ObjectiveThis paper aims to probe into the effect of working and studying combined teaching reform of chnical medicine major.MethodsTwo classes containing 46 students respectively were selected at random as observation group and control group,from the six classes of Grade Two majoring in clinical medicine.The two groups of students were trained by adopting working and studying combined teaching model and traditional teaching model respectively,after which they were evaluated in terms of clinical theory,practical skills and operations,and exercitation achievement.ResultsThe observation group does better in practical skills and exercitation achievement than the control group,while they have no difference in clinical theory.ConclusionWorking and studying combined teaching model can improve students' clinical analytical ability,strengthen their awareness of medical morals,and help them achieve more in exercitation.

Objective To explore effect of immune function of children with EB virus infectious mononu-cleosis (IM). Methods From Sep. 2011 to Jun. 2013, a total of 62 cases of children with IM were analyzed retrospectively. The proportion of T-lymphocyte subsets ,B-lymphocytesand and NK cells in EBV-DNA group with positive and negative were compared. Results The numbers of IM EBV-DNA-negative cases were 18 (29.03%), the numbers of IM EBV-DNA-positive cases were 44(70.97%), the averages of EBV-DNA in positive group is 6.1 × 103/mL. CD3+,CD8+cell ratios in IM children are significantly higher than control group (P<0.01), CD4+, CD19+cell ratios are significantly lower than control group (P<0.01), NK cells are not significantly different (P>0.05). In the IM children, CD4+, CD19+cells in DNA-positive group are significantly less than DNA-negative group (P<0.01), CD8+cells are higher than DNA-negative group (P<0.05), NK cells are not significantly different (P>0.05). Conclusions Positive blood EBV-DNA is closely related to changes in T-lymphocyte and B-lymphocyte, but isn′t obviously related in NK cells. So effect of EB virus in IM child have certain clinical values to judge the severity and prognosis.

Objective To explore the effects of progressive relaxation training on the nailfold microcirculation for psychological stress state population .Methods According to the mental health screening criteria ,60 cases of psychological healthy individuals were selected as the research object ,took the attention distribution test as psychological stress stimulation ,test self rating anxiety scale(SAS) and nailfold microcirculation function changes of test before and after stress .60 cases were divided into intervention group and normal control group ,30 cases in each group .The intervention group adopted progressive relaxation training intervention after stress ,while normal control group taking natural rest ,then detected the change of nailfold microcirculation .Results The SAS level and the nailfold microcirculation parameters before and after stress between the two groups were significantly different (P<0 .05);the difference of nailfold microcirculation morphological integral and the total integral between the two groups were statisti-cally significant(P<0 .01);and there were no difference on flow integral and around the loop integral between the two groups (P>0 .05) .Conclusion Progressive relaxation training can effectively improve the microcirculation state of the psychological stress a-mong people ,under certain conditions ,the effective intervention to the stress state population can influence the microcirculation .

Objective To explore the rule of early Jun’ expression in craniocerebral gunshot injury and its significance. Methods After a direct shot of the dog′s head with a small calibre rifle, the expression of Jun ′ protein was assayed by immunohistochemistry method at different periods and in different regions, and the water contents and the ultrastructural changes in brain tissue were also observed. Results Nearly no Jun expression was found in cerebral tissues of the control group. However, the Jun expression was first observed begun at 30min postinjury both at the regions of contusion and concussion ( P

Anterior cruciate ligament (ACL) has two important functional roles, including biomechanics and proprioceptive sense. A groat propr!oceptive sense is a basis to exactly obtain highly functional exercise. ACL injury may block perception and conduction information and seriously influence motion and daily activities. A complete rehabilitation of ACL function depends on rehabilitation of both mechanical structure and proprioceptive sense. Therefore, reconstruction of joint function following ACL injury is focus on reconstruction of both joint biomechanical stability and proprioceptive sense. This study was designed by distribution and function of proprioceptive sense to analyze the altemation of propdoceptive sense following ACE injury, and to investigate the related factors and ways for rehabilitation of propriocaptive sense following ACL reconstruction.

