Improving medical students' legal quality is not only the requirements of modern education and their self-improvement,but also the needs of reform on medical system in the new era and establishment of a harmonious relationship between doctors and patients.Medical universities should carefully integrate the existing law education resources and establish three staged teaching model (stages of basis law education,health law education and stage of comprehensive improvement) when being fronted with the education model which is unilateral,sporadic and lack of cohesion in order to improve the law quality of medical students.

OBJECTIVE: To evaluate the current situation and the trend of cardiovascular drugs used in 6 cities in the Yangtze river valley between 2002 and 2004.METHODS:Consumption of cardiovascular drugs used in 157 hospitals of 6 cities in the Yangtze river valley were analyzed by the way of sum and DDDs ranking. RESULTS:The total annual cost of the cardiovascular drugs used in 6 cities was 13.6 billion yuan in 2004, increasing by 58.8%, as compared with that in 2002.The total average consumption of anti-anginal and vasodilating agents, antithrombotic agents and antihypertensives accounted for 84.1% of the total cost in 3 years.CCB, ACEI, Nitrate esters,?-blockers and Chinese medicines dominated in the ranking of sum and DDDs.CONCLUSION: Right medicines with higher patient compliance rates, lower ADR occurrence, more certain therapeutic effect and economical daily cost have become the preferable choices for clinical physicians.

Primary liver cancer is one of the common malignant tumors.However, the efficacy of traditional treatments is not satisfactory.RNA interference is a new treatment method, which develops rapidly in recent years.It has been found that RNA interference can exert the anti-tumor effect through inhibiting the growth and proliferation of hepatocarcinoma cells, promoting apoptosis, inhibiting the invasion and metastasis of hepatocarcinoma cells, inhibiting angiogenesis and overcoming the resistance to chemotherapy.

OBJECTIVE:To analyse the current situation and developing trend of consumption of cardiovascular drugs in Nanjing district,so as to provide information for the research,production,sale and application of these drugs METHODS:According to the order of sum of money,the purchasing information of the drugs used for cardiovascular diseases in 19 hospitals in Nanjing district between 1997～2001 were analysed RESULTS:The sum of money of the drugs used for cardiovascular diseases in 19 hopsitals in Nanjing district was increased more than twice in 5 years,and the consumption of anti-anginal and vasodilating agents,antithrombotic agents and antihypertensives occupied first three places in the category all the time In recent three years,calcium antagonists have occupied the front three places in the category CONCLUSION:With the increase of old age people's proportion in our country,the market requirement is enormous and the prospects for exploitation are capacious for the drugs used for cardiovascular diseases

Objective Present study aimed to research the mechanism of the use of 0.2% brimonidine tartrate eye drops in the treatment of optic nerve crush injury of rat.MethodsAnimal models of optic nerve crush injury were created in 60 SD female rats by clipping the exposed optic nerve at 2 mm in retrobulbar for 6 seconds with 78 grams of reverse forceps.The successful model was identified as Marcus-gun pupil without bleeding of fundus after operation.The animals were randomly assigned to model group and brimonidine treating group,and another 30 normal SD rats were used as the normal control group.The 0.2% brimonidine tartrate eye drops was topically administered at 2 hours before operation and after operation twice per day in the brimonidine treating group.The retinas from 18 rats were isolated after 3,7,21 days for RGCs counting by H&E staining,and the retinal ultrastructure was examined under the transmission electron microscope.The retinas from the other 72 SD rats (including normal,model and brimonidine groups) were prepared for the detection of bcl-2 and bax using immunohistochemistry l,3,5,7,14,21 days after the operation.ResultsNormal and almost normal retina structure was exhibited in rats of the normal group and brimonidine treating group,but disorder of cellular arragement and decrease of retinal thickness were found in the model rats under the optical microscope.The RGCs counting was significantly different among the three groups from 3 days through 21 days after operation with the considerably declination in the model group and brimonidine treating group compared with the normal control group (P＜0.05-0.01).However,that of the brimonidine treating group was obviously increased in comparison with the model group (P＜0.01).The expression of bax in rat retina was obviously reduced (P＜0.01),but the expression of bcl-2 was increased in brimonidine group compared with the model group from 5 through 7 days after operation (P＜0.01).ConclusionThe 0.2% brimonidine tartrate eye drops has a preventive effect on optic nerve crush injury of rat,and its inhibition on apoptosis is one of the mechanisms.

