Although the humanity had already developed the numerous teaching design theory,under the social background of information explosion,it is necessary for instructional technologists to continue developing comprehensive guidelines to support new areas of human learning and development.The new theory includes the instructional values,preconditions for how to facilitating SDL.

Taking the modern occupation education concept as the guide,oriented by adapting to the demand of occupation post,we established a new open education mechanism of medical occupation education to promote the reform of personnel training mode,curriculum and teaching content to explore the effective way of the sustainable development of local medical occupation education.

[Objective] To evaluate the influence of dexmedetomidine on median effective target effect-site concentration(EC50)of sufentanil-inhibiting urethroscope insertion response in patients undergoing transurethral resection of prostate(TURP).[Methods] Forty patients with ASA grading Ⅰ-Ⅱ who accepted selective TURP were divided by random digits table method into two groups with 20 cases each.The patients in dexmedetomidine group were treated with 0.6 μ g/kg dexmedetomidine intravenous infusion for more than 10 min,while control group were treated with equivalent capacity of 0.9％ sodium chloride.At 5 min after stopping injection,target-controlled infusion of propofol was started and the plasma target concentration was 3.0 μ g/ml.At 10 min after infusion,target-controlled infusion of sufentanil began and the plasma target concentration was 0.20 ng/ml.The target concentration of sufentanil of the next patient accorded to the patient with or without the urethroscope insertion response and the adjacent rate of the target concentration was 1.1.The EC50 and 95％ confidence interval(CI)of sufentanil were calculated.[Results] There were 20 cases in dexmedetomidine group ultimately selected and 19 cases in control group.There was no statistical significance in absolute value of ST segment of intraoperative electrocardiogram,systolic blood pressure,heart rate,pulse oxygen saturation and bispecual index between two groups(P＞0.05).EC5o of sufentanil-inhibiting urethroscope insertion response in dexmedetomidine group was 0.1148 ng/ml(95％ CI 0.1055-0.1249 ng/ml),which was significantly lower than that in control group[0.1454 ng/ml(95％ CI 0.1339-0.1580 ng/ml)](P＜0.05).[Conclusions] 0.6 μg/kg dexmedetomidine intravenous infusion before operation can reduce the EC50 of sufentanil-inhibiting urethroscope insertion response in patients undergoing TURP.

As a new technology for rehabilitation training for function disorders, exoskeletons and orthoses are more concerned than before.This article discussed the classification of exoskeletons and orthoses and their application in rehabilitation training, as well as current research status and prospects.

Objective To explore the image features of multilocular cystic nephroma and its correlative differential diagnosis. Methods Eight cases of multilocular cystic nephroma were retrospectively analyzed by comparing the imaging findings with surgical and pathological results. Results In all 8 cases, multilocular cystic nephromas were unilateral and circumscribed by thick capsules. These lesions ranged in diameter from 2. 5 cm to 7. 5 cm. The lesions were entirely composed of locules and septa without solid nodules. These locules did not communicate with each other. The septa of these lesions were clear in 2 cases, partly clear in 4 cases, and not very clear in 2 cases. All lesions were better detected on enhanced scans than on non-enhanced ones. Four of 8 cases also underwent MR scan, which presented low signal intensity on T1WI and high signal intensity on T2WI. The Interlocular septa was demonstrated much better with MM than with CT. Histopathology proved that the capsule and septa of the lesions were lined by cuboidal or flattened epithelial cells. Conclusion Multilocular cystic nephroma is a rare disease of the kidney. CT and MRI scanning are valuable in the diagnosis of multilocular cystic nephroma, but the imaging features are not specific enough to differentiate benign multilocular cystic nephroma from multilocular cystic renal cell carcinoma.

Objective To improve and innovate the dispensing equipment in oncology.Methods Plexiglass plate was used in the counter in order to give an isolate space for preparation of chemotherapy drugs.Through the ventilation hole,the air polluted by chemotherapy drugs was sent out of door.The operator put on special protective gloves before preparation of chemotherapy drugs.Results There was a decrease of dispensing errors and confusion,when the counter was used to separate the conventional dosage from chemotherapy dosage.The counter effectively prevented the skin and respiratory tract damage to the operator during the preparation of chemotherapy drugs.Conclusion It is practical,cheap,easily operated and produced,which is worth promoting.

