Through the exertion of the PBL in the teaching of the medical college,the teachers exert the effect in bringing forward questions,grouping,discussion and competition.After the practice of PBL,some new methods have been put forward.

A new teaching model for food fermentation technology education is proposed in this paper,aiming at improving some of the drawbacks of the traditional teaching method. Some novel approaches,such as summarization,comparison,discussion,as well as bi-lingual lecturing and multi-media assisted teaching,are introduced to inspire students’ passion for learning. Meanwhile,arranging students as dedicated class speaker and organizing students to participate in the exploring experiments also reflect the technology major education characteristics of normal university.

地震造成大规模人群的复杂创伤,病情进一步发展,常导致多脏器功能障碍(MODS)。本文总结了地震伤后MODS的发病机制、预防、早期诊断以及治疗措施。

ObjectiveTo explore the application value and techniques of vaginal hysterectomy of non-prolapsed uterus lesion in primary hospital. Methods140 cases who suffered from uterine fibroid without adhesion,glandular fibroids,functional bleeding without uterine prolapse and malignant disease were selected and divided into observation group(80 cases with vaginal hysterectomy)and control group(60 cases with routine abdominal hysterectomy).Then the clinical treatment effect was analyzed. ResultsCompared with control group,peri-operative bleeding (150 ±23)ml vs(243 ±41)ml,operation time(65 ± 14.0)min vs(90 ± 27.0)min,body temperature recovery time (3 ±0.5)d vs(4 ±0.8)d,anus exhaust time(14 ± 1.8)h vs(26 ±2.7)h,the length of time(5 ±0.8)d vs(11 ±2.9)d in observation group were all reduced,differences were significant(all P＜0.01)and no case was transferred to opening appendectomy. ConclusionFor these disease including uterine fibroids with no adhesion,glandular fibroid uterine bleeding,the vaginal hysterectomy was safe and feasible,and had the advantage of smaller trauma,less bleeding,shorter hospitalization time,faster recovery etc.It was worthy to be popularized in primary hospital.

Objective To set up a method to detect the mutation of CYP2C9 1075A ＞ C and VKORC1-1639 G ＞ A in clinical practice,investigate the distribution of CYP2C9 1075A ＞ C and VKORC1-1639 G ＞ A in Beijing Han native,and evaluate the correlations between CYP2C9 1075A ＞ C,VKORC1-1639 G ＞ A and Warfarin maintenance dose,so that the results will contribute to Warfarin therapy.Methods A total of 145 Han Beijing patients received long-term Warfarin anticoagulant therapy orally in the people's hospital between May to September in 2011 were enrolled in this study.The patients suffer from atrial fibrilation,thromboembolism and heart operation respectively.The ARMS-TaqMan real time PCR technique was used to detect the mutation of CYP2C9 1075A ＞ C and VKORC1-1639 G ＞ A.The data were collected on gender,age and BSA.The correlations between stable warfarin dosage and each factor were analysised.Results The detection limit of ARMS-TaqMan real time PCR technique was 105 copies/ml in this assay.The intra-and inter-coefficients of variations (CV) were less than 5.5％ and less than 9.0％ respectively.The coincidence rate of ARMS-TaqMan real time PCR and direct sequencing was 100％ for testing 50 paralled samples.Among the 145 patients,the frequencies of CYP2C9 1075 AA,AC and CC was 93.8％ (136/145),6.2％ (9/145),0(0/145) respectively.The frequencies of VKORC1-1639 GG,GA and AA was 0.7 ％ (1/145),21.4％ (31/145),77.9％ (113/145) respectively.Allele frequencies of genotypes were in Hardy-Weinberg equilibrium.Every patients' INR was within range 2.0-3.0.Among the 145 patients,dosage requirements were higher in CYP2C9 1075 AA phenotype than that in AC type (F =0.199,P ＜0.05) and were higher in VKORC1-1639 GA phenotype than that in AA type (F=1.745,P ＜0.001).Irrespective of other factors,age,BSA,CYP2C9 1075 and VKORC1-1639 was accounted for 11.9％,12.9％,4.4％ and 16.7％ of interindividual variation of Warfarin dosage respectively.Linear stepwise regression analysis was used to identify factors contributing to Warfarin stable does.The final equation accounted for 40.4％ of interindividual variation of Warfarin dose.Conclusions The ARMS-TaqMan real time PCR technique was established to analyse CYP2C9 1075 and VKORCl-1639 genotype.The technique can achieve the needs of clinical practice.Warfarin dosing by multivariable regression equation in patients could increase efficiency for Warfarin dose adjustment,and could give suggestion for the individualization and rationalization for Warfarin dose.

