Based on summarizing the importance of education environment and the development and current status ofresearch on medical education environment, the authors measured the status of, and the problems existing in, educationenvironment of China Medical University by DREEM (Dundee Ready Education Environment Measure), and then sug-gested strategies to modify the education environment and hence to improve the quality of medical education on thebasis of the advanced concepts of education environment design and construction in the world and the authors' experi-ence in the reform of medical curriculum.[

To improve the quality of health care by improving the quality of residency training,the Accreditation Council for Graduate Medical Education of USA has renewed the standards and methods of residency training to improve health care,and issued the compe- tence-based training standards. The residents have to achieve six key competences when they finish the training. The University of Washington,School of Medicine,responds to the new re- quirements and standards by reforming its residency training pathway,enriching formal teach- ing/training activities,and improving its supervision and the evaluation. We should use for refer- ence reforming the residency training in China.

Objective To establish a method for simultaneous determination of 12 kinds of organophosphorus pesticides in water. Methods Organophosphorus pesticides in the water were extracted by liquid-liquid extraction, then analyzed with DB-1701 capillary column. In the same time, they were determined with GC by controlling the temperature and the speed of nitrogen. Retention time of the peaks was used for qualitative analysis, while external standard method was used for the quantitative analysis. Results The linear ranges of organophosphorus pesticides were 0.2～50.0 ?g/L, r≥0.999 1. The lowest detection limit was 0.009～0.04 ?g/L, the rate of recovery were 78.4%～93.9% and RSDs were 3.4%～7.5%. Conclusion This method is simple, rapid, sensitive and can efficiently separate and determine 12 kinds of organophosphorus pesticides in the water with 32.5 minutes of operation only.

Objective To discuss the promoting effect of clinical pathway in the standard and reasonable medication by the application of clinical pathway in the anticoagulation treatment of warfarin and health education for patients with atrial fibrilation.Methods Sixty eight patients with atrial fibrilation and receiving anticoagulation treatment of warfarin were divided randomly into the intervention group(36 cases)and the control group(32 cases).The control group received routine nursing while the intervention group underwent nursing intervention with clinical pathway based upon routine nursing intervention.The time cost to achieve the aims,compliance,incidence rate of complications and satisfaction degree were compared between the two groups.Results All the items in the intervention group were superior to those of the control group except for the items of satisfaction degree and health knowledge score(P<0.05).Conclusion Application of clinical pathway in the anticoagulation treatment of warfarin for patients with atrial fibrilation could ensure standard and reasonable medication in order to decrease medical cost,lower the incidence rate of complications,improve patients compliance and increase nursing quality.

Objective To probe the diagnostic value of MRI in synovial hemangioma of the knee.Methods Seven patients(2 male,5 female,age ranged from 8 to 58 years with mean age 25.1 years) selected from 2025 cases with MRI examination of knee,which were proved to be intra-articular hemangiomas histologically or clinically.All of the patients had plain film before MRI examination.MR findings of synovial hemangioma of knee were analysed ultrasound.Results Four hemangiomas occurred in infrapatellar bursa,others 3 cases in both infrapatellar and suprapatellar bursa were involved.MR signal intensity of hemangiomas appeared three types:(1)nodular hypointensity on both T_1WI and T_2WI in 2 cases;(2)iso-hypointensity on T_1WI and hyper-hypointensity on T_2WI in 2 cases;(3)hypointensity mixed with isontensity on T_1WI and nodular of linear mixedintensity on T_2WI in 3 cases.The difference of synovial hemangioma of knee in histologic elements,the MR findings were different.Conclusion MRI features of synovial hemangioma are correlated with pathology histologic elements.

