Improving the innovation quality of medical students is the key for cultivating the medical staff with international competition. The most important point for improving the innovation quality is to establish an educational model in favor of cultivation of medical students.Adjusting curriculum system,conforming experimental content and enhancing extracurricular research activity can make for the improvement of medical stndents' innovation and cultivation of scientific research quality.

[Objective]To summarize the clinical experience of Professor FAN Binghua in treating sacroiliac joint dysfunction. [Method] From following Professor FAN Binghua's clinical and studying experienced cases ,summarizing the academic viewpoints and methods of Professor FAN Binghua in treating sacroiliac joint dysfunction, and with one classical case for experiencing details and methods when Professor FAN Binghua cures sacroiliac joint dysfunction. [Result]Based on theory of relationship between symptoms and etiology, Professor FAN comes up with concept of where there is symptom, there is reason and curing etiology should be put forward,starting with clinical symptoms to cure sacroiliac joint dysfunction, applying examinations of specialty to find out the internal close relationship between symptom and etiology and eliminate the similar disease, then curing the etiology in right way.[Conclusion]Pro.FAN has flexible thoughts, clear pertinence, and strong practicality, and histhree principls in cliniccan be guidence in clinic, and it is worth drawing reference and learning.

Objective To explore the effect of glial cells on cerebral neuron damage induced by amyloid beta protein (Aβ) in Alzheimer′s disease rat .Methods 20 male Wistar rats were randomly divided into the control group and the model group ,10 cases in each group The gel state Aβ(10μg) was injected into the rat′s bilateral hippocampus in the model group ,while the control group was injected with normal saline ;the Morris water maze test was performed to assess the rat′s learning and memory ability ;the thio‐nine stain was used for observing the morphology and quantity of cerebral cortex neurons ;the enzyme linked immunosorbent assay (ELISA) was adopted to detect the serum tumor necrosis factor alpha (TNF‐α) and interleukin 1 beta(IL‐1β) levels ;the immuno‐histochemical was used to detect the expression of glial cell and glial fibrillary acidic protein (GFAP) .Results The various indexes in the model group were significantly lower than those in the control group(P<0 .05);the quantity of cerebral cortex neurons in the model group was significantly decreased compared with that in the control group (P<0 .01);the ELISA results showed that the lev‐els of TNF‐αand IL‐1βin the model group were significantly higher than those in the control group(P<0 .05);the immunohisto‐chemistry showed that the number of GFAP positive cells in the hippocampus in the model group was significantly more than that in the control group(P<0 .05) .Conclusion Aβmight activate the glial cells and promote the release of inflammatory cytokines ,which causes the damage of rat cerebral neurons and leads to decrease the rat′s learning and memory ability .

Objective To investigate the efficiency and safety of agkistrodon hemocoagulase on coagulation function in pa?tients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB). Methods In this prospective,randomized controlled trial,80 eligible patients accepted valve replacement were assigned to control group (n=20) and agkistrodon hemoco?agulase groups (H1, H2, H3) according to the different timing of administration. Twenty patients were given treatment 20 minutes before anesthesia induction (H1 group), 20 patients were given treatment 20 minutes after CBP (H2 group) and 20 patients were given treatment after CBP (H3 group). Coagulation parameters including prothrombin time (PT), activated partial thromboplas?tin time (APTT), thrombin time (TT), fibrinogen (Fib) and platelet (PLT) were detected 20 minutes before surgery (T0), immedi?ately after surgery (T1) and 24 hours after surgery(T2). Data of 24-h postoperative drainage of mediastinal and pericardial, dura?tion of mechanical ventilation, stay time of intensive care unit (ICU), the actual days of hospitalization and hospital costs were recorded. The clinical parameters were also recorded including blood transfusion after surgery, secondary thoracotomy, aller?gies, liver and kidney dysfunction, deep vein thrombosis and neuropsychiatric symptoms. Results Compared with control group, values of PT, APTT and TT at T1 and T2 were significantly lower in H1, H2 and H3 groups (P<0.05). Compared with T0, values of PT, APTT and TT at T1 and T2 were significantly higher in all groups of patients (P<0.05). Values of PT and TT at T1 and T2 were significantly decreased in H3 group than those of H1 group (P<0.05). The pericardial and mediastinal drainage, the duration of ventilation support within 24-h after surgery were significantly lower in H1, H2 and H3 groups than those of control group (P<0.05). There was no significant difference in the incidence of adverse events between groups. Conclusion Agkis?trodon hemocoagulase is safe and effective in patients undergoing cardiac valve replacement with cardiopulmonary bypass.

