The Department of Obstetrics and Gynecology has performed series of teaching reforms for the seven-year medical students.For the theory classes,all the teachers are the senior ones who can enhance the bilingual teaching and combine the clinical cases with the latest development in the subject.We let the interns follow the diagnosis and treatment of the patients just as the patients'relatives.We also let a tutor to guide each intern to help him master the basic clinical art.During the ward inspection for teaching,we let the students be the main speaker,hoping that we can build a new student-centered teaching model.

Animals ; Avoidance Learning ; physiology ; Cues ; Extinction, Psychological ; physiology ; Fear ; physiology ; Male ; Mental Recall ; physiology ; Rats ; Sleep Deprivation ; physiopathology ; Sleep, REM ; physiology

Objective Evaluation of left ventricular ( LV) function has great clinical significance in patients with early chro-nic kidney disease (CKD).The study was to evaluate whether two-dimensional speckle tracking imaging (2D-STI) technique can offer additional information of cardiac dysfunction in early CKD patients . Methods Conventional echocardiography and 2D-STI echocar-diography were performed in CKD group of 20 patients at stage Ⅱ-Ⅲ and control group of 20 healthy volunteers .LV structure and function were evaluated by conventional echocardiography .Multidirectional strain , strain rate and LV twist parameters were analyzed by 2D-STI technique. Results There was no statistical difference in conventional echocardiographic parameters such as left atrial diam -eter, end-diastolic LV diameter and ejection fraction between CKD group and control group .By applying 2D-STI technique, CKD group had significantly decreased value of global longitudinal strain (-19.8 ±2.4)%and strain rate(-1.1 ±0.3)S-1 in comparison to control group(-22.6 ±2.1)%、( -1.8 ±0.2)S-1, along with significant increase in the values of maximum LV rotation (11.6 ± 4.4)°and LV twist(19.6 ±3.8)°in comparison to control group(8.2 ±3.7)°、(13.5 ±3.6)°(P<0.05).There was no differences in both global circumferential and radial deformation parameters as well as maximum rotation value of LV assist device between two groups(P>0.05). Conclusion 2D-STI can detect subclinical LV dysfunction sensitively in early CKD patients .

Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Astrocytoma ; metabolism ; pathology ; CD3 Complex ; metabolism ; Central Nervous System ; metabolism ; pathology ; Central Nervous System Neoplasms ; metabolism ; pathology ; Demyelinating Diseases ; diagnosis ; metabolism ; pathology ; Diagnosis, Differential ; Glial Fibrillary Acidic Protein ; metabolism ; Humans ; Lymphoma ; metabolism ; pathology ; Magnetic Resonance Imaging

Objective To evaluate whether global 2-dimensional strain imaging can offer additional benefit over conventional echocardiography to detect subclinical myocardial damage in patients with chronic kidney disease(CKD). Methods Conventional echocardiography and global 2-dimension strain imaging were performed in 39 patients with CKD [23 men and 16 women,mean age (45.6± 14.6) years] and 29 control subjects. Twenty patients had CKD stage 2 or 3(group 1 ) and nineteen patients had CKD stage 4 or 5(group 2). Left ventricular structure and function were evaluated by conventional echocardiography. Global longitudinal and circumferential strain and strain rate were analyzed. Results There were no differences in ejection fraction and fraction shortening between CKD patients and controls. Compared with controls, CKD groups had significantly decreased value of global longitudinal strain and strain rate. Global longitudinal strain decreased from - (23.8 ± 3.1 ) % in controls to - ( 18. 5 ± 2.4) % in group 1 and to - (15.2 ± 3.2) % in group 2 ( P ＜0. 001 ). Compared with controls, there was no difference in global circumferential strain and strain rate between group 1 and controls, but global circumferential strain and strain rate of group 2 was reduced [ - (17.1± 3. 0) % vs -(21.2±2.8)%, P＜0.05;-(1.0±0.2)% vs -(1.3±0.3)%, P＜0.05]. In correlation analyses, global longitudinal strain was positively related to eGFR( r =0. 376, P ＜0. 001 ) and inversely related to left ventricular mass index( r = - 0. 473, P ＜0.01). Conclusions Global 2-dimensional strain imaging may represent a useful tool for the assessment of subclinical myocardial dysfunction in patients with CKD.

Objective To quantify the neurons in the temporal lobe white matter and find their distribution in the neurologically normal individuals.Methods The temporal lobe at the level of exterior geniculata body from brain autopsy samples of 14 neurologically normal individuals were made into large slice followed by quantitative analysis of neuron density,cell density,ratio and diameter of the neuronal nuclear and the distribution of white matter neurons using two-dimensional cell counting methods.Results With the depth of the white matter of the temporal lobe increasing,the neuron density decreased from 29.26 neurons/ mm~2 to 7.32 neurons/mm~2 and 0.00 neurons/mm~2,respectively;the cell density,neuron ratio and diameter of the neuronal nuclei all decreased.Conclusion There are neurons in the temporal lobe white matter of neurologically normal individuals,whose distribution of neurons is related to the depth of white matter.

