Objective To discussion on the effectiveness of the five-phase instructional method inmedical field teaching Methods Appling the five-phase teaching methods in Social Medicine and General Family Care courses,and comparing it with traditional teaching methods.Results The five-phase teaching method is more effective than traditional teaching.Conclusion To apply the five-Phase teaching method in Public Health Education can gain better feedback from students and improve the teaching quality.

BACKGROUND: Previous studies demonstrated that,metabolic phenotype of cytochrome P450 2C19 has genetic polymorphism,which presents with extensive or poor metabolisms and has great differences in races and individuals.OBJECTIVE: To study the genotype distribution of cytochrome P450 2C19 in Xinjiang Uigur population.METHODS: In total 144 unrelated Uigur and 156 unrelated Han subjects were genotyped for cytochrome P450 2C19 by polymerase chain reaction-restriction fragment length polymorphism.The differences of gene phenotype and gene frequency were compared between Uigur and Han populations.RESULTS AND CONCLUSION: The frequency of extensive metabolism wt/wt,wt/m and wt/m1+wt/m2 of Uigur was notably higher than that of Han population(P<0.05),but the frequency of poor metabolism m1/m1 was obviously lower than that of Han population(P<0.05).There were significant differences between Uigur and Han populations in allele frequency wt,m1 and m2(P<0.05),especially m1,which was 58-fold of m2(P<0.01).The results revealed that,distribution frequency m1/m1 of poor metabolism of Uigur is obviously lower than that in Han population,and m1 frequency is higher than that of Han population,accordingly,m1 is the main gene mutation of cytochrome P450 2C19 in Uigur population.

Objective To investigate the clinical effect of long-term home non-invasive assisted ventilation in stable chronic obstructive pulmonary disease (COPD) combined with type Ⅱ respiratory failure.Methods Seventy-eight patients with stable COPD combined with type Ⅱ respiratory failure were divided into treatment group (26 cases) and control group (52 cases).Patients in control group were given conventional treatment,including inhaled salmeterol/fluticasone plus long-term home oxygen therapy (LTOT).Patients in treatment group on the basis of conventional treatment were given non-invasive assisted ventilation therapy for 6-8 hours a day,and the course was 12 months.Blood gas analysis index [pH,arterial blood carbon dioxide partial pressure (PaCO2),arterial blood oxygen partial pressure (PaO2)],pulmonary function index [forced expiratory volume in 1 second (FEV1),FEV1 percentage of expected value (FEV1％)],6 min walk test (6-MWT) distance,St George's respiratory questionnaire (SGRQ) and acute episodes.Results After 12 months'follow-up,there was no endotracheal intubation and dead patients in treatment group.Five patients had acute trachea intubation and invasive mechanical ventilation,and 1 case died in the control group.The index of pulmonary function (FEV1,FEV1％) in two groups after treatment was improved compared with that before treatment (P＜ 0.05).But FEV1 and FEV1％ over the same period in treatment group after treatment was higher than that in control group (P ＜ 0.05).The blood gas analysis indicators (pH,PaCO2,PaO2) in treatment group after treatment were improved compared with that before treatment (P ＜0.05).PaO2 in control group after treatment was improved,compared with that before treatment (P＜ 0.05),but there was no significant difference in control group in pH and PaCO2 levels before and after treatment (P ＞0.05).After treatment 6-MWT distance,and SGRQ scores were improved,compared with that before treatment (P ＜ 0.05),6-MWT from the same period in treatment group after treatment was higher than that in control group,and SGRQ scores was lower than that in control group during this period (P ＜ 0.05).There was significant difference in average acute episodes between treatment group and control group [(0.84 ± 0.16) times vs.(1.49 ± 0.78) times,t =-3.65,P ＜ 0.05].Conclusion Home non-invasive assisted ventilation treatment can improve blood gas analysis and pulmonary function in patients of COPD combined with type Ⅱ respiratory failure of stationary phase,increase exercise tolerance,improve the quality of life,and reduce the number of acute episodes and intubation rate.

