Objective To explore the teaching effect of sandwich teaching in medical psychol-ogy. Methods Totally 101 preventive medicine majors of five-year program were divided into two groups:control group(n=52) and experimental group(n=49). Students in control group were taught by traditional teaching while those in experimental group by sandwich teaching method. Teaching qualities were evaluated by final exam and questionnaire. Exam scores were expressed as x±s and were ana-lyzed by t test. Questionnaine results were expressed as number of people and percentage. Results Scores of experimental group in multiplechoice, case study and final grade (30.347±4.171, 32.031± 2.781, 74.296±5.642, respectively) were better than those of control group (28.520±4.443, 28.760± 4.305, 70.010±7.783, respectively), with significant differences between two groups(P<0.05 for all). But there was no significant difference between two groups in short-answer questions score (11.918± 2.431, 12.731±2.523, respectively)(P>0.05). More than 80.0% students in experimental group thought sandwich teaching improved their communication collaborative capacity , logical thinking ability and problem solving ability, etc. Conclusions With satisfactory teaching effect, sandwich teaching promotes teaching quality.

Objective To analyze the effect of total parenteral nutrition (TPN) and enteral nutrition (EN) in patients with acute pancreatitis. Methods Randomized controlled trials of TPN and EN in patients with acute pancreatitis were searched in Medline and China Biological Medicine Disk from Jan 1966 to June 2004. Eight studies were enrolled into the analysis. The detail about the trial design, characters of the subjects, results of the studies were reviewed by two independent authors and analysed by using Revman 4.2 software. Results Compared with TPN, EN was associated with a significantly lower incidence of secondary infections (RR 0.45, 95% CI 0.29-0.68, P=0.0002) and other complications(RR 0.67, 95% CI 0.47-0.96, P=0.03), fewer surgical interventions (RR 0.47, 95%CI 0.24-0.94, P=0.03) and shorter hospitalization. However, there was no significant difference in mortality (RR 0.61, 95%CI 0.32-1.18, P=0.14) between patients with TPN and EN. Conclusion EN could be the preferred nutrition feeding method in patients with acute pancreatitis.

Objective:To investigate the cellular immunological regulation mechanism of Zhongjiling tablet on the myasthenia gravis(MG) patients.Methods:The myasthenia gravis patients were randomly divided into 2 groups, the curing group and the control group, 30 cases per group. Patients of curing group administered Zhongjiling tablet and prednisone placebo, patients of control group administered prednisone tablet and Zhongjiling tablet placebo. Course of treatment was 12 weeks. The distribution of T lymphocyte subgroup of myasthenia gravis patients was detected by flow cytometry. The content of IFN-?, IL-4 and TGF-? of the patients’ peripheral blood mononuclear in vitro were detected by ELISA kits.Results:After treatment, CD4+T cell percentage and the ratio of CD4+/CD8+ decreased significantly(P0.05). The IFN-? and IL-4 of treating group depressed, compared with that of pre-treatment, significant difference exited(P

Objective To set up a method of rapid culture,drug susceptibility testing and identification for Mycobacterium Tuberculosis.Methods Using the method by ourselves made and examined the standard strains and clinical strains of mycobacterium,research to the culture, the drug susceptibility testing and the identification of group in mycobacterium by this method compared with the method of Lowenstein-Jensen (L-J) method. To make sure the characteristic identification of group in mycobacterium.Results Detection time of culture of this method was 19.13 d earlier than that of L-J method. The positive rate of the method was higher than that of the L-J method. The applied concentration of each drug was: INH:0.1 ?g/ml, RFP:1 ?g/ml, EB:2 ?g/ml, AMK:2 ?g/ml、LVFX:2 ?g/ml、PNB 200 ?g/ml、TCH 2.5 ?g/ml respectively. The report time of the method was 7～10 d. It was 18～21 d shorter than that of the L-J method (28 days).Conclusion The method shortened significantly the report time of culture、drug susceptibility testing and identification of group in mycobacterium. The rate of positive was raised.This method was economic, practical and suitable to expansion and application in the substrata units.

