To investigate the effect of the case-centered teaching method in biochemistry teaching. 47 students were divided into two groups :the study group and the control group.The casecentered teaching method was used in the studying group.The control group was taught by traditional method.The final examination showed that the results of the studying group were better than the control group.

An introduction to the concept ofintegration of medical service and aging care,the strategic goals and policies in support of the new ecology of integration of medical service and aging care.The authors described specific practices in the development of laws and regulations,provision of various services and update means to build such an ecology in Wuxi,along with proposals to speed up the innovation and development.

Objective To evaluate the antidepressant efficacy and adverse reactions of 3 different stimulus dosage of modified electroconvulsive therapy ( MECT) in patients with depressive episode. Methods 120 patients with depressive episode were randomized into low dosage group ( n=40) ,medium dosage group ( n=40) and high dosage group ( n=40) . Low dosage were 50%× age,medium dosage was 70%×age,high dosage was 80%×age . All patients received 6 treatments. Hamilton depression scale?17(HAMD?17) was used to evaluate the clinical symptoms at baseline,3 and 6 treatments. Effects and adverse reactions were compared among three groups.Results Compared with baseline the HAMD?17 scores of the 3 groups were significantly improved after 6 treatments( t=24.026, P=0.000;t=26.541, P=0.000;t=25.904, P=0.000) , but there were no statistically significant differences among the three dosage groups(F=0.409, P=0.665). Compared with low dosage group((27.2±5.4)%),the HAMD?17 scores reductive ratio of medium dosage group((34.3±6.8)%) and high dosage group((33.9±6.9)%)) were significantly improved after 3 treat?ments ( t=-5.513, P=0.000;t=-4.785, P=0.000). Compared with the low dosage group,the incidence rate of headache,nausea and vomiting,delirium were significantly higher in high dosage groups( headache:χ2=14.532, P=0.000;nausea and vomiting:χ2=13.333, P=0.000;delirium:χ2=14.907, P=0.000) . The re?covery time was significantly longer in medium dosage group ( ( 10. 5 ± 1. 6 ) min ) and high dosage group ((11.2±1.8)min) than that in low dosage group((8.8±1.2)min)( t=-5.144,=0.000;t=-6.889, P=0.000).Conclusion Different stimulus dosage of MECT for depressive episode has equivalent curative effect after 6 treatment . Medium dosage and high dosage treatments appear to have an early onset of efficacy,but may also be associated with more adverse reactions.

It is recommended that cyclophosphamide combined with corticosteroids should be used as the first-line treatment of ANCA ( antineutrophil cytoplasmic antibody) associated with systemic vasculitis ( AASV) , however, cyclophosphamide has notable ad-verse reaction of causing pulmonary fibrosis ( PF) . In this paper, whether cyclophosphamide should be used in an AASF patient with PF was analyzed in order to decide whether AASV with PF is one of contraindications of cyclophosphamide in clinical practice.

Objective: To investigate the analgesic effect and impact of lornoxicam on the expression of plasma IL-6 and IL-10 in patients undergoing upper abdominal surgery.Methods:Sixty patients undergoing upper abdominal surgery were randomly allocated into three groups,morphine group(M,n=20),postoperative lornoxicam group(L,n=20) and preemptive lornoxicam group(P,n=20).For group M the subjects received patient controlled intravenous analgesia(PCIA) with morphine(loading dose 0.05 mg/kg,bolus 1 mg,lockout time 10 min,background dose 0 mg) after the surgery.While in group L,8 mg lornoxiam was administered at the end of the surgery,then the same morphine PCIA scheme as in group M was used in combination with intermittent intravenous lornoxiam(8 mg per injection) at 12,24 and 36 h after the surgery.Except that the first 8 mg lornoxicam was injected 30 min before the operation,the analgesic paradigm of group P was similar to group L.The analgesic effect assessed by VAS at rest,the consumed dosage of morphine,and the adverse effects as nausea and vomiting,were recorded at 4,8,12,24 and 48 h.Furthermore,2 ml of the venous blood was drawn before the induction of anesthesia 2,6,12,and 24 h after the surgery to measure the levels of interleukin 6(IL-6) and interleukin 10(IL-10).Results: During the 48 h observation,the VAS at rest was not statistically significant in the three groups,but more morphine was consumed in group M than in group L and group P.There was no difference among the three groups in the incidence of such adverse effects as nausea or vomiting.The basic levels of IL-6 and IL-10 were too low to be measured.The concentrations of IL-10 and IL-6 reached the peak at 2 and 6 h after surgery respectively,and the level of IL-10 in group M was significantly lower than in groups L and P at 2 h.In contrast,the level of IL-6 in group M was significantly higher than in group L and group P at 6 h,and even higher than in group P at 12 h. Conclusion: Lornoxicam,especially when administered before upper abdominal operation,could significantly decrease the dose of morphine for postoperative analgesia and attenuate the inflammatory cytokine response after surgery.

