Objective To investigate the role of problem-based learning (PBL) in the improve-ment of students' comprehensive ability in experimental classes of fundamental nursing. Methods A total of 172 nursing students were randomly divided into the experimental group (n=76) and the control group (n=96), they received PBL and traditional education, respectively.The teaching effect was compared using X2 tesL Results The experimental group was better than the control group in comprehensive a-bility such as communication skills, operant skills, coping skills, health education, appearance and at-titude. Conclusions PBL can promote the nursing students to understand the comprehensive information of special problems, and improve their skills of resolving practical problems and autonomic learning.

Objective To investigate the relationship of carotid artery intima-media thickness(IMT) and blood pressure variation in patients with prehypertension. Methods Three hundred and ninety-two patients were selected as our subjects. Artery IMT was measured by Doppler ultrasonography. All patients were divided into carotid artery IMT group( n = 204 ),not carotid artery IMT group( n = 188 ) based on carotid IMT. Meanwhile,all patients were monitored by ambulatory blood pressure. Results (1)The indices of 24 h mean systolic blood pressure,systolic blood pressure variability and diastolic blood pressure variability in patients of carotid artery IMT group were(136. 85 ± 9. 67)mmHg,(4. 13 ± 0. 67)% ,(2. 97 ± 0. 45)% respectively, higher than those of Not carotid artery IMT group((121. 92 ± 6. 54)mmHg,(2. 64 ± 0. 86)% ,(2. 06 ± 0. 36)% ;t = 21. 08,5. 97,3. 32;P < 0. 05).(2)The rate of the carotid artery thickness increased with systolic blood pressure variability increasing( P = 0. 001). There were no significant correlations between rate of the carotid artery thickness and diastolic blood pressure variability,24 h mean diastolic blood pressure(P = 0. 435, 0. 126). The IMT thickening rate was higher when the average systolic blood pressure was greater(P = 0. 013). (3)Regression analysis indicated that carotid artery IMT was positively related with systolic blood pressure variability,high-sensitivity C-reactive protein,24 h mean systolic blood pressure,2-hour postprandial blood glouse. Conclusion Carotid artery IMT is independently associated with variation of blood pressure,especially with systolic blood pressure variability in prehypertension patients.

Objective To investigate the relationship of plasminogen activator inhibitor type 1(PAI-1) and ultrasensitive C-reative protein(hsCRP) in patient with metabolic syndrome and coronary heart disease.Methods Between June 2006 and December 2007,87 patients with metabolic syndrome were divded into two groups:simple MS group which consisted of 45 patients and MS with CHD group which consisted of 42 patients.30 health people at the same stage,whose age and sex were similar with those in MS group served as normal control group.The levels of body mass index(BMI),waist circumference(WC),systolic blood presser(SBP),diastolic blood presser(DBP),triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),fasting plasma glucose(FPG),PAI-1 and hsCRP were measared.Results BMI,WC,FPG,SBP,DBP,TG,PAI-1 and hsCRP in both MS groups were higher than those in normal control group(P

Objective To study the relationship between MRI and histopathological findings of cerebral schistosomiasis,and the value of MRI on this disease. Methods 18 patients with cerebral schistosomiasis proved by pathological examination and laboratory test were enrolled in the study. Plain and Gd DTPA enhanced MRI were performed in all patients with GE 1.5 T MRI scanner. Results The lesions were located in infratentorial region in 7 cases and in supratentorial region in 11. There were three types of pathological pattern in the disease including focal encephalitis and meningiomas (5), granuloma (12), and encephalatrophy (1). Most of the lesions were iso or hypointensity on T 1WI, hyperintensity on T 2WI, with nodules, spot or ring like enhancement, and periphery edema. Conclusion MRI manifestations of cerebral schistosomiasis have specific features,which is a very important tool in early diagnosis and follows up for this disease.

An adult patient with hypophosphatasia caused by compound heterozygous mutations in alkaline phosphatase,liver /bone /kidney(ALPL)gene was investigated through comprehensively reviewing the medical history and clinical records of the proband and her family members in order to better understand the disease.The proband and her older sister had mild decreased serum alkaline phosphatase level accompanied with frequently nontraumatic fractures at limbs and all the teeth fell off at the age of 20 and 7, respectively.Both of them carried a missense mutation c.407G>A(p.Arg136His)in exon 5 and a deletion mutation c.1318_1320delAAC(p.Asn440del)in exon 12 simultaneously.Other four family members were p.Arg136His mutation carriers and two members were p.Asn440del mutation carriers.We found that p.Asn440del mutation was associated with the oral disorders.In this family, compound heterozygous manifested more serious symptoms, while heterozygous showed relatively mild symptoms.In addition, it is necessary to differentiate it from primary osteoporosis and other diseases of disturbed bone mineralization.

