CBS(Case Based Study)is a new teaching method,which is based on the case given.It requires students to answer questions according to the case. In the teaching,the students who are divided into groups,seek for resolvent by themselves. They should combine the information provided in the case,find the key answer and the relationship.The students gain the knowledge by reviewing and studying in the textbook,then analyse and solve questions with them. The application of CBS could make knowledge more relatively and systematic, moreover,it also make study more actively and initiatively.

Adolescent ; Adult ; Environmental Exposure ; Female ; Humans ; Inhalation Exposure ; Male ; Middle Aged ; Nasopharynx ; pathology ; Sulfuric Acid Esters ; poisoning ; Young Adult

Objective To evaluate the clinical significance of CT angiography(CTA)in the diagnosis of arterioportal shunts(APS)associated with hepatocellular carcinoma(HCC).Methods One hundred and twenty-seven consecutive HCC patients accepted both dynamic enhancement CT and DSA examinations.The interval between CT and DSA exam was from 3 to 15 days.Based on transverse CT images in hepatic artery phase,CTA was performed for all the patients.By contrast with DSA results,the capabilities of transverse CT and transverse images combined with CTA in APS diagnosis were analyzed. Results In all 127 HCC cases,52 cases with APS were confirmed by DSA(40.94%),33 with central type of APS and 19 with peripheral type.Diagnostic sensitivity of APS based on transverse CT and combined CTA with transverse CT images were both 94.23%(49/52).However,specificity was 84.00%(63/75) and 97.33%(73/75),respectively,accuracy was 88.19%(112/127)and 96.06%(122/127),the predictive value of positive cases was 80.33%(49/61)and 96.08%(49/51),and the predictive value of negative cases was 95.45%(63/66)and 96.05%(73/76).Combined with CTA,false positive cases of 4 central type of APS and 6 peripheral type of APS were excluded which were demonstrated by transverse CT images.By contrast with DSA,the coincidence rate of the type of APS diagnosed by transverse images combined with CTA was 88.46%(46/52),including 90.91%(30/33)of central type of APS and 84.21%(16/19)of peripheral type.The supplying arteries of central type of APS were intuitively displayed by CTA in 23 cases,19 from proper hepatic artery and 4 from gastro-duodenal artery.Conclusion CTA techniques based on the dynamic enhancement CT exams could effectively promote the specificity and the accuracy of APS diagnosis.

AIMTo study the active constituents of Swertia davidi Franch..

METHODSChromatography was used to isolate and purify the chemical components, their structures were identified by spectral analysis.

RESULTSThree compounds were identified as 1,7-dihydroxy-3,8-dimethoxyxanthone (gentiacaulein) (V), 1,8-dihydroxy-3,7-dimethoxyxanthone (methylswertianin) (VI) and 1,8-dihydroxy-3,4,7-trimethoxyxanthone (VII).

CONCLUSIONCompound VII is a novel xanthone, named daviditin A, the others were isolated from Swertia davidi Franch. for the first time.

Molecular Structure ; Plants, Medicinal ; chemistry ; Swertia ; chemistry ; Xanthones ; chemistry ; isolation & purification

Acute Disease ; Adult ; Aged ; Angiography ; Female ; Humans ; Male ; Middle Aged ; Phlebography ; Thrombolytic Therapy ; Tomography, X-Ray Computed ; Venous Thrombosis ; diagnostic imaging ; drug therapy

OBJECTIVETo reveal the allelic frequencies and haplotype frequencies of fourteen Y-chromosome short tandem repeat (STR) loci in a Tibetan population.

METHODSThe Y-chromosomal STR loci were analyzed from 126 healthy unrelated autochthonous male individuals of Chinese Tibetan using a multiplex PCR system. Allele and haplotype frequencies for these loci were determined by the AmpFISTR Y filer PCR Amplification kit.

RESULTSOne hundred and twenty-one alleles were detected from the 14 STR loci. The allele diversity values (DP) for each locus ranged from 0.4104 (DYS391) to 0.9489 (DYS385a, b), the DP value of these loci were higher than 0.5 except for that of DYS391. A total of 105 haplotypes were identified in the Y-STR loci, among which 103 were unique, while two occurred more than once. The overall haplotype diversity for the Y-STR loci was 0.9998, and the discrimination capacity was 0.9898.

CONCLUSIONThe 14 STR loci above belong to loci of high discriminating ability, the haplotypes are highly polymorphic.

