Objective To evaluate the effect of progressive problem-based learning (PBL) in teach-ing of neurology and study its impact factors. Methods A total of 110 5-year undergraduate students were randomly divided into LBL and progressive PBL groups, with 55 students in each group. Both groups ac-cepted basic knowledge, clinical skills, case analysis and document retrieval teaching. Progressive PBL were given by three steps including introduction phase, transition phase and PBL stage. At the end of the internship, theoretical knowledg,practical skill scores and questionnaires were used to evaluate the effects of different teaching methods. Pearsonχ2 test was used to analyze the effects of gender, urban-rural character, mastery of relevant based knowledge and intra-group contribution on examination results of progressive PBL. Results Theoretical knowledge score of progressive PBL group was significantly lower than LBL group [(78.49 ±3.15) vs. (81.94 ±5.37), t=-4.11, P=0.000], while clinical skill score [(86.34 ±9.16) vs. (80.96±7.85), t=1.63, P=0.003] and clinical analysis score [(82.25±5.17) vs. (70.54±3.85), t=13.47, P=
0.000] of progressive PBL group were significantly higher than LBL group. Teaching satisfaction scales of learning interest ( χ2=7.21, P=0.007), self-learning ability ( χ2=6.70, P=0.010), knowledge use ability ( χ2=7.92, P=0.005), analytical thinking ability (χ2=4.36, P=0.037) and expression ability (χ2=9.17, P=0.003) in progressive PBL group were significantly higher than LBL group. Gender( χ2=0.0109,P=0.917) and urban-rural character (χ2=0.045, P=0.831) showed no significant impact on examination results of progressive PBL. While relevant based knowledge (χ2=6.82, P=0.009) and intra-group contribution (χ2=4.91, P=0.027) showed significant impact on examination results of progressive PBL. Conclusion Progressive PBL can improve the clinical skill and case analysis ability of students. Relevant based knowledge and intra-group contribution have significant impact on the effect of progressive PBL.

Objective To investigate the clinical efficacy of acupoint application plus massotherapy for scapulohumeral periarthritis (periarthritis of shoulder). Method One hundred and two patients with scapulohumeral periarthritis were randomly allocated to treatment and control groups, 51 cases each. The treatment group received acupoint application plus massotherapy and the control group, massotherapy. Both groups were treated for three courses. The VAS score and the Neer shoulder function score were recorded in the two groups before and after treatment. Result The VAS score and the Neer shoulder function score improved in the two groups after treatment compared with before (P<0.05) and improved more in the treatment group than in the control group (P<0.05). Conclusion Clinically acupoint application plus massotherapy has a satisfactory therapeutic effect on scapulohumeral periarthritis with a certain effect on pains in the affected shoulder.

Objective To compare the effect and compliance of Rifampicin by vein and oral in treating pulmonary tuberculosis in elderly patients who were primary treated and had positive sputum. Methods A total of 100 first-time smear-positive pulmonary tuberculosis patients were randomly divided into two groups, the treatment group and the control group,with 50 cases in each group. During the observation enhancement period,patients of the treatment group were given HZE added rifampin inoculation fluid and HEZ plus rifampin capsules for the control group.The indicators were recorded, such as:the rate of digestive discomfort, liver digfunction ,symptom improvement, sputum smear negative conversion at the end of the second month and chest X-ray improvement. Results In therapy group and control group,the rate of digestive discomfort was 14% and 82% respectively,P ＜0. 05 ;the rate of liver disfunction at the first weekend was 16% and 12% respectively(P ＞ 0. 05 ) ;The rate of liver disfunction at the second weekend was 36% and 30% respectively(P ＞0. 05) ;The rate of the symptom improvement was 96% and 70% respectively ( P ＜ 0. 05 ) ;The rate of improvement remarkably in chest film was 80% and 32% respectively( P ＜ 0. 05 ) ;The rate of sputum smear negative conversion at the end of the second month was 52% and 34% ,P ＞0. 05 ;the rate of.sputum smear negative conversion at the end of the sixth month was 96% and 82% (P ＜ 0. 05 ) ;The rate of chemotherapy formula changed during the therapy was 14% and 82% ( P ＜ 0. 05). Conclusion The Rifampicin was used by vein in elderly PTB that primary treated and got positive sputum could get better effect indexes,less side effect in digestive tract,similar liver disfunction and fine compliance to the standardized chemotherapy formula.

