OBJECTIVE:To provide reference for promoting the application ofwhole course tutorial systemin the practice teaching of medical higher vocational colleges. METHODS:Totally 106 students on internships of medical higher vocational colleg-es were selected and randomly divided into control group(n=53)and observation group(n=53). Control group received routineteaching method;observation group receivedwhole course tutorial systemteaching method on the basis of control group. Score, teaching quality and students'satisfactory degree were compared between 2 groups after the end of internship teaching. RESULTS:The scores of autonomous learning ability,comprehensive ability,communication ability,judgment ability,thinking and solving problem ability and total score in observation group were all significantly higher than control group after the end of internship teach-ing;the proportion of good teaching quality in observation group was significantly higher than control group,manifesting as high practical ability,good adaptability,caring patient,good learning condition;the satisfactory degree of students in observation group was significantly higher than control group(98.11% vs. 88.68%),there was statistical significance(P<0.05). CONCLUSIONS:The implementation ofwhole course tutorial systemteaching method in practice teaching of medical higher vocational colleges based on conventional teaching method achieves ideal effect and can improve the students'learning effect,teaching quality and stu-dents'satisfactory degree.

OBJECTIVE:Alfuzosin concentration in human serum was determined by RP-HPLC METHODS:The mobile phase was methanol-acetonitrile-phosphate buffer-triethylamine(10∶30∶60∶0 05) After being extracted with ethyl ace_tate,alfuzosin was analyzed by reversed-phase HPLC (Shim-pack CLC-ODS,4 6mm?150mm,5?m)and fluorescence detection with excitation wavelength set at 334nm and emission at 378nm RESULTS:Over the concentration range of 0 4～51 2?g/L,the linear regression equation was A=0 3 909C+0 0 605(n=8,r=0 9 996) The average recovery of alfuzosin was 99 4% The intra-and inter-day RSDs were less than 15% CONCLUSION:The method is accurate and can be used for studying the pharmacokinetics of alfuzosin

Objective:To investigate the adjusting role of Chinese herb purpura No.1 on the immune function of henoch-schonlein purpura(HSP).Methods:100 HSP children were divided into Chinese herb group and western medicine group with 1∶1,observing the effects of two groups and compare T lymphocyte subgroups such as CD3,CD4,CD8,CD4/CD8 and the level of IgG,IgA,IgM of two groups between before-treatment and after-treatment.Results:The effect and the adjusting role on the HSP children′s immune function of Chinese herb group was better than that of western medicine group while the recurrence rate of Chinese herb group was lower than that of western medicine group.Conclusion:Chinese herb can adjust the immune function and condense the symptoms′ duration time of HSP children. It also can decrease the recurrence rate of HSP children.

Objective To study the correlation between serum level of antiendothelial cells auto-antibodies (AECA) and anticardiolipin antibodies (ACA) and the roles in the pathogenesis of Behcet′s disease (BD). Methods Thirty two BD patients were randomly selected from our outpatients and inpatients. Thirty-three healthy controls were studied in parallel. AECA/ACA were examined by indirect immunoflourescence technique and enzyme linked immunosorbent assay (ELISA) respectively, IgG-AECA and IgM-AECA antibodies were detected, too. Results The positivity rates of AECA, IgG-AECA and IgM-AECA in BD patients were 81.3%, 71.9% and 53.1%, respectively. Increased serum AECA levels were observed in all BD patients compared with those of normal controls. There was some significant positive correlation in the positivity rate of AECA between erythema nodosum, nodular vasculitis and rapid erythrocyte sedimentation rate. The positivity rate of ACA was 53.1%, A significant difference in the positivity rate of ACA compared with those of normal controls. Neither of these two kinds antibodies was significantly correlated with oral ulcers, clinical manifestations of skin and external genital organ, anemia or erythrocyte sedimentation rate. Conclusion The detection of AECA level is useful to identify cutaneous vasculitis and the activity of disease in BD, but the value of ACA in the diagnosis of the condition of BD needs further study. [

OBJECTIVE: To probe into the medication status of the elder patients in community so as to provide reference for pharmacists to promote rational medication for the elderly people in community. METHODS: The medication status of 484 cases in the community was investigated through questionnaire and interview. RESULTS: The principal diseases affecting the health of the elder people included hypertension, diabetes mellitus, coronary heart disease, cerebrovascular disease. The average number of drugs they used totaled 2.92 kinds; the higher the educational background, the higher proportion of the elder people who read drug package instruction but the lower ratio of medication compliance. The elder people commonly had poor knowledge about the drugs and adverse drug reactions(91.74% and 60.74%);21.11% responded that they had ever received medication guidance from pharmacists, only 3.10% responded that they had once consulted pharmacists about medication problems. CONCLUSION: The medication of the elder people in community is characterized by multiple drug varieties, poor ADR knowledge and lower cognition on pharmacists. It is urgent to improve the pharmaceutical care ability of medical institution and enhance the social influence of pharmacists.

