ObjectiveTo analyze the results of implementing the tutorial system for medical interns, and to put forward some suggestions. MethodsThe medical interns and the doetors selected as tutors were asked to do questionnaires to study the tutorial system's feasibility and effectiveness. Simultaneously, we adopted the Objective Structured Clinical Examination ( OSCE ) to assess its process and resuits. Results74.3％ of the students and 75.5％ of the doctors think that they need the tutorial system,73.2％of the students think that this system can train better clinical skills,67.9％ of the doetors think that they can review the knowledge learned through teaching. Implemented after one year, students' OSCE scores are improved. ConclusionTutorial system for medical interns has achieved preliminary success, and the preparatory work and related-system building need to be further improved.

Objective To compare the results of emergency clinical training for medical students and to put forward some suggestions.Methods Toatlly 207 medical students of Grade 4 studied in the first people' s hospital of Shanghai Jiaotong university from 2009 to 2011 were divided into the traditional group (n =90 ) and the experimental group (n =117 ).The students in the experimental group participated in emergency clinical training in summer vacation while those in the traditional group did not.Questionnaires about their self-learning ability,clinical communicating ability and critical thinking ability after training the were conducted and the data were analyzed by descriptive statistical analysis.Results One hundred and five effective questionnaires were recovered from the experimental group,with the recovery rate 89.7％ and 62 effective questionnaires were recovered from the traditional group,with the recovery rate 68.9％.The scores about clinical communicating ability and critical thinking ability of the experimental group were significantly highcr than those of the traditional group [ (79.45 ± 9.354)vs.(75.87 ± 9.926),(263.38 ± 30.925 ) vs.(251.36 ± 23.679),P ＜ 0.05 ].However,there was no significant difference in scores about self-learning ability between the two groups [ ( 153.97 ± 23.725 ) vs.( 149.83 ± 13.891 ),P ＞ 0.05].Conclusion Emergency clinical training is helpful to improve medical students' clinical communicating ability and critical thinking ability.It is worth popularizing.

OBJECTIVE:To understand the drug use of sample hospitals,and to provide reference for drug production,man-agement and service department. METHODS:Statistical analysis was conducted in the data of drug use in national 1 248 sample hos-pitals during 4th quarter of 2012-3rd quarter of 2013. RESULTS&CONCLUSIONS:Anti-infection medicine,Chinese patent medi-cine,nervous system drugs has being ranked the top 3 in the list of consumption sum,and that of various drugs is in an upward trend. Top 20 drugs in the list of consumption sum mainly are biological products,drugs for the nervous system,digestive system drugs;that of human albumin and deproteinized calf serum have increased greatly. Top 10 imported pharmaceutical enterprises or joint ventures in the list of consumption sum mainly are multinational enterprises,and they are stable in ranking. The development of pharmaceutical enterprises should focus on brand,quality,price and service,etc.,so that their competitiveness can be improved.

Lymph nodes (LN)are the main parts of the esophageal cancer metastasis,and the current status of LN is the important indicator of prognosis.LN metastasis appears in early stage of esophageal cancer.One side,LN metastasis easily appears in the regions near the tumor and some special areas.On the other side,LN metastasis has the characteristics of wide metastasis and skip metastasis.Therefore,the researches of the pattern of esophageal cancer lymph node metastasis can help to comform the scope of the esophageal cancer lymph node dissection and the target regions of radiotherapy.

Objective To treat a group of patients with port wine stains (PWS) using a variable pulse width (VPW) frequency doubled Nd:YAG 532nm with high energy long pulse green (HELP G) laser and to evaluate the clinical efficacy, side effects and different histological changes between VPW and HELP G. Methods Thirty two patients with PWS were treated in order to study the clinical improvement by transforming from 11～16 J/cm 2 at 3 mm spot size (VPW,7～10 ms) gradually to 16～24 J/cm 2 at 4～5 mm spot size (HELP G,15～50 ms). Two patients were biopsied before and after the laser treatment.Results After treatment of 1～8 times(3.19 average), very good results were achieved in 7 PWS, and excellent results were achieved in 15 PWS.Improvement was found in 68.75 % of the patients.Conclusion VPW with HELP G laser at 532 nm appears to be an effective treatment for PWS.

