The practical teaching system for information management and information system science in higher medical institutions was constructed with job skill training as its target by intruding the concept of competence-based education model into it in order to improve the practical performance of undergraduates majoring in informa-tion management and information system science. The system was designed by taking into consideration the teaching contents, teaching methods and teaching practice, and implemented in the undergraduates of Chengdu Medical College, and the implementation experiences were summarized.

Objective To screen the effective silencing targets of P21 gene at the cellular level in rhesus monkey . Methods To detect the expression of P21 gene in COS-7 cells ( derived from the kidney of African green monkey , Cerco-pithecus aethiops).Four small hairpin RNA (shRNA) sequences targeting rhesus monkey P21 gene were designed and in-serted into lentivirus-based gene silencing constructs FUGW-TDT.The vectors were transfected into COS-7 cells respective-ly.The suppression of P21 mRNA was detected by real-time PCR, and the expression of P21 protein was detected by West-ern blot assay .Results Four gene-silencing sequences were screened that lied in 541-561 bp, 542-562 bp, 215-239 bp, and 624-648 bp of the rhesus monkey P21 mRNA.Their silencing rate was (91.82 ±3.21)%, (82.47 ±2.48)%, (81.31 ±2.69 )% and ( 87.35 ±4.59 )%, and the protein expression was ( 11.97 ±0.70 )%, ( 20.22 ±0.65 )%, ( 23.21 ± 0.63)%and (14.42 ±0.86)%, respectively.Conclusions Four effective silencing target sequences are screened at cel-lular level , which can be used in gene silencing research of rhesus monkeys .

A new method was proposed for analysis of the organic compounds in cigarette smoke by high resolution Orbitrap mass spectrometry based on polyacrylonitrile-silica (PAN-SiO2) nanofiber membrane extraction and methanol elution.Hydrophobic PAN-SiO2 nanofiber membrane which was used to enrich small molecular organic compounds in cigarette smoke was prepared by the technology of electrospinning.Several parameters including the concentrations of PAN and SiO2 nanopartical,elecrospining voltage,needle aperture and flow rate of spinning solution were optimized.Under the optimal conditions,a PAN-SiO2 nanofiber membrane with good adsorption performance and great physical strength was obtained.A total of 21 compounds including acetone,styrene,acrolein,isoprene,and acrylonitrile were identified by analyzing the cigarette smoke with Orbitrap MS spectrometry in the positive ion mode.Six organic acids including salicylic acid,malic acid and lactic acid were detected in negative ion mode.The limits of detection and quantification for nicotine were 0.071 ng/L and 0.236 ng/L,respectively.

A brief description of performance appraisal as used in the healthcare sector, and an analysis of problems existing in performance appraisal for posts in community heahhcare organizations in the country. The paper proposes a job-analysis based performance appraisal for such posts, featuring the appraisal model of "performance + skills + attitude+ work intensity". On the basis of work analysis, a job description should be worked out for such healthcare workers as doctors, nurses and prevention workers in community healthcare organizations, aided by a targeted job-based performance appraisal system. These efforts can effectively enhance the job performance in such organizations, catering to the healthcare needs of community residents.

Objective To investigate early changes of angiopoietin-2(Ang-2)in multiple trauma patients and assess its clinical significance.Methods Forty-five multiple trauma patients aged 2060 years admitted to the hospital within one hour after injury were randomly divided into three groups according to injury severity score(ISS).Blood specimens were obtained immediately upon arrival in the emergency department and plasma samples were assayed for comparing changes of Ang-2,TNF-a and IL-6.Meanwhile,plasma level of Ang-2 was measured and analyzed under different oxygenation index,shock index and base deficit.Results Plasma level of Ang-2 was positively correlated with ISS(P ＜ 0.01)and was concordant with the plasma levels of TNF-a and IL-6(P＜0.01).Furthermore,plasma level of Ang-2 was elevated upon increase of shock index or decrease of oxygenation index(P ＜ 0.01).Plasma level of Ang-2 was elevated with the increase of base deficit(P ＜ 0.01).Conclusions High level of Ang-2 is a marker of endothelial activation and dysfunction early after trauma.Ang-2 is related tightly with the injury severity,inflammation factors,systemic oxygenation and tissue hypoperfusion and may have a tight relation with pathophysiological development and clinical outcome after trauma.

