Objective In problem-based learning, students are often found difficult to con-struct medical knowledge systematically and transfer knowledge to solve new problems. In face of this challenge, this study aims to investigate the effect of visualization tool-supported online problem-based learning on medical students' clinical diagnostic expertise development. Methods A controlled study was conducted and 52 medical students were randomly assigned into experimental group (using visual-ization tool-supported online PBL environment for learning) and control group (using online PBL envi-ronment for learning without visualization tool support). Participants were asked to complete the diag-nostic analysis of three kidney problems according to the requirements of the learning environments and to provide feedback of online learning experience afterwards. Paired-sample t test and one-way analysis of vonriance were used to analyze both group's case 1 and case 3 on line learing scores. Results The results revealed that the experimental group had significant improvement in online learning performance [case 1: (1.47 ±0.54), case 3: (2.14 ±0.55), P=0.015], while the control group had no significant improvement [case 1:(1.57±0.67), case 3:(1.66±0.49), P=0.234]. Early performance of online learning and group factor had interative effects (F=7.266, P=0.013). Conclusions The findings suggest that visualization tool-supported online PBL environment can facilitate medical student clinical diagnostic expertise development effectively.

Objective To establish a mouse model for human esophageal cancer.Methods Human PBL were isolated directly from whole blood by density gradient centrifugation.Fifteen SCID mice were randomly divided into two groups.Group A was control group,and in group B there were 12 mice intraperitoneally injected with 2×107 human PBL and subcutaneously injected with 5×106 ECA109 cells.The rate of tumor transplantation,tumor growth,metastasis and histological features were observed.After 3,4,5,6 weeks of engraftment,the level of IgG in mouse serum and the spleen weight were detected.Results The successful rate of tumor transplantation was 100 ％.Metastasis was not found.After 3,4,5,6 weeks of engraftment,the spleen weight in group B were (55.44±4.45) mg,(88.62±2.24) mg,[(125.98±2.19) mg] (P ＜ 0.05) and (213.71±2.96) mg,which had statistical significance compared with the control group (41.87±2.97) mg.The level of IgG was significantly higher than that in control group (P ＜ 0.01).Conclusion The experimental results demonstrate that human esophageal cancer models have been established in Hu-PBL-SCID mice.

Objective To observe the control effect of heat preservation infusion on incidence of infection after artificial abortion.Methods 168 cases of patients after artificial abortion were randomly divided into the heat preservation infusion group and normal infusion group with 84 cases in each group.The normal infusion group received routine nursing,and was intravenously infused fluid with non heat preservation method,the heat preservation infusion group was intravenously infused constant temperature liquid heated to 37℃.The incidence of infection was observed in two groups of patients after artificial abortion.Results The infection rate of the heat preservation group was significantly less than the normal infusion group.Conclusions Heat preservation infusion can effectively reduce the infection rate after artificial abortion.

Objective To investigate the application effect of evidence-based nursing(EBN) in family planning surgery,evaluate the clinical nursing value and improve the quality of clinical nursing.Methods 240 patients who received family planning surgery were randomly divided into the control and the observation groups (120 patients in each group).The conventional nursing model was used in the control group and evidence-based nursing was implemented in the observation group.Self-rating Anxiety Scale(SAS),patients satisfaction(PA) and adverse reaction rate(ARR) were adopted to assess the two groups after different nursing.Results The score of SAS and ARR were significantly lower in the observation group than those in the control group.The patients satisfaction was significantly higher in the observation group than the control group.Conclusions Application of evidence-based nursing plays a significant role in treatment,nursing and life quality improvement of patients with family planning surgery,which is worthy of wide application.

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Objective To explore the constant temperature infusion on postoperative body temperature and blood coagulation of patients undergoing induced labor.Methods Eighty patients undergoing induced labor were divided into the observation group and the control group randomly:In the former the infusion was done using fluids constantly kept at the temperature of 36℃and in the latter,the infused fluid was kept at room temperature.The two groups were compared in terms of changes of body temperatures,loss of energy,postoperative blood loss and blood coagulation.Results The temperatures of the controls were declined to different extents after infusion and the temperatures of the observation group showed no significant change,but the difference between the two groups was significant(P<0.05).As for the blood coagulation,there were no significant differences in the prothrombin time(PT),activated partial thromboplastin time(APTT)and thrombin time(TT)between the two groups(P>0.05),but the platelet(PLT)and fibrinogen(FIB) content were significantly decreased(P<0.05)and the blood loss of the observation group was significantly less than those in the control group(P<0.05).Conclusion The constant temperature infusion may maintain the temperature and blood coagulation of the patients, reduce blood loss and prevent adverse reactions induced by induced labor.

Humans ; Kidney ; pathology ; Kidney Neoplasms ; pathology ; Neuroectodermal Tumors, Primitive ; pathology

