Objective To evaluate the resultof applying computer simulated human for the diagnostics teaching.Methods The survey was conducted on medical simulation teaching and traditional teaching applied in 338 medical students through statistical evaluation of operative performance and questionnaire.Results The simulation teaching group performed better than the traditional teaching group on the operative assessment(P<0.05).79.2%students thought it was necessary to have simulation teaching.Conclusions Computer simulated human Can improve students'clinical practice ability.

In order to raise international comprehensive medical talents to have strong competition capability,the bilingual teaching is on the rise in the domain of medical education. Questionnaire-based survey among the 5-year-proguam medicinal undergraduate students was conducted to investigate the students'learning condition,acquaintanceship and requirements on the bilingual teaching so as to further reform and explore ways to improve the quality of bilingual teaching

Maternity insurance is a policy support of China for women of child-bearing age.Given its good outcomes since it is enforced clinically,such insurance has been confronted with challenges as well.Doctors and nurses of Ob/Gyn departments serve as both protectors of parturient women's interests and practioners of the economic and social interests of the hospital.This paper summarized the experiences of maternity insurance of the Ob/Gyn department of the hiospital in rencent 6 years.The hospital has had 2026 inpationts covered by maternity insurance,without any medical disputes and harvesting a cash surplus of 657145 yuan.Such doctors and nurses are found to play a key role in ensuring a good doctor-patient relationship,and serve as clinival references for the single-disease management and teaching of the hospital.

Objective To investigate the effect factors for language and memory dominance testing in propofol Wada test in refractory epilepsy patients.Methods From January 2010 to August 2013,total of 23 patients underwent propofol Wada tests for language and memory dominance evaluation.According the performance in language test and memory test,the patients were divided into two groups,respectively:succeed with test or failed in test.The relevant factors including age,duration of epilepsy,handedness,FIQ (full scale of intelligence quotient),lateralization of lesions,language dominance,dose of propofol and the adverse effects of propofol were recorded as independent variables.Logistic regression was adopted to screen the effect factors for memory dominance evaluation.All statistical analyses were processed with SPSS software.Results All 23 patients succeeded with language test,but only 13 patients succeed with memory test.The difference of success ratios between language test and memory test was significant (P=0.001).For memory test,the difference of duration of epilepsy and FIQ in success group and failed group was significantly different (duration of epilepsy:(10.57±4.68) vs (18.30±9.30),P=0.032,FIQ:(81 ±25.33) vs (64.2±10.86),P=0.046).More grade Ⅱ adverse effects of propofol occured in the patients who failed in memory test (P=0.011).Logistic regression results indicated the grade Ⅱ adverse effects of propofol were the main risk factor for memory test failure (OR=28.0,P＜0.01).Conclusions Propofol Wada test is an effective method for language dominance evaluation.However,the effect factors for memory dominance evaluation are much more than language evaluation,such as duration of epilepsy,FIQ and grade Ⅱ adverse effects of propofol,and grade Ⅱ adverse effects of propofol may be the most significant risk factor.

