results PE model was made successfully in 7 rabbits. Six rabbits with 30 lobes were evaluated with one exception because of the catheter affecting the quality of lung peffusian image. PE was found pathologically in 18 lobar arteries. On DEPI, the region with PE showed low peffusion area comparing with the normal parenchyma and CTPA showed the filling defect within corresponding pulmonary artery or interruption of the artery. The sensitivity, specificity, PPVand NPV of CTPA were 66. 7% (12/18), 100.0% (12/12), 100.0% (12/12) and 66. 7% (12/18), respectively. The Kappa value was 0. 651 indicating moderate correlation with pathology. The sensitivity, specificity, aPv, and NPV of DEal were 88. 9% ( 16/18), 91.7% ( 11/12, 94. 1% (16/17) and 84. 6% ( 11/13 ), respectively. The Kappa value was 0. 795 indicating excellent correlation with pathology. Conclusion Dual-energy lung perfusion imaging of DSCT can display the blood distribution of rabbit's lung and has a high sensitivity for the diagnosis of acute pulmonary embolism.

OBJECTIVE To investigate the incidence of the mitochondrial DNA 12SrRNA A1555G and connexin 26 gene (GJB2) in Chinese northwest population with nonsyndromic sensorineural hearing loss,and to explore the relationship between mitochondrial DNA A1555G and mutation of GJB2 gene. METHODS Blood samples were obtained from 221 patients with nonsyndromic sensorineural hearing loss in Northwest of China; Genomic DNA was extracted from the isolated leukocytes ; Screening the mitochondrial A1555G mutation by PCR-Alw26l digestion and sequence analysis, PCR and direct sequencing were used to analyze the coding region of GJB2 gene. RESULTS The homoplasmic A1555G mutation was found in 21 individuals of 221 patients,17 of these 21 patients had been treated with aminoglycosides. Eleven different variants of GJB2 were found in all patients ,the disease-causing mutations of GJB2 were 44 individuals in these patients(44/221), The mutation 235delC is found in 54.54 % of all disease-causing mutations ; Among 21 patients with the A1555G mutation, 11 cases were found polymorphic change in GJB2 gene ,only 1 case had V37I heterozygous mutations ,other 9 cases were not found any nucleotide changes of GJB2 gene. CONCLUSION The mtDNA 12SrRNA A1555G mutation has a high incidence in Chinese northwest population with non-syndromic sensorineural hearing loss.The 235delC mutation in the GJB2 gene is most frequent mutations responsible for non-syndromic hearing impairment in this region .It is unlikely that the GJB2 gene is a major modulatory factor for hearing loss due to the A1555G mutation in Chinese population.