Objective To investigate the distribution of urate crystal as well as the relationship bet ween the features of the crystals and the attacks of joint pain and/or swollen by foot dual-energy CT.Methods Eight-four patients (68 were diagnosed as gout, 11 were patients with hyperuricemia and 5 were diagnosed as other types of arthritis) who recently experienced foot swelling and/or pain were enrolled and all of them were performed foot dual-energy CT.The relationship between the features of the urate crystals and the attacks of gouty arthritis was determined by Chi test and the potential risk factors were identified by Logistic multiple regression analysis.Results Two hundred and seventyeight urate crystal depositions were found in 68 gout patients,and the most common deposition sites were the distal parts of the first toe(18.2％),the first metatarso-phalangeal joint ( 16.8％ ),calcaneus ( 17.5％ ),the lower end of tibia ( 11.8％ ).Furthermore,patients with the urate crystals deposited in the first metatrasophalangeal joint or the lower end of of tibia were more likely to experience acute episodes of gout attack (P＜0.01,P＜0.05 respectively).In addition,the shape,size and quantity of urate crystals also affected episodes of acute attack of gout.Conclusion Dual-energy CT,which is a non-invasive method,could clearly reveal urate crystal depositions and is helpful for the diagnosis and follow-up of patients with gout.The location,shape,size and quantity of urate crystals and soft tissue swelling,bone erosion may affect the acute attack of gout.

Objective To investigate the application and clinical effect of uncut Roux-en-Y (uncut RY) anastomosis in laparoscopic distal radical gastrectomy of gastric cancer.Methods The retrospective crosssectional study was adopted.The clinical data of 23 patients with gastric cancer who were admitted to the Northern Jiangsu People's Hospital from December 2014 to July 2015 were collected.All the 23 patients underwent laparoscopy-assisted distal gastrectomy (LADG) and total laparoscopic distal gastrectomy (TLDG) according to the individual situations.The indexes of observation were collected,including (1) intraoperative indexes:operation time,uncut RY anastomosis time and volume of inraoperative blood loss,(2) postoperative indexes:time to anal exsufflation,time for initial water intake,time for semi-fluid diet intake,time for out-off-bed activity,duration of hospital stay,occurrence of complications and results of pathological examination,(3) results of follow-up.The follow-up was performed by outpatient examination and telephone interview up to November 2015,including postoperative discomfort after diet intake,barium meal examination of gastrointestinal tract at postoperative month 1 (anas-tomotic stenosis,recanalization and dehiscence of occlusion),detecting situations of gastric remnant and anas-tomotic stoma at postoperative month 3 by gastroscopy and occurrence of gastrointestinal obstruction.Measurement data with normal distribution were presented as x ± s.Results (1) Intraoperative situations:all the 23 patients underwent successful uncut RY anastomosis,including 18 receiving LADG and 5 receiving TLDG.The operation time,uncut RY anastomosis time and volume of intraoperative blood loss were (165.9 ± 11.6) minutes,(18.2 ± 2.2) minutes,(48 ± 6) mL in all the 23 patients and (172.0 ± 8.5) minutes,(26.6 ± 1.5) minutes,(46 ± 4) mL in 5 patients with TLDG,respectively.Two patients received hemostatic treatment using suture and hemostatic forceps due to anastomotic bleeding.(2) Postoperative situations:time to anal exsufflation,time for initial water intake,time for semi-fluid diet intake,time for out-off-bed activity,duration of hospital stay and incidence of complications in all the 23 patients were (2.2 ± 0.4) days,(2.7 ± 0.4) days,(3.5 ± 0.4) days,(2.7 ± 0.3) days,(10.6 ± 1.4) days and 8.7％ (2/23),respectively.No patient was dead in the perioperative period.Two patients complicated with incisional infection and high fever were cured by symptomatic treatment,without occurrence of anastomotic leakage,bleeding and anastomotic-related complications.All the patients received postoperative barium meal examination of upper gastrointestinal tract,with unblocked anastomotic stoma and without leakage of barium meal.Diameter of tumor and number of lymph node dissected were (3.2 ± 1.2) cm and 30 ± 4,with negative upper and lower resection margins.Numbers of patients with tumor differentiation,T stage,N stage and TNM stage were 12 and 11 in differentiated and undifferentiated tumors,1,9 and 13 in T1,T2 and T3 stages,9,11 and 3 in N0,N1and N2 stages,1,4,9,6 and 3 in Ⅰ a,Ⅰ b,Ⅱ,Ⅲ a and Ⅲ b stages,respectively.(3) All the 23 patients were followed up by outpatient examination for 3-11 months.One patient had discomfort in upper abdomen with vomiting at postoperative week 3,and no anastomotic leakage,bleeding and anastomotic-related complications were occurred in other patients.Conclusion As a modified anastomotic method,uncut RY anastomosis is safe and feasible,and it is also an ideal method of digestive tract reconstruction after laparoscopic distal radical gastrectomy.

