Objective To observe and investigate the effects of the case-based learning assisted with WeChat software in the teaching of nursing constitution regulating theory. Method The two classes of nursing undergraduate Grade 2013 were randomized into the case-based learning (CBL) group and the traditional teaching group (LBL). WeChat group combined with CBL group made preparation before class, including teachers writing the cases and thinking questions, WeChat sending teaching information, students discussing problems in group and collecting information. In class, students gave presentation and made speech, and the teachers made comments, did summary and gave scores to students' performance. In LBL group teacher prepared a lesson, and taught lessens assisted by multimedia PPT. After class, we used the test of nursing constitution regulating and teaching effect questionnaire to compare the differences between the two groups, using SPSS 21.0 for data statistics, and t test for measurement data. Results The single choice score, multiple choice score and the total score of the test of nursing constitution regulating in the CBL group were (52.46±4.35), (33.42±3.11), and (85.88±5.72), higher than the LBL group which were (47.63±5.84), (29.88±4.55), and (77.50±7.88). The difference was statistically significant. Scores of self-study ability, interest in learning, literature retrieval ability, communication and cooperation ability, TCM differentiation and the examination scores in CBL group were significantly higher than that in LBL group. Conclusion The case-based learning assisted with WeChat software can inspire the interest of learning, cultivate the self-study ability and practice the ability of TCM differentiation. It is worthy of being generalized.

OBJECTIVE:To evaluate the analgesic effects and ADR of fentanyl transdermal patches in different therapies. METHODS:189 patients with cancer pain were randomized into three groups:routine dose fentanyl transdermal patches group(group A) ;routine dose fentanyl transdermal patches +12 h controlled-release morphines(Ms) group(group B) ;twice routine dose fentanyl transdermal patches+12 h controlled-release Ms group(group C) . The curative effects of treatment for 6 days in3 groups were compared by VAS method. RESULTS:In group A,B and C,significant differences were noted in curative efficacy(P0.05) . CONCLUSION:The therapy of group C shows better analgesic effect,safety and clinical value than the other two groups.

OBJECTIVE: To compare the economic effects of MS Contin and oxycontin in treatment of cancer pain. METHODS: 120 patients with cancer pain were divided into GroupA1(30 cases),GroupA2 (30 cases),GroupB1 (30 cases) and GroupB2(30 cases). GroupA1 and GroupA2 were received MS Contin via p.o. for 15 days while GroupB1 and GroupB2 oxycontin via p.o. for 15 days. Pharmacoeconomics was applied in costeffectiveness analysis. RESULTS: Effective rates of GroupA1,GroupA2,GroupB1 and GroupB2 were 70.00%,83.33%,96.67% and 90.00%. The costeffectiveness ratios were 385.71,324.01, 284.58 and 305.67,respectively.The incremental costeffectiveness ratios of GroupB1 and GroupB2 were 19.12 and 25.50,respectively as comparing with GroupA1. CONCLUSION: Therapy of GroupB1 is optimal among 4 schemes based on the curative effect or costeffectiveness analysis.

Rhetsinine has been isolated from the fruits of Evodia rutaecarpa ( Juss. ) Benth. ~1H NMR and ~(13)C NMR assignments reported previously for rhetsinine were revised on the basis of UV, IR, ESI-MS,~1H NMR, ~(13)C NMR and X-ray crystallographic analysis.

Objective To study the relationship between tacrolimus blood level/dose and the genotype of CYP3A5 at 6th month after lung transplantation.Method Forty-six cases of lung transplant recipients who received the surgery between January 1st,2011 and January 1st,2013 served as the research subjects,and the genotypes of these patients were measured.These patients were divided into 3 groups (CYP 3A5 * 1 * 1,CYP 3A5 * 1 * 3,CYP 3A5 * 3 * 3) according to their different genotypes.The dose of tacrolimus and daily intake were detected at 6th month after surgery in each group,then the level/dose of tacrolimus was calculated.Result In all 46 recipients,5 of them were CYP 3A5 * 1 * 1 homozygous genotype,20 CYP 3A5 * 1 * 3 heterozygous genotype and 21 CYP 3A5 * 3 * 3 homozygous genotype.Under the condition of holding tacrolimus blood level between therapeutic range,there was significant difference in the dose of tacrolimus between the CYP3A5 * 1/ * 1 and * 1/* 3 versus * 3/* 3 genotypes (P＜0.01),but there was no significant difference between CYP3A5 * 1/* 1 genotype and * 1/* 3 genotype.Conclusion Tacrolimus dosing in lung transplant patients is associated with CYP 3A5 gene polymorphisms.

