Objective To explore the effects of PBL teaching method on classroom atmosphere of basic nursing course.Methods Two classes of nursing sophomore were enrolled and were divided two groups,60 as PBL group and other 60 as traditional group.Students in two groups were evaluated by questionnaire of classroom atmosphere.Data were statistically analyzed through t-test,P＜0.05 standing for statistical significances.Results There were statistical differences in classroom atmosphere between two groups (P ＜ 0.05) ; class democracy,elicitation in teaching and student cooperation in PBL group were significantly better than those of traditional mode (P ＜ 0.05).There was no significant difference in learning autonomy between the two groups (P ＞0.05).Conclusions PBL teaching is conductive to stimulating students' learning potentials,culturing their cooperative learning,raising the efficiency of classroom learning and improving the classroom atmosphere.But learning autonomy of students needs to be further improved.

ObjectiveTo measure fetal lung volumes in different gestational age (GA) by using 3D ultrasound,and further to obtain the regression formula between fetal lung volume and GA.MethodsTotal 228 fetal lung data had been collected.By using the 3D reconstruction function in Philips Qlab,fetal lung volumes were obtained by subtracting the non lung volumes from the whole thoracic volumes.For each slice of 3D data,thoracic area and non-lung area were manually outlined.The contour stacking technique in Qlab was then used to transform 2D slices into 3D volumes.ResultsThe measurement results of total 228 cases indicate that the fetal lung volumes increase with the GA.The average lung volume at GA of 20 weeks was 8.85 cm3,and 70.5 cm3 at 36 weeks.The fetal lung volume increases about 3- 4 cm3 in each week,and the increasing trend turns to a little lower after 24 weeks.During 33 to 34 week there was a great increasing in fetal volumes.Second-order regression,exponential regression and logarithmic regression were respectively used to characterize the relationship between fetal lung volume and GA.The second-order regression formula was:Volume =39.52 - 4.48 × GA + 0.149 × GA2.The exponential regression formula was:Ln (Volume) =- 8.233 + 1.747 × Ln(GA2 ).The logarithmic regression formula was:Ln(Volume) =- 2.413 + 0.29× GA- 0.003 × GA2.The correlation coefficients of three formulas are equal,with r =0.99,P ＜ 0.001.Conclusions 3D ultrasound fetal lung volume measurement is useful for fetal lung maturity assessment and thus can provide important referential information for prenatal diagnosis.

OBJECTIVETo discuss the effect of integrated traditional Chinese and Western medicine on Th1/Th2 cytokines level in children with asthma.

METHODChildren with asthma were randomly divided into control group and treatment group. The control group was given Montelukast Sodium tablets for 4 mg (2-5 years old) or 5 mg (6-14 years old), once every night before sleeping. At the same time, the treatment group was given Pingchuan water decoction additionally for one tie per day, in four to six-divided doses for eight weeks. On the other hand, groups of health children were selected as blank control. Before and after treatment, the level of IL-4, IL-13 and IFN-gamma were detected by elisa from 3 mL of venous blood.

RESULTBefore treatment, IL-4 and IL-13 in two groups were obviously higher than healthy group, but IFN-gamma was lower (P < 0.01, P < 0.05). After eight weeks, IL-4 and IL-13 in treatment group went down, but IFN-gamma increased. And there were significant different compared with the control group (P < 0.05).

CONCLUSIONTreating children asthma by integrated traditional Chinese and western medicine can obviously reduce IL4 and IL-13, increase IFN-gamma, and therefore lighten the airway inflammation, prevent asthma attacks effectively.

Adolescent ; Asthma ; drug therapy ; immunology ; metabolism ; Child ; Cytokines ; metabolism ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; methods ; Th1 Cells ; drug effects ; metabolism ; Th2 Cells ; drug effects ; metabolism ; Western World

Objective To observe the surgical results of prominent malar-complex and to explore the more effective methods by improving the shape of face through operation.Methods Total 80 patients of prominent malar-complex were treated by strengthening reduction plasty of mala and zygoma through intra-oral approach accompanied with minor pre-auricular incision and the midfacial SMAS lift in order to improve the shape of prominent malar-complex and to prevent malar-cheek parenchyma sag.Results The face skeleton and midfacial chalasis of all patients were significantly improved with satisfaction.All the patients obtained good results during the follow-up period of over six months.Of them there was one case of maxillary sinusitis that had been cured by further symptomatic treatment.Conclusions Strengthening reduction plasty of mala and zygoma accompanied with the midfacialSMAS lift can properly and safely improve the facial shape of patients with prominent malar-complex.

