In order to improve teaching lever and explore teaching approach, the feasibility study on the combination of the problembased learning method CPBL) and the lecture-based learning method (LBL) was conducted in the teaching of Acupuncture and Moxibustion. The 2010 undergraduates in the major of clinical integrated Chinese and western medicine of five years were randomized into a PBL and LBL group and a LEL group. In the first semester, according to the basic teaching requirement, LBL was used to accomplish the teaching of basic theory. In the internship teaching section, the different teaching method was applied. In the PBL and LEL group, PEL was used, and in the LBL group, LBL was given. At the end of semester, the examination results of the theory learning and medical cases learning were evaluated. The questionnaire was summarized in the teachers and students. The final examination result of theory learning was not different significantly between the two groups (P >0. 05), but the result of medical cases learning in the PEL and LEL group was better than that in LEL group (84. 47±10. 72 vs 76. 00±9. 97, P<0. 05). The questionnaire for the students and teachers indicated that the result of PEL and LEL combined method was higher than that of LEL method (86. 27±8. 36 vs 56. 00±14. 59, P< 0. 01; 45. 89±3. 68 vs 36. 61±6. 41, P<0. 0l), indicating that the combined method of PBL and LEL is feasible in teaching of Acupuncture and Moxibustion and the teaching outcome is superior to the simple LBL, which provides the new approach to the teaching reform.
Acupuncture ; education ; Acupuncture Therapy ; methods ; Adolescent ; Education, Medical ; Faculty ; Female ; Humans ; Male ; Moxibustion ; methods ; Problem-Based Learning ; Students, Medical ; psychology ; Surveys and Questionnaires ; Teaching ; methods ; Young Adult

Objective:To analyze the depression incidence in premenopausal or postmenopausal women, find out the countermeasures to control or eliminate depression. Methods:Randomly divided the menopause group and premenopausal group in 724 patients who were assessed using Zung depression scale and venous blood determination of endocrine hormone FSH, LH, E2. Zung score≥40 points can diagnose depression. Results:The incidence in premenopausal group of climacteric depression was 13.3%, and postmenopausal group was 5.6%. The incidence of climacteric depression premenopausal group was obviously higher than that after menopause (x2=12.797, P<0.05). Conclusion:Menopause depression patients often have some physical or mental factors as incentive, spirit and body disease, etc.;Patients often change in physical and psychological. So the comprehensive care in the biological, psychological and social are necessary.

Objective To investigate the expression change of P2X3 receptor in spinal dorsal horn and dorsal root ganglion(DRG) in rats with experimental inflammatory pain.Methods Totally 30 SD rats received a subcutaneous injection of carrageenan in the right paw to establish inflammatory pain model,and then divided randomly and equally into 5 groups,that is 6,12,24,72 and 168 h after injection.Another 6 rats undergoing a subcutaneous injection of normal saline in the right paw served as control.Pain threshold was assayed by thermal radiation and von Frey filament in 2,4,6,12,24,72 and 168 h after injection.Expression of P2X3 receptor in spinal dorsal horn and DRG of every group was measured by immunohistochemical staining(IHC).Results After injection of carrageenan,thermal hyperalgesia and mechanical allodynia appeared in the rats.The thermal withdrawl latency(TWL) and 50% paw withdrawl threshold(PWT) were decreased obviously from 2 h,descended to the lowest at 12 h,then returned to the normal level after 72 h.The expression of P2X3 receptor in spinal dorsal horn was increased obviously from 24 h,while that at DRG was increased obviously from 12 h.Both of the expressions lasted for 72 h,and returned to the normal level at 168 h after injection.Conclusion Thermal hyperalgesia and mechanical allodynia appear in the rats after carrageenan injection,and the P2X3 receptor is activated and up-regulated in the DRG and spinal cord,suggesting that P2X3 receptor may play an important role in the incidence and development of inflammatory pain.

