From the starting point of clinical examination of five-year clinical medicine students, we analyzed the medical teaching reform in our hospital. The results of graduation examinations for undergraduates of clinical medicine in 2009 were selected and used SPSS 19. 0 for statistical analysis. The average score of graduation exams for undergraduates in clinical medical test classes is 87. 24 + 12. 45 points, and the average score for graduation examinations for non-examination students in clinical medicine is 81. 07 ± 10. 24 points. There is a statistically significant difference between the two, and the clinical medicine test class for undergraduate students. The average correlation coefficient between courses was 0. 484-0. 561 (P ＜ 0. 01). The average score of graduation exams for undergraduates of clinical medical test class is better than that of non-test class students, and the scores of each subject in the graduation exam are positively correlated, indicating that the reform of clinical medicine teaching in our hospital was effective at the beginning.

本文分析了临床医学本科生主要临床课程学习成绩的相关性。其方法选取2006级临床医学本科生主要临床课程成绩,运用SPSS进行统计分析,并计算各科成绩的相关系数。得出结果临床医学本科生主要临床课程平均成绩在74.80～83.08分之间,各科课程之间的相关系数平均值为0.464～0.551(P<0.01)。所以临床医学本科生主要临床课程平均成绩较好,各科成绩呈正相关。

案例教学法以其生动、真实、启发性强等鲜明特点在法学等领域广泛使用,在临床医学教学中的作用尚无系统研究.通过结合具体病例对案例教学法的作用、编写设计、组织实施和规范化等进行了系统分析总结,显示在临床医学教学中该方法能显著提高培养医学生分析和处理实际问题的临床思维能力.

Objective To evaluate the efficacy and safety of ibutilide and propafenone for treatment of atrial flutter(AFL) and atrial fibrillation(AF). Methods The random controlled trials (RCTs) concerning the ibutilide and propafenone in the treatment of atrial flutter or atrial fibrillation were collected in a meta-analysis. The Rev Man 5.0 software of Cochrane Coordination Net was used for statistical analysis. Results Meta-analysis showed that :①total cardioversion rate of ibutilide for AFL/AF (64.52%) was higher than that of propafenone(42. 37% ) ( P ＜0.05). No bias was prompted on the funnel plot. ②cardioversion rate of Ibutilide for AF (61.31%) was higher than that of propafenone(41.61% )( P ＜0.05). No bias was prompted on the funnel plot. ③cardioversion rate of Ibutilide for AFL ( 82.69% ) was higher than that of propafenone(40.82% ) ( P ＜ 0.05 ). No bias was prompted on the funnel plot. ④Adverse reaction rates showed no significant difference between the 2 medicine. Conclusion Compared with propafenone, ibutilide is more effective for the treatment of atrial flutter or atrial fibrillation, but the security of both drugs shows no significant difference.

2006年日本京都大学Yamanaka从与小鼠胚胎干细胞(embryonic stem cells,ES)增生分化的24个候选因子中筛选出Oct4、 Sox2、 c-Myc、 Klf4等4个转录因子将成纤维细胞诱导为ES类似的细胞,将其命名为iPS细胞(inducedpluripotent stem cell)[1].从此,人们对iPS细胞的研究便迅速开展起来.

Aim: To research the adhesion of platelets on Dacron and polytetrafluoroethylene (PTFE) coated by tissue-typed plasminogen activator (t-PA) materials through experiments in vivo and vitro. Methods: The experiment was accomplished in the Laboratory of Cardiology, the People's Hospital of Wuhan University (State Key Laboratory of the 211 Project) between June 2004 and June 2005. A total of 72 healthy male New Zealand rabbits were randomly divided into three groups: control group, glutathione S-transferase (GST) protein group and GST-t-PA recombinant protein group. Each group of 24 rabbits was randomly assigned into Dacron material group and PTFE material group. Experimental materials: Dacron B (Suzhou Minghua Weave Ribbon Co.,Ltd), PTFE (Gore&Associates Company). GST and GST-t-PA fusion protein were prepared by this laboratory. Femoral artery were dissected, clamped and incised with 0.3 cm area by eye scissors, with the interval of more than 6 cm. After washing by saline, the incision was put with material chaff coated with GST protein or GST-t-PA fusion protein in the artery of corresponding groups. In the control group, the incision was sutured without materials. The adhesion of platelets on Dacron and PTFE coated by t-PA materials was observed through experiment in vivo and vitro. Results: All 72 rabbits were involved in the result analysis.1 In vitro experiment: on Dacron materials, the adhesion of platelets in GST group and GST-t-PA group were lower than those of control groups, decreasing 76.4% and 42.3% (4.3× 109 L-1, 10.5×109 L-1, 18.2×109 L-1, respectively, x2 =20.15, P < 0.01). As for PTFE materials, the two groups showed the identical trend and decreased 74.8% and 34.1% compared with control group (3.1×109 L-1, 8.1×109 L-1, 12.3×109 L-1, X2 = 22.85, P < 0.01, 0.05). 2 In vivo experiment: on both materials, the adhesion of platelets in GST-t-PA group were obviously lower than those of GST group and control group (Dacron material: (83.04±19.56)×109 L-1, (154.68±21.95)×109 L-1, (215.87±85.13)×109 L-1; PTFE material: (110.2,5±35.23)×109 L-1, (195.32±54.76)×109 L-1, (210.77±72.48)×109 L-1, P < 0.01). Conclusion: Due to the specific thrombolysis action, t-PA can inhibit the adhesion of platelets on Dacron and PTEF material, and prevent the bacterial adhesion on biomaterial.

医学生的临床实习是培养合格医务工作者的关键一步。在新的历史时期,由于社会和环境因素的影响,医学生和患者所构成的"学患"关系正发生着相应的变化,这种特殊的医患关系,直接影响到医学生临床工作的效率和成果。本文讨论、分析了这一现象及其产生的原因,并就如何减少"学患"冲突,构建和谐"学患"关系提出了相应的对策和措施。