ObjectiveTo study the effect of heuristic teaching to the medical students in interest, initiative spirit, and comprehensive ability. Methods110 students majoring in rehabilitation medicine were divided into two groups, heuristic teaching group and rote teaching group. The teaching contents included ROM(range of movement), ADL(activity of daily living) and the techniques of movement and transfer. Eight items were assessed. ResultsThere are no difference between the two groups in application of basic knowledge and ability of comprehension (P>0.05), obvious difference in the interest in study, the initiative spirit, and the ability of self study and analyzing (P<0.05).Conclusions In medical rehabilitation teaching, heuristic teaching is more advantageous than rote teaching in the interest in study, the initiative spirit, and the ability of self study and analyzing.

Objective: To establish the determination of Shexianbaixin Pill. Methods: HPLC was applied to determine cinobufagin and resibufogenin. The determination was carried out using an ODS column with a solvent system: acetonitrile 0.5KH 2PO 4. The flow rate was 1.0mL?min -1 , detection wavelength was at 296nm and the column temperature was at 35℃. Results: The linear ranges of cinobufagin and resibufogenin were 0.148?g～0.746?g and 0.116?g～0.580?g, respectively. The average recoveries of cinobufagin and resibufogenin were 100.90%( RSD =1.004%, n =5), and 100.64%( RSD =1.006%, n =5), respectively. Conclusion: This method is simple, accurate with strong specificity and can be used to control the quality of Shexiangbaoxin Pill.

The standard administration and the management of the teaching files have been built firstly in the teaching and research apartment of medicine.A variety of databases to achieve files informatics and a series of teaching resources have been reinforced for recent years.Informatics technology,curriculum construction and teaching methods have been conformed to take full advantage of the teaching files.

Based on the present standardized training model for medicine residents,we analyzed the problems we met in the performance and discussed how to innovate the standardized management.

Objective To find out more optimal surgical approach for glioblastoma located in sensofimotor cortex and language area. Methods A respective review of 27 cases of glioblastomas located in sensorimotor and language area were operated, via the transsylvian-opercular approach, ineluding outcomes of microneurosurgery between January 2005 to December 2007. Results Among of 27 cases, tumors in 21 cases were covered by opereular cotex and were totally resected, tumors protruded into sylvian and wrapped around middle cerebral artery in 6 cases. 3 of them were totally removed, others were subtotally. Neurofunction of 26 cases were preserved of one were injuried. Conclusion Transsylvian-opercnlar approach for resection of glioblastomas located in subcortex of sensorimotor and language area is more optimal surgical approach, which not only ensure tumor resection with great degree, but preserve neurofunction well.

Objective To discuss the surgical strategy of parasagittal and falcial meningiomas in the middle 1/3 cortex area and raise resective rates of tumors and surgical effects.Methods The clinical,imaging and operative data of 74 cases of parasagittal and falcial meningiomas in the middle cortex area which underwent operation were reviewed and followed up.Results Of 74 tunors,67 were resected with Simpson Ⅱ grade,7 with Simpson Ⅲ,none of them with Simpson Ⅰ.Superior sagittal sinus and the vein of central suleus and feeders of cortex were reserved well.Severe brain injury was not occurred in 66 cases with tumors debulking(Simpson Ⅱ 61 cases,Simpson Ⅲ 5 cases),the neuro-functions of patients were normal or transient slight weakness of contralateral lower extremities postoperatively.Tumors of 8 cases were "turned over" and resected by piecemeal (Simpson Ⅱ 6 cases,Simpson Ⅲ 2 cases),weakness and paralysis of contralateral lower extremities occurred in 7 cases and 1 cases respectively after surgery.Followed-up ranged from 6 months to 4 years and 2 months,4 cases were lost to follow-up.Neuro-function of all cases with weakness of contralateral lower extremities recovered after one month.Muscle strength of the cases with paralysis of contralateral extremity recovered to grade Ⅳ 6 months later,no recurrence and death.Conclusion The measures,including piecemeal tumor reseeted mierosugically,good protection of the vein of central sulcus,excellent management of superior sagittal sinus,and avoiding damage to functional cerebral cortex during operations,are best ways for raising the tumor resection rate and nearo-function reserved.