To obtain a number of penicillinases and degrade penicillin in milk by using the penicillinases,the gene encoding penicillinase was amplified by PCR from Bacillus cereus ATCC10987,cloned into pET28a(+) ,transformed into E. coli BL21;analysis of SDS-PAGE and penicillinase activity of the recombinant protein were done under induction of IPTG and the result showed that the maximum penicillinase activity reached 480 U/mL;the purity of penicillinase purified by Ni2+ Purification System was more than 90%;the immobilized penicillinases were obtained by sodium periodate method and the residual quantity of penicillin in milk(containing 0.5 U penicillin G/mL) was less than 4 ppb after degraded by the immobilized penicillinase.

Objective To explore the application of "Work-Study Combination"(referred to "Institutions Join Forces with Hospitals" in this paper) in nursing education system of Shanghai Institute of Health Sciences. Methods Data of teaching plan and curriculum of students from 2005 and 2006 grades were compared.With construction of "National Model of Higher Vocational Institutions",transformation in professional curriculum reforming,teaching resources sharing,teachers staff constructing,in-school and out-school vocational training bases establishing,and students evaluation system were compared.Results Regulated and updated teaching contents and new curriculum reflected vocational education characteristics.The ratios of in-school vocational training,clinical teaching and practice in curriculum rose rapidly.Conclusion The results showed that "Institutions Join Forces with Hospitals" applying in higher nursing vocational education system was a direct expression of combination of work and study to the process of personnel cultivating.

OBJECTIVETo study the effectiveness and safety of deferasirox (DFX) in the treatment of iron overload in children with β-thalassemia major.

METHODSTwenty-four β-thalassemia major children with iron overload who received regular blood transfusion were randomly enrolled. The serum feritin (SF) levels were measured in the patients after different doses of DFX treatment. The DFX treatment-related adverse events were observed. The values of cardiac MRI T2* and liver MRI T2* were compared between the patients receiving DFX treatment for 5 years and the patients treated with deferoxamine and deferiprone.

RESULTSThe patients with iron overload did not respond to DFX at the initial dose of 20-30 mg/kg•d. However, the SF level decreased significantly after the dose of DFX increased to 30-40 mg/kg•d (U=58, P<0.01). Serum liver transaminase elevation was the most common adverse effect, followed by non-progressive elevation in serum creatinine level. The mean SF level was significantly lower (1748±481 ng/mL vs 3462±1744 ng/mL; P<0.05), in contrast, the liver MRI T2* value was significantly higher (8.5±2.9 ms vs 2.7±1.9 ms; P<0.01) in patients receiving DFX treatment for 5 years than in the controls. There were no significant differences in the cardiac MRI T2* value between the two groups.

CONCLUSIONSDFX can reduce SF levels in a dose-dependent manner in children with β-thalassemia major. It can significantly lower liver iron overload but not cardiac overload. Serum liver transaminase elevation and non-progressive elevation in serum creatinine level are major adverse effects in DFX treatment.

Adolescent ; Adult ; Benzoates ; adverse effects ; therapeutic use ; Child ; Child, Preschool ; Dose-Response Relationship, Drug ; Female ; Ferritins ; blood ; Humans ; Iron Chelating Agents ; adverse effects ; therapeutic use ; Iron Overload ; drug therapy ; Male ; Transfusion Reaction ; Triazoles ; adverse effects ; therapeutic use ; beta-Thalassemia ; blood ; complications ; therapy

Objective To analyze the epidemiological characteristics of mumps in Zaozhuang city from 2010 to 2017, and establish a predictive model to predict prevalence trend, so as to provide scientific basis for the prevention and control of mumps. Methods Mumps cases between 2010 and 2017 screened from Infectious Diseases Report Information Management System of Chinese Information System of Disease Prevention and Control were analyzed by the descriptive epidemiologic method. The time series analysis method was applied to model and predict the trend of disease. Results A total of 6 353 mumps cases were reported in Zaozhuang city from 2010 to 2017. The average annual incidence was 19.75/100 000. The incidence of men was higher than that of women. The seasonal indices for December to next January and April to July were all above 1. The incidence rates of Shizhong and Yicheng were higher than in other areas. The incidences aged from 3 to 14 accounted for 76.85 % of the total number of cases, while students, scattered children and childcare accounted for 86.11%. The established time series model was ARIMA (1, 0, 0) * (0, 0, 0)12. The mean absolute percentage error of the predictive values based on the model was 39.99% and the number of cases predicted by the model in 2018 was 471. The predictive incidence rate was 11.13/100 000. Conclusions Primary and secondary school students and scattered children are the main population for the prevention and control of mumps. The model obtains better forecasting results and can be used for short-term prediction and dynamic analysis of mumps.