Emergency practice is an important part of clinical study.At present,the emergency teaching content of general practice is so wide that the teaching time is not enough,We do not pay enough attention to the cultivation of clinical thinking,pre-hospital care,two-way referral,and first aid skills training and so on.In this paper,the development of community emergency oriented teaching content,cultivation of de-escalation clinical thinking,and the pre-hospital emergency training and other aspects are studied for the students' teaching in emergency practice in order to improve the clinical practice teaching level of general medicine sttdents.

Objective To investigate the risk factors in the outcome of neonatal pulmonary hemorrhage. Methods A total of 69 cases of neonatal pulmonary hemorrhage from January 2005 to December 2011 were studied. They were divided into 2 groups according to clinical outcome (death or alive). The data of the two groups were compared using single factor analysis. The risk factors were analyzed using multi-factor analysis. Results The death of neonates with pulmonary hemorrhage was correlated with aspiration pneumonia, coagulation abnormalities, DIC, heart failure and MPV. Multi-factor analysis showed that DIC (OR=6.90, 95%CI:1.514-31.419), heart failure (OR=9.62, 95%CI:1.710-54.150) and MPV<11 prior to pulmonary hemorrhage (OR=7.01, 95%CI:1.475-33.312) were the independent risk factors of neonatal pulmonary hemorrhage. Conclusions For the neonatal pulmonary hemorrhage with DIC, heart failure and low MPV, active intervention should be implemented.

Objective To explore the role of zinc finger protein (ZNF)185 in the proliferation of human glioma cells. Methods Human glioma tissues and tumor adjacent tissues were obtained from glioma patients diagnosed pathologically in Tangshan Gongren Hospital from January 2011 to December 2013. Total protein was extracted from different tissues. The ZNF185 expression was detected by Western-blot assay. Total RNA was extracted from tumor adjacent tissues. ZNF 185 cod?ing sequence was obtained by RT-PCR and inserted into pEGFPC2 plasmid to construct the ZNF185 expression vector. Li?pofactamine2000 was used to transfect the ZNF185 expression vector to human glioma cell SF767. pEGFPC2 blank vector transfected SF767 cells were used as control. Changes of cell cycle were analyzed by flow cytometry, and cell proliferation was analyzed by MTT assay. Results The expression of ZNF185 decreased significantly in human glioma tissues compared to that of tumor adjacent tissues(P<0.01). The over expression of ZNF185 in SF767 resulted in the increased proportion of cell cycle G0-G1phase, but decreased proportion of S phase(P<0.05). Furthermore, the cell proliferation was significantly inhibited in the ZNF185 over-expressed SF767 cells compared with that of blank vector transfected cells(P<0.05). Con?clusion ZNF185 plays an inhibitory role in cell proliferation of human brain glioma cells.

Objective:To explore the effect of Zinc finger protein 185 (ZNF185) on the migration of human gliocytoma cells. Methods: ZNF185 protein expression in human gliocytoma and its adjacent normal tissues was detected through Western blot. The ZNF185 gene was cloned and transfected into the human gliocytoma cell line SF767. ZNF185 cells were located through immunofluo-rescence staining, and cell migration was analyzed using the cell scoring method. Results:CZNF185 protein expression was lower in the human gliocytoma cell line than in normal para-neoplastic tissues. ZNF185 protein was mainly expressed in the cytoplasm and cell membrane of the human gliocytoma cells and was co-located with F-actin. ZNF185 overexpression repressed the migration of human gliocytoma cells. Conclusion:ZNF185 represses the migration of human gliocytoma cells by binding to F-actin.

Objective To observe the effects of VEGF antisense oligonucleotide on growth of micrangium of xenograft in nude mice.Methods VEGF-ASODN was synthesised.After transfection with VEGF-ASODN,RNA copy was detected by real-time PT-PCR,VEGF protein was examined by ELESA,Survival of cells was tested by MTT.Growth of cells was shown by growth curve.After the model of human gastic cancer xenografts in nude mice was developed,model animals were divided randomly into three groups:antisense group、scrambled group and saline group.ResultsVEGF-ASODN can reduce the VEGF mRNA and VEGF protein in cells and supernate remarkably.Survival and growth of cells were suppressed.It can significantly reduce VEGF protein in serum of nude mice.It also reduced the volum and weight of xenografts.Density of micrangium decreased in xenografts.Conclusion VEGF-ASODN can suppress the growth of micrangium in xenografts.

