Through the research and practice of computer basic course at medical colleges, the paper summarizes the experience of using modern technical means, to reform the traditional teaching ideas, teaching methods, teaching means and teaching management, to diversify teaching resources sharing. It also analyzes the shortcomings and makes recommendations to further strengthen the course development.

Speeding up the training of quality personnel in clinical medicine is an important historic mission of clinicians. Practice has proven that the training, growth and maturity of quality clinical personnel are inseparable from clinical practice. Thus, firstly, clinical workers must, in accordance with the goals of training, rigorously enforce process management, including implementation of the training regulations, strict assessments, and cultivation of abilities in doing scientific research and writing up research papers. Secondly, the overall quality of postgraduates must be enhanced. Thirdly, files of postgraduates must be set up. Fourthly, experience in training academic degree postgraduates in clinical medicine should be constantly summed up, including ways of strengthening organization and control and clarifying goals and requirements

Objective To explore the application value of plastic biliary stent and fully covered self-expandable metallic stent (FCSEMS) in endoscopic retrograde cholangio pancreatography (ERCP) for treatment of benign biliary stricture after liver transplantation.Methods The retrospective cross-sectional study was conducted.The clinical data of 54 patients with benign biliary stricture after liver transplantation undergoing ERCP treatment who were admitted to the First Affiliated Hospital of Xi'an Jiaotong University between January 2010 and August 2016 were collected.Among 54 patients,44 had simple anastomotic stricture and 10 had non-anastomotic stricture.All the patients underwent stent implantation by ERCP.Patients with stricture within 1 month postoperatively initially selected single plastic stent or endoscopic nasobiliary drainage (ENBD),and then changed into multiple plastic stents at the second stent replacement.Patients with stricture after 1 month postoperatively selected multiple plastic stents,multiple plastic stents after balloon dilation or FCSEMS.Observation indicators:ERCP situations,stent implantation,time of stent indwelling,postoperative complications,stent dislocation,treatment outcome and follow-up situations.Patients were followed up by outpatient examination and telephone interview up to November 2016.Clinical symptoms of patients were observed within 1 month postoperatively and liver function and abdominal ultrasound were retested.Liver function and remission degree of biliary stricture were monitored regularly once every 3 months.Measurement data were described as average (range).Results All the patients underwent successful ERCP,of which 53 completed the process of ERCP and 1 rejected treatment due to economic problems.All the 54 patients received 140 times ERCPs with an average of 2.59 times per person,21 times ENBDs,11 times FCSEMSs and 108 times plastic stent implantations (including 35 times single stent implantations,46 times double stents implantations,23 times 3-stents implantations and 4 times 4-stents implantations).All the 54 patients were followed up for 3-143 months,with an average time of 73 months.Of 44 with anastomotic stricture,34 received plastic stent implantation and 98 times ERCPs,with an average number of stent implantation of 2 (range,1-4) and an average time of stent indwelling of 10.7 months (range,9.0-13.0months);the postoperative acute pancreatitis,biliary infection,hyperamylasemia and adverse stent implantation or dislocation were detected in 4 persons every time,7 persons every time,10 persons every time and 3 persons every time,respectively;26 patients were cured and 5 were improved,with an effective rate of 91.2％ (31/34);3 patients with noneffective treatment continued to undergo ERCP and 3 patients had recurrence of anastomotic stricture.Among 10 patients with initial FCSEMS implantation,12 times ERCPs were performed,with an average time of stent indwelling of 7.6 months (range,6.0-12.0 months);postoperative biliary infection,hyperamylasemia and stent dislocation were detected in 1 person every time,1 person every time and 1 person every time,respectively;8 patients were cured,with an effective rate of 8/10;of 2 patients with persistent stricture,1 patient received contrast examination after stent removal,showing a comparative stricture in level 1 branch of intrahepatic duct and considering combined ischaemia,and then underwent the second implantation using multiple plastic stents;the other patient had elevated level of jaundice at 3 months after stents removal and received ERCP,showing anastomotic inflammatory polyp,and then underwent FCSEMS implantation again.Ten patients with non-anastomotic stricture received plastic stent implantation and 30 times ERCPs,with an average number of stent implantation of 3 (range,2-4) and an average time of stent indwelling of 11.3 months (range,10.0-14.0 months);the postoperative acute pancreatitis,biliary infection,hyperamylasemia and adverse stent implantation or dislocation were detected in 2 persons every time,5 persons every time,2 persons every time and 1 person every time,respectively;3 patients were cured and 3 were improved,with an effective rate of 6/10;of 4 patients with noneffective treatment,2 died of gradually deteriorating liver function and 2 underwent the second liver transplantation.Conclusions Stent implantation in ERCP is safe and effective for treatment of benign biliary stricture after liver transplantation,single plastic stent should be used in the early period (within 1 month) and multiple plastic stents should be used in the later period.Although FCSEMS has a higher displacement rate,it should be recommended due to a better clinical effect,lower incidence of complications and simple operation.For patients with non-anastomotic stricture,plastic stent should be used for extrahepatic biliary stricture,with a good clinical effect,and there is worse effect in stent implantation through ERCP for multiple intrahepatic biliary strictures.

