After-department examination palys an important role in clinical teaching.The level of clinical teaching is one of the most important markers to evaluate the whole quality of the hospital.To improve the ability of teaching and teaching concept,we summarized the problem of after-department examination and put forward a series of reformation methods.

Polycystic ovary syndrome (PCOS) is one of the most popular diseases in obstetrics and gynecology research at internal and abroad at present, traditional Chinese medicine(TCM)in the clinical treatment of the disease have the advantage. Clinical epidemiological study of descriptive research method this research adopts investigation, observation of TCM syndromes and improper diet through 401 cases in Jiangsu Province confirmed PCOS patients, to explore the relationship between TCM syndrome type distribution and improper diet factors, and to provide the clinical basis for further etiology of this disease research. TCM syndrome type distribution of the disease is kidney deficiency, phlegm stagnation syndrome, qi stagnation and blood stasis syndrome, syndrome of dampness heat of liver channel and is composed of 4 basic syndromes and formed complex syndrome, and the composite and syndrome type (60.85%); combined with the analysis of traditional Chinese medicine dialectical, Pure empirical syndrome this disease (46.88%), followed by the actual card (45.39%), pure deficiency is rare. Improper diet factors associated with the disease, in which improper diet with different TCM syndrome type distribution significantly related. Stagnation of phlegm dampness syndrome is the main syndrome of the disease type, improper diet factors and every syndrome PCOS type distribution is as follows: the partial eclipse fatness greasy with basic syndromes of phlegm dampness stagnation of kidney deficiency syndrome, the nephrasthenia syndrome is less; eating spicy stimulation by basic syndromes of stagnation of Qi and blood stasis; eating cold people the basic certificate type of qi stagnation and blood stasis; The diet of patients are more prone to stagnation of phlegm dampness syndrome.
Adolescent ; Adult ; China ; Diagnosis, Differential ; Diet ; Eating ; Female ; Humans ; Medicine, Chinese Traditional ; Polycystic Ovary Syndrome ; diagnosis ; metabolism ; physiopathology ; Young Adult

Adult ; Causality ; Death, Sudden ; epidemiology ; Female ; Herbicides ; poisoning ; Humans ; Male ; Middle Aged ; Paraquat ; poisoning ; Retrospective Studies ; Young Adult

Adult ; Aged ; Alveolar Ridge Augmentation ; methods ; Dental Implantation ; methods ; Female ; Humans ; Male ; Maxillary Sinus ; surgery ; Middle Aged

Chemokines are major regulators of cell transformation and adhesion.Recent study has demonstrated that CXCR7 can bind to CXCL11 and CXCL12 with high affinity,and the activated CXCR7 may influence tumor invasion and metastasis by regulating extracellular matrix (ECM) and epithelial-mesenchymal transition (EMT) and other signal transduction pathways.Therefore,in-depth study of the molecular mechanisms of CXCR7 in tumor invasion and metastasis may provide a more effective theoretical basis for tumor treatment.

