Objective: To make students grasp basic thinking and learning methods, improve practice efficiency and creativity. Methods: In surgery teaching we should pay attention to building helpful thinking environment, design the breakthrough point of thinking, train students in problem consciousness, make students think vertically, horizontally, reverse and train them to think comprehensively. Results: Through various kinds of training of dispersing thinking, students can use these methods to think actively to seek different solutions to the same problems or improve the ability of problem analyzing and solving. Conclusion: The teacher should pay attention to the training of student's dispersing thinking ability in surgical teaching course.

Objective To explore the effect of dexmedetomidine(DEX)for blood pressure,heart rate(HR) and SpO2 levels during anesthesia inquiry in elderly hypertensive(HBP)patients.Methods 96 cases with HBP accepted surgery were selected,and were randomly divided into the observation group and the control group,each group in 48 cases,The patients in the observation group continuous pumped into the 4μg/mL of DEX during surgery, while the control group continuous pumped into 0.9% sodium chloride solution during surgery.Heart rate(HR),sys-tolic blood pressure(SBP),diastolic blood pressure(DBP),pulse oxygen saturation(SpO2 )of the two groups after room entrance(T0),after DEX infusion(T1),before intubation(T2),after 2min intubation(T3)and 10 min(T4)after intubation were recorded and compared,extubated time,spontaneous breathing recovery time,call time to eye opening and hospitalization time and the incidence of adverse reactions in two groups were recorded.Results The difference of HR SBP,DBP and SpO2 at T0 and T4 between the two groups was not statistically significant(all P >0.05);HR, SBP and DBP were significantly lower in the observation group than those in the control group at T1,T2,T3(all P <0.05).There were no significant changes of SpO2 in the patientˊs after the room entrance;extubated time,spontaneous breathing recovery time,call time to eye opening and hospitalization time in the observation group were significantly lower than those in the control group(t =8.874,9.073,8.573,all P <0.05).The adverse reactions rate in the observation group was 4.2%,which in the control group was 6.3%,the difference was not statistically significant(P >0.05). Conclusion Continuous pumped DEX has a significant sedative effect in elderly HBP patients during surgery,and does not produce respiratory depression,can help elderly patients with HBP smoothly pass the perioperative period.

Objective To explore effects of different doses of fluvastatin on serum hs -CRP,NT -proBNP in patients with coronary heart disease (CHD)and chronic heart failure (CHF)and its clinical efficacy.Methods 120 CHD patients with CHF were randomly divided into three groups,each group included 50 cases.Each group received the therapy of 20mg/d(20mg group),40mg/d(40mg group),and 80mg/d(80mg group),respectively,three groups were treated for 12 weeks.The related indicators were compared among the three groups before and after treat-ment,and the incidence of major cardiovascular events (MACE )and adverse reactions were recorded.Results There was no statistically significant difference between groups before treatment (P >0.05).The serum hs -CRP and BNP of three groups were significantly different after treatment(F =185.956,16.824,all P <0.05).The hs -CRP and NT -proBNP of 80mg group were lower than those of group 20mg and 40mg group (hs -CRP:LSD -t value =3.143,4.113,all P <0.05;NT -proBNP:LSD -t value =2.986,3.765,all P <0.05).The △hs -CRP,△NT -proBNP of C group were higher than those of 20mg group and 40mg group(LSD -t value =4.783,5.819,all P <0.05).The TC,TG,LDL -C of three groups were significantly different after treatment (F =14.402,10.929, 121.968,all P <0.05).The TC,TG,LDL -C of 80mg group were lower than those of 20mg group and 40mg group (LSD -t value =3.538,4.765,4.387,all P <0.05).The ALT,CPK of three groups had no significant differences before and after treatment (P >0.05).The incidence of MACE in 80mg group was lower than that in 20mg group and 40mg group.However,the incidence of three groups had no significant difference after treatment (P >0.05 ). Conclusion The treatment of high -dose fluvastatin can significantly decrease inflammatory of CHD patients with CHF,and also decreases the NT -proBNP level,effectively control lipid levels,the treatment is safe and worthy of clinical recommendations.

