Objective To evaluate the efficacy of applying problem based learning (PBL) combined with traditional teaching in clinical internship in department of gastroenterology.Methods Totally 60 full-time medical undergraduates of clinical medicine in clinical internship in department of gastroenterology of the Second Hospital of Baoding were randomly divided into PBL group (n=30) and traditional group (n=30).Practical effect of the different modes was evaluated by questionnaire and examination resuits.Data were analyzed by SPSS 15.0.Enumeration data were compared between groups using x2 test and measurement data were manifested (x-) ± s with P ＜ 0.05 signifying significant difference.Results PBL group was superior to traditional group in comprehensive analysis capabilities,motivation to learn and learning outcomes with statistically significant differences between the two groups (P values were 0.001,0.007 and 0.005).Concerning stimulating students' interest and satisfaction of the teaching mode,the difference between the two groups was not statistically significant (P ＞ 0.05).PBL group was superior to traditional group in the pre-class preparation,full and accurate expression of views in classroom and clinical logic,with statistically significant differences between the two groups (P values were 0.002,0.000 and 0.002).There was no difference in communicative abilities with patients between the two groups (P=0.118).PBL group had higher scores than traditional group in the quiz,case analysis and overall performance,with statistically significant differences between the two groups (P values were 0.005,0.045 and 0.013).Concerning score of glossary and multiple-choice questions,differences between two group were not statistically significant (P＞0.05).Conclusions PBL combined with traditional teaching method is suitable for internship teaching in the department of gastroenterology for full-time undergraduates of clinical medicine.PBL can improve students' clinical comprehensive analysis capabilities and helps to develop the ability to take the initiative to solve practical problems.

Objective To explore the clinical characteristics and related factors of Helicobacter pylori (Hp) infection in gastric stump lesion.Methods Eighty-nine patients with subtotal gastrectomy gastrointestinal symptoms underwent gastroscope,the clinical data were retrospectively analyzed.The relationship between gastric Hp infection and different operation reasons,different operation,different degree of inflammation,postoperative time,the existence of bile reflux was assessed.Results There were 29 cases of gastric Hp infection,the positive rate of Hp was 32.6％ (29/89).There were no significant difference between different preoperative disease such as duodenal ulcer (bleeding/perforation),gastric ulcer (bleeding/perforation),gastric cancer,leiomyosarcoma and HP infection (P ＞0.05).There was no significant different positive rate of Hp infection between Billroth Ⅰ and Billroth Ⅱ after operation (P ＞0.05).The rate of Hp infection increased with the degree of inflammation (moderate to severe) in gastric stump and anastomotic inflammation.There were significant difference [gastritis severity of inflammation:27.3％ (12/44) vs.57.1％ (16/28),anastomotic inflammation:25 ％ (10/40) vs.50％ (18/36),P ＜ 0.05] ;there was significant difference between two groups of more than 10 years [43.9％ (18/41)] and less than 10 years [22.9％ (11/48)] of Hp infection rate (x2 =4.433,P =0.035) ; the positive rate of Hp infection in group of no bile reflux under gastroscopy were higher than the group of bile reflux,there was significant difference [22.2％ (10/45) vs.43.2％ (19/44),x2 =4.449,P =0.035).Multivariate Logistic regression analysis showed that,the degree of inflammation (severe) and bile reflux was associated with gastric Hp infection,inflammation (severe) was the dominant risk factor [OR =1.24,95％ CI:1.22-1.56,P =0.01],with bile reflux were protective factors [OR =0.76,95％CI:0.58-0.99,P =0.04].Conclusions Hp infection can promote and aggravate the gastric remnant mucosa inflammation,Hp infection and bile reflux can lead to gastric mucosa pathological changes,there can be independence pathogenic factors,also can cause at the same time,regulate the eradication of residual gastric Hp infection is very important,also deal with the residual stomach regular line of gastroscope and Hp,histologic examination.