BACKGROUND: Observation and comparison about space-occupying lesions due to herniated nucleus pulposus, as well as nerve root compression in lumbosacral disc herniation and manipulative therapy are easily available; however, there is still lack of related quantitative research regarding the internal pressure in herniated nucleus pulposus.OBJECTIVE: To observe the influence of the internal pressure in herniated nucleus pulposus on nerve root compression in patients with lumbosacral disc herniation.DESIGN: Case control study.SETTING: Bone Setting Therapeutic Center, the Air Force General Hospital of Chinese PLA.PARTICIPANTS: Totally 30 patients with lumbosacral disc herniation received operation in the Orthopedic Department of the Air Force General Hospital between October 2002 and December 2003; meanwhile, 15 patients with lumbosacral disc herniation received manipulative therapy in the Bone Setting Therapeutic Center of the same hospital.ing positive group and negative group according to the results of straight leg raising test. The pressure in herniated nucleus pulposus was detected during operation, and the straight leg raising height was also recorded beThe size of intervertebral disk herniated nucleus was presented by the maximum vertical distance from the intervertebral disk herniating apex to the posterior edge of vertebra on CT and/or MRI transverse section.raising height.RESULTS:Totally 30 patients received operative treatment whereas 15The pressure in lumbosacral disc herniated nucleus andthe size of herniated nucleus pulposus: as for patients who received operation, the pressure in herniated nucleus pulposus was obviously higher in positive group than in negative group [(2.119±0.753), (0.483±0.420) kPa, P ＜ 0.01]. However,the size of herniated nucleus pulposus was not significantly different between positive group and negative group [(4.688±1.991), (4.857±2.033) mm,nipulative therapy, their straight leg raising height was obviously increased compared to that before operation [(54.000±16.388)°, (72.668±15.338)°,P ＜ 0.01], but the size of herniated nucleus pulposus was proved not obviously changed by CT or MRI examination after manipulative therapy (P ＞ 0.05).cleus pulposus on nerve root is related to the iuternal pressure of herniated nucleus pulposus; higher internal pressure in herniated nucleus pulposus would limit straight leg raising height while lower internal pressure has less effect. However, the compression of herniated nucleus pulposus on nerve root has no obvious relationship with the size of herniated nucleus compression by reducing the internal pressure in herniated nucleus pulposus, which may not only depend on changing the space-occupying of herniated nucleus pulposus.

Objective To analyze the complications, treatments and prognosis of simultaneous pancreas-kidney transplantation. Methods Forty cases of simultaneous pancreas-kidney transplantation performed between Dec. 1999 and Jan. 2010 in our center were retrospectively analyzed. Results Regarding surgical complications, 4 cases had severe hematuria after operation,which needed clinical intervention, including 1 patient receiving catheterization in duodenum to stop bleeding. Two patients were treated with continuous bladder irrigation, and the remaining one received surgical haemostasis because of donor's duodenum and bladder anastomotic artery hemorrhage.Abdominal hemorrhage occurred in 4 patients, including pancreatic hemorrhage in 3 cases and duodenal muscularis hemorrhage in one case. All of them received surgical treatment for hemostasis.Abdominal infection occurred in 8 cases: one died of multiple organ failure, 2 cases were cured after drainage of abscess, 2 cases underwent surgical removal of abscess, and 3 cases were cured after antibiotic therapy. In one case of postoperative anastomotic leakage, pancreas was resected. Four cases of postoperative ileus were cured by continuous clysis with traditional Chinese medicine. Seven cases had pulmonary bacterial infections, including one cases associated with fungal infection. They were cured by the anti-infective treatment. Other complication included poor healing in 5 cases and urinary infection in 2 cases. After combined simultaneous pancreas-kidney transplantation, 10 patients received reoperation because of surgical complications (14 operations). The re-operation rate was 25 %, including 2 patients (4 operations) for hematuria, 4 patients for abdominal hemorrhage, 2 patients (3 operations) for abdominal infection, 1 patient for pancreatic venous thrombosis, 1 patient for anastomotic leakage, and 1 patient for pancreatic fistula. Conclusion Although simultaneous pancreas-kidney transplantation provides a successful and effective treatment for diabetics with endstage renal disease, surgical complication is still affecting the pancreas and kidney grafts after transplantation.

