The traditional indoctrination typed teaching mode restricts students' subjective initiative,not conducive to the cultivation of students' practical ability and improvement of the comprehensive qualities.Innovating teaching mode of ideological and political theory course in higher vocational school is the objective requirements of higher vocational school.The innovation was made in teaching concept,organizational form of teaching,teaching contents,teaching methods,teaching means and teaching evaluation.

Objective To approach the mechanisms and myocardial protective effect of Qishen Yiqi dropping pills on rats with myocardial infarction. Methods Sixty clean healthy male Sprague-Dawley (SD) rats were randomly divided into sham operation group, model group and observation group (each n = 20). The rat model of acute myocardial infarction (AMI) was established by ligation of left anterior descent (LAD) branch of coronary artery. After modeling, the rats in observation group were given 0.135 g/kg of Qishen Yiqi dropping pills, and sham operation group and model group were administered the same amount of normal saline, once a day for consecutive 28 days. At the end of treatment, the levels of serum inflammatory factors of leukotriene B4 (LTB4), prostaglandin E2 (PGE2), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) were measured by enzyme linked immunosorbent assay (ELISA); the changes of the indexes of hemodynamic [left ventricular systolic pressure (LVSP), left ventricular end-diastolic pressure (LVEDP), the maximal rate of increase/decrease in left ventricular pressure (±dp/dt max)], the ratio of the heart weight/body weight, and the ratio of the left ventricular weight/heart weight (LVW/HW), the myocardial infarction area, myocardial histopathological changes were observed in the three groups; myocardial tissues inflammatory related factors [the mRNA and protein expressions of cytosolic phospholipase A2 (cPLA2), cyclooxygenase-2 (COX-2), 5-lipoxygenase (5-LOX)], and the expression levels of transforming growth factor-β (TGF-β)/Smads signal transduction pathway related protein (TGF-β1, Smad2/3, Collagen Ⅰ, Collagen Ⅲ ) and cell apoptosis related factors (Bcl-2, Bax) protein were measured. Results Compared with the sham operation group, levels of serum inflammatory factors, the index of LVEDP, the ratio of the heart weight/body weight, LVW/HW, myocardial infarction area, the mRNA and protein expression levels of inflammatory factors in myocardium, the expression levels of TGF-β/Smads signal transduction pathway related protein and the cell apoptosis related factors protein in model group were all significantly elevated, while LVSP and ±dp/dt max were obviously decreased in model group. Compared with the model group, the levels of inflammatory factor in serum [LTB4 (ng/L): 370.11±46.98 vs. 633.23±83.37, PGE2 (ng/L):48.75±26.35 vs. 131.25±29.75, TNF-α (μg/L): 177.28±22.65 vs. 248.47±16.21, IL-6 (μg/L): 493.22±165.99 vs. 638.41±191.66], LVEDP [mmHg (1 mmHg = 0.133 kPa): -2.03±2.98 vs. 7.03±1.39], the ratio of the heart weight/body weight [(6.53±0.11)% vs. (7.14±0.24)%], LVW/HW (0.26±0.01 vs. 0.32±0.02), myocardial infarction area [(27.21±2.87)% vs. (44.98±1.52)%], mRNA and protein expression of myocardial inflammatory factors, the expression of TGF-β/Smads signal transduction pathway related protein, and the protein expression of Bax were all significantly decreased in observation group (all P < 0.05), LVSP (mmHg: 129.01±11.93 vs. 108.11±12.69), the +dp/dt max (mmHg/s: 3101.3±378.6 vs. 2105.3±245.9), the -dp/dt max (mmHg/s: 2612.4±249.7 vs. 1654.4±188.1), while the protein expression of Bcl-2 in observation group were obviously increased (all P < 0.05). It was demonstrated by hematoxylin-eosin (HE) staining that there were no obvious pathological changes in the sham operation group; obvious infiltration of inflammatory factors in myocardium was shown in model group; pathological changes in the observation group were significantly improved as compared with those in the model group. It was shown by Masson staining that there were slight hyperplasia of myocardial fibers and no obvious pathological changes in the sham operation group. Severe collagen hyperplasia was found in model group, and the degree of fibrosis in the observation group was significantly improved. Conclusions Qishen Yiqi dropping pills can reduce the degree of myocardial fibrosis and inhibit the ventricular remodeling via TGF-β/Smads signal transduction pathway. The dropping pills can also suppress the release of inflammatory factors by reducing cPLA2 to decrease the inflammatory response and inhibit apoptosis and alleviate myocardial injury by up-regulating the expression of Bcl-2 and down-regulating the expression of Bax.

