Objective:To design the teaching method of problem-based learning(PBL) and verify as well as evaluate its effectiveness in the teaching practice of clinical nuclear medicine.Methods:A new teaching method-PBL was introduced on the basis of summarizing the problems and shortcomings in the teaching of clinical nuclear medicine.The students raised questions centering on the typical cases and discussed under the guidance of the teacher by team.Afterward the teaching effectiveness was judged by the results of test and the evaluation of students and teachers.Results:PBL received favorable feed-backs from students and teachers.The results of test had obviously improved in the PBL groups(P

Objective To observe the effect of Guanxin Ⅱ Hao on plasma NO and NOS in dog with myocardial ischemia. Methods 20 dogs of myocardial ischemia were divided into the control group, isosorbidi mononitratis group and the Guanxin Ⅱ Hao group by random. The NO and NOS of serum were measured, before and after treatment. Results In the control group, the level of NO and NOS were higher than that of the isosorbide mononitrate group. There was significant difference between the control group and the Guanxin II Hao groups (P

Aim To study the effect of puerarin on reperfusion injury after thrombolytic therapy in acute pulmonary thromboembolism and its mechanism. Methods Thirty-two Japanese rabbits were randomly divided into sham operation group (group S),Thrombolysis-only group(group T), and Puerarin group(group Pur). Acute pulmonary thromboembolism models of rabbits were established with injection of autologous blood clots through the right heart catheters,haemodynamic monitoring was performed by introducing heart catheter through right jugular vein.The activity of plasma superoxide dismutase (SOD) and content of plasma malondialdehyde (MDA) were detected before embolization,2 h after embolization,2 h and 4 h after thrombolysis. At the end,the rabbits were sacrificed and their lung,removed for histopathologic and electron microscopic investigations. Results ①Pulmonary arterial mean pressure (PAMP) were decreased at 1 hour after thrombolysis both in group T and group Pur(P

Objective To investigate clinical observation of different narcotic drugs compatibility in elderly patients with laparoscopic resection of tumor .Methods From June 2015 to June 2017 ,86 cases of elderly lapa-roscopic tumor resection were selected from our hospital .They were divided into the observation group and the control group according to the random number table ,each with 43 cases .The control group received propofol and dexmedetomidine anesthesia ,and the observation group received sevoflurane and dexmedetomidine anes-thesia maintenance .Results The observation group anesthesia total satisfaction rate (97 .67%) higher than that of the control group (79 .07%) ,the difference was statistically significant (P＜0 .05) ;The two group af-ter 3 h and 24 h OAAS score increased after operation ,the difference was statistically significant (P＜0 .05) ;The patients in the observation group 3 h and 24 h OAAS were higher than those of the control group ,the difference was statistically significant (P＜0 .05) ;The observation group extubation time ,called the open time and the recovery time of spontaneous breathing faster than the control group ,the difference was statistically significant (P＜0 .05) ;Two group T1 time HR MAP compared with T0 time reduction ,the difference was sta-tistically significant (P＜0 .05) ;The control group at T2 of HR and T0 of MAP were constantly reduced ,the difference was statistically significant (P＜0 .05) ,while the observation group at T2 HR and MAP did not change significantly compared with T0 time ,the difference was not statistically significant (P＞0 .05) ;Two group T0 ,T1 and T2 HR ,MAP and SpO2time was not statistically significant (P＞0 .05) ;The observation group T1 and T2 HR ,MAP times higher than that of the control group ,the difference was statistically signifi-cant(P＜0 .05) .Conclusion Sevoflurane combined with dexmedetomidine combined anesthesia in elderly pa- tients with laparoscopic resection surgery is obviously good effect ,little influence on sedation ,patients with HR ,MAP and SpO2.