Alleles ; Chromosomes, Human, Y ; genetics ; Gene Frequency ; Haplotypes ; genetics ; Humans ; Male ; Microsatellite Repeats ; genetics ; Polymorphism, Genetic ; genetics ; Tibet

BACKGROUNDThe diagnosis of diffuse hepatic lesions in early stage is a tough task at any time for clinical conventional imaging. Magnetic resonance diffusion-weighted imaging (MR DWI) can detect the changes of tissue structure at molecular level. This study was designed to determine the value of DWI in the diagnosis of diffuse liver lesions in early stage.

METHODSDiffuse liver lesions were induced by diethylnitrosamine in 42 rats of test group. Fourteen rats in control group were fed with pure water. Dynamic changes of MR DWI were observed every week in both groups during the early stage of diffuse liver lesions (1 to 12 weeks after drug administration in the test group). Apparent diffusion coefficient (ADC) values of liver parenchyma in different stages and pathologic changes were analyzed.

RESULTSThe process of diffuse hepatic lesions in the test group was classified into three stages according to pathological changes, namely hepatitis, hepatic fibrosis and cirrhosis. No obvious morphological changes were shown by conventional imaging in both groups during this stage. But MR DWI demonstrated heterogeneous signal changes in early stage of hepatic cirrhosis in the test group. No significant change of ADC values was found in the control group between different weeks (P > 0.05). The ADC values of the test group declined from the fifth week, and after the tenth week the ADC values were significantly different between the test and control groups at gradient factor (b) value 300 sec/mm(2) (P < 0.05). At b value 600 and 1000 sec/mm(2), significant difference was seen between the two groups from the sixth week onward. The range of ADC value of the groups was (1.7 - 0.9) +/- (0.40 - 0.04) mm(2)/sec (b = 600) and (1.38 - 0.75) +/- (0.07 - 0.35) mm(2)/sec (b = 1000), respectively. Dominant pathological changes included swelled hepatocytes within 1 to 4 weeks after the administration of diethylnitrosamine in the test group, hyperplasia of fibrous tissues in 5 - 8 weeks and formation of cirrhotic nodules in 9 - 12 weeks.

CONCLUSIONSMR functional DWI could detect diffuse liver lesions earlier than conventional morphological imaging. ADC value as a marker for early diagnosis of diffuse liver lesions could also be used to inspect changes of the lesions.

Animals ; Diffusion ; Diffusion Magnetic Resonance Imaging ; Liver Diseases ; diagnosis ; pathology ; Male ; Rats ; Rats, Wistar

OBJECTIVETo introduce the technique of transarterial interventional embolization treating for arteriovenous malformations (AVM) in the face.

METHODSFrom April 1998, 17 patients have been treated with this method. Seldinger's maneuver was used in this series. Of them, 11 cases received only interventional embolization; 6 cases received both interventional embolization and surgical resection.

RESULTSThe interventional embolization was effective in all the 17 cases, which was confirmed by immediate angiography. Their clinical symptoms were gradually relieved. Interventional embolization obviously decreased hemorrhage during surgical resection.

CONCLUSIONSInterventional embolization provides a new way for the treatment of AVM. Preoperative embolization can lower the surgical risk as it obviously decreases hemorrhage during the surgical procedure.

Adolescent ; Adult ; Arteriovenous Malformations ; diagnostic imaging ; therapy ; Child ; Embolization, Therapeutic ; methods ; Face ; blood supply ; Female ; Humans ; Male ; Radiography, Interventional

OBJECTIVETo study the changes in the constituent ratio of patients received surgical therapy for their thyroid diseases in Peking Union Medical College Hospital from 1986 to 2012.

METHODSThe clinical data of patients received surgical therapy with pathologically confirmed findings from 1986 to 2012 were collected, and a corresponding database was established. The constituent ratios of thyroid diseases and thyroid malignant tumor among different population groups in different years were analyzed.

RESULTSThe number of patients with thyroid diseases admitted to our hospital had significantly increased in the past 27 years, particularly those with nodular goiter or thyroid cancer. The composition ratios of thyroid cancer and nodular goiter increased significantly, and among malignancies the papillary thyroid carcinoma increased obviously. The detection rate of papillary thyroid micro-carcinoma had continuously increased since 2008.

CONCLUSIONThyroid diseases and malignant tumor pathological types had dramatically changed in hospitalized patients in our hospital in the past 27 years.

Adult ; Female ; Goiter, Nodular ; epidemiology ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Thyroid Diseases ; epidemiology ; surgery ; Thyroid Neoplasms ; epidemiology ; pathology

Atrial Fibrillation ; surgery ; Catheter Ablation ; adverse effects ; Female ; Humans ; Middle Aged ; Pleural Effusion ; pathology ; Postoperative Complications ; Pulmonary Veins ; surgery