ObjectiveTo investigate the feasibility and effect of complete thoacoscopes and laparoscopes combination operation for thoracoabdominal injuries.MethodsFrom March 2007 to March 2011,the clinical data of 36 patients (observation group) with thoracoabdominal injuries who were performed with complete thoracoscopes and laparoscopes combination operation were analyzed retrospectively,and compared with 36 patients (control group) treated with traditional standard operation in the same period.The intraoperative and postoperative situation was compared between two groups.ResultsAll the patients in observation group were successfully performed by complete endoscopic surgery.There were no operative mortality and complications related to operation,such as diaphragmatic hernia,delayed hemopneumothorax.The operative time of observation group was (98 ±38 ) min,operative blood loss was ( 120±45 ) ml,drainage flow within 24 h was(230 ±55) ml,drainage tube duration was(5 ±2) d,postoperative pain vasual analogue scale (VAS) score was (3.31±0.87) scores,hospitalization cost was ( 1 2.3±7.6) thousand yuan,postoperative recovery time of intestinal function was (2.29±1.02) d,hospital stay was ( 10±3 ) d.Those values of control group were respectively ( 135±31 ) min,(220±30) ml,(400±160) ml,(9±3) d,(6.82±1.67) scores,(23.4±8.5) thousand yuan,(5.46 ±2.31 ) d and ( 16±2) d.There were significant differences between two groups(P ＜0.05).The occurrence rate of cardiopulmonary complication of observation group [ 11.1％(4/36) ] and control group [ 13.9％(5/36) ] had no significant difference (P＞0.05).ConclusionsComplete thoracoscopes and laparoscopes combination operation for thoracoabdominal injuries is a safe and mini-invasive treatment with quicker recovery,less cost and morereliable effect.Therefore,it deserves further clinical application.

Objective To investigate the efficacy of retroperitoneal laparoscopic heminephroureterectomy for duplex kidney anomalies.Methods Retroperitoneoscopic heminephroureterectomy was performed on nine patients, six males and three females.The average age of the study group was 37 years ( range 13 to 58).Seven cases had anomalies on the upper kidney pole, two cases had anomalies on the lower kidney pole.Five anomalies were on the left side, two were on the right side and two were in bilateral sides (one special case had three ureters on the left side and two ureters on the right side ).Three cases complained of flank pain; two cases were found hydronephrosis by physical routine examination;Three cases complained of flank pain and fever; one cases complained of hematuria and kidney atones.All the cases were preoperatively diagnosed by color doppler ultrasound, MRU, IVP or CTU.Retroperitoneal laparoscopic heminephroureterectomy was performed on all patients.The operation time, blood loss, hospital stay, intraoperative and postoperative complications and efficacy were observed.Results All the retroperitoneal laparoscopic procedures were successfully completed.No intraoperative complications were found.The average operation time was 87 min (range, 65 to 125).The average blood loss was 112 ml (range, 30 to 600).The recovery times of intestinal function was 1.6 days ( range, 1 to 3 ).The average postoperative hospital stay was 7 days (range, 5 to 12).The syndrome disappeared and kidney function was normal at a mean followup of 18 monthes.Conclusions Retroperitoneal laparoscopic surgeries for duplex kidney has the benefits of being minimally invasive, fewer complications, quick recovery and certainty of efficacy.Retroperitoneal laparoscopic surgeries can be considered as a first operation method to treat duplex kidney anomalies.

