Case teaching plays an important role in cultivating medical social work talents.This paper analyzed the constructivism characteristics in the case teaching of medical social work.Not Case teaching of medical social work is not only a subjective meaning realization process of teachers and students and case situations,but also a multi-direction interactive dynamic knowledge construction process.In the case teaching,teachers should correctly grasp their own roles of resource linker and encourager,fully realize the drawbacks of constructivism theory and establish the correct view of knowledge.

Objective To evaluate the effectiveness of anus misoprostol for cervial dilation for menopausal women in hysteroscopy.Methods 86 menopausal women before hysteroscopy were divided into two groups.The misoprostol group(46 cases) were handled with misoprostal through anus.The control group(40 cases) were injected with lidocaine through cervix.Results Compared with the control group,the effective cervial dilatation rate of misoprostol groupwas significantly higher,and the incidence of abortion syndrome was lower.Conclusion Anus misoprostol can significantly facilitate cervial dilation in menopausal women before hysteroscopy.

Objective To investigate the alteration of nuclear factor kappa B( NF-κB) and tumor necrosis factor-a (TNF-α) mRNA and protein in hippocampus in chronic constrictive injury (CCI) model of rats. Methods Seventy-six male Wistar rats were randomly divided into 2 groups ( n = 38): the CCI group which received the chronic constriction injury and the sham group which received the sham operation as control. The mechanical and thermal nociceptive thresholds were assessed with paw withdrawal latency (PWL) to von Frey filaments and radiant heat at 1d before and ld,4d,7d,14d and 28d after CCI operation. Five animals were sacrificed at each time point for real-time polymerase chain reaction (real-time PCR) and another three animals sacrificed at 7d postoperation for immunofluorescence histochemical staining. Results The thresholds to mechanical and thermal stimuli decreased obviously after operation in CCI group. The expressions of TNF-α and NF-κB mRNA began to increase at ld( (2.079 ±0. 104)times and 4d( ( 1.640 ± 0.064) times) after operation and reached the peak at 7d ((2.748 ±0.147)times, (2.010 ±0.096)times) ,then the expressions of TNF-a mRNA began to decrease,while the expressions of NF-kB mRNA maintained at a high level throughout the experiment. The result of immunofluorescence histochemical staining revealed that NF-kB and TNF-α protein expressions at 7 day increased significantly on the hippocampus,which was consisted with NF-κB and TNF-a mRNA levels. Conclusion The activation NF-κB and TNF-α in hippocampus may be involved in the procession of neuropathic pain.

Objective:To understand the knowledge, attitude and behavior of volume management of maintenance hemodialysis patients, so as to provide a basis for standardizing volume management and carrying out refined individual care.Methods:By means of convenience sampling, 608 patients from 4 hospitals who received regular dialysis treatment in Xuzhou and Yancheng hemodialysis rooms in October 2021 were selected as subjects. Patients were surveyed by a self-designed knowledge questionnaires of volume management, Maintenance Hemodialysis Patients′ Capacity Management Behavior Scale and Self-Efficacy Scale. Questionnaires were collected through the questionnaire star.Results:A total of 608 valid questionnaires were collected. The knowledge dimension scored 8.21 ± 2.27 , atitude dimension scored 7.36 ± 2.06 and behavior dimension scored 15.07 ± 4.22. Multiplelinear regression analysis showed that age, dialysis age and self-care ability were predictors of volume management knowledge score ( t=-2.07, 2.35, -3.90, all P<0.05 ). Medical insurance type was a predictor of volume management attitude score ( t=-2.17, P<0.05). Education level was a predictor of volume management behavior score ( t=3.04, P<0.05). Conclusions:The capacity management knowledge and capacity management attitude of maintenance hemodialysis patients is in the medium level, but with poor volume management executive ability. It is suggested that medical staff carry out health education related to volume management according to different characteristics of patients, and effectively improve patients′ volume management ability.

Objective To investigate the value of serum IgG4 level for the diagnosis of IgG4-related hepatobiliary diseases and the differentiation from other hepatobiliary diseases.Methods A total of 270 patients with hepatobiliary diseases in the People's Hospital of Hunan Province from August 2015 to April 2017 were enrolled in this study,and 20 healthy subjects were selected as controls.The 270patients were divided into eight groups:liver cirrhosis group (n =17),acute pancreatitis group (n =52),chronic pancreatitis group (n =33),cholecystitis and gallstone group (n =27),bile duct carcinoma group (n =30),cholangitis and biliary calculi group (n =41),pancreatic cancer group (n =47),IgG4-related hepatobiliary disease group (n =23).The levels of serum IgG4 were measured by rate nephelometery assay.The sensitivity and specificity of IgG4 levels for distinguishing IgG4-associated hepatobiliary diseases were evaluated by receiver operating characteristic curve.Results The levels of IgG4 of the cirrhosis group and the IgG4 related hepatobiliary disease group were significantly higher than those of the control group (P ＜ 0.05).The IgG4 level in the hepatobiliary disease group was significantly higher than those of the other seven groups (Z =-5.267,-6.802,-5.921,-6.005,-6.173,-6.513,-6.014,P all ＜ 0.01).The area under curve (AUC) for IgG4 level in distinguishing IgG4 associated hepatobiliary diseases and other hepatobiliary diseases was 0.982.When 4.13 g/L was used as the cut off value of diagnosis,the sensitivity and specificity of IgG4for diagnosis were 95.7％ and 96.0％ respectively.The IgG4 levels in twelve patients with IgG-associated hepatobiliary diseases after 2 months of glucocorticoid therapy were significantly lower than those before glucocorticoid therapy (Z =-2.021,P =0.043).Conclusion The elevated serum IgG4 level may not be specific just for IgG4-related hepatobiliary diseases.The cut off value of 4.13 g/L should be very useful for diagnosing IgG4-related hepatobiliary diseases,differentiating from other hepatobiliary diseases and evaluating the therapeutic effect of glucocorticoid therapy.The further detailed verification for these findings should be necessary in clinical practice by increasing the sample size.

