Contents of laboratory diagnosis is complex.Traditional teaching method cannot arouse students' interest in study and the teaching effect is poor. Teachers should choose different teaching emphasis for students in different specialty,increase and decrease theory teaching contents according to the demands of students' future actual work,introduce case analysis,train students' capability of clinical logical thinking,enhance students' perceptual knowledge of theory through the training of experiment skills and using PBL teaching method to make students truly participate in teaching course so as to arouse their enthusiasm,These reforming measures will benefit the improvement of teaching quality.

OBJECTIVE: To investigate the clinical application effects of tinnitus diagnosis and treatment process. METHOD: The 1541 clinic patients with tinnitus were included in the diagnosis and treatment process. The diagnosis was clarified based on comprehensive examinations and tests. According to the characteristics of tinnitus, the patients underwent etiological treatment, drug therapy, masking therapy, sound therapy and psychological therapy, respectively, and the curative effect was evaluated. RESULT: There were 781 patients received etiological treatment, where the effective rate is 86.17%. For 369 cases of acute and subacute tinnitus, the effective rate for low frequency tinnitus is 80.77% (126/156), and that for high frequency is 72.30% (154/213). For 224 cases of chronic compensated tinnitus, the effective rate of masking therapy is 79.63% (86/108), and the effective rate of sound therapy is 79.31% (92/116). For the 124 cases of chronic decompensated tinnitus, the effective rate of sound therapy combined with psychological counseling is 83.06%. CONCLUSION The utilization of tinnitus diagnosis and treatment process can give the patients of tinnitus with different characteristics satisfactory curative effects, and is suggested to be proposed for clinical application.
Acoustic Stimulation ; Counseling ; Humans ; Tinnitus ; diagnosis ; therapy ; Treatment Outcome

Objective To investigate the clinical effects of sound therapy and psychological counseling on chronic tinnitus .Methods Two hundred and thirty - two cases of chronic tinnitus patients were treated with sound therapy and psychological counseling in this study .The time course of treatment was 12 months .Tinnitus Evalua‐tion Questionnaire(TEQ) was filled out before sound therapy ,3 ,6 and 12 months after the therapy to evaluate the effects .Results After the therapy ,the patients had a significant improvement in tinnitus symptoms .Before the therapy ,178 patients had severe tinnitus ,while after the therapy ,this number decreased obviously .In the end of treatment there were only 36 cases ,with severe tinnitus(15 .52% ) .After the 6 months treatment ,the effective rate was 79 .31% ,after 12 months the effective rate was 86 .21% .Conclusion Sound therapy and psychological counse‐ling are effective treatments for chronic tinnitus ,and the effects are stable and durable .

Objective To observe the effects of neuromuscular stimulation (NMES) intensity on post-stroke dysphagia.Methods Thirty patients with dysphagia resulting from a stroke were randomly divided into a control group,an NMES group,and an intensive NMES group,with 10 patients in each.The 3 groups all received conven-tional swallowing training.Patients in the NMES group also received NMES once a day and those in the intensive NMES group received it twice a day.Kubota's water drinking test and videofluoroscopy were used to assess the subjects' swallowing function before treatment and after 2 and 4 weeks of treatment.Results After 2 weeks,the average water drinking test score was significantly better in the intensive NMES group than in the control group.The fluoroscopic results of all three groups had improved significantly,but the results in the NMES group and the intensive NMES group were significantly better than those of the control group.The intensive NMES group also scored significantly higher than the NMES group.Conclusion NMES can improve the swallowing reflex and the contraction of the suprahyoid muscles.It can strengthen the effect of re-learning swallowing.Two NMES sessions a day are better than one.

Objective:To observe the influence of methylprednisolone in the respiratory mechanical parameters in the elderly patients undergoing major surgeries with general anesthesia intubation after mechanical ventilation,and to investigate whether methylprednisolone can improve the respiratory system degenerative diseases and benefit the mechanical ventilation. Methods:Sixty patients undergoing elective line laparotomy were divided into experimental group and conrol group (n=30) according to their wishes.The patients in experimental group receieved intravenous injection of methylprednisolone 1 mL (40 mg) after endotracheal intubation,and the patients in control group receieved 1 mL intravenous saline water injection.The airway peak pressure (Ppeak), airway platform (Pplat), lung compliance (Compl), and airway resistance (Raw) of the patients in two groups were recorded at the time of immediately before administration and 10,20,30,40 min after administration.The arterial blood oxygen partial pressure(PaO2),arterial blood CO2 partial pressure(PaCO2),CO2 partial pressure at the end of breathe out(PetCO2) of the patients were detected at the time of immediately before administration and 20 min after administration.Results:Compared with before administration, the respiratory mechanics parameters of the patients in control group 10,20,30,40 min after administration had no statistically significant differences (P>0.05);the Comple of the patients in experimental group was singnificantly increased (P<0.05), and the Ppeak, Pplat,and Raw were significantly decreased (P<0.05).Compared with control group, the Compl of the patients in experiment group 10,20,30,and 40 min after administration were significantly increased (P<0.05),and the Ppeak, Pplat, and Raw were decreased (P<0.05).Compared with before administration,the PaO2,PaCO2,and PetCO2 of the patients in control group 20 min after administration had no significant differences(P>0.05);the PaCO2 and PetCO2 of the patients in experimental group 20 min after administration were decreased(P<0.05),and the PaO2 was increased(P<0.05).Compared with control group,the PaCO2 and PetCO2 of the patients in experimental group 20 min after administration were decreased(P<0.05),and the PaO2 was increased(P<0.05).Conclusion:Methylprednisolone can obviously reduce PaCO2,Peak, and Pplat and increase PaO2 and Compl;methylprednisolone has possibility in improving the adverse effects of degenerative disease of respiratory system on general anesthesia in the elderly patients.