Objective:To explore the effect of hydrotherapy combined with breathing training on lung function and mobility of patients with thoracolumbar spinal cord injury.Methods:A total of 80 patients with thoracolumbar spinal cord injury admitted to Beijing Rehabilitation Hospital Affiliated to Capital Medical University from April 2018 to March 2020 were selected as observation objects.A prospective cohort study was conducted and randomly divided into observation group and control group with 40 cases in each group.The control group was given routine rehabilitation therapy combined with respiratory training.On the basis of the control group, the observation group was treated with water therapy.The indexes of lung function, motor function, lower limb muscle tension, function evaluation and activities of daily living were compared between the two groups.Results:After intervention, the observation group′s forced vital capacity (FVC) was (3.86±0.82) L, the forced expiratory volume in the first second (FEV1) was (3.76±0.68) L, the maximum ventilation (MVV) was (102.34±10.38) L/min, the maximum suction pressure (MIP) is (50.36±4.62) cmH 2O; the control group FVC was (3.41±0.76) L, and FEV1 was ( 3.35±0.63) L, MVV was (90.67±11.68) L/min, MIP was (44.38±4.85) cmH 2O, the difference between the two groups is statistically significant ( t=2.546, 2.797, 4.723, 5.646, respectively, all P<0.05). After the intervention, the motor function score of the american spinal injury association (ASIA) of the observation group was (58.62±7.56) points, and the modified ashworth scale (MAS) score was (2.74±0.89) points; The ASIA motor function score of the control group was (42.24±6.40) points, and the MAS score was (3.36±0.94) points.The difference between the two groups was statistically significant ( t=10.459 and -3.029, respectively, all P<0.05). After intervention, the observation group′s spinal cord independence measure (SCIM III) score was (75.33±10.72) points, and the modified barthel index (MBI) was (66.64±6.34) points; the SCIM III score of the control group was (68.34±9.55) points, and the MBI score was (57.52±6.77) points, the difference between the two groups was statistically significant ( t=3.079 and 6.219, respectively, all P<0.05). Conclusion:Hydrotherapy combined with breathing training can significantly improve lung function and respiratory muscle strength in patients with thoracolumbar spinal cord injury, and improve motor function and ability of daily living.

Objective To determine the clinicopathologic characteristics and prognostic factors that may be used to predict the poor outcome of patients with borderline ovarian tumors. Methods All cases with borderline ovarian tumors treated in the West China Second University Hospital from January 2001 to June 2007 were analyzed retrospectively for elinicopathologic features, treatment parameters and outcome of treatment. Univariate and multivariate analyses were used to assess independent prognostic factors using the logistic regression model. Results The median age of 234 patients was 40. 1 years with a range of 14 to 80 years. There were 101 (43.2%), 94 (40.2% ) , 19 (8.1% ), 12 (5.1%) , 8 (3.4%) cases of serous, mutinous, mixed, endometrioid and clear cell tumors, respectively. Out of 234 cases, 182 (77.8%) underwent laparotomy and 45 ( 19.2% ) underwent laparoscopy. Seven women underwent laparoconversion. Fertility sparing surgery was performed on 119 cases (50.9% ) and radical surgery was performed on 115 cases (49.1% ). Totally 161 (68.8% ) patients had stage Ⅰ , 19 ( 8.1% ) had stage Ⅱ, 54 ( 23.1% ) had stage Ⅲ, and none had stage Ⅳ disease. Sixty-four women received postoperative chemotherapy. The median follow-up was 40 months with a range of 8 to 78 months. Recurrence was found in 26 cases (11.1%) during follow-up, and no tumor-related death was reported. The logistic regression model showed that surgery procedure ( OR=2.304, P=0.024), cyst rupture ( OR=2.213, P=0.038 ), stage ( OR= 4.114, P<0.01 ), microinvasion ( OR=2.291, P=0.046) and peritoneal implants ( OR=2.101, P = 0.016) were the five independent prognostic factors affecting recurrence. Conclusions Although patients with borderline ovarian tumors have an excellent prognosis, the risk of recurrence remains in some patients. Emphasis should be put on these patients with high risk factors and preventive strategies should be taken to prevent their progression.

