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Dalian Medical University, aiming at cultivating innovative talents, has formulated and implemented a "5+3" innovative talents training reform plan. In the whole process of medical undergraduate education, tutorial system is used as the carrier to develop a phased innovative ability training system, which covers basic scientific research ability training such as courses, lectures, experimental design, papers and so on, and strengthens the cultivation of undergraduate scientific research ability. Through statistical analysis of the results of the first "5+3" students' periodic training, it is found that the proportion of "5+3" students publishing Chinese periodicals and SCI, and hosting national innovation projects and provincial innovation projects is significantly higher than that of ordinary 5-year students ( P<0.05). Although there are some problems and deficiencies in the implementation process, the basic scientific research training with tutorial system as the core has a significant effect on improving students' scientific research thinking and innovation ability, and is feasible for training medical innovative talents.
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Objective To detect gap junction protein Cx45, gap junction protein Cx40 and Tumor Necrosis Fαctor-α(TNF-α) expression in the infarcted myocardium, and to study their combined effects. Methods Immunohisto-chemical staining (S-P immunohistochemical staining method) and qRT PCR detection of gap junction were used to identify protein Cx45, Cx40 and TNF-α respectively in 30 cases of late early myocardial ischemic stroke group and 30 cases of myocardial infarction due to sudden death group with control group being 20 cases of normal expression in myocardial group. The effect of the different expressions was compared in the different groups. Results Immuno-histochemical results: Between the two groups, Cx45 expression was higher in the sudden death group compared to normal myocardium. Cx40 expression was decreased significantly in the sudden death group when compared to normal myocardial group while TNF-α expression was high. The expressions had significant differences in the three groups (P<0.05). Qrt - PCR results showed that the mRNΑ expression of Cx45, Cx40 and TNF-α was consistent with their respective protein expression and that there was statistically significant difference in three groups (P<0.01). Cx45, Cx40 and TNF-α had a correlation in the three groups of cardiac muscle. Conclusion Gap junction protein Cx45, Cx40 and TNF-α expression can be useful indicators for the diagnosis of the cause of sudden cardiac death.
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Under the guidance of strengthening medical undergraduates' practical ability and their competence in future jobs, Dalian Medical University has established a clinical medical talents practical ability training mode. This model has implementedThree Turnsclinical skills training pattern to strengthen the three stage (before, during and after practice) clinical skills training and concentrated on humanistic quality education through overall evaluations and set up clinical skill examination system to evaluate teach-ing effectiveness comprehensively and truly , which has effectively improved the quality of education by perfecting safeguard mechanisms and guaranteeing teaching quality.
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Objective To explore the evaluation of contrast enhanced CT with multi -direction adjusting multi -planar reformation(MPR)on the stomach wall invasion of advanced gastric cancer.Methods 105 cases of advanced gastric cancer proved by pathology after surgery were checked by contrast enhanced CT before surgery.All the images were reconstructed by multi -direction adjusting MPR to show perfectly the lesions of gastric cancer,T stage diagnosed by CT were compared with the T stage diagnosed by pathology.Results T1,T2,T3,T4 stage diag-nosed by pathology were 9 cases,23 cases,46 cases and 27 cases respectively,the accuracy of multi -direction adjus-ting MPR in diagnosing T1,T2,T3,T4 stage were 98.1%,93.3%,86.7%,91.4% respectively.Conclusion Con-trast enhanced CT with multi -direction adjusting MPR can improve the accuracy in diagnosing the T stage of ad-vanced gastric cancer,which can be used to evaluate the staging of advanced gastric cancer.
