Objective To explore the role of case based learning (CBL)on Otolaryngology-Head and Neck Surgery teaching. Methods First, correct and high-quailty teaching case was selected. Then, reasonable and precise question was edited. All students needed to prepare their lessons before class and were encouraged to ask question or answer question. And some warnings should be noticed. Result After CBL being implemented, the students received higher clinical grades and more clinical skills. They were more likely to retain their initial interest in or switch their preference to careers in otolaryngology. The supervisor highly appreciated our teaching. Conclusion CBL is feasible in Otolaryngology-Head and Neck Surgery teaching and it should be applied more in future.

Objective To compare the immunoregulatory effects of Radix Millettia Speciosa (RM Speciosa) and Radix Millettia Championi (RM Championi)on immunosuppressed mice.Methods Kunming mice were randomly divided into normal control group,CTX model group,LMS positive group,RM Speciosa groups and RM Championi groups (20,10 and 5 g/kg).The mice were treated respectively with drug or NS once a day for consecutive 20 days.Mice in the other groups were injected intraperitoneally with CTX at days 8,10 and 12 to establish immunosuppressed mice model except the normal group.The changes of body weight,immune organ weight,white blood cell (WBC)number,carbon particle clearance capability of macrophages and delayed type hypersensitivity (DTH)of mice in all groups were determined and compared.Results Compared with that in CTX group,the WBC number was significantly increased (P<0.01 or P<0.05)and the degree of DTH (P<0.01) was enhanced at different doses in RM Speciosa groups and RM Championi groups.The activity of macrophages and the index of thymus and spleen were also improved in the treatment groups (P<0 .0 5 or P<0 .0 1 ).The index of thymus and the degree of DTH in RM Speciosa groups (20 and 10 g/kg)were slightly higher than those in the corresponding RM Championi groups (P<0.01 or P<0.05).For other indicators,RM Speciosa groups did not significantly differ from RM Championi groups (P>0.05).Conclusion Both RM Speciosa and RM Championi can improve the immune function of CTX-induced immunosuppressed mice,and RM Speciosa is slightly superior to RM Championi in improving specific cellular immunity.

Objective:To investigate parents′ knowledge and attitude toward post-operative pain management in pediatric orthopedics and analyze influencing factors.Methods:A total of 170 parents of 6 to 16 years old children who underwent selective surgeries and were hospitalized because of limb fracture were conveniently selected in Children′s Hospital of Soochow University from April to December in 2019, They were investigated using the general data questionnaire, Pain Management Knowledge and Attitudes Questionnaire.Results:There were 167 parents completed questionnaires in our study. The mean score of parents′ knowledge, general attitude and negative attitude to pain medication were 15.0(3.00), 24.0(4.00) and 17.0(3.00) respectively. There were statistical differences between different educational levels of parents′ knowledge ( χ2 value was11.599, P=0.021), as well as different age of parent′s general attitude ( χ2 value was 7.053, P=0.029). Spearman-related results showed that parents′ cognition was positively correlated with general attitudes ( r value was 0.394, P<0.01). Conclusions:The majority of parents are at moderate to high level of knowledge, general attitude and negative attitude to pain medication. Pediatric nurses should pay more attention to parents′ knowledge deficit of and negative attitude toward pain assessment tools and pain-drugs to develop targeted educational intervention programs for promoting parental involvement.

A 41-year-old woman with liver cirrhosis had recurrent portal hypertension and bleeding from esophageal varices due to complete occlusion of a previously inserted transjugular intrahepatic portosystemic shunt stent. Because recanalization of the stent by the transjugular approach was unsuccessful, ultrasound-guided entry to the splenic vein and portal vein was used. After catheter-directed intrathrombus thrombolysis, successful opening of the stent was achieved and a stent was placed. We herein report a rare case in which thrombolysis and recanalization of a TIPS stent were performed via a percutaneous transhepatic approach.
Adult ; Esophageal and Gastric Varices/etiology/*surgery ; Female ; Humans ; Hypertension, Portal/etiology/*surgery ; Liver Cirrhosis/complications ; Portasystemic Shunt, Transjugular Intrahepatic/*adverse effects ; Reoperation ; Stents/*adverse effects ; Vascular Patency