Objective To investigate the clinical value of the combined detection of Golgi protein 73 (GP73),alpha-fetoprotein variant-L3 (AFP-L3)and transforming growth factorβ1(TGFβ1)in the early diagnosis of hepatocellular carcinoma (HCC).Meth-ods 48 cases of healthy control,42 cases of hepatitis B,50 cases of posthepatitic cirrhosis and 58 cases of HCC were selected and detected GP73,AFP-L3 and TGFβ1.The detection results were compared among 4 groups.Results (1)The levels of GP73,AFP-L3 and TGFβ1 had statistical differences among 4 groups(P <0.05 );(2 )The positive rate of the 3-marker combined detection reached 96.55%,which was higher than that of the 2-marker combined detection and the single marker detection.Conclusion (1) GP73,AFP-L3 and TGFβ1 may be used as the serum indicators for the early diagnosis of HCC;(2)Compared with the traditional HCC marker AFP,AFP-L3 has relatively high sensitivity and specificity and has the important role in the differential diagnosis of benign and malignant diseases of the liver,which is considered as a better serum marker in the HCC diagnosis;(3)The 3-indicator combined detection can significantly improve the positive detection rate of HCC and has better application value.

In the present study ,we aimed to observe the effect of curcumin on TSST-1-induced inflammatory cytokines in splenocytes of mouse and provide evidence for the further study on the effect of curcumin on inflammatory shock .Lactate de-hydrogenase (LDH) release assay was used to determine cytotoxicity of different doses of TSST-1 and curcumin .Inflammatory cytokines were determined by ELISA and flow cytometry .The doses of TSST-1 and curcumin we used in the present study did not cause significant cytotoxicity .TSST-1 induced higher level of IFN-γand IL-2 production but relatively lower level of TNF-α.The production of IL-1β,IL-6 and IL-12 was undetectable .TSST-1 induced Th1 cytokines (IFN-γand IL-2) were not IL-12-dependent which was different from LPS-induced IFN-γ.Curcumin significantly reduced IFN-γand TNF-αproduction at the concentration of 15 umol/L (P<0 .05) ,but had no effect on IL-2 production (P>0 .05) .It’s suggested that curcumin could significantly inhibit the production of IFN-γand TNF-αby splenocytes induced by TSST-1 ,but could not affect the prolifera-tion of T cells .

Objective To study the roles of serum tumor necrosis factor-α (TNF-α),sTNFR-Ⅰ and sT-NFR-Ⅱ in asthmatic children.Methods The levels of serum TNF-α,sTNFR-Ⅰ and sTNFR-Ⅱ in 60 asthmatic children,including 30 cases of acute exacerbation group and 30 cases of clinical paracmasia group,and 22 cases of healthy children (control group) were detected by ELISA.Results (1) The level of serum TNF-α in acute exacerbation group was (98.87 ± 16.25) ng/L,it is significantly higher than the clinical paracmasia group (62.19 ± 15.85) ng/L and control group (44.25 ± 10.44) ng/L (F =94.78,P ＜ 0.05).The level of serum sTNFR-Ⅰ and sTNFR-Ⅱ in acute exacerbation group were (11.14 ±2.04) μg/L and (11.81 ±2.14) μg/L respectively,they were significantly higher than their own clinical remission group (8.91 ± 1.63) μg/L and (9.36 ± 1.72) μg/L,also significantly higher than the control group (5.03 ± 1.18) μg/L and (5.21 ±1.23) μg/L,(F =83.03 and 87.62,all P ＜ 0.05).The levels of TNF-α,sTNFR-Ⅰ and sTNFR-Ⅱ in clinical paracmasia group were significantly higher than that in control group (P ＜ 0.05).(2) The levels of sTNFR-Ⅰ and sTNFR-Ⅱ in asthmatic children,both acute exacerbation and clinical paracmasia,were positively correlated (r=0.908,P ＜ 0.05 and r =0.737,P ＜ 0.05).Conclusion The level of TNF-α maybe indicate the inflammatory severity of asthma,and the changes of serum sTNFR-Ⅰ and sTNFR-Ⅱ were closely related with asthmatic airway inflammation.