BACKGROUND:The incorporating of zeolites or porous fillers into polymer membranes can improve the pervaporation separation properties of membranes.But the effect mechanism of zeolites or porous fillers on membrane properties needs to be further studied.OBJECTIVE:The study was designed to prepare ZSM-5 zeolite incorporated chitosan membrane by solution blending method to investigate the effecIs of zeolite on membrane pervaporation properties.DESIGN:A controlled observation.SETTING:Dalian Institute of Chemical Physics,Chinese Academy of Sciences.MATERIALS:This study was performed at the Laboratory of New Type Membrane Separation Technology,Dalian Institute of Chemical Physics,Chinese Academy of Sciences in May 2006.Chitosan,with deacetylation degree of 75%-85%,was obtained from Sigma-Aldrich Chemical Company,USA;Dimethyl carbonate(DMC),with purity of 99%,was purchased from Fluka Chemical Company,USA:ZSM-5 zeolite was kindly supplied by Dalian Institute of Chemical Physics,Chinese Academy of Sciences,China;Methanol,with purity＞99.5%,were purchased from Shenyang Lianbang Chemical Company,China.METHODS:ZSM-5 zeolite incorporated chitosan membranes were prepared by solution blending method.MAIN OUTCOME MEASURES:①Swelling and sorption of ZSM-5 zeolite-incorporated chitosan membranes in the DMC/methanol mixture.②Effects of zeolite content in the membrane and operating temperature on pervaporation properties.RESULTS:Scanning electron mieroscope demonstrated that zeolite was uniformly distributed in the membrane matrix and the membranes were free from possible defects.The separation selectivity of dimethyl carbonate(DMC)/methanol mixtures was dominated by solubility selectivity rathcr than diffusivity selectivity.Swelling degree increased and the permeation flux of the membranes increased significantly with the zeolite content increasing.From the temperature-dependent permcation values,the Arrhenius activation parameten were estimated.CONCLUSION:The pervaporation results indicated that the membranes incorporated with the ZSM-5 zeolite exhibited better separation properties for DMC/methanol mixtures comparing with homogeneous chitosan membranes.

Objective To investigate the effects of recombinant human growth hormone (rhGH) on tumor growth and tumor angiogenesis factor relevant to Janus kinase 2-signal transducer and activator of transcription 3 of human gastric carcinoma xenografts in nude mice with different expressions of growth hormone receptor (GHR).Methods Immunocytochemical method was used to pick out one GHR-positive and one GHR-negative cell line. The cells were subcutaneously injected into 26 nude mice separately, then the patterns of xenografts in nude mice with different expressions of GHR were established. The nude mice bearing two different kinds of human gastric caicinoma were equally randomized into control group, low-dose rhGH group, and high-dose rhGH group,and were treated with drugs for 14 days. Changes of tumor volumes and body weight of nude mice were record. The protein and mRN A expressions of tumor angiogenesis factor in tumor tissue were detected by RT-PCR and Western blot, respectively. Results GHR was highly expressed in SGC-7901 celk but negative in MKN-45 cells. For nude mice bearing GHR+ SGC-7901 xenografts, the tumor volumes were significantly larger in low-dose rhGH group [(1. 141 ±0. 234) cm3] and high-dose rhGH group [(2. 106 ±0. 260) cm3] than in control group [(0.612±0. 156) cm3] (P = 0. 034, P = 0. 001), and the high-dose rhGH group revealed greater effect (P =0. 043 ). Body weight was not significantly different among three groups. Compared with the control group, the mRNA expressions of tumor angiogenesis factor were significantly increased in low-does rhGH group, and the P values of GHR, Janus kinase 2, signal transducer and activator of transcription 3, vascular endothelial growth factor (VEGF), hypoxia-inducible factor-1α (HIF-1α), fibroblast growth factor, and matrix metalloproteinases-2 (MMP-2) was 0.001, 0.011, 0.042, 0.045, 0.040, 0.002, and 0.003, respectively; however, the high-does rhGH group did not show the greater effects. The protein expressions were significantly increased in low-does rhGH group, and the P value of phosphorylation-signal transducer and activator of transcription 3, signal transducer and activator of transcription 3, VEGF, HIF-1α, and MMP-2 was 0. 015, 0.003, 0.010, 0.008,and 0. 005, respectively; furthermore, the high-does group revealed the further greater effects, and the P value of VEGF, HIF-1α, and MMP-2 was 0.012, 0.025, and 0.046, respectively. On the contrary, for nude mice bearing GHR- MKN-45 xenografts, the body weights of low-dose rhGH group [(24.94 ±0. 517) g] and high-dose rhGH group [(26.97 ±0.686) g] were significantly higher than that of control group [(22.78 ±0.418) g] (P =0. 040, P = 0.012 ) , while tumor growth as well as the expressions of mRNA and protein of tumor angiogenesis factor in tumor tissue were not significantly different Conclusions rhGH can promote tumor growth and up-regulate the expression of tumor angiogenesis factor in the GHR-highly-expressed SGC-7901 xenograft tumor model; However,such effects do not exist in GHR-negatively-expressed MKN-45 xenograft tumor model. The existence of GHR may be a key target by which rhGH influences the tumor growth and the expressions of tumor angiogenesis factor, which is probably achieved through Janus kinase 2-signal transducer and activator of transcription 3 activation.