Objective To investigate the thyroid ultrastructural pathological changes of diabetes mellitus (DM) rats as well as the intervention effects of insulin and aminoguanidine. Methods Totally 87 rats were treated with streptozotocin to establish DM animal models and divided into DM group(n=27),insulin intervention group(n=32) and aminoguanidine intervention group(n=28),25 rats were taken as normal controls. Twelve and 20 weeks after the animal model establishment, animals were sacrificed, thyroid tissue was taken and ultrastructure was observed. Results In the thyroid of DM rats, follicular epithelial cells present as applanate shape, microvilli were depleted, rough endoplasmic reticulum dilated to irregular vesicular. None pinocytotic vacuole and casual primary or secondary lysosome were seen. Follicular cavity was dilated, colloid in the cavity had higher electronic-density. Interstitial edema, capillary base lamian was thickened at different stage. Proteo-substance deposition with granulo-shape, cloud shape or homogeneity appeared. The number of thyroid parafollicular cells increased. But endocrine granule in parafollicular cells was few. When compared with DM group, the thyroid tissue injury of insulin intervention group and aminoguanidine intervention group were lessened to different degree. Conclusion The hypofunctional thyroid follicular cells, large quantity of proteo-substance deposition in the interstitium and increased parafollicular cells of DM rats may be related with hyperglycemia toxicity. Insulin and aminoguanidine treatment have some protection effects.

Background Endothelin-1 (ET-1) is an active regulator of intraocular pressure.The ET-1 level in aqueous humor is elevated in primary open-angle glaucoma,normal intraocular tension glaucoma and the animal model of glaucoma.There is now accumulating evidence for a role of ET-1 in the pathogenesis of glaucoma.However,the effect of ET-1 on the phagocytic function in trabecular meshwork cells (TMCs) is unclear.ObjectiveThis study is to observe the effect of ET-1 on the phagocytic function in cultured human TMCs.Methods Human trabecular meshwork tissue was obtained from healthy donator and cultured and subcultured in vitro by the explant culture method.The third passage of human TMCs were incubated with fluoresent red-labeled latex beads for 0,4,8,12,24,48 and 72 hours.The phagocytic kinetics of human TMCs were continuously evaluated by counting the number of latex beads in TMCs using a fluorescence microscope.Depending on the concentrations of ET-1 in culture medium,the TMCs were divided into control group (without ET-1),low-dose ET-1 (10~(-9)mol/L) treatment group,middle-dose ET-1 (10~(-8)mol/L) treatment group and high-dose ET-1 (10~(-7) mol/L) treatment group.In addition,based on the addition of endothelin receptor (ETAR) antagonist,the TMCs were divided into control group (without ETAR antagonist),ET-1 (10~(-8)mol/L) treatment group,ETAR antagonist (1×10~(-7)mol/L BQ123+10~(-8)mol/L ET-1) treatment group and ETBR antagonist(1×10~(-7) mol/L BQ788+10~(-8) mol/L ET-1)treatment group.TMCs of each group were incubated with latex beads,and the numbers of latex beads in TMCs were counted under a fluorescent microscope.Results Cultured HTM cells showed positive reactions for FN,LN,NSE and negative response for FⅧRag.The phagocytic kinetics test revealed that the latex beads were detected 4 hours after incubation.The density of latex beads was gradually increased with the delay of incubation duration and peaked at 24 hours.The number of the latex beads saturated after 48 hours of incubation.However,the number of latex beads in TMCs was significantly reduced after the addition of ET-1 in a dose-dependent manner (F=28.91,P＜0.05).The number of latex beads in the ET-1 group was less than that in the control group and the ETAR receptor antagonist group (q=13.7228,q=9.4312,P＜0.05).No significant difference was found in latex beads number between the ET-1 group and the ETBR antagonist group (q=1.1600,P＞0.05).Conclusion ET-1 inhibits the phagocytic function of human TMCs and ETAR plays a partial role in the phagocytic function of human TMCs.

