Diversified clinical teaching methods which include theoretical teaching by multimedia,specific chapter explains with PBL,contacting with clinical diseases and integrating theoretical knowledge by case discussion,solving learning problems and introducing new progress by seminars,can improve the quality of teaching in the department of obstetrics and gynecology.

Objective To study the efficacy of problem-based learning (PBL) in clinical teaching of gynecology and obstetrics.Methods Totally 170 students in our department for probationary were divided into two groups randomly.Students in the two groups were taught by theoretical lecture and case study in the ward.PBL (After the lectures,teachers choose clinical cases,students inquire medical history and do physical examination,students discuss on the case and propose treatment scheme,students look up references and consult specialist to determine treatment scheme,students do team report and teachers give comments) was used in experimental group (n=87) while traditional teaching method (teachers guide students to inquire medical history,do physical examination,analyze the cases and make diagnosis,do differential diagnosis and give treatment as well as answer the questions posed by students) in control group (n=83).Ability of students to solve the practical problems was assessed by final examination (theoretical exam and case analysis) and the efficacy of PBL was investigated by questionnaire survey.SPSS 11.5 soft ware was employed to do statistic analysis.Measurement data were analyzed by t test and manifested asand enumeration data were analyzed by chi-square test.P≤ 0.05 stands for statistical differences.Results There was no difference in theoretical score between experimental group and control group.Score of case analysis was higher in experimental group than in control group (t=2.236,P=0.017).Students' satisfaction degree of PBL was much higher than that of traditional teaching method.Conclusions PBL is better than traditional teaching method in clinical teaching of gynecology and obstetrics.It can improve students' ability of problem-analyzing and problem-solving,therefore should be promoted in clinie education.

Objective To sum up transplantation of forearm skin flap to repair the whole defect of the lip.Method Forearm free skin flap was used to repair the whole defect of the lip in 5 cases. Results The treatment was completed in one stage and the results were satisfactory in 5 cases.And the reconstructed lip showed good shape.Conclusions Forearm skin flap has many strong points:the skin flap has big area and wide blood vessel diameter.It is successed easy to be identical,operation can be completed once, and don't suffered harm to face or neighbour supply area.The skin flap has safe grain,more thinner, good springy and similar colour.It plays an important role in the repairs of the whole defect of the lip with nearby skin soft tissue defect.

Objective To study the clinical efficacy and safety of purse-string suture on the treatment of peptic ulcer bleeding. Methods Data of 42 patients with peptic ulcer bleeding treated by purse-string suture with hexiejia combined with endoloop in Dongguan Tung Wah Hospital from January 2016 to January 2017 were retrospectively analyzed. The immediate hemostasis rate, effective hemostasis rate, additional surgery rate, recurrence rate in two weeks and mortality were analyzed. Results Among 20 cases with active bleeding during operation, 19 were immediately arrested, and 1 case of failure was diagnosed as marginal ulcer after gastric resection. The overall effective hemostasis rate was 97. 6%(41/42), additional surgery rate was only 2. 4%( 1/42). The vital signs of 41 patients with successful endoscopic hemostasis were stable after operation, and no fever, hematemesis, black stool or other symptoms occurred. No recurrence of bleeding or death occurred within two weeks. The ulcers were healed well in follow-up of one month. Conclusion Endoscopic purse-string suture is a safe and feasible method for treatment of patients with peptic ulcer bleeding.

OBJECTIVE:To study the clinical effects of curettage under hysteroscopy combined with estrogen and progesterone in preventing intrauterine adhesion after missed abortion.METHODS:A total of 120 patients receiving missed abortion selected from gynecology department of our hospital during Jun.2014-Jun.2016 were randomly divided into observation group (60 cases) and control group (60 cases) according to seguential coding.Observation group was given estradiol valerate 3 mg,qd,for 5 d in total,received curettage under hysteroscope,and was given Estradiol valerate tablet/Estmdiol valerate cyproterone tablet one tablet,qd after surgery,for 21 d.Control group received routine curettage and didn't take estrogen and progesterone during the perioperative period.The time of vaginal bleeding,endometrial thickness 14 d after surgery,the amout of vaginal bleeding with in 3 months after surgery,intrauterine adhesion,the occurrence of ADR were observed in 2 groups.RESULTS:In observation group,57 cases completed the study except that 2 cases withdrew from the study due to the amount of vaginal bleeding as much as menstrual volume and 1 case withdrew from the study due to pregnancy tissue self-discharge.The duration of postoperative vaginal bleeding was (3.2 ±1.1) d in observation group and (5.4 ± 1.9) d in control group.The endometrial thickness of observation group was (8.04 ± 1.52)mm and that of control group was (5.27 ± 2.36) mm;the incidence of intrauterine adhesion was 3.5％ in observation group (2/57)and 15％ in control group (9/60).Above indexes of observation group were better than those of control group (P＜0.05).CONCLUSIONS:Curettage under hysteroscope combined with estrogen and progesterone helps to reduce post-curettage vaginal bleeding,promote endometrial repair and prevent intrauterine adhesion so as to protect women's reproductive ability.

BACKGROUNDMetastasis is not only the malignant characteristics of lung can- cer, but also the chief cause of failure to cure and high mortality of lung cancer. To better explore and understand the mechanism of lung cancer metastasis and to search for potential markers for early diagnosing and reversing lung cancer metastasis, differential proteomic analysis is conducted in two human large cell lung cancer cell lines with high metastasis potentials (L9981) and low metastasis potentials (NL9980) by two-dimension gel electrophoresis (2-DE).

METHODSThe total proteins of the two cell lines were separated by immobilized pH gradient (IPG)-based 2-DE. The differentially expressed proteins of the two cell lines were analyzed using image analysis software.

RESULTSA high resolution and reproducible 2-DE image was successfully obtained. Average deviations for protein position in IEF direction were (0.858±0.076)mm and (1.514±0.127)mm in SDS-PAGE direction. The relative standard deviation for protein volume was (12.06±0.580)% in L9981 and (12.22±0.640)% in NL9980. The average total number of protein spots was 902±169 in L9981 cells and 941±173 in NL9980 cells in three repeated experiments. Image analysis of siliver-stained 2-DE image revealed that 4 protein spots had significant differential expressions in L9981 and NL9980 (student's t-test, P < 0.05). Fifteen protein spots were only detected in L9981, and 27 protein spots were only detected in NL9980.

CONCLUSIONSThe results in this study suggest that an obviously differential proteomic expression exists between the human high- and low-metastatic large cell lung cancer cell lines. It will be helpful to further understand the molecular mechanisms of lung cancer invasion and metastasis, and provide new experimental evidence for searching metastatic-related molecule of lung cancer.