Objective:To inspire students'interests in surgery,to enhance students observing,analyzing and problem-solving abilities and to explore methods of surgical teaching.Methods:According to typical cases,students referred to correlative information,wrote operations planning and implemented it.Results:All operations were completed according to their plans,the result of the survey shows that the overwhelming majority of the students approved of the teaching method and obtained good results,and in basic skills assessment the exam classes are superior to the control classes.Conclusion:In the process of surgery teaching,the implementation of designing experiment is feasible and can improve teaching effect.So it is necessary to set up designing experiment in surgery teaching of clinical medical specialty five-year program.

0.05). Median serum activities of CK was significantly higher in newborn delivered by forceps(256 U/L)than that in those of normal labor(220 U/L)and with C-section(204 U/L).But,pattern of delivery did not influence serum activity of CK and serum level of cTnI in newborns.Serum activities of CK and CK-MB were significantly lower in term newborns than in those of preterm ones(P

OBJECTIVETo observe the changes in the adhesive function of vascular endothelial cells (VEC) and rat monocytes induced by lipopolysaccharide (LPS) and co-cultured with smooth muscle cells (SMC) and the intervention effect of paeonol (Pae).

METHODPrimary rat vascular endothelial cells (VECs) and rat vascular smooth muscle cells (VSMCs) were cultured by predigesting and adhering tissue blocks. The VEC-VSMC co-culture model was established by Transwell chamber. LPS was used to induce VEC injury. MTT assay and LDH assay were used to determine the VEC activity. ELISA assay was used to detect IL-1beta and TNF-alpha secreted by the VEC. The immunocytochemistry assay was carried out to detect the expression of ICAM-1. The Rose Bengal Staining was used to test adhesive function between VECs and monocytes.

RESULTThe concentration of LPS-induced VEC injury was 100 microg x L(-1), and the time was 7 h. after the intervention on the above cell model for 24 h, Paeonol (15, 30, 60 micromol x L(-1)) could effectively inhibit LPS-induced VEC injury and VEC injury, significantly enhance the survival rate of LPS-injured VECs, decrease IL-1beta and TNF-alpha secreted by the injured VEC, and reduce the expression of ICAM-1, so as to inhibit the adhesion of LPS-induced VECs and monocytes.

CONCLUSIONPaeonol could inhibit IL-1beta and TNF-alpha expression to protect VECs from being injured by LPS, and reduce ICAM-1 expression to inhibit the adhesion between VECs and monocytes.

Acetophenones ; pharmacology ; Animals ; Cell Adhesion ; drug effects ; Coculture Techniques ; Endothelial Cells ; cytology ; drug effects ; metabolism ; secretion ; Gene Expression Regulation ; drug effects ; Intercellular Adhesion Molecule-1 ; metabolism ; Interleukin-1beta ; metabolism ; Lipopolysaccharides ; pharmacology ; Male ; Monocytes ; cytology ; drug effects ; Myocytes, Smooth Muscle ; cytology ; Rats ; Rats, Sprague-Dawley ; Tumor Necrosis Factor-alpha ; secretion

Motivational interviewing was a consultation model which centered on patients, and changed patients′unhealthy behaviors by changing their motivations, and promoting their health. Motivational interviewing had been widely used in improving the capacities of patients′self-management with chronic diseases in abroad. Through reviewing the application in chronic disease self-management of motivational interviewing at home and abroad, the paper pointed out the prospect and problems that needed to be solved in our country and provided references for further research on motivational interviewing in self-management of chronic diseases.

Objective To screen the abnormal glucose metabolism in pregnant women without diabetes and to give early intervention to reduce perinatal maternal and fetal adverse complications.Methods 2 579 pregnant women who received obstetric examination and revealed no diabetes,underwent GCT screening and OGTr reexamination.The results confirmed the 263 GIGT patients,22 GDM patients.They were givien intervention therapy until delivery and their pregnancy outcome was compared with the normal pregnant women.Results The pregnancy outcome of GIGT pregnant women received intervention and the normal pregnant women had no significant difference.The incidence rates of macrosomia and cesarean section in GDM group were higher than those of normal pregnant women (P ＜0.05,P ＜ 0.01).Conclusion Development of gestational abnormal glucose tolerance screening is important to the early diagnosis and intervention of potential IGT,GDM patients,which can significantly reduce the incidence rate of maternal and fetal adverse complications.

Objective To evaluate the effects and cosmetic results of total removal of the glands for male gynecomastia . Methods A total of 13 male patients with gynaecomastia were operated by using the method of keyhole-style total removal of the glands from March 2012 to March 2013.The fat lysate was injected into the subcutaneous area of the breast enlargement .Then an incision about 1.0 cm in length was made by the side of areola , through which a vacuum aspiration was carried out to suck the fat tissues.Also, the hypertrophical breast tissues were excised gradually .Finally, the incision was closed with medical biological adhesive or absorbable suture . Results The time of unilateral operation was 40-100 min ( average , 70 min) .The amount of blood loss was 20-50 ml (average, 30 ml).Subcutaneous effusion occurred in 2 cases (accompanying local hematoma in 1 case), which was cured by repeated aspiration for 3 days.The postoperative hospitalization was 2-5 days (mean, 2.8 days).All the patients were cured with incision healed by first intention and no obvious scars left .There was no necrosis on the nipple or areola .The breast curve was flat and natural .A total of 8 cases were followed up for 3 months, with satisfactory appearance .Three patients felt numbness of nipples and areola of breast after surgery and the symptom disappeared 3 months later . Conclusion Keyhole-style total removal of the glands for the male ynaecomastia has advantages of easy operation ,safety,and good cosmetic results .