ObjectiveTo investigate response monitoring function in individuals with pathological internet use(PIU) using the modified Eriksen flanker task by event-related potentials(ERPs).Methods23 individuals met Young's diagnostic questionnaire (YDQ) criteria for PIU were enrolled as research group and 23 sexual-and age matched healthy persons enrolled as control group.EEG was recorded during participants performed the modified Erikson flanker task.Reactive time (RT) and error rates were compared between two groups. BESA 5.2.0was used to perform data analysisand theerror-related negativity(ERN)amnplitudeswereanalyzed.Results False alarm rate of PIU group was higher than that of control group.A repeated measure ANOVA revealed a significant group,frontal electrode sites and group × frontal electrode sites main effect for ERN amplitudes ( for group:F =768,df=1,P =0.000 ; for frontal electrode sites:F =615,df=2,P =0.000 ; for group × frontal electrode sites:F =516,df=2,P=0.000),and a significant group,central electrode sites and group × central electrode sites main effect for ERN amplitudes ( for group:F=768,df=1,P =0.000 ; for central electrode sites:F =599,df=2,P =0.000 ; for group × central electrode sites:F =483,df=2,P =0.000).ERN amplitudes of PIU group were lower than those at control group.ConclusionIndividuals with PIU present response monitoring dysfunctions and share neuropsychological and ERPs characteristics of compulsive-impulsive spectrum disorder,which supports that PIU is an impulse disorder or at least related to impulse control disorder.

Objective To study the main infectious bacteria and their drug-resistance after liver tra nsplantation. Methods K-B method was used to detect the susceptibility of agents of the main bacteria after liver transplantation. ESBLs and AmpC ?-lactamase among the main negati ve bacillus were detected by three-dimensional tests. ?-lactamase and Van gen e among Enterococcus were dectected by standard agar dilution susceptibility tes ts and Nitrocefin respectively. Results Among the main Gram-negative bacteria in 55 cases of infection following liver transplantation, the ratio of resistance to 4 or more antibiotic were all beyond 40% . The detectable rate of ESBLs and AmpC ?-lactamases in Enterobacter cloacae and Escherichia coli was 32.4% and 36.8% , and 33.8% and 10.5% re spectively. Moreover, the detectable rate of both ESBLs and AmpC ?-lactamases in Enterobacter cloacae and Escherich ia coli was 24.3% and 7.0% repectively. 8.8% and 11.1% produced ?-lactamases in Enterococcus faec alis and Enterococcusfaecium, with the ratio of resistance to Vancomycin being 11.2% and 18.5% respectively. Conclusions The primary pathogens have the high and multiple resistance to antimicrobial aft er liver transplantation. ESBLs and AmpC ?-lactamases were the main two factor s of drug-resistance among Gram-negative bacillus. we should pay much attentio n to the high detectble rate of Enterococcus which are resistant to Vancomycin a fter liver transplantation.

Objective To build the screening model for population with Impaired Glucose Regulation (IGR)in community, and to evaluate its validity by using the model in general population. Methods Based on the epidemiological survey of DM in the community population in 2006, the analysis of the risk factors and the risk factors scoring method were used to build the screening model for IGR in community which was then used to screen for IGR in 2 120 general population in community to evaluate its validity. Result When the screening model was built with the accumulative score of risk factors ≥5, the sensitivity and specificity for identifying undiagnosed IGR were 68.2% and 61.7%, Youden's index was 0.299 and the positive predictive value was 14.2%. When 2 120 general population used the screening model, only 974 (45.9% of them)had to take OGTT test, and 124 (68.9%) IGR were identified. Conclusion The screening model with the accumulative score of risk factors ≥5 is an easy, effective and economic tool for IGR screening, and it can be tried to use in the screening for IGR in community, further research is needed.

OBJECTIVE:To reduce the risk of high-risk drugs dispensing in PIVAS. METHODS:Main measures of risk con-trol of high-risk drugs in PIVAS of our hospital were introduced,i.e. establishing high-risk drug risks control group and high-risk drugs list,pharmaceutical staff undertaking all job of PIVAS except finished product distribution,information management of high-risk drugs application procedure,clinical pharmacist's participation,etc. The effects of error and ADE evaluation and manage-ment in PIVAS were analyzed statistically to summarize the experiences. RESULTS & CONCLUSIONS:During 2012-2014,the in-cidence of high-risk drugs related error was in low level in PIVAS of our hospital(0.009‰,0.004‰,0.002‰)and decreased year by year. The number of error decreased from 8 in 2012 to 3 in 2013 and 2 in 2014. It is important for risk control to enhance drug check,new staff training and PIVAS staff professionalization in pharmaceutical,and extablishing warning mark of high-risk drugs.