Objective Evaluation the effect to improve the eight-year program medical students` comprehensive ability between standard of PBL mode and complex scenarios PBL mode.Methods To comparative improved teaching quality between complex scenarios PBL teaching mode and standard of the PBL teaching mode by final exam scores and DREEM scale.Results The complex scenarios PBL teaching mode improve the ability of problem solving score significantly higher than the standard scores of PBL teaching mode at the start of analyzing questions and help students to stimulate interest, increase self-confidence, (P<0.05).Comparative analysis shows the comprehensive thinking ability of medical students has improved significantly.ConclusionsComplex scenarios PBL teaching mode can improve the ability of handling the students` study enthusiasm, comprehensive ability and strain capacity more effectively than that of standard PBL teaching mode.The obvious effect is worth promoting.

Objective To evaluate the changes and significances of malondialdehyde(MDA)and Superoxide dismutase(SOD)in unstable angina pectoris(UAP)patient after percutaneous coronary intervention(PCI). Methods MDA and SOD were tested in 25 UAP patients before and 1h,24h,72h after PCI.20 UAP patients who were performed on coronary angiography(CAG) and 20 normal individuals entered this study as contrasts.All the UAP patients were followed up for 3 months。 Results Level of MDA in UAP cases significantly increased compared with the normal individuals, P

Objective Present study aimed to research the mechanism of the use of 0.2% brimonidine tartrate eye drops in the treatment of optic nerve crush injury of rat.MethodsAnimal models of optic nerve crush injury were created in 60 SD female rats by clipping the exposed optic nerve at 2 mm in retrobulbar for 6 seconds with 78 grams of reverse forceps.The successful model was identified as Marcus-gun pupil without bleeding of fundus after operation.The animals were randomly assigned to model group and brimonidine treating group,and another 30 normal SD rats were used as the normal control group.The 0.2% brimonidine tartrate eye drops was topically administered at 2 hours before operation and after operation twice per day in the brimonidine treating group.The retinas from 18 rats were isolated after 3,7,21 days for RGCs counting by H&E staining,and the retinal ultrastructure was examined under the transmission electron microscope.The retinas from the other 72 SD rats (including normal,model and brimonidine groups) were prepared for the detection of bcl-2 and bax using immunohistochemistry l,3,5,7,14,21 days after the operation.ResultsNormal and almost normal retina structure was exhibited in rats of the normal group and brimonidine treating group,but disorder of cellular arragement and decrease of retinal thickness were found in the model rats under the optical microscope.The RGCs counting was significantly different among the three groups from 3 days through 21 days after operation with the considerably declination in the model group and brimonidine treating group compared with the normal control group (P＜0.05-0.01).However,that of the brimonidine treating group was obviously increased in comparison with the model group (P＜0.01).The expression of bax in rat retina was obviously reduced (P＜0.01),but the expression of bcl-2 was increased in brimonidine group compared with the model group from 5 through 7 days after operation (P＜0.01).ConclusionThe 0.2% brimonidine tartrate eye drops has a preventive effect on optic nerve crush injury of rat,and its inhibition on apoptosis is one of the mechanisms.

Objective To investigate the effects of Chaishao Chengqi Decotion on intestinal microbiota and intestinal mucosal lesion in severe acute pancreatitis(SAP).Methods 46 Patients with SAP were randomized into two groups.Routine medical management was initiated in two groups.The treatment group received Chaishao Chengqi Decotion for 1 week.The plasma concentrations ofDiamine Oxidase (DAO),D-lactate were detected and changes of microflora were evaluated by bacterial culture.Results The levels of DAO in the treatment group (4.65 ±0.82)U/ml were significantly lower than those in the control group (5.66 ±2.17) U/ml (P ＜ 0.05) 7 days after treatment.The levels of D-lactate in the treatment group (10.65 ± 5.24)mg/L were significantly higher than those in the control group (5.42±2.13)mg/L (P＜0.05).Bacterial culture revealed that the amount of bifidobaterium (6.02± 1.42)In/g and lactobacilli (7.21 ± 2.02) In/g were significantly increased when compared to those before treatment (3.74± 1.71)In/g and (4.03 ± 1.79)In/g respectively,while there was imbalance of intestinal microflora to some extent in the control group.Conelusien Chaishao Chengqi Decotion exerted the protective effects on gut barrier function by alleviating the damage of intestinal mucosa and balancing the intestinal microbiota following severe acute pancreatitis.

OBJECTIVE To clarify the features of nosocomial infections for patients with multiple myeloma(MM).METHODS One hundred and seventy eight cases of MM treated in our hospital from Oct 1982 to Dec 2006 were analyzed retrospectively.RESULTS Eighty five patients(47.8%) suffered from nosocomial infections.The nosocomial infection took place more frequently on respiratory tract.Elder,granulocytopenia,hypoproteinemia,severe anemia,and diabetes were the risk factors.Totally 91 pathogens were isolated.Gram-negative bacilli accounted for 45.1%,and were the major pathogens.Fungi accounted for 37.4% and Gram-positives accounted for 17.6%.The ESBLs producing strains accounted for 31.6% in Klebsiella pneumoniae and Escherichia coli.Vancomycin resistant strains were found.The top one of fungi presented organism was the Candida albicans.CONCLUSIONS Nosocomial infections for patients with multiple myeloma has a high incidence.There are many risk factors.The resistance of commonly encountered bacteria to antimicrobial agents is a serious problem.Immunity protection and the rational use of antimicrobial agents should be emphasized.

