Four hundred eighty patients with carbon monoxide poisoning were randomly assigned to receive hyperbaric oxygen alone or hyperbaric oxygen plus Nimodipine.Treatment outcomes and the incidence of delayed encephalopathy after acute carbon monoxide poisoning(DEACMP)were observed.We found that the incidence of DEACMP was 14.0％(67/480)in all cases,19.2％(46/67)in hyperbaric oxygen group,and 8.8％(21/67)in hyperbaric oxygen plus Nimodipine group(hyperbaric oxygen group vs hyperbaric oxygen plus Nimodipine group,P＜0.05).These results suggested that hyperbaric oxygen combined with Nimodipine could prevent the development of DEACMP.

Objective To explore the effect of leukotriene receptor antagonist on the airway inflammation in bronchiolitis after respiratory syncytial virus(RSV)infection and the prevention of post-bronchiolitis asthma by studying the changes of serum concentration of inflammatory cellular factors including ECP,IL-12,IL-13 and LTE4.Methods 156 children with mild and moderate RSV bronchiolitis were recruited in the study and they were randomly divided into three groups after alleviation of asthmatic symptoms:the intervention group with montelukast sodium tablets oral;hormone intervention group with Budesonide suspension spray;control group.Blood samples were collected on the first day on admission,before treatment,3 months after medication.Serum concentrations of ECP,IL-12,IL-13 and LTE4 were measured by ELISA.Clinical and telephone follow up was done for one year.Results Compared to control group,the ECP,IL-13 and LTE4 levels of 156 RSV bronchiolitis in acute phase and recovery phase were signifieantly increased,while the IL-12 level was significantly decreased.The ECP,IL-13levels of singulair intervention group and the hormone intervention group were decreased after intervention,and the IL-12 level rise to normal;the LTE4 level of singulair intervention group and the hormone intervention group decreased significantly than before intervention,singulair intervention group recovered to normal levels(t=1.0866,P＞0.05),but hormone treatment group did not recover to normal levels(t=3.4355,P＜0.01).Singulair intervention group had lower recurrence of asthma(χ2=7.8156,P＜0.01).Conclusion The leukotriene receptorantagonists could regulate the imbalance of Th1/Th2,reduce the release of LTE4 and the activation of eosinophils,alleviate airway inflammation and airway hyperreactivity,reduce wheezing,and it play a role in the prevention of asthma.

Objective:To construct the online teaching model of clinical clerkship teaching and improve the online teaching system of clinical medicine in China.Methods:Based on "3P" teaching model, a complete online clinical clerkship teaching model was constructed from three links: pre-class preparation, classroom teaching and after class evaluation. It was applied to practical teaching in 101 students in 2017 batch of clinical medicine "5+3" class, 2017 batch of five-year pediatrics class and 2017 batch of basic medicine class. After practice, all students were surveyed and the results were analyzed.Results:Through the analysis of questionnaire, 89.5% of the students were satisfied with the online course design, 81.61% of the students thought that the online design was scientific and reasonable, 86.6% of the students thought that the clerkship teaching process was attractive and could stimulate students' interest in learning, and 90.72% of the students thought that the goal of clerkship teaching was clear and the key problems and difficulties were clear.Conclusion:The online teaching mode of clinical clerkship has high student satisfaction and good teaching effect, which provides a new way for online clerkship model.

In order to construct the online teaching mode of clinical clerkship course and improve the online clerkship teaching system of clinical medicine in China, based on the "3P" model, a complete set of online clinical clerkship mode has been constructed from three links of teaching, pre-class preparation, classroom teaching and after-class evaluation, and applied to clinical teaching practice of Internal Medicine. The practice suggests that students are highly satisfied and the teaching effect is good, which provides a new idea for the reform of online clerkship teaching of clinical medicine.

Humans ; Dyslipidemias ; HIV Infections/drug therapy* ; Risk Factors

Humans ; Immune Checkpoint Inhibitors/therapeutic use* ; Prospective Studies ; HIV Infections/drug therapy* ; Anti-HIV Agents/therapeutic use* ; Comorbidity