PBL tutoring is quite different from the traditional tutoring and emphasizes the importance of student-centred instead of teacher-centred education.In PBL,teachers guide students to find answers to their own questions and facilitate students' learning process.Therefore,the tutor role is complex and has a fundamental change.

Objective To explore the effect of valproate(VPA) on body mass index(BMI),leptin and serum lipids in children with epilepsy.Methods (Twenty-)four cases with epilepsy were selected.BMI and serum levels of leptin,total cholesterol(TC),(triacylgly)-cerol(TG),high density lipoprotein-cholesterin(HDL-C),low density hipoprotein-cholesterin(LDL-C) after treated with VPA for 3 months and 6 months were determined.Results The levels of BMI,leptin,TC,TG,LDL-C after treated 3 months were all significantly higher than those of initial(all P0.05).Those in treated 6 months were same as levels of treated 3 months.Only LDL-C level was lower than that of 3 months and same as level of before treatment.Conclusion VPA do have efficacy to cause obesity in children with epilepsy,and most of the cases occur in the first 3 months after VPA treatment.

Codon ; Herpes Simplex ; virology ; Herpesvirus 1, Human ; genetics ; metabolism ; Humans ; Protein Binding ; Protein Biosynthesis ; Viral Proteins ; genetics ; metabolism

Animals ; Herpesviridae ; genetics ; metabolism ; Humans ; Viral Proteins ; chemistry ; genetics ; metabolism

Objective To investigate the diagnostic value of procalcitonin(PCT)as an early indicator for sepsis.Methods Serum levels of PCT and C-creative protein(CRP)and white blood cell (WBC)count were measured in 30 patients in critical condition hospitalized at an intensive care unit(ICU) with diagnosis of systemic inflammatory response syndrome(SIRS).They were divided into two groups, sepsis and non-sepsis,based on their clinical manifestations and results of lab tests.Blood specimen was collected from each patient for measurement of PCT,CRP and WBC count on the 1~(st),3~(rd)and 7~(th)day after hospitalization and bacteriological culture for blood and sputum,and chest X-ray was performed,as well. Acute physiology,age and chronic health evaluation(APACHE Ⅱ)was made on the 1~(st),3~(rd)and 7~(th)day after hospitalization to assess their ill condition.Their prognosis were judged on the 28~(th)day of the follow-up. Results Serum level of PCT increased significantly in the sepsis group(with the highest of 10.13 ng/ml), as compared with that in the non-sepsis group.Sensitivity,specificity and predictive value of a positive test for a cut-off value of serum level of PCT at 0.5 ng/ml were 97.0%,91.7% and 82.1%,respectively, which were all better than those of serum level of CRP and WBC count.Serum level of PCT in the patients was significantly associated with their prognosis,and PCT in those died was significantly higher than that in those survived.Whereas,serum level of CRP and WBC count elevated in both groups,but the difference between the two groups did not reach a level of statistical significance.Conclusion Serum level of PCT can be used as an early indicator for judgment of sepsis for a patient with infection and reflection of severity of illness.

To optimize the growth condition for the established gene engineer bacteria express cardiac troponin-I(cTnI) and to obtain purified cTnI as an antigen to produce clinical assay kits used in acute myocardial injury(AMI) diagnosis.Plackett Burman Design(PBD) was applied to select the factors which effect the expression of cTnI in Escherichial coli(E.coli) mostly.Induction time,pH and KCl were proved influenced expression of cTnI notably.Afterward,Response Surface Methodology(RSM) as second step to optimize the selected three factors,an equation was deduced to predict the percent of cTnI.In the most optimized condition,the percent of cTnI can reach to 26% of total cell protein.The procedures of purification included ammonium sulfate deposition and DEAE Cellulose ion exchange chromatography.SDS-PAGE shows that purified cTnI contain one band.cTnI could be used to immune animals as an antigen to produce monoclonal antibodies with high affinity and specificity.It maybe as calibrators to harmony the difference assays of cTnI measurement in clinical.

Objective To systematically review the efficiency of 18 F-FDG PET in glioma grading by using Meta-analysis. Methods Retrieval in PubMed and China National Knowledge Infrastructure (CNKI)was performed. Relevant papers concerning with glioma diagnoses with 18 F- FDG PET were selected. Paper quality was evaluated according to the standard of diagnostic test recommended by Cochrane Workshop. The data of glioma malignancy degree defined as semi-quantitatively and qualitatively were extracted from the papers. Meta-analysis was conducted with the Meta-Disc software to calculate pooled weighted sensitivity and specificity with 95% confidence interval (CI). Summary receiver operating characteristic (SROC) curve was performed and the areas under the curve (AUC) were calculated. Results Seven hundred and fifty-three patients from 17 papers ( 16 in English, 1 in Chinese) were included. Two hundred and seventy-two patients from 11 papers were using semi-quantitative (tumor to cortex ratio, T/C; tumor to white matter ratio,T/W) method and 481 patients from 9 papers were using qualitative method (visual observation, some of the papers had 2 or more methods). After heterogeneity test was done, different effect models were selected. The pooled weighted sensitivity, specificity and diagnostic odds ratio (DOR) with 95% CI for T/C group was 0. 952 (95% CI: 0. 903 -0. 980), 0. 409 (95% CI: 0. 318-0. 504) and 11. 746 (95% CI:5. 368-25. 702) respectively. The pooled weighted sensitivity, specificity and DOR with 95% CI for T/W group was 0. 857 (95% CI: 0. 768-0. 922), 0. 538 (95% CI: 0. 431 -0. 642) and 22. 066 (95% CI:7. 077-68. 800) respectively. The pooled weighted sensitivity, specificity and diagnostic odds ratio (DOR)with 95% CI for qualitative method was 0.810 (95%CI: 0.757-0.855), 0.870 (95%CI: 0. 819-0.911 ) and 15.282 (95% CI: 3. 716-62. 851 ) respectively. The AUC for T/C group, T/W group and qualitative method was 0.8604, 0. 8373 and 0. 8724 respectively. Conclusions Grading glioma by 18 F-FDG PET with semi-quantitative method may provide high diagnostic sensitivity. If qualitative method is used, the diagnostic specificity may be higher.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cluster Analysis ; Diagnosis, Differential ; Female ; Humans ; Liver Diseases ; classification ; epidemiology ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Yang Deficiency ; classification ; epidemiology ; Yin Deficiency ; classification ; epidemiology

Asthenopia ; epidemiology ; etiology ; Fatigue ; epidemiology ; etiology ; Humans ; Occupational Diseases ; epidemiology ; Railroads ; Sampling Studies

Objective To discuss the application value of 18F-FDG PET/CT in diagnosis of colorectal cancer. Methods We retrospectively analyzed the data of 186 patients who were diagnosed as colorectal cancer by 18F-FDG PET/CT. We classifed all cases according PET/CT imaging into position group and type group,and calculated SUV (maximum standard uptake value) of tumor tissue, and compared with normal tissue. Results There were 112 cases of rectal cancer,27 cases of carcinoma of sigmoid, 17 cases of carcinoma of cecum,16 cases of ascending colon carcinoma,14 cases of carcinoma of descending colon according to positions via PET/CT. There were 68 cases of protrude type,57 cases of ulcerative type,34 cases of infiltrating type,27 cases of colloid adenoma according types via PET/CT. The SUV of tumor tissue was higher than normal value,the difference had statistical significance. Conclusion 18F-FDG PET/CT has high application value in colorectal cancer diagnosis, positions and types.