Objective: To explore the clinical and radiological features of myelin oligodendrocyte glycoprotein (MOG) antibody associated disease. Methods: The clinical data of 22 MOG antibody associated disease cases treated in the Department of Neurology, Qilu Hospital of Shandong University from January 2017 to June 2019 were retrospectively analyzed. The clinical data of MOG antibody associated disease were summarized, including clinical and imaging features. Results: Of the 22 included patients with MOG antibody associated disease, the average age was 38.5 years, 13 were male and nine were female. Among them, 11 cases manifested as aquaporin-4 (AQP4)-negative neuromyelitis optica spectrum disorder (NMOSD), four cases optic neuritis, two cases transverse myelitis, one case acute disseminated encephalomyelitis (ADEM), two cases cortical encephalitis and two cases vestibular neuronitis. Magnetic resonance imaging (MRI) results showed that multiple anatomical areas were involved. Among the nine patients with optic nerve involvement, five patients had longitudinally extensive optic nerve lesions, which were longitudinally enhanced. In eight patients, MRI lesions in the spinal cord showed mostly long or short segments involvement, involving 2-5 spinal cord segments. Five cases involved the cervical spinal cord, six cases involved the thoracic spinal cord, and one case involved the lumbar spinal cord. Brain MRI abnormalities were found in 13 cases and the lesions were mostly patchy and point-shaped. MRI lesions demonstrated T₂ hyperintensity and some of them could be strengthened, which may involve the basal ganglia, thalamus, radiographic crown, frontal temporal lobe, brain stem and other parts. Among them, 16 patients were sensitive to high-dose intravenous/oral methylprednisolone in the acute phase. Seven patients had recurrence after two months to two years of follow-up. Conclusions MOG antibody associated disease include multiple manifestations. Among them, AQP4-negative NMOSD is the most common form. The clinical manifestations of patients showed diversity. Imaging is characterized by multiple parts involvement such as optic nerve, spinal cord, and brain. Most patients are sensitive to high-dose intravenous/oral methylprednisolone, and have a good prognosis in the acute phase, but some patients may relapse.

Objective To explore the changes of mineral and bone metabolism before and after renal transplantation as well as the effect of preoperative parathyroid hormone (PTH) level on postoperative mineral and bone metabolism.Methods In this retrospective analysis,we recruited 82 cases of renal transplant recipients with normal renal function and receiving kidney transplantation in our hospital from January 2011 to January 2015.All of these patients had intact PTH (iPTH) level ＞300 pg/mL.We chose 26 cases of recipients whose preoperative iPTH was more than or equal to 800 pg/mL as very high PTH group,and 56 cases of recipients whose preoperative iPTH was between 301-799 pg/mL as high PTH group.We monitored and performed analysis of the total serum calcium (Ca),serum inorganic phosphorus (P),25-(hydroxyl) vitamin D3 (25 OHD),serum alkaline phosphatase (ALP),Beta C-terminal telopeptide (β-CTX),N-terminal/midregion (N-MID) pre-and 1 month,4 months,1 year,2 years,3 years post-kidney transplantation.Results Serum total calcium in the two groups was gradually increased,returned to normal range 1 month post-transplantation and reached the plateau 4 months post-transplantation.The incidence of hypercalcemia in very high PTH group was statistically significantly higher than in high PTH group.Serum phosphorus in the two groups showed a trend of gradual decline after renal transplantation,and returned to the normal range 1 month post-transplantation.The serum phosphorus level in very high PTH group reached the plateau 4 months post-transplantation,and that in high PTH group 1 month post-transplantation.Compared with high PTH group,very high PTH group has greater The incidence of long-term hypophosphatemia after renal transplantation was significantly higher in very high PTH group then in high PTH group.iPTH,ALP,β-CTX and N-MID in the two groups showed a downward trend after renal transplantation.At first month post-transplantation,iPTH,ALP,β-CTX and N-MID levels were reduced most significantly.The average levels of the three mentioned indicators in very high PTH group were higher than in high PTH group at every time point after surgery with the difference being significant during the early post-transplantation period.The anomalies of iPTH and β-CTX levels persisted to long term after transplantation in very high PTH group.25-OHD levels in these two groups showed rising trend after renal transplantation,reached the plateau 4 months posttransplantation,but failed to achieve the ideal reference level,and no significant difference was found between two groups at any time point monitored.Conclusion The anomalies of mineral and bone metabolism after renal transplantation could persist a long time.Conclusion hyperparathyroidism in the renal transplantation plays an important role in mineral and bone metabolism.Preoperative severe HPT could continue to post-transplantation period and increase the incidence of hyperphosphatemia and hypocalcemia long term after transplantation,which may aggravate bone turnover and this effect can last a long time after transplantation.