Background:With the increasing of antibiotic resistance and decreasing of eradication rate of standard triple therapy, bismuth-containing quadruple regimens were recommended by the update Chinese consensus report for eradication of Helicobacter pylori( Hp ) infection. Aims:To evaluate the eradication rate of the recommended bismuth-containing quadruple regimens for guiding the choice of low cost and high efficiency eradication regimens. Methods:A search of online database( CNKI,Wanfang and VIP)was carried out. Clinical trials published in Chinese from 2011 to 2013 that evaluated the eradication rate of the recommended bismuth-containing quadruple regimens were retrieved. Data were extracted by standardized data forms. According to the categories raised by Dr. Graham,the eradication rates were graded and analyzed. Results:A total of 166 eligible articles including 192 clinical trials for eradication of Hp infection were obtained. Nationwidely,the eradication rates of amoxicillin-containing regimens were acceptable,among which PAFB( PPI+amoxicillin+furazolidone+bismuth)regimen was more prone to achieve excellent eradication rate(≥95%). PACB ( PPI+amoxicillin+clarithromycin+bismuth)regimen was optimal for Hp eradication in East China,and PAFB regimen was optimal in Central South China. A 14-day treatment course was appropriate. Conclusions:In the recommended bismuth-containing quadruple regimens,PAFB regimen might be the first choice nationwidely for eradication of Hp infection in individuals without amoxicillin-hypersensitivity because of its low cost and high efficiency. The recommended treatment course is 14-day.

Objective: To imrove the current situation that disinfection is inconvenient and ineffective when infant incubators are used. Methods: To make some improvements without changing the structure and performance of existing infant incubators. Results: Built-in disinfection device is designed to overcome the difficult operation, poor effect and inconvenience in use. Conclusion:It has been awarded“the state utility model”for its safety and convenience (patent no:ZL200520117573.9).

Objective To investigate the expression of sex hormone receptor (SHR) in meningioma and its relationships to the origin of tumor central artery.Methods The expressions of sex hormone receptors, including progesterone receptor (PR), androgen receptor (AR) and estrogen receptor (ER) in 43 cases with meningioma were detected by immunohistochemically streptavidin-peroxidase (SP) method. These data combined with the characteristics of digital subtraction angiography (DSA) were analyzed.Results The expression of ER in meningioma was not related to the origin of tumor central artery. The positive expression rates of PR and AR in external carotid artery (ECA) original group (26.9%,23.1%) were significantly lower than those in internal carotid artery (ICA) original group (88.9%,77.8%) and ECA combined with ICA group (87.5%,87.5%) (all P

Objective To study preliminar il y the mutual antigens between Lumbricus terrestris[WT5”BZ ] and Schistosoma japonicum. Methods The antigen s of Lumbricus terrestris (L.terrestris) and [ WT5”BX]Schistosoma japonicu m (S.japonicum) were analysed by SDS-PAGE technique, and reacte d with the sera of patients with schistosomiasis and the sera of rabbits immunized with LtAg by Dot-ELISA and Western-blot. Results [WT5” B Z]There were many similar molecular weight antigens between LtAg and SjAg. Spe cially some antigens between 30-90 kDa form LtAg had intensive cross reactio n with the sera of patients with schistosomiasis. SjAg was also reacted with the sera of r abbits immunized with LtAg. Conclusion There are at least three immunocompetent antigens with similar molecular weight between L.terrestris and S.japonicum. [

ObjectiveTo study the effect of nutritional intervention combined with aerobic exercises on serum adiponectin and insulin resistance in nonalcoholic fatty liver (NAFL) patients.Methods32 patients confirmed as NAFL between April 2008 and August 2009 were enrolled into NAFL group and 31 health people into control group.NAFL group received nutritional intervention and followed aerobic exercise program.The changes of body mass index (BMI),serum adiponectin,fasting blood glucose (FBG),fasting insulin (FINS) and serum lipids were recorded before and after interventions.Insulin resistance index (HOMA-IR) was calculated.Inter-group difference,changes after intervention,and correlation between serum adiponectin and the other indexes were analyzed.ResultsCompared with the control group,BMI [ (29.84 ±3.16) kg/m2 vs.(22.22 ± 1.81 ) kg/m2,P =0.000],total cholesterol (TC) [ (5.09 ±0.86) mmol/L vs.(4.38 ±0.85) mmol/L,P =0.002],triglyceride (TG) [ (1.99±0.86) mmol/Lvs.(1.10±0.38) mmol/L,P=0.000],FBG[ (6.02±0.63) mmol/Lvs.(5.02±0.71) mmol/L,P=0.000],FINS[ (13.73±3.24) mU/Lvs.(9.55±1.99) mU/L,P=0.000],HOMA-IR [ (3.74±1.21) mmol/L vs.(2.08 ±0.27) mmol/L,P=0.000] in the NAFL group were significantly higher,while serum adiponectin in the NAFL group was significantly lower [ (4.89 ± 1.81 ) ug/L vs.( 12.97 ± 3.15 ) ug/L,P =0.000 ].After nutritional intervention and aerobic exercises,BMI [ ( 26.65 ± 2.39 ) kg,/m2 vs.(29.84 ±3.16) kg/m2,P =0.000] 、FBG [ (5.61 ±0.47) mmol/L vs.(6.02 ±0.63) mmol/L,P =0.004 ],and FINS [ ( 11.12 ± 2.01 ) mU/L vs.( 13.73 ± 3.24) mU/L,P =0.000 ] in the NAFL group were decreased significantly,while serum adiponectin [ (6.54 ±2.12) ug/L vs.(4.89 ± 1.81 ) ug/L,P =0.001 ] was significantly higher than the level before intervention.Serum adiponectin was negatively correlated with BMI,FBG,FINS,HOMA-IR,and TG (P =0.004,0.000,0.000,0.000,and 0.010),and positively correlated with high density lipoprotein cholesterol (P =0.026),but not correlated with TC (P =0.101 ).ConclusionThe combination of nutritional intervention and aerobic exercises can improve the level of serum adiponectin,adjust the level of serum glucose and serum lipids,and alleviate insulin resistance in NAFL patients.

