Case study approach is an important teaching method, which can improve the study interest of students if properly usd. It can train students' creative and comprehensive ability and increase the interaction between teachers and students. It can also enhance the leave of teaching and effects of class. The practicing of the application of case study approach on teaching of pharmacy administration is summarized to explorethe teaching reformation.

Objective To explore the effect of narrow band imaging on the clinical outcomes of patients with high grade intraepithelial neoplasia in gastric mucosa.MethodsFrom June 2006 to June 2016, 96 patients of gastric high-grade intraepithelial neoplasia were enrolled in the study. All patients were divided into control group and observation group using a random number table method, 48 cases in each. In control group, patients were treated with endoscopic submucosal dissection treatment, while in observation group, patients were treated with narrowband imaging combined with endoscopic submucosal dissection treatment. The operation time, pathological type and occurrence of complications of the two groups were compared.Results The operation time, positive margin rates in observation group were lower than that in control group, while tumor diameter, one en bloc resection rate and curative resection rate was higher, the difference was statistically significant (P < 0.05). Pathological type: observation group includes 27 cases of HGIN, 15 cases of focal HGIN and 6 cases of high-moderately differentiated adenocarcinoma;while in control group, including 1 case of LGIN, 33 cases of HGIN, 11 cases of focal HGIN and 3 cases of high-differentiated adenocarcinoma patients, the difference was not statistically significant (P > 0.05). Overall incidence of complications in observation group and control group were 6.25% and 22.92% respectively; which shown observation group has significantly lower rate than control group, the difference was statistically.Conclusion Narrow-band imaging combined with endoscopy in the treatment of gastric neoplasia in patients with high-grade intraepithelial lesions can significantly improve the cure rate and complete resection en bloc resection rate, shorten the operation time, reduce the incidence of complications.

Objective To establish a method of culturing mesenchymal stem cells from umbilical cord blood. Methods The mononuclear cell fraction of umbilical cord blood was isolated with the aid of a Ficoll/Hypaque gradient, then MSC were cultivated in serum containing medium or serum-free medium. The serum containing medium (SC) consisted of LG-DMEM supplemented with 10% fetal calf serum and 10-6M hydrocortisone, with a final cell concentration of 1?106 cells/ml. The serum-free medium (SF) was supplemented with 1?10 -6M hydrocortisone and 40ng/ml fibronectin with a final cell concentration of 1?106 cells/ml. After a week, 50% of the media were renewed. Before reaching the monolayer phase cells were trypsinised and re-cultured under similar conditions for the another 3 weeks. Cells were counted at the beginning and the end of the culturing period. Phenotypes were identifiad by PAS, NAE, ALP staining. Identification of surface markers and cell cycle analysis of MSCs were performed with flow cytometry. Results Adherent cells appeared 24h after plating of mononuclear cells. The cells formed adherent heterogeneous cell populations after 4-7 days in culture, and they consisted of round and spindle-like cells. In the primary passage of culture, the cells proliferated slowly and became confluent in 14-20 days. When subcultured, the heterogeneous cell populations became homogeneous assuming flat and fibroblast-like shape. Though colonies in the medium containing serum formed earlier than those in the serum-free medium, passage times and cell morphology were the same. The total cell numbers in SF group were lower than those of SC group. The percentage of cells at G0-G1 cell cycle was higher in SF group than that of SC group with significant difference. By flow cytometry analysis, cells of two groups were negative for CD34, CD13 and CD45, but strongly positive for specific surface markers such as CD166, CD29, CD105 and CD54. Conclusion Serum-free medium was superior to medium containing serum for culturing MSCs.