Objective To observe rehabilitation and functional prognosis of patients suffered from brain infarction of acute phase complicated by depression. Method We selected 38 cases of acute brain infarct complicated with depression disorder as depression group, 40 cases of non－ depression patient admitted at the same period were selected as non depression group.Antidepressants drugs administration and rehabilitation therapy were performed.We evaluated patients according to functional independence measure(FIM)of Chinese edition. HAMD grading comparison was carried out in depression group. Result Before treatment,two groups score nearly the same,compared with pretreatment. After treatment,patients in depression group and non depression group showed significant improvement esp non－ depression group (P<0.01).11 cases with severe depression in the depression showed no changes in FIM score before and after treatment. Conclusion Compared with non－ depression patients,functional recovery of patients with depression following brain infarction of acute stage is much slower,especially for patients with severe depression.

Objective: To discuss the importance of pharmaceutical care in anti-infective treatment for one patient with severe pneumonia and renal insufficiency performed by clinical pharmacists. Methods: Clinical pharmacist participated in evaluating and changing the anti-infective treatment regimen, adjusted the drug dosage according to the renal function reasonably to avoid adverse drug reactions and completed the medication education and health education for the patient. Results:The infection was controlled effective-ly, gasp was controlled effectively and blood pressure was steady. Conclusion:Clinical pharmacists should monitor the whole treatment process,evaluate the drug regimen comprehensively and reduce adverse drug reaction to the maximum limit during the pharmaceutical care.

Objective To investigate the effect of triple therapy treatment combined danshen injection in treatnent of gastric ulcer. Methods Period gastroscopy 1 Hp-positive gastric ulcer diagnosed 70 patients as subjects,34 patients were randomly divided into two groups,control group 36 cases. Control group,omeprazole 20mg + amoxicillin clarithromycin 1.0g + 0.5g,2 times / d and treated for 7d,the observation group based in the control group given Danshen injection fluid 250ml, 1 times/d treatment intravenous infusion 7d,observe and compare the efficacy and side effects two groups. Results The total effective rate was observed 97.06% (34/33), significantly higher than the total effective rate 75.00% ( 27/36), by statistical analysis, the total effective difference between the two groups was significant (P < 0. 05). Before treatment, clinical symptom score difference between the two groups not significantly,after 6 weeks of treatment,clinical symptom score than those in the two groups before treatment significantly reduced( P <0. 01 ) ,and the difference between the two groups was significant( P <0. 05 ). Diminished appetite and the observation group 2 patients,nausea in 3 cases the control group, 1 case of anorexia, dizziness, headache in 1 case,were mild and tolerable, without treatment, treatment of and withdrawal go away. Conclusion Triple therapy omeprazole combined Danshen injection treatment of gastric ulcer lidocainefor with good ulcer symptoms disappeared and quick, was worthy of promotion and application.

[Objective]To investigate the etioloty of the early nerve root lesion(RNRL) after collagenase chemonucleolyoio(CC) and its prevention and treatment.[Method]Twelve-hundred and eighty case of lumbar disc herniation undergoint cc were reviewed and analyzed.From January,2000 to December,2004 with follow-up time of 4~30 months,in which 12 cases(0.94%)had obvious ENRL after CC.Eighteen rabbits were randomly divided into three groups of six each:Group A,posterior longitudinal ligament intepated+intradisca injection;group B,parterior longitudinal ligamen+booteen+intradiscal injection,and group C,extradiscae injection.The disc and the nerve roots at the inject side were removed,fixed and examined by microscope,and the changes of the discs end nerve roots were analyzed in different inject side and different time after CC.[Result]As the collagenase dose was large in groups of intradiscal+intradiscal injections case of ENRL in this group were more than that in other groups.In the 12 ENRL cases,ten cases of ENRL appeared in about 7 days after CC,8 cases without nerve root compression and all cases were improved in different degree,but no one reeovered completely at follow-up with excellent and good rate of efficiency in the cases operated in 3 days than that in cases operated after 8 days.In the experiment rabbits,there lowed obvious lyeis of nucleus.Pulpus in group A and group B,with severe damage of nerve roots in group B,while in group C,there was no obvious lipis of nucleuss pulpus and damage of nerve roots[Conclusion](1)As the larger collagenas dose in the cases with intradiscal and extradiscal injections can raise.The incidence of ENRL,it is suggested that CC used in cases with broken posterior longitudenal ligament of and brous anmulus and,with nucleus pulpuses herniated into spinal canal,CC should be prudent to apply.(2)The prognoseo of the ENRL after CC is poor and is related to operation time.(3)The incidence of ENRL after CC can be lowered with absolute bed rest and changing body position after CC.