Objective To investigate the risk factors and the characteristic patterns of development changes of macrosomia.Methods 208 cases of macrosoroia were collected.Then the risk factors related to macrosomia by use of Logistic regression analysis were researched.208 infants of normal birth weight were selected as control group.The weight and length in 8 growth development monitoring time according to their health care manual were recorded.Mental development index(MDI)and physical development index(PDI)were tested and calculated by CDCC method when macrosomia and normal birth weight infants were 30 months.The characteristic patterns of development changes of macrosomia wre analyzed statistically.Results The risk factors of macrosomia contain age and height of the pregnant women,weight before pregnancy,weight increasing during pregnancy,nutriture,physical activity,family history of obesity and father's weight.Macrosomia was weighter than normal birth weight infants in the 8 growth development monitoring time and was longer than normal birth weight infants from 3 to 30 months(P ＜0.05).However,the length of macrosomia was not significantly different with that of control group when they were 36 months(P ＞ 0.05).MDI and PDI in macrosomia group were(107.33 ± 7.29)and(104.71 ± 6.93)respectively.MDI and PDI of normal birth weight infants group were(112.58 ± 7.61)and(109.09 ± 7.14)respectively.The differences were statistically significant(t =4.28,5.33;both P ＜ 0.01).Conclusion There were several risk factors for macrosomia such as environment and heredity.At the period of infants and young children,macrosomia were weighter than normal birth weight infants.The mental development and psycho-moter development of macrosomia were behind normal birth weight infants.

Objective To evaluate the application of capsaicin to improve bladder stability after suprapubic prostatectomy for BPH. Methods 40 patients with BPH underwent suprapubic prostatectomy under epidural anesthesia were randomly divided into A?B?C and D groups (n=10 in each group).Capsaicin of 1 mmol/L was instilled into the bladder preoperatively for 30 minutes in group B and group D had 10 ml of 1 mmol/L capsaicin given epidurally.Group A and Group C received saline only. Results The bladder instability was lessened.The time of bladder perfusion clearance,indwelling catheter delivery,duration of cystospasm and number of postoperative cystospasm cases in group B and D reduced significantly as compared with group A and C.The Pdet and volume were improved significantly,the Qmax and residual urine were also improved. Conclusions The intravesical and epidural capsaicin delivery helps to prevent detrusor instability and reduces the pain caused by postoperative cystospasm.It also improves the bladder function deteriorated by BPH.

Depression in modern medicine belongs to the depression syndrome in TCM. As early as the pre-Qin period, the ancient doctors recognized depression syndrome as a kind of disease associated with the function of visceral organs or emotional stimulation, which showed mood disorders and a variety of physical symptoms. The doctors in the past dynasties had explored different kinds of non-medicine therapies except for general medicine therapies, such as acupuncture and moxibustion, tuina, music and emotional therapy etc., which had obtained definite therapeutic effects. This article reviewed the non-medicine therapies for depression syndrome in ancient literatures and modern clinical researches, in order to provide some references for the treatment of depression.

Objective: To investigate effects of different frash gas flow of oxygen ventila-tion on emergence time and delirium undergoing Enflurane general anesthesia. Methods: Forty- eight patients, ASA Ⅰ- Ⅱ, aged 33- 68yr, mean 50.5yr, underwent elective abdominal op-eration were randomly divided into three groups according to the different frash gas flow at the end of operation: GroupⅠ, the flow of oxygen maintained at 2 L/min, GroupⅡ 4 L/min, GroupⅢ 10 L/min. Anesthesia was induced with intravenous midazolam 0.08- 0.1mg/kg, etomidate 15- 20mg,fentanyl 3- 4 ?g/kg, pipecuronium 0.08- 0.1mg/kg and maintained with Enflurane(1.5- 2.0vol%), supplemented with intermittent iv pipecuronium and fentanyl. The concentration of Enflurane was monitored continuous which involved Fi, Fa and Fao, originated from inspiration, expiration and the moment expiration when stopped inhalation. Accounted Fao and after this detailed every one minute Fa until the patients recovery and calculated Fa/Fao ratio. Emergence time was recorded. Mini- Mental State Examination (MMSE) was performed before anesthesia and after surgery. Results: Fa/Fao ratio in GroupⅠ was significantly defferent from GroupⅡ and Ⅲ. MMSE scores in GroupⅠwere higher compare with GroupⅡand Ⅲ after surgery. Emergence time was no signif-icantly difference among three groups. Conclusion : The frash gas low flow of oxygen ventila-tion might reduce the incidence of delirium,but does not influnce the time of emergence from general anesthesia.

Objective To investigate the efficacy of acupuncture at mind-tranquilizing points plus conventional shoulder points in treating scapulohumeral periarthritis (periarthritis of shoulder) at the early stage of adhesion. Method Sixty patients were randomly allocated to two groups. The treatment group received acupuncture at mind-tranquilizing points plus conventional shoulder points and the control group, at conventional points. In both groups, treatment was given three times a week, for two weeks. The Hamilton Anxiety Scale (HAMA) score, the Hamilton Depression Scale (HAMD) score, the Japanese Orthopaedic Association (JOA) score and the Visual Analogue Scale (VAS) score were recorded before and after treatment. Result The VAS score,the HAMA score, the HAMD score and the JOA score improved in both groups after treatment compared with before (P<0.05). The VAS score and the HAMA score improved more in the treatment group than in the control group (P<0.05). There were no statistically significant post-treatment differences in the HAMD score and the JOA score between the treatment and control groups (P>0.05). Conclusion Mind-tranquilizing acupuncture plus conventional acupuncture is more effective than conventional acupuncture in treating scapulohumeral periarthritis at the early stage of adhesion.