Objective To screen the plasma differential expressed proteins in patients with Crohn's disease(CD)and ulcerative colitis(UC)using surface-enhanced laser desorption ionizationtime of flight mass spectrometry,and to establish decision trees algorithms.Methods The plasma samples from 24 UC patients,25 CD patients and 25 healthy controls were analyzed with CM10 protein chip.The proteomic spectra of CD,UC and inflammatory bowel disease(IBD)were compared with controls respectively.The differential proteins that significantly altered expression levels were selected to establish decision trees algorithms of CD.UC and IBD and then blind validations were tested.Results In the range of m/z 2000-30 000,differential expressed proteins that changed at least 2-fold between CD and controls were 9.between UC and controls were 5,and between IBD and controls were 11(P＜0.05).The software automatically picked up the m/z 8208 and 8837 as decision trees algorithms for differentiating CD from controls and m/z 6985 for differentiating UC from controls as well as m/z 8208,1752,28840 and 1702 for differentiating IBD from controls.The sensitivities of decision trees algorithms for CD,UC and IBD were 96%,82%and 91%respectively,and the specificities were 100%,85%and 100%respectively.Conclusions The protein of m/z 8208 which has high sensitivity in differentiating CD from controls is worthy of further study.

Objective To apply the oral gastrointestinal ultrasound contrast agents for evaluating the gastric motility abnor‐mality in the patients with anxiety disorder .Methods Twenty patients with anxiety disorder complicating upper digestive tract symptoms without organic pathological changes were enrolled as the anxiety disorder group .Twenty healthy volunteers were en‐rolled as the control group in this study .The two groups orally took gastrointestinal ultrasound contrast agents .The antral contrac‐tion frequency ,antral contraction amplitude amd MI were measured at each time point .GER was calculated .The the gastric motility parameters in the patients with anxiety disorder were evaluated .Results The antral contraction frequency and MI at initial 2 min had no statistical difference between the anxiety group and the control group .The antral contraction amplitude ,antral contraction frequency amd MI at each time point during 5 -10 min after contrast in the anxiety disorder group were significantly decreased compared with the control group ,and the differences were statistically significant (P< 0 .05) .After 20 min ,GER in the control group was significantly higher than that in the anxiety group ,the difference was statistically significant (P<0 .05) .Conclusion O‐ral gastrointestinal ultrasound contrast agents is a economic ,strongly operable ,non‐invasive and highly repeatable method for evalu‐ating the gastric motility .

Objective To analyze the cost of capsule endoscopy in diagnosing small bowel bleeding and to compare it with traditional diagnostic methods.Methods The patients suspected with small bowel bleeding were divided into group A(n=58,collected during 1998 to 2005)diagnosed with traditional processes and group B (n=93,collected during 2002 to January 2005)diagnosed with capsule endoscopy.The diagnostic yield,specific treatments,examination costs and other accumulated costs of two groups was compared.The examination cost ratio and the integration cost ratio were evaluated.The sensitivity analysis was performed.Results The diagnostic yield of small bowel bleeding in group A and group B were 22.4%(13/58) and 86%(80/93),respectively.The total of examination costs were 133 750 RMB and 790 500 RMB,respectively.The examination costs in group B(RMB 9881.3/each) was slightly lower than group A(RMB 10 288.5/each).Furthermore,as the diagnostic yield of group B was significantly higher than group A(P=0.001).The specific treatments based on the results of the diagnosis was 37.4% higher in group B(49.5%) than group A(12.1%).That means the cost of repeat- ed consultations,emergencies room visit,examinations,supporting treatments and hospitalizations in group B were significantly decreased.After the adjustment,the cost in group B(RMB 9881/patient) was lower than group A(16 361.5 RMB in one month—97 424.0 over 5 years/patient).The total cost of each patient in group A was 6480.2—87 542.7 RMB more than group B,which represented 1.7—9.9 folds increase.Conclusions The patients who suspected with small bowel bleeding and had a negative results of gastroscopy and colonoscopy were recommended to have capsule endoscopy which yields early diagnosis and less cost.

The medical ethics curriculum education in American universities developed earlier,was more ma-ture,and has conducted more practice and exploration in various aspects of curriculum setting,teaching objectives, teaching content,teaching methods,evaluation methods,and faculty and so on. Taking medical ethics curriculum ed-ucation in University of Pittsburgh as an example,this paper expounded the concrete practice of all above aspects in American colleges and universities,and using this as a reference,hoped to have enlightenment to medical ethics ed-ucation and medical humanities education in China.

Objective:To investigate the application of case-based learning (CBL) combined with evidence-based learning (EBL) teaching in clinical teaching of oncology.Methods:Totally 57 resident doctors were divided into experimental group and control group. The experimental group received CBL and EBL teaching, and the control one received lecture-based learning (LBL) teaching. The teaching effect was evaluated by examination and questionnaire, and the data were analyzed by SPSS 20.0.Results:The examination scores of the experimental group and the control group were (85.393±7.213) and (81.276±8.035), and the ones of case analysis were (34.393±2.485) and (32.379±3.005) respectively. Meanwhile, questionnaire survey showed that the evaluations of experimental group were significantly better than those of the control one in promoting learning interest and initiative, retrieval ability, self-learning ability, clinical thinking and learning efficiency ( P<0.05). Conclusion:The teaching effect of integration of CBL and EBL is better than LBL.