The potential of a Sinorhizobium fredii strain producing a copolymer polyhydroxyalkanoate(PHA)from glucose and sodium decanoate substrates was studied in this paper.Using orthogonal design in a flask-shaker culture system,the culture medium,some culture conditions and vital regulation conditions for polymer synthesis were optimized.These optimized results were applied into further studies in two-stage fed-batch with a 10L fermentor.The whole culture process consisted of two stages,that is,the cell growth and the copolymer production.The first stage was for the cell growing to a desired biomass and the second was for the copolymer synthesis.For producing PHA polymers,the selected 8 mM sodium decanoate was added into the broth by adopting a two-step adding method for avoiding of foaming when the biomass had approached 28.5g/L dry cell.The maximum P(HB-HH)production could be 17.55 g/L with a monomer ratio of 79.4%(W/W)3-HB and 20.6%(W/W)3-HH.The molecule constitute of the copolymer is poly(3-hydroxybutyrate-co-3-hydroxyhexanoate)[P(HB-HH)] and its molecular weight(MW)is 1.4?105D.The results demonstrated that the employed S.fredii strain could be a potential candidate for industrial production of the copolymer.The fermentation parameters acquired in the experimental system offered some valuable references for studying large-scale production of the copolymer.

Objective To evaluate the effects of nucleoside/nucleotide analogue treatment on immunoglobulin and complement in patients with chronic hepatitis B (CHB).MethodsA total of 157 CHB patients were recruited and divided into CHB group,liver cirrhosis (LC) group and severe hepatitis B (SHB) group.There were 50 patients who received oral antiviral treatment (lamivudine 100 mg/d,or entecavir 0.5 mg/d,or telbivudine 600 mg/d).Serum levels of complement 3 and 4 (C3,C4),C-reaction protein (CRP),hemolytic complement (CH50),immunoglobulin G,M,A (IgG,IgM,IgA),hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) were detected by enzyme-linked immunosorbent assay (ELISA) or immunoturbidimetry.Hepatitis B virus (HBV) DNA was quantified by real-time polymerase chain reaction (RT-PCR) before and 1,2,3 and 4 weeks after nucleoside antiviral therapy.Comparison of means was done by t test and Mann-Whitney test.The correlation was analyzed by Pearson correlation coefficient test.ResultsSerum IgA and IgM levels of SHB and LC patients were significantly higher than those of CHB patients (P＜0.01).Levels of C3,C4,CH50 and CRP were significantly different among three groups.Levels of C3,IgM,IgG and HBV DNA in HBeAg positive patients were significantly different from those in HBeAg negative patients.There was a statistically significant difference of IgA,IgM,C3 and CH50 levels between patients with high HBV DNA level and low HBV DNA level in HBeAg-positive patients.While in the HBeAg-negative patients,only the IgA level was significantly different with HBV DNA levels.After anti-viral treatment,immunoglobulin and HBV DNA levels were all decreased in three groups,while the serum complement level was increased compared to baseline,and the differences became significant at week 4 of treatment. HBV DNA level was negatively correlated with C3 (r=-0.78,P=0.021) and HBeAg titer was positively correlated with C3 (r=0.87,P=0.015).ConclusionsThe immunoglobulin,CRP,C3,C4,and C H50 could reflect the inflammatory activity in liver.The changes of C3 level can predict the efficacy of antiviral therapy.

AIM: To observe the effect of partial liquid ventilation with perfluorocarbon on gas exchange, hemodynamics and lung histological change in the piglets with surfactant depletion-induced acute lung injury. METHODS: 12 piglets were treated by lung lavage to a partial pressure of oxygen in arterial blood (PaO 2) below 100 mmHg for one hour and randomly divided into gas ventilation group (control group) and partial liquid ventilation (PLV) group, in PLV group, piglets received PFC (FC3280) intratracheally at doses of 15 mL/kg. The parameters of gas exchange and hemodynamics were measured before lung lavage, after lung lavage when the acute lung injury (ALI) was established, and 1 hour, 2 hours after ALI. Animals underwent euthanasia at the end of the study, lung histologic analysis followed. RESULTS: Surfactant depletion by lung lavage induced a stable acute lung injury.Gas exchange increased markedly in the animals that underwent PLV, less hemodynamic damage was observed in PLV group compared with the animals in GV group. Lung histologic analysis demonstrated a less lung damage, including atelectasis, neutrophil excudation, intra-alveolar hemorrhage and interstitial edema in PLV group compared with control group. CONCLUSION: In piglets with surfactant depletion-induced acute lung injury, partial liquid ventilation with perfluorocarbon can improve the gas exchange with less adverse hemodynamic effect and less lung injury compared with conventional gas ventilation.

