The author explained the necessary of clinical case teaching for infectious disease teaching in clinical technical skill training,shortage of disease species and practice effect. Then,the author propounded his experience on how to practice the infectious disease clinical cases teaching,which included clinical cases selection,cases discuss and students’ clinical skill training.

Humans ; Liver Cirrhosis

Aim To investigate the effects of ecdysterone on insulin sensitivity and glucose metabolism in the insulin resistant HepG2 cell model induced by high concentration of insulin. Methods The insulin-stimulated glucose incorporation rate was determined with ~3H-D-glucose uptake test which was used to estimate insulin sensitivity of HepG2 cell, and glucose consumption, the amounts of glucose disappeared from the culture medium of HepG2 cells within 24 h were determined. Results The incubation of insulin resistance cells with ecdysterone 1?10~ -6 ～10~ -4 mol?L~ -1 could significantly increase the glucose uptake and glucose consumption of the cells compared with that of control cells(P0.05). Conclusion Ecdysterone could improve the insulin sensitivity in the cell model and can attenuate the aggression of insulin resistance. The effect to improve the insulin sensitivity with ecdysterone is similar to that with pioglitazone.

This article reviewed the appli ca tion of molecular biology technology, such as genomics, DNA labeling technology, and DNA microarray. The aim is to provide the reference for the modernization o f Chinese material medica.

Aim To investigate whether ecdysterone is able to exert glucose-lowering effect on hepatocytes or stimulate the secretion of insulin.Methods For glucose consumption studies,the amounts of glucose disappeared from the culture medium of HepG2 cells within 24 h were determined.?TC3 cells were also used to monitor insulin secretion.Results The glucose concentrations decreased significantly by ecdysterone 1?10~(-6)～10~(-4) mol?L~(-1),while glucose consumption increased by 44%～77% with ecdysterone.Glucose consumption declined as its concentrations increased.Insulin had no effect on glucose-lowering of ecdysterone.?TC3 cells were not stimulated by ecdysterone.Conclusion Ecdysterone is able to exert glucose-lowering effect on hepatocytes which is insulin independent,but has no effect on insulin secretion.

Aim To establish insulin resistant HepG2 cell model induced by high concentration insulin in vitro culture and evaluate the effects of pioglitazone on insulin sensitivity and glucose metabolism in the cell model.Methods HepG2 cells were incubated with 5?10~(-7)mol?L~(-1) insulin for 16 h and insulin-stimulated()~3H-D glucose incorporation was determined.Then,insulin-stimulated glucose incorporation rate which was used to estimate insulin sensitivity of HepG2 cell,and glucose consumption,the amountsof glucose disappeared from the culture medium of HepG2 cells within 24 hours was determined.The insulin resistance cells were incubated with pioglitazone 1?10~(-5) mol?L~(-1).Results It was demonstrated that the incorporation rate of()~3H-D-glucose in insulin-resistant HepG2 cells was decreased significantly than that in the control cells.Insulin-resistant HepG2 cells were free from stimulation for 48 h by insulin,but the incorporation rate of()~3H-D-glucose was lower than that in control cells.Incubation of insulin resistance cells with pioglitazone significantly increased glucose uptake and glucose consumption by the cells compared with that of the control cells(P

Objective To summarize the recent progress in pathogenetic,diagnostic and therapeutic researches on the intestinal barrier dysfunction(IBD) of severe acute pancreatitis(SAP).Methods The advancement of IBD in SAP,which was published recently at home and abroad,was collected and reviewed.Results The pathogenesis of IBD in patients with SAP was complex.Ischemia-reperfusion injury,endotoxin,inflammatory mediators and gastrointestinal hormone played an important role in the process of IBD.There were many ways to detect IBD,and the ratio of lactulose and mannitol,plasma diamine oxidase were relatively ideal markers.Medical therapies,such as treatment of SAP and maintaining the perfusion of intestines,were essential to cure IBD.On this basis,the propulsives,nutritional support and traditional Chinese drugs should be administered reasonably.Conclusions IBD is a sophisticated process of pathophysiology.In recent years,abundant of animal experiments and clinical researches have provided new clue for prevention and cure of IBD,but further researches are still needed on the mechanism of the cells and molecules implicated.

Objective To analyze the effect of intensive pupillary dilation on intraocular pressure(IOP) in early stage after vitreoretinal surgery(VRS).Design Retrospective case series.Participants 32 patients(34 eyes) with 30 mmHg or more of IOP at the first day after VRS were enrolled in this study.Methods Tropicamide-phenylephrine eyedrop(Mydrin-P~(?)) was applied to the operated eye 3 times with interval of 5 minutes and IOP was measured again 2 hours later.IOPs were compared with t test.Main Outcome Measures IOP.Results The mean IOP was 37.26?6.07 mmHg before using tropicamide-phenylephrine eyedrop and 34.82?8.46 mmHg after using it two hours later(P=0.02),and mean decline of IOP was 2.44 mmHg in general.IOP was decreased in 20/34 eyes(58.82%) with mean decline 6.2 mmHg.IOP was unchanged in 4/34 eyes(11.76%).IOP was increased in 10/34 eyes(29.41%) with mean IOP up 4.1 mmHg.Conclusions The IOP increasing after vitreoretinal surgery is not the reason for stopping pupillary dilator.On the contrary,the IOP of about 60%patients can decrease with rational using pupillary dilator.

Objective To explore the feasibility and curative effect of arthroscopic treatment of avulsion fracture of the tibial attachment of anterior cruciate ligament ( ACL ) using Ethibood line plus double Endobutton plates. Methods From May 2014 to January 2016, 26 cases of acute ACL tibial attachment fracture were treated surgically. They were 16 males and 10 females, aged from 9 to 45 years ( average, 26. 6 years ) . By the Meyers-McKeeve classification, there were 17 cases of type Ⅱand 9 ones of type Ⅲ. In preoperative examina-tion, their Lachman test and Anterior Drawer Test were all positive. All their bone blocks were fixated using Ethibond line plus double Endobutton plates. Results Their operative time ranged from 50 to 70 min, averaging 57 min. On average, the 26 patients obtained a follow-up of 8 months ( from 6 to 13 months ) . X-rays at 3 months after operation showed all fractures united. At the last follow-up, their Lachman test and Anterior Drawer Test were all negative. The range of motion of the knee joint was larger than 120° in all; their Lysholm score of the knee joint averaged 90. 6 ± 2. 9 points, significantly higher than their preoperative value ( 43. 6 ± 4. 7 points ) ( t=7. 583, P=0. 026 ); their International Knee Documentation Committee ( IKDC ) scores averaged 93. 1 ± 4. 2 points, significantly higher than their preoperative value ( 46. 3 ± 5. 1 points ) ( t=8. 162, P=0. 021 ) . No such complications as reflexive neural dystrophy, avascular necrosis or weak knee extension occurred during follow-ups. Conclusion The avulsion fractures of ACL tibial attachment can be treated arthroscop-ically using Ethibood line plus double Endobutton plates, because this technique has such advantages as simple operation, limited invasion, good fracture reduction, strong fixation, and possibility of early functional rehabil-itation of the knee joint.

Triage is one of the important taches for the wounded whom is cured effectively under the condition to limited medical resource in public health emergency events.It is a decision based on doctrine rather than expediency.By the view of ethics,the article considered three doctrines: fairness,benthamism and scientific decision-making,which assures that the outcome of wartime triage at the sea is speedy and exact.