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Objective To explore CT and MRI imaging in the application of newly diagnosed esophageal cancer staging.Methods 200 patients with newly diagnosed esophageal cancer were selected as the research object, who voluntarily accepted the chest CT and MRI examination.Newly diagnosed esophageal cancer pathological results and CT,MRI features were observed.Spiral CT,MRI for T staging of esophageal cancer and N staging diagnosis were compared.Results In 200 patients,including 160 cases of squamous cell carcinoma,30 cases of adenocarcinoma, 10 cases of other types,T1 ,T2 ,T3 and T4 clinical staging period were respectively 19 cases,47 cases,81 cases and 53 cases,while N0 and N1 period were 65 cases and 135 cases respectively.The lesion diameter was 10 -22 (16.5 ± 4.6)mm.CT and MRI showed irregular thickening of the esophageal wall,CT showed equal or slightly lower density, T1 WI was MRI or low signal,T2 WI showed a slightly higher signal.Enhanced scanning,a substantial part of lesion enhancement,while the dead part had no enhancement.In T1 ,T2 of the diagnosis of esophageal carcinoma,MRI had higher diagnostic sensitivity and accuracy compared with CT,and the difference was statistically significant (χ2 =4.32,3.89,all P 0.05).By using the joint appli-cation of the two methods,the diagnostic sensitivity and accuracy were significantly higher than that used alone,the difference was statistically significant (χ2 =4.12,3.98,all P 0.05).The combined application of MRI and CT significantly improved the diag-nostic sensitivity and accuracy.Compared with the single application,the difference was statistically significant (χ2 =4.32,4.54,all P <0.05).Conclusion MRI is more sensitive to diagnosis T1 ,T2 stage and N0 ,N1 stage in esopha-geal carcinoma.Combined application of MRI and CT can improve the diagnostic sensitivity and accuracy.
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Objective To explore the effect of two different position fixing methods on position deviation of different directions and lesions in patients with lung cancer receiving radiotherapy .Methods 100 cases were randomly selected and divided into the two groups .Group A included 50 cases using thermoplastic membrane and group B included 50 cases using vacuum cushion .Position deviations of different directions and lesions of the two groups were observed and compared .Results The forward and backward directions′position deviation of group A was significantly lower than that of group B(t=3.67,P=0.00).The total position deviation of group A was significantly lower than that of group B(t=2.83,P=0.00).The position deviation in the middle of lung field of group A was significantly lower than group B(t =4.26,P=0.00).The repositioning cases of group A accounted for 30.00%(15/50)and group B accounted for 56.00%(28/50).The difference was significant (χ2 =6.90,P=0.00).Conclusion Using thermoplastic membrane as position fixing method in patients with lung cancer receiving radiotherapy can reduce position deviation .
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Objective To explore the setup errors of two different position fixing techniques in radiotherapy for thoracic canc -er, and analyze and compare the accuracy and repeatability of the two different techniques .Methods Sixty four patients with thoracic cancer were selected in our hospital from December 2011 to June 2013 .All patients received radiotherapy .Patients were divided into two groups by means of random number table .Each group had 32 cases.The low-temperature thermoplastic membrane group used ther-moplastic membrane method to fix position while vacuum bag group with negative pressure fixed position by vacuum bag method .The setup errors in the right/left direction (X-axis), anterior/posterior direction (Z-axis), head/foot direction (Y-axis) and three dimen-sional directions ( I) were compared and analyzed between the two groups .Results The low-temperature thermoplastic membrane group was able to reduce the setup errors significantly in the Z-axis (1.13 ±0.33 /2.33 ±1.24, P 0.05).Conclusions Position fixing technique with low-temperature thermoplastic membrane can help to fix position in radiotherapy for thoracic cancer , reduce the setup errors in the Z-axis, and improve the setup accuracy .
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Through feedback from questionnaire,relevant problems are summed up,further understanding of the status of medical students' clinical practice is found.then some problems,such as low positivity of students,week didactical consciousness of teachers and inflexibility of practice system,are researched to table some proposals for reformation of clinical practice.
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Objective To evaluate the value of computed tomography myelography(CTM)in diagnosing the laceration of brachial plexus. Methods Sixteen cases with brachial plexus injury underwent thin-slice high resolution CT scanning two hours after the examination of conventional lumber puncture myelographs.The results of CTM in patients were compared with surgical exploretation and seven patients underwent preoperatively electrophysiological examination .Results There were totally 28 nerve roots injury.Of them,26 were detected by CTM,the accuracy was 92.8%.The main signs of nerve root laceration were the disapperance of the filling defect of ventral and forsal root,the indirect signs were false meningeal cyst,displacement and deformation of spinal cord,twist of nerve root.Conclusion CT myelography is of significant value in diagnosing the laceration of nerve root.