Objective To study the relationship between serum adiponection and liver function and insulin level in patients with hepatogenous diabetes.Methods The research subjects included:28 patients with hepatog-enous diabetes who were admitted at Liaocheng People's Hospital (hepatogenous diabetes group);27 patients with simple type 2 diabetes without any complication (simple type 2 diabetes group),and 27 normal controb (control group).Blood adiponectin,fasting blood glucose (FBG),fasting insulins (FINS),alanine aminotransferase (ALT),aspartate transferase (AST),total bilirubin (TBIL) and albumin (ALB) were measured,and according-ly the insulin sensitivity index (ISI) was calculated.Results Compared with the control group.serum adiponec-tin levels and ISI levels were significantly lower in the other two groups (P<0.01),and the adiponectin levels were significantly higher in hepatogenous diabetes group than in simple type 2 diabetes group (P<0.05).The FBG and FINS levels in the hepatogenous diabetes group and the FBG levels in the simple type 2 diabetes group were significantly higher than those in control group (P<0.01).The FINS levels were significantly higher in the hepatogenous diabetes group than in simple diabetes group (P<0.05),while the levels of FBG and ISI were lower than that of simple type 2 diabetes group (P<0.05).Adiponectin levels were negatively correlated with ISI (r= 0.5265,P=0.000),and positively correlated with FBG (r=-0.6040,P=0.000),and were not correlated with liver functions Conclusion Insulin resistance and abnormal metabolism of adipenection exist in patients with hepatogenous diabetes and may together affect the occurrence and development of hepatogenous diabetes.

BACKGROUND: Bilateral pedicle screw fixation combined with intervertebral decompression and fusion is a classic surgical approach in treatment of lumbar degenerative diseases, but it can cause ligament and other soft tissue damage of lumbar spine and degeneration of the adjacent segments. While translaminar facet screw fixation has its unique advantages.OBJECTIVE: To compare the clinical efficacy of unilateral pedicle screw fixation combined with translaminar facet screw fixation and bilateral pedicle screw fixation for lower lumbar degenerative diseases.METHODS: Forty-six patients with single-level lower lumbar degenerative disease were enrolled, and were then treated with bilateral pedicle screw fixation combined with intervertebral fusion (group A, n=24) or unilateral pedicle screw along with translaminar facet screw fixation and intervertebral fusion (group B, n=22). Afterwards, the clinical indexes and efficacy were compared between two groups.RESULTS AND CONCLUSION: (1) All operations were performed successfully. The length of incision, operation time,intraoperative blood loss, postoperative drainage volume and cost of hospitalization in the group B were significantly superior to those in the group A (P < 0.05). (2) There was no significant difference in the rate of fusion between two groups (P > 0.05). (3) The visual analogue scale and Japanese Orthopaedic Association scores in both groups at 1 week,3, 6, 12 and 24 months postoperatively were significantly improved compared with baseline (P < 0.05), but the scores had no significant differences between two groups (P > 0.05). (4) To conclude, unilateral pedicle screw fixation combined with translaminar facet screw fixation and bilateral pedicle screw fixation both exhibit satisfactory treatment outcomes,while the former holds little trauma, good stability, high fusion rate and less cost, which is a better choice for lower lumbar degenerative diseases.