Objective To study on application of problem-based learning in experimental teaching of medical statistics for medical undergraduates and to improve the quality of experimental teaching in medical statistics. Methods 72 medical undergraduates were selected at random. They were devided into the PBL group and the control group were observed for a term. Results The comparison of a questionnaire showed a clear preference for PBL group over the control group. Most of the constituent ratios in the PBL group were higher than the control group, showing significant difference(P

BACKGROUND:Tissue engineering involves many disciplines such as biology, material science, medicine and engineering, so, the col aboration among different research departments is becoming an important factor to enhancing research outputs with the rapid development of related sciences and technologies. OBJECTIVE:To draw the visualizing map of col aboration network of animal-derived regenerative implantable medical devices based on tissue engineering technology and describe its evolving process and current situation. METHODS:2 518 Chinese literatures about the animal-derived regenerative implantable medical devices based on tissue engineering technology published before 31 December 2014 were searched in CNKI, WANFANG DATA and VIP. Subsequently, social network analysis was conducted on those literatures by utilizing UCINET software and SASI developed by Peking University. RESULTS AND CONCLUSION:The col aboration network of the animal-derived regenerative implantable medical devices has evolved from scattered to single-core dominated, and then to a core-edge one, characterized by increasing and extensive col aborations as wel as decreasing network density and centralization. The core units from 2010 to 2014 include Tsinghua University, General Hospital of Chinese PLA and Affiliated Nanfang Hospital of South Medical University. Also, plenty of edge institutes exist. In conclusion, edge institutes should expand their scope of cooperation, while core institutes should improve their cooperation sustainability. Furthermore, cooperation among enterprises, research institutes and clinical hospitals should be strengthened to promote the industrialization of tissue engineering technology.

Objective: To investigate the relationship between plasma level of asymmetric dimethylarginine (ADMA) and coronary artery ectasia in relevant patients. Methods: A total of 72 patients received coronary angiography (CAG) in our hospital were studied and the patients were divided into 3 groups: Coronary ectasia group, Coronary stenosis group and Normal coronary group.n=24 in each group. Plasma levels of ADMA, symmetric dimethylarginine (SDMA) and L-arginine (Arg) were measured by HPLC-MS/MS methods. The relationship between ADMA and CAD was examined by Logistic regression analysis. Results: Plasma level of ADMA in Coronary ectasia group (0.437 ± 0.098) μmol/L and Coronary stenosis group (0.456 ± 0.088) μmol/L were higher than that in Normal coronary group (0.381 ± 0.057) μmol/L,P<0.05. The ratio of Arg/ADMA in Coronary ectasia group (208.54 ± 61.52) and Coronary stenosis group (220.00 ± 104.82) were lower than that in Normal coronary group (254.26 ± 76.22),P<0.05. Logistic regression analysis presented that with adjusted age, gender, smoking, family history of CAD and LDL-C level, and plasma ADMA was still related with CAD (Partial regression coefifcient 9.469, P=0.011). Conclusion: Plasma levels of ADMA were higher in patients with coronary artery ectasia/stenosis than those with normal coronary artery; while ADMA levels were similar between the patients with coronary ectasia and stenosis. Plasma ADMA level was the independent risk factor of CAD.

Objective To evaluate the efficacy and adverse effects of gefitinib as the first line treatment in elderly patients with lung adenocarcinoma.Methods 81 elderly patients of previously untreated advanced lung adenocarcinoma,who were non-smokers and unsuitable for chemotherapy,received gefitinib treatment until disease progression or intolerable toxicities occurred.The curative effect performance status of improvement and adverse effects were observed.Results All of the patients were evaluable.Partial response rate and stable disease rate of gefifinib were 25.9 ％ (21/81) and 48.1％ (39/81),respectively.55.5 ％ (45/81)of patients had performance status improved after treatment.Conclusion Gefitinib has curative effect and is well tolerated in the treatment of elderly patients with previously untreated advanced lung adenocarcinoma.

In current health care management of floating population pregnant women, health care utilization rate does not reach the ideal level.Push service has been used as a key business in development and utilization of information resources for knowledge service institution, with initiative, customized, personalized, intelligent, dynamic and integrated characteristics.On the basis of analysis of cur-rent situation about the health care management of floating population pregnant women, the paper discussed the applications of push serv-ice.New thinking of application of push service to the health care management is put forward, The right aged women can be early linked through integrated mobile phone SMS, micro message interaction, email, channel type push and other means, and broad cover and whole course service management can be achieved, leading to the enhanced care utilization rate of floating population pregnant women.

Objective To investigate the expression and significance of keratinocyte growth factor-1(KGF-1) in the kidneys of septic rats.Methods Eighty male Wistar rats were randomly divided into the sepsis group and sham operation group.Either group was divided into 3-hour,6-hour,12-hour,24-hour and 36-hour subgroups,with 8 rats in each.Sepsis models were established by cecum ligation perforation (CLP).The kidney and blood samples were respectively taken for pathological study.Serum creatinine (Cr) and blood urea nitrogen (BUN) level determination and leukocyte counting were performed.KGF-1 protein was detected by immunohistochemical method and the expression of KGF-1 genes by real time PCR.Results The renal tubules in sepsis group were injured most at 24h after operation,which were infiltrated by considerable neutrophilic granulocytes,leukomonocytes and mononuclear cells,with vacuolar degeneration,focal hemorrhage and necrosis under the light microscopy.Serum Cr and BUN increased from 6h after operation,and reached the peak at 24h after operation in sepsis group,which were significantly different in those of sham operation group (P< 0.01).Compared with sham operation group,the expression of KGF-1 protein and genes of sepsis group increased significantly and reached the peak at 6h after operation.KGF-1mRNA was positively correlated with BUN and Cr (r=0.504,P<0.01;r=0.382,P<0.05).Conclusion KGF-1 was also expressed in normal kidneys,mainly in tubule epithelial cells of renal medulla and also in that of renal cortex.The expression of KGF-1 in sepsis group was obviously higher than that of sham operation group,and was positively correlated with the degree of kidney damage after infection.KGF-1 was speculated to be one of the protective factors affecting the repair of impaired kidneys caused by infection.