Objective To investigate urinary iodine and dietary iodine intake in adults, and to ana-lyze the relationship of urinary iodine and daily dietary iodine intakes with thyroid nodules.Methods To-tally 30 participants with nutritional background were enrolled prospectively from January to March 2015 in Shanghai.The 3-day survey of 24-hour's diet record was made using weighting method to evaluate the daily nutrient intakes.On the second and third days of dietary records, urine samples in fasting status and 2 hours after meals were collected from all the participants (n=240).The levels of urine iodine were meas-ured, and dietary iodine intake calculated.3-month food frequency questionnaire was completed and thy-roid ultrasonography performed.Results The median urinary iodine ( MUI) of fasting and 2 h postprandi-al urine samples was 137.56 μg/L ( 91.4-211.5 μg/L) .The portions of participants with iodine insuf-ficiency, iodine adequate, and iodine above requirements or excess were 20.2%, 56.7%, and 23.3%, respectively.Inter-individual MUI varied from 36.31 μg/L to 359.20 μg/L.No significant difference was found between the fasting urinary iodine and 2 h postprandial urinary iodine ( P=0.389 ) .The average di-etary iodine intake was (197.2 ±74.2) μg/d, and the proportions from iodine salt and drinking water were 70.2% and 5.4%, respectively.There was a significant positive correlation between dietary iodine intake and urinary iodine value of the same day (r=0.426, P=0.019).Participants with thyroid nod-ules had higher urinary iodine than participants without thyroid nodules [ ( 194.0 ±101.5 ) μg/L vs. (135.7 ±72.9) μg/L, P<0.001].Conclusions Inter-individual iodine nutritional status are signifi-cantly different under natural living status.Increased urinary iodine may be related with thyroid nodules. Repeat random urine iodine test combined dietary assessment may reduce the error in evaluating individual iodine nutritional status.

Objective To increase the awareness of the incidence trend of ischemic colitis and improve the level of diagnosis and treatment.Methods From January 2004 to December 2013,the clinical data of 89 in patients with ischemic colitis were retrospectively analyzed.At the same period,100 patients diagnosed as chronic colitis were enrolled as control group.The laboratory findings of patients with ischemic colitis were compared with those of control group.Non normal distribution data were analysed by non parametric test.Results The annual person-times of patients with ischemic colitis and the percentages accounted in the whole hospital annual person-times increased year by year in recent 10 years,which was one person time and 0.01％ in 2004 increased to 41 person-times and 0.11％ in 2013.The average age of the 89 patients was (63.5±12.7) years,and the male to female ratio was 1∶2.18.The most common underlying disease in the 89 patients was hypertension,accounted for 43.8％.Thirty-eight patients had a history of abdominal surgery,and eighteen patients with appendectomy,accounted for 20.2％.Seventy-eight patients had abdominal pain and defecation desire.Seventy-four patients complained of hematochezia.Compared with control group,there was no statistically significant difference in fasting blood glucose,triglyceride,total cholesterol,blood platelet levels and prothrombin time (all P＞0.05).While the levels of C reactive protein and Ddimer were higher than those of control group (89.21 mg/L vs 61.29 mg/L,90.13 μg/L vs 59.39 μg/L; Z=-3.959,-4.377; both P＜0.05).The images of computed tomography (CT) indicated thickened bowel wall in lesion segment.The results of colonoscopy showed that in the left colon and rectum were the predilection sites,accounted for 93.88％ (138/147).The average hospital stay was (10.59 ± 5.97) days and t he recurrence rate was 3.37 ％ (3 / 89).The percentage of chronic cases was 2.25 ％ (2/89),and no death was reported.Conclusions The incidence of ischemic colitis significantly increased in recent years.Patients with abdominal pain and/or hematochezia should be considered,especially those over 60 years old.Receiving colonoscopy as earlier as possible was helpful for the diagnosis.

Objective To investigate the difference between anagenetic fibula with normal fibula in mechanical parameters, osteogenesis and tissue morphology,through establishing the model of fibula defect in rabbit.Methods Twenty New Zealand white rabbits were randomly divided.Model group were cuted the right fibula bone with 1.5 cm length.X-ray was used to observe the anagenetic fibula(half month,one month,two months).Stumped the anagenetic and normal fibula(1.5 cm)after two months. Three-point bending test was used to test the mechanical properties;alkaline phosphatase staining was checked the bone-formation ability;HE staining to check the tissue morphology.Results After half month a few new bone were formed at the edges of resec-tion area,one month later new bone were growed in the donor site,and after two month new fibula were completely formed.The three point bending test of fibula showed:there was no statistically significant difference between anagenetic fibula and normal fibu-la(P >0.05);alkaline phosphatase staining and HE staining showed the anagenetic fibula bone forming ability,histology had no sig-nificant difference compared with normal fibula.Conclusion Fibula were regenerated successfully after removing which retaining the periosteum.Compared with the normal fibula,there were no remarkable differences in mechanical parameters,osteogenesis and tissue morphology.

