The flip classroom,as a new teaching form,has innovated the traditional teaching model.Although the flip classroom has its superiority,it will encounterchallenges in practice.This paper firstly analyzed the feasibility and necessity of medical ethics education based on the flip classroom.Then,it introduced the teaching model of medical ethics flip classroom based on three aspects:the basic pattern design,learning resources design and teaching process design.Finally,it discussed the application and effects of the flip classroom on the teaching of medical ethics.

ObjectiveTo explore the practicability of combined surgical treatment for the patients with Hepatocellular Carcinoma(HCC) complicated with Portal Hypertension(PH).MethodsThe clinical data of 43 patients withHCCcomplicatedwithsignificantesophagealvaricesandhyperspleniawereanalyzed retrospectively.All patients were diagnosed with esophageal varices and hypersplenia of different degrees, 14 of them had severe esophageal varices, the other 29 patients had moderate esophageal varices.Firstly all patients underwent splenectomy, 18 of them had selective portoazygous devascularization in addition.After that the patients received hepatectomys ,with local excision or segmentectomy as the major operation methods.Results All patients received hepatectomy combined with splenectomy treatment.There was no perioperative mortality, but 12 patients had complications after the surgery.Over seventy percents patients(33/43)accepted regular followup.Among these 33 patients,the 1-year and 3-year survival rates were 90.9％ (30/33) and 63.6％ (21/33)respectively.Eleven patients died of tumor recurrence.Four patients had upper postoperatively gastrointestinal hemorrhage.ConclusionHepatectomy combined with splenectomy didn't increase the mortality in the patients with HCC complicated with PH.The combined surgery might reduce the incidence of severe complications, such as postoperative bleeding.We believe the combined surgical treatment is feasible for this group of the patients.

To investigate the effects of unpredictable chronic mild stress and Xiaotan Jieyu Recipe (XTJYR), a compound traditional Chinese herbal medicine, on the behaviors of Walker 256 tumor-bearing rats and to explore the mechanism.

Objective To investigate the characteristics and mechanisms of attentional bias in anxiety sensitivity individuals.Methods By using Anxiety Sensitivity Index (ASI),23 participants were included in the high score group and 20 participants were included in the low score group.Then,2 (between-subject factor:the high and low score group) ×2 (within-subject factor:the positive and negative picture) mixed design experiments were adopted.Emotional faces picture pairs were chosen as stimuli.Picture pairs were presented 100 ms in experiment 1 and 1 250 ms in experiment 2.Dot-probe task was adopted to inspect the attentional bias and the response time and correct rate were recorded.Results Experiment 1 implied the main effect of type of pictures was found in mixed design experiments(F(1,41)=4.40,P＜0.05).The reaction time of two groups in positive pictures was greater than zero((12.22±30.24) ms vs (10.07±21.55) ms).It showed input effect to positive pictures.An input effect due to the reaction time of the high score group was greater than zero to negative pictures((4.81± 17.88)ms),while the low score group tended to avoid the negative pictures ((-6.81 ±21.33) ms).Experiment 2 implied positive score was not significant between two groups (F(1,41) =0.29,P＞0.05).And positive score showed the attentional bias to some certain extent.Significant outcome was found by negative score between two groups (F(1,41) =6.41,P＜0.05).It implied that the high score group tended to avoid the negative pictures and the low score group had the tendency of input effect.Conclusion At the initial stage of attention,anxiety sensitivity individuals had the attentional bias to negative emotional faces and avoidance in the late stage of attention.It suggests that the attentional bias of anxiety sensitivity individuals may have an important effect on the development of the mental disorders.