Objective To design a kind of special support mattress for the endoscopic retrograde cholangiopancreatography (ERCP), and to improve the comfort of the patients during the procedure, and evaluate the efficacy and safety during clinical application. Methods By 3D modeling, we designed a special memory foam mattress for ERCP. From January 2014 to September 2014, 424 patients who underwent ERCP treatment without general anesthesia and could take semi-prone position, were divided into special mattress group (210 cases) and ordinary mattress group (214 cases) according to the random number table method. The satisfaction of the patients and the operators of the two groups were evaluated and compared. Results The operation times of the two groups were (32.9±18.5) min and (33.2±20.1) min, respectively, and there was no significant difference between the two groups (P>0.05). The overall satisfaction ratings of the patients in the two groups were (7.9±1.6) points and (6.3±1.3) points, respectively (P<0.01), and the discomfort ratings of the patients in the two groups were (1.3± 0.9) points and (3.8 ±1.2) points (t=116.45, 246.91, P<0.01). The operator satisfaction scores of two groups were (8.5±1.3) points and (8.5±1.8) points, respectively, and there was no significant difference (P>0.05). No mattress related complications were found. Conclusions The special memory foam mattress for ERCP can alleviate the discomfort and improve the tolerance during the procedure. Therefore, it is worth promoting the application.

Objective To study the clinical significance of plasma(1→3)-β-D-Oaten measurement in invasive fungal infections.Methods The levels of plasma(1→3)-β-D-glucan were measured bymicrobiology kinetic rapid reader MB-80 and GKT-5M set dymmic fungus detecting kit in 14 patients proven to suffer from invasive fungal infection and 13 healthIy voluntary persons.And the difference between them was compared.Results In 14 patients with invasive fungal infection,8 patients had fungal infection of lower respiratory tract and lung,6 patients had fungemia.There were 11 patients infected by monilia(1 patient combined infection),2 patients infected by aspergillus,and 2 patients infected by pneumocystis(1 Datient clinical diagnosis without aetiology proof).The levels of plasma(1→3)-β-D-slucan in invasive fungal infections patients were(105.02±82.22)ng/L,which were higherthan thosein healthy persons[(6.65±1.01)ng/L)J,P＜0.01.Conclusion The levels of plasma(1→3)-β-D-glucanisan ia an important index in diagnosis of invasive fungal infections.

Objective To investigate the changes and clinical significance of T-lymphocyte subsets in the treatment of advanced lung adenocarcinoma. Methods Ninety six patients with advanced lung adenocarcinoma who underwent treatment in Xuanwu Hospital Capital Medical University from October 2015 to May 2016 were selected as the subjects. There were 63 cases in the transferred group and 23 cases in the un-transferred group. The peripheral blood was taken, then flow cytometry was used to detect CD3+, CD3+CD4+, CD3+CD8+, CD4+/CD8+, CD3-CD16+CD56+(NK), CD8+CD28+, CD8+CD28-, Treg cells, CD3+γδ, and the results were analyzed statistically. Results The levels of CD3+γδand Treg cells in the transferred group were significantly higher than those in the un-transferred group (6.56±3.11 vs. 3.05±2.23; 25.83±6.22 vs. 20.81±9.03) (t=1.590, P=0.026; t=2.027, P=0.044). The level of CD45RA+in the effective group (52.15 ±7.99) was significantly lower than that in the untreated group (70.26 ±17.33) (t= 1.660, P= 0.024). Conclusion The detection of peripheral blood T-lymphocyte subsets in treatment of patients with advanced lung adenocarcinoma has a certain value in predicting the therapeutic effect and prognosis.

Objective This study aims to evaluate the impact of early surgery on long-term outcome of patients with left-sided native valve infective endocarditis (IE).Methods Clinical data were retrospectively reviewed in 239 consecutive patients with left-sided native valve IE from 2002 to 2012 in Peking Union Medical College Hospital (PUMCH).Propensity score was used to match patients in the early operation and conventional treatment groups.Results Early surgery was performed in 70 (29.3％)patients and the conventional treatment strategy was applied in 169 (70.7％) patients.The median followup period was 2 years.IE-related mortality was lower in the early operation group than in the conventional treatment group (10.0％ vs 23.1％,P =0.02).For 58 propensity score-matched pairs,the cumulative survival free from IE related death was significantly higher in the early operation group than in the conventional treatment group (P =0.027).Regression analysis of the matched cohorts revealed that early surgery was independently associated with decreased IE-related mortality (HR 0.286 ; 95％ CI 0.092-0.893 ;P =0.031).While either cardiac function with NYHA Class Ⅲ-Ⅳ (HR 4.044; 95％ CI 1.318-12.407;P =0.015) or uncontrolled infection (HR 52.064; 95％ CI 10.996-247.194; P ＜ 0.001) was associated with poor prognosis of increased mortality.Conclusions Early surgery improved long-term outcome in patients with left-sided native valve IE compared with conventional therapy.Risk factors related to increased mortality included heart failure and uncontrollable infection.