BACKGROUND:There is no effective drug for idiopathic pulmonary fibrosis (IPF), because of a lack of the animal model imitating the complete pathogenesis of human IPF. Therefore, it is critical to establish an ideal animal IPF model used for investigating the underlying pathogenesis and developing a kind of effective drug. OBJECTIVE:To establish an animal model that can mimic more characters of human IPF. METHODS:Seventy male C57BL/6 mice were randomly divided into two groups, fol owed by subjected to the intraperitoneal injection of bleomycin (35 mg/kg) on days 1, 4, 8, 11, 15, 18, 22, and 25, twice (group A) or once (group B) a week. Mice were sacrificed at 2, 4, 6, 8, and 10 weeks after the eighth injection, and the lung tissues were moved used for hematoxylin-eosin, Masson and immunohistochemical stainings. RESULTS AND CONCLUSION:There were various degrees of alveolitis and pulmonary fibrosis in the two groups at different time points after the last injection. The scores of alveolitis and pulmonary fibrosis in the group A began to gradual y increase from the 2nd week and reached the highest level at the 6th-8th weeks until the 10th week. In contrast, the scores of alveolitis and pulmonary fibrosis in the group B peaked at the 2nd week, then fluctuately decreased, and were significantly lower than those in the group A at the 6th week (P<0.05). Immunohistochemistry showed that type I col agen deposition was mainly distributed in the subpleural region, peri-vascular region and alveolar septa, which was consistent with Masson staining findings. The expression levels of transforming growth factorβ1 (TGF-β1) andα-smooth muscle actin (α-SMA) in the regions developing alveolitis and pulmonary fibrosis were significantly increased. In the group A, the expression levels of type I col agen, TGF-β1,α-SMA, and the hydroxyproline content in the lung tissues reached the peak level at 6-8 weeks. However, in the group B, al above indicators reached the highest level at the 2nd week, but gradual y decreased thereafter. At the 4th week, the expression Levels of TGF-β1 andα-SMA in the group B were significantly lower than those in the group A (P<0.05). At the 6th week, the hydroxyproline and type I col agen levels in the group B were significantly lower than those in the group A (P<0.05). In conclusion, the mouse model of pulmonary fibrosis induced by intraperitoneal injection of 35 mg/kg bleomycin twice weekly can be used to mimic the repetitive wound healing process, pathological morphology and cytokine changes of human IPF, which is prone to administration, with better stability and repeatability. This model is of great significance for the study on IPF. Subject headings:Disease Models, Animal;Pulmonary Fibrosis;Bleomycin

Objective To compare the effects of three kinds of Oncomelania hupensis RNA extraction methods,namely a modified SDS method,TRIzol reagent method,and CTAB method,so as to obtain an economical and efficient method for RNA extraction from O. hupensis. Methods The modified SDS method,TRIzol reagent method and CTAB method were applied to ex-tract the RNA from O. hupensis. A nucleic acid protein analyzer was used to measure the concentration and purity of RNA. The yields were calculated by the concentration of the products. The purity was indicated by A260/A280 and A260/A230. The quality of RNA was inspected by 1% agarose gel electrophoresis. The β-acting gene was selected as the target gene for RT-PCR analysis. Re-sults The RNA yields obtained by using the three kinds of extraction methods were significantly different(F = 16895.85,P <0.01)according to the analysis of variance. The LSD test showed that the yields obtained by using the modified SDS method were the highest,and those obtained by the CTAB method were the lowest. The purity of RNA extracted by the CTAB method was su-perior to that by the other two methods,and the A260/A280 and A260/A230 ratios of the CTAB method were in the range from 1.8-2.0 and 2.0-2.2. The A260/A230 ratios of the other two methods were both lower than 2.0. The RNA extracted by the modified SDS meth-od had the better integrity. The electrophoresis results showed that the 28S rRNA band,18S rRNA band and 5S rRNA band were clear,and there was no obvious smear between each band. The RNA obtained by the TRIzol reagent method had no 28S rRNA band,and that obtained by the CTAB method had no 28S rRNA and 5S rRNA bands. The β-acting gene of the RNA ex-tracted by all the three methods could be amplified by RT-PCR. The costs and time-consuming of the modified SDS method were less than those of the other two methods. Conclusion The modified SDS method is an economic and efficient method,and it is suitable for extracting the RNA of O. hupensis,especially for large sample preparation.

Objective To observe the changes of tear film stability,goblet cell and mucin 5AC expression in conjunctivochalasis patients,and explore the mechanism of conjunctivochalasis.Methods Conjunctivochalasis patients (30 cases) and single age-related cataract patients (15 cases) were collected as conjunctivochalasis group and normal control group.Eye symptom assessment (OSDI score),tear break-up time (BUT),Schirmer Ⅰ test,tear fern crystallization tests were performed for all the selected persons.Conjunctival rescent-shaped resections were made for all the conjunctivochalasis patients.Conjunctival tissue samples were stained by HE staining,AB staining,mucin 5AC immunohistochemical staining from the conjunctivochalasis group and norral control group respectively,and then statistical analysis was made.Results The OSDI score in the conjunctivochalasis group (37.80 ± 8.94) was significantly higher than that in the normal control group (11.40 ±4.08) (P ＜0.01).BUT in the conjunctivochalasis group (6.70 ± 2.76) s was significantly lower than that in the normal control group (13.67 ± 3.48) s (P ＜ 0.01).Schirmer Ⅰ test in the conjunctivochalasis group (6.23 ± 3.13) mum was significantly lower than the normal control group (13.40 ± 3.74)mm (P ＜ 0.01).Tear ferbing crystallization of the conjunctivochalasis group was decreased significantly compared with the normal control group (x2 =14.309,P =0.003).Light microscopic showed that conjunctival thickness was thinned,collagen fibers were less,elastic fiber was reduced,the lamina propria and interstitial were congestion and edema,the number of goblet cells was significantly reduced,and the positive staining of mucin 5AC staining was significantly lower in the conjunctivochalasis group than in normal control group (x2 =9.499,P =0.023).Conclusion For patients with conjunctivochalasis,the tear film function is affected,goblet cells are decreased,tear fern crystallization is decreased,mucin 5AC content is decreased,which finally leads the excessive conjunctival relaxation and abnormal ocular surface and tear.