Objective:To investigate the relationship between plasma factor VIII (FVIII) level and the clinical indicators and prognosis in IgA nephropathy (IgAN) patients.Methods:The clinical data of IgAN patients diagnosed from the Second Xiangya Hospital of Central South University from January 2016 to December 2016 were collected. Patients were divided into high FVIII group (FVIII>140.50%) and low FVIII group (FVIII≤140.50%) according to the time-dependent receiver operating characteristic curve analysis. The baseline clinical parameters at the time of renal biopsy between two groups of patients were compared. Taking the estimated glomerular filtration rate (eGFR) reduction ≥30% or entering end-stage renal disease (ESRD) as the endpoint event, Kaplan-Meier analysis and Cox proportional hazards models were used to explore the association between plasma FVIII level and prognosis in IgAN patients.Results:A total of 93 patients were ultimately retained for this study, with a median follow-up of 35.15(33.77, 36.76) months. Twelve (12.90%) patients reached the endpoint event. The levels of serum creatinine, urea nitrogen, triglyceride, total cholesterol, plasma fibrinogen, D-dimer, 24-hour urinary protein, protein C, protein S, slope of eGFR and age in the high FVIII group were higher than those in the low FVIII group (all P<0.05). The levels of eGFR, serum albumin and follow-up time in the high FVIII group were lower than those in the low FVIII group (all P<0.05). The renal cumulative survival rate was significantly lower in the high FVIII group than that in the low FVIII group ( χ2=5.635, P=0.018) according to the Kaplan-Meier analysis. After adjusting for variables such as systolic blood pressure, eGFR, urinary protein, and renal tubular atrophy/interstitial fibrosis, multivariate Cox proportional hazards models analysis showed that high level of plasma FVIII was an independent risk factor for poor prognosis in IgAN patients ( HR=4.147, 95% CI 1.055-16.308, P=0.042). Conclusions:The level of plasma FVIII is associated with clinical indicators and prognosis in IgAN patients. The higher level of plasma FVIII can be identified as an independent risk factor for poor prognosis in IgAN patients.

Objective To explore the relationship between the levels of peroxidoredoxin(PRDX)1 and chromosome 10 deletion phosphatase-tensin homologous gene(PTEN)and liver function and disease activity in patients with autoimmune liver disease.Methods A total of 83 patients with autoimmune liver disease ad-mitted to the hospital from January 2021 to December 2022 were selected as the study objects.According to the disease activity at admission,they were divided into active group(37 cases)and remission group(46 ca-ses).Clinical data and serum PRDX1 and PTEN levels of the two groups were analyzed.At the same time,Child-Pugh classification of liver function was performed,and the patients were grouped.A total of 100 health-y volunteers who underwent physical examination during the same period were selected as the control group.Multivariate Logistic regression was used to analyze the influencing factors of disease activity in patients with autoimmune liver disease,and the evaluation value of serum PRDX1 and PTEN levels on disease activity in pa-tients with autoimmune liver disease after treatment was analyzed by receiver operating characteristic(ROC)curve and area under the curve(AUC).Results Compared with the grade A group,there were no significant differences in serum PRDX1 and PTEN levels in the grade B group(P＞0.05),while serum PRDX1 level was increased and PTEN level was decreased in the grade C group(P＜0.05).Compared with the grade B group,the serum PRDX1 level was increased and PTEN level was decreased in the grade C group(P＜0.05).Com-pared with the control group,there were no significant differences in serum PRDX1 and PTEN levels in the re-mission group(P＞0.05),while the serum PRDX1 level was increased and PTEN level was decreased in the active group(P＜0.05).Compared with the remission group,the level of serum PRDX1 was increased and the level of PTEN was decreased in the active group(P＜0.05).The AUC of serum PRDX1 and PTEN for evalu-ating the disease activity in autoimmune liver disease patients was 0.750 and 0.854,respectively,and the AUC of the combined detection of serum PRDX1 and PTEN was 0.916.The proportion of patients with hepatic dis-comfort and cirrhosis in the active stage group was higher than that in the remission stage group(P＜0.05).Multivariate Logistic stepwise regression analysis results showed that hepatic discomfort(OR=3.487,95％CI:1.534-7.927),cirrhosis(OR=4.289,95％CI:1.744-10.545),PRDX1 ≥5.22 ng/mL(OR=5.068,95％CI:1.951-13.164),PTEN≤0.31 pg/mL(OR=5.387,95％CI:2.099-13.829)were risk factors for disease activity of autoimmune liver disease(P＜0.05).Conclusion The increase of serum PRDX1 level and the decrease of serum PTEN level are closely related to liver function and disease activity in patients with au-toimmune liver disease,and they have certain clinical evaluation value in patients with autoimmune liver dis-ease.