There are still two outstanding problems in comprehensive quality assessment index system of clinical medical undergraduates:contents of assessment is incomprehensive and every index has no quantitative research based weight.This article elaborated on a complete index framework,covering required knowledge,abilities,attitude,morality of clinical medical undergraduates and proposed a set of methods and processes,including literature research method,system analysis method,brainstorming,expert interviews,Delphi method,and some statistical methods,providing a theoretical basis for the development of comprehensive quality assessment index system for clinical medical undergraduates.

Objective: By analyzing the psychological state of patients during pre-hospital care,proper psychological support is provided for better rescue,reduce patients′ suffering and and incidence of medical conflicts.Methods: Follow-ups with patients of pre-hospital care,discussion of medical cases,and practical experiences are reviewed,and combine psychological knowledge and pre-hospital care.Results: When psychological support is given during pre-hospital care,patients′ pain was greatly reduced with satisfaction increased.Conclusion: The psychological support is given during pre-hospital care is necessary,and benefits both doctors and patients.

Objective:Comparative analysis of imaging features of abdominal CT, B ultrasound and magnetic resonance cholangiopancreatography in three different methods for detection of extrahepatic bile duct stones. Methods: A random sample of extrahepatic bile duct stones were a sample of 150 cases as the object of study, patients in the endoscopic retrograde cholangiopancreatography after diagnosis, followed by B ultrasound examination, the implementation of CT scanning and MRI imaging in 142 cases, including 78 cases of B ultrasound detection, CT detection, 118 cases underwent MRI examination. Results: The detection results were recorded and compared the 3 imaging methods. Results: The positive rate of B ultrasound 39.4%, the positive rate of CT was 53.8%, MRI positive rate was 86.4%, the positive rate of MRI was significantly higher than that of B ultrasound and CT (x2=59.725, x2=25.595; P<0.01), the detection rate of CT was significantly higher than that of B ultrasound(x2=4.231, P<0.05). Diameter less than 8 mm of extrahepatic bile duct stones with B ultrasound and positive rate of 25%, the positive rate of CT was 33.3%, MRI positive rate was 60%, the positive rate of MRI was significantly higher than that of B ultrasound and CT(x2=7.789, x2=7.789;P<0.01), the detection rate of CT with no significant differences between the B ultrasound. Conclusion:MRI of extrahepatic bile duct stones with B ultrasound and the positive rate of CT is higher, but the clinical needs according to the comprehensive evaluation of individual patients, economic status, symptoms, diagnosis method for selecting suitable.

Background and purpose:Internal mammary sentinel nodes (IMSNs) lymphoscintigraphy could guide in ?-detecting and removing the IMSNs for the purpose of biopsy during the operation,which is helpful to determine the necessity of postoperative radiotherapy. However,IMSNs imaging rate remains low if using axillary lymph nodes (ALNs) lymphoscintigraphy. This study was to investigate the tracer’s properties and try to improve the IMSNs imaging rate through changing the label procedure. Methods:The boiling time of 99mTC-sulphur colloidal particles was shortened from 3~5 minutes to 2 minutes during the label procedure, then the colloidal particles’ diameter, distribution and stability were observed by Transmission Electron Microscope (TEM), then the IMSNs lymphoscintigraphy was performed. Results:This colloidal tracer’s shape and distribution remained stable for 3 hours, and 90% of the particles had a diameter of 10 nm, the particles tended to aggregate afterwards. 4 hours after labeling, the diameter of particles exceeded 100 nm. IMSNs could be clearly imaged if the tracer was freshly used (within 3 hours after labeling). Conclusion:Within 3 hours after the labeling the unfiltered colloidal tracer with modified procedure, the particle could be used and internal mammary lymph nodes could be imaged more clearly.