Objective To analyse the high-dose dexamethasone suppression test(HDDST)-related differences in the clinical and biochemical features of the patients with Cushing's disease Methods Cases were drawn from 60 consecutive patients with Cushing's disease,who were then divided into two groups according to the response to the HDDST.The clinical and biochemical features between two groups were compared.Results(1) Of the 60 patients with Cushing's disease,23.3%(14/60)of patients(group A)did not yield results of suppression with the HDDST,and the others(group B)did.No difference was found in the age[(33.8?10.4 vs 36.2?11.2)years]and duration of illness[(2.1?1.6 vs 3.9?3.1)years]between two groups.(2)In clinical features,the patients in group A were more likely to have edema of lower limbs(64.3% vs 32.6%),hypokalemia (71.4% vs 28.3%),secondary diabetes(57.1% vs 26.1%)and purple striae(85.7% vs 54.3%,all P

Objective This study aims to biomechanically analyze a mini-implant at different healing times before loading. Methods Sixty-four mini-implants with (12±1) N·cm insertion torque were placed in the low jaw of eight beagle dogs. The test mini-implants remained in the low jaw for 0, 1, 3, and 8 weeks of bone healing and for an additional 10 weeks under a force of 0.98 N. The unloaded control implants were further divided into four groups (1, 3, 8, and 10 weeks). Maximum removal torque (MRT) testing was performed to evaluate the interfacial share strength of each group. Surface analysis of the removed implants was performed by scanning electric microscope (SEM). Results The MRT for the loading implants at 0, 1, 3, and 8 weeks of healing were 4.10, 4.25, 2.42, and 4.42 N·cm, respectively. During the healing process, the removal torque values of the 3-week implants were significantly lower than those of the other healing groups (P<0.05). The unloaded 3-week implants also had lower removal torques (P<0.05). The implant surface of the 3-week test group showed more fibrous bone. However, the other loading implants had more lamellar-like tissue. Conclusion A stable dangerous period occurred approximately 3 weeks after mini-implant insertion. A 3-week healing is disadvantageous to the stability of the implant. Orthodontics loading occurred immediately or after 1 week as a function of the healing time. The 8-week implant appeared to have a positive effect on peri-implant bone remodeling and implant stability.

Carcinoma, Hepatocellular ; metabolism ; pathology ; Cyclin D1 ; biosynthesis ; Hepatitis B virus ; Humans ; Liver ; pathology ; Liver Cirrhosis ; metabolism ; pathology ; NF-kappa B ; biosynthesis ; Trans-Activators ; biosynthesis

OBJECTIVETo evaluate the difference of clinical outcomes and radiological outcomes through meta-analysis on the total hip arthroplasty (THA) between hydroxyapatite(HA) coating and non-HA coating femoral stems.

METHODSWe searched the MEDLINE, Embase, Cochrane library and CBM for published randomized controlled trial (RCT) comparing HA coating and non-HA coating femoral stems in primary THA clinical outcomes with Harris hip score and incidence postoperative thigh pain, radiological outcomes with presence of endosteal condensation and radioactive line on the prothesis, heterotopic ossification. Data analysis were performed using RevMan 5.0(the Cochrane Collaboration).

RESULTSTen studies and 917 hips into our analysis, with 464 hips in HA groups and 453 hips in non-HA groups. The combined results of the meta-analysis indicated there was no statistical differences between the two groups on postoperative Harris hip score(WMD = 3.04, 95%CI:-4.47-10.54, P = 0.43) , there was statistical difference on incidence postoperative thigh pain (RR = 0.56, 95%CI:0.33-0.94, P = 0.03) . There were no significant differences between the two groups on presence of endosteal condensation (RR = 1.01, 95%CI:0.91-1.11, P = 0.91), presence of radioactive line (RR = 0.99, 95%CI:0.88-1.11, P = 0.83) and incidence of heterotopic ossification (RR = 0.97, 95%CI:0.77-1.21, P = 0.77).

CONCLUSIONSThere are no clinical and radiological benefits in the use of HA coating femoral stems in Primary THA, there is not enough evidence prove the HA can reduce the incidence postoperative thigh pain.

Arthroplasty, Replacement, Hip ; instrumentation ; Coated Materials, Biocompatible ; Durapatite ; Femur ; Hip Prosthesis ; Humans ; Randomized Controlled Trials as Topic ; Treatment Outcome