Self-directed learning(SDL)is an important learning form for the future educational development and the continued medical education.SDL facilitates the learning effects of advanced studying doctors in neonatology.This article investigates the major developments and influencing factors relative to self directed learning,and provides insight into the practice and progress of self directed learning of the advanced studying doctors in neonatology.

Objective To observe the curative effect of Yiqi Congming Decoction on tinnitus and deafness. Methods From May 2015 to May 2017 in the first affiliated hospital of Tianjin university of traditional Chinese medicine 74 cases of tinnitus and deafness patients, all patients were diagnosed as tinnitus, deafness, and has been hearing examination, examination and imaging examination of tympanic membrane. All patients were treated with Yiqi Congming decoction, 2 weeks for a course of treatment, a total of 3 courses of treatment. The therapeutic effect of the patients was observed. Results After 3 courses of treatment, 44 cases were markedly effective (59.46%), effective in 22 cases (29.73%), ineffective in 8 cases (10.81%), and the total effective rate was 89.19%. At the same time, follow-up studies were conducted on patients with significant efficacy and no recurrence was observed. Conclusion The method of Yiqi Congming decoction has better curative effect in the treatment of tinnitus and deafness.

Objective To investigate the effect of Qingjing Capsule (QC) in treating advance menorrhea (AM) and to evaluate its safety. Methods Double- blind, double- imitating, parallel- controlled and randomized trial was performed in 63 cases of AM with deficiency- heat syndrome.Thirty- two cases was in QC group(Group A) and other 31 in Gujing pill group(Group B).The menstrual cycle, clinical symptoms and signs, basal body temperature (BBT), serum levels of estradiol (E2) and progesterone and endometrium biopsy were observed to evaluate the effects of QC. Results The short- term markedly- effective rate was 90.63% and 77.42% and the short- term effective rate was 96.88% and 93.55% in Group A and Group B respectively. The long- term markedly- effective rate was 83.87% and 67.74% and the long- term effective rate was 93.55% and 80.65% in Group A and Group B respectively. The long- term markedly- effective rate in QC group is superior to that in Gujing pill group, the differences being significant(P

Objective:To observe the regulative effects of different concentrations of glucose on the expressions of osteoprotegerin(OPG),the ligand of osteoprotegerin(OPGL) and the related cytokines[tumor necrosis factor related apoptosis inducing ligand(TRAIL),macrophage colony-stimulating factor(M-CSF) and transforming growth factor ?(TGF-?)] in osteosarcoma MG63 cells.Methods:The expressions of OPG,OPGL,M-CSF,TRAIL and TGF-? mRNA was examined by reverse transcriptase(RT)-PCR.Results:High concentration glucose up-regulated the expression of OPGL,M-CSF and TRAIL but down-regulated OPG and TGF-? expression in the MG63 cells.Conclusion:One of the key pathogenetic factors of diabetic osteoporosis is that high concentration glucose leads to the down-regulated expression of OPG and TGF-? but the up-regulated expression of some bone-resorbing cytokines such as OPGL,M-CSF and TRAIL in osteoblasts,then stimulates osteoclast differentiation and activity,which potentiates bone resorption and bone loss.

Objective To compare the postoperative changes in immune function of patients undergoing robot-assisted laparoscopic cholecystectomy(RLC) and conventional laparoscopic cholecystectomy(CLC).Methods The clinical data of 52 cases of gallbladder stones and gallbladder polyps treated with RLC(23 cases),and with LC(29 cases) was compared.Blood samples from both groups were taken to measure immune markers(T cells,IgA,IgM,IgG,C3,C4) before operation and in the first postoperative morning.Results The postoperative levels of CD4/CD8 and IgM decreased from 1.56?0.67,1.42 ?0.58 to 1.30?0.53,1.26?0.46 respectively after RLC(all P0.05).Conclusions RLC and CLC showed no significant postoperative effect on cellular immune function,but both had some effect on humoral immune function.

Objective To evaluate the effect of antler polypeptides from Cervus elaphus yarkandensis on MC3T3-E1 cells. Methods The concentration of antler polypeptides of Cervus elaphus yarkandensis was measured by BCA protein assay kit. MC3T3-E1 cells were cultured and analyzed by BCIP/NBT chromogenic alkaline phosphatase (ALP) staining kit. After being induced to form mineralized knot, the cells were stained by using Alizarin red staining. Three different concentrations (10, 1.0, 0.1 μg/mL) of antler polypeptides were analyzed by MTT method and micronutrients enzymes standard method to determine the effect of cell proliferation and ALP synthesis. Results The concentration of antler polypeptides was 0.07 mg/mL. The results of in vitro cell activity analysis showed that the positive rate of ALP was 90%and the mineralization knot was stained red. Compared with the control group, the different concentrations of antler polypeptides all showed the function of cell proliferation and the effect was dose-dependent after 3 d and 7 d. Compared with the control group, at the 3 d, three groups of antler polypeptides promoted synthesis and secretion of ALP (P<0.01) and the results showed a dose-dependent effect. Conclusion Antler polypeptides could obviously promote the proliferation of MC3T3-E1 cells and secretion of ALP, which indicated that antler polypeptides have certain effect on osteoporosis.