Objective To explorethe chest x-ray and MSCT findings and the diagnostic value of pulmonary lymphangioleiomyomatosis (PLAM).Methods Four cases of PLAM proven by pathology were retrospectively analyzed,and the literature was reviewed.Result The clinical manifestations were dyspnoea(4 cases),cough(2 cases),haemoptysis(2 cases),recurrent pneumothorax(2 cases)and chylous effusions (1 case).The chest radiography presented diffused reticular shadows(2 cases),honey-comb changes(1 case),pneumatothorax(2 cases),and pleural effusion(1 case).The characteristic MSCT manifestations of 4 cases with PLAM were multiple different-sized and thin-walled cystoid transparent areas, which were diffusely-distributed throughout both lungs,most cysts were of 3-15 Him in diameter.One case combined with extensive pulmonary interstitial fibrosis,pleural thickening and adhesion.Conclusions PLAM is a kind of exceptional chronic diffuse lung interstitial disease.The chest radiography has been lack of characteristic imagines,but MSCT has characteristics of PLAM,and is more valuable for accurate clinical diagnosis of PLAM.

Objective To investigate the effect of rocuronium 0.3 mg/kg(ED95)for anesthesia induclion on monitoring of recurrent laryngeal nerve in patients undergoing thyroid surgery.Methods Seventy-five patients,ASA Ⅰ or Ⅱ,aged 20-70 yr,weighing 50-85 kg,scheduled for thyroid surgery,were randomly divided into two groups:rocuronium group(groupⅠ,n=38)and sevoflurane group(group Ⅱ,n =37).Anesthesia was induced with midazolam 2 mg,propofol 2 mg/kg,sulfentanil 0.5 ug/kg.After loss of eyelash reflex,group Ⅰ received rocuronium 0.3 mg/kg(ED95)and was intubated with the electromyographic(EMG)endotracheal tube under glidescope al 2 min after rocuronium administration.Group Ⅱ received sevoflurane inhalation and was endotracheal intubated with EMG tube until end-tidal sevoflurane concentration achieved 4％.Anesthesia was maintained with inhalation of sevoflurane in both groups.SP,DP,and HR were monitored continuously through the surgery.Cooper's score and the success of attempt at endotracheal intubation were recorded.Recurrent laryngeal nerve evoked EMG was recorded by neuromonitoring and the amplitude of EMG responses was recorded at 5 min intervals from 30 min to 70 min of surgery duration.Results SP,DP and HR remained within normal range in both groups.The success rates of endotracheal intubation were 100％ in both groups,but the Cooper' s score of group Ⅰ was significantly higher than that of group Ⅱ(P ＜ 0.05).Compared with group Ⅱ,the amplitude of EMG respouses was significantly decreased in group Ⅰ(P ＜ 0.05).However,the EMG response in group Ⅰ was adequate for neuromonitoring of recurrent laryngeal nerve.Conclusion Rocuronium 0.3 mg/kg(ED95)for anesthesia induction can not only provide satisfied endotracheal intubation conditions,but also be adequate for monitoring of recurrent laryngeal nerve in patients undergoing thyroid surgery.

Objective:To study the influence of morphine on the expression of synaptophysin(SYN)and synapse structure in mice hippocampus,so as to provide pathological evidence for studying the development and treatment of chronic morphine intoxication, addiction and abstinence symptoms of morphine.Methods:Twenty mice were evenly randomized into control group and experiment group.Mice in control group were injected with normal saline(0.1 ml daily)and those in experimental group were injected with morphine(0.1 ml,1 mg daily).Thirty days later the mice in 2 groups were killed and their brain tissues were harvested and made into slices,stained with immunohistochemical techniques(SP)and photographed under the light microscope.The images were analyzed with the image analytical system and the data were statistically analyzed.Results:In the control group,positive staining of SYN was found in the entorhinal area,subiculum,stratum plextiforme,polymorphic layer of gyrus dentatus,stratum oriens,and stratum radiatum of hippocampus;weak positive staining of SYN was noticed in the stratum lacunosum-moleculare of hippocampus;positive staining of SYN was also found the membrane of pyramidal cells and granule cells,with the mean gray scale value of the hippocampal structure being 132.84?8.67.Positively stained neurons was also found in the entorhinal area and the subiculum,with a intensity of(7.80?1.03)/ mm~2.In the experiment group,the suhiculum and polymorphic layers of gyrus dentatus were positively stained for SYN;the entorhinal area,stratum oriens,stratum radiatum and stratum lacunosum-moleculare of hippocampus were strongly positive of SYN;the membrane of pyramidal cells and granule ceils were also strongly positive of SYN,with the mean gray scale value of the hippocampal structure being 116.27?5.70.Strongly stained neurons were also found in the entorhinal area and the subiculum,with the intensity being(11.90?1.45)/mm~2.The number of SYN positive neurons and the intensity of SYN in the experimental group were higher than those in the control group(P

