Objective To study the clinical effect and safety of Dinoprostone suppositories for cervical ripening and labor induction.Methods 50 primiparas with sinsle cephalic term pregnancy.cervical Bishop score≤6 points,with vaginal delivery conditions,no previous uterine scar or prostaglandin allergies or other contraindications were randomly divided into two groups:the dinoprostone suppositories group(observation group)and the sulfuric pula group(control group).The primiparas were administered sulfuric pula keto 200mg/day via intravenous injection for 3 days.Bishop score was assayed in both groups before treatment and 6h.12h after treatment to compare the effect of cervical ripening,labor rates,the total time of labor,mode of delivery,postpartum hemorrhage,neonatal outcomes and adverse reactions.Results Cervical scores were(3.85±0.72)point and(6.79±0.63)point in the observation group 6h and 12h after administration,which were significantly higher than those of control group[(2.85±0.41)point,(4.26±0.52)point](t=6.034,15.485,all P＜0.05).Labor rates of 12h and 24h in the observation group were signitlcandy higher than control group.There Was no significant difference between two groups of neonatal outcomes and postpartum hemorrhage.Conclusion Dinoprostone suppositories sas safe and effective for cervical ripening and labor induction,without adverse effects on mothers and children.

Objective To observe the clinical characteristic and prognostic analysis of severe anti-N-methyl-D-aspartate receptor ( anti-NMDAR) encephalitis.Methods The clinical data of 9 patients with severe anti-NMDAR encephalitis were retrospective analyzed.Results Nine patients ( two male and seven females ) were taken care at ICU.They were 27.7 years old at average.The median course was 22.4 d and median length of stay in ICU was 50. 9 d.The mainly clinical characteristics were fever(7 cases), psychiatric behavioral symptoms(9 cases), seizures(9 cases) , decreased consciousness ( 8 cases ) , abnormal movement ( 7 cases ) , automatic instability ( 9 cases ) and hypoventilation(6 cases) .Three cases had ovarian teratoma.Anti-NMDAR antibodies in CSF of all patients were testing positive, while in serum were 6 cases.CSF-IgA in 7 cases were increased.The brain MRI indicated abnormal signals in temporal lobe, hippocampus in 3 patients.The EEG showed slowing wave abnormal in 5 patients.All patients were treated with combined first-line immunomodulatory therapies with steroids, intravenous immunoglobulin, or plasma exchange. Five patients were fullly recoveried, 4 patients were improved with residual symptoms. Conclusions Severe anti-NMDAR encephalitis may present progress quickly mental behavior change, epilepsy, and disturbance of consciousness, movement disorders, autonomic nerve dysfunction.Which accompanied with tumor is rare.Most patients with active immunotherapy can get good prognosis.

Objective To discuss the effect of group counseling for medical students in reducing academic procrastination,and explore effective means to improve learning efficiency.Methods 24 students identified as voluntary research subjects were divided into the experimental group and the control group,male and female ratio was 1:1.The experimental group received counseling activities for eight times,the control group members did not receive any intervention.This thesis took use of Procrastination Assessment Scale-Students (PASS) as an evaluation tool in before and after test and tracing test,and did the significance test,as a quantitative analysis of this study.Results The quantitative study showed that the difference between the experimental group and the control group in pre-test was insignificant,indicating these research subjects belong to homogeneous research subjects; differences in pre-test and post-test of the experimental group were significantly greater than the differences of pre-test and post-test in the control group,indicating the group counseling producing an effect on learning procrastination.In order to verify the effect's continuity of the group psychological counseling,a tracking test was conducted on the members three months later.After three months,the tracking test scores of the experimental group and the control group were not significantly lower than the pre-test score.In tracking tests,the experimental group's scores were lower than before-test,indicating the effect of group psychological counseling was sustainable.Conclusions Group psychological counseling activities can reduce academic procrastination of medical school students and the group psychological counseling scheme has effectiveness and feasibility.

On the basis of educational psychology fundamentals and characteristics, this study constructed the experiential teaching of music therapy. The preparations made before class include the construction of experiential teaching system, improvement of multimedia resources, and the establish-ment of music therapeutic room. Music therapy activities were taken as the main body and problem-based learning as the leading factor, clinical observation as the basis, and social practice as the com-plement, etc. This study provides basis and reference for the theoretical teaching and clinical practice of music therapy in medical colleges and universities.

