Objective To discuss the promoting effect of clinical pathway in the standard and reasonable medication by the application of clinical pathway in the anticoagulation treatment of warfarin and health education for patients with atrial fibrilation.Methods Sixty eight patients with atrial fibrilation and receiving anticoagulation treatment of warfarin were divided randomly into the intervention group(36 cases)and the control group(32 cases).The control group received routine nursing while the intervention group underwent nursing intervention with clinical pathway based upon routine nursing intervention.The time cost to achieve the aims,compliance,incidence rate of complications and satisfaction degree were compared between the two groups.Results All the items in the intervention group were superior to those of the control group except for the items of satisfaction degree and health knowledge score(P<0.05).Conclusion Application of clinical pathway in the anticoagulation treatment of warfarin for patients with atrial fibrilation could ensure standard and reasonable medication in order to decrease medical cost,lower the incidence rate of complications,improve patients compliance and increase nursing quality.

Objective To establish a method for simultaneous determination of 12 kinds of organophosphorus pesticides in water. Methods Organophosphorus pesticides in the water were extracted by liquid-liquid extraction, then analyzed with DB-1701 capillary column. In the same time, they were determined with GC by controlling the temperature and the speed of nitrogen. Retention time of the peaks was used for qualitative analysis, while external standard method was used for the quantitative analysis. Results The linear ranges of organophosphorus pesticides were 0.2～50.0 ?g/L, r≥0.999 1. The lowest detection limit was 0.009～0.04 ?g/L, the rate of recovery were 78.4%～93.9% and RSDs were 3.4%～7.5%. Conclusion This method is simple, rapid, sensitive and can efficiently separate and determine 12 kinds of organophosphorus pesticides in the water with 32.5 minutes of operation only.

Based on summarizing the importance of education environment and the development and current status ofresearch on medical education environment, the authors measured the status of, and the problems existing in, educationenvironment of China Medical University by DREEM (Dundee Ready Education Environment Measure), and then sug-gested strategies to modify the education environment and hence to improve the quality of medical education on thebasis of the advanced concepts of education environment design and construction in the world and the authors' experi-ence in the reform of medical curriculum.[

To improve the quality of health care by improving the quality of residency training,the Accreditation Council for Graduate Medical Education of USA has renewed the standards and methods of residency training to improve health care,and issued the compe- tence-based training standards. The residents have to achieve six key competences when they finish the training. The University of Washington,School of Medicine,responds to the new re- quirements and standards by reforming its residency training pathway,enriching formal teach- ing/training activities,and improving its supervision and the evaluation. We should use for refer- ence reforming the residency training in China.

Objective To probe the diagnostic value of MRI in synovial hemangioma of the knee.Methods Seven patients(2 male,5 female,age ranged from 8 to 58 years with mean age 25.1 years) selected from 2025 cases with MRI examination of knee,which were proved to be intra-articular hemangiomas histologically or clinically.All of the patients had plain film before MRI examination.MR findings of synovial hemangioma of knee were analysed ultrasound.Results Four hemangiomas occurred in infrapatellar bursa,others 3 cases in both infrapatellar and suprapatellar bursa were involved.MR signal intensity of hemangiomas appeared three types:(1)nodular hypointensity on both T_1WI and T_2WI in 2 cases;(2)iso-hypointensity on T_1WI and hyper-hypointensity on T_2WI in 2 cases;(3)hypointensity mixed with isontensity on T_1WI and nodular of linear mixedintensity on T_2WI in 3 cases.The difference of synovial hemangioma of knee in histologic elements,the MR findings were different.Conclusion MRI features of synovial hemangioma are correlated with pathology histologic elements.

AIM: To study the effects of astragalosides (AS) on the proliferation and cell cycle of rat glomerular mesangial cell (MC), and verify the correlation between the influence and the AS concentration. METHODS: The experiment was carried out in the Physiological Laboratory of Liaoning Medical University from December 2006 to July 2007. Rat glomerular MCs were cultured in high glucose for 4-7 passages. The experiments were randomly divided into control group and three AS groups with different concentrations (50, 100, 200 mg/L), which were treated with high-glucose liquid and AS respectively. MC proliferation was determined with MTT colorimetric method in each group at hours 48 after intervention. MC cell cycle was detected with flow cytometry. RESULTS: ①MTT results showed that, the values of A490 nm in AS groups were lower than that in the control group at hours 48 (P