Objective To evaluate the method and result of thyroid artery embolization as a new therapy for hyperthyroidism. Methods Twenty two patients with hyperthyroidism underwent selective thyroid artery embolization. Totally 52 thyroid arteries were embolized with microspheres. The indications to this therapy were following: hyperthyroid patients having indications to surgical and 131 I therapy, clinically being difficult to complete the preparation for subtotal thyroidectomy and having high risk for surgical process because of their huge thyroid gland. Results Serum level of thyroid hormones dropped significantly [median T3 from 8 8 nmol/L(4 3～ 43 0 nmol/L) to 4 0 nmol/L(1 1～9 2 nmol/L), median T4 from 206 4 nmol/L(77 4～748 2 nmol/L) to 144 5 nmol/L(25 8～279 9 nmol/L), P

Objective To investigate effectiveness of treatment of Upper urinary tract calculus by MPCNL application.Methods From May 2000 to May 2007,causing artificial kidney hydronephrosis for the affected kidney,established renal percutaneous channels(F16～18),which established the single channels of 202 cases,dual-channel of 14 cases,by Ureteroscopic Lithotripsy and holmium laser lithotripsy.Results 183 cases of 216 patients were One-time stone;33 cases were second stone.The average clearance rate is 90.32%,the average operation time is 79min,average valume of about bleeding is 80ml,the average hospitalization days are 8 days,kidney ostomy average stay 7.5 days.Of the operation,9 cases of obviously bleeding(4%)before and after operation,1 case uncontrollable bleeding after interventional treatment failure with Nephrectomy,others to stop beeding by symptomatic treatment,2 cases find urinary extravasation postoperative and cured by adjusting location of renal ostomy.Conclusion Minimally invasive percutaneous nephrolithotomy for the treatment of Upper urinary tract calculus is safe and effective for patients with less trauma,quicker recovery and high learance rate,the efficacy is satifactory.

Objective To investigate the value of percutaneous transsplenic varices embolization (PTSVE) for treatment of upper gastrointestinal bleeding. Methods Twenty cases with liver cirrhosis and portal hypertension suffered upper gastrointestinal bleeding. PTSVE was administered to them with hardener and coils. Among them, 8 cases had massive hepatocellular carcinoma (HCC) in right lobe; 10 cases with hepatocellular carcinoma had portal vein tumor thrombus and occlusion; the other two cases with liver cirrhosis had portal vein thrombosis. All of these cases were not suitable for percutaneous transhepatic varices embolization (PTHVE) . PTSVE was performed under the guidance of fluoroscopy. Results Technical success was achieved in 18 patients. A total of 35 gastric coronary veins were embolized. In all these cases, upper gastrointestinal bleeding stopped after PTSVE. There was no recurrence within 1 month follow-up. No serious complication occurred. Conclusion PTSVE is a safe and efficient alternative treatment for upper gastrointestinal bleeding, especially for cases with portal vein occlusion or with massive HCC in right lobe of liver.

ObjectiveTo explore the methods and effectiveness of interventional revascularization of complex arteriosclerosis obliterans (ASO)of lower extremity arteries according to their imaging characteristics.Methods Seventy-eight patients with lower extremity ASO complex lesions classified as TASC Ⅱ C/D ( n =68 ) and TASC Ⅱ B ( n =10) underwent antigrade or combined antigrade-retrograde subintimal angioplasty.Their clinical situations were Fontaine stage Ⅲ/Ⅳ or severe stage Ⅱ.All the long occlusion,flush occlusion,multiple occlusion,popliteal artery occlusion,below knee artery occlusion and aortoiliac artery occlusion were identified as complex lesion imaging features and as the indication of interventional treatment if only there were visible outflow vessels and suitable puncture site.Statistical analysis was used to compare ankle-brachial index (ABI) pretreatment and post-treatment by t test.Results Successful revascularization was achieved in 73 patients technically.No obvious complications occurred.Ischemia symptoms improved quickly after accomplishment of recanalization.Average ABI increased from 0.45 ±0.07 to 0.76 ±0.11 after the treatment(t =- 19.78,P ＜0.01 ).Symptoms in 5 patients who failed to get arterial recanalization were stable.Follow up of 6 to 12 months in 47 patients showed stable improvement in 22 of them.Conclusion It is more practical to choose and expand application of interventional treatment for complex ASO according to imaging characteristics of lesions than according to TASC classification.

Objective To discuss the therapeutic efficacy of bidirectional subintimal angioplasty in the treatment of atherosclerotic occlusive of lower limbs.Methods Five patients with long segment of obstructed artery in lower limb were enrolled in the study.Of five patients,occlusion of the lower segment of abdominal aorta and bilateral iliac artery was seen in one,occlusion of iliac artery in 2 and occlusion of superficial femoral artery in the remaining two.Antegrade subintimal angioplasty procedure was unsuccessful in all five patients as the wire could not be placed into the true lumen,so retrograde subintimal angioplasty by puncturing the distal segment of the occlusive artery was employed.Through the newly created channel the retrograde guide wire was manipulated to be pulled out of vessel through the antegrade catheter.The subintimal tract was dilated with angioplasty balloon and the stent implantation was performed.Results Bidirectional subintimal angioplasty was successfully accomplished in all five patients,with a total of nine stents being implanted.Conclusion Bidirectional subintimal angioplasty is a safe and effective procedure for bringing the subintimal recanalization to success,this technique can be regarded as a remedial measure when unidirectional subintimal angioplasty ends up in failure.