PBL teaching is popular internationally as a teaching mode in recent years.It takes students as the main body and centers on problems,and the teaching process has the important effect to improving stuents'enthusiasm and developing their ability to innovate.This article has discussed the application of PBL teaching and attention in teaching,combined with aspects such as teaching objects,teaching contents,teaching objectives and teaching links in the teaching of medical insurance.

Objective To evaluate the effect of Jianpi Bushen Formula(Formula for Invigorating Spleen and Nourishing Kidney) combined with moxibustion on quality of life(QOL) and maturation degree of vaginal exfoliate cells(MDVEC) in premature ovarian failure(POF) patients.Methods Totally 55 POF patients were randomized into treatment group(33 cases,treated by Jianpi Bushen Formula with moxibustion) and control group(22 cases,treated by Premarine).Menopause-specified quality of life(MENQOL) was adopted to evaluate QOL of the patients.Maturation index(MI) and maturation value(MV) were applied to evaluate MDVEC.Results The scores of MENQOL of both groups were improved and the effect of the treatment group(except sexual life dimension) was superior to that of the control group(P

This paper summarizes the systematic management of artificial airway for 36 postoperative patients with laryngeal cancers. A full-time nurse is responsible for the systematic artificial airway management to implement respiratory care,endotracheal tube care,infection prevention and control,nutritional support and health education. As a result,the incidence of fever,frequent cough,and bloody sputum was 2.12%. Pharyngeal fistula and pulmonary infection occurred in one patient,respectively. All the patients recovered well after intensive care. It is suggested that systematic artificial airway management can effectively reduce complications,improve the quality of nursing and increase patient satisfaction.

Objective:To evaluate the effect of clinical pharmacists in the continued therapy of stroke patients .Methods:Totally 146 cases were selected and randomly divided into the observation group and the control group according to the standard matching meth -od.The observation group was treated with the continued therapy .The control group was given one-month telephone follow-up after the discharge.The differences in the drug compliance (Morisky scale), systolic blood pressure (SBP), diastolic blood pressure (DBP), glycosylated hemoglobin (HbA1C), serum total cholesterol ( TC), low density lipoprotein ( LDL-C), health behaviors ( HPLPⅡscale) and relapse rate were compared between the two groups in the 3rd, 6th and 12th month after the discharge.Results:The differ-ences in the above indices were statistically significant between the two groups ( P <0.05) at the various time points , and those were more significant with time extending (P<0.01).The difference of the relapse rate in the 3rd, 6th and 12th month after the discharge between the two groups were significant .Conclusion: Clinical pharmacists can improve the drug compliance and health behaviors of stroke patients and reduce the relapse rate .It is worthy to be recommended in clinics .

Objective To elucidate the effects of endothelin-1(ET-1) on expression of extra-regulated kinase 1(ERK 1), cell cycle and changes of Ca 2+ in activated hepatic stellate cells (HSCs). Methods Effects of different concentra tions of ET-1 on ERK 1 expression were determined by Western blotting. Effects of ET- 1 on cell cycle were observed by flow cytometry(FCM) analysis. Effects of ET-1 on changes of calcium concentration and cell area were observed by laser scanning confocal microscopy (LSCM). Results ET-1 could inhibit the expression of ERK 1 i n a dose-dependent manner, compared with the control, the expression of ERK 1 in E T-1 highest concentration group decreased 10.91%?3.36% (P

Objective To silence the expression of CTGF by small interfering RNA technology,to observe the influence on fibroblast?like synovial cell apoptosis and several apoptosis?related genes,and to explore the mechanism of action of CTGF in rheumatoid arthritis synovial lesions. Methods Effective CTGF siRNA was screened through real?time PCR. The influence of CTGF siRNA on FLS apoptosis was detected with FITC?PI double staining by flow cytometry. bax,bcl?xl and survivin were detected using real?time PCR when CTGF mRNA has been silenced. Results Compared with other 2 groups of oligo and NC oligo,H1 oligo exhibited the strongest interfering action to CTGF(inhibition ratio>70%),so that it is selected as the effective target gene sequence for the following experiment. Apoptosis of FLS induced by serum deprivation was significantly decreased in the presence of exogenous CTGF. When expression of the CTGFgene was knocked down in FLS,FLS apoptosis was significantly increased,and expres?sion levels of survivin mRNA were decreased significantly(P<0.01). Conclusion FLS survival is positively regulated by CTGF,which may through the sustaining the expression of survivin.

Acute bulbar palsy is considered an extremely rare manifestation of neuromuscular disorder in thyrotoxicosis.It happens abruptly and progresses quickly,sudden onset of dysphagia is common.It will endanger patient's life without proper treatment.The definite treatment of acute bulbar palsy in hyperthyroidism is to restore the euthyroid state.The dysphagia usually resolves within 3 to 4 weeks.In this article a case of thyrotoxicosis with acute bulbar palsy in reported herewith to call attention to the diagnosis and treatment of this disorder.

This paper summarizes the 10 cases weaning from mechanical ventilation with proportional pressure support(PPS).The nursing care focus on dynamic monitoring of PPS,asphyxia ventilation,system airtight care,etc.Ten patients were successfully remove the respirator.

Objective To design a checklist (NICU-PoHC) for postoperative handover in the NICU (Neurosurgery Intensive Care Unit) in case of information omissions or task errors during the handover process,thus to improve patient safety.Methods Team discussion and literature review was conducted to compose the preliminary version of the NICU-PoHC.Then two rounds of panel review were conducted using the Delphi methods to revise the preliminary checklist and to calculate its Content Validity Index (CVI).Results The authority coefficient of experts was 0.86.Twenty experts proposed 7 suggestions for revision.The NICU-PoHC was developed,and its CVI was 0.88.Conclusions Our study developed the NICU-PoHC,which can be used as an assistant tool guiding the postoperative handover,preventing information omissions and task errors,and thus improving patient safety.

Objective To research the relationship between the gene polymorphism of serum amyloid A protein(SAA)1 and coronary heart disease(CHD).Methods By using PCR-RFLP and sequencing,the gene polymorphism of SAA1 of 183 patients with coronary heart disease and 152 healthy controls were analyzed.Result In the both groups 3 alleles(1.1,1.3,1.5)and 6 genotypes(1.1/1.1,1.1/1.5,1.1/1.3,1.3/1.3,1.3/1.5 and 1.5/1.5)were found.The frequency of 1.5 allele in healthy controls group was notably higher than that in CHD group(P