It is important and necessary for the teaching process in histology and embryology integrated by psychological quality.The psychological quality of teachers can be improved by professional training and by themselves.Teachers should teach everyone differently according to the different psychological character of medical students who are born after 1990.Teachers can improve psychological quality of medical students in teaching process including the discussion,visiting the embryo sample and the second class.

Objective:To explore the significance of detecting serum CRP,myocardial enzymes,liver function index in pediatric patients with rotavirus infectious diarrhea.Methods:110 pediatric patients with rotavirus infectious diarrhea and 85 age-matched patients with bacterial infectious diarrhea who were both treated in our hospital from January,2014 to May,2016 were enrolled in the present study.Another 20 healthy patients who had physical examination in our hospital were considered as control group.The differences of serum CRP,IL-6,hs-cTnT,CK,CL-MB,AST,ALT level and the incidence of parenteral injury were compared.Results:The incidence rate of lower respiratory tract infectivity,rash,myocardial damage and hepatic injury in RV group were significantly lower than the bacterial infectious group (P＜0.05),the level of serum CRP,IL-6 in RV group and bacterial infectious group were significantly higher than the control group,and those of RV group were significantly lower than bacterial infectious group (P ＜0.05);the level of hs-cTnT,CK,CL-MB,AST,ALT in RV group were significantly higher than bacterial infectious group and control group (P＜0.05),and those indexes of bacterial infectious group were no significantly differences compared with healthy control (P ＞ 0.05).Conclusion:The combined detection of serum CRP,myocardial enzyme and liver function indexes were of certain significance in the early distinguishing diagnosis of bacterial infectious diarrhea from rotavirus infectious diarrhea.

OBJECTIVE: To establish an HPLC method for the determination of the contents of the related substances in metoclopramide.METHODS: The sample was separated on C18 column with the mobile phase consisted of acetonitrile-0.02 mol?L-1 phosphonic acid solution(19∶81) at a flow rate of 1.0 mL?min-1.The detection wavelength was set at 275 nm;the column temperature was kept under room temperature and the injected volume was 20 ?L.The contents of the related substances in metoclopramide were computed by self-control method of main constituent.RESULTS: Under the above described chromatographic conditions,metoclopramide was completely separated from its impurities.A good linearity between impurities' peak area and metoclopramide(contrast solution) concentration was achieved when the concentrations of impurities were over the range of 0.05%～4.0%.The lowest detectable limit of metoclopramide was 0.3 ng,and the contents of the related substances were all less than 0.26%.CONCLUSION: The method is convenient,accurate,sensitive and,specific,and it can be used for the determination of the related substances in metoclopramide.

Background:Esophageal non-variceal hemorrhage is relatively uncommon in clinical,however,it can be life-threatening in severe cases. Thus,retrospective analysis of esophageal non-variceal hemorrhage could provide important evidence for its diagnosis and treatment. Aims:To analyze the clinical characteristics of esophageal non-variceal hemorrhage. Methods:A total of 175 cases of esophageal non-variceal hemorrhage from January 2006 to December 2016 at Daping Hospital were enrolled. Gender,age,cause of bleeding,location of bleeding,season of onset,treatment and prognosis were retrospectively analyzed. Results:The ratio of male to female was 3. 5: 1 in 175 patients with esophageal non-variceal hemorrhage,73. 1％ of patients were middle-aged and elderly. The main cause of bleeding of esophageal non-variceal hemorrhage were cardiac mucosal laceration syndrome (46. 9％),esophageal cancer (23. 4％),esophageal ulcer (12. 6％)and esophageal foreign body (12. 0％). The most common site of bleeding was lower esophagus (70. 9％). Fifty-one patients accepted endoscopic treatment or surgery. After treatment,142 patients (81. 1％)were cured or improved,and death was occurred in 27 patients (15. 4％). Conclusions:The incidence of esophageal non-variceal hemorrhage is higher in male than in female,and is commonly seen in middle-aged and elderly patients. The most common cause of bleeding of esophageal non-variceal hemorrhage is cardiac mucosal laceration syndrome,and the most common site of bleeding is lower esophagus. Medicine combined with endoscopic treatment is effective for most of the patients.

