Objectives Aiming at the current health management mode of chronic disease preven-tion and control as the focus of work, this paper was to evaluate the effect of chronic disease management-based education on clinical teaching and training in cardiovascular medicine. Methods Totally 54 students participating in internship training in Department of Cardiology, the Shanghai Ninth People’s Hospital be-tween July 2013 and Aug 2014 were enrolled. Twenty-eight students were taught by chronic disease man-agement-based method while twenty-six students were taught by traditional method. After the internship training in cardiology, final examination (theoretical exam, skill appraisal and case analysis) were compared between the two groups to assess the teaching efficacy. Questionnaire survey was employed to investigate student satisfaction with chronic disease management-based teaching method. Data were analyzed by SPSS 13.0 software. Quantitative data or enumeration data between two groups were compared by t-test or chi-square test respectively. Results There was no significant difference in the theoretical exam score between two groups (P=0.422). However, the scores of skill appraisal and case analysis in students taught by chronic disease management-based method were significantly higher than those in students taught by traditional method (P<0.05). Most students taught by chronic disease management-based method were satisfied with the novel teaching method. Conclusion In the course of clinical medicine education, the emphasis on the management of chronic diseases can not only significantly improve the quality of clinical teaching in car-diovascular medicine, but also lay the foundation for the implementation of the concept of chronic disease management.

The curriculum construction of medical students' occupational career planning has its own character. Principles of curriculum construction siuh as practical object, professional content and target-oriented organization should be sticked to and four aspects of curriculum construction such as target,content, organization and evaluation. are discussed in detail.

Objective To explore the effects of lead acetate on free radicals and lipid peroxidation in the cerebral cor?tex, cerebellum, and hippocampus in rat brains. Methods SD rats (n=48), who were just weaned, were randomly divided in?to 4 groups base on their weight. Then the rats were fed with lead acetate in drinking water at the final concentrations of 0 mg/L (deionized water), 200 mg/L, 400 mg/L, 800 mg/L respectively. Blood lead level as well as the hydroxyl free radical inhibiting activity, the levels of hydrogen peroxide (H2O2) and malondialdehyde (MDA) in cerebral cortex, cerebellum, and hippocam?pus were measured 60 days after lead contamination in water. Results Upon lead exposure, blood lead levels increased sig?nificantly as compared with the control. The hydroxyl free radical inhibiting activity in cerebral cortex, cerebellum, and hip?pocampus decreased significantly in a dose dependent manner of lead(P < 0.05). And they all correlated negatively with blood lead level (r=-0.505,-0.414,-0.448, P<0.05). By contrast, blood lead level was positively correlated with H2O2 and MDA in these brain tissues (r=0.301, 0.411, 0.378, and 0.404, 0.324, 0.510,P < 0.05). Conclusion Lead exposure can lead to lipid peroxidation of rat brain tissues through inducing free radicals.

Objective To investigate the risk factors of fetal death in patients with severe preeclampsia Methods Clinical data of 70 cases with severe preeclampsia were analyzed retrospectively,including 53 cases of fetal survival and 17 cases of death.Results There was shorter pregnancy duration in fetal death group (P ＜ 0.05) but there were no significant differences in the age,serum albumin level,systolic blood pressure,diastolic blood pressure and mean arterial pressure in 2 groups (P ＞ 0.05).Pulmonary edema was correlated to gestational week (P ＜ 0.05);the higher the gestational age was,the higher the occurrence of pulmonary edema.Conclusion Earlier onset of severe preeclampsia predicts higher rate of fetal death.

Objectives Toexplorethe effect of the Balint group on improving the empathy and doctorpatient communication skills among medical students in clinical practice.Methods We investigated 500 clinicalmedicalstudentsin fourth grade by JSE-HP and SEGUE framework scalein Shanghai Jiao Tong university school of medicine between July 2016 and December 2016.60 students with insufficientempathy and doctor-patient communication skills were selected randomly.These students were thanrandomly divided into the Balint group (experimental group) and the routine clinical practice group(control group).The experimental group participated inthe Balint group activitiesin addition to routine clinical practice,whilethe control group only participated in routine clinical practice.After 20 weeks of the Balintgroup intervention,the two groups were invited to assess theempathy and doctor-patient communication skills again to analyze the effect of the Balintgroup on improving the empathy and doctor-patient communication ability among intern students.The evaluation result was analyzed by SPSS 22.0 software.Data comparison was conducted using pair t test,independent sample t test and x2 testing.Results There were no statistically significant differences in age,sex,whether only child or class leader and previous year theoretical exam scoresbetween the two groups (all P＞0.05).For empathy,there was no statistically significant difference in terms of opinion,emotional care,empathy,and total scorebefore the routine clinical practicebetween the two groups (P＞0.05) and they all improvedsignificantly after the routine clinical practice (all P＜0.05).But the experimental group had higher scoresin all above scalesthan the control group (all P＜0.05).For communication skills with patients,there were no statistically significant differencesbetween the two groupsin communication initiation,information collection,understanding of patients,information giving,end questioning,and SEGUE scoresbefore the routine clinical practice (all P＞0.05),and they allimprovedsignificantly in all above 5 scales after the routine clinical practice (all P＜0.05).While except for understanding of patients,the experimental group had higher gains in other scales than the control group (all P＜0.05).Conclusion Use of the Barring group activities on the basis of routine clinical practice canimprove the empathy andthedoctor-patientcommunication skills in medical students.

