The teaching of geriatrics requires the combination of basic medicine,clinical medicine,nursing,rehabilitation medicine and pharmacy,and the intersection of medical science and humanities.In order to meet the problems of coping with much disease coexistance in geriatrics,poor efficacy,long course of disease,slow recovery and adverse drug reactions,the article puts forward the combination of blackboard and multimedia,the combination of teacher teaching and student lectures,the combination of PBL and CBL,and the combination of theoretical knowledge and clinical practice.It also puts forward carrying out reforms from such measures as the classroom teaching,teaching rounds,case discussion,literature reading,academic research,humanistic influence,going to community pension center for social practice and so on,to improve the quality of gerontology teaching.

Objective To understand the cognition of clinical medical postgraduates' professional ethics,in order to provide the basis for the further development of graduate professional ethics education.Methods The survey was carried out among 650 graduate students of the first hospital of Jilin University by self-designed questionnaires.The questionnaires included the general situation and the understanding of professional ethics of medicine.All data were analyzed by SPSS 17.0,using Chi-square test to compare the results in different grades about the understanding of professional ethics.Results In this study,a total of 650 questionnaires were issued,and 629 valid questionnaires were collected with a recovery rate of 96.7％.Most graduates' professional values were in line with the socialist core values.For example,for the attitude of medical workers to accept red envelopes,410 graduate students (65.2％) firmly opposed to accepting this behavior.For the purpose of the study medicine,there was no statistically significant difference among different grades (P=0.273).For the attitude of red paper,the main problem in medical ethics education and the biggest factor for graduates,there was statistically significant difference among different grades (P=0.012,P=0.002,P=0.002,respectively).Conclusion At present,the professional ethics of postgraduates in clinical medicine is in good condition,but still needs to be improved.We can give further education and guidance to students for the problems existing in graduate students of different grades.

When the synergy medicine education training model increasingly sophisticated,the cultivation of postgraduates of Clinical Medicine research capability has become increasingly prominent.While synergy medical education reforms will train postgraduates to become qualified doctors,we must also train students to master the basic method of clinical research and have basic research capabilities.This paper mainly discusses the measures and mechanisms for cultivating the clinical degree students' research ability from the follow aspects:the construction of innovative training mode of clinical medicine graduate students' scientific research ability,establishment of a joint training mechanism of multi tutor for clinical medical students,Strengthening instructors to guide the process of quality control,strengthening the research project research proposal assessment and increasing the graduate degree thesis review and reply process supervision and so on.

Objective To explore the effect of applying Case-based study (CBS) in combina-tion with Reference-induced self education (RISE) in clinical teaching of Digestive endoscope diag-nostics. Method One hundred and twenty undergraduates in Grade 2012 of clinical imaging speciality of Beihua University were selected as the objects of study and classified at random into experiment group (60 students) and control group (60 students), In the course of teaching, the traditional LBL study and CBS-RISE study were separately employed, and examined through theoretical assessment in combination with case analysis, and the teaching effect in experiment group students was also evaluated through examination paper. SPSS 16.0 statistic soft ware was employed for data treatment and analysis, t test was used for quantity data and expressed as x±s, and x2 test for number counting data, and P<0.05 as the statistical significant difference. Results In experiment group, the total result, and the results of theoretical examination and case analysis were all superior to the control group, and the dif-ference between two groups exhibited statistical significance (P values respectively 0.008, 0.017 and 0.021). The excellent and good rate of the experimental group's theory examination score was 70%, which was higher than that of the control group (48.3%). The excellent and good rate of the experimen-tal group in the case analysis of examination results was 63.3%, higher than that of the control group (43.3%), and the difference was statistically significant (P values respectively 0.016 and 0.028). The students in experimental group showed better degree of satisfaction to the teaching model of CBS-RISE. In general, they considered that the CBS-RISE model could stimulate the learning interest of students, enhance the ability of analyzing and solving problems, deepen the understanding of knowl-edge, train a better clinical thinking model, and also develop a cooperative group idea. Conclusions CBS-RISE teaching model is feasible in the application of teaching in digestive endoscope diagnostics, and beneficial to the training of self learning ability and clinical consideration, deserving populariza-tion.

Our university actively carried out the reform and innovation of the training mode of clinical medicine postgraduates . We implemented the standardized training of resident physicians throughout postgraduate training process , and carried out the comprehensive reform of the training mode of cultivating master degree students of clinical medicine and the standard training of resident doctors. Meanwhile, we trained the master degree students with the synergy of medical education and strengthened the cultivation of students' clinical practice ability, to cultivate qualified doctors for the country, and to improve the quality of postgraduate training.