Objective To study the changes of plasma ET-1,CGRP,TXA2 and their receptor expression in lung tissue of children with congenital heart disease-assicated pulmonary artery hypertension.Methods Plasma was collected from 60 children patients.ET-1,CGRP and TXB2 levels were measured by EIA,RIA and ELISA,respectively.Expression of their receptors in the lung tissue was detected by RT-PCR.Results The plasma ET-1 and TXB2 levels were significantly higher in CHD patients than in control children.The plasma CGRP level was significantly lower in CHD patients than in control children.Fourteen days after treatment with PGE1,the plasma ET-1 and TXB2 levels were significantly decreased with no significant changes in CGRP.The expression level of ET-1 and TXA2 receptor mRNA was significantly higher in patients with pulmonary artery hypertension than in those without pulmonary artery hypertension.However,the expression of CGRP receptor mRNA was lower in patients with pulmonary artery hypertension than in those without pulmonary artery hypertension.Conclusion Plasma ET-1,CGRP and TXA2 levels are closely related with congenital heart disease-associated pulmonary artery hypertension,and can be used as an index for its prognosis.

Medical professionalism is an important part of competencies which physicians are acquired to own.Team of physician's competency model construction and education revolution project concluded the current situation and theoretical cognition of physician's professionalism of experts from medical education and administration organizations in China according to the results of the first round of Delphi.Meanwhile,suggestions for the further improvement of physician's professionalism were pro

OBJECTIVE:To compare therapeutic efficacy and safety of laparoscopy combined with dienogest and laparoscopy combined with dienogest and TCM in the treatment of endometriosis. METHODS:126 endometriosis patients were selected and divid-ed into control group and observation group,with 63 cases in each group. Control group received combined with dienogest(25 mg/time,qd);observation group was additionally given TCM on the basis of control group. Therapeutic efficacy,recovery time of ovula-tion,menstrual recovery time and ADR were compared between 2 groups,and recurrence and pregnancy of them were followed up for 2 years. RESULTS:The total effective rate of observation group (93.65%) was significantly higher than that of control group (80.96%),with statistical significance (P<0.05). The menstrual recovery time and recovery time of ovulation in observation group were significantly shorter than control group,with statistical significance (P<0.05). The incidence of ADR in observation group (9.52%)was significantly lower than control group(26.98%),with statistical significance(P<0.05);the recurrence rate of observa-tion group (4.76%) was significantly lower than that of control group (17.46%),with statistical significance (P<0.05). In 2-year follow-up,there were 23 pregnancy patients in observation group,which was significantly higher than that of control group (9 cas-es),with statistical significance (P<0.05). CONCLUSIONS:Laparoscopy combined with dienogest and TCM in the treatment of endometriosis have better clinical effect,higher safety and lower recurrence rate. The patients are easily pregnant.

Objective:To investigate the recent and long-term efficacy and safety of pancreaticoduodenectomy for pancreatic head carcinoma and periampullary carcinoma.Methods:82 cases of pancreatic cancer combined with periampullary carcinoma patients admit ted in our hospital from August 2009 to June 2013 were selected and randomly divided into the control group and the observation group With 41 patients in each group.The control group received palliative surgical treatment,while the observation group underwent pancreatoduodenectomy.The operation time,hospitalization time,intraoperative bleeding volume and the incidence of complications,1,2,3-year survival rate and the recurrence rate at 1 year after operation and tumor eradication rate were compared between twp groups.Results:The amount of bleeding,operation time of observation group were significantly higher than those of the control group(P＜0.01),no signif icant difference was found in the hospitalization time between the two groups(P＞0.05);the incidence of complications in the observation group (41.46％) was significantly higher than the control group (22.96％)(P=0.03);the 2-year and 3-year survival rate of observation group were significantly higher than those of the control group (P＜0.05),the recurrence rate at 1 year after operation of observation group was significantly lower than that of the control group (P=0.04),the tumor eradication rate was significantly higher in the observation group than that of the control group (P=0.04).Conclusion:Though pancreaticoduodenectomy could prolong the operation time,increase the risk of bleeding and complications for pancreatic head carcinoma and periampullary carcinoma,but it could effectively reduce the possibility of recurrence after operation,significantly improve the long-term survival rate.