Adult ; Aged ; Arthritis, Rheumatoid ; complications ; Female ; Humans ; Intracranial Thrombosis ; complications ; Male ; Middle Aged ; Pulmonary Embolism ; complications ; Venous Thrombosis ; complications

By analysis on mechanism of dampness and hotness obstruction of RA in active stage,explore the relationship between RA and dampness and hotness obstruction, and the clinical status of Qingre Lishi Huoxue Tongluo method in treating RA in active stage, for more effectively guiding clinic administration.

Acute respiratory distress syndrome (ARDS) is a severe respiratory condition that is characterized by rapidly progressive hypoxemia with noncardiogenic pulmonary edema.Despite the improvement of therapeutic methods,the mortality of ARDS is in the range of 40％-50％ all over the world.Some studies have shown that a significant number of patients with ARDS had acute cor pulmonale (ACP),and ACP is independently associated with the mortality of patients with ARDS,which has attracted wide attention in recent years.This paper reviewed recent related studies,summarized the prevalence,pathogenesis and diagnostic approaches of ACP in ARDS,especially echocardiography which was considered as a cornerstone for ACP diagnosis,and elucidated the beneficial effects of right ventricular protective ventilatory strategy and prone-positioning on the pulmonary vasculature and right heart,in order to provide a novel idea for the therapy of ACP in ARDS.

Objective To investigate the characteristics of lymph node metastasis in T 1 stage of lung cancer and the curative effects of minimally invasive surgery and open surgery .Methods Totally 120 cases of T1 stage of lung cancer were divided into two groups ,68 cases in the minimally invasive surgery group and 52 cases in the open surgery group ,the number of lymph node me‐tastasis in the patients with lung cancer in T 1 stage were studied ,the perioperative related indicators for different tumor size were compared between the two different surgical methods .Results All patients were successfully completed the operation without op‐erative death case .The two groups had no significant difference in the aspects of operation time ,intraoperative bleeding volume and number of lymph node dissection .The lymph node metastasis rates in the maximum tumor diameter ≤1 .0 ,1 .0 -3 .0 cm were 1 .3% and 9 .7% respectively .N1 ,N2 squamous cancer of the maximal tumor diameter ≤1 .0 cm had no metastasis .The periopera‐tive related clinical indicators in the maximal tumor diameter ≤1 .0 cm had significant differences between the two kinds of opera‐tion method(P<0 .05) ,the perioperative related clinical indicators in the maximal tumor diameter 1 .0-3 .0 cm had no significant differences between the two kinds of operation method .Conclusion The patients with T1 stage of lung cancer and the maximal tumor diameter ≤1 .0 cm are more suitable for the minimally invasive surgery ,but the patients with T1 stage of lung cancer and the maximal tumor diameter>1 .0 cm have little difference in minimally invasive surgery and open surgery .

Objective To evaluate the efficacy and safety of somatostatin and ileus tube for adhesive bowel obstruction.Methods From January 2008 to February 2010,ninety-one patients diagnosed with adhesive bowel obstruction were enrolled in the study.Patients were randomly divided into four groups:somatostatin + ileus tube group ( group A,n =22 ),somatostatin + nasogastric tube group (group B,n=19),ileus tube group (group C,n=23),and nasogastric tube group (group D,n =27).All cases received conventional treatment,including fasting,maintaining electrolyte and acid-base balance,enteral and parenteral nutrition support and antibiotics; Groups A and B received somatostatin 0.6 mg/day,groups B and D received nasogastric tube decompression.ANOVA analysis and x2 test were used to compare the variables.Results Group A had a quick recovery of flatus and stool compared with group D,[ (4.5 ±1.9) vs.(7.8 ± 1.7) d] (F =28.715,P =0.000).Abdominal pain and abdominal distension recovered faster [ (3.6 ± 1.5) vs.(8.4 ± 2.2) day ] in group A compared with group D ( F =23.857,P =0.000).Less amount of gastric drainage were observed in somatostatin-treatment groups [ group A vs.C:(632 ±102) ml/d vs.(1020±148) ml/d; group B vs.D:(410±86) ml/d vs.(590±97) ml/d] (F=11.687,P =0.000;F=10.399,P =0.000).The rate of laparotomy in group A was O,which was significantly less than the 22％ in group D ( x2 =5.571,P =0.018 ).Conclusions The high improvement rate in abdominal symptoms suggested the efficacy of somatostatin and ileus tube in patients with small bowel obstruction.The application of somatostatin combined with ileus tube improves the symptoms of adhesive intestinal obstruction and decreases the rate of laparotomy.