Objective To study the effect of blood glucose variation on gastric emptying and ghrelin expression in diabetic rats,and to explore the relationship between the delayed gastric emptying and the ghrelin expression in different diabetic stages.Methods Sixty Wistar rats were randomly divided into three groups:a normal control group(NC group),a diabetes mellitus group (DM group) induced by intra- peritoneal injection of streptozotocin (STZ),and an insulin-treated group (INS group).After one and four weeks the gastric emptying was measured by intragastric administration of phenol red and the expression of gastric ghrelin was determined by immunohistochemistry and semi-quantitative RT PCR.Results After one week of STZ injection,the gastric emptying,the ghrelin integral optical density and the ghrelin mRNA expression decreased significantly in DM group compared to those in NC group and INS group(P0.05).Conclusion Short term hyperglycemia delay gastric emptying through the reduction of gastric ghrelin expression,while long-term hyperglycemia may enhance the expression and release of gastric ghrelin to stimulate food intake and maintain energy balance.

Objective To primarily explore the efficacy and adverse effects of the combination of fiudarabine,cytarabine and granulocyte colony-stimulating factor(G-CSF)(FLAG regime)therapy for relapsed and refractory acute leukemia in children.Methods Ten children were treated with the FLAG regime for relapsed and refractory acute myeloid leukemia (AML)and acute lymphoblastic leukemia(ALL)from Feb.2007 to Mar.2010.There were 8 male and 2 female,with mean age 8 years(ranging from 4 to 12 years).AML was diagnosed in 8 children,AML-M2 in 5 cases,AML-M4 in 3 cases.ALL was diagnosed in 2 children,both were B-ALL.Six children had refractory disease,and 4 cases were in relapse.FLAG regime included:fludarabine 25 mg?m-2?d-1,days 1-5;cytarabine 2 g?m-2?d-1,days 1-5;G-CSF 150-300 ?g?d-1,from day 0 to neutrophils ≥0.5?109 L-1.Results Complete remission was obtained in 6 children(60%),partial remission was obtained in 1 child(10%),and 3 children were considered non-response(30%).The total effective rate was 70%.For 8 children with AML,6 children had achieved complete remission(75%),2 children had non-response(25%).While in children with ALL,1 child got partial remission,and the other one had non-response.Myelosuppression and infections due to neutropenia were the most frequent adverse effects,severe nonhematologic toxicity were not observed in these children.And there were no chemotherapy-related death.Conclusions The FLAG regime is effective in treatment of children with relapsed and refractory acute leukemia,especially for the children with the relapsed and refractory AML.The adverse effects from this regime were well tolerated.FLAG regime can give children with relapsed and refractory acute leukemia another chance.

? AIM: To investigate the differences between synoptophore and triple prism strabismometry and its possible cause.?METHODS: There were 347 patients with horizontal concomitant strabismus involved, in which 76 patients were esotropia, 37 patients were male while 39 were female, with average age of 13. 27 ± 7. 77 years old. There were 271 patients with exotropia, 131 cases were male while 140 were female, with average age of 15. 43 ± 8. 42 years old. All the patients were examined by synoptophore and prism plus shaded strabismometry in a long distance of 6m. Datas were analyzed by SPSS 17. 0.?RESULTS:In the exotropia patients, the conversions of circular degree(°) and prism degree(△) were:1°=0. 29△ ~1. 78△, which was statistically significant with intermittent strabismus (P=0. 001). While in the esotropia patients, the conversions were:1°=2. 01△ ~2. 15△.?CONCLUSION: The diversity between the two methods is enlarged with the increase of squint angle for exotropia patients. While in esotropia patients, the diversity decreased with the increase of squint angle. Synoptophore equipped with +7. 00D, defects of the triple prism itself and proximal convergence during exam may be the reasons for the diversity.

Objective:To have an experimental investigation on teaching reform of Orthopedics of TCM based on network resources.Method:Two comparison groups were set and observed when we were teaching the orthopedics students of 2003 grade.One was taught by traditional problem-based learning(PBL) method,the other was taught by PBL method based on network resources.Results:The creative thought and research ability of the students who had been taught by PBL method based on network resources were greatly improved.Conclusion:The teaching method based on network resources has so many advantages such as students being able to self-learn and research without time and space limit that it can be used more in medical students teaching.

Blindness ; epidemiology ; etiology ; prevention & control ; China ; epidemiology ; Humans ; Vision, Low ; epidemiology ; etiology ; prevention & control