Objective To compare the advantages and disadvantages between the discussion teaching round model and the traditional round model in the tralning of medical graduate students. Methods 38 and 41 medical graduate students were practicing under the discussion teaching round model and the traditional round model in our hospital from Jan 2012 to Dec 2012. The questionnalre and the Clinical Skill Test were used to evaluate the teaching effect. The t test group design was used to make comparison between group mean. Results Compared with the traditional round model group, the discussion teaching round model group had higher evaluation to the teaching methods, consciousness of participation, the rounds impressions and clinical thinking cultivation, with statistically significant difference (P<0.05). The total score of the Clinical Skill Test was higher in the discussion teaching round model group than the traditional round model group[(86.4±4.8) vs (78.2±6.4), P=0.02]. Conclusion The discussion teaching round model can improve the quality of clinical practice and is an effective method for the education in medical graduate students.

Objective To establish the method of content determination of chlorogenic acid in Shuanghua eardrop. Methods High performance liquid chromatography (HPLC) was adopted with Kromasil C18 column (5 ?m,4.6 mm?250 mm) and acetonitrile-0.4% phosph acid solution (10∶85) as the mobile phase. The detective wavelength was 328 nm,the flow rate was 1.0 mL/min,column temperature was room temperature. Results Average recovery was 99.8%,relative standard error was 1.51% (n =5). Conclusion The linearity relationship of chlorogenic acid was good at the range of 0.102 4～0.061 44 ?g.

Objective To develop a method for simultaneous determination of 4 compounds in Zhizhu Pills by HPLC.Method Reversed-phase HPLC was used to determine the content of the compounds such as hesperidin,naringin,neohesperidin and atractylenolideⅠ.The column was symmetry C18(250 mm?4.6 mm,5 ?m) with temperature of 30 ℃.Methanol-0.095 %phosphoric acid solution served as the mobile phase by gradient elution.The wavelength of detection was set at 283 nm and 224 nm.The injection volume was 10 ?L and the flow rate was 1.0 mL/min.Results Hesperidin,naringin,neohesperidin and atractylenolideⅠin Zhizhu Pills can be isolated completely.Three batches of samples were determined and the recoveries of naringin,hesperidin,neohesperidin and atractylenolideⅠwere 98.81 %(RSD=1.11 %,n=6),100.63 %(RSD=1.90 %,n=6),99.32 %(RSD=1.44 %,n=6) and 99.65 %(RSD=1.53 %,n=6) respectively.Conclusion This method is accurate,reliable and with good reproducibility.It can be used for the quality control of Zhizhu Pills.

Objective To investigate the weight,length and scale of normal children′ stools and discuss clinical signification.Met-(hods) The fresh stools of 60 normal children (male 34,female 26)were measured,classify the stools according to Bristol′s scale.Results 1.The average weight of stools in 60 cases was (109.53?52.00) g,of male was (123.79?55.87) g,of female was (90.12?(39.66)) g,there was significant difference between them (t=0.013 P0.05);3.The stools was classified into 7 group according to Bristol′s scale.From 1 grade to 6 grade were 3.30%,(5.10%),5.10%,64.40%,15.30% and 6.80%,respectively,but there was no 7 grade stools.Conclusion The weight,length and scales of normal children′s stools can be used as a sign to evaluate the clonic movement of children,especially in diagnosis and treatment of constipation and stools dryness

Objective To investigate the relationship between diabetes and bone metabolism and the potential epigenetic mechanisms. Methods BMSCs were cultured for 7 and 15 days in cell culture medium with different concentrations of glucose. The mRNA and protein expression of HDACs and osteogenesis-related genes were detected by RT-PCR and Western blot assay ,respectively. Moreover ,the combination of HDAC to the promoter region of Runx2 was tested by the chromatin immunoprecipitation (ChIP) assay. Results ThemRNA expression of osteogenesis-related genes ,incuding OCN(P < 0.05)and Col1(P < 0.05),in the bone marrow of diabetic mice was significantly reduced compared with the control mice. The mRNA and protein expression of ALP ,OCN ,Runx2 and OSX was gradually reduced with the increasing concentration of glucose ,while HDAC2 mRNA and protein expression was increased. The binding activity of HDAC2 to the upstream and downstream of Runx2 promoter region in 25mM glucose-treated BMSCs was higher than the control group(P < 0.05). Conclusoins Diabetes might repress osteogenesis of BMSCs via inhibiting the activity of Runx2 through upregu-lating the expression of HDAC2.

Objective To investigate the effect of dexmedetomidine combined anesthesia on postoperative delirium in the elderly patients undergoing hip joint replacement.Methods One hundred and sixty ASA Ⅱ or Ⅲ patients,aged 75-85 yr,with a body mass index of 20-25 kg/m2,scheduled for elective total hip joint replacement under general anesthesia,were randomly divided into 2 groups (n =80 each):sevoflurane-fentanyl control group (group C) and dexmedetomidine-sevoflurane-fentanyl group (group D).Dexmedetomidine was intravenously infused at 0.2 μg· kg-1 · h-1 until the end of operation after a loading dose of 0.6μg/kg over 15 min before induction of anesthesia in group D,while the equal volume of normal saline was infused in group C.Anesthesia was induced with iv injection of fentanyl 2-4 μg/kg and etomidate 0.1-0.3 mg/kg at 5 min after the end of administration of the loading dose.Tracheal intubation was facilitated with cisatracurium 0.15 mg/kg and the patients were mechanically ventilated.Anesthesia was maintained with target-controlled inhalation of sevoflurane (the end-tidal concentration 1％-3％) and intermittent iv boluses of fentanyl 0.05 mg.BIS was maintained at 40-60 during operation.The consumption of etomidate,fentanyl,and sevoflurane,agitation during emergence from anesthesia,and postoperative delirium within 24 h after operation were recorded.Results Compared with group C,the consumption of etomidate,fentanly,and sevoflurane was significantly reduced and the incidences of agitation during emergence from anesthesia and postoperative delirium within 24 h after operation were significantly decreased in group D (P ＜0.05).Conclusion Dexmedetomidine combined anesthesia can reduce the occurrence of postoperative delirium in the elderly patients undergoing hip joint replacement.