Salmonella enterica serovar Choleraesuis strain C500 is a live attenuated vaccine that has been widely used in Chi‐na for over 50 years to prevent piglet paratyphoid .However ,as C500 is obtained by chemical methods ,the genetic background of this strain remained unclear .In this study ,we compared the genomic differences between the virulent reference strain C 78‐2 and C500 by suppression subtractive hybridization combined with the mirror orientation selection method (MOS‐SSH ) .Six genes (asr ,ydgF ,ydgD ,ydgE ,rpoS ,and ptsG) were lost in C500 strain .Using real‐time PCR analysis ,we demonstrated that the genes regulated by rpoS ,a vital transcriptional regulator playing an important role in Salmonella infection ,were downregulated in C500 .Additionally ,the virulence of the rpoS mutant strain C78‐2ΔrpoS was 100 000 times lower than the parental strain in BALB/c mice .So loss of rpoS gene is the major factor leading to the attenuation of C500 strain .

Objective To investigate the diagnosis and treatment of pancreatic carcinoma with acute and chronic pancreatitis as the initial symptoms.Methods The clinical data of 13 patients with pancreatic carcinoma who were admitted to the First Affiliated Hospital of Dalian Medical University and the Affiliated Central Hospital of Dalian Medical University from January 2003 to June 2014 were retrospectively analyzed.The first symptoms were acute and chronic pancreatitis.Laboratory and imaging examinations were carried out on all the patients,and the treatment plan was designed according to the location and stage of the tumor as well as the patient's wishes.Surgery,radiotherapy,chemotherapy and other symptomatic treatment were selected.All the patients were followed up by telephone interview till July 2014.Results The major symptoms included abdominal pain and lumbodorsal pain (7 patients).Of the 13 patients,1 patient refused to received laboratory examination,and the levels of CA19-9 of the other 12 patients were elevated (the levels of CA19-9 of 11 patients were above 1 × 105 U/L).The levels of carcinoembryonic antigen (CEA) of 5 patients were elevated.Thirteen patients received plain or enhanced abdominal computed tomography (CT),3 received magnetic resonance imaging (MRI) and 3 received sonography.The tumors located at the head of the pancreas wcrc observed in 9 patients,tumors located at the neck of the pancreas was observed in 2 patients,and tumors located at the tail of the pancreas were observed in 2 patients.The sizes of the tumors ranged between 1.7 cm × 1.7 cm and 4.9 cm × 4.8 cm.The common bile duct,intrahepatic bile duct and pancreatic duct of 7 patients were dilated.The superior mesenteric vein of 3 patients were invaded by the tumor.The lymph nodes of 4 patients were swollen,and 3 patients had peritoneal effusion.The results of CT confirmed that 2 patients were with cholecystolithiasis,and the results of magnetic retrograde cholangiopancreatography (MRCP) confirmed that 1 patient had choledocholithiasis.The size of he pancreas of all the patients were increased using ultrasonography,and the main pancreatic ducts of 2 patients were dilated.Ten patients were diagnosed as with advanced pancreatic carcinoma.All the patients were staged by the imaging findings,5 patients belonged to stage Ⅱ and 8 belonged to stage Ⅳ.Two patients underwent pancreaticoduodenectomy,and 1 of them underwent postoperative radiotherapy and chemotherapy,and the other patient underwent palliative biliary enteric anastomosis and gastrojejunostomy.Two patients were treated by chemotherapy and 1 by radiotherapy in the 10 patients who did not received surgery.The rest 7 patients were treated with symptomatic therapy.The pathological results of the 2 patients who underwent pancreaticoduodenectomy were both moderately and poor-differentiated adenocarcinoma,and the size of the tumors were 4.0 cm × 3.0 cm × 2.5 cm and 2.5 cm × 2.0 cm × 1.0 cm.Three patients lost to follow-up among the 13 patients.The survival time of the patients with acute pancreatitis as the initial symptom ranged from 2.0 months to 6.0 months,and the median survival time was 4.5 months.The survival time of the patients with chronic pancreatitis as the initial symptom ranged from 0.5 months to 10.0 months,and the median survival time was 3.0 months.The median survival time of the 4 patients with elevated level of CEA was 3.5 months,and the median time of the 5 patients with normal level of CEA was 5.4 months.All the 10 patients who were followed up died of tumor recurrence and metastasis.Conclusion The clinical presentation of patients with acute and chronic pancreatitis as the initial symptoms is atypical,and it is difficult to achieve early diagnosis.Dynamic monitoring and combined diagnosis with laboratory and imaging examinations will improve the accuracy of diagnosis.Surgery based treatment is the preferred option.