Objective To investigate the effect of acupuncture at point Neiguan on mouse myocardial hypertrophy.Methods Thirty-sixty healthy C57BL6 mice were randomized into blank, model and treatment groups, 12 rats each. In the treatment group, an acupuncture needle was inserted into point Neiguan and retained for 15 min, once daily. After nine days of treatment, the ratios of cardiac weight/tibial length were compared between the groups. Left ventricular myocardial tissues were processed by Masson trichrome staining in every group of mice. The differences in myocardial fiber arrangement and collagen fiber distribution between the groups were observed under the ordinary optical microscope in 100 times of field of vision. Sarcomere structure, myofibril arrangement, collagen fibers and mitochondria in injured myocardial tissues were observed by transmission electron microscopy. Results Heart rate increased significantly in the model group and decreased significantly in the acupuncture group compared with the blank group. Cardiac weight and the ratios of cardiac weight/tibial length increased significantly in the model and acupuncture groups compared with the blank group (P<0.01) and decreased significantly in the acupuncture group compared with the model group (P<0.01). In the model group, myocardial tissues had compensatory hypertrophy with incontinuous status, and myocardial transverse striations had severe disorder/disruption, karyopyknosis appeared and cytoplasmic eosinophilic change became obvious in few of the rats. The results were better in the acupuncture group than in the model group. In the model group, part of myofibrils had focal fusion, interstitial collagen fibers proliferated and mitochondria had swelling and compensatory increase. The results were also better in the acupuncture group than in the model group.Conclusions Acupuncture at point Neiguan can reduce the production of collagen fibers and mitochondria, improve the arrangement of sarcomere structure and delay the progression of myocardial hypertrophy.

Objective To compare new type streamlined liner pharynx airway with standard type Ⅰ laryngeal mask airway in the clinical effectiveness in gynecologic laparoscopic surgery.Methods Seventy three cases undergone gynecologic laparoscopic surgery were divided into two groups randomly.The observation group(40 cases) and the control group(33 cases) were maintained by streamlined liner pharynx airway(SLIPA) and standard type Ⅰ laryngeal mask airway respectively.The success rate of placement,throat hemorrhage and pain before/after anesthesia and other indicators.were strictly observed and recorded during anesthesia.Results The success rate of placement was significantly higher in the observation group than in the control group(P＜0.05).The incidence of throat hemorrhage and throat pain after surgery were significantly lower in the observation group(P＜0.05).Conclusion The streamlined liner pharynx airway could be easyly and safely placed and causes less tissue injury and complications in gynecologic laparoscopic surgery.SLIPA was worthy of being recommended in clinical surgery.

Reform was made on traditional education mode based on the criterion of undergraduate medical education at home and aboard.The reform includes the changes in teaching content,teaching methods and assessment methods in an aim to establish independent learning mode,cultivate students' self-study ability,initiative spirit and innovation ability.

Objective To investigate diagnostic magnetic resonance imaging features of orbital Langerhans cell histocytosis (LCH)and improve its diagnostic accuracy.Methods The symptoms and image data of fourteen histophathology verified orbital LCH cases are reviewed and analyzed.Results Nine patients had swollen eyelids,accompanying with symptoms of inflammation, esphthalmos and orbital masses.One case had cough symptom and another had diabetes insipidus.Of these fourteen cases,seven occurred in right orbital,six occurred in left orbital and one involved bilateral orbital.As to the location of LCH,six cases located in super-lateral wall of the orbit,five cases located in lateral wall of the orbital,and three cases located in roof of orbital.On MRI, thirteen cases lesions show hypo or iso signal intensity on T1 WI,and eleven cases lesions show heterogeneous hyper or iso signal in-tensity on T2 WI.The lesions of eosinophilic granuloma has clear border,which differentiate it from other types.After contrast en-hancement,MR imaging showed marked inhomogeneous enhancement.Conclusion MRI is the primary modality in diagnosing of or-bital LCH,clearly and accurately manifesting the extent of orbital LCH.It will be helpful to diagnose LCH timely if combining with clinical data.MR could provide reliable information for making surgical operation and treatment plan.

Objective On the basis of internet of things technology,to initially establish a management model of chronic obstructive pulmonary disease (COPD) patients in Gumei community,so as to provide experience for the comprehensive management of community COPD patients.Methods According to the characteristics of the Internet of things technology,we formulated a scheme as a technical route to manage the COPD patients.A homogenous COPD management team of doctors was established under the training of experts from the Department of Respiration of Zhongshan Hospital,Fudan University.Results We drew a COPD patient management model chart,and initially formed a qualified and homogeneous COPD management team of general practitioner.Conclusions Through the Internet of things technology management,we initially formed a set of manual quality control model in the process of data automatic transmission,and initially formed a management model of community COPD patients,based on the internet of things.

Acinar cell cystadenoma (ACA),also referred to as acinar cystic transformation,is a rare and newly recognized cystic lesion of the pancreas.This cystic lesion displaying apparent acinar cell differentiation and lacking of distinct cellular atypia was accepted as the benign counterpart of acinar cystadenocarcinoma.However,the exact etiopathogenesis of ACA is still not clear.

Obesity is an independent risk factor for acute pancreatitis (AP),and the morbidity risk and severity of AP in obese patients were significantly increased than those in non-obese patients.However,the exact mechanism has not been fully elucidated.In recent years,the researches on the role of adipose tissue (AT) in AP have gradually attracted wide attention of scholars both at home and abroad.To better understand the pathogenesis and new therapeutic targets of AP,in this paper,we overviewed the recent research progress on the role of AT in AP.