The efficacy of constructivism teaching mode in physical diagnostics teaching was evaluated in this study. We built up the constructivism teaching mode in diagnostics teaching taking the clinical symptoms as the theme, and through such aspects as courseware design, teaching plan preparation, SP playing and inquiry, SimMan simulated physical examination, condition analysis, etc. Then questionnaires were conducted to analyze the role of the constructivism teaching mode in diagnostics teaching. The diagnostics constructivism teaching mode can provide students with a platform for self-construction of diagnostics and integrated application of knowledge. Meanwhile, students' sense of participation can be improved and multiple learning skills are enhanced during the course.

Poly (propylene fumarate) is an unsaturated linear polyester, which degrades, in the presence of water, into propylene glycol and fumaric acid, and the degradation products can be cleared from the human body by normal metabolic processes. In this paper, different methods of the synthesis of PPF are listed, the crosslinking characteristics of polymerizing composite as well as the mechanical properties of cross-linked composite are discussed, and the potentialities of PPF composite used as particularly degradable polymeric cement for orthopedic application are reviewed.
Biocompatible Materials ; chemical synthesis ; Biodegradation, Environmental ; Cross-Linking Reagents ; chemical synthesis ; Fumarates ; chemical synthesis ; chemistry ; Humans ; Polypropylenes ; chemical synthesis ; chemistry

Objective To investigate the expressions of Toll-like receptor (TLR)-1,TLR-3,TLR-9 in peripheral blood mononuclear cells (PBMC) of children with idiopathic nephrotic syndrome (INS).Methods The expressions of TLR-1,TLR-3 and TLR-9 mRNA were measured by real time-polymerase chain reaction (RT-PCR) in PBMC of 45 children with INS came from the First Affiliated Hospital of Xinxiang Medical University before and after treatment (active group and remission group,respectively) and 30 healthy children from medical examination center as healthy control group,so as to explore the relativity between TLR-1,TLR-3 and TLR-9 mRNA and serum levels of albumin and cholesterol.Results The expression of TLR-1 mRNA/β-actin in PBMC of children with INS before treatment (the active group) was significantly higher than that in the remission group (2.432 ± 0.231 vs.1.675 ± 0.627,t =7.599,P ＜ 0.05) and the healthy control group (2.432 ± 0.231 vs.0.512 ± 0.228,t =35.446,P ＜0.05),and the differences were statistically significant in the expression of TLR-1 mRNA/β-actin between remission group and healthy control group (1.675 ± 0.627 vs.0.512 ± 0.228,t =9.722,P ＜ 0.05).The expression of TLR-3 mRNA/β-actin in PBMC of children with INS before treatment (the active group) (0.987 ± 0.124) was significantly higher than that in the remission group (0.501 ± 0.016) and the healthy control group (0.021 ± 0.001),the differences were statistically significant (t =26.076,42.571,all P ＜ 0.05),and the remission group was significantly higher than that in healthy control group (t =163.732,P ＜ 0.05).The expression of TLR-9 mRNA/β-actin in PBMC of children with INS before treatment (activity group) (1.965 ±0.952) was significantly higher than that in the remission group (1.336 ±0.282) and the healthy control group (0.790 ±0.731),the differences were statistically significant (t =4.249,5.734,all P ＜ 0.05),and the remission group was significantly higher than that in healthy control group (t =4.541,P ＜ 0.05).The serum levels of albumin in children with INS before treatment (activity group) (23.62 ± 11.67) g/L was significantly lower than that in remission group (42.19 ± 16.33) g/L and healthy control group (46.88 ± 14.80) g/L,and the differences were statistically significant (t =-6.20,-7.58,all P ＜0.01).The serum levels of cholesterol in children with INS before treatment (the active group) (9.54 ±2.53) mmol/L was significantly higher than that in the remission group (3.01 ± 1.72) mmoL/L and the healthy control group (2.89 ± 1.66) mmol/L,and the differences were statistically significant (t =14.32,12.677,all P ＜ 0.01).The serum levels of albumin and cholesterol in children with INS after treatment were not statistically significant difference compared to the healthy control group (t =-1.264,0.30,all P ＞ 0.05).The correlation analysis showed that there was a negative correlation between the expressions of TLR-1,TLR-3 and TLR-9 mRNA and the serum level of albumin in PBMC of children with INS before treatment (r =-0.457,-0.891,-0.125,respectively,all P ＜ 0.05).However,there was a positive correlation between the expressions of TLR-1,TLR-3 and TLR-9 mRNA and the serum level of cholesterol (r =0.445,0.911,0.872,all P ＜ 0.05).Conclusions The expressions of TLR-1,TLR-3 and TLR-9 mRNA in PBMC of children with INS were significantly higher and correlated with activity of disease.