OBJECTIVE To investigate the clinical curative effect of acellular dermal matrix contrast with temporalis fascia in type Ⅰ tympanoplasty. METHODS A retrospective analysis of 60 inflammatory chronic suppurative otitis media patients from January 2014 to January 2015 in Genenral Hospital of PLA Guangzhou Military Area were conducted.All cases were perpormed the ear incision under local anesthesia, including 32 cases(32 ears) with acellular dermal matrix, 28 cases(28 ears) with temporal fascia. The operation time, postoperative pain, the healing of tympanic membrane and the postoperative recovery were compared between the two groups. RESULTS There was significant difference in the operation time and postoperative pain between the two groups(P<0.05). There was no significant difference in the success rate of tympanic membrane healing and postoperative hearing improvement(P>0.05). CONCLUSION The effect of acellular dermal matrix for repairing tympanic membrane is similar to the temporalis fascia. The use of acellular dermal matrix has the advantage of shorter operation time, less postoperative pain, and can avoid regional two incisions, it is worthy of clinical application.

Objective To investigate the safety and short-term efficacy for evaluation of the low-profile visualized intraluminal support device (LVIS stents )compression and lantern release shapes for the treatment of wide-necked intracranial aneurysms. Methods From December 2014 to October 2015,15 patients with intracranial wide-neck aneurysm (16 aneurysms)received LVIS stent treatment, whose stent shapes had shortening changes were analyzed retrospectively. Thecompression mode refers to the length of LVIS stent to be shorter for more than 5 mm than the label release value by operation. Thelantern mode refers to the widened diameter of LVIS stent at the neck of aneurysm. The metal coverage rate in the posterior communicating segment of internal carotid artery after stent compression was calculated, and its safety and efficacy were assessed immediately after procedure and at 3 months after procedure. Results (1 )Using LVIS stent-assisted treatment,16 wide-necked aneurysms were treated,including 8 posterior communicating aneurysms,6 ophthalmic aneurysms,one anterior choroidal artery aneurysm and one M2 bifurcation fusiform aneurysm. The aneurysm neck was 1. 8 to 8. 0 mm (mean 3. 9 ± 1. 7 mm). A total of 15 LVIS stents were implanted (one patient with 2 aneurysms were treated with 1 stent). All the stents were released by using compression mode,and 4 of the patients (4 stents)also used the lantern mode at the same time. (2 ) After LVIS stenting,the Raymond grade Ⅰ embolization was in 10 aneurysms (62.5%),the covered branch arteries were patent immediately after procedure. (3)No perioperative technology-related hemorrhagic and ischemic complications occurred. The success rate of stent implantation was 100%(15/15). (4)The metal coverage rate after stent compression in the internal carotid artery posterior communicating segment was 30. 3%-38. 5%(mean 35. 0 ± 2. 8%). (5)After LVIS stent implantation,15 patients were followed up by whole brain DSA for 3 to 5 months (mean 3. 2 ± 0. 5), 14 aneurysms were cured on imaging (Raymond gradeⅠ),and no aneurysm recurred. All branch arteries covered by the stents did not have vascular occlusion. There was no in-stent restenosis or parent artery occlusion. The total disability rate was 6. 7%(1/15),and no patient died. Conclusions LVIS stents can increase aneurysm neck metal coverage rate and short-term cure rate throughcompression andlantern modes,while does not affect the covered branches. Choosing the appropriate cases for thelanternmode may be beneficial to the short-term protection of the vascular branches at the aneurysm necks.