Using new tape of teaching models in modern medical science education is a trend for medicine development.Investigating medical students’approbation degree and attitudes towards the teaching models,analyzing and resolving the problems about that will provide the valuable reference to reforming the medical education and fostering qualified practitioners.

Objective To investigate the level of mental health and effect of psychological rehabilitation on paraplegic patients. Methods 38 paraplegic patients were randomly divided into control group (n=19) and treatment group (n=19). Both groups received physical therapy and occupational therapy, while the treatment group received psychotherapy in addition, once a week for 3 weeks. Their mental health level was assessed with Self-reporting Inventory. Results The psychological problems occurred was ranked as somatization, anxiety, fear, interpersonal sensitivity, depression and obsession from more to less. The scores of each factor reduced after treatment (P<0.05). Conclusion The paraplegics are in poor mental health condition, so more psychotherapy intervention should be taken to improve their rehabilitation effect and quality of life.

Objective To investigate the mental health status of patients with cervical spondylosis and the curative effect of psychotherapy.Methods71 patients of cervical spondylosis with psychological obstacles were randomly divided into the experiment group (32 cases, treated by physiotherapy combined with psychotherapy simultaneously) and control group (39 cases, treated by physiotherapy only). The patients' somzatization and mental health status were evaluated by the Symptom Checklist-90 (SCL-90) and the table of curative effect estimation of cervical syndrome before and four weeks after treatment.ResultsThere was no significant difference between two groups in the degrees of somzatization and scores of SCL-90 before treatment. After four weeks treatment, both two groups had improvement in the physical symptom and psychological condition, but the curative effect of the experiment group was better than the control group ( P<0.05).ConclusionBecause having a long disease course, the patients with cervical spondylosis have different level mental health troubles. Psychotherapy is helpful to improve curative effect.

Objective To investigate the effect of self-efficacy theory in rehabilitation on stroke patients with hemiplegia complicated psychological disorder. Methods 26 cases were divided into the combined therapy group (13 cases, accepted physical therapy with self-efficacy) and the routine physical therapy group (13 cases). They were assessed with General self-efficacy scale (GSES), Fugl-Meyer Assessment before and 1, 3 months after treatment, as well as symptom checklist (SCL-90) before and 1 month after treatment. Results The scores of GSES raise 63% in the combined therapy group 1 month after treatment, obviously different from that of routine physical therapy (P<0.01).The score of Fugl-Meyer Assessment of the combined therapy group were increased from (53.08±13.04) to (90.07±6.54 ) and from (56.46±12.95) to (81.77±8.51)in the routine physical therapy group (F= 85.53,P<0.05). All the scores of depression, anxiety, compulsion, hostility in SCL-90 were markedly lower in the combined therapy group than in the routine physical therapy group(P<0.01). Conclusion Utilization of self-efficacy theory in rehabilitation can improve the emotion and effect of rehabilitation.

PBL (Problem-based learning) is a kind of teaching method, which is helpful for guiding students to solve practical and complex problems. The compiling of PBL teaching plans is the key to the implementation of PBL teaching. According to the teaching outline of internal medicine, we set the PBL teaching plan, formulated the teaching goal, collected the clinical real cases, finished the compiling of PBL cases of student version and teacher version, and preceded teaching practice accord-ing to the PBL cases. Improving and constructing the compiling framework of internal medicine PBL teaching plan laid the theoretical foundation for carrying out internal medicine PBL teaching.