Objective: To investigate the diagnostic values of separated renal multi-locular cystic lesions color Doppler ultra-sound and contrast-enhanced ultrasound performance in multi-locular cystic renal cell carcinoma and cysts. Methods:A total of 53 pa-tients (54 lesions) with multi-locular cystic renal cell carcinoma and cysts were included in the study. The presence of carcinoma and cysts was confirmed via histopathology and tested using ultrasound. Contrast-enhanced ultrasound was applied in 24 (24 lesions) of the total number of patients, and the receiver operating characteristic (ROC) curve was used to analyze the numbers of separation, thick-ness, and type of blood flow patterns of the lesions. The contrast-enhanced ultrasound characteristics were also analyzed. We analyzed the diagnostic value of the color Doppler ultrasound in the separated renal multilocular cystic lesions and the contrast-enhanced ultra-sound performance in multi-locular cystic renal cell carcinoma and cysts. Results:Based on the analysis of the ROC curves of the sepa-ration number, thickness, and type of the blood flow of the lesions in 53 patients (54 lesions), the diagnostic specificity was relatively higher in the lesions where the separation number was≥5 strips (86%), the thicknesses were>3 and≤4 mm (95%), and blood flow was band-like (86%). The areas under the curve of the three indexes were 0.7621, 0.8331, and 0.7962, respectively, which indicate high diagnostic values. The separation number of 4 strips, the thicknesses of>2 and≤3 mm, and the point-like blood flow could be used as critical values for the diagnosis. The contrast enhancement, enhancement peak, and disappearance were (11.2 ± 3.4), (21.7 ± 3.8), and (32.1±4.0) s in 14 patients with multi-locular cystic renal cell carcinoma and (18.4±4.5), (37.8±8.0), and (51.3±9.0) s in 10 patients with multi-locular renal cysts, with statistically significant differences (t=4.47, t'=5.90, t'=6.31, respectively;P<0.05). Conclusion:The sepa-ration number, thickness, and type of blood flow of lesions have relatively higher specificity in multi-locular renal cysts than in multi-locular cystic renal cell carcinoma. The ROC curves show a high diagnostic value. Contrast-enhanced ultrasound of the lesions helped in the differential diagnosis of multi-locular cystic renal cell carcinoma and renal cysts.

OBJECTIVE To investigate the clinic significance of screening high risk human papillona virus DNA(HR-HPV-DNA) in pregnant and postpartum women.METHODS HR-HPV-DNA screening was carried by HC-Ⅱ in 711 pregnant and postpartum women.RESULTS In 711 specimens,the infection rate of HR-HPV was 15.07%,15.92% in pregnant women,and 10.11% in postpartum ones;13.43% in the group

Objective To explore the clinical features of spontaneous intracranial hypotension (SIH) headache. Methods Thirty-six cases with SIH headache who were admitted between August 2009 and September 2014 were retrospectively analyzed. Results Twenty-five (69.4%) of 36 cases were female, and 11 cases (30.6%) were male. The age of onset was (39.6 ± 11.9) years. All the cases had headache, among whom 91.7% (33/36) had typical postural headache. The common concomitant symptoms were nausea, vomiting and neck stiffness. The average cerebrospinal fluid (CSF) pressure was (45.3 ± 28.6) mmH2O (1 mmH2O=0.009 8 kPa) which in male was (67.4 ± 15.4) mmH2O , and in female was (37.3 ± 28.2) mmH2O, and there was significant difference (P<0.05). The content of CSF protein was (545.6 ± 377.1) mg/L and the level of IgG was (57.4 ± 41.1) mg/L. Seventeen cases showed abnormality on MRI scan, with diffuse pachymeningeal enhancement, subdural hematoma, hyperemia and swelling pituitary. Eleven cases (52.4%, 11/21) showed abnormal on EEG examination, with theta waves and epiletiform waves in bilateral cerebral hemisphere. All cases were cured after conservative treatment, 3 cases relapsed within 1 month and was cured again. Conclusions Typical postural headache, cerebrospinal fluid pressure less than 60 mmH2O, higher levels of CSF protein and IgG, diffuse pachymeningeal enhancement and hyperemia and swelling pituitary on MRI scan are the main features in SIH headache, and this disease has favorable prognosis.

Objective To explore the value of afterdischarges monitoring for intraoperative electrical stimulation for brain mapping. Methods 34 patients received cerebral cortex electrical stimulation for brain mapping during operation of brain function area , afterdischarges were monitored simultaneously to determine the upper limit of stimulus intensity. Results 34 cases underwent electrical stimulation successfully , and received surgery without neurologic decline except 2 cases of hypokinesia. Conclusion After discharges monitoring improve the accuracy, reduce the risk of intraoperative cerebral cortex electrical stimulation.