Objective To investigate the clinical characteristic and treatment of dieulafoy lesion in order to improve the early diagnosis and treatment.Methods A retrospective review of clinical records of 15 cases of dieulafoy lesion admitted to our emergency department from October 2005 to August 2012 was carried out.Results The male patients were more vulnerable to this disease than female patients,thereby the ratio of male to female patients was 6.5∶ 1,and the mean age was 48.3 years.The precipitating factors were often obscure,and some possible factors were related with certain amount of wine (1/15),using nonsteroidal anti-inflammatory drugs (2/15),and eating irritant food (2/15),and a few patients had a past history of hypertension (3/15) or diabetes mellitus (5/15) and no patient had past history of peptic lesion and cirrhosis of liver.The Dieulafoy' s lesion occurred suddenly without premonitory symptoms such as pain or upset of stomach,presented with the episodes of hematemesis or hemafecia,and the patients were in a stage of shock and moderate to severe anemia because of massive blood loss.The majority of lesions located at the posterior wall of the stomach (9/15) or adjacent to the lesser curvature (10/15).Endoscopy was of prime importance for confirming the diagnosis of Dieulafoy's lesions.Endoscopic treatments included hemostasis with clipping combined with epinephrine submucosa injection and successfully excising the lesion in 14 patients (14./15).Surgical treatment was done in 1 patient after failure of endoscopic treatments.Conclusions Dieulafoy lesion is characterized by sudden massive hemorrhage of the alimentary tract,it most commonly locates in the pars posterior of stomach adjacent to the lesser curvature in the middle-aged and the elderly males.Endoscopy is the most simple and essential method to confirm the diagnosis,and emergency endoscopic hemostasis with clipping for treating Dieulafoy lesion is an effective therapeutic strategy.

This study analyzes the strength,weakness,opportunity and threat(SWOT)of laboratory certification and accredi-tation on detection of parasitic diseases by SWOT analysis comprehensively,and it puts forward some development strategies spe-cifically,in order to provide some indicative references for the further development.

Purpose:To study the therapeutic effects of beta-ultrasound guided percutaneous alternating cryogenic- heating therapy(ACHT) through liver puncture combined with other regional therapy for advanced hepatocellular carcinoma. Methods:68 patients with advanced hepatocelluar carcinomas were divided into 4 groups.Group A,17 patients are treated with ACHT plus transcatheter hepatic arterial chemoembolization(TACE).Group B,16 patients were treated with ACHT plus intravenous chemotherapy;GroupC,19 patients were treated with TACE only;GroupD,16 patients were treated with in- travenous chemotherapy only.Results:In ACHT+TACE group,the rate of complete response(CR) plus partial response (PR) was 88.2%,the 0.5-,1-year survival rates were 94.1%,94.1%,the rate of AFP decreased was 84.6%.In ACHT+ ICT group,the rate of complete response(CR) plus partial response(PR) was 87.5%,the 0.5-,1-year survival rates were 87.5%,68.8%,the rate of AFP decreased was 78.6%.In the TACE group,the rate of complete response(CR) plus par- tial response(PR) was 57.6%,the 0.5-,1-year survival rates were78.9%,42.1%,the rate of AFP decreased was 69.2%. In ICT group,the rate of complete response(CR) plus partial response(PR) was 25.0%,the 0.5-,1-year survival rates were 50.0%,18.8%,the rate of AFP decreased was 41.7%.For CR+PR,ACHT+TACE group and ACHT+ICT group were significantly higher than TACE group and ICT group,but significant changes between ACHT+TACE group and ACHT +ICT group were not found.For survival rates,ACHT+TACE group was significantly higher than the other 3 groups, ACHT+ICT group was significantly higher than ICT group.There were no serious side effects after chemotherapy except that 5 patients' leucocytes decreased to degree Ⅲ.The postoperative complications after ACHT included bleeding,hemoglo- binuria and reactive thoracic,which disappeared after short term treated.Conclusions:Alternating cryogenic-heating therapy (ACHT) through liver puncture combined with other regional therapy is effective in treating advanced hepatocellular carci- noma and its side effects and postoperative complications are mild.

Animals ; Cadherins ; metabolism ; Carcinoma, Hepatocellular ; metabolism ; pathology ; Catenins ; metabolism ; Epithelial-Mesenchymal Transition ; drug effects ; genetics ; Humans ; Liver Neoplasms ; metabolism ; pathology ; MicroRNAs ; genetics ; metabolism ; Transforming Growth Factor beta ; pharmacology

As one of the species of soil-transmitted helminths (STH), hookworm infection is widely prevalent in tropical and subtropical developing countries. Hookworm is harmful to human health mainly including anemia, digestive tract symptoms, female infection can also cause menopause, abortion, infection in infants and young children can lead growth retardation. With the development of economy and implementation of mass drug administration strategies, the infection of hookworm in human body has decreased continuously, but there are still a large number of mild infection cases which clinical symptoms are not obvious, easy to cause missed diagnosis and misdiagnosis. Several zoonotic hookworm species can cause large-scale infections in cats, dogs and other animals, so as to increase the risk of human hookworm infection. Therefore, it is important to find a highly sensitive and rapid detection techniques to identify hookworm species. In this paper, the existing detection techniques of hookworm were reviewed and their application were prospected to provide ideas for hookworm detection at present situation.