Through investigation on the cognition and status of the cultivation of innovative ability of the students,we found that the innovative ability of medical students was extremely weak.Their practical ability was out of joint to the cognition of innovative ability.We are trying to analyze the reasons and resolve the problem.

Objective To compare the clinical characters and hemodynamic data of the prone position and supine position percutaneous nephrolithotomy. Methods Patients with kidney stones in 100 cases were randomly assigned into the supine position group and prone position group.There were 50 cases in each group.The following data were recorded at preoperative,intraoperative,change position:the blood pressure,heart rate,respiration,saturation of blood oxygen and blood gas analysis results.The VAS score was recorded in patients for postural comfort,dyspnea and pain score. Results The systolic blood pressure in the preoperative,intraoperative,postoperative on supine position and prone position were as follows:(137±12),(119±15),(115±17) mm Hg and (137±10),(110±18),(104±16) mmHg.The diastalic blood pressure was as follows:( 81 ± 9 ),(74 ± 8 ),(63 ± 14 ) mm Hg and ( 84 ± 8 ),(63 ± 9 ),(60 ± 15) mm Hg.Compared with preoperative,there was a blood pressure decreased in both groups.The blood pH at preoperative,intraoperative,postoperative in supine position and prone position:7.4 ± 0,7.3 ± 0,7.3 ± 0 and 7.4 ± 0,7.3 ± 0,7.3 ± 0.The bass excess (BE) of two groups were:(2.1 ± 0.5),(-2.7 ±0.5),( -1.5 ±0.5) mmol/L and (3.2 ±0.5),(-3.8 ±0.5),(-2.5 ±0.5) mmol/L.Compared with preoperative data,the pH and BE declined in both groups.The prone position had more pronounced decrease in serum sodium,serum potassium; but with no significant difference.Supine group in postural comfort and breathing difficulties were 1.6 ± 0.4 and 7.1 4± 05,while prone group were 7.5 ± 0.2 and 1.4 ± 0.3.The supine position showed better in postural comfort and breathing difficulties with statistical significance. Conclusions Compared with the prone position,the supine positioned percutaneous nephrolithotomy could have less influence on hemodynamics,blood gas analysis.It could have better postural comfort.

It was reported that pancreatic arteries constricted during the early phase of bile salt-induced acute pancreatitis (AP), leading to pancreatic microcirculatory disturbance. We conducted this experiment to verify whether the above-mentioned finding was true. AP was induced with intraductal injection of taurodeoxyholate. Small pancreatic artery pressure in dogs was recorded. Functional capillaries were counted and calibrated by multiplying wet weight of pancreas. Pancreatic perfusion was measured with Laser Doppler flowmeter. Pancreatic arterioles of rats dilated during the initial 20 min of AP, and pancreatic arterial pressure declined during the early phase of AP in dogs (from 104.5 +/- 4.8 mmHg to 54.6 +/- 5.6 mmHg). The hematocrit of blood from inferior vena cava was significantly lower than that of portal vein at 5 min after pancreatitis induction. The "true" pancreatic functional capillary density increased. The early pancreatic microcirculatory disturbance coincided with a marked increase of portal vein pressure (PVP) as high as 9.18 +/- 0.78 mmHg. Reduction of PVP to baseline level was followed by a marked increase of pancreatic perfusion (by 1.4-fold). Arterial dilatation, but not constriction, occurred during the early phase of bile salt-induced AP. The pancreatic microcirculatory disturbance was due to a marked rise in PVP that greatly reduced the pressure difference in the pancreatic blood vessels and increased plasma extravasation which led. to local hemoconcentration.
Animals ; Bile Acids and Salts ; adverse effects ; Hypertension, Portal ; complications ; Male ; Microcirculation ; drug effects ; physiology ; Pancreas ; blood supply ; Pancreatitis ; etiology ; physiopathology ; Portal Pressure ; Portal Vein ; physiopathology ; Rats ; Rats, Sprague-Dawley