Objective To explore the effect of TBL based on evidence-based medicine PICOS model in practice teaching of neurology. Methods Totally 47 medical undergraduates in our department were chosen and randomly divided into 2 groups during March 2016 to April 2016. 24 students in the trial group were taught with TBL based on PICOS, while other 23 students in the control group were only taught with conventional TBL method. After three times clinical practices, the test referring to disease pathogenesis, clinical manifestations, auxiliary examinations, diagnosis and treatments of related diseases was performed, and meanwhile, questionnaires were distributed to students in order to survey their satisfaction degree of teaching methods. All the evaluation results and scores of two groups were compared. Statistical data were analyzed by using t-test or Chi-square test with SPSS 17.0 software. Results The score of the theoretical test of trial group was significantly superior to the control group [(89.08±3.60) vs. (79.09±7.75), t=5.707, P=0.03 ]. Survey showed that in the experimental group , the number of students in the trial group who thought teaching method could help understand clinical thinking of neurology and could help integrate the theory into clinical practicewas significantly higher than that in the control group (P<0.05). Conclusion In the clinical teaching of neurology, the TBL based on PICOS model is more effective than conventional TBL method for medical undergraduates.

Congresses as Topic ; Humans ; Otorhinolaryngologic Surgical Procedures

Objective To explore the role of eNOS and NF-?B in the cultured endothelial cells apoptosis induced by TNF-? and Ang II.Methods The cultured endothelial cells were treated with TNF-? and Ang II in absence and presence of PDTC(an inhibitor of NF-?B);the mRNA of eNOS was measured by RT-PCR,the protein of eNOS and I?B? were assessed by Western-blot,the activity of NF-?B was evaluated by EMSA,and the apoptosis of cells was detected with Tunel.Results The mRNA and protein of eNOS were significantly decreased in the endothelial cells induced by TNF-? and AngII(P

SHG was sulfated by chlorosulfonic acid-pyridine method, and six samples which we got were prepared in different reaction conditions. There is a characteristic absorption peak near 260 nm in UV spectra and there are two characteristic absorption peaks near 1240 cm(-1) and 810 cm(-1) in the FT-IR. Degree of sulfation (DS) was calculated by elemental analysis and turbidimetry. Under the same conditions the absorption peaks become strong with the DS increase. The anticoagulant activity of SHG and sulfated modification samples was evaluated by the classic coagulant assays of prothrombin time (PT), activated partial thrombin time (APTT) live enzymes, and plasma thrombin time (TT). Results show that sulfated SHG has a good anticoagulant activity in vitro, and DS increased activity within a certain range.

OBJECTIVE:To develop a method for the concentration determination of olanzapine,risperidone and paliperidone in human plasma.METHODS:After liquid-liquid extraction,using buspirone hydrochloride as internal standard,the concentration of plasma sample was determined by UPLC-MS/MS.The determination was performed on ACQUITY UPLCTM BEH C18 column with mobile phase consisted of methanol-0.01 mol/L ammonium formate solution (gradient elution) at flow rate of 0.2 mL/min.The column temperature was 45 ℃,and sample size was 5 μL.The electrospray ionization source was adopted for positive ion scanning under MRM mode.Ion-pairs for quantitative analysis were as follows:m/z 313.29→256.25 (olanzapine),m/z 411.42→191.19 (ris peridone),m/z 427.45→207.18 (paliperidone) and m/z 386.43→122.37 (internal standard).RESULTS:The linear ranges of olanzapine,risperidone and paliperidone were 0.426-108.954,0.213-54.476,0.213-54.476 ng/mL,respectively.RSDs of inter-day and intra-day were all lower than 20％.The recoveries of them ranged 83.3％-112.9％,90.0％-109.8％ and 95.2％-114.9％,respective ly.Extraction recoveries ranged 65.5％-95.0％,73.9％-98.5％ and 73.6％-99.4％,respectively.Both plasma matrix effect and dilute effect didn't influence the determination of plasma concentration.The plasma concentrations of olanzapine,risperidone and paliperidone in 100 schizophrenia patients were (103.3 ± 73.6),(13.1 ± 13.1) and (23.2 ± 20.0) ng/mL,respectively.CONCLU SIONS:The method is simple,rapid,sensitive and specific.It can be used for the determination of plasma concentration and pharmacodynamic study of olanzapine,risperidone and paliperidone.

Objective To study the effect of angiotensinⅡ(AngⅡ) on apoptosis in endothelial cells(EC). Methods Human umbilical endothelial cells were cultured in vitro and treated with AngⅡ in various concentrations alone and in combination with fumonisin B1(FB1, an inhibitor of ceramidase). TUNEL was employed to determine the apoptosis of the cultured EC. The bax mRNA and protein levels of EC were detected by RT-PCR and Western-blot techniques. Results The results showed that the number of apoptotic cells was significantly higher in AngⅡ-treated endothelium than in the control group(P0.05). Conclusion AngⅡ may induce apoptosis of endothelial cells via ceramide and up-regulating the bax mRNA and protein expression. Ceramide is the upper stream of bax and induces apoptosis by bax pathway.