Objective To explore the diagnosis and treatment of gastrointestinal stromal tumors(GIST).Methods 26 patients with gastrointestinal stromal tumors in Ji'an Central People's Hospital from 1998 to 2006 Were retrospectively analyzed.Results All patients received operation.Of them,low malignant GIST wag in 17 eases,high malignant GIST in 9.All patients were follwod-up from 6 to 84 months.4 ofthem had local recurrence and metastasis and 5 eases died.Condusion The diagnosis of GIST Was dimcult because of the lack of clinical features.Final diagnosis should be based on IHC pathology.The main choice of treatment Was operation.Glivee could prolong the life and improve the prognosis of the patients in recurrent and metastatic cases.

Objective To investigate the association between postprandial triglyceride and the severity of coronary artery disease in patients with metabolic syndrome (MS). Methods AlI of 91 patients with MS were recruited for this study. Thirty-one patients with normal fasting and postprandial triglyceride was in MS1 group, 29 patients with normal fasting triglyceride and postprandial hypertrigtyceridemia was in MS2 group, and 31 patients with fasting hypertriglyeeridemia was in MS3 group. Blood triglyceride at the time of postprandial 4 hours was measured and the quantity of coronary artery branch disease was determined by coronary angiography. The relationship between them was analyzed. Result There was significant positive correlation between the quantity of coronary artery branch disease and the level of blood triglyceride at the time of postprandial 4 hours (r = 0.42, P < 0.01 ). Conclusions It is important to detect the level of blood triglyceride at the time of postprandial 4 hours. Prompt intervention maybe decrease the incidence and mortality rate of cardiovascular disease in patients with MS.

Microglial cells are the resident immune cells of brain. The activated microglia produces a range of deleterious substances, which plays an important role in the inflammation of post-stroke, such as superoxide, nitric oxide, matrix metalloproteinases, etc. The activa-tion of microglia may involve triggering receptor expressed on myeloid cells-1, Toll-like receptors 4, peroxisome proliferator-activated re-ceptors, purinergic receptors, etc. Intervention targeted to microglial receptor is becoming a new strategy for ischemic stroke.

Autophagy plays an important role in the regulation of activation and inflammation of microglia after ischemic stroke. The interaction between autophagy of microglia and the inflammation mediated by microglia after ischemic stroke was complex and a large num-ber of molecules were involved. The receptors of microglia activation and related substances may be possible mechanism in the regulation of microglia autophagy. Autophagy inhibitors and microglia receptor targeting therapy may provide new strategies for the clinical treatment of ischemic stroke. This paper summarized the progress of microglia autophagy after ischemic stroke.

Objective To investigate the surgery method for early spontaneous posterior interosseous nerve entrapment,to observe the postoperative efficacy in treatment,to evaluate the surgical outcomes,and to provide a foundation for clinical choice of reasonable operation scheme.Methods 21 cases of early spontaneous posterior interosseous nerve entrapment received operation. 1 3 cases (1 8 arms) were treated by neurolysis, and 8 cases (8 arms )were treated by nerve grafts with small vessels wrapping operation;all the patients were followed up for 10 to 20 months;the finger extensor muscle strength and metacarpophalangeal joint activity were evaluated. Results The lesion extensor muscles were part of the denervation changes.Neurolysis muscle strength:14 arms were excellent(82.35%),2 arms were good,1 arm was fair,1 case was lost;extensor function:15 arms were excellent(88.24%),1 arm was good,1 arm was fair,1 case was lost.Nerve graft muscle strength:6 arms were excellent(75.00%),1 arm was good,1 arm was fair;extensor function:7 arms were excellent(87.50%),0 arm was good,1 arm was fair.Conclusion Neurolysis can have a good efficacy in treatment of early spontaneous posterior interosseous nerve entrapment without obvious degeneration.When the severe degeneration of entrapment nerve happens,a nerve graft surgical treatment is needed.