Objective To evaluate the efficacy and safety of paclitaxel drug-coated balloons (DCB)in treating acute coronary syndrome in patients with high bleeding risk.Methods A total of 35 inpatients with acute coronary syndrome and high bleeding risk who were treated in our hospital from March 2017 to December 2017 were retrospectively analyzed.The patients were divided into the control group (n=20) treated with normal balloon dilatation and the experimental group (n =15) treated with DCB treatment.The age,major cardiac adverse events(MACE)within 3 months,fatal hemorrhage events,all-cause mortality,attributable mortality,target lesion revascularization rate(TLR),coronary artery stenosis degree before intervention,and coronary artery stenosis degree at once and 3 months after surgery,were used for comparison and for statistical analysis between the control and the experimental group.Results There were no significant differences between the two groups in the indexes as the followings:MACE within 3 months after surgery(25.0％ vs.6.7％,x2 =2.03,P =0.15),fatal hemorrhage events (10.0 ％ vs.6.7 ％,x2 =0.12,P =0.727),all-cause mortality (20.0％ vs.6.7％,x2 =1.24,P =0.27),attributable mortality(10.0％ vs.0.0％,x2 =1.59,P=0.21),TLR(14.3％ vs.0％,x2 =3.08,P =0.08).However,the incidence of fatal hemorrhage and MACE,all-cause mortality,attributable mortality and TLR were relative low in the experimental group (P＞0.05).Conclusions Drug-coated balloon treatment is safe and effective in treating acute coronary syndrome in patients with high bleeding risk.

Objective:To study the changes of food characters in early swallowing recovery in patients with different laryngeal function preservation surgery.Methods:Collected patients with laryngeal cancer hypopharyngeal cancer who underwent laryngeal function preservation surgery in Lihuili Hospital of Ningbo Medical Center from January 2019 to March 2020. By fiberoptic endoscopic evaluation of swallowing (FEES) combined with Penetration and Aspiration Scale (PAS), prospectively observed the aspiration and invasion of solid, paste, fluid and other food in the early stage of trial feeding in patients with laryngeal hypopharyngeal cancer undergoing open laryngeal function preservation.Results:Among the 69 patients, 21 had vertical partial laryngectomy and 19 had partial pharyngeal partial laryngectomy. 15 days after the operation, 2 groups of patients after solid and paste food adaptability scored (1.14±0.36), (1.29±0.56) and (2.53±2.04), (2.84±2.31) points, Friedman Mtest for comparison difference had statistical significance ( Mvalues were 23.463 and 22.227, P<0.01); the liquid food for adaptability scored (2.10±1.09), (4.42±2.24) points, the pairwise comparison of liquid, solid and paste showed statistically significant differences ( tvalues were-0.976 to 1.105, P<0.05). The pairwise comparison of the adaptability of the two groups on 20 days after surgery showed no statistically significant difference ( P>0.05).Throat on the cricoid cartilage resection-ring hyoid epiglottis anastomosis (SLCP-CHEP) was 17 cases, laryngeal glottis level partial resection was 12 cases; postoperative 15 days the adaptability on the behavior of three kinds of food grade 2 groups of patients (4.65±1.90), (5.59±1.46), (6.53±1.13) points and (6.67±1.07), (4.50±2.07), (6.92±0.79) points, respectively; Minspection differences were statistically significant ( Mvalues were 29.525, 22.136, P<0.01).The pairwise comparison of solid and paste food in the two groups 20 days after the operation showed no statistically significant difference ( P>0.05), while the difference of liquid and paste was statistically significant ( tvalues were-1.375 to-0.853, P<0.05). Conclusion:In the early recovery of patients undergoing laryngeal function preservation surgery, the vertical group and the partial pharyngeal partial laryngectomy group has better adaptability to solid and paste food. The horizontal group has better adaptability to paste, the CHEP group has better adaptability to solid, and the four groups has the worst adaptability to convection, the recovery time of convective mass between the CHEP group and the horizontal group was longer. To understand the adaptability of patients with different surgical methods to food traits at the early stage of trial feeding can help to implement targeted rehabilitation programs, carry out progressive diet training, and reduce the complications of misinvasion, aspiration, aspiration pneumonia and other complications in the recovery cycle.