OBJECTIVE: To observe the clinical effect of perforated bovine amnion combined with recombinant bovine basic fibroblast growth factor (rb-bFGF) on degree Ⅱ burn wounds.METHODS: A total of 43 patients with small and medium-size thermal burn were collected, and the area of testing wound was 1% -2%. The wounds with the same nature were divided into three groups: perforated bovine amnion (treatment group), bovine amnion (control 1 group), and vaseline gauze dressing (control 2 group). All the three groups combined with rb-bFGF. RESULTS: Compared with control 1 group (P < 0.01) and control 2 group (P < 0.05), the treatment group could obviously decrease the healing time of deep degree Ⅱ burn wounds. For superficial degree Ⅱ burn wounds, compared with the control 2 group, the treatment group could also decrease the healing time; however, there was no significant difference between treatment group and control 1 group (P > 0.05). Dressing was not changed frequently, and the pain was relieved. Rash or other adverse effects were not detected in the three groups.CONCLUSION: The combination of perforated bovine amnion and rb-bFGF can obviously promote the healing of burn wounds.

This study was aimed to improve the sensitivity of magnetic induction phase shift detection system for cerebral hemorrhage. In the study, a cerebral hemorrhage model with 13 rabbits was established by injection of autologous blood and the cerebral hemorrhage was detected by utilizing magnetic induction phase shift spectroscopy (MIPSS) detection method under the feature band. Sixty five groups of phase shift spectroscopy data were obtained. According to the characteristics of cerebral hemorrhage phase shift spectroscopy under the feature hand, an effective method, B-F distribution, to diagnose the severity of cerebral hemorrhage was designed. The results showed that using MIPSS detection method under feature band, the phase shift obviously growed with increase of injection volume of autologous blood, and the phase shift induced by a 3-mL injection reached -7.750 3 degrees ± 1.420 4 degrees. B-F distribution could effectively diagnose the severity of cerebral hemorrhage. It can be concluded that the sensitivity of the cerebral hemorrhage magnetic induction detection system is improved by one order of magnitude with the MIPSS detection method under the feature band.
Animals ; Cerebral Hemorrhage ; diagnosis ; Magnetic Phenomena ; Magnetics ; Rabbits ; Spectrum Analysis ; methods

Objective To assess the effect of low-dose cytarabine and aclarubicin in combination with gran-ulocyte colony-stimulating factor (G-CSF) protocol (CAG) in patients with acute myeloid leukemia (AML),and to understand the potential factors affecting the outcome of CAG induction therapy, therefore to find the optimum pa-tients for CAG therapy. Methods Twenty-one AML patients were enrolled in the current study. All patients were treated with CAG regimen including cytarabine (10 mg/m~2, subcutaneously, every 12 h, days 1 - 14), lacinomycin (5～7 mg/m~2,intravenously,every day, days 1 -8) ,and G-CSF (200 μg/m~2,subcutaneously, every day,12 h be-fore Ara-C was given) priming. Results The overall complete remission (CR) rate of the 21 AML patients was 66.7% (14/21). The CR rates was 87.5% (7/8) in patients older than 60 yrs,60.0% (9/15) in the refractory or relapsed patients,83.3% (5/6) in the MDS transformed AML patients. The CR rates for patients with hyperprolif-erative BM and median to poor proliferative BM were 33.3% and 91.7% ,respectively(P =0.009). The median o-verall survival (OS) time of the 21 AML patients was 450 days. Two-year survival rate estimated by Kaplan-Meier Method was 30.6%. The overall median disease free survival (DFS) was 165 days. The median OS time for those refractory or relapsed was 435 days. The median OS time for those with poor cytogenetic state or standard or good cytogenetic state was 140 days and 620 days, respectively (P = 0.001). The median OS time for patients with hyperproliferative BM and median to poor proliferative BM was 321 days and 620 days, respectively (P = 0.05). The median recovery time of granulocytes above 1.0×10~9/L was 8 days. The median duration of fever was 3.5 days. The rate of infections exceeding WHO grade Ⅱ was 42.9%. No early death occurred. Conclusions The CAG induction therapy may have a higher CR rate in patients with refractory or relapsed AML, elderly AML and secondary AML from MDS transformation, and extend the median overall survival time in refractory or relapsed patients. CAG therapy can not improve the outcome of patients whose BM was in high grade proliferation state or whose cytogenetic state was poor. CAG therapy can shorten the duration of agranulocytosis and decrease the inci-dence of serious infection. Therefore, CAG therapy is worth recommending to patients who can not endure the rou-tine intensive chemotherapy.