Objective Toinvestigate the effect ofPBLmethod in the pediatrics'nurse teaching.Methods PBL teaching was practiced in trial group,while LBL teaching was practiced in control group.The writers made an analysis of this teaching by way of questionnaire and exam.Results Many students by PBL teaching accept PBL teaching,and improve their self-study ability,understanding ability,analyzing ability and so on.Conclusion PBL teaching method can effectively promote both the teaching quality in pediatric nursing and the students'study interest.

Objective]The article summarizes the H-hypertension's clinical experience by professor He Jia. [Methods]From following professor He Jia clinical studies, summarize professor He Jia from different ages, the treatment by applying the method of tonifying qi by stasis H-hypertension qi deficiency blood stasis syndrome differentiation thinking and clinical experience, and for proven cases.[Result]The professor He Jia considers the method of Buqi Zhuyu as the basic therapeutic principle, with pathogenesis of qi deficiency and blood stasis in the collaterals. And also to make up for points and syndromes differentiation from youthes and older, in the young and middle-aged people and see blood stasis into collaterals, the treatment of blood stasis by the main,the old people see more Qi deficiency into the network, to make up for the deficiency of Qi.Her clinical medicine is characterized in paying equal attention to the Qi and blood, Buqi Zhuyu, using opportunely insect medicine,Soufeng Tongluo,using the mineral medicine, Ziyin Qianyang along with the disease change, with good effect.[Conclusion]Professor He Jia for H-hypertension treatment of qi deficiency blood stasis unique insights, obtains good effect, often with fellow mutual information.

Objective The loss of NF2 gene in cutaneous schwannomas of neurofibromatosis type 2 patients was investigated in order to explore the tumorigenesis and characteristics of NF2 tumor suppressor gene, and to provide evidence for presymptomatic gene diagnosis for NF2 patients. Methods DNA was extracted from whole blood and frozen tumor tissue, respectively. Genotyping was performed using 6 microsatellite markers flanking or within the NF2 gene: CRYB2－ D22S193－ NF2CA1－ NF2CA3－ D22S268－ D22S430, which is tightly linked to the NF2 gene and analyzed on an ABI Genetic Analyzer 310 after PCR amplification. Results A total of 18,14,0,13,16,12 samples showed loss of heterozygosity at microsatellite markers CRYB2， D22S193， NF2CA1， NF2CA3， D22S268， D22S430 in 43 samples of cutaneous schwannomas, respectively. Conclusions The method for detection of NF2 allelic loss was established. Frequent allelic loss reconfirms that NF2 gene is a tumor suppressor gene. The observation that tumors with or without allelic loss of the NF2 gene exist in the same patient indicates that these tumors are originated from different clones in which genetic alterations occurred independently.

OBJECTIVE:To observe therapeutic efficacy and safety of paroxetine combined with flupentixol melitracen in the treatment of post-stroke major depressive disorder(PSMDD). METHODS:120 PSMDD patients were randomly divided into group A(40 cases),group B(40 cases)and group C(40 cases). All patients received routine stroke treatment;group A was additionally given Paroxetine hydrochloride enteric-coated sustained-release tablet 25 mg orally,once a day;group B was additionally given Flu-pentixol melitracen tablet 20 mg orally twice a day;group C was additionally given Paroxetine hydrochloride enteric-coated sus-tained-release tablet (same usage and dosage as group A)+flupentixol melitracen (same usage and dosage as group B). Three groups were treated for 28 d. Clinical efficacies of 3 groups were observed as well as NIHSS,ADL,HADM,SS-QOL score,hos-pitalization stay and the occurrence of ADR. RESULTS:Total response rate of group C was significantly higher than those of group A and B;hospitalization day was significantly less than those of group A and B,with statistical significance(P<0.05);there was no statistical significance between group A and B(P>0.05). There was no statistical significance in the incidence of ADR among 3 groups (P>0.05). Before treatment,there was no statistical significance in NIHSS,ADL,HADM,SS-QOL score among 3 groups(P>0.05). After 10,28 d of treatment,NIHSS,HADM,SS-QOL score of 3 groups were significantly lower than before, above indexes were decreased gradually as time,and the group C were lower than the group A and B;ADL score of 3 groups were significantly higher than before,this index was increased gradually as time,and the group C were lower than the group A and B with statistical significance (P<0.05);there was no statistical significance between group A and B (P>0.05). CONCLUSIONS:Based on routine treatment,paroxetine combined with flupentixol melitracen in the treatment of PSMDD can relieve neurologic function injury,improve depression condition and the quality of life without increasing the occurrence of ADR.

Objective To investigate the reproductive outcome after high intensity focused ultrasound (HIFU ) ablation for pa-tients with adenomyosis who have fertility requirements .Methods From October 2010 to June 2013 ,38 patients with adenomyosis who have fertility requirements treated by HIFU in our hospital were analyzed .Results In 38 cases ,the menorrhagia severity score ,the dysmenorrhea pain score and adenomyosis lesions after HIFU ablation were significantly different from the levels before HIFU treatment(P<0 .05) .Successful pregnancy occurred in 15 patients ,full-term birth was seen in 7 patients(three of Cesarean section ,four of vaginal delivery);the remaining patients accept routine prenatal examination .All pregnant patients showed no ab-normality .Conclusion Although large sample size study with long-term follow up is need ,based on our results ,HIFU ablation for patients with adenomyosis might improve the pregnancy rate safely .