Objective To identify the genetic mechanism of fetuses with short limbs deformity.Methods From Aug.2008 to Aug.2011,ten fetuses with obvious short limbs were found in ultrasound screening performed at 18-24 and (or) 30-32 gestational weeks and underwent artificial induced labor with the patient' consent.Amniotic fluid or cord blood of the fetuses was collected for karyotyping analysis and detection of mutation point of fibroblast growth factor receptor 3 (FGFR3)gene by polymerase chain reaction and gene sequencing.One fetus (case 3) who presented with achondrogenesis underwent sequencing of SLC26A2 and Trip11 gene meanwhile.Results Among the 10 fetuses with short limbs deformity,five cases were found during second trimester and five during third trimester.Nine cases were identified as normal karyotype and one was chimera (46,XY/45,XY,- 18).One fetus carried a rare FGFR3 mutation of c.1108G＞T (G370C) and was diagnosed as thanatophoric dysplasia at 21+3 weeks.Three fetus carried c.1138G＞A (G380R) mutation and were diagnosed as achondroplasia.These four families had low recurrent risk because no gene mutations were found in the parents.Three mothers of these four fetuses were pregnant again and had normal neonates now.No mutations were found in all gene sequencing in case 3.Conclusions Karyotyping analysis and sequencing of FGFR3 gene could find causative gene mutations and provide genetic counselling and prenatal diagnosis for some fetuses with short limbs deformity.In the third trimester,achondroplasia is the most possible diagnosis when short limbs fetus is found by ultrasound.

Objective To investigate the value of detection of fetal cell-free fetal DNA(cff-DNA)in maternal plasma in the prenatal diagnosis of chromosomal abnormalities.Methods The plasma from 3200 gravidas(singleton with 20.3 ± 3.8 gestational weeks)was collected from April 1st 2011 to May 30th 2012.They were divided into 3 groups:(1)To tally 1720 cases were included in the high-risk serological screening group,in which women were younger than 35 years and got high-risk results in serological screening;(2)To tally 1310 cases were included in the advanced age group,in which women's age was more than 35 years;(3)To tally 170 cases were included in the supplementary group,in which women were younger than 35 years and got low-risk results in serological screening,or women who didn't take serological screening tests.All the 3030 gravidas in group 1 and 2 didn't take invasive prenatal diagnosis because of fear of abortion or short of prenatal diagnosis.Cff-DNA were detected by next generation sequencing in Shenzhen BGI Genomics Center for clinical laboratory.Amniocentesis and karyotype analysis were provided to the positive cases and women with negative results were followed-up by telephone.Results(1)The 3200 cases took cff-DNA detection,and 31 cases got positive results,including 27 cases of trisomy 21 and 4 cases of trisomy 18.Sixteen cases of trisomy 21 and 1 case of trisomy 18 were in the high-risk serological screening group.7 cases of trisomy 21 and 2 cases of trisomy 18 were in the advanced age group.Four cases of trisomy 21 and 1 case of trisomy 18 were in the supplementary group.(2)And the 84％(26/31)cff-DNA detecting positive cases received amniocentesis.In the 27 trisomy 21 positive cases,23 received amnioeentesis and got karyotype of 47XN,+ 21,with the diagnostic accordance rate of 100％.In the 4 cases who didn't take karyotype analysis,fetal anomaly(ventricular septal defect,dextrocardia and choroid plexus cyst)was found in 1 case before 20 gestational weeks;intrauterine fetal demise happened in 1 case before getting the result;2 other cases who already had healthy children took abortion in the local hospital without taking amniocentesis.In the 4 trisomy 18 positive cases,3 took amniocentesis,2 of which were trisomy 18 and took abortion,the other was chimera(46,XN/47,XN,+ 18)with only 2％ cells of trisomy 18,with no malformation found after delivery.Hypoevolutism(3 weeks less than gestational week),general hydropsy and intrauterine fetal demise happened before the other case took amniocentesis.(3)Follow up of cff-DNA negative cases:until May 30th 2012,no Down's baby was found in the 1230 cases with cff-DNA test negative results.Conclusions(1)The non-invasive fetal trisomy test(NIFTY)by next generation sequencing is a safe,accurate and high throughput method for the prenatal diagnosis of trisomy-21.(2)Use NIFTY as a further screening for pregnant women with high-risk serological screening results could lower invasive prenatal diagnosis rate.(3)Cases with positive NIFTY test results should receive amniocentesis and karyotype analysis to confirm the diagnosis before abortion.