BACKGROUND: The method of culture purified sinoatrial node cell is important in investigating its ultrastructural characteristics and autorhythmic mechanisms.However,the corresponding method has not been standardized.OBJECTIVE: To summarize the localization,cultivation and purification of sinoatrial nodes isolated from newborn rabbits,and to study the morphological characters of primary cultured pacemaker cells.METHODS: Hearts of the newborn rabbits(within 24 hours)were embedded in paraffin for hematoxylin-eosin staining,The location of sinoatrial nodes was observed under an optical microscope,the morphology of sinoatrial nodes cells were observed by light microscope and electron microscope.RESULTS AND CONCLUSION: Sinoatrial nodes localized in the anterior wall of the superior vena cava and the posterior laterial wall of right atrium.There was about 0.32 mm between its lowest point and sulcus terminalis.Three distinct types of cells were observed among the cultured cells of sinoatrial nodes: spindle,spider and polygon.The spindle cells occupied the greatest proportion of the cultured cells(59.6±7.3)%.The spontaneous contraction frequency of spindle cells was the highest among the constracting cells(145±9)times per minute.The ultrastructure observation showed that myofibrils and other organelles in spindle cells were sparse and significantly decreased in number compared with triangle cells.There was no significant difference between triangle cells isolated from sinoatrial nodes and from atrial muscle.Sinoatrial nodes could be harvested along the anterior root of the superior vena cava down to the posterolateral sulcus.Among the cultured cells from neonatal rabbit sinoatrial nodes,the spindle cells with small body and fast pulse frequency are pacemaker cells.

Objective To observe the effect of Isoket on standard dobutamine stress echocardiography(DSE).Methods Thirty-seven patients were divided into three groups according to the results of quantitative coronary angiography(QCA):the control group(CON) including 12 patiens,the coronary artery disease group 1(CAD1) including 15 patients,and the coronary artery disease group 2(CAD2) including 10 patients.Among the three group,the DSE+Isoket was done in CAD2,while the standard DSE was done in the other two groups.The improvement of segments of left ventricular after percutaneous transluminal intervention(PCI) was looked as the standard evaluating DSE.Results Isoket could increase heart rate and decrease systolic blood pressure,but could hardly affect diastolic blood pressure.The rate of biphysic response was 62.5% in group CAD1,and the sensitivity of detecting viable myocardium was 61%,while the specificity was 76%.In group CAD2,the rate of biaphysic response was 72.2% ,and the sensitivity of detecting viable myocardium was 82%,while the specificity was 88%.The rate detecting viable myocardium and sensitivity was improved significantly in group CAD2.Conclusions DSE combined with Isoket was beneficial for detecting viable myocardium.

BACKGROUND: Studies have demonstrated that hyperpolarization-activated andcyclic nucleotide-gated cation channels (HCN) 2 and HCN4 are abnormal expressed in ventricular muscle following heart disease, which is closely correlate to ventricular arrhythmia. Bone marrow stem cells (BMSCs) transplantation can improve damaged cardiac muscle; however, its effect on remodeling of ion channel is unclearly. OBJECTIVE: To detect the changes of HCN2 and HCN4 expression in left ventricle following BMSCs transplantation.METHODS: Five Sprague-Dawley (SD) rats, aged 3 weeks, were prepared for BMSCs by Percoll method. Additional 30 health, male, SD rats, were randomly divided into DMEM, cell transplantation, sham operation and control groups. At 4 weeks after model preparation, DMEM culture medium was injected into the infarcted area and surroundings with 5 points in the DMEM group. The 3rd generation of cultured BMSCs (200 μL, with 5×10~6 cells) were injected into rats in the cell transplantation group with the same methods. The mRNA and protein expression of HCN2 and HCN4 gene was detected by RT-PCR and Western blot respectively.RESULTS AND CONCLUSION: In non-infarcted region, the mRNA and protein expression of HCN2 and HCN4 among each groups had no significant difference (P > 0.05). Compared with the control and sham operation groups, mRNA and protein expression of HCN2 and HCN4 in surrounding of the infracted region was elevated in the DMEM group (P < 0.05), which was greater than that of the cell transplantation group (P < 0.05). The mRNA and protein expression of HCN2 and HCN4 was smaller in the center area of infracted region in the DMEM group than that of the control and sham operation groups (P < 0.05), which was similar to the cell transplantation group (P > 0.05). Acute myocardial infarction can increase mRNA and protein expression of HCN2 and HCN4 in infracted region surrounding. BMSCs transplantation may lower the fatality rate of ventricular arrhythmia by reducing HCN2 and HCN4 expression.