Objective:To introduce a newly modified surgical approach and explore the clinical efficacy of en bloc kidney transplantation from deceased infant donors to adults.Methods:Four cases of en bloc kidney transplantation from deceased infant donor to adult were performed with a new modified surgical approach in renal transplantation and dialysis center of the Second People's Hospital of Shanxi Province from January 2017 to September 2019. All 4 cases were cardiac death donors. There were 3 males and 1 female donors, aged (54 ± 22.69) d and weighing (5.6 ± 0.79) kg. There were 1 male and 3 female recipients, aged (41.5 ± 5.97) years and weighing (45 ± 3.56) kg. For lowering operative difficulties and preventing hemodynamic disturbances, bilateral kidneys were sutured and fixed during trimming. Then end-to-side anastomosis was performed between donor kidney abdominal aortic valve and recipient external iliac artery and between donor renal inferior vena cava valve and recipient external iliac vein.Results:All operations were successful without vascular or urinary complication. The average duration of donor kidney repair was 20 min and the average duration of transplantation 68.75 min. The functions of transplanted kidney recovered well during a follow-up period of 12 months. The long-term survivals of recipient and transplanted kidney were satisfactory.Conclusions:The newly modified surgical approach of en bloc kidney transplantation from deceased infant donor to adult has optimized operative handling. With a higher success rate, vascular complications are lowered. A wider popularization is recommended.

The expression of KAI1/CD82 and MRP-1/CD9 in transitional cell carcinoma of bladder (TCCB) and its clinical significance were investigated. Immunohistochemistry was used to detect KAI1/CD82 and MRP-1/CD9 protein expression in 52 TCCB specimens. Correlation between the expression of KAI1/CD82 and MRP-1/CD9 to clinicopathologic factors was statistically analyzed. The results showed that the positive rate of KAI1/CD82 and MRP-1/CD9 in TCCB was 50% and 61.5%, respectively. The MRP-1/CD9 and KAI1/CD82 expression was significantly associated with grade of TCCB (P<0.05), but no correlation was found between MRP-1/CD9 or KAI1/CD82 expression and clinical stage of TCCB (P>0.05). The expression level of MRP-1/CD9 and KAI1/CD82 in recurrent TCCB samples was lower than that in non-recurrent samples (P<0.05). Meanwhile, the correlation between the KAI1/CD82 expression and MRP-1/CD9 expression was statistically significant (r=0.316, P<0.05). It was concluded that KAI1/CD82 and MRP-1/CD9 expression may be important prognostic indicators and potentially useful for assessing the biological behavior of TCCB.

Objective To optimize the prescription of flaxseed lignans sustained release tables by central composite design-response surface methodology.MethodsWith HPMC, EC and starch dosage as factors, and flaxseed lignans in 2, 6 and 12 h of cumulative release as evaluation indexes, central composite design-response surface optimization method was used to conduct prescription optimization experiments, and optimized prescription analysis was carried out.Results The optimal prescription of flaxseed lignans sustained release tables was as following: HPMC dosage was 43%; EC was 26%; starch content was 17%. Optimized index forecast values were very close to the observed values. In vitro release test of three selected optimal formulations indicated that there existed high approximation between the observed and estimated values.Conclusion It shows that the established model is suitable for flaxseed lignans sustained release tables, which can be used in the optimization of the prescription of flaxseed lignans sustained release tables.