The medical curriculum which is designed reasonable, plays a decisive role in the training specifications and quality of medical talents. The medical education in England is always in the world first column, and its medical curriculum is distinctive. The courses are mostly offered by the form of integration. They pay more attention to the setup of selective courses, humanities and social sciences courses, and they also put emphasis on the early clinical contact and early scientific research training. In addition, they are also outstanding in practice and internship. There is much beneficial enlightenment for our country's course reform from the British medical curriculum design, namely to establish integration courses which is interdisciplinary, to strengthen the humanistic quality's cultiva-tion, to advocate early clinical contact and early scientific research, and to strengthen cooperation and coordination between medical colleges and social organizations in all aspects.

With the growth of people's living standard,the prevalence of childhood obesity is increasing year by year.Meanwhile,the adverse effect caused by obesity occurred more frequently as well.Therefore,obesity in childhood has become a critical issue in public health area.Complications of obesity may lead to enormous implications on children,including their endocrine,cardiovascular,digestive system,etc.,which will have an impact on the body growth in the adolescence.Obesity not only has a huge threat to children's physical and psychological health,but also has a long-term effect on body health condition in the future.Consequently,it is significant to diagnose the occurrences of complications of children,and implement the guiding and curing at an early stage.

OBJECTIVE:To provide information about the current situations and trend of development in Chinese phar?maceutical trade.METHODS:We have generally overviewed the basic situation and existing problems in Chinese pharmaceu?tical trade and analysed and discussed its trend of development in the future.RESULTS&CONCLUSION:Chinese pharma?ceutical enterprises must think highly of their existing problems and the chances and challenges after entry into WTO,and take corresponding countermeasures to continually strengthen and improve their power of competition and jointly keep Chinese pharmaceutical trade healthy,constant and stable development.

The growing trend of childhood obesity has attracted much attention globally.Overweight and obesity are not only popular in developed countries,but have spread to developing countries.China has entered an overall epidemic stage of childhood obesity.Studies have shown that obesity does not only impairs children's health,but also leads to health hazards in adult stage.Diabetes,coronary heart disease and other cardiovascular diseases may take place sooner or the incidence may become higher.The causes of obesity include genetic,early life events,physical activity patterns,diet and social psychological factors.This article reviews the current epi-demic status and the influencing factors of childhood obesity worldwide.

Due to the restriction of the specific situation in China and the concrete conditions of universities,Problem-based learning teaching method failed to gain its popularity in medical education in China.In the era of information globalization,the web-based teaching method relying on the network and taking the PBL as the dominant has many advantages and there is nothing comparable to this.To establish a network of PBL platform in the area of medical education will provide medical education with a new chapter.

Ojective To determine the risk factors and the clinical distribution of multiple drug resistant bacteria in stroke- associated pneumonia (SAP) patients with multiple drug-resistant bacterial infections from in-tensive care unit, providing guidance for clinical treatment of SAP. Methods A retrospective study was de-signed to analyze the clinical data of the SAP patients from January 2012 to December 2015. Univariate analysis and multivariable regression analysis were taken for risk factors of MDR infections , and investigated the distribu-tion and drug resistance of MDR. Results There were 183 SAP patients, of which 131patients (71.6%) had MDR infection. There are 193 MDR strains in the 131 patients , the first 5 MDR strains were Acinetobacter bau-mannii, Pseudomonas aeruginosa, Klebsiella pneumoniae, Staphylococcus aureus and Escherichia coli. MDR in-fection is highly associated with sever unconsciousness , time of stay in ICU longer than 7 days , ventilator time longer than 7 days and late-onset pneumonia and the difference was significant (P < 0.05). Conclusion SAP patients with MDR bacterial infections are in association with the following risk factors: sever unconsciousness , time of stay in ICU longer than 7 days, ventilator time longer than 7 days and late-onset pneumonia. The rate of MDR bacterial infections was high , and these MDR strains were widely different degrees of resistance to many antibiotics.

Objective To observe the effects of Ulinastatin on pulmonary vascular endothelium permeability and respiratory function in patients with extrapulmonary acute respiratory distress syndrome(ARDS exp). Methods The data of 39 patients with ARDS exp were retrospectively analyzed.According to whether treated with Ulinastatin or not, all patients were divided into Ulinastatin group(n = 21)and control group(n = 18); The level of extravascular lung water index (EVLWI), pulmonary vascular permeability index(PVPI) and respiratory function were measured before and after the treatment. Results The mortality rate of Ulinastatin group was lower than that of control group (28.6% vs 38.9%). The time of decreasing EVLWI, PVPI and improving PaO2/FiO and respiratory function in Ulinastatin group was shorter than that of control group, and the effect was superior. Conclusion Ulinastatin could reduce EVLWI and PVPI, improve pulmonary compliance and oxygenation, and reduce mortality rate in patients with extrapulmonary acute respiratory distress.

Education reform and innovative education are the strong requirements of the times and social development.We developed immunological paper free examination system based on the optimized question bank,characteristics of immunological examination and information technology.This system can randomly develop electronic examination paper and can integrate the processes of exam registration,examination paper development,online examination,paper inspection,scores generation and printing into one system,which can save human resources,enhance the accuracy and fairness of the examination,making it conform to international standards.

Objective To analyze the relation between calcium and phosphate metabolism and the death for cardiovascular disease in continuous peritoneal dialysis patients.Methods60 peritoneal dialysis patients from our hospital were collected from July,1999 to December,2007 were divided into two groups by the death causes:the death cause for CVD group and the death cause for non-CVD group,and then compare their gender、age、time for dialysis、difference for pulse pressure(PP)、the content of Ca、P、Ca?P and PTH in serum.Results There are 28 cases in CVD group(47%);there are 32 cases in non-CVD group(53%).There are not differences for age、gender、time for dialysis and serum calcium between two groups;there are significant differences for PP、serum phosphorus、Ca?P、PTH between two groups.ConclusionThe high value for phosphorus、Ca?P and PTH in serum are closely related to the death cause for CVD in continuous peritoneal dialysis patients,which are the main dangerous factors in the death cause for CVD.

Dietary surveyis a method to evaluate whether dietary intake meets body requirements by recording food consumed during a certain period.Widely-used dietary survey methods include:24 h dietary recall,dietary record,food frequency questionnaire and dietary history questionnaire.Since each method has its own advantages and limitations,researchers need to choose appropriate methods according to research purposes,accuracy requirements,availability of resources,etc.Obese children who are the focus and the major difficulty in dietary survey,it is important to choose an appropriate survey method.This article reviews widely-used dietary survey methods and evaluates them in the study of obese children related dietary surveys.