Objective To evaluate the accuracy of the fetal weight estimation system in terms of estimating the fetal weight.Methods The fetal weight estimation system developed by the Department of Electronic Engineering,Fudan University was applied to estimate the fetal weight in many hospitals,and the differences between the estimated results of the system and the actual weight of newborn fetuses,as well as the accuracy of the estimation system and the traditional estimation methods were compared.Results A total number of 610 cases were employed,with each case including the ultrasound images of fetus before birth,the corresponding measurement data and the newborn weight.The correlation coefficients between the weight of the newborn babies and the fetal parameters,which were measured by the estimation system in terms of the biparietal diameter,the head circumference,the abdomen circumference and the femur length,were higher than those obtained by manual annotations,with improvements of 0.08,0.17,0.09 and 0.05,respectively.The absolute error of the estimated weight of the system with respect to the actual weight was 44 g smaller than those estimated by traditional method,and the variance of the absolute error was 53 g smaller;while the corresponding absolute percentage error was 1.8％ lower,and the corresponding variance percentage was 1.5％ lower.Conclusions The fetal weight estimation system improves the accuracy of the prenatal ultrasound assessment and provides reliable information to clinical diagnosis.

OBJECTIVE:To develop a method for simultaneous determination of geniposide,baicalin,aloe-emodin,rhein, emodin,chrysophanol and physcion in Zhizi jinhua dispersible tablets. METHODS:HPLC method was adopted. The determination was performed on Dimonsil C18 column with mobile phase consisted of methanol-0.05%phosphoric acid(gradient elution)at the flow rate of 0.8 mL/min. The detection wavelength was set at 254 nm,and the column temperature was 25℃. The sample size was 20 μL. RESULTS:The linear ranges of geniposide,baicalin,aloe-emodin,rhein,emodin,chrysophanol and physcion were 0.0323-0.323 μg (r=0.9998),0.1374-1.374μg(r=0.9999),0.00372-0.0372μg(r=0.9997),0.0069-0.069μg(r=0.9995),0.00332-0.0332μg (r=0.9997),0.00864-0.0864 μg(r=0.9997) and 0.00122-0.0122 μg(r=0.9995),respectively. The limits of quantitation were 0.0321,0.1374,0.00372,0.0067,0.00330,0.00864,0.00122 μg,respectively. The limits of detection were 0.0095, 0.0041,0.0012,0.0020,0.0010,0.0026,0.0003 μg,respectively. RSDs of precision,stability and reproducibility tests were all lower than 3%. The average recoveries were 96.54%-99.52%(RSD=1.17%,n=6),97.23%-101.23%(RSD=1.36%,n=6), 97.22%-101.25%(RSD=1.83%,n=6),97.32%-100.23%(RSD=1.09%,n=6),97.99%-102.71%(RSD=1.73%,n=6), 96.99%-100.23%(RSD=1.21%,n=6),96.99%-103.01%(RSD=2.31%,n=6),respectively. CONCLUSIONS:The methods is simple and reproducible. It can be used for the content determination of 7 components in Zhizi jinhua dispersible tablets.

Objective To study and explore the application effect of compound ipratropium bromide combined with budesonide in acute severe asthma.Methods 100 emergency patients with severe asthma were selected as study subjects,the patients were divided into two groups by following the principles of randomized single blind,each group had 50 cases.The control group received aminophylline treatment,the observation group was treated with budesonide combined with ipratropium bromide inhalation therapy.The clinical curative effect,relieve symptoms,condition of arterial blood gas and pulmonary function were compared between the two groups.Results The total effective rate of the observation group was 96％,which of the control group was 80％,the difference was statistically significant (x2 =6.061,P ＜ 0.05).The remission time of cough [(5.60 ± 1.35) d],expectoration [(3.54 ± 1.25) d],shortness of breath[(1.93 ± 0.87) d],wheezing [(6.09 ± 1.26) d] and other symptoms in the observation group were significantly shorter than those in the control group [(7.39 ± 1.72) d,(5.17 ± 1.54) d,(3.26 ± 1.08) d,(8.43 ±1.95) d](t =5.789,5.811,6.781,7.127,all P ＜ 0.05).After treatment,the arterial blood gas and lung function in the observation group were significantly improved (all P ＜ 0.05),which were better than those in the control group after treatment (all P ＜ 0.05).Conclusion The clinical curative effect of budesonide combined with ipratropium bromide in the treatment of patients with severe asthma is significant,it can improve the symptoms,pulmonary ventilation function and arterial blood gas.

