Clinical teaching constitutes a critical content of clinical course system.To that aim,we formulate typical case archive for teaching and apply bed-side teaching combined with PBL(problem based learning) method.Still supported by personating,case investigation and casuistics as well as multimedia means,we teach students in accordance with their aptitude and in so doing,initiatives of students can be mobilized to ensure sound teaching effects.

Adolescent ; Alopecia ; diagnosis ; therapy ; Bone and Bones ; abnormalities ; Denture, Complete, Upper ; Diarrhea ; diagnosis ; therapy ; Female ; Humans ; Spasm ; diagnosis ; therapy

Objective To summarize the diagnosis and treatment experience of the pancreatic fistula secondary to abdominal operations.Methods The clinical data of 27 patients with pancreatic fistula due to abdominal operations were analyzed retrospectively.Results 25 patients were diagnosed by the amylase concentration of the drainage fluid and 2 patients were diagnosed by the percutaneous puncture fluid amylase concentration.Four patients underwent percutaneous puncture drainage by BS-guide.Five patients underwent re.operation drainage.Enteral feeding,total parenteral nutrition,total parenteral plus oral nutrition were applied to 15,6 and 6 patients,respectively.Altogether 3 patients died,all of these patients were in the total parenteral nutrition group.13 cases were discharged with draining tubes,including 2 patients who developed Dseudocyst and received surgical treatment,and the others 1 1 patients were discharged with tubes for(9.0±3.2)months.The mean hospital stays for oral feeding,jejunum tube nutrition and total parenteral nutrition groups were(36.3±10.2)d,(57.6±17.3)d and(63.3±33.4)d,respectively;and difference was statistically significant(F=3.49,P=0.049).The mean hospital stays for patients with or without somatostatin treatment were(53.5±20.3)d and(51.5 ±21.0)d,and difference was not statistically significant(t=0.207,P=0.838).Conclusions hereasingthe understanding ofpancreaticfistula,adequate drainage and rational nutrition phyed a key role in impmving the treatment effects of pancreatic fistula.

BackgroundResearches found that the posterior capsular opacification (PCO) after lensextraction is associated with the elevation of the transforming growth factor-β(TGF-β).To seek the drug for inhibitingproliferation of lens epithelial cells (LECs) is crucial in the treatment and prevention of PCO.ObjectiveThisstudy was to investigate the preventing effects of decorin on the proliferation of LECs.MethodsRabbit LECs wascultured and passaged.The LECs in growth phase were incubated in 96 well plate at the density of 8×106/L.Decorinwith the concentrations 0.1,1.0,10.0 mg/L was added into the medium for 24,48 and 72 hours respectively.0.1％DMSO was used at the same way as positive control group,and the regular cultured cells worked as blank controlgroup.The inhibitory rates of different concentrations of decorin on the growth of LECs were detected by MTT at 24,48and 72 hours after addition of decorin.The percentage of LECs in different cell cycles in various groups was assayedusing flow cytometry.TGF-β level in medium suspension was detected using ELISA.The expression of TGF-β mRNA in LECs was checked by RT-PCR,and α-SMA expression in LECs was determined using immunochemistry.Results ELISA assay showed a statistical difference in the TGF-β levels of different groups (F=39.24,P=0.03 ).The TGF-β levels in 1.0,10.0 mg/L decorin groups were significantly decreased in comparison with blank control group (P＜0.01) and 0.1 mg/L decorin group (P＜0.05 ).The inhibitory rates of decorin in the concentrations of ≥ 1.0 mg/L on the growth of LECs were higher than the blank control group,and those in various concentrations of decorin groups were considerably lower in 24 hours compared with 48 and 72 hours ( P＜0.05 ) and so was the 48 hours compared with 72 hours (P＜0.05 ).The percentages of LECs in G0/G1 phase were ascent in 0.1,1.0 and 10.0 mg/L decorin groups in comparison with G2/M and S phase (P＜0.05).Immunochemistry revealed the weak expression of α-SMA in various decorin groups in comparison with control group. Conclusions Decorin can effectively inhibit LECs growth and induce LECs apoptosis in concentration- and time-dependent manner.It is suggested that decorin can be used in the prevention and treatment of after cataract.