Objective To observe the effects of physical agents therapy on serum hs-CRP, TNF-α andadiponectin in patients with cerebral infarction and the possible underlying mechanisms. Methods Sixty patientswith cerebral infarction were randomly and equally divided into two groups: 30 cases were treated with physical a-gents therapy ( physical therapy group) , and 30 with drugs only ( drug treated group). Thirty normal subjectsserved as the control group. The level of hs-CRP in the serum was determined by latex agglutination reaction, TNF-and adiponectin were determined by using ELISA before and after therapy. Results The levels of serum hs-CRP and TNF-α of patients with cerebral infarction before therapy were much higher than those of the control group,but adiponectin was significantly lower than those of the control group( P < 0.01 ). After therapy, the levels of ser-um hs-CRP and TNF-α were decreased and adiponectin was increased significantly in both treated groups ( P <0.01 ). Comparison with two treated groups showed that the levels of hs-CRP and TNF-α were lower and adiponec-tin was obviously higher in physical agents therapy group than those in the drug treated group ( P < 0.05 ). Con-clusion The patients with cerebral infarction have low level of serum adiponectin. Physical therapy might exertbeneficial effects on patients with cerebral infarction by the decreasing serum hs-CRP and TNF-α, as well as by ele-vating adiponectin.

Objective To develop a beam orientation optimization algorithm for the gantry orientation in three-dimensional conformal radiotherapy(3 DCRT).Methods Patients' data were imported from the Pinnacle v 7.2 treatment planning system.including the DICOMRT and dose distribution files.These imported files were merged using a uniforiB coordinate system.The algorithm determined the optimized beam weight for each beam group and optimized the beam orientation with genetic algorithm.The optimized parameters,including the optimized beam orientations and weights,were exposed back to the Pinnacle v 7.2 to compare with the conventional 3DCRT plan.The optimized algorithm was implemented with our in-house program. The dose distributions, the DVH diagram and the conformity index of two lung cancer patients were compared. Results for the two lung cancer patients,the conformity index of the optimized plan(0.59 and 0.7)was higher than the conwentional 3DCRT plan(0.36 and 0.58).The maximum dose in spinal cord was reduced by 17.8%and 22.4%,the lung V20 reduced by 3.12%and 4.35%,and V30 reduced by 4.47%and 1.49%.For the brain tumor patient. the dose of lens and eyes was also decreased significantly. Conclusion This beam orientation optimization can be used as an assistant planning tool.

Objective To explore the value of serum ischemia modified albumin (IMA) level in assessment of disease severity for patients with chronic obstructive pulmonary disease (COPD).Methods A total of 81 cases of patients with COPD treated in our hospital from September 2015 to March 2016 were selected (COPD group),including 51 cases of patients with acute exacerbation of COPD and 30 cases of patients with stable of COPD.Meanwhile,30 volunteers without COPD were collected as control group.Serum levels of IMA were detected and compared among different groups.Correlations between serum level of IMA and serum level of myoglobin (MYO),troponin T (TNT) and C reactive protein (CRP),and white blood cell (WBC) count were analyzed respectively.A receiver operating characteristic (ROC) curve was also plotted to investigate the diagnostic value of serum IMA level for diagnosing COPD.Results Serum level of IMA in the COPD group was higher than that in the control group [84.1 (79.1,88.5) U/L vs.73.1 (70.2,75.1)U/L],serum level of IMA in patients with acute exacerbation of COPD was higher than that of patients with stable of COPD [85.5 (82.3,89.4)U/L vs.78.1 (75.9,83.0)U/L],serum levels of IMA in patients with acute exacerbation and stable of COPD both were higher than that in the control group,there were statistically significant differences (P＜0.05).The serum level of IMA was positively related with serum level of MYO in patients with COPD (r=0.554,P =0.00).ROC curve indicated when the cutoff value was set as 76.55 U/L,the sensitivity and specificity of serum level of IMA for diagnosing COPD was 88.5％ and 80.0％ respectively,and area under the ROC curve was 0.88.Conclusion Serum level of IMA could be a valuable indicator for clinically assessing disease severity of patients with COPD,which deserves further study through expanding samples size.