Objective:To explore the correlation between white matter lesions (WML) at different locations and cognitive function.Methods:The cognitive function of 68 patients with WML in Beijing Electric Power Hospital from January 2019 to May 2020 were assessed with Montreal Cognitive Assessment Scale (MoCA), and the extent of WML were assessed with age-related white matter changes rating scale(ARWMCRs). Correlation between the ARWMCRs scores of different locations and the scores of all locations and the scores of cognitive function, as well as the relationship between the ARWMCRs scores of different locations and each subitem of cognitive function were analyzed.Results:In 68 patients with WML, the degree of lesions in different parts from heavy to light was frontal area, parietooccipital area, basal ganglia area and temporal area, and no white matter lesions were found in infratentorial area. Except the basal ganglia region, the ARWMCRs scores in other regions and the total score were negatively correlated with MoCA score, among which, the ARWMCRs score in left frontal area, right frontal area, left parietal pillow and right parietal pillow region had the strongest correlation with MoCA score( rs=- 0.388, - 0.479, -0.418, -0.502, all P<0.01).In WML patients, the left frontal area was negatively correlated with language, abstraction and orientation ( rs=- 0.479, - 0.324, - 0.288, all P<0.01).The ARWMCRs score in right frontal area was negatively correlated with visual spatial and executive function, memory, language, abstraction, and orientation ( rs=- 0.324, -0.272, -0.459, -0.382, -0.352, all P<0.05). The ARWMCRs score in left parietal occipital region was negatively correlated with visual spatial and executive function and memory ( rs =-0.287、- 0.270, all P<0.05). The ARWMCRs score in right parietal occipital region was negatively correlated with memory, language, abstraction and orientation ( rs=-0.366, -0.289, -0.260, - 0.307, all P<0.05).The ARWMCRs score in left temporal region was negatively correlated with language, abstraction and orientation ( rs=- 0.248, -0.372, - 0.608, all P<0.05).The ARWMCRs score in right temporal region was negatively correlated with abstraction and orientation ( rs=- 0.525, -0.465, all P<0.01).The ARWMCRs score in right basal ganglia was negatively correlated with orientation and memory ( rs=- 0.455, - 0.275, all P<0.01), while The ARWMCRs score in left basal ganglia was not correlated with MoCA subitems. Conclusions:The frontal area and parietal occipital area are the most serious lesions in WML patients, and the lesions in these two areas also cause the widest range of cognitive impairment.

Objective The aim of this study was to investigate the differences on origin distribution and radiofrequency ablation characteristics between premature ventricular contractions (PVC) from left and right ventricular.Methods A total of 354 frequent PVC patients were enrolled.Two hundred and eighty patients were PVCs with right ventricular origin (group RV) and 74 patients with left ventricular origin (group LV).The age,gender,ablation power,temperature and duration,time of target potential before QRS onset,fluoroscopic time,procedure time and success rate were compared between the two groups.Results Majority PVCs (79.10％) were of right ventricular origin,in which the most common site was at right ventricular outflow tract (RVOT) (55.93％);whereas,only 20.90％ were of left ventricular.There were significantly differences between group RV and group LV in age [(44.7 ± 13.6) yrs vs (49.6 ±15.9) yrs,P =0.017],gender [male:35.4％ (99) vs 55.4％ (41),P =0.002],time of target potential before QRS onset [(37.9 ± 16.2) msvs (31.3 ± 11.7) ms,P=0.008],procedure time [(85.1 ± 36.9) minvs (100.8 ± 45.5) min,P=0.017],fluoroscopic time [(12.3 ± 9.2) min vs (15.9± 10.8) min,P =0.028] and success rate (96.4％ vs 89.2％,P =0.012).Conclusions Radiofrequency ablation of PVCs was a safe and effective method.Subjects with RV PVCs are younger and more females than subjects with LV PVCs.The radiofrequency ablation for RV PVCs was easier,and the success rate was higher than that for LV PVCs.