Objective To investigate the outcome of endovascular treatment of large or giant intracranial aneu?rysm by long-term angiographic follow-up. Methods Clinical data of 72 patients with large or giant intracranial aneu?rysms receiving endovascular treatment were analyzed retrospectively. Thirty aneurysms were treated with coil emboliza?tion alone, 14 with stent-assisted coiling, 15 with covered stent-deployment and 13 with parent artery occlusion. Results complete occlusion was achieved in 10 cases of pure coil embolization, 7 cases of stent assisted coil embolization,11 cas?es of completely covered stent-deployment and,13 cases of parent artery occlusion. The postoperative immediate com?plete embolism rate was 56.9%. Nearly completely occlusion was achieved in 17 cases of pure coil embolization, in 6 cas?es of stent auxiliary coil embolization, 4 cases of covered stent-deloyment and zero case of parent artery occlusion. The total postoperative immediate nearly completely embolism rate was 37.5%. Incomplete occlusion was achieved in 3 cases of pure coil thrombosis, 1 case of stent assisted coil, zero case of ,covered stent-deloyment and zero case of parent artery occlusion. The total immediate postoperative incomplete embolization rate was 5.6%. Patients were followed up for 6 to 72 months, with an average follow-up of 24.2 months . All patients had no bleeding. The total periprocedural complica?tion rate was 9.7%and there were no death cases. The recurrence of aneurysm in pure spring coil embolization treatment was higher compared with other treatments. The overall recurrence rate was 23.6%. The recurrent 14 aneurysms were suc?cessfully treated endovascularly. Conclusions Endovascular embolization treatment of intracranial large or giant aneu?rysm is safe and effective but its long-term recurrence rate is high. Thus a close follow-up is needed. Endovascular inter?ventional therapy based on the location of aneurysm and shape characteristics can improve treatment effectiveness and re?duce recurrence rate.

Objective To evaluate the application effect of pneumatic arm assisted single surgeon uniportal thoracoscopic surgery.Methods A total of 40 patients were admitted to our treatment group in Shanghai Pulmonary hospital in October who accepted pneumatic arm assisted single surgeon uniportal thoracoscopic surgery.All the clinic statistics of patients were collected including operative time,the volume of blood intra-operation,postoperative complications and hospitalization time.23 of 40 patients who accepted lobectomy/segmentectomy with pneumatic arm assisted single surgeon uniportal thoracoscopic surgery were assigned to the observation group,while another 30 concurrent patients who accepted lobectomy/segrnentectomy with conventional uniportal thoracoscopic surgery were assigned to the control group.Both groups were compared.Results The average postoperative hospitalization time of observation group was(4.6 ± 1.3) days.The average time for postoperative drainage tube retention was(46.7 ± 18.6) hours.The average operation time of patients in observation and control groups was(121.74 ± 25.16) min and (119.7 ± 14.26) min separately.The volume of blood intra-operation in observation group was(91.74 ± 32.88)ml and(89.00 ± 41.22) ml in control group.There is no significant difference between two groups(P ＞ 0.05).Conclusion The field of view and adjustment of camera in uniportal thoracoscopic surgery by single surgeon with pneumatic arm assistance are more accurate and steady,in which human resource can be saved.It is safe and reliable and does not prolong operative time or increase bleeding during operation,and can be applied to different kinds of diseases in thoracic surgery.It is worth promotion and application in eligible hospitals and medical institutions.

AIM: To observe the safety and effect of cataract extraction combined with intraocular lens(IOL)implantation surgery in patients with abnormal morphology of corneal endothelium.

METHODS: We collected 72(90 eyes)age related cataract patients with abnormal morphology of corneal endothelium and 120(158 eyes)patients with normal morphology of corneal endothelium from January 2018 to January 2020 in our hospital. All of them measured corneal endothelial cell density(CD)>2 000cell/mm² and underwent phacoemulsification combined with IOL implantation. CD, coefficient of variation(CV), frequency of hexagonal cells(HEX), central corneal thickness(CT)were recorded at 1wk, 1, 3mo postoperatively and compared in each group.

RESULTS:There were significant differences in endothelial CD, CV, HEX and CT between the two groups 1wk and 1mo postoperative, while there were significant differences in CD and HEX between the two groups after 3mo, but there were no significant differences in CV and CT.

CONCLUSION: Endothelial damage after phacoemulsification in abnormal morphology of corneal endothelium group is comparable to that in control group, and we should pay more attention to the examination of corneal endothelium, especially the corneal endothelial cells morphology before operation and protect it during operation.

Objective:To investigate the efficacy and safety of endovascular recanalization in the treatment of chronically occluded internal carotid artery (COICA).Methods:From January 2014 to January 2019, patients over 50 years of age with symptomatic COICA underwent endovascular recanalization in the Department of Neurosurgery of the First Affiliated Hospital of Xinjiang Medical University were enrolled retrospectively. The modified Rankin Scale (mRS) was used to evaluate the improvement of neurological function.Results:A total of 19 patients with symptomatic COICA were enrolled, of which 16 (84.21%) were successfully recanalized. None of the patients had severe neurological deficits during the periprocedural period and after procedure. The neurological function of patients with successful recanalization gradually improved over time. The neurological function improved in 4 patients (25.0%) at 24 h after endovascular treatment and 9 (56.3%) at 18 months postprocedural follow-up. The follow-up of CT angiography showed that the internal carotid artery in patients with successful recanalization was unobstructed, and there was no obvious in-stent stenosis.Conclusion:Endovascular recanalization is feasible, safe and effective in patients with symptomatic COICA.