Objective:To investigate the recent and long-term efficacy and safety of pancreaticoduodenectomy for pancreatic head carcinoma and periampullary carcinoma.Methods:82 cases of pancreatic cancer combined with periampullary carcinoma patients admit ted in our hospital from August 2009 to June 2013 were selected and randomly divided into the control group and the observation group With 41 patients in each group.The control group received palliative surgical treatment,while the observation group underwent pancreatoduodenectomy.The operation time,hospitalization time,intraoperative bleeding volume and the incidence of complications,1,2,3-year survival rate and the recurrence rate at 1 year after operation and tumor eradication rate were compared between twp groups.Results:The amount of bleeding,operation time of observation group were significantly higher than those of the control group(P＜0.01),no signif icant difference was found in the hospitalization time between the two groups(P＞0.05);the incidence of complications in the observation group (41.46％) was significantly higher than the control group (22.96％)(P=0.03);the 2-year and 3-year survival rate of observation group were significantly higher than those of the control group (P＜0.05),the recurrence rate at 1 year after operation of observation group was significantly lower than that of the control group (P=0.04),the tumor eradication rate was significantly higher in the observation group than that of the control group (P=0.04).Conclusion:Though pancreaticoduodenectomy could prolong the operation time,increase the risk of bleeding and complications for pancreatic head carcinoma and periampullary carcinoma,but it could effectively reduce the possibility of recurrence after operation,significantly improve the long-term survival rate.

Objective To assess the ability of pixel-based quantitative evaluation of CT values in differentiating benign and malignant cystic-solid ovarian tumors.Methods CT images of 41 cystic-solid ovarian lesions from 39 patients were reviewed,with 27 benign and 14 malignant confirmed by post-operation pathology or follow-up.Regions of interest (ROIs) were drawn along edges of tumors on all slices of contrast-enhanced images with ImageJ software.CT values of each pixel were extracted.CT values of 20,25,30,35 and 40 HU were used respectively as the threshold to divide cystic and solid components.Solid proportion,the mean and median CT values of solid component were calculated and compared between benign and malignant groups.Results Mean CT values of solid components were all higher in malignant than in benign ovarian masses under all the threshold values (P<0.05).For median CT values, the same trend existed under the threshold of 20,25,35 and 40 HU (P<0.05).For the solid proportion,difference was found only under the 40 HU threshold, with lower value in malignant group (0.67±0.25) than in benign group (0.47±0.31).ROC curves were drawn to differentiate benign and malignant lesions.The highest AUC was obtained by using the mean CT value of solid components defined by 40 HU threshold (AUC=0.735).Conclusion Pixel-based quantitative evaluation on CT images could help to define cystic and solid components of ovarian masses, with 40 HU to be an optimal threshold.Cystic-to-solid proportion and CT value of solid components derived from whole lesion can help to differentiate benign or malignant lesions.

AIM: To study the effects of astragalosides (AS) on the proliferation and cell cycle of rat glomerular mesangial cell (MC), and verify the correlation between the influence and the AS concentration. METHODS: The experiment was carried out in the Physiological Laboratory of Liaoning Medical University from December 2006 to July 2007. Rat glomerular MCs were cultured in high glucose for 4-7 passages. The experiments were randomly divided into control group and three AS groups with different concentrations (50, 100, 200 mg/L), which were treated with high-glucose liquid and AS respectively. MC proliferation was determined with MTT colorimetric method in each group at hours 48 after intervention. MC cell cycle was detected with flow cytometry. RESULTS: ①MTT results showed that, the values of A490 nm in AS groups were lower than that in the control group at hours 48 (P

This paper introduces the international experiments of risk management in clinical trails, responsibility of sponsor, responsibility of investigator and responsibility of other participators and to help to improve our management level of clinical trails.

Objective To investigate the effect of the extracts of Centella asiatica(L.) Urban (ECA) on the depressive-like behavior alteration in rats and mice. Method 60 Wistar rats were randomly divided into 6 groups (10 rats each), the normal group, model group, Fluoxetine group, ECA high dose group (component 10.08 mg+component 24.48 mg/kg), ECA middle dose group (component 1 0.04 mg+component 2 2.24 mg/kg) and ECA low dose group component 1 0.02 mg+component 2 1.12 mg/kg. Chronic unpredictable mild stress (CUMS) induced depression in rats and sugar consumption to detect the antidepressant effect of ECU. 60 Kunming mice were randomly divided into six groups as above. Locomotor activity, forced swim, tail suspension test were used to detect the effect of ECA on the behavioral alteration in mice. Results Compared with model group, sugar consumption in ECA groups was significant increased (P<0.01). ECA treatments also decreased duration of immobility in the tail suspension test and forced swim. Conclusion ECA could improve the depressive-like behavior in rats and mice.