In order to train the high-quality medical talents,the traditional teaching models should be reformed in the physiological teaching.This article has conducted researches on the teaching contents,methods,means,experiments and evaluation systems so as to achieve the goal of the special training.

‘Guided Learning Plan Module’uses learning plans as studying materials,designs students’studying targets as learning plans,transfers teachers’teaching targets to students’studying targets and then teachers assign their learning plans to students.Students study and discuss by themselves according to the learning plans,and teachers guide,explain,regulate and control.This module emphasizes teachers’guidance,students’self-study and develops students’studying abilities,creative sensations and comprehensive qualities.Applying "Guided Learning Plan Module" to physical teaching can have a fairly effective effect on teaching.

Objective Through the research of the disposal of clinic laboratory result information,the paper explore the methods of building up laboratory's online management system and network information system.Methods This project began with the analysis of the need of laboratory and applies computer to simulate the manual disposal process.The system framework was separated into many sub parts according to its function.VB,etc were used to program.Results The project has been gained successfully in the online managemert of two analyzers and the management of data network consisting of three laboratories.Conclusion The project has established a practical and reliable in-formation management system which matches the work mode in clinical laboratory and has novelty functions.

Objective To investigate the morphological characteristics of superior sagittal sinus (SSS) and bridging vein (BrV) with virtual reality (VR) technology and their clinical significances.Methods Forty-three patients with parasagittal meningioma (PSM group) and 21 patients with trigeminal neuralgia or hemifacial spasm who had no intracranial venous system diseases (normal group),admitted to our hospital from October 2011 to March 2013,were chosen.The morphological characteristics of SSS and parasagittal BrV of patients from the 2 groups were observed,which was finished in the VR workstation.The number and diameter differences of cortical veins between the 2 groups,and bilatelal side and the first,middle and third 1/3 of SSS of normal group were analyzed.Results Among the patients from the 2 groups,4 having SSS extremity with morphological variation were observed firstly.The direction of BrV entering the SSS mainly was retrograde,which concentrated in the middle and third 1/3 of SSS.There were many directions of BrV entering the SSS in the first 1/3 of SSS,and the direction mostly was perpendicular.In normal group,there were no statistical differences of number and diameter in the bilatelal cortical veins (P＞0.05); in the first,middle and third 1/3 of SSS,there was statistical difference of cortical veins number (P＜0.05),but no difference of diameter (P＞0.05).The number and diameter of cortical veins of PSM group were under the normal group,with statistically significant difference (P＜0.05).With the growth of PSM,violations of SSS and cortical venous gradually aggravated,affecting venous return,which resulted in increase number and complication of collateral veins.Conclusions There is certain variability of SSS and related BrV.The direction of BrV entering the SSS may be associated with intracranial venous system hemodynamic.It is clear and three-dimensional to observe SSS and cortical veins in the help of VR,and to analyze the venous circulation changes caused by PSM.

According to the pathological characteristics of symptomatic chronic thoracic and lumbar osteoporotic vertebral fracture (SCOVF), the different clinical treatment methods are selected, including vertebral augmentation, anterior-posterior fixation and fusion, posterior decompression fixation and fusion, and posterior correction osteotomy. However, there is still a lack of a unified understanding on how to choose appropriate treatment method for SCOVF. In order to reflect the new treatment concept and the evidence-based medicine progress of SCOVF in a timely manner and standardize its treatment, the clinical guideline for surgical treatment of SCOVF is formulated in compliance with the principle of scientificity, practicability and advancement and based on the level of evidence-based medicine.

Ankylosing spondylitis (AS) combined with lower cervical fracture is often categorized into unstable fracture, with a high incidence of neurological injury and a high rate of disability and morbidity. As factors such as shoulder occlusion may affect the accuracy of X-ray imaging diagnosis, it is often easily misdiagnosed at the primary diagnosis. Non-operative treatment has complications such as bone nonunion and the possibility of secondary neurological damage, while the timing, access and choice of surgical treatment are still controversial. Currently, there are no clinical practice guidelines for the treatment of AS combined with lower cervical fracture with or without dislocation. To this end, the Spinal Trauma Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate Clinical guidelines for the treatment of ankylosing spondylitis combined with lower cervical fracture in adults ( version 2024) in accordance with the principles of evidence-based medicine, scientificity and practicality, in which 11 recommendations were put forward in terms of the diagnosis, imaging evaluation, typing and treatment, etc, to provide guidance for the diagnosis and treatment of AS combined with lower cervical fracture.