Objective To explore the elasticity of carotid artery in children with simple obese by echo tracking imaging technique.Methods Intima-media thickness (IMT), resistent index (RI), pulsatility index(PI ), the ratio of systolic phase and diastolic phase(S/D ) of common carotid artery (GCA) were detected differently in 50 simple obese children (obese group) and 50 normal children (control group) by CDFI.Internal systolic diameter (Ds), internal diastolic diameter (Dd),pressure-strain elastic moduhs(E ρ ), stiffness parameter ( β ), arterial compliance (AC), augmentation index (AI), pulse wave velocity ( PWV β ) were calcuhted automatically by means of echo tracking system.Results There was no significant difference in Ds,Dd,RI, PI,S/D and AI'between two groups (P >0.05).In obese group, IMT was significantly thicker,E ρ,β, PWV β were significantly higher,and AC was significantly lower thon those in control group (P < 0.05).Conclusions It has alteration of early atherosele in carotid artery of simple obese children.Echo tracking imaging technique is a quick, noninvasive, accurate and quantitative evaluating method for the elasticity of carotid artery.

Objective To evaluate four tumor markers of insulin-like growth factor 1((IGF-1), CEA, cytokeratin fragment antigen 21-1 (CYFRA21-1), neuron-specific enolase (NSE) for the diagnosis and prediction of treatment response in human lung cancer. Methods Serum samples were taken from three groups: 91 patients with lung cancer, 30 healthy adults and 15 patients with benign pulmonary diseases. Serum IGF-1 was assayed by radioimmunoassay and CEA, CYFRA21-1, and NSE by electrochemiluminescence immunoassay. The differences among the three groups were determined by Kruskal-Wallis one-way analysis of variance (ANOVA) and with Mann-Whitney rank-sum test. Diagnostic efficacy was evaluated by ROC curves. Results The four serum tumor marker levels were significantly higher in lung cancer group, as compared with the benign and the healthy (IGF-1:χ2=26.95,P<0.001, CEA:χ2=49.11,P<0.001; CYFRA21-1:χ2=40.63,P<0.001; NSE:χ2=14.76;P<0.001). The diagnostic sensitivities of IGF-1, CEA, CYFRA21-1 and NSE was 75.6% (34/45), 53.3% (24/45), 66.7% (30/45) and 42.2% (19/45) respectively for lung cancer. The diagnostic sensitivity of IGF-1 combined with CYFRA21-1 was 95.5 %( 43/45) and that of IGF-1 combined with CEA and CYFRA21-1was 97.8%(44/45). Only IGF-1 and CYFRA21-1 showed significant changes before and after treatment (IGF-1: χ2=5.99,P=0.014; CYFRA21-1:χ2=4.99, P=0.025) in cancer group. Conclusions Serum IGF-1, CEA, CYFRA21-1 and NSE are all valuable for lung cancer diagnosis and the combination of those parameters can enhance the diagnostic efficiency. Serum IGF-1 and CYFRA21-1 may also be useful for evaluating the treatment response in lung cancer.

Objective To study the development of medical imaging in Shandong province and identify existing problems. Methods 378 secondary hospitals and above were surveyed with questionnaires and other means for a general picture of their radiology departments. The survey covered medical imaging examinations, human resources and equipment configurations. Results The recent five years have found a rapid growth of a variety of medical imaging examinations, digital imaging in dominance, high-end equipments as the mainstream, sufficient staffing, shortage of high-level talents in these hospitals. Conclusion The medical imaging examinations should be regarded as justified and reasonable, the competence of hospital staff should be upgraded, and operation of medical imaging examinations should be normalized.

Objectives To evaluate the methodology of preoperative diagnosis for Mirizzi syndrome. Methods Fifteen cases of Mirizzi syndrome were retrospectively investigated. The data of semeiology and imaging including B-type ultrasound, endoscopic retrograde cholangiopancreatography (ERCP) and MR cholangiopancreatography (MRCP) were compared with each other and analyzed. Results Preoperative data were consistent with and suggestive of Mirizzi syndrome in 93% (14/15) of cases, and in 67% (10/15) of cases, respectively. Conclusions Preoperative B-type ultrasound is the primary examination. ERCP and MRCP further elevate preoperative definite diagnosis. In patients with preoperative tentative diagnosis of Mirizzi syndrome, jaundice lasting for more than 7 week is suggestive of cholecystocholedochal fistula.

ObjectiveTo investigate the relationship between KAI1/CD82 protein expression in human hepatocellular carcinoma (HCC) and invasion and metastasis.MethodsSpecimens from primary hepatocellular carcinoma (155 cases), tumorous emboli (22 cases), intrahepatic satellite metastases (4 cases), extrahepatic metastases (16 cases), and normal livers (5 cases) for which a tissue microarray was constructed and used for immunohistochemical detection of KAI1/CD82 protein expression. ResultsImmunohistochemical analysis of tissue microarrays demonstrated KAI1/CD82 protein expression in 61%(95/155)of the primary HCCs and only in 32%(7/22) of the tumorous emboli ( P