Objective To investigate and analyze the effects of problem-based learning used in clinical nursing education. Method The research papers on the effect of problem-based learning used in clinical nursing education were retrieved via CNKI, Wanfang,VIP,PubMed,ProQuest and Google scholar websites and then analyzed by Revman5.0 software.Results Totally 11 RCTs were included.Meta-analysis showed that PBL could significantly promote students’examination scores,self-study ability, critical thinking and clinical skill,but insignificantly improved the effect in improvement of their theory learning,interest and ability in cooperation.Conclusions PBL is a scientific clinical teaching method,which can stimulate students’initiative and exploratory learning and enhance effects of clinical teaching.Meanwhile,we suggest formulating evaluation criteria and implementing rigorous RCT designs in the future.

BACKGROUND:Fracture of the distal humerus is a common type of fracture. Conservative treatment or metal implant fixation can be used during the clinical treatment of elderly patients, but the choice of specific treatment options stil lacks of clear conclusion. OBJECTIVE:To explore the clinical repair effect and biocompatibility of titanium aloy implant internal fixation for aged patients with distal humeral fractures. METHODS: A total of 41 elderly patients with humeral fractures, who were hospitalized in Danzhou Municipal First People’s Hospital from July 2011 to July 2014, were enroled in this study. In accordance with the wishes of patients, repair program was selected. 22 patients in the control group received conservative treatment. 19 patients in the observation group received titanium aloy implant fixation. After 12 months of folow-up, elbow joint activity, elbow joint function recovery and adverse reactions were observed and compared in the two groups. RESULTS AND CONCLUSION: After conservative treatment and internal fixation, each index score and total score of range of motion of shoulder joint were significantly higher in the two groups as compared with pre-treatment (P < 0.05). Each index score and total score were significantly higher in the observation group than in the control group (P < 0.05). Curative effect evaluation results showed four excelent patients and three good patients in the control group, eight excelent patients and four good patients in the observation group. The excelent and good rate was significantly lower in the control group than in the observation group (P < 0.05). Two patients suffered from mild inflammatory hyperplasia during taking out the fixator in the observation group, and the remaining patients did not affect inflammatory hyperplasia or capsular tissue. In the observation group, after surgery, one case experienced numbness of the ulnar nerve, which disappeared after treatment with trophic nerve. One case suffered from wound infection, which was controled by antibiotic treatment, and did not induce a serious outcome. After folow-up, none of them had nonunion or internal fixation loosening. The results show that titanium aloy implant fixation for the treatment of distal humerus fractures can get better repair effect compared with conservative treatment, can effectively improve the elbow joint function, and titanium aloy material has good biocompatibility.

Objective To develop a method of quantitative analysis of multi-components by single marker( QAMS) for determination of quercetin, kaempferide,isohamnetin in Chuipencao granules,providing method to control the quality of Chuipencao granules.Methods The analysis was performed at 30 ℃,on an Shimadzu C18 column(250 mm ×4.6 mm,5μm),and the mobile phase was methanol-0.4% phosphoric acid solution .The flow rate was 1.0 mL/min, and the injection volume was 10 μL.Quercetin as a reference to establish the relative correction factor kaempferol and between isorhmnetin, the method was evaluated for reproducibility, and the difference between calculated and measured values was compared. Results Quercetin, kaempferol and isorhmnetin respectively 32.36-426.43μg, 11.56-136.87μg, 10.45-155.68μg showed a good linear relationship, and the regression equation was: Y=3625.8X-13658 (R2 =0.9998), Y=2682.9X-10253(R2 =0.9999), Y=3012.2X-11223 (R2 =0.9999).The average recoveries were 99.3%, 99.6%, 98.5% (RSD were less than 1.0%).Determination of 10 batches of Chuipencao granules with QAMS and external standard method, kaempferol and isorhamnetin were measured, and measured values were basically the same.Conclusion The QAMS method is reliable and accurate, which might be used for the quality control of Chuipencao granules.

Objective To study the clinical features of cryptococcosis. Method The clinical manifestations of 101 patients with cryptococcosis were comprehensively analyzed using clinical statistical method. Results Among the 101 patients, 68 were male and 33 were female, 94.1% cases were chronic or sub chronic in onset. Headache and fever were the most common symptoms, over 85.0% patients got headache and(or) fever, vomiting (71.3%) was the second common, and the confusion, convulsion, seizure, visual and hearing damage are also relatively common. Nearly 70.0% patients had intracranial hypertention. Among the 58 patients who received brain CT scaning, 40 showed abnormal changes. All of 8 patients who received brain magnetic resonance imaging(MRI) showed abnormal changes. And 97 cases were positive in cerebrospinal fluid ink stain, 2 cases were negative in ink stain but positive in cerebrospinal fluid culture, and 2 were diagnosed after brain biopsy or brain surgery. Most cases had been falsely diagnosed as many other diseases. Conclusions Most patients with cryptococcosis should be chronic or sub chronic in onset, and their clinical features, cerebrospinal fluid routine and biochemical test, or CT and MRI are lack of specificity. The finding of Cryptococcus in cerebrospinal fluid culture and brain biopsy should be the golden standard of diagnosis.