Objective To observe the acute pain service for analgesia effect and complications of postopera-tive analgesia and satisfaction after cesarean section.Methods 360 patients undergoing cesarean section and postop-erative continue analgesia were randomly divided into two groups.The control group (group C,n =178)was given with routine postoperative self -control analgesia give guidance.In the observation group (group A,n =182),a group for acute pain was founded,and the patients were explained about PCA self -control analgesia related knowledge before operation,together with the APS analgesia group people,the patients were given with postoperative pain management,observed self -control analgesia efficacy and side effects,and gives the corresponding treatment and guidance.The difference of analgesia incomplete and complication were observed such as nausea and vomiting,calm, itchy skin.Questionnaires that postoperative analgesia satisfaction survey were filled inafter discharged.The satisfac-tion of nurse with the APS were observed.Results Postoperative analgesia complication in group A were significantly lower than that in group C(P <0.01,P <0.05),APS analgesic incomplete in group C was significantly higher than groupA (χ2 =11,P <0.01).The satisfaction of PCA in group A were significantly higher than group C (P <0.01, P <0.05),ward nurses job satisfaction also increased significantly (t =2.63,P <0.05).Conclusion Acute pain service effectively improve analgesic quality and reduce related complications after cesarean section increase patients postoperative analgesia satisfaction,increase the ward nurses job satisfaction.

Adult ; Ammonia ; poisoning ; Female ; Humans ; Medical Staff, Hospital ; Occupational Exposure ; Poisoning ; therapy

OBJECTIVETo evaluate that the effect of formula of removing both phlegm and blood stasis in improving cardiac function of Chinese mini-swine with coronary heart disease of phlegm-stasis cementation syndrome.

METHODTotally 36 Chinese mini-swine were randomly divided to six groups: the normal control group, the model group, the Danlou tablet group, and Tanyu Tonzhi Fang(TYTZ) groups with doses of 2. 0, 1. 0 and 0. 5 g kg-1, with six in each group. Except for the normal control group, all of other groups were fed with high-fat diet for 2 weeks. Interventional balloons are adopted to injure their left anterior descending artery endothelium. After the operation, they were fed with high-fat diet for 8 weeks to prepare the coronary heart disease model of phlegm-stasis cementation syndrome. After the operation, they were administered with drugs for 8 weeks. The changes in the myocardial ischemia were observed. The changes in the cardiac function and structure were detected by cardiac ultrasound and noninvasive hemodynamic method.

RESULTCompared with the normal control group, the model group showed significant increase in myocardial ischemia and SVR and obvious decrease in CO, SV and LCW in noninvasive hemodynamic parameters (P <0.05 or P <0.01). The ultrasonic cardiogram indicated notable decrease in IVSd, LVPWs, EF and FS, and remarkable increase in LVIDs (P<0. 05 orP<0.01). Compared with the model group, TYTZ could reduce the myocardial ischemia, strengthen cardiac function, and improve the abnormal cardiac structure and function induced by ischemia (P <0. 05 or P <0. 01).

CONCLUSIONTYTZ shows a significant effect in improving cardiac function of Chinese mini-swine with coronary heart disease of phlegm-stasis cementation syndrome. The clinical cardiac function detection method could be adopted to correctly evaluate the changes in the post-myocardial ischemia cardiac function, and narrow the gap between clinical application and basic experimental studies.

Animals ; Coronary Circulation ; Coronary Disease ; diagnostic imaging ; metabolism ; physiopathology ; therapy ; Heart ; physiopathology ; Hemodynamics ; Medicine, Chinese Traditional ; methods ; Mucus ; metabolism ; Swine ; Swine, Miniature ; Ultrasonography