Objective To explore the clinical characters,treatment and prognosis of gastrointestinal Dieulafoy lesion in China.Methods Dieulafoy was used as search term,the literatures about Chinese patients with Dieulafoy lesions from January 1998 to October 2016 were retrieved in the Chinese literature library including China National Knowledge Infrastructure,VIP network,Wanfang database and China Biology Medicine disc,and a total of 515 literatures,5 145 patients were enrolled and analyzed.The gender,age,geographical distribution,location of the lesion,treatment and prognosis of the disease were summarized.Results Among the 5 145 patients (male 3 959,female 1 186) with Dieulafoy disease,the ratio of male to female was 3.34∶1.00.The age was from 3 to 95 years,and mean age was 51 years.The lesion location was mainly in stomach (88.82％,4 570/5 145) and second was small intestine (8.28％,426/5 145).In stomach,the lesions were mainly located in gastric corpus,fundus and cardia.The small intestinal Dieulafoy lesions were mainly located in duodenum.The main manifests were sudden hematemesis,melena,and hematochezia.The treatments mainly was endoscopic treatment (72.56％,3 733/5 145),and second was surgery (25.27％,1 300/5 145).Among the5 145 patients withDieulafoy disease,5 099 patients (99.11％) were cured and 46 patients (0.89％) died.The proportions of endoscopic treatment,interventional therapy and first endoscopic treatment within 24 hours in tertiary hospitals were all higher than those of nontertiary (all P＜0.01).The cure rate of tertiary hospitals (99.22％,3 674/3 793) was significantly higher than that of nontertiary hosptials (98.54％,1 421/1 442) (x2 =0.89,P＜0.05) and the mortality was significantly lower than that of nontertiary hospitals (P＜ 0.05).Conclusions The male is more susceptible to Dieulafoy lesion which occurred at any age than the female in China.The predilection sites of Dieulafoy lesion were stomach and duodenum.The primary treatments were endoscopic treatment and surgery,and the disease usually had a good prognosis.

Objective:To investigate the predictive value of cerebroplacental ratio (CPR) for adverse perinatal outcomes of induction of labor in prolonged pregnancy.Methods:This retrospective study recruited 315 singleton pregnant women who had induced labor due to prolonged pregnancy (≥41 gestational weeks) in the First Affiliated Hospital of Chongqing Medical University from January 1, 2019 to April 30, 2020. Based on the occurrence of adverse perinatal outcomes (emergency delivery due to persistent abnormal fetal heart rate monitoring, umbilical artery blood pH at birth <7.2, 5 min Apgar scores<7, transferring to neonatal intensive care unit after birth, chorioamnionitis and vaginal delivery converted to cesarean section), they were divided into two groups: case group ( n=76) and normal group ( n=239). Clinical features and umbilical artery blood flow, middle cerebral artery (MCA) flow and CPR measured in the last ultrasound scan before induction were compared between the two groups using student's t-test, Mann-Whitney U test and Chi-square test. Receiver operating characteristic (ROC) curve was used to analyze the predictive values of umbilical artery blood flow, MCA flow and CPR for the adverse perinatal outcomes. Multivariate logistic regression analysis was used to screen the meaningful predictors. Results:Compared with the normal group, the umbilical artery pulsatility index (PI) (0.9±0.1 vs 0.8±0.1, t=-5.458, P<0.001) and the percentage of abnormal CPR (<1.0) increased significantly [21.1%(16/76) vs 6.3%(15/239), χ2=14.190, P<0.001] in the case group, while the MCA-PI and CPR decreased significantly (1.1±0.2 vs 1.3±0.3, t=5.658, P<0.001; 1.2±0.3 vs 1.6±0.5, t=8.940, P<0.001). The areas under the ROC curves of umbilical artery PI, MCA-PI and CPR for predicting adverse perinatal outcomes were 0.71, 0.71 and 0.77, respectively. CPR had the highest sensitivity (0.74) compared with umbilical artery PI (0.68) and MCA-PI (0.71), but the specificity of them were similar (0.67, 0.66 and 0.66). Multivariate logistic regression analysis showed that only CPR was the independent risk factor for adverse perinatal outcomes ( OR=0.028, 95% CI: 0.010-0.080, P<0.001). Conclusions:As an indicator for early prediction of adverse perinatal outcomes of induction of labor in prolonged pregnancy, CPR was more sensitive but less specific.

OBJECTIVETo identify the relationship between coagulation factor V (FV) gene single nucleotide polymorphisms (SNPs) and venous thromboembolism (VTE).

METHODSThe FV clotting activity (FV: C) and FV antigen (FV: Ag) in plasma of VTE group (111 patients) and normal control (110 patients) were detected using one-stage clotting assay and ELISA, respectively. Five pairs of primers of the F V polymorphisms including Asp79His, Arg306The, Arg306Gly, Arg506Gln and Ile359The/His1299 Arg were synthesized and amplified by PCR. The PCR products were digested by restriction enzyme using PCR-RFLP. The detected polymorphisms were confirmed by direct sequencing. The samples containing the polymorphisms were screened for coding regions of all F V exons with direct sequencing.

RESULTSThe plasma levels of F V: C and F V: Ag of VTE group and normal control were (106.9 +/- 28.0)%, (110.4 +/- 33.3)% and (102.4 +/- 30.9)%, (102.1 +/- 24.1)%, respectively. The plasma level of FV: Ag was significantly different between VTE group and normal control. However, there was no difference in F V: C levels. Polymorphisms for the fore mentioned 5 primer pairs were not found in either patients or normal controls. Polymorphism of His1299Arg was identified in 5 patients with VTE and 3 normal controls. And these 5 cases also combined Met1736Val polymorphism, 3 of them combined another Asp2194Gly polymorphism.

CONCLUSIONThe higher plasma level of F V: Ag contribute to venous thromboembolism. There is no relationship between polymorphisms of Asp79His, Arg306The, Arg306Gly, Arg506Gln, Ile359The and venous thromboembolism in Chinese studied. Polymorphism His1299Arg is higher in VTE group than in normal control, but has no statistical difference. Polymorphisms of His1299Arg, Met1736Val and Asp2194Gly are linked disequilibrium in Chinese Han population.