Objective To evaluate the effect of dexmedetomidine on intraoperative wake-up test in patients undergoing scoliosis surgery.Methods Sixty ASA Ⅰ patients,aged 13-18 yr,scheduled for elective scoliosis surgery,were randomly divided into 2 groups (n =30 each) ∶ sufentanil group (group S) and dexmedetomidine combined with sufentanil group (group DS).Anesthesia was induced with sufentanil,etomidate and cisatracurium,and maintained with target-controlled inhalation of sevoflurane combined with target-controlled infusion of sufentanil in both groups.In group DS,dexmedetomidine 0.2 μg·kg-1 · h-1 was infused during operation,while the equal volume of normal saline was given instead in group S.Before the wake-up test,cisatracurium infusion was stopped,the end-tidal concentration of sevoflurane was adjusted to 0,and the target effect-site concentration of sufentanil was adjusted to 0.1 and 0.08 ng/ml in groups S and DS,respectively.The wake-up test was performed 5 min later.The wake-up time and bucking/restlessness and cardiovascular events during the wake-up test were recorded.The occurrence of intraoperative awareness was recorded in the patients who were followed up after operation.Results No cardiovascular events occurred during the wake-up test in group DS.The wake-up time was significantly shorter and the incidences of cardiovascular events and bucking/restlessness were significantly lower in group DS than in group S (P ＜ 0.05).No intraoperative awareness occurred in the patients.Conclusion Dexme-detomidine can be used for intraoperative wake-up test in patients undergoing scoliosis surgery,with shorter wakeup time,stable hemodymamics and fewer adverse reactions.

Objective To randomly compare the therapeutic effect and safety between Levetiracetam (LEV) and Phenobarbital (PB) in the treatment of neonatal seizures.Methods A total of 61 infants with acute convulsion were randomly divided into 2 groups:LEV group (n =30) and PB group (n =31) during January 2013 to December 2014 in Urumqi Children's Hospital.All neonates received routine management including etiology treatment and adverse drug reaction monitoring.In the LEV group,subjects received oral formulation of LEV with initial loading dose 30 mg/kg,followed by 15 mg/kg twice a day.If the seizures were not controlled completely,PB treatment was added until seizures were completed controlled.If seizures were controlled quickly,the dose of PB was gradually reduced and LEV was used as monotherapy.The subjects in PB group received intramuscular or intravenous injection of PB with 10 mg/kg as the first dose,then 5 mg/(kg · d) oral PB was administered,if seizures were not controlled,LEV treatment was added,then dose of PB was gradually reduced until seizures were controlled completely,and then patients were switched to LEV monotherapy gradually.The drug adverse reactions were observed.Results (1) After LEV or PB monotherapy,66.7％ (20/30 cases) and 54.8％ (17/31 cases) of the subjects obtained sustainable seizure free respectively.Although,there was a higher control ratio in LEV group,but no significant difference was observed between the 2 groups (P ＞0.05).(2) LEV group (16/30 cases,53.33％) had higher rapid seizure control ratio with seizure controlled within 24 h after first dosage administration than that of PB group (8/31 cases,25.80％),and there was significant difference (x2 =4.841,P =0.028).Further more,if adding the cases who had to change to use another comparative one (LEV or PB) due to their seizures failure control with the first one treated,LEV group (21/44 cases,47.72％) still had higher rapid seizure control ratio in total patients than that of PB group(10/41 cases,24.39％),and there was significant difference (x2 =4.988,P =0.026).(3) Eight cases who changed to LEV after PB as the first treatment drug failed obtained sustainable seizure free.(4) One case in PB group with transient urinary retention was observed but the symptom disappeared 36 h after PB withdrawal,and no significant drug adverse reaction was observed in LEV group.Conclusion LEV is more rapid and safe for seizure control of neonates than PB.

Objective To explore the correlation between caring behavior and critical thinking of nursing students in clinical practice. Methods Totally 203 nursing students in clinical practice were investigated with Critical Thinking Disposition Inventory- Chinese Version (CTDI- CV) and Caring Behavior Scale (CBS). Results The structural model obtained a good fit. Critical thinking and caring behavior were positively correlated with each other(β=0.46,P<0.01). Conclusions Nursing students′caring behavior could improve their critical thinking. With the cultivation of critical thinking of nursing students, nursing educators should pay attention to improving their caring behavior.

Ebola hemorrhagic fever is an acute infectious disease caused by Ebola virus,the mor-tality rate of which is up to 90% . Due to its high infection rate,high mortality rate as well as being a serious threat to public health and safety,Ebola virus is listed as a World Health Organization Risk Group 4 Patho-gen(requiring Biosafety Level 4-equivalent containment). However,there is no effective control method and treatment for Ebola virus infection. Different approaches have been used to develop vaccines and therapeutic drugs against Ebola virus infection and clinical trials of some products have been initiated,such as ZMapp, BCX-4430,GS-5734,DNA vaccines,and adenovirus vector vaccines. National Institutes of Health(NIH) announced a successful development of vaccine for Ebola virus which had passed the clinical trial by the end of 2014. At the meantime,the first anti-Ebola virus medicine had also been approved in China for emergency use only. Recent advances in the research and development of therapeutic drugs and vaccines against Ebola virus will be described in this review.