Objective To investigate the effect of glucocorticoids of different dosages on mortality and hippocampal neuron apoptosis in rats after traumatic brain injury (TBI).Methods All the adult male Wistar rats were allocated into normal control group,dexamethasone (DXM) treatment group,methylprednisolone (MP) treatment group,injury control group,low-dose DXM treatment group,moderate-dose DXM treatment group,high-dose DXM treatment group,low-dose MP treatment group,moderate-dose MP treatment group,and high-dose MP treatment group (n=22).Rats in the later seven groups (the injuried groups) accepted fluid percussion injury to induce TBI models,and then,treatments were given.The injury severity was evaluated with modified Neurological Severity Scale 24 h after injury.The number ofhippocampal neuron apoptosis was examined using TUNEL after 24 and 48 h,and 7 and 14 d of injury.The mortality of rats in each group was also observed during a 14-day-follow-up period.The changes of brains,pituitaries,hearts and lungs in the dead rats were examined by H.E.staining.Results No significant difference on the scores of modified Neurological Severity Scale was noted in the injuried groups 24 h after the injury (P＞0.05).The hippocampal neuron apoptosis began to appear 24 h after inju~,peaked at 48 h,and declined in 7 to 14 d.At 48 h after injury,the number of hippocampal neuron apoptosis in high-dose DXM treatment and high-dose MP treatment groups was significantly higher than that in the injury control group (P＜0.05).The mortality of rats in high-dose DXM treatment and high-dose MP treatment was significantly higher than that in the injury control group (P＜0.05).The autopsy of dead rats in each group revealed various degrees of interstitial pneumonia and hypophysial congestion in rats receiving high-dose glucocorticoids.Conclusion TBI could induce hippocampal neuron apoptosis,and early administration of high-dose glucocorticoids aggravates the apoptosis and increases the mortality,for which interstitial pneumonia and hypophysial congestion would account.

OBJECTIVETo study the clinicopathologic features and disease outcome of intravascular natural killer-cell lymphoma (IVNKL).

METHODSThe histologic features, immunohistochemical findings and results of in-situ hybridization for Epstein-Barr virus-encoded RNA (EBER) were analyzed in 2 novel cases of IVNKL. Seven cases of IVNKL previously reported in the literature were reviewed.

RESULTSThe patients were a 68-year-old woman and a 22-year-old man. They both presented with erythematous patches and nodules on their trunk and extremities. Skin biopsies confirmed the diagnosis of IVNKL. The tumor cells were positive for CD3, CD56, granzyme B and EBER. Both patients died 2 months after the diagnosis. Amongst the 9 reported cases, including those from the literature, the male was 4 cases, the female was 5 cases. The mean age of the patients was 45.7 years and the median age was 47 years. Skin lesions represented the commonest clinical manifestations. Multiple organ involvement was found in 7 cases and central nervous system was involved in 3 cases. Six patients died during 2 to 17 months of follow-up. The median survival was 9 months and the one-year survival rate was (35.6±18.6)%. The clinical outcome of the patients with multiple organ involvement was worse than that with skin manifestations only. The difference however was not statistically significant (P=0.083).

CONCLUSIONSIVNKL is a rare disease. Diagnosis should be made according to typical histologic findings, immunophenotype and EBER in-situ hybridization results. The overall prognosis of IVNKL is poor. Early diagnosis and treatment before multiorgan involvement may be helpful in improving the clinical outcome.

Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; CD3 Complex ; metabolism ; CD56 Antigen ; metabolism ; Cyclophosphamide ; therapeutic use ; Doxorubicin ; therapeutic use ; Female ; Follow-Up Studies ; Granzymes ; metabolism ; Humans ; Killer Cells, Natural ; metabolism ; pathology ; virology ; Lymphoma, Non-Hodgkin ; drug therapy ; metabolism ; pathology ; virology ; Male ; Middle Aged ; Prednisone ; therapeutic use ; RNA, Viral ; metabolism ; Vascular Neoplasms ; drug therapy ; metabolism ; pathology ; virology ; Vincristine ; therapeutic use ; Young Adult

To study the effect of hemoporphyrin derivative(HPD) combined with laser irradiation on human breast tumor cell line MCF-7 and normal human umbilical cord blood-derived hematopoietic cells by using MTT assay. The results showed that HPD plus laser irradiation was more efficient for killing MCF-7 cells than normal human umbilical cord blood-derived hematopoietic cells. The photochemical effect with laser irradiation were higher than with light irradiation and it's effect on MCF-7 cells was higher gradually with the increase of HPD concentration.