Objective To evaluate the relationship between perioperative myocardial injury(PMI)and serum N/OFQ levels in elderly patients with coronary heart disease.Methods Totally 120 elderly patients who underwent hip fracture surgery under general anesthesia from January 2022 to May 2023 were included,including 60 patients with coronary heart disease(CHD group)and 60 patients without coronary heart disease(control group).The venous blood of patients was collected 10 minutes before anesthesia induction(T0),12 hours after surgery(T1)and 24 hours after surgery(T2)to detect the content of N/OFQ and high-sensitivity myocardial troponin I(hs-cTnI)in serum.Record perioperative adverse cardiovascular events(PACE)and the use of vasoactive drugs during surgery.Results Compared with the control group,the N/OFQ and hs cTnI levels at T0 and T1 in the CHD group were significantly increased(P<0.05).There was a positive correlation between N/OFQ and hs-cTnI levels at T1 and T2 in CHD and control group(P<0.05).The use of PACE and intraoperative vasoactive drugs in the CHD group was higher than that in the control group(P<0.05).Conclusion There is a correlation between the increased N/OFQ content and PMI in elderly patients with coronary heart disease after surgery,which may become an early predictive indicator of PMI.

Objective To investigate treatment effects of levonorgestrel-releasing intrauterine system (LNG-IUS) for adenomyosis with severe dysmenorrhea in a prospective cohort study. Methods From December 2006 to December 2014, patients of symptomatic adenomyosis diagnosed by transvaginal ultrasound in outpatient or inpatient clinics of Peking Union Medical College Hospital were given the treatment of LNG-IUS. Before and after placement of LNG-IUS, all the patients′parameters were recorded prospectively, including symptoms and scores of dysmenorrhea, menstruation scores, biochemical indicators, physical parameters, carrying status of LNG-IUS, menstruation patterns and adverse effects. Changes of scores and patterns of pain during follow-up were analyzed. Results Totally 1 100 women meets inclusion criteria, among which 640 cases (58.18%, 640/1 100) had severe dysmeorrhea, with median follow-up period of 35 months (range 1-60 months), and accumulative carrying rate of 65% at 60 months follow-up. After placement of LNG-IUS, scores of pain and ratio of severe dysmenorrhea had decreased significantly compared with baselines (all P<0.01), the scroes of visual analog scale (VAS) were 8.1 ± 0.9, 5.5 ± 2.4, 4.6 ± 2.4, 3.3 ± 2.2, 2.2 ± 2.1, 2.2 ± 1.8, 1.4 ± 1.6 and 1.3 ± 1.3 at 0, 3, 6, 12, 24, 36, 48 and 60 months respectively. During 36 months after placement of LNG-IUS, scores of pain had improved significantly compared with preceding period (all P<0.01). We found no universal dependent factors predicting improvement of pain, which was neither relevant with simultaneous changes of menstruation patterns nor adverse effects (all P>0.05). Conclusion LNG-IUS is effective for adenomyosis of severe dysmenorrhea. Improvement of pain is independent on patients characters, menstruation patterns or adverse effects.

Objective To investigate treatment effects of levonorgestrel-releasing intrauterine system (LNG-IUS) for adenomyosis with menorrhea in a prospective study. Methods From December 2006 to December 2014, patients of symptomatic adenomyosis diagnosed by transvaginal ultrasound in outpatient or inpatient clinics of Peking Union Medical College Hospital were given the treatment of LNG-IUS. Before and after placement of LNG-IUS, all the patients′parameters were recorded prospectively, including scores of menstruation blood loss, carrying status of IUS, symptoms and scores of dysmenorrhea, biochemical indicators, physical parameters, menstruation patterns and adverse effects. Changes of pictorial chart scores of menstruation and distribution of anemia during follow-up were analyzed. Results Totally 1 100 women meets inclusion criteria, among which 618 cases (56.18%, 618/1 100) had severe menorrhea, with median follow-up period of 28 months (range 1-60 months), and accumulative carrying rate of 66% at 60 months follow-up. After placement of LNG-IUS, compared with baselines, pictorial chart scores and ratio of menorrhea had decreased significantly (all P<0.01), the scroes of menstruation were 157±34, 94±35, 70±33,67 ± 18, 67 ± 20, 65 ± 19, 66 ± 19, 65 ± 21 at 0, 3, 6, 12, 24, 36, 48 and 60 months respectively. During 24 months after placement of LNG-IUS, pictorial chart scores and distribution of anemia had improved significantly compared with preceding period (all P<0.01). We found no dependent factors predicting improvement of pictorial chart scores of menorrhea, which was neither relevant with simultaneous changes of menstruation patterns nor adverse effects (all P>0.05). Conclusions LNG-IUS is effective for adenomyosis of menorrhea. Improvement of menstruation blood loss is independent on patients characters, menstruation patterns or adverse effects.