AIM: To observe the effect of partial liquid ventilation on gas exchange and histopathological changes of lung in acute lung injury. METHODS: After acute lung injury (ALI) was induced by saline lavage,twenty piglets were assigned randomly to 2 groups: partial liquid ventilation with perfluorocarbon (PFC) group (PLV) and conventional gas ventilation group (CV). The changes of gas exchange were examined before ALI, during ALI and at 1,2,3,4 h after ALI, and histological sections taken from 8 different parts of lung were stained by H & E. RESULTS: The PaO_2 significantly increased and alveolar-aterial oxygen gradient (AaDO_2) markedly decreased in PLV group compare with CV group (P

AIM: To investigate the anti-inflammatory effect of partial liquid ventilation in the piglets with lung lavage-induced acute lung injury. METHODS: 16 piglets were treated by lung lavage to a partial pressure of oxygen in arterial blood (PaO_2) below 100 mmHg for one hour and randomly divided into mechanical ventilation group (MV group) and partial liquid ventilation group (PLV group). Blood-gas analysis, hemodynamics, the contents of TNF-?, MDA, SOD, and MPO activity in lung tissue were measured. RESULTS: (1) Lung W/D, PPI and the count of WBC in the BALF in PLV group were significantly lower than those in MV group. The contents of MDA and MPO in lung tissue in PLV group were significantly lower than those in MV group. However, no evident difference in SOD activity in lung tissue between two groups was observed. (2) The contents of TNF-? in lung tissue in PLV group were significantly lower than those in MV group. CONCLUSION: Partial liquid ventilation with perfluorocarbon has anti-inflammatory effect on lung lavage-induced acute lung injury in the piglets.

Objective To establish an early cognitive disorder model in rats and investigate the early cognitive functioning after ischemic hypoxic brain injury during the neonatal period. Methods Forty-six newborn Sprague-Dawley rats were randomized into a 21-d-old group and a 31-d-old group. These 2 groups were then subdivided into model and sham-operated subgroups (M21, n=12; SH21, n=11; M31, n=12; SH31, n=11). A model of neonatal early cognitive disorder was established in the rats of the M21 and M31 groups using a modification of Rice's method. Rats in the SH21 and SH31 groups received skin incisions and common carotid artery separation without ligation or hypoxia. Each group was tested with a Morris water maze. The rats were sacrificed after testing, and brain tissue was examined under the electron microscope. Nissl staining allowed Nissl body quantification and neurocyte acin the M21 group was significantly longer than in the SH21 group. The 31-d-old subgroups had shorter average escaping latencies than the corresponding 21-d-old subgroups. (b) Spatial memory: The average platform times, Ⅰ region times and Ⅰ region distances showed no significant differences among groups. ②Brain pathology (a) Gross appearance: Obvious ischemic hemisphere atrophy was observed in the M group, and no abnormality was observed in the SH group. (b) Electron microscopic observation: In the SH group cell ultrastructures in the ischemic hippocampus were normal. Karyopyknosis and dilated endoplasmic reticulums were found in the M group. More mitochondria were found in the presynaptic membranes of the ischemic hippocampus in the M group than that in the SH group. (c) Nissl body quantification and neurocyte activity analysis: Significantly less activity in the ischemic cortex was found in the M21 group compared to the SH21 group. More activity was observed in the 31-d-old subgroups than in the corresponding 21-d-old subgroups. Conclusions ①The neonatal rats with ischemic hypoxic brain injury had prolonged average escaping latency and depressed neuronal activity. ②The 31-d-old rats had better spatial localization learning ability than the 21-d-old rats.