ObjectiveTo investigate the social support status and influencing factors of schizophrenics in remission in Northeast Sichuan， and to provide ideas for improving their social support. MethodsFrom May to September 2020， a total of 533 patients who met the diagnosis criteria of the International Classification of Diseases， tenth edition （ICD-10） for schizophrenics in remission at the mental health institutions in Guangyuan， Bazhong and Dazhou cities were selected for the survey， and patients were assessed by self-made demographic and clinical data inventory and Social Support Rating Scale （SSRS）. Then the social support status of schizophrenic in remission and influencing factors were analyzed， meantime， the impact of the second round reimbursement policy of medical insurance benefits on their social support was addressed particularly. Results①The SSRS total score， objective support， subjective support， and utilization of support scores of schizophrenics in remission were lower than those of the national norm （t=5.065~30.382， P<0.01）. ②Univariate analysis showed that SSRS score was relatively high among patients with female gender （t=-3.632）， retired status （F=5.951）， married status （F=5.951）， spouse as primary caregiver （F=23.841）， annual household income >5 000 yuan （F=15.892）， patient's economic income （t=4.083）， and outpatient or online follow-up （F=3.954）， with statistically significant differences （P<0.05 or 0.01）. ③The total and dimensional scores of SSRS in patients with access to the second round medical insurance reimbursement were significantly higher than those without （t=10.195~25.103， P<0.01）. ④Multiple linear regression analysis denoted that gender， work status， marital status， primary caregivers， annual family income， economic income， follow-up visits and the second round medical insurance reimbursement were the factors influencing social support status of schizophrenics in remission （β=0.201~2.115， P<0.05 or 0.01）. ConclusionThe social support of schizophrenics in remission in Northeast Sichuan is below the national average， furthermore， their social support levels are affected by the gender， work status， marital status， primary caregivers， annual family income， economic income， follow-up visits and the second round medical insurance reimbursement， and the second round medical insurance reimbursement may ameliorate the social support status of patients.

OBJECTIVE: To analyze the effect of bronchoalveolar lavage( BAL) on respiratory function and arterial blood gas of pneumoconiosis patients. METHODS: The published literatures about relationship between BAL and respiratory function and arterial blood gas in pneumoconiosis patients from China National Knowledge Internet,Wanfang Database,Chinese Biomedical Literature Database,Chinese Journal Database,Pub Med,Embase,Web of Science Database and the Cochrane Library Database and so on from 2000 to 2016 were retrieved,collected,and screened by using bibliometric method. The data was analyzed by Meta analysis with the help of Rev Man 5. 0 software. The weighted mean difference( MD) and 95%confidence interval( CI) were calculated on selected literatures. RESULTS: A total of 20 articles were selected and used.The forced vital capacity( FVC)( MD = 0. 21,95% CI: 0. 04-0. 37),the forced expiratory volume in one second( FEV1)( MD = 0. 12,95% CI: 0. 01-0. 23),the maximum ventilatory volume( MD = 10. 73,95% CI: 3. 48-17. 98) and partial pressure of oxygen( MD = 8. 85,95% CI: 0. 30-17. 39) in the patients after BAL were higher than before( P < 0. 05),while the partial pressure of carbon dioxide in artery( MD =-3. 58,95% CI:-5. 61--1. 55) decreased( P < 0. 01).Both of the FEV1/FVC( MD = 2. 08,95% CI:-6. 27-10. 43) and the FEV1%( MD = 0. 86,95% CI:-0. 55-2. 28)had not statistically significance before and after BAL( P > 0. 05). CONCLUSION: BAL can improved respiratory function and arterial blood gas in pneumoconiosis patients.