Objective:To investigate the protective effects of matrine(MT) preconditioning against hepatic ischemia-reperfusion injury in rats. Methods:Fifty male SD rats were randomly allocated into 5 groups:sham operation(SO) group,ischemia-reperfusion (NS) group and MT preconditioning groups (of 3.75,7.5,15 mg/kg). Rats of NS and MT groups were injected normal saline or MT,respectively; and 15 min later,the pedicales of the left and median liver lobes were clampped for 45 minutes,and reperfused for 40 min. The portal trial were only separated but not obstructed in SO rats. After reperfusion,the serum activity of ALT,AST and LDH was determined,the activity of SOD and content of MDA in liver tissue were examined,and histopathological changes of liver were observed. Results:Compared with those of NS group,the serum levels of ALT,AST,LDH,and the content of MDA in liver tissue of MT groups were lower,and the activity of SOD was higher(P

Arginine-8-vasopressin (AVP) could promote the acquisition of shuttle-box passive avoidance behavior and delay the extinction of the behavior when injected into the hippocampus of rats.Intrahippocampal injection of 6-hydroxydopamine (6-OHDA) prevented AVP from enhancing memory.The authors had also observed that AVP could accelerate the degradation of cate-cholamine in the hippocampus when the contents of monoamine transmitters and their metabolites were analyzed with high-performance liquid chromatography and electrochemical detection. These facts suggest that vasopressin promotes the shuttle-box passive avoidance behavior in rats,strcnthens long-term memory as well as short-term memory,and exerts its effect on memory through its enhancing the degradation of norepinephrine and/or dopamine in the hippocampus.

Purpose: To review radiotherapy for Grave's ophthalmopathy. Materials and Methods: From 1964 through 1992, 94 patients with Grave's Ophthalmopathy (4 unilateral and 90 bilateral lesions) were treated by radiotherapy with the doses of 9～25Gy. Results: The overall effective rate was 83%. Edema of the eyelid , proptosis and ophthalmalgia were significantly improved. No complication of pituitary gland was found for patients whose pituitary glands were involved in the radiation ports. Conclusion: Radiotherapy is effective for Grave's Ophthalmopathy. The radiation dose advised is 20～25Gy/3wks.

Objective To make sure if there is single nucleotide polymorphisms(SNP) of c135 in RET proto-oncogene in Han ethnic group of Shaan Xi,China and investigate the relationship between Hirschsprung disease(HSCR) and SNP of RET proto-oncogene c135.Methods A total of 40 blood samples were collected from healthy donors through cluster sampling in Xi'an,Shaan Xi province.Sixteen tissues in aganglionic segments of HSCR were studied(they were all sporadic in Han ethnic group of Shaan Xi province of China and diagnosed by pathology).DNA was isolated from above samples and PCR amplified.The fragment of products were 300 case pairs(bp) which located in RET exon2 including c135.All of fragments were purified and directly sequenced and analyzed by related software and statistical methods.Results There really existed the single nucleotide polymorphisms of c135 A/G of RET in controls.A,G allele frequency was 0.475 and 0.525,respectively,and there was no distinctive dominant genotype.In patient group,A,G allele frequency was 0.844 and 0.156,respectively.c135A genotype was dominant in patients.There was significant statistical difference between patients and controls in RET c135A/G(PA.There is relationship between the disease and the c135 A genotype of RET.c135A genotype in the RET proto-oncogene are over-expressed in patients with Hirschsprung disease.

Objective To study the ultrasonic features of fetus deformity.Methods 34 cases with fetus defomity were examined by Aloka 280 B-mode ultrasound and Hp-image point system(3.5 MHz transducer).Results Of the thirty-four cases with fetus deformity,thirty-one cases were seen and proved by the clinical induced labour and parturition.Only three of the cases were misdiangnosed.Conclusion Examination with the ultrasonic equipment is a simple and convenient way in the antenantal examination.Fetus deformity often exists simultaneously with various types of deformity and has close relationship with the amount of amniatic fluid.

Objective:This research integrated the attribution of responsibility and aggressive retaliation to find their relationship. Methods: 204 subjects attended this experiment, and two structural equation models that reflect the relationship among intentional attribution, affect, responsibility and aggressive retaliation were set up. EQS was used to test the models. Results: The data fitted both Weiner's model and ours well, which suggested that intentional attribution contributed to the judgment of responsibility and the response of affects, and then linked with the retaliation action. And in this process, judgment of responsibility and the response of affects were two media variables that had two-way interrelationship. Conclusion:A general model suggested here was:intentional attribution →judgment of responsibility, affect response →aggressive retaliation.