BACKGROUND: It has been demonstrated that pedicle screw internal fixation influencing factors involve screw structural morphology, thread parameter, bone density, moment size for tightening screw during operation, and depth of screw placement. There is little known about the correlation of pullout strength of spinal pedicle screw with device for transverse traction to extraversion angle. OBJECTIVE: To assess effect of the spinal pedicle screw with device for transverse traction on pullout strength at different extraversion angles. DESIGN: Repeated measurement. SETTING: Center for Bone Joint, the First Affiliated Hospital of Nanjing Medical University. PARTICIPANTS: This study was performed at Laboratory for Material Mechanics, Hehai University between June and November 2003. A total of 18 adult dried lumbar vertebrae (L1-5) were provided by Department of Anatomy, Nanjing Medical University, and recruited for this study. The protocol was approved by the hospital's Ethics Committee. The pedicle screw was made of stainless steel. Each pedicle screw had a diameter of 5.5 nun, total length of 150 nun (thread part 50 into included), and the same thread parameter. Electrical universal material machine (EW type) was provided by Laboratory for Material Mechanics of Hehai University. METHODS: Bone density was measured with a single photon bone density determinator. According to the bone density, the lumbar vertebrae were numbered and randomly divided into 3 groups with 6 lumbar vertebrae in each: extraversion angle 5 ° group, extraversion angle 15° group, and extraversion angle 30° group. ① Installation of pedicle screw and clamping apparatus: According to Wein-Stein method, one entry-point was selected at each side of lumbar vertebra, and at the sametime, extraversion angle 5°, 15° ,and 30° were respectively defined for extraversion angle 5° , 15° ,and 30° groups. A 50 mm-depth pinhole was drilled with a drill bit with a diameter of 3.0 nun. Pedicle screw was screwed into 50 nun, and its end part was connected to the device for transverse traction. Spinal vertebrae and the device for transverse traction were fixed with a specially made clamping apparatus. ② Determination of pullout strength and observation of pedicle and vertebral injury: Spinal vertebrae, on which pedicle screw and device for transverse traction were installed, was placed on a EW electrical universal material machine together with clamping apparatus for determining the pullout strength of pedicle screw. Sensor was connected to a computer to draw strength-displacement curve. The wave crest of the curve was considered the maximum pullout strength. At the same time, injuries to pedicle and vertebra caused by pullout of pedicle screw were observed. MAIN OUTCOME MEASURES: Pullout strength and injuries to pedicle and vertebra. RESULTS:①The mean maximum pullout strength of pedicle screw was respectively 0.878 167, 1.420 333, and 2.154 167 KN for extraversion angle 5° , 15 ° , and 30° groups. There was significant difference among the 3 groups (F = 12.554 22, P < 0.01). ② In the extraversion angle 5° group, 4 patients presented with cortical bone fracture which occurred at the entrance for pedicle screw, and 2 patients presented with fragmentation of junctional zone between pedicle and vertebral posterior edge; In the extraversion angle 15° group, 1 patient presented with cortical bone fracture which occurred at the entrance for pedicle screw, 4 patients presented with fragmentation of junctional zone between pedicle and vertebral posterior edge, and 1 patient presented with vertebral posterior coronal fragmentation; In the extraversion angle 30° group, 1 patient presented with cortical bone fracture which occurred at the entrance for pedicle screw, 2 patients presented with fragmentation of junctional zone between pedicle and vertebral posterior edge, and 3 patients presented with vertebral posterior coronal fragmentation. There was statistical significance in the intergroup rank-sum test (P < 0.01).CONCLUSION: During application of pedicle screw with device for transverse traction, proper accrescence of extraversion angle can increase pullout strength of the screw and enhance fixative strength, and excessive extraversion angle easily injures vertebra.