With self-designed experiment as its basis,Basic Medical College of Shanghai Jiao Tong University has made teaching reform that is design-oriented and integrative with intent to cultivate students' innovation consciousness and practice ability.As a result,a teaching model of"research-based learning",which aims at bringing forth innovative talents,has been constructed and produced desired effects.

Physiological pacing has undergone three stages: atrioventricular sequential pacing,chronotropic pacing and cardiac resynchronization therapy.How to make pacing therapy more physiological,so as to meet the physiological needs of patients,is the unremitting pursuit of clinicians.With further understanding of cardiac function and the development of pacemaker manufacturing technology,pacing function will become more and more physiological.At the same time,the newer generation of pacemakers will have more sophisticated program control function,higher automation,simulation of the doctor's thinking,and the pacing parameters can be optimized automatically after implantation allowing pacemaker to operate in the most effective and energy-saving state.From cardiac rhythm managers to heart disease managers,their unique efficacy will make physiological pacing function perfect day by day.In this paper,the research progress in this field is analyzed,which aims to provide the basis for pacing mode,pacing site and pacing interval in the future.

Objective To investigate the clinical pathological features and prognosis of gastric carcinoma with neu-roendocrine differentiation (NED) and mixed gonadal neuroendocrine carcinoma of the stomach (MANECs). Methods A retrospective analysis of 61 cases of gastric carcinoma with NED and 34 cases of MANECs and their histochemistry and im-munohistochemistry were also observed. Prognosis of the 2 groups were compared by the Kaplan-Meiers survival analysis. Prognostic factors associated with patients with gastric cancer were analyzed by COX proportional hazards model. Results Tumor location, distant metastasis and lymph node metastasis were statistically different between these 2 groups (P<0.05). Syn positive expression rate is higher than CgA and CD56 in the gastric carcinoma with NED group;Postoperative survive pe-riod of the gastric carcinoma with NED is shorter than that of MANECs (P<0.05). Lymph node metastasis and distant region-al transfer is obviously correlated with prognosis (P<0.05). Conclusion Immunohistochemistry is important for the diag-nosis of these two tumor. The number of neuroendocrine cells can help to assess prognosis and guide treatment.

We conducted questionnaire for anonymous answers.The sample comprised 388 papers.The results obtained response to inquiry.Based on human dermatoglyphics development,its teaching reform,curriculum construction have been made in this paper.

Based on the analysis of 5-year collected data,our study showed that the teacher and course characteristics influence student ratings significantly.The scientific and rea-sonable evaluation approaches provides fundamental information for teaching capacity enhancement and course improvement.

Objective To explore the synchronous cosmetic surgical procedures for the beauty-seekers who have both single eyelid and commonly horizontal cockeye in order to acheive either time saving or beautifying. Methods Firstly, the distance of moving backwards and shortening length of the eye muscle were calculated and designed according to the degree of cockeye; secondly, the height of the double eyelids line and positioning were re-designed; then the moving backwards and shortening of the horizontal macula were put up to rectify the cockeye; finally, the incisal double eyelid operation was performed. Results All 25 patients with inner cockeyes were corrected at the right position; 4 of 11 patients with outer cockeyes were corrected 5～10 degrees over the right position, and others were at the right position. The single eyelid with thin-eyelid and middle-thick-eyelid restored within 3 months; but the patient with thick-eyelid restored slowly, about half a year in average. 2 patients with redundant skin at inner corner of eye were also corrected at the right position. Conclusions Although there is somewhat difficulty in the plastic surgery for patients with cockeye and single eyelids, synchronous operation can save time and outlay, and also acheive the aim of beautifying. Therefore, it is a good approach to deal with cockeye.

Objective To explore the advantages and disadvantages of high quality care in clinical care. Methods 2000 cases of hospitalized patients from August 2010 to August 2011 in department of neurology were selected as research subject.The 2000 hospitalized patients were divided into the control group and the research group with 1000 cases in each group.The control group was given routine care,the research group selected high quality care.General activity of daily living (ADL) assessment and satisfaction degree of patients was surveyed at discharge for two groups and the results were compared. Results When patients were discharged,ADL scores and satisfaction degree of patients in the research group were higher than those of the control group. Conclusions Application of high quality care for patients can promote the improvement of activity of daily living and satisfaction degree of patients.

Efforts have been directed at the development of efficient protocols for the differentiation of pluripotent stem cells into pancreatic β-cells.This review focuses on the mechanism of RA,BMP,FGFs,IDE1,IDE2,ALK-i 1 and ALKI-2 during the process in which pluripotent stem cells differentiate to pancreatie β-cells and the relationship between the differentiation and the expression of the surface markers including CD14,CD49e,CD238,CD24,EpCAM,SSEA3 and SSEA1 in the different stage of this process.

Objective To determine quantity of type Ⅰ collagen and mRNA expression of decorin and transforming growth factor (TGF)- β_1 in the upper portion of the anterior vagina in women with pelvic organ prolapse (POP). Methods Transvaginat biopsies were obtained from the anterior vaginal wall in 27 POP(POP group) and 21 non-poP(control group). The concentration of type Ⅰ collagen was determined by ELISA technique. RT-qPCR was used to verify the mRNA level of decorin and TGF- β_1. Results The mean concentration of type Ⅰ collagen in the premenopausal women in POP group [(47.94 ± 6.82) mg/g total protein (TP)]was significantly lower than that in control group [(62.33±6.57) mg/g TP],in the postmenopausal women in POP group, it was (41.82±5.96) mg/g TP, significantly lower than that in control group[(61.21 ± 4.84)mg/g TP](P< 0.01). The mRNA expression of decorin was 1.61 ± 0.10 in POP group, significantly lower than that in control group 2.77±0.60 ,while that of TGF-β_1 was higher in POP greup10.86 ± 0.23 than that in control group 9.87 ± 0.92 (P < 0.05). In the postmenopausal women in two groups, there were no significant difference in the mRNA expression of decorin and TGF-β_1 (P > 0.05). Conclusions A decrease in quantity of type Ⅰ coUagen in the connective tissue of anterior vagina may compromise the tensile strength and an increase susceptibihty to prolapse. Deeorin might be involved in the pathogenesis in premenopausal women with POP. The pathogenesis of POP is muhifactorial.

According to the goal of promoting all-round ability and the core idea of PRICE,the Medical School of Shanghai Jiao Tong University improves the curriculum,teaching method,experimental teaching,multidimensional examination to explore the new system of teaching reform for eight-year clinical medical education.