We investigated the endemic situation of alveolar echinococcosis (AE) in Nileke County,Yili Prefecture,Xinjiang and its genetic diversity of Echinococcus multilocularis.Human AE cases in the county were retrospectively investigated including their location and surrounding ecological conditions.Sequence detection and analysis of nad2,cob gene fragments of AE mtDNA from patients was used to identify genotype variation.Results showed that a total of 48 AE cases were diagnosed and the first AE patient was identified in 1989 in the county.The 45.8％ of AE cases were found in the recent 5 years (2011-2015) and annual prevalence was 1.7 per 100 000.The patients were distributed along the Kashgar River,particularly intensive in Wulasitai Township.The 38.6％ of the patients were aged arranged 35-44 years old,64.6％ were male and 95.8％ were farmers and herdsmen.AE cases were confirmed further and there was only one haplotype by sequencing analysis from 11 AE clinical patients in the county.It suggests that Nileke County is AE foci,and alveolar echinococcosis with sequences conserved is an emerging disease in the county.

Objective:To investigate the correlation between serum cystatin C (CysC), blood lipids and the risk of intracranial aneurysm (IA) rupture.Methods:Patients with saccular IA admitted to the First Affiliated Hospital of Xinjiang Medical University from December 2017 to May 2019 were enrolled retrospectively. The patients were divided into the ruptured group and the unruptured group. The correlation between CysC, lipids and IA rupture was identified by univariate and multivariate logistic regression analyses. Results:A total of 392 patients were enrolled, including 143 (36.5%) males and 249 (63.5%) females. Two hundred and seventy-eight patients (70.9%) were ruptured IAs, 114 (29.1%) were unruptured IAs. Univariate analysis showed that triglyceride (1.26±0.94 mmol/L vs. 2.12±1.45 mmol/L; t=5.872, P<0.001), apolipoprotein A-Ⅰ (0.95±0.29 g/L vs. 1.08±0.34 g/L; t=3.744, P<0.001 ), CysC (0.63±0.20 mg/L vs. 0.80±0.48 mg/L; t=3.650, P<0.001) level, and the proportions of hypertension (46.8% vs. 61.4%; χ2=6.938, P=0.008), hyperlipidemia (19.4% vs. 48.2%; χ2=32.493, P<0.001) and aneurysm diameter >7 mm (24.4% vs. 41.2%; χ2=11.504, P<0.001) of the ruptured group were significantly lower than those of the unruptured group, while the level of apolipoprotein B was significantly higher than that of the unruptured group (1.07±0.29 g/L vs. 0.99±0.30 g/L; t=2.417, P=0.016). Multivariate logistic regression analysis showed that aneurysm diameter ≤7 mm (odds ratio [ OR] 2.281, 95% confidence interval [ CI] 1.342-3.876; P=0.002), and the serum levels of triacylglycerol ( OR 0.484, 95% CI 0.333-0.705; P<0.001), apolipoprotein A-Ⅰ ( OR 0.248, 95% CI 0.105-0.587; P=0.002) and CysC ( OR 0.130, 95% CI 0.038-0.444; P=0.001) were significantly independently correlated with the risk of IA rupture. Conclusions:CysC, apolipoprotein A-Ⅰ and triacylglycerol are protective markers for IA rupture, and aneurysm diameter ≤7 mmis associated with IA rupture.

【Objective】 To observe the effects of early postnatal immune activation (EPIA) on social behaviors of male and female mice, and to explore the possible role of the functional state of astrocytes and microglia in this process. 【Methods】 Using lipopolysaccharide (LPS) induced EPIA mice as study subjects, mice were divided into the male-control, male-model, female-control, and female-model groups, each containing 10 mice (n=10). Behavioral tests were performed at 25 - 32 days of age, and the social behavior ability of mice was evaluated by open field test, three-chamber sociability test, and marble burying test. The expression levels of GFAP, IBA-1, TLR4, and NFκB p65 in the cortex and hippocampus were detected by Western blot (n=3). 【Results】 In behavioral tests, social index significantly decreased in LPS treatment group (F=14.907, P<0.05). The interaction effect between treatment and sex was significant in the residence time (F=5.260, P<0.05) and the number of buried marbles (F=7.788, P<0.05). LPS treatment decreased the retention time of the central region in male mice (F=4.261, P<0.05), and increased the number of buried marbles in males (F=20.645, P<0.05). Western blot results showed that LPS treatment increased the expression of GFAP protein in the hippocampus (F=50.443, P<0.05) and cortex (F=30.116, P<0.05), as well as the expression of IBA-1 protein (F=21.844. P<0.05) and TLR4 protein (F=6.215, P<0.05) in the cortex. The results of NFκB p65 showed a significant interaction between treatment and sex in the cortex (F=6.558, P<0.05), and LPS increased the expression of NFκB p65 protein in the cortex in female mice (F=16.317, P<0.05). 【Conclusions】 EPIA is sufficient to induce sex-specific autism spectrum disorder (ASD)-like behavior and enhance astroglial and microglial reactivity in mice. ASD-like behavior induced by EPIA may be related to the TLR4/NFκB signaling pathway in the cortex.