Chronic Disease ; Cresols ; toxicity ; Humans ; Multiple Organ Failure ; chemically induced

Objective To compare the biochemical and immunological parameters and histopathological characteristics in the patients with autoimmune hepatitis (AIH),biliary cirrhosis (PBC)and AIH/PBC overlap syndrome,and to provide basis for working out the reference standard of clinical diagnosis and reasonable treatment.Methods 135 cases of autoimmune liver disease patients were selected,including 49 cases of AIH patients,43 cases of PBC patients, and 43 cases of AIH/PBC overlap syndrome patients. The biochemical, immunological parameters and histopathological changes of the patients were detected. The patients with AIH/PBC overlap syndrome were treated with different therapy methods including ursodesoxycholic acid (UDCA ) treatment,prednisone treatment and combination treatment with UDCA and prednisone,and the effectiveness of different treatment programs were evaluated.Results The activities of GGT and ALP and IgM level of the patients in the AIH/PBC group were significantly higher than those in AIH group,there were significant differences (P<0.05);the activities of ALT and AST and IgG level of the patients in AIH/PBC group was significantly higher than those in PBC group,there were significant differences (P<0.05).The detection rates of AMA and AMA M2 of the patients in AIH/PBC group were higher than those in AIH group, there were significant differences (P<0.05);the detection rates of ANA and SMA of the patients in AIH/PBC group were higher than those in PBC group,there were significant differences (P<0.05).There were high incidence of piecemeal necrosis (100.0%), liver cell rosette-like changes (83.72%)and bile duct lesions (69.77%)of the patients in AIH/PBC group.The effective percentage in combination therapy group was 85.7% which was significantly higher than those in various drug alone groups (P< 0.05 ). Conclusion The changes of biochemical and immunological indicators and pathological features of the patients with AIH/PBC overlap syndrome are in combination with the particular indicators of AIH and PBC which would provide the diagnostic basis for AIH/PBC overlap syndrome. The combined therapy for AIH/PBC overlap syndrome is effective and should be popularized.

Objective To investigate the mechanism of nuclear factor-kappa B(NF-κB)in thioactamide(TAA)induced acute hepatic injury.Methods Seventy-eight Wistar rats were randomly divided into normal group(n=18),TAA model group(n=30)and pyrrolidine dithiocarbamate (PDTC)pretreated group(n=30).The rats in PDTC group were received 100 rag/kg of PDTC 1 h before induction of the model.Every 10 rats in TAA group and PDTC pretreated group and 6 rats in normal group were sacrificed at 6,24,48 hour after induction of the model tO mesure levels of endotoxin,tumor necrosis factor(TNF)-α and interleukin(IL)-6.The expression of the intercellular adhesion molecular(ICAM)-1 in hepatic tissue was tested using RT-PCR and the NF-κB activity was 48 hour were higher in TAA group[(87.11±8.23)%.(78.55±6.82)%and(74.27±6.26)%,respectively]than those in normal group[(4.64±1.82)%,(4.55±1.67)%and(4.91±2.12)%,all comparison with normal group(P＜0.01).The serum concentration of endotoxin and TNF-α in PDTC pretreated group were higher than those in normal group(P＜0.0 1).but lower than those in TAA with ticrmal group(P＜0.01).The serum concentration of IL-6 in PDTC pretreated group was higher at 24 and 48 hour than those in normal group(P＜0.01),but lower than thoes in TAA group(P＜group(P＜0.01).The expression of ICAM-1 in PDTC pretreated group was higher than that in immunohistochemical examination showed that liver necrosis was folund in TAA group and PDTC pretreated group.Conclusion The Nuclear factor-κB may aggravate the injury of liver by promoting expressions of TNF-α,IL-6 and ICAM-1.

Objective To investigate the efficacy of transplantation of induced bone marrow mesenchymal stem cells(MSCs)via various route for treatment of chronic liver injury.Methods MSCs were isolated and expanded by density gradient centrifugation combined with adherent culture.MSCs were induced to differentiate into hepatocyte-like cells in vitro.The markers of hepatocyte lineage were examined by RT-PCR and immunocytochemistry.The changes of ultramicrostructure of MSCs were observed by transmission electron microscope.One hundred and fourteen Wistar rats were treated with mixture of 40%CCl4 and peanut oil to establish chronic liver injury model and another 6 rats were served as control.Twelve rats in model group were died within 8 weeks,and the rest rats were divided into portal vein,spleen and tail vein transplantation groups.The rats were transplanted with DAPI-labelled MSCs which were induced for 14 days.The distribution of the DAPI-labelled cells were observed by fluorescence microscopy.The liver function and pathology were examined.Results AFP mRNA expression were detected at 7th and 14th day after induction,expressions of ALB mRNA,CK18 and hepatocyte antigen were found at 14th and 2lth day.The ultrastructure examination revealed that MSCs were enlarged with a lot of endoplasmic reticulum,mitochondrion,lysosome and glycogen granule.DAPI labelled cells were found in the spleen and liver transplantion groups.The pathological changes of liver were alleviated in all treated groups,especially in intraspleenic transplantion group(P＜0.05).Conclusions Induced bone marrow MSCs can ameliorate liver function of chronic hepatic injury after transplantation.The intraspleenic transplantation is better than others.