Objective To investigate the effect of Bi-level positive airway pressure ventilation (BiPAP) combined with Seretide on quality of life of elder patients with moderate and severe chronic obstructive pulmonary disease (COPD) and type Ⅱ respiratory failure.Methods Eighty elderly patients with moderate to severe COPD and type Ⅱ respiratory failure were selected and randomly divided into observation group (n =40) and control group(n =40).The two groups were given conventional anti infection,oxygen inhalation,spasmolysis,expectorantand other conventional treatment,and the use of BiPAP ventilator assisted ventilation.Patients in observation group were administered the combined of Seretide and BiPAP treatment,and patients in control were received only BiPAP.Arterial blood gases before and after 7 d treatment,lung function and quality of life evaluation results (SQGR score) before and after 7 d,3 months and 6 months treatment,were measured.Results There were significant differences in terms of arterial blood gases,pulmonary function key indicators,SQGR score between two groups before and after treatment(P ＜ 0.01).PaCO2 was significantly after 7 d of treatment in observed group was (42.9 ± 7.9) mmHg,lower than that of the control group ((47.6 ± 8.0) mmHg; t =8.467,P ＜0.001).There was no significant difference in terms of forced expiratory volume in one second(FEV1) in both groups at 7 d,3 months,6 months after treatment (P ＞ 0.05).FEV1/forced vital capacity (FVC) in two group at 3 months,6 months after treatment were different compared to 7 d after treatment (observation group:(49.9 ±5.1)％ and (47.1 ±4.2)％,(50.2 ± 5.0)％ and(47.1 ±4.2)％ ;control group:(49.0 ± 5.4)％and (46.6 ± 5.9) ％,(49.8 ± 5.2) ％ and (46.6 ± 5.9) ％ ; P ＜ 0.05).SQGR score in observation group at six months after treatment were (40.8 ± 8.5),significantly lower than that of 7 d after treatment(45.9 ± 10.8),P ＜ 0.05),and significantly lower than the control group after 6 months of treatment ((40.8 ± 8.5) vs (46.0± ± 8.0),P ＜ 0.05).Conclusion Seretide combined with BiPAP treatment can significant improve lung function and the quality of life of patients with moderate and severe COPD and type Ⅱ respiratory failure.

Objective: To estimate the incidence, mortality and characteristics of cancer in Pearl River Delta Area of Guangdong Province between 2009-2013. Methods: Based on five population-based cancer registration data from Guangzhou, Shenzhen, Zhongshan, Jiangmen and Sihui spanning from 2009 to 2013, along with those corresponding population data, the incidence and mortality rates were estimated by gender and age groups. Chinese standard population derived from the 2000 Population Census and Segi′s standard population were used for age-standardized incidence and mortality rates. Results: Between 2009 and 2013, the crude cancer incidence rate was 262.50/100 000, 274.76/100 000 in male and 249.49/100 000 in female. After adjusting for Chinese and Segi′s standard population, the age-standardized incidence rates were 225.63/100 000 and 219.88/100 000, respectively. The crude mortality rate was 175.51/100 000, 222.92/100 000 in male and 127.46/100 000 in female, respectively. After adjusting for Chinese and Segi′s standard population, the age-standardized mortality rates were 116.02 /100 000 and 114.31/100 000, respectively. The incidence rates were at low levels in the population less than 40 years old, thereafter went up rapidly with age especially in male, and then reached the peak in the population aged 80 and above. As with incidence, the mortality rates kept at low levels in the population before their 50 s and then rose up steadily with age until peaking in the 85+ age group. The most common cancers were female breast cancer, lung cancer, colorectal cancer, liver cancer and nasopharyngeal cancer with descending incidence rate. Lung cancer, liver cancer, colorectal cancer, female breast cancer and nasopharyngeal cancer were the top five cancer-attributable causes of death. Conclusions Currently, Pearl River Delta Area were faced with huge cancer burden. Lung cancer, colorectal cancer, nasopharyngeal cancer, female breast cancer and male liver cancer are predominant cancers and more efforts should be made to fight against them.