Objective: To explore value of exercise stress test guiding aerobic exercise rehabilitation in patients with myocardial infarction.Methods: A total of 102 patients with myocardial infarction in recovery were selected.According to random number table, they were randomly and equally divided into routine rehabilitation group (received routine rehabilitation guidance) and aerobic exercise rehabilitation group (received aerobic rehabilitation exercise in guidance of exercise stress test).Amount of exercise, hemodynamic parameters and psychological state were compared between two groups.Results: After treatment, amount of exercise: compared with routine rehabilitation group, there were significant rise in amount of exercise[(6.79±0.58)METs vs.(7.42±0.69)METs], maximum heart rate[(126.27±5.26) beats/min vs.(138.18±5.81) beats/min], heart rate blood pressure product[(221.87±21.46) vs.(244.85±23.09)]and exercise duration[(10.36±1.36) min vs.(11.18±1.45) min]in aerobic rehabilitation group, P<0.05 or <0.01;hemodynamic parameters: compared with routine rehabilitation group, there were significant rise in cardiac output[(5.36±0.57) L/min vs.(5.72±0.68) L/min], cardiac index[(2.96±0.53) L min-1 m-2 vs.(3.25±0.52) L min-1 m-2], stroke volume[(73.16±8.47) ml vs.(78.12±9.14) ml]in aerobic exercise rehabilitation group, P<0.05 all;psychological state: compared with routine rehabilitation group, there were significant reductions in scores of Hamilton rating scale for anxiety[HAMA, (9.74±3.26) scores vs.(6.35±1.18) scores]and Hamilton rating scale for depression[HAMD, (14.83±4.58) scores vs.(10.56±3.27) scores]in aerobic exercise rehabilitation group, P<0.05 both.Conclusion: Exercise stress test guiding aerobic exercise rehabilitation can help to improve exercise function and hemodynamic indexes, alleviate the negative mood, then promote patients recover.

Standerdized patiets oan serve as patients, teachers and evaluators. Establishment of standardized patients' teacher-identity is helpful to improving their teaching passion, and it also makes sure all teaching steps may develop successfully and promote accuracy and fairness of evaluation in Standerdized patiets examinations.

Objective To evaluate the effect of contrast-enhanced transcranial Doppler (c-TCD) for detection of patent foramen ovale (PFO) comparing to transesophageal echocardiography (TEE). Methods 28 ischemic stroke patients with PFO detected with TEE were evaluated with TCD bubble study at rest and under Valsalva maneuver (VM). Results PFO was identified in 20 cases (71.43%) at rest by TCD bubble study. When VM was performed, PFO was detected in 24 cases (85.71%). There was no relevant in sensitivity of c-TCD with PFO size (P>0.05). Conclusion c-TCD is an excellent method for PFO identification with high sensibility while under VM. C-TCD can be used as a screening method for suspected PFO in patients with stroke test before TEE.

Objective To explore the value of using the temporary cardiac pacing on the acute poisoning patients with serious bradycardia. Methods 38 cases of the acute poisoning patients with serious bradycardia patients were treated randomly with temporary cardiac pacing(pacing group,18 cases) and drug therapy(control group,20 cases) and then treated their poisoning. Results 18 cases of pacing group were right ventricular pacing successfully and placed the temporary cardiac pacemaker,with the further treatment of poisoning, the efficiency of anti-bradycardia was 100% ,the poisoning cure rate was 89% ;The control group were 60% and 65% respectively;There were statistically significant difference between two groups ( P < 0.05 ). Conclusion The treatment of temporary cardiac pacing were exactly for the acute poisoning patients with serious bradycardia. It could effectively improve the rate of patients' resuscitation.

Objective To analyze the clinical features and prognosis in adult Chinese patients with anti-γ-aminobutyric acid B receptor (GABA-BR) encephalitis.Methods We reviewed the clinical manifestations,cerebrospinal fluid (CSF) examinations,brain magnetic resonance imaging and prognosis of 12 patients who were diagnosed as anti-GABA-BR encephalitis in Capital Medical University Xuanwu Hospital from March 2013 to December 2015.Results The major clinical features of anti-GABA-BR encephalitis patients included seizures (12/12),cognitive disorder (10/12),psychiatric symptoms (10/12),sleep disorders (3/12),visual hallucination (2/12),involuntary movements (2/12),decreased consciousness (3/12),cerebellar signs (2/12),fever (2/12).GABA-BR-antibody was positive in CSF and serum of all the patients.Electroencephalogram revealed epileptic discharges in 4/12 patients.Brain MRI showed abnormal signal in up to 9/12 patients,located in the hippocampus,temporal lobes,thalamus and periventricular area.PET or SPECT indicated hypometabolism in 5/6 patients.After the average of fourteen months follow-up,9/12 patients had good prognosis,3 patients did not.Of 3 patients with poor outcome,2 had small cell lung cancer.Conclusions The predominant clinical features of the anti-GABA-BR encephalitis are seizures,cognitive disorder and psychiatric symptoms.The lesions are not only located in limbic system.Early diagnosis and immune modulation may provide a good outcome.

OBJECTIVE: To study the formulation and technology of dexamethasone solid lipid nanoparticles(DXM-SLN) lyophilized injection and evalnate it's quality. METHODS: The formulation of the supporting agent was optimized and the preparation technology of lyophilized injection was established to prepare the lyophilised injection. The content of DXM in the sample was determined and its quality was investigated as well. RESULTS: 30% mannitol was supporting agent, the particle size of DXM-SLN was 340 nm, with zeta potential at -25.2 mV, entrapment ratio at 92.10% and drug-loading at 7.10%. It was stable within 3 months' at 2～8 ℃storing. CONCLUSION: The preparation technique of this preparation is simple and feasible and its quality is stable and controllable.