Objective The aim of the paper is to investigate the alteration of the physical-chemical properties and disinfection effect of electrolyzed-oxidizing water during storage, and to provide theory support for its application. Methods A typical electrolyzed-oxidizing water was stored under a closed and light condition for 66 days and its physical-chemical parameters and disinfection effect were measured at fixed periods. Results The results showed that the chlorine loss of the electrolyzed-oxidizing water was quite fast and reached 50% and 100% after 10 days and 66 days of storage period respectively, the pH value was quite stable, from 2.5 to 2.47. The oxidation-reduction potential(ORP) of the water decreased slowly only from 1 146 mV to 1 100 mV within 45 day, but decreased rapidly after 45 days of storage. The results also showed that the inactivation of Bacillus subtilis var niger spores by the electrolyzed-oxidizing water also decreased rapidly after one week of storage,from 100%(the first week) to less than 90%(after 10 days). Conclusion The electrolyzed-oxidizing water can keep its strong disinfection effect after 7-10 days of storage. It was believed that the chlorine loss from the electrolyzed-oxidizing water was the main reason for the decrease of its disinfection effect during storage.

In this study,we observed that PGE2 3?10-7~3?10-6 mol/L & nifedipine 1 ?10-5mol/L inhibited lymphocyte proliferation markedly.The effect of nifedipine was completely reversible, however the effects of PGE2(3 ?10-6mol/L)was only partly reversible .In combination of PGE2(3?10-8mol/L) with nifedipine (1 ?10-6mol/L) ,the effect was additive,no significant antagonism and synergism were observed .PGE26? 10-6mol/L and nifedipine 1?10-3 mol/L directly inhibited maerbphage migration but no significant effect on PHA-induced MIF .Preincuba-tation with nefidipine did not influonce macrophage phagocytosis, but PGE2 slightly enhanced it. The results stated above strongly suggests that PGE2 may regulate cells interaction and Ca2+ is required during lymphocyte proliferation.

Objective To explore the outcome of acetabular fractures operative treatment. Methods 62 patients with acetabular fractures were enrolled in this study. According to classification of Letournel, fracture of posterior wall 13 cases, fracture of posterior column 9 cases, fracture of anterior column 5 cases, transverse fracture 4 cases, transverse fracture with fracture of posterior wall 6 cases, double column fracture 10 cases, fracture of posterior wall and posterior column 8 cases, fracture of T type 7 cases. Results 62 patients were followed-up for more than one year after operation. All cases had bone union without complications of the infection and sciatic nerve injury. Traumatic arthritis occurred in 2 cases, and the function of the hip-joint was limited in 3 cases. Conclusion Operative reduction and internal fixation can notably increase forward outcome of acetabular fractures.

Objective To compare the influence of different end-tidal concentrations of sevoflurane on transcranial electrical four-limb muscle motor evoked potential (MEP) monitoring. Methods Twenty ASA Ⅰ-Ⅱpatients aged 23-62 years undergoing craniotomy were enrolled. Triangular muscle, biceps brachii muscle, triceps brachii muscle, brachioradialis muscle, extensor digitorum communis muscle, abductor pollicis brevis abductor digiti minimi muscle, rectus femoris muscle, tibialis anterior muscle, gastrocnemius muscle and abductor hallucis were selected for MEPs recording. Sevoflurane was introduced at 0.5, 0.75, 1.0 and then 1.3 MAC (15 min each), and the effects on MEPs were studied. Results ①Maximum MEP amplitude was observed at abductor pollicis brevis muscle in upper limb and abductor hallucis muscle in lower limb at baseline and 0.5 MAC. Up to 1.0 MAC, there was no significant difference in MEP amplitude among extensor digitorum communis muscle, abductor pollicis brevis and abductor digiti minimi muscle. ②The success rate of MEP recording from abductor pollicis brevis muscle and abductor hallucis muscle was 100% during the administration of 0.5-1.0 MAC sevoflurane. ③The MEP amplitude was decreased and the latency was increased in a sevoflurane dose-dependent manner. Conclusions Abductor pollicis brevis muscle and abductor hallucis muscle were suitable for MEP monitoring during the administration of 0.5-1.0 MAC sevoflurane.