Objective To investigate the expression level of serum microRNA-663 (miR-663) in nasopharyngeal carcinoma (NPC) patients and its relationships with clinicopathological features and prognosis.Methods The serums of 60 NPC patients (NPC group),40 patients with nasopharyngeal chronic inflammation (nasopharyngitis group) and 30 healthy subjects (health control group) were collected from June 2014 to April 2017 in our hospital.The relative expression levels of serum miR-663 were detected by quantitative real time polymerase chain reaction (qRT-PCR).The relationships between the expression of miR-663 and clinicopathological features were analyzed.The diagnostic value of serum miR-663 in patients with NPC was analyzed by receiver operating characteristic (ROC) curve.According to the optimal cut-off value determined by the ROC curve,the patients were divided into miR-663 ≥ optimal cut-off value group and miR-663 ＜ optimal cut-off value group,and prognosis analysis was performed for the two groups.Results The relative expression levels of miR-663 among NPC group (6.38 ± 2.05),nasopharyngitis group (3.11 ± 0.97) and health control group (1.74 ±0.75) were significantly different (F =107.722,P =0.001).Serum miR-663 level in NPC group was significantly higher than that in nasopharyngitis group and healthy control group,with significant differences (both P ＜0.001).The relative expression level of miR-663 in nasopharyngitis group was significantly higher than that in health control group,with a significant difference (P ＜ 0.001).The relative expression of serum miR-663 in patients with NPC was not related to patient's age,sex and differentiation (t =1.832,P =0.072;t =0.578,P =0.565;F =0.132,P =0.877).The relative expression of miR-663 in stage Ⅰ-Ⅱ (5.24 ±1.98) was significantly lower than that in stage Ⅲ-Ⅳ (6.99 ± 1.84) of NPC patients,with a significant difference (t =3.417,P ＜ 0.001).The relative expression of serum miR-663 in patients with lymph node metastasis (7.55 ± 1.38) was significantly higher than that in patients without lymph node metastasis (4.62 ± 1.60),with a significant difference (t =7.572,P =0.001).The analysis of the diagnostic value of serum miR-663 in patients with NPC using the ROC curve showed that the area under the curve (AUC) of miR-663 was 0.939.When the optimal cut-off value of miR-663 was 3.190,the sensitivity was 80.0％ and the specificity was 89.0％.The median survival time in miR-663 ≥3.190 group (21.7 months) was significantly shorter than that in miR-663 ＜3.190 group (33.4 months),with a significant difference (x2 =4.332,P =0.037).Conclusion The relative expression level of serum miR-663 in patients with NPC is increased,and the expression level of miR-663 is related to lymph node metastasis and clinical stage.High expression of miR-663 predicts poor clinical outcomes,and miR-663 may be a potential predictor of prognosis in patients with NPC.

OBJECTIVE: To explore the clinical effect of the free radial forearm flap on repairing tissue defects and reconstructing functions after tumor resection.
 METHODS: From January, 2003 to December, 2011, 70 patients, including 43 squamous cell carcinomas of tongue, 12 buccal cancers, 5 carcinomas of the soft palate, 4 basal cell carcinomas of external nose, 3 lower lip cancers, 2 upper lip cancers, and 1 posterior wall of hypopharynx carcinoma, with the soft tissue defects in the head and neck underwent reconstructive operations with the free radial forearm flap after the malignant tumor resection. The area of defects ranged from 5 cm × 4 cm to 14 cm × 8 cm with the process of diseases from 4 to 30 months. The technique for grafting the free radial forearm flap and the appearance at sites of the donor and recipient, and the influence on the anatomy and function in both local sites were analyzed.
 RESULTS: In the 70 patients, only 1 case of flap appeared necrosis due to venous reflux obstacle, and the remaining (98.4 ﹪) survived. During the follow-up for 12-36 months, one case of hypopharyngeal carcinoma died from distant metastasis a year later, 2 cases of tongue cancer died of cardiovascular accident. Morphology and function for the sites at donor and recipient were satisfactory.
 CONCLUSION Free radical forearm flap is a good choice for the repair and functional reconstruction for tissue defects after tumor resection.
Forearm ; Head and Neck Neoplasms ; surgery ; Humans ; Reconstructive Surgical Procedures ; Skin Transplantation ; Surgical Flaps ; Treatment Outcome