The elements of the teaching system driven by the "Internet +" era are undergoing fundamental changes . Intelligent teaching platform is gradually becoming an important guarantee of the reform of teaching system elements for educators while they are teaching. With the support of intelligent teaching platform, the elements of teaching system break through the limitation of classroom teaching, the traditional structure of teacher-centered is disintegrating, the individual roles of teachers and students are being reconstructed , the teaching content is greatly enriched , and the function of teaching media is becoming more and more intelligent. This thesis, which will take the learning support function of the WeChat Public Platform of "Medical History" as an example by drawing lessons from the reversed classroom teaching mode, carries out the mixed teaching model of Chinese Medical History course by three stages: pre-class autonomous learning, in-class knowledge perfection and after-class knowledge transfer. It will elaborate its overall influence on the elements of the teaching system of Chinese Medical History and its important technical support for the reform of classroom teaching structure.

OBJECTIVE: To investigate the pathogenic bacteria distribution and drug susceptibility in children with acute otitis media (AOM) in different age and different season in the Pearl River Delta region. METHOD: Four hundred and forty-two children diagnosed as AOM were divided into three groups by age factor and four groups by season factor. Midge ear pus collecting and culturing were used for bacteria and antimicrobial susceptibility test. RESULT: (1) Strains of bacteria were isolated from 356 children with the positive rate of 80.5%. Streptococcus pneumoniae (39.2%), staphylococcus aureus (25.9%) and haemophilus influenzae (7.4%) were the most frequently isolated pathogens. (2) Streptococcus pneumoniae was the main pathogenic bacteria in 0-1 year group and > 1-3 years group (P < 0.05), staphylococcus aureus was the most frequently isolated pathogen in >3 years group (P < 0.05); (3) In the season groups, the number of children with AOM decreased significantly in July-September group. There was no significant difference of streptococcus pneumoniae distribution among the four groups (P > 0.05). Staphylococcus aureus was the main pathogen in January-March group (P < 0.05); (4) Drug sensitivity shown that linezolid and ofloxacin were most sensitive to streptococcus pneumoniae and staphylococcus aureus, and macrolides had a good therapy effect to haemophilus influenzae. CONCLUSION The pathogens distribution and drug susceptibility in children with AOM were varies in different age and different season. As a result, a treatment should be done based on the climate, environment, and pathogens distribution of a region.
Adolescent ; Anti-Bacterial Agents ; pharmacology ; therapeutic use ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Haemophilus influenzae ; drug effects ; isolation & purification ; Humans ; Infant ; Male ; Microbial Sensitivity Tests ; Otitis Media ; drug therapy ; epidemiology ; microbiology ; Seasons ; Staphylococcus aureus ; drug effects ; isolation & purification ; Streptococcus pneumoniae ; drug effects ; isolation & purification

Objective To analyze the characteristics and to evaluate the application of quantitative CT spectral parameters in patients with suspected lung cancer.Methods One hundred and thirty two patients with occupying lesions of the lung underwent chest plain and two-phase contrast enhanced CT scan with gemstone spectral imaging (GSI) mode.The CT images of patients with confirmed lung cancer by pathological evidence were analyzed with GSI viewer.Optimal energy value supplying optimal contrast-tonoise ratio (CNR) was recorded.The CT values of lesions at 40 keV,70 keY and optimal energy level were measured.Spectral curve slope at different intervals of 40-70 keV,40-100 keV and 40-140 keV was computed.Effective atomic number (Zeff),iodine concentration (IC) and water concentration (WC) were measured and analyzed by statistical methods.Results Sixty six patients with confirmed lung cancer were included in the analysis.The optimal energy values for optimal CNR on plain scan,arterial phase and venous phase were (63.09±5.33) keV,(52.65±6.44) keV and (54.06±5.53) keV,respectively.The difference of CT values at different energy levels on each scan phase was statistically significant (F=4.561,P=0.025).The spectral curve slope values among three different energy intervals were significantly different (F=2.137,P＜0.001).The differences of the slope between arterial phase and venous phase at same energy interval were not significant (40-70 keY:t=1.165,P=0.248;40-100 keV:t=1.102,P=0.274;40-140 keV:t=1.118,P=0.268).Zeff on plain scan,arterial phase and venous phase was 7.73±0.14,8.35±0.37 and 8.39±0.30,respectively.There was positive correlation between IC and Zeff on enhanced phase (arterial phase:r=0.998,P＜0.001;venous phase:r=0.998,P＜0.001).Conclusion CT spectral imaging can supply the optimal energy value for optimal CNR.CT value at optimal energy level and spectral curve slope at 40-140 keV are suitable for analysis.IC and Zeff can be used jointly in evaluation of patients with suspected lung cancer.