Objective:To evaluate the feasibility of delineating subvolume target in radiotherapy for brain tumors using Gd-based contrast clearance difference.Methods:Twenty-six patients with malignant brain tumors were scanned with MRI. The first and second acquisitions of standard T 2-weighted images (T 2WI) and T 1-weighted images (T 1WI) were performed at 5 min and 60 min after injection of contrast agent. Delayed contrast extravasation (DCEM) MRI computed by Brainlab comprised regions of contrast agent clearance representing active tumors and regions of contrast accumulation representing non-tumor tissues. Based on T 2WI images, 14 patients with liquefaction necrosis were divided into group A, and 12 patients without liquefaction necrosis into group B, respectively. Then, gross target volume (GTV) was delineated on T 1WI images. Based on the GTV, active tumor (GTV tumor) and non-tumor regions (GTV non-tumor) were delineated on T 1WI-DCEM fusion images, while liquefaction necrosis (GTV liquefaction) and non-liquefaction (GTV non-liquefaction) were delineated on T 1-T 2WI fusion images. Finally, the differences between different subvolumes were compared by paired t-test. Results:In group A, the GTV non-liquefaction and GTV liquefaction were (13.65±18.15) cm 3 and (6.30±7.57) cm 3. The GTV tumor was (10.40±13.52) cm 3 and the GTV non-tumor was (9.55±14.57) cm 3. The GTV non-liquefaction was significantly increased by 16.3% on average compared with the GTV tumor ( P<0.05). The GTV non-tumor was significantly increased by 16.3% on average compared with the GTV liquefaction ( P<0.05). In group B, The GTV non-tumor was significantly reduced by 68.8% on average compared with the GTV tumor ( P<0.05). Conclusions:Compared with T 2WI, DCEM has advantages in identifying the liquefaction area and can clearly differentiate the subvolume of active tumors from non-liquefaction necrosis. DCEM provides evidence for guiding the delineation of subvolume in primary and metastatic brain tumors.

The improvement of diagnostics teaching system,including the establishment of curriculum system and evaluation system,is the base of promoting clinical- medicine teaching.Our study showed that the theoretical knowledge and clinical skill of medical students could be improved by constructing clinical diagnostics curriculum system and improving organization management and assessment system,which could pave the way for the transition from medical students to clinicians.

Objective To explore the effect of core stability training (CST) on motor of upper limbs after stroke. Methods 60 patients with stroke were divided into observation group (n=30) and control group (n=30). Both groups accepted routine medicine and motor relearning program, and the observation group accepted CST before training. They were assessed with Simple Test for Evaluating Hand Function (STEF), modified Barthel index (MBI), and the Trunk Control Test (TCT) before and 4 weeks after treatment. Results The scores of STEF,MBI, and TCT improved after treatment in both groups (P<0.01), and improved more in the observation group than in the control group (P<0.01). Conclusion CST may facilitate the motor recovery of upper limbs after stroke.

Objective To study the defects of bone marrow-derived endothelial progenitor cells (EPCs) in number ratio and biological abilities (proliferation, adhesion and migration) in diabetic rats. Methods (1) Establishment of diabetic rat model:1%STZ solution was quickly injected into the abdominal cavity of the male SD rats with the dose of 60 mg/kg. (2). Isolation, culture and identification of bone marrow-derived EPCs in diabetic and normal rats. Bone marrow mononuclear cells were isolated from diabetic and normal rats by density gradient centrifugation methods and cultured by EGM-2 MV medium. The cells were identified by morphological observation, FITC-UEA-1 binding and Dil-Ac-LDL uptake assay, and fluorescent immunocytochemistry was used for detection of CD34 , CD133 and VEGFR-2 expression. CCK-8 method and Transwell kit method were used to determine biological activities of EPCs. Results (1) When cultured in vitro, both bone marrow-derived EPCs in diabetic and normal rats were fusiform in shape, the cells snuggled up to the wall. The expression of CD34, CDl33, VEGFR-2 could be detected in these cells, and the cells could uptake Dil-Ac-LDL and bind FITC-UEA-1, which proved that these cells were EPCs. (2) No significant difference in the number of EPCs derived from bone marrow existed between diabetic rats and normal rats, but the proliferation ability, migration ability and adhesion ability of bone marrow-derived EPCs in diabetic rats were obviously lower than those in normal rats. Conclusion The number of bone marrow-derived EPCs in diabetic rats is not obviously different from that in normal rats, but the biologic activity of EPCs derived from bone marrow in diabetic rats is degraded, which is manifested as weakened abilities of the proliferation, adhesion and migration.

Typical clinical symptoms rarely appears in hypophysoma,and specific detection marker is absence;neglect or misdiagnosis could often be noted in hypophysoma at the early stage.Metabonomics has been widely used in cancer research and early diagnosis of tumors showing great potential.In this paper,the application status of the technology of metabolism in pituitary adenoma is summarized.