In order to ef fectively control the quality ofSophora lfos carbonisatus (flower and flower buds), this study established quality control methods and standard of the decoction pieces. Referring to the related methods in appendix of Chinese Pharmacopoeia (2010 Edition), the moisture, total ash, acid insoluble ash, alcohol extracts ofSophora lfos carbonisatus were measured, respectively, with rutin, quercetin as control substance. The eluents for rutin and quercetin are ethyl acetate - formic acid - water (8: 1:1) and chloroform - methanol - water (6.5:1:1), respectively and all TLC plates were observed at 365 nm. Total flavonoids are measured by visible - UV - spectrophotometric, and rutin and quercetin were determined by HPLC. The chromatographic conditions for rutin are: Kromasil C18 as the stationary phase, methanol -1% acetic acid (32:68) as mobile phase, flow rate: 0.8 mL·min-1, detection wavelength 257 nm,the column temperature 35℃; for quercetin: Kromasil C18 as the stationary phase, methanol -0.4% acetic acid (44:56) as the mobile phase, flow rate: 0.8 mL·min-1, detection wavelength 257 nm, the column temperature 40℃.The contents of moisture, total ash, acid insoluble ash, should not exceed 6%, 16%, 8.0% in flower and not exceed 6.0%,9.0%, 1.5% in buds, respectively. Under the conditions of TLC, in flower and flower buds, 2 reference substances can be separated well with others. Extract, total flavonoids, rutin, quercetin were no lower than 40.0%, 5.0%, 2.5%,0. 2% in flower and no lower than 45.0%, 10.0%, 5.0%, 0.9% in buds, respectively. The established standards can improve the levels of quality control, provide experimental data for safety and efficacy of clinical application of Sophora flos carbonisatus, and also offer supporting data for the Chinese Pharmacopoeia 2015 Edition.

BACKGROUND:The meningeal defect patients can be treated with artificial dural materials combined neurosurgical techniques which can protect the integrity of brain tissue. OBJECTIVE:To analyze the biocompatibility and application feasibility of various artificial dura mater materials. METHODS:The artificial dura materials were classified according to the different sources, and the biocompatible and application feasibility of various artificial dura mater materials were analyzed, as wel as the advantages and disadvantages of various materials. The anticoagulant and hemolytic properties of the materials were analyzed through recalcification test and hemolysis test. 100 patients receiving col agen membrane repair selected from Department of Neurosurgery, Dongfang Hospital of Beijing University of Chinese Medicine were observed. RESULTS AND CONCLUSION:The dural repair materials mainly include autologous material, al ograft materials, dissimilar materials, synthetic materials and natural materials. Each kind of material has its advantages and disadvantages. Meningeal defect complications include cerebrospinal fluid leakage, pseudo meninges, infection and arachnoiditis. There are many problems of artificial dural materials to be solved, and the novel biological dural materials and absorbable materials are the direction of dural material research.

This paper summarizes the nursing care of patients with extracorporeal membrane oxygenation (ECMO) for postoperative support in heart transplantation. Ten patients suffered from acute graft failure after heart transplantation and applied the extracorporeal membrane oxygenation for postoperative support. All the patients were monitored on electrocardiogram, hemodynamics, body temperature, urine volume, drainage volume, activated coagulation time, liver and renal function, free hemoglobin and colloid osmotic pressure. Nine survivals were discharged with recovery and one patient died. The duration of ECMO support ranged from 40 to 824 hours. When the heart function showed recovered based on bedside UCG. the ECMO could be weaned off uneventfully after 100 hours and the long-term clinical outcomes were good. It is suggested that close monitoring of heart & lung function during ECMO support, proper adjustment of ventilator index, intensive lung & respiratory tract care, prevention of arrhythmia, bleeding, embolism, infections, bedsores and other complications may decrease the mortality of severe patients with heart transplantation.

Objectiv e To investigate the correlation between ( CAG) n repeat polymorphism of androgen receptor(AR)geneandmalebreastcancer.Methods 40casesofmalebreastcancerand40controlswerecol-lected.DNA was extracted from peripheral blood and the AR gene CAG coding exon sequences for PCR amplifica -tion,sequencing and calculated the number of CAG repeats frquency .χ2 test and Logistic regression analysis were used assess the AR gene CAG repeat length frequency affect the number of male breast cancer risk .Results There was statistically significant difference in male breast cancer cases and controls the number of CAG repeat length frequency.Man for whom the(CAG)n≥22 repeat sequence had 3.52 times risk of male breast compared (CAG)n≤22(OR=3.52,P=0.036).Conclusion AR gene CAG repeat length is a predictor of the frequency of male breast cancer risk .Longer CAG repeats can increase the risk of male breast cancer .