OBJECTIVE: To explore the application of double pedicle blood supply pectoralis major myocutaneous flap in reconstruction of laryngeal and hypo pharyngeal defect after carcinoma resection. METHOD: All the patients received initial treatment. Pectoralis major myocutaneous flap was Applied in one-stage reconstruction in 22 cases of laryngocarcinoma and hypopharyngeal carcinoma with post-operation defect. During operation, pectoral branches of thoracoacromial vessels and branch of lateral thoracic vessels were reserved and prepared to be double pedicle vessel fascia bundle without muscle at the beginning part, rearched to defect area through subclavian tunnel. After operation, it is necessary to closely observe the subcutaneous swelling, quantity and color of the drain and others of neck surgery area to exclude the occurrence of surgical hematoma. When there is suspicion, do timely exploration. RESULT: Pectoralis major myocutaneous flaps of 22 patients were all survived. Pharyngeal fistula occurred in 2 cases and was cured by change of dressing. Twenty-one cases received radiotherapy after operation without secondary flap necrosis. After follow-up of 6 months to 24 months, one case of roll repairment of circumferential defect in cervical esophagus,found to have anastomotic stenosis 8 months after radiotherapy and then underwent gastrostomy treatment,the other 21 cases showed good recovery of swallowing function. Among 13 cases with laryngeal function reserved, only 1 case wearing tube and the extubation rate was 92.3% without communication barriers, no patient died in the short follow-up period. CONCLUSION For double pedicle blood supply pectoralis major nyocutaneous flap, blood supply are fully guaranteed and does not require complicated equipment to observe and monitor the flap blood supply after operation, it is important to exclude factors that may lead to muscular flap necrosis to ensure the survival of pectoralis major myocutaneous flap.
Esophagus ; surgery ; Fistula ; pathology ; Humans ; Hypopharyngeal Neoplasms ; surgery ; Laryngeal Neoplasms ; surgery ; Larynx ; surgery ; Myocutaneous Flap ; Pharynx ; pathology ; surgery ; Reconstructive Surgical Procedures

Objective To understand the incidence of hemolytic disease in newborn (HDN)among the newborns with jaundice and the coincidence degree of the blood group serological results and the clinical diagnosis in HDN.Methods The microcolumn gel method was adopted to detect the 3 serological indexes in 276 jaundice newborns of maternal fetal blood group incompatibility,in-cluding the direct antiglobulin test,free antibody test and antibody release test.Results 108 cases of HDN were clinically diagnosed with the positive rate of 39.13%.The positive detection rate in newborns with 0-2 d old was highest(50.00%).Conclusion The serological test can provide the basis for the early diagnosis and treatment of HDN.Collecting the specimen as early as possible can improve the positive diagnosis rate of HDN.

AIM: To explore the effect of L-arginine (L-Arg) on the arrhythmia induced by ischemia/reperfusion (IR) of the right coronary artery in rabbits. METHODS: 48 healthy adult rabbits were divided into 4 groups (n=12 of each) randomly: IRa group (120 min reperfusion after 30 min ischemia), IRb group (120 min reperfusion after 120 min ischemia), IRa+L-Arg group and IRb+L-Arg group. I/R model was established by occluding and loosening the root of the right coronary artery in rabbits. The changes of ECG and arrhythmia were recorded and graded. RESULTS: ① The longer time of IR was, the higher the score of the arrhythmia was found. The incidence of atrial-ventricular block (AVB), sinus-atrial block (SAB), even sinus arrest were detected and aggravated gradually. ② The incidence of AVB was decreased and from Ⅲ?→Ⅱ?→Ⅰ? markedly, some of sinus and atrial arrhythmia were transformed into sinus rhythm gradually, and all of the arrhythmia scores in IRa group were decreased significantly as compared with the same time phases of IRb group (P

0.05). H/R injury significantly decreased the GSH level (P