OBJECTIVE To study the effects of Phellodendron amurense polysaccharides （PAP） on improving gouty nephropathy （GN） in rats， and to investigate its mechanism primarily by interfering the p38 mitogen-activated protein kinase （p38 MAPK）/nuclear factor-κB（NF-κB）/tumor necrosis factor-α（TNF-α）. METHODS Sixty rats were randomly divided into normal group （water）， model group （water）， allopurinol group （positive control， 20 mg/kg）， PAP high-dose， medium-dose and low-dose groups （100， 50， 25 mg/kg， by raw material） after being stratified by body weight， with 10 rats in each group. Except for the normal group， the other groups were induced to construct GN model by giving 1 500 mg/kg potassium oxazinate and 100 mg/kg adenine intragastrically for 14 days. After modeling， the rats in each group were given relevant medicine/water intragastrically， once a day， for consecutive 28 days. After the last medication， the levels of biochemical parameters related to renal function [uric acid， creatinine （Cr）， blood urea nitrogen （BUN）， xanthine oxidase （XOD）] were detected in rats， and the histopathological changes in the rat kidney were observed. The protein expressions of monocyte chemoattractant protein-1（MCP-1），TNF-α and interleukin-6（IL-6） as well as the phosphorylation levels of p38 MAPK and NF-κB p65 protein were determined in renal tissue of rats. RESULTS Compared with the normal group， the model group suffered from the dilatation of renal tubules， structural damage to glomeruli， accompanied by inflammatory infiltration and fibrosis； the contents of uric acid， Cr， BUN and XOD， the protein expressions of MCP-1，TNF-α and IL-6 and the phosphorylation levels of p38 MAPK and NF-κB p65 protein were all increased significantly （P＜0.05 or P＜0.01）. Compared with the model group， the pathological symptoms of renal tissue in rats had been improved to varying degrees in different dose groups of PAP； the contents of uric acid， Cr， BUN and XOD， protein expressions of MCP-1， TNF-α and IL-6， the phosphorylation levels of p38 MAPK and NF-κB p65 protein in PAP high-dose and PAP medium-dose groups were all decreased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS PAP exhibits an anti-GN effect， the mechanism of which may be associated with inhibiting the p38 MAPK/NF-κB/TNF-α signaling pathway.

Ankylosing spondylitis (AS) combined with spinal fractures with thoracic and lumbar fracture as the most common type shows characteristics of unstable fracture, high incidence of nerve injury, high mortality and high disability rate. The diagnosis may be missed because it is mostly caused by low-energy injury, when spinal rigidity and osteoporosis have a great impact on the accuracy of imaging examination. At the same time, the treatment choices are controversial, with no relevant specifications. Non-operative treatments can easily lead to bone nonunion, pseudoarthrosis and delayed nerve injury, while surgeries may be failed due to internal fixation failure. At present, there are no evidence-based guidelines for the diagnosis and treatment of AS combined with thoracic and lumbar fracture. In this context, the Spinal Trauma Academic Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate the Clinical guideline for the diagnosis and treatment of adult ankylosing spondylitis combined with thoracolumbar fracture ( version 2023) by following the principles of evidence-based medicine and systematically review related literatures. Ten recommendations on the diagnosis, imaging evaluation, classification and treatment of AS combined with thoracic and lumbar fracture were put forward, aiming to standardize the clinical diagnosis and treatment of such disorder.

The acute combination fractures of the atlas and axis in adults have a higher rate of neurological injury and early death compared with atlas or axial fractures alone. Currently, the diagnosis and treatment choices of acute combination fractures of the atlas and axis in adults are controversial because of the lack of standards for implementation. Non-operative treatments have a high incidence of bone nonunion and complications, while surgeries may easily lead to the injury of the vertebral artery, spinal cord and nerve root. At present, there are no evidence-based Chinese guidelines for the diagnosis and treatment of acute combination fractures of the atlas and axis in adults. To provide orthopedic surgeons with the most up-to-date and effective information in treating acute combination fractures of the atlas and axis in adults, the Spinal Trauma Group of Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field of spinal trauma to develop the Evidence-based guideline for clinical diagnosis and treatment of acute combination fractures of the atlas and axis in adults ( version 2023) by referring to the "Management of acute combination fractures of the atlas and axis in adults" published by American Association of Neurological Surgeons (AANS)/Congress of Neurological Surgeons (CNS) in 2013 and the relevant Chinese and English literatures. Ten recommendations were made concerning the radiological diagnosis, stability judgment, treatment rules, treatment options and complications based on medical evidence, aiming to provide a reference for the diagnosis and treatment of acute combination fractures of the atlas and axis in adults.