Objective To investigate the relationship between renin (REN) gene G10631A, angiotensinogen (AGT) gene T704C mononucleotide polymorphisms and cerebral infarction and to investigate the mechanisms and characteristics of cerebral infarction from molecular level. Methods REN gene G1063A and AGT gene T704C polymorphisms in 82 patients with cerebral infarction and 89 controls were detected with polymerase chain reactionrestriction fragment length polymorphism. The differences of the genotypes and allele frequencies were compared between the patient group and the control group. Results The frequency of REN 10631AA genotype (31. 7% vs. 10. 1%,χ2 =12. 816, P = 0. 002) and the frequency of A genotype (49. 4% vs. 30. 3% χ2 = 12. 969, P =0. 000), as well as the frequency of AGT 704 CC genotype (63. 4% vs. 34. 8% χ2 = 15. 029, P = 0. 001) and the frequency of A genotype (79. 9% vs. 61. 2% χ2 = 14. 173, P = 0. 000) in the cerebral infarction group were all significantly higher than those in the control group; the frequency of haplotype 704C 10631A was also significantly higher than that in the control group (P=0. 000). Conclusions REN 10631AA genetype and A allele as well as AGT 704 CC genetype and C allele may be the susceptible factors of cerebral infarction. Haplotype 704C-10631 A may be a genetic risk factor for the occurrence of cerebral infarction.

Objective To investigate the changes in intrapulmonary shunting during controlled hypotension induced by sodium nitroprusside(SNP)in patients undergoing naso-endoscopic operation.Methods Forty ASAⅠorⅡpatients of both sexes(23 male,17 female)aged 16-50 yrs weighing 50-75 kg undergoing naso-endoscopic operation under general anesthesia with muscle relaxation and mechanical ventilation were studied.Radial artery was cannulated for direct BP monitoring and blood sampling.Right internal jugular vein was cannulated and the catheter was advanced into right ventricle.Blood sample taken from right ventricle was used as mixed venous blood instead of blood from pulmonary artery.ECG,MAP,HR and P_(ET) CO_2 were continuously monitored during operation Cardiac output was monitored with noninvasive cardiac function monitor(NC-COM.)based on impedance principle.SNP infusion was started at the beginning of operation at 1-3?g?kg~(-1)?min~(-1) and was then adjusted.MAP was reduced by 30%-40% and maintained at this level until the end of operation.Blood samples were taken from artery and right ventricle simultaneously before SNP infusion(T_1,baseline)at 30 and 60 min of hypotension(T_2,T_3)and at 20 min after BP returned to the baseline level(T_4)for blood gas analysis.Qs/Qt was calculated.Results Qs/Qt was significantly increased during controlled hypotension at T_2 and T_3 as compared to the baseline value(P＜0.01)and returned to the baseline level at T_4.HR was increased and cardiac output and stroke volume was significantly reduced during hypotension as compared to the baseline value.Conclusion The intrapulmonary shunting is increased and the hemodynamics is depressed during SNP-induced controlled hypotension and they return rapidly to baseline level after SNP is discontinued.No hypoxemia develops during SNP- induced hypotension.

Objective To explore the pattern of lymph node metastasis in patitsen with squamous cell carcinoma of the thoracic esophagus and its significance in lymphadenectomy.Methods The clinical data of 230 patients who received radical esophagectomy with three-field lymphadenectomy was analyzed.The metastatic sites of lymph nodes were correlated with tumor location by chi-square test.Logistic regression was used to analyze the relationship between clinic pathoingical factors and lymph node metastasis.Results Lymph node metastases were found in 133 of the 230 patients(57.8%).The average number of resected lymph nodes was 25.3? 11.4 per patient(range 11～71).The rates of lymph node metastasis were 41.6%,19.44%and 8.3%in the neck,thoracic medi- astinum and abdominal cavity for patients with upper thoracic esophageal carcinoma,33.3%,34.7%and 14%for patients with mid- die thoracic esophageal carcinoma and 36.4 %,34.1%and 43.2 %for patients with lower thoracic esophageal carcinoma.No signifi- cant difference in cervical or thoracic metastatic rate was observed among upper,middle and lower thoracic carcinoma.The difference in lymph node metastatic rate for nodes in the abdominal cavity was significant among upper,middle and lower thoracic carcinoma. The lower thoracic esophageal cancers were more likely to metastasize to the abdominal cavity.Logistic-regression showed depth of tu- mor invasion and angiolymphatic invasion were factors influencing lymph node metastasis.Conclusion Cervical and mediastinal node dissection should be performed independently from tumor location.Abdominal node dissection should be conducted more vigorously for lower thoracic esophageal cancer than of other locations.Patients with greater tumor grade,depth of tumor invasion and angiolymphatic invasion were more prone to develop lymph node metastasis.

ced glutathione in MHD patients appears to be associated with an improvement of oxidative stress.

Objective: Extracting ephedrine and berberine from the water extract of Ephedra Herba and Rhizoma Coptidis. Methods: Modified PVA was used as separating membrane and separated alkaloids. Results: A colorless ephedrine aqueous solution was obtained when extraction time was less than 8 hours; while a three constitution solution was obtained when time of extraction is over 8 hours. So is Rhizoma Coptidis. The membrane is hardly fouled. Conclusion: Purity of alkaloids from Herba Ephedra and Rhizoma Coptidis by membrane separation is Superior to that by alcoholic sediment but amount of alkaloids is reverse.