Objective To analyze the endoscopic features of patients with the lower esophageal sphincter (LES) and crural diaphragm (CD) separation and explore its significance in hiatus hernia (HH) diagnosis.Methods From January 2011 to June 2012,the data of patients underwent esophagus high resolution manometry (HRM) examination were retrospectively analyzed and of which the patients with LES-CD separation were selected.Patients who received digestive tracts operation or lack of complete endoscopic date were excluded.A total of 93 cases were enrolled for analysis.According to Chicago Criteria,the cases were divided into three groups.There were 21 cases in type Ⅰ group (LES-CD separation＜1 cm),37 cases in type Ⅱ group (LES-CD separation≥l cm and ＜2 cm),35 cases in type Ⅲ group (LES-CD separation≥2 cm).The differences among groups in endoscopic features were analyzed.HRM were taken as golden standard,the sensitivity and specificity of endoscopy in HH diagnosis were analyzed.Measurement data were expressed as x ± s,one-way ANOVA was performed for multi-groups comparisons,LSD method or Dunnett T3 test for pairwise comparisons and chi-square test or Fisher's exact test for two groups' comparisons.Results There were no significant differences in the distance between esophagus gastric junction (EGJ) and foreteeth of the three groups (P＞0.05).Distances between EGJ and diaphragmatic HH pressure impression in type Ⅲ group,type Ⅱ group and type Ⅰ group were (3.57±0.78) cm,(1.89±0.81) cm and (1.14±0.67) cm,respectively and the differences were significant (LSDt=9.26,11.44,3.57; all P＜0.05).The percentage of continuously-open cardia and showing pressure impression of the gastric pouch of type Ⅲ group was higher than that of type Ⅱ group and the percentage of continuously-open cardia and showing pressure impression of gastric poach of type Ⅱ group was higher than that of type Ⅰ group (80.0％,40.5％ and 4.8％,x2 =11.64,29.76 and 8.59; 91.4％,27.0％ and 4.8％,x2 =30.69,40.73 and 4.32' all P＜0.05).The occurrence rates of the His angle blunting and sac of type Ⅲ group were higher than those of typeⅡ group and type Ⅰ group (74.3％ and 77.1％,24.3％ and 24.3％,4.8％ and 4.8％,x2 =17.97 and 25.41,both P＜0.05),there was no significant difference between type Ⅱ group and type Ⅰ group (P＞0.05).The rates of esophagitis of type Ⅲ group and type Ⅱ group were higher than that of type Ⅰ group (71.4％,59.5％ and 14.3％,x2 =17.14 and 11.15,both P＜0.05),there was no significant difference between type Ⅲ group and type Ⅱ group (P＞0.05).There was one case of Barrett's esophagus in each group.The sensitivity and specificity of endoscopy in HH diagnosis were 91.4％ and 81.0％,respectively.Conclusions The distance between EGJ and hiatal pressure impression,continuously-open cardia,the His angle blunting,hiatal pressure impression of the gastric pouch and hernia sac were important indicators of HH endoscopic features.The sensitivity of endosocopy is higher than the spcificity of endosocopy in HH diagnosis.

Objective To evaluate the diagnostic performances of seven estimation formulas for glomerular filtration rate (GFR) in pre-operative patients with renal cell carcinoma.Methods A total of 386 pre-operative patients with renal cell carcinoma in the first affiliated hospital of Chongqing medical university from January 2012 to October 2014 were selected.All the patients' GFRs were measured by the renal dynamic imagingwith 99mTc-DTPA as reference (rGFR) and the seven GFR estimation equations (eGFR) were compared with the rGFR respectively.Their correlations and consistencies were observed with spearman correlation analysis and Bland and Altman analysis.The diagnostic sensitivity,specificity and likelihood ratios were calculated and the eGFR accuracies were assessed with receiver operator curve (ROC) analysis.Results The correlations between the rGFR and eGFRs were significantly (P＜0.001).In addition,CKD-EPI-Asian Crea and Ruijin formula were more accurate than others in different stages with larger ROC area in diagnosing renal cell carcinoma.Conclusion There were significant correlations between the eGFRs and rGFR,but some deviations existed.CKD-EPI-Asian Crea and Ruijin formula were more suitable for assessment of eGFR of pre-operative patients with renal cell carcinoma.However,both of these equations had a few limitations.