Objective To investigate the effect of atorvastatin on vascular endothelial cell function and vasoactive substances in essential hypertensive patients without hyperlipemia. Methods Sixty-five essential hypertensive(EH) patients without hyperlipemia were enrolled and randomly divided into atorvastatin group and conventional treatment group(oral taken atorvastatin or placebo once every night in addition of routine antihypertensive drugs).Twenty five healthy subjects were also recruited as control.All cases were followed up for eight weeks.Serum cholesterol,nitric oxide(NO),emdothelin-1(ET-1),vonWillebrand-factor(vWF) levels were determined in each case.Flow-medizted dilation(FMD) was determined by high-resolution ultrasonography before and after eight weeks atorvastatin medication.Results (1)Before treatment,the FMD and NO levels of EH group were significantly lower than those of control group(P＜0.01),while the ET-1 and vWF levels of EH group were significantly higher than those of control group(P＜0.01);(2)In EH patients,the FMD and NO levels significantly increased after treatment and increased even more dramatically in atorvastatin group,when compared to conventional treatment group(Ps＜0.01);(3)In EH patients,the ET-1 and vWF levels significantly decreased after treatment and decreased even more dramatically in atorvastatin group,when compared to conventional treatment group(Ps＜0.01).Conclusion In patients of EH without hyperlipemia,atorvastatin can decrease plasma levels of ET-1,vWF,while increase plasma NO concentration and improve vascular endothelial function.

Objective To assess the nutritional risk of patients with inflammatory bowel disease (IBD).Methods The nutritional status of 112 IBD patients from PUMC Hospital were evaluated by Nutritional Risk Screening 2002 (NRS 2002).Using Chinese standard,a body mass index (BMI) that was lowered than 18.5 kg/m~2 according to clinical material was regarded as malnutrition,and the score was recorded as 3.The se-verity of ulcerative colitis (UC) was evaluated using True-Love criteria as mild,moderate,and severe.Crohn's disease (CD) was evaluated using Harvey-Bradshaw Index as in remission stage (≤4),moderately active stage (4-8),and severely actively stage (≥9).Results All these 112 patients,including 70 UC cases and 42 CD cases,were evaluated by NRS2002.Forty-five patients (40.2%) were judged as at the risk of malnutrition.The incidence of malnutrition was significantly higher in CD patients than in UC patients (52.4% vs.32.9%,P<0.05).It was also significantly correlated with the severity of disease.In patients with severe IBD,the rate of mal-nutrition evaluated by BMI according to clinical material was significantly lower than the rate of nutritional risk.Con-clusions The risk of malnutrition is high in IBD patients.NRS 2002 can be used for nutritional risk screening.

Objective To investigate liver regeneration after transplantation of microencapsulated hepatocytes in rats with acute liver failure (ALF). Methods ALF rat model was established by intraperitoneal injection of D-galactosamine (D-GalN). After 18 h, rats were randomized into control group ( Ⅰ ), free hepatoeyte transplantation group ( Ⅱ ) and the microencapsulated hepatecyte transplantation group (Ⅲ). Six rats for each group were randomly selected and sacrificed at 6, 12, 24, 36, 48, 72, 120, 168 and 240 h after ALF induced and blood samples from inferior vena cava were collected. Liver functions were tested in blood samples, and the expression of proliferating cell nuclear antigen (PCNA) was detected by immunohistochemistry. Results Ten-day survival rates of 3 groups were 26.7% (4/15), 40.0% (6/15) and 73. 3% (11/15), respectively (x2 = 9. 349,P = 0. 009). Survival rate of group Ⅲ was significantly higher than that of group Ⅰ and Ⅱ. Levels of ALT and AST in each group increased significantly at 6 h after ALF induced, and peaked between 48 ～ 72 h. Levels of ALT and AST in group Ⅱ and Ⅲ declined from 36 h, which was more significant in group Ⅲ. Tbil levels in group Ⅰ gradually increased after ALF induced and peaked at 72 h. Tbil in group Ⅱ and Ⅲ declined from 48 h, which was more markedly in group Ⅲ. In normal rats, the expression of PCNA protein was almost negative, but it was strongly expressed in ALF rats and peaked at 48 h. The number of positive cells in group Ⅲ was higher than that in group Ⅰ and Ⅱ, and the differences were of statistical signifieance. Conclusion The transplantation of microencapsulated hepatocytes can promote the regeneration of liver, and it can improve the liver function and prognosis in rats with ALF.