Objective To study the appearances of split cord malformation(SCM)and evaluate the diagnostic value of CT for SCM.Methods Clinical and CT data of 48 cases with SCM were analyzed retrospectively ,21 were males and 27 were females,ranged from 1 day to 8 years with a mean of 11.6 months. All cases evaluated by plain CT with coronal and sagittal reconstructions.Results Type I accounted 75%, consisted of two hemicords, each contained in its dural tube and separated by a rigid median septum .TypeⅡaccounted 25%, consisted two hemicords contained in a single dural sac separated by a non-rigid, fibrous median septum. Associated abnormalities: tethered cord syndrome(n=38), syringomyelia(n=9), intradural lipomas(n=10), meningocele(n=18).Conclusion CT can clearly demostrate the position, the septum and the shape of the SCM, as well as associated abnormalities.

Objective To clearify the features of an outbreak of Guillain-Barré syndrome (GBS) from Shuangyang district of Changchun city, Jilin province, China.Methods Serum samples obtained were tested serologically for antibodies to chlamydia, coxsackie virus, cytomegalovirus, and hepatitis B virus.Stool samples obtained were cultivated to search Campylobacterjejuni.Electrudiagnostic studies were done 1 day after onset to 10 days.Results Twenty-two patients (12 males and 10 females, aged 15-71 years) were from Shuangyang district, a suburb of Changchun, during a 2-week period in June to July 2007.An illness in the preceding 4 weeks was reported in 17 patients, 16 gave a history of diarrhoea, 1 patient had symptoms consistent with an "upper respiratory infection" and 1 patient had both.Limb weakness were the earliest symptoms.Respiratory assistance was needed by 3 patients.Tendon reflexes were lost as weakness developed.Eleven patients had raised concentrations of protein in the cerebrospinal fluid ((0.74±0.32) g/L), and the averaged cell count was 3×106/L There were 3 kinds of antibodies of hepatitis B virus positive above 17 GBS patients.Electrodiagnostic studies showed severe reductions in motor evoked amplitudes from distal stimulation in 12 patients.Sensory action potentials were normal.Conclusions The distinctive epidemiologicai, clinical and electromyography characteristics of these patients suggest that the disorder, different from acute inflammatory demyelinating polyneuropathy, is concordant with acute motor axonal neurupathy.The features of Shuangyang GBS was similar to those previously reported in several aspects.

Objective To assess the cardiovascular events after percutaneous transluminal coronary intervention (PCI) and the influence of fluvastatin on inflammation factors and prognosis of PCI patients.Methods One hundred and eighty-seven patients whose coronary stenosis ≥ 70% diagnosed through coronarography and underwent PCI from Jun.2005 to Feb.2008 were recruited in the current study.These patients were divided into two groups,the control group (n =91) was treated regularly and the treat group (n =96) was treated with additionally fluvastatin(40 mg/d).Fasting venous blood was obtained before and after medicine treatment,12,24 hours and two weeks after PCI.IL-18,IL-6 and TNF-α were measured through ELISA.Results Before medicine treatment,there were no difference of IL-18 ,IL-6 and TNF-α between the two groups( P ＞ 0.05 ).After medicine treatment,IL-18,TNF-α and IL-6 decreased significantly compared to those before treatment in both groups ( P ＜ 0.05 ),and these measurements decreased more in the treatment group ( P ＜ 0.01 ).At the 12th hours after PCI,IL-18,TNF-αand IL-6 in the control group increased to (423.5 ± 298.7 ),( 316.1 ± 72.6 ) and (42.3 ± 10.1 ) ng/L,respectively,and arrived the peak at the 24th hour,which were significantly higher than those before medicine treatment( P ＜ 0.01 ).In the treatment group,these measurements at the 12th and 24th hour after PCI were slightly higher than those before medicine treatment without significant difference ( P ＞ 0.05 ).After 12 hours ofPCI,IL- 18,TNF -αand IL-6were (276.5 ± 189.4 ),( 175.3 ± 51.9) and ( 10.1 ± 8.1 ) ng/L,which were significantly lower than those in the control group(P ＜ 0.01 ).Two weeks after PCI,IL-18,TNF-α and IL-6 in the treatment group were (137.0 ±34.2),(35.1 ± 21.6) and ( 8.7 ± 3.2 ) ng/L,which were significantly lower than before medicine treatment ( P ＜0.01 ).Conclusions PCI may aggravate the inflammation response of coronary artery.Statins may alleviate the inflammation response.IL-18,TNF-α and IL-6 are sensitive indices of early inflammation response after PCI,their changes might have prediction value for adverse cardiovascular events.Therefore these indices might be used as a target in the statins treatment in the primary prevention,as well as the evaluation of the effectiveness of PCI,statins and joint PCI and statins.