Objective: To compare the treatment effect of surgical clipping and endovascular coil embolization for aneurysmal subarachnoid hemorrhage (aSAH) in the elderly. Methods: Elderly patients with aSAH (aged >65 years) treated in Shanghai Pudong Hospital from January 2009 to December 2017 were enrolled retrospectively. They were divided into craniotomy clipping group and endovascular intervention group according to the treatment strategy. The Glasgow Outcome Scale was used for short-term outcome assessment at discharge, 4-5 were defined as good outcome, and 1-3 were defined as poor outcome. Long-term follow-up was performed to assess clinical outcomes using the modified Rankin Scale, 0-2 was defined as good outcome and 3-6 were defined as poor outcome. The clinical and imaging information, perioperative complications, short-term and long-term clinical outcomes, and long-term imaging outcomes were compared between the two groups. Multivariate logistic regression analysis was used to assess the independent influencing factors of clinical outcomes. Results: A total of 68 elderly patients with aSAH were enrolled. Of these, 47 (69.1%) received endovascular coil embolization and 21 (30.9%) underwent microsurgical clipping. There were no significant differences between the two groups in the incidence of perioperative complications, short-term and long-term adverse outcomes, and imaging recurrence rate. Multivariate logistic analysis showed that smoking (odds ratio [OR] 36.319, 95% confidence interval [CI] 3.530-373.640; P=0.003), modified Fisher grade (OR 20.406, 95% CI 2.022-205.964; P=0.011) and World Federation of Neurological Societies (WFNS) grade (OR 4.686, 95% CI 1.012-21.692; P=0.048) were the independent risk factors for short-term poor outcomes in elderly patients with aSAH. Conclusion Both endovascular intervention and microsurgical clipping are safe and effective treatments for elderly patients with aSAH.

Objective To study the association, clinical presentation, and diagnosis and treatment of bile duct cancer as a late complication of biliary-enteric anastomoses for benign diseases. Methods A retrospective study was carried out on 5 patients and the medical literature was reviewed. Results They were 3 males and 2 females. The average age was ( 66. 0 ± 0. 7 ) years. The average time period was ( 14. 0 ± 6. 1 ) years after biliary-enteric anastomosis. The clinical presentations included right upper quadrant pain, fever, chills and jaundice. CA19-9, CT and MRI were valuable in diagnosis. There were two patients with distal and three patients with perihilar cholangiocarcinomas (type IIIa, n=2, and type IV, n=1). Local resection with lymphadenectomy was carried out in one patient. Another patient underwent pancreaticoduodenectomy. The remaining three patients only underwent percutaneous transhepatic cholangial drainage ( PTCD). The 2 patients who underwent surgery died of progressive tumor disease at 8 and 13 months postoperatively. The other three patients who underwent palliative biliary drainage died within 6 months of PTCD. There was no significant difference between the two types of treatment ( P ＞0. 05). Conclusions Chronic cholangitis caused by reflux and bacterial infection was properly a predisposing factor leading to late development of bile duct cancer after biliary-enteric anastomosis for benign diseases. Patients treated with biliary-enteric anastomosis should be closely monitored for late development of cholangiocarcinoma. Some procedures such as choledochoduodenostomy and jejunum interposition choledochoduodenostomy should be abandoned because of their poor outcomes and severe complications. Proper indications of biliary-enteric anastomosis should strictly be followed and the Oddi's sphincter should be protected if possible to prevent late development of bile duct cancer.

Dissolving microneedles carried drug molecules can effectively penetrate the stratum corneum of skin to improve the transdermal drug delivery. The traditional Chinese medicine acupuncture is based on the needle stimulation at a specific location (acupoint) to generate and transmit biochemical and physiological signals which alter the pathophysiological state of patients. However, the pain associated with conventional acupuncture needles and the requirement of highly trained professionals limit the development of acupuncture in non-Asian countries. The purpose of this study is to investigate whether the dissolving microneedles can be utilized as a self-administered painless replacement for acupuncture and locally released drug molecules can achieve expected therapeutic outcomes. Immunosuppressive rats were treated with acupuncture at Zusanli (ST36) acupoint using microneedles containing thymopentin. The immune functions and psychological mood of the immunosuppressed animals were examined. The proliferation of splenocytes was examined by CCK-8 assay. CD4 and CD8 expression patterns in spleen cells were detected by flow cytometry. The current study showed that use of either microneedles containing thymopentin or conventional acupuncture both resulted in immune cell proliferation, which was confirmed by flow cytometry. Furthermore, either conventional acupuncture or microneedles were able to effectively mitigate the anxiety caused by immune-suppression when applied on the ST36.