In order to improve the teaching quality of epidemiology and better serve the situation of disease prevention and control,problem-based learning (PBL) teaching method was applied in the teaching of epidemiology. This paper introduced the implementation of PBL and its advantages and disad-vantages. PBL teaching method can improve students' self-learning ability,communication skills,team cooperation,practical ability and capability of integrating knowledge of many subjects.

Objective To compare the immediate effects of extracorporeal shock wave therapy with that of joint mobilization plus short wave therapy in treating scapulohumeral periarthritis, and to elucidate the mechanism of extracorporeal shock wave therapy and how it should be used. Methods Forty-seven patients diagnosed with scapulohumeral periarthritis were selected and randomized into two groups, a treatment group (n = 26) treated with extracorporeal shock wave therapy, and a control group ( n = 21 ) treated with joint mobilization plus short wave therapy. The short form of the McGill pain questionnaire (SF-MPQ) and range of motion (ROM) measurements were used to evaluate shoulder function. Results Compared with baseline, both groups improved significantly af-ter treatment, but the immediate effect in the treatment group was superior to that in the control group. Concln-sions As a safe, time-saving and effective therapy, extracorpnreal shock waves could be used to treat scapulo-humeral periarthritis.

Angioplasty, Balloon, Coronary ; Coronary Occlusion ; diagnostic imaging ; therapy ; Fluoroscopy ; adverse effects ; Humans ; Male ; Middle Aged ; Radiodermatitis ; etiology ; Treatment Failure

Adolescent ; Adult ; Female ; Humans ; Male ; Maxillary Fractures ; diagnostic imaging ; Middle Aged ; Nasolacrimal Duct ; injuries ; Tomography, Spiral Computed ; Young Adult

This paper illustrates the company's cleaning validation of many varieties of Chinese materia medica (CMM) preparation manufatured in the same production line by real case from four aspects such as selection of target product, confirmation of marker, validation of acceptance criteria, and analytical methods. It is a scientific, rational, and economic validation strategy to use CMM preparation extract or the whole extract powder as marker components for validation and determination of the marker components using UV-full wavelength scan method.

Objective To compare the effect of botulinum toxin A(BTX-A)applied according to experi- ence with its effect when the application is guided by electrical stimulation on spasticity in the ankle plantarflexors of children with cerebral palsy(CP).Methods Forty-five children with CP were randomly assigned into 2 groups to receive injections of BTX-A guided by electrical stimulation,or injections of BTX-A guided by experience.All chil- dren received a local injection in the ankle plantar flexors.Physiotherapy and ankle-foot orthoses were applied by a physical therapist 3 days after the BTX-A injections.After the first 10 days,the therapy was administered by the patient's family.Clinical assessments included the patient's passive range of movement(PROM),scoring on the Ash- worth scale(MAS),the composite spasticity scale(CSS),and the D and E dimensions of the gross motor function measure(GMFM),and walking velocity(WV).Assessments were performed before treatment and at 3 days,2 weeks,1,2,and 3 months following the injection with BTX-A.Results All children showed significant decrease in spasticity(PROM,MAS and CSS)after 3 days.The improvement was maintained at 3 months.When compared with the results before the injection,the improvements in standing and walking(GMFM)and in walking velocity were statistically significant after 2 weeks of treatment for both groups,and were maintained at 3 months.The differences in PROM and CSS scores at 3 days,2 weeks,1,2,and 3 months following the injection were statistically significant between the 2 groups.Significant differences were also found between the 2 groups in MAS scores at 3 days,2 and 3 months after treatment,and in GMFM and WV at 2 and 3 months after treatment.Conclusions A BTX-A injec- tion,whether guided by electrical stimulation or experience,in combination with physiotherapy,can reduce spasticity in the ankle plantarflexors of ambulant children with CP and improve their functional performance.BTX-A injection guided by electrical stimulation was more effective than an injection guided by experience.