OBJECTIVE:To investigate the situation of ADR reporting entities in Henan province and Hebei province to pro-vide reference for the improvement of ADR monitoring. METHODS:Literatures were consulted to investigate the ADR monitoring at home and abroad. With the subject of ADR reporting entities(pharmaceutical manufacturers,drug distributors and medical insti-tutions)in Henan and Hebei province,questionnaires and descriptive statistical analysis were conducted to analyze the results. RE-SULTS:186 valid questionnaires were received. There were respectively 58 and 62 ADR reporting entities with ADR monitoring de-partment in Henan and Hebei province,all of them had personnel who were responsible for ADR;ADR monitoring mostly belonged to quality control department in pharmaceutical manufacturers and drug distributors,and pharmacy department in medical institu-tions;most were equipped with computer,printer,phone and other basic office equipments;most were not clearly for major duty;there were respectively 24 and 2 entities with special budget for ADR monitoring;95.7% and 96.8% had communication with the local ADR monitoring centers,however,the information feedback was not ideal;86.7%and 98.9%had training for the stuff;stan-dard operation procedure was relatively good in Hebei province;96.7% and 98.9% would report ADR immediately after finding ADR,92.3% and 97.8% would record and backup the reported ADR;the form mainly by network report;the average degree of satisfaction evaluation in Henan province was higher than Hebei. CONCLUSIONS:According to the results,it is suggested to pro-mote the implementation of ADR monitoring by optimizing the work conditions,ensuring work fund and strengthening work feed-back.

OBJECTIVE:To understand the present situation of ADR reporting entities in Shaanxi and Sichuan province,and provide evidence for the improvement of ADR monitoring. METHODS:Getting the overview of ADR monitoring at home and abroad by reading a lot of literature,the ADR monitoring entities(drug manufacturers,drug distributors and medical institutions) in Shaanxi and Sichuan province were selected as subject for cluster sampling,questionnaires were sent out and descriptive statis-tics analysis was adopted to processing and analyze the results. RESULTS:Totally 198 questionnaires were received,100 for Shaanxi province and 98 for Sichuan province. In Shaanxi and Sichuan province,there are 61 and 63 investigated subjects had es-tablished ADR monitoring departments,98.0% and 100% had had personnel for the ADR work;ADR monitoring work mostly be-longed to the quality control department in drug manufacturers and drug distributors,and belonged to pharmacy department in medi-cal institutions;most of them were equipped with computer,printer and other basic office equipment;however,the major duty of most was not clearly;13 and 23 subjects had special budget for ADR monitoring;87 and 89 subjects had communication with lo-cal ADR monitoring center,however,the information feedback was not very ideal;training the workers accounted for 80.0% and 83.0%,respectively;in terms of system construction,the standard operation procedure was relatively good,and the other related was not ideal;reporting quickly when finding ADR was 89.0% and 96.9%,88.0% and 96.9% of which had backup records for ADR reporting,it was mainly network report;Shaanxi province was better than Sichuan province about the satisfaction evaluation of ADR work. CONCLUSIONS:According to the results,it is suggested to adjust the structure of workers,buy related software re-source,improve the responsibilities and strengthen the financial support to promote the implementation of ADR monitoring.

Objective To investigate the impacts of mecobalamin on plasma inflammatory factors (plasma high-sensitivity C-reactive protein (Hs-CRP) and carotid artery plaques in patients with H type hypertension.Methods Forty-eight acute ischemic stroke patients who were diagnosed with H type hypertension in the People's Hospital of Taixing were collected,and they were randomly divided them into treatment group and control group,and 24 cases of each group.Patients in both groups were given conventional therapies,including treatment of anti platelet aggregation,plaque stability and reduced plaque treatment.While patients in the treatment group were given additional oral drug of mecobalamin,500 μg each time,three times a day,6 months in all.Each case was evaluated at the second day of hospitalization,four weeks later,eight weeks later,three months and sixth months later.The examination items involved included level of plasma homocysteine(Hcy),level of hsCRP and conditions of carotid artery plaques under ultrasonography.Results Aafter four weeks,eight weeks,three months and sixth months therapy,there were significant differences between treatment group and control group in terms of Hcy (t =4.049,3.896,6.052,6.159 ; P ＜ 0.05) and the level of hs-CRP (t =37.249,28.376,26.454,0.522P ＜ 0.01).Afrter three months and sixth months therapy,compared to the control group,the carotid artery plaques were obviously reduced,and the differences were statistically significant (t =2.309,2.434 ; P ＜ 0.05).Conclusion Mecobalamin can reduce the level of plasma homocysteine,then lead to reductions of levels of plasma inflammatory factors and volume of carotid artery plaques.

Objective A retrospective analysis were conducted to identify the effect of bypassing the emergency department on 30-days outcomes of patients with acute myocardial infarction undergone primary percutaneous coronary intervention ( PPCI) . Methods From June 2014 to April 2015, 187 patients underwent PPCI in Kunming General Hospital were included. 13 patients were excluded owing to their incomplete follow-up data. The total 174 patients were divided into two groups: the control group (n =59) who did not bypass the emergency department, and the bypass group ( n = 115) who bypassed the emergency department and directly received PPCI. The data of all patients were collected and analyzed. Results There were no significant differences in baseline characteristics and PPCI related data (including percentage of thrombus aspiration catheter used, length or diameter of stents applied between two groups (all P ﹥ 0. 05) . The bypass group had shorter door-to-ballon ( D2B) than the control group [ (67. 7 ± 21. 5) min vs. (89. 4 ± 23. 6) min, P ﹤ 0. 001] . There were no significant differences in 30-days all-cause mortality, re-myocardial infacrtion and target ressel revascularization (TVR) between the two groups (P ﹥ 0. 05) . Total MACEs rate in the bypass group was lower than in the control group (10. 2% vs. 1. 7% , P = 0. 012) . Logistic regression analysis showed that age, diabetes, pain-to-door (PTD) time and CK peak value were the main influencing factors for 30-day MACEs rate of patients receiving PPCI ( P ﹤0. 05) . Conclusions Bypassing the emergency department can shorten D2B time and reduce 30-days MACEs post-PPCI, but reducing the total ischemic time will be more beneficial to patients with acute myocardial infarction.