About half of the world population and more than 90% of rural households in the developing countries still use unprocessed biomass fuels (wood, dung and crop residues) as the fuels. These substances, burning in the open fire or in the simple stoves, can cause indoor air pollution and the pollutants exposure in women and children is more serious. Biomass smoke contains lots of toxic and harmful substances which may impact the health of human. This article presented a recent research progress in the indoor air pollution and health effects caused by combustion of biomass fuels in China and in the world.

Objective To inustigate oceular blood flow velocity in the eyes of paicients with diabetic retino pathy.Methods Hemodynamic parameters in the ophthalmic arteny(OA),central retinal artery(CRA) were determined with color Doppler sonography(CDS) in 70 eyes of 35 patients with diabetic retinopathy and 80 eyes of 40 patients of mormal controlts.Results Compared with normal subjects,the patients with diabetic retinopathy showed significant slower hemodynamic pararneters with OA.CRA and higher with resistive index(P

Objective To explore the clinical , EMG and genetic characteristics of children with hereditary neuropathy with liability to pressure palsies phenotype (HNPP).Methods One case of HNPP diagnosed by gene were reported, and combined with the literature , the clinical, electromyography and genetic characteristics were summarized.Results Female patient, 11 years and 8 months, left foot could not be dorsal flexion and numbness appeared after the movement in 10 d before admission ,EMG showed multiple peripheral nerve injury .Patient's father and uncle were very similar to the history .Genetic examination showed 1363.2 kb heterozygous deletion on the chr17:14095421 -15458636, and the diagnosis was HNPP .Conclusions When limb weakness happened in children after slight stretch or compression , perform EMG examination as early as possible .Children with extensive peripheral nerve damage , limited limb paralysis , and a similar family history , should pay attention to HNPP , and gene examination should be given .

Objective To investigate the therapeutic effect of transplantation of limbal epithelial cells and decellularized porcine cornea construct in rabbits with corneal alkali burn.Methods Allogeneic rabbit limbal epithelial cells were cultured and identified.Porcine cornea scaffold was fabricated by decellularization.The LECs-DPC construct was cultured and transplanted to the alkali-burned corneal surface of rabbits(4month follow-up).Results Immunocytochemistry and RT-PCR analyses revealed the presence of ABCG2 positive limbal stem cells.A general view showed the corneas were clear and vessel-free postoperatively.HE and Masson Trichrome staining results indicated the epithelial stratification,fewer cellular infiltration,DPC' integration into host corneal tissues,and more regular collagen configuration.Transmission electron microscopy exhibited formation of desmosomes and microvilli.Conclusion Allogeneic limbal epithelial cells transplantation using DPC as a carrier can restore corneal clarity after alkali burn in a rabbit model.

Hypertension is a highly prevalent cardiovascular risk factor worldwide.Although the treatment of hypertension has been shown to prevent cardiovascular diseases and to extend and enhance life,hypertension remains inadequately managed,especially in developing country,such as China.Hypertension is one of the major causes of current global disease burden and is as prevalent in China as in the developed world.Blood pressure-induced cardiovascular risk rises continuously across the whole blood pressure range.During the past decades,much evidence has become available to support a systolic blood pressure threshold of 140 mmHg for even 'low-risk' patients,and,in high-risk patients there is evidence for lower thresholds.Lifestyle modification is recommended for all individuals and should be taken as the cornerstone of anti-hypertensive schedule.Monotherapy is inadequate for the majority of patients and more than two-thirds patients should receive combined anti-hypertension treatment,with fixed-dose combination being an ideal choice.The situation of blood pressure controlling could be improved if the government is involved in the anti-hypertension program.

A series of research achievements have been made in the cardiovascular disease prevention and treatment in 2009.Important trials in the fields of ischemic heart disease,hypertension,heart failure,lipid abnormality,and cardiac arrhythmia have been conducted,which casts new lights on management of cardiovascular diseases.Moreover,some guidelines have been updated and published by authorities based on the new research findings,providing new evidence for management of related diseases.