Objective To investigate the effects of sevoflurane postconditioning on lung function in patients undergo-ing heart valve prosthesis implantation with cardiopulmonary bypass (CPB). Methods Thirty patients, scheduled for heart valve prosthesis implantation, were randomly divided into control group (C, n=15) and sevoflurane postconditioning group (S, n=15). Anesthesia was maintained by intermittent intravenous injection of midazolam, fentanyl and pipecuronium. In group S, 2%sevoflurane was inhaled continuously for 15 min , 2 min before aortic unclamping. Blood samples were taken at 30 min before CPB (T2), 30 min after CPB (T3), 6 h (T4), 12 h (T5) and 24 h (T6) after operation. The values of p(O2), SaO2, airway peak pressure (Ppeak) and airway plateau (Pplat) pressure during the time of mechanical ventilation were recorded. Oxygen index (OI), alveolar arterial oxygen tension difference (AaDO2), dynamic pulmonary compliance (Cdyn) and static pulmonary compli-ance (Cstat) were calculated. Results Compared with group C, the values of SaO2 and Cdyn were significantly higher in group S after 30 min of CPB. The values of OI, p(O2), Cdyn and Cstat were significantly higher in group S than those of group C after 6 h of operation. The value of AaDO2 was significantly lower 12 h and 24 h after operation than that of group C (P＜0.05). Conclusion CPB led to the lung injury. The sevoflurane postconditioning has a protective effect on lung function in pa-tients undergoing cardiac valve replacement with CPB.

Objective To find out the distribution of the subunit of Gs proteins (GNAS1) T393C polymorphism genetic in congestive heart failure patients and to investigate the effects of genetic polymorphisms on the therapeutic efficacy of carvedlol. Methods Genotype of 65 patients with congestive heart failure (heart function was ranked Ⅱ~Ⅳ level by NYHA) underwent PCR-RFLP for GNAS1 polymorphism genetic analysis, and then were treated with carvedlol. The initial dosage of carvedlol was 12.5 mg once daily in patients , and increased by 6.25 mg every 1 ~ 2 weeks for 12 months to a maximum dosage within 50 mg/d. Degree of LVEF changes and heart function improvement was adopted as measuring index , effect of Gs proteins α subunit T393C genetic polymorphism on carvedlol response in congestive heart failure patients was analyzed. Results After carvedlol treatment for 12 months , NYHA class distribution and LVEF in congestive heart failure patients improved significantly (P < 0.05). After carvedlol treatment for 6 months and 12 months mutation symptoms patients′ heart function improved significantly (P < 0.05) and LVEF increased significantly (P < 0.01). Conclusions GNAS1 T393C genetic polymorphism can influence the therapeutic efficacy of carvedlol in chronic congestive heart failure patients. 393 homozygous mutant and mutated symptoms patients′ heart improved more obviously and their LVEF improved more significantly.

Objective To investigate the action and skills of camera-assisted laparoscopic rectal cancer radical surgery.Methods From January 2009 to May 2015,a total of 577 cases with rectal cancer underwent laparoscopic rectal cancer radical surgery,including 152 cases of abdominal perineal resection,and 425 cases of abdominal resection.The skills of camera-assisted operation were summarized.Results All the operations were successfully completed without serious complications.Conclusions Regarding for skills of camera assistant,mastering the clinical topography of rectum,understanding the operational habit of operator,understanding operating procedure and operation characteristics are the necessary condition to complete laparoscopic rectal cancer radical surgery.

Objective Transesophageal Doppler monitoring ( TDM) has been widely applied to fluid therapy in some major op-erations but rarely used in aortic valve replacement.The purpose of this study was to assess the value of TDM in fluid therapy, vasoactive drugs use, and left ventricular function in patients undergoing aorta valve replacement after cardiopulmonary bypass. Methods This study included 40 patients undergoing aotic valve replacement after cardiopulmonary bypass in Anhui Provincial Hospital from March 2014 to June 2015, which were randomly assigned to a TDM and a control group of equal number.TDM was used for the guidance of fluid infu-sion and vasoactive drug administration for the patients in the former group, while central venous pressure, mean arterial pressure, and heart rate were employed for those in the latter.The fluid volume infused, urine volume, blood loss, hemodynamics, arterial blood lac-tate, and outcomes were compared between the two groups. Results Compared with the control, the TDM group showed significantly increases in the colloidal fluid volume ([303 ±60] vs [373 ±65]mL, P<0.05), crystal fluid volume ([533 ±87] vs [596 ±83]mL, P<0.05), and urine volume ([274 ±95] vs [338 ±84]mL, P<0.05), but remarkable decreases in the red blood cell count, blood plasma vol-ume, postoperative extubation time, doses of dopamine and dobu-tamine, and length of hospital stay (all P<0.05).The hemodynamics were more stable and arterial blood lactate was lower in the TDM group than in the control (P<0.05). Conclusio n Transesophageal Doppler monitoring can timely and exactly manifest the hemodynamic changes and left ventricular function of the patient undergoing aotic valve replacement and provide precise guidance for fluid therapy and vasoactive drug administration.