Objective To understand the current economical operation of public hospitals in Hubei province and its effect on their public welfare performance. Methods To collect data in field survey and to analyze the current economic situation of such hospitals in the province based on relevant statistics.Results Financial revenue and expenditure of these hospitals keep rising and achieving a balance in general; for the insufficient government financial subsidy, 90% of the revenue of such hospitals come from their medical services and drugs sold; the per capita revenue of these public hospitals maintains a yearly rising trend; their asset-liability ratio was relatively high. Conclusions The public welfare performance of these hospitals tends to be impeded by the reform on the macro economic system and health policy changes, on top of the attraction of economic interests. Improving the government subsidy mechanism for public hospitals and standardizing the financial management mechanism of public hospitals.

Objective To investigate the prevalence of renal insufficiency and its associated factors in type 2 diabetes mellitus with normoalbuminuria using estimated glomerular filtration rate ( eGFR) .Methods We retrospectively analyzed 10-year data of chronic complications in type 2 diabetics in-patient from the Chinese Diabetes Society.eGFR was estimated using the equation from Modification of Diet in Renal Disease(MDRD) study.The clinical characteristics as well as associated factors for low eGFR were analyzed among the normoalbuminuric type 2 diabetic patients.Results A total of 1351 type 2 diabetic patients were included, 755 patients with normoalbuminuria, 466 patients with microalbuminuria and 130 patients with macroalbuminuria respectively.Among the patients, 310 (22.9% ) had low eGFR (GFR <60 ml · min~(-1) · 1.73 m~(-2) ) , 19.7% (149/755) in the patients with normoalbuminuria, 21.9% (102/466) in microalbuminuria and 45.4% ( 59/130 ) in macroalbuminuria Patients with normoalbuminuria and low eGFR suffered more chronic complications than those with normoalbuminuria and normal eGFR, mainly retinopathy, cerebrovascular diseases and sensory neuropathy.Stepwise logistic regression analysis revealed that age ( OR = 1.042, P < 0.001), diabetic duration ( OR = 1.038, P = 0.045), systolic blood pressure (OR = 1.017, P < 0.001) were independently associated with renal impairment among the patients with normoalbuminuria.Body mass index ( OR = 0.868, P < 0.001) and HbAlc (OR =0.898, P =0.021) were also related with renal insufficiency.Conclusion A considerable proportion in type 2 diabetic patients without albuminuria may exist renal impairment, and eGFR estimation could benefit the evaluation of renal function in such patients.

Objective To compare the outcome of laparoscopic with open partial nephrectomy for duplication anomalies. Methods A total of 64 patients with mean age of 17 months were divided into 2 groups.Open group consisted of 36 patients,and laparoscopic group consisted of 28 patients.In open group,there were 19 boys and 17 girls,15 cases were of ectopic ureter,18 of ureterocele,2 of vesicoureteral reflux (VUR) and 1 of ureteropelvic junction obstruction.Mean age was 18 months.In laparoscopic group,there were 18 boys and 10 girls,9 were of ectopic ureter,16 of ureterocele and 3 of VUR.Mean age was 1 6 months.There were no significant differences in age and diseases.Results There were 2 conversion to open surgery in laparoscopic group and no other intra-operative and post-operative complications in 2 groups.Mean duration of operation was 2.5 h for open group,the difference of pre- and post-operation hemoglobin was 2.64 g,the volume of drainage was 91.4 ml,the time of drainage was 4.2 d and mean hospital stay was 19.3 d.In Iaparoscopic group,the figures were 2.9 h,1.45 g,55.4 ml,3.4 d and 14.3 d,respectively.The differences of the figwres were significant between the 2 groups (P＜0.05). Conclusion Laparoscopic partial nephrectomy is effective and safe for the treatment of duplicated kidney with a dysfunctional moiety.

AIM To study the anti oxidation and cancer chemoprevention mechanism of procyanidins extracted from Vitis vinifera. METHODS A simple colorimetric method is used for the measurement of H 2O 2 produced by PMNs induced by croton oil. RESULTS It was shown that procyanidins could inhibit PMNs releasing H 2O 2 induced by croton oil. Procyanidins serum of rats also had the same effect. The effect was time and dose dependent. Inhibitory effect of procyanidins on hepatic mitochondria lipid peroxidation induced by croton oil was also observed. Procyanidins could raise the activity of SOD and decrease the level of MDA. CONCLUSION It was concluded that anti oxidation effect of procyanidins was one important mechanism of cancer chemoprevention.