Factor V ; genetics ; Female ; Gene Frequency ; Humans ; Linkage Disequilibrium ; Male ; Middle Aged ; Polymorphism, Single Nucleotide ; Venous Thromboembolism ; genetics

OBJECTIVETo study the molecular mechanisms of protein C (PC) deficiency caused by PC gene mutations of C64W, F139V and K150 deletion (K150d).

METHODSWild-type and mutant PC cDNA expression plasmids (PCwt, PC C64W, PC F139V, PC K150d) were constructed and transfected into COS-7 cells or CHO cells respectively for in vitro expression study and immunofluorescent assay. Fluorescent real-time PCR was used to detect the expression of PC mRNA, protein degradation inhibition and endo-beta-N-acetylglucosaminidase H (Endo H) digestion experiments to explain the mutant protein degradation pathway and its localizations inside the cells.

RESULTSPC C64W was not secreted from the cells and was gradually degraded inside the cells. There was partial secretion of PC F139V, most of the protein molecule was not secreted and degraded intracellularly. Mutant PC K150d was secreted normally from the cells. Fluorescent realtime PCR analysis of total mRNA from transfected cells showed no reduction of the mutant PC mRNA expression compared with that of wild-type PC mRNA. Protein degradation inhibition experiments showed that mutants PC C64W and PC F139V were degraded intracellularly through the proteasome pathway. Endo H digestion experiments and immunofluorescence results suggested that mutant PC molecules were located mainly in pre-Golgi apparatus.

CONCLUSIONSImpaired secretion and degradation intracellularly of the mutants might be the molecular mechanisms of PC deficiency caused by C64W and F139V mutations. K150 deletion mutation might not affect the secretion of the mutant.

Animals ; CHO Cells ; COS Cells ; Cercopithecus aethiops ; Cricetinae ; Cricetulus ; Humans ; Mutation ; Plasmids ; genetics ; Protein C ; genetics ; Protein C Deficiency ; genetics ; Transfection

Objective:To explore the effect of narrative nursing plan on patients with cancer fatalism at the initial stage of radiotherapy for nasopharyngeal carcinoma.Methods:Convenience sampling was used to select 126 patients with nasopharyngeal carcinoma who were admitted to the Third Ward of Radiotherapy, Affiliated Tumor Hospital of Guangxi Medical University from July 2019 to June 2020 with cancer fatalism at the initial stage of radiotherapy. Among them, 62 cases from July to December 2019 were set as the control group, and 64 cases from January to June 2020 were set as the observation group. Routine nursing intervention and narrative nursing intervention were given respectively, and before the intervention (the second day after admission), after 7 weeks of intervention, the Fatalism Scale and Center for Epidemiologic Studies-Depression scale scores of the two groups were compared.Results:Before the intervention, the cancer fatalism and depression scores of the two groups were at a high level and the difference was not statistically significant ( P>0.05); after the implementation of the narrative nursing intervention program, the cancer fatalism and depression scores of the observation group were (37.23±6.12), (9.42±1.36) points, lower than (47.78±9.14), (15.65±2.03) points of the control group. There was statistical significance ( t values were 7.698, 7.524, P<0.05). Conclusion:In the early stage of radiotherapy, patients with nasopharyngeal carcinoma have a strong concept of cancer fatalism, and narrative nursing intervention can effectively reduce their cancer fatalism and depression.

Objective:To analyze the cerebroplacental blood flow distribution characteristics in monochorionic-diamniotic(MCDA) twin pregnancies with stageⅠ-Ⅱof twin-twin transfusion syndrome (TTTS), and investigate the predictive value of cerebroplacental ratio (CPR) in the stageⅡ of TTTS.Methods:The cerebroplacental blood flow distribution were analyzed retrospectively in 68 cases from June 2017 to June 2019 in the First Affiliated Hospital of Chongqing Medical University (34 cases for each stage) with TTTS, including the umbilical artery pulsatility index (UA-PI), middle cerebral artery peak systolic velocity (MCA-PSV), middle cerebral artery pulsatility index (MCA-PI), CPR, and their discordances(UA-PI disc, MCA-PSV disc, MCA-PI disc and CPR disc). Results:The differences of UA-PI, MCA-PI, and CPR between donors and recipients in TTTS Ⅱ were statistically significant (all P<0.05), the differences of UA-PI disc, MCA-PI disc and CPR disc between TTTS Ⅰ and TTTS Ⅱ were statistically significant (all P<0.05). Multivariate Logistic regression analyses showed that only CPR disc was independently associated with the stage Ⅱ of TTTS( P<0.05), and it had moderate predictive accuracy for the stage Ⅱ of TTTS with an area under the curve of 0.766, a sensitivity of 64.71% and a specificity of 82.35%( P<0.001). Conclusions:More cerebroplacental blood flow discordances are observed and CPR disc is closely related to stageⅡof TTTS.