ObjectiveDouble-outlet right ventricle,which often associated with total anomalous pulmonary venous connection and complete endocardial cushion defects,has been considered a risk factor for biventricular repair procedure.To reviewed cases treated by biventricular repair for endocardial cushion defects with double outlet right ventricle.MethodsFrom July to November of 2009,6 patients (3 males and 3 females) aged from 7 to 24 (16.17±5.98) years and with endocardial cushion defects and double outlet right ventricle underwent operation of biventricular repair The duration of follow-up ranged from 10 days to 2 years(median,16 months).Endocardial cushion defects were repaired with a 2-patch technique.The artificial vascular patch was implanted to connect the ventricular septal defects and the aorta for draining the blood stream from the left ventricle to the aorta.The other patch was used to repair the ostium primum atrial septal defects.Right ventricular outflow tract obstructions was released and reconstructed by transplanting a bovine pericardium patch.If the size of pulmonary valve annulus was far more below the normal,a transannular pericardial patch was used.Rastelli procedure with a valved conduit between the right ventricle and the pulmonary artery would be performed if the obstruction in the right ventricular outfolw tract was severe.ResultsOne death occurred 2 days after the operation,resulting in a mortality rate of 16.6%.The case,a boy of 7 years old,had a mirror-image dextrocardia,complete endocardial cushion defect ( C type),anomalous pulmonary venous drainage and single atrium.In this case,the operation lasted for 8 hours,acute renal failure happened next day to the operation,the effect of CRRT was unsatisfied,and eventually cardiac arrest occurred as a result of hyperkalemia.The remaining cases had survived.Follow-up examinations showed that the systolic pressure gradients across the pulmonary valves decreased,with a range of 14 to 40 mm Hg,(23.9 ± 11.03) mm Hg.Mild mitral and tricuspid regurgiration were identified in 4 cases and moderate mitral regurgitation was identified in one case.The cardiac function in all patients was classified as NYHA class Ⅰ/Ⅱ,Conclusion Endocardial cushion defects with double outlet right ventricle can be corrected by means of biventricular repair procedure.The procedure was associated with a low mortality,The interim life quality of patients may be improved.The longterm outcomes should be further studied.

Objective To compare the efficacy of the reforming endoscopic minimally invasive releasing(REMIR) with open procedure for treatment of carpal tunnel syndrome.Methods Senventy patients with unilateral carpal tunnel syndrome were randomly divided into REMIR group and open procedure group,with 35 cases in each group.Kelly's standard,two-point discrimination,operation time and complication occurrence were compared between the two groups.Results All patients were followed-up for 12 months.There was no significant difference in the therapeutic results and in the improvement of two-point discrimination between the two groups (P ＞ 0.05 ).The operation time of REMIR group was significantly shorter than the open procedure group ([ 10.03 ± 1.84] min vs [37.63 ±7.18]min,t =22.210,P ＜0.001 ).And there was no cases with scar tenderness in REMIR group while there was 7 cases in open procedure group.Conclusion Compared with the open procedure,the REMIR method has the same clinical efficacy while with the advantages of causing smaller skin scar and being less time consuming.

Female ; Humans ; Immunohistochemistry ; In Situ Hybridization ; Infant, Newborn ; Lung ; metabolism ; pathology ; Macrophage Migration-Inhibitory Factors ; analysis ; genetics ; Male ; Respiratory Distress Syndrome, Adult ; blood ; genetics ; pathology

OBJECTIVETo study the effects of skin wound induction gel on the glans scabbing rate, class-A wound healing rate, and wound healing time of circumcision for phimosis in pediatric patients.

METHODSWe randomly assigned 48 six to thirteen years old children with phimosis to an experimental group (n = 25) and a control group (n = 23) to be treated by circumcision. After surgery, the patients in the experimental group received application of skin wound induction gel while those in the control group received that of povidone iodine only to the glans and incision. We recorded and compared the glans scabbing rate, class-A wound healing rate, and wound healing time between the two groups of patients.

RESULTSGlans scabbing was observed in 3 cases in the experimental group and 17 cases in the control group (12.0% vs 73.9%, P < 0.01). No statistically significant differences were found in the rate of class-A wound healing between the two groups (100% vs 91.3%, P > 0.05). The wound healing time was significantly shorter in the experimental than in the control group ([10.7 ± 1.7] d vs [11.9 ± 2.1] d, P < 0.05).

CONCLUSIONPost-circumcision application of skin wound induction gel to the glans and incision can effectively reduce glans secreta, alleviate inflammatory reaction, and shorten the healing time in the treatment of phimosis in children.

Adolescent ; Child ; Circumcision, Male ; Gels ; administration & dosage ; Humans ; Induction Chemotherapy ; methods ; Inflammation ; prevention & control ; Male ; Phimosis ; drug therapy ; Postoperative Complications ; prevention & control ; Wound Healing ; drug effects