Objective To investigate the causes, diagnosis and surgical treatment of ERCP related duodenal per﹣foration. Methods Clinical data of 6 cases of surgical treatment of ERCP related duodenal perforation were retro﹣spective analyzed. All the 6 perforation patients underwent emergency surgical procedure, including 3 cases trans﹣fered from other hospital after duodenal perforation. 4 cases with a history of abdominal surgery. Preoperative con﹣firmed bravery manager stone 4 cases, 1 case of obstructive jaundice after gallbladder surgery, bile duct expansion in 1 case. Results Perforation causes include duodenum mirror improper operation related in 2 cases, duodenal papilla sphincterotomy related 3 cases (1 case of pre-dissection operation with needle knife), small endoscopic sphincteroto﹣my combined with endoscopic papillary balloon dilation lead to perforation in 1 case.4 cases of intraoperative found right kidney week pneumatosis, 2 cases of postoperative CT found after peritoneal pneumatosis, effusion. All patients with surgery including common bile duct exploration, T tube drainage, duodenal perforation repair, jejunum colostomy, among them 2 cases at the same time line of gastrointestinal anastomosis. 5 cases recovered, 1 case died. Conclusions Inappropriate duodenal papilla sphincter incision indications and Many previous abdominal surgery have higher perforated ration;Found in time, reasonable treatment is the most important;For serious typeⅠand typeⅡperforation, active surgical treatment in time, can effectively reduce serious consequences caused by the ERCP related perforation.

The aim of the present study is to investigate the effects of sequoyitol (Seq) on expression of eNOS and NOX4 in aortas of type 2 diabetic rats. Type 2 diabetic rats induced by high fat and high sugar diet and low dose of streptozotocin (STZ, 35 mg x kg(-1)) and were administered Seq (12.5, 25 and 50 mg x kg(-1) x d(-1)) for 6 weeks. The fasting blood glucose (FBG) and body weight were tested. Acetylcholine (Ach) induced endothelium-dependent relaxation and sodium nitroprusside (SNP) induced endothelium-independent relaxation were measured in aortas for estimating endothelial function. Aortic morphological change was observed with HE staining. The level of serum insulin was measured by radioimmunoassay. The total antioxidative capacity (T-AOC), malondialdehyde (MDA) and NO levels in aortas were determined according to the manufacturer's instructions. In addition, the expressions of eNOS and NOX4 in aortas were measured by immunohistochemisty, real-time PCR or Western blotting. The results showed that Seq significantly decreased FBG and insulin resistance, and improved aortic endothelium-dependent vasorelaxation function. The expressions of NOX4 and MDA content were obviously decreased, while the expression of eNOS, the levels of NO and T-AOC increased significantly in aortas of diabetic rats with Seq treatment. In conclusion, Seq protects against aortic endothelial dysfunction of type 2 diabetic rats through down-regulating expression of NOX4 and up-regulating eNOS expression.
Animals ; Aorta ; metabolism ; pathology ; Blood Glucose ; metabolism ; Body Weight ; Diabetes Mellitus, Experimental ; chemically induced ; metabolism ; physiopathology ; Diabetes Mellitus, Type 2 ; chemically induced ; metabolism ; physiopathology ; Hypoglycemic Agents ; pharmacology ; Inositol ; analogs & derivatives ; pharmacology ; Insulin ; blood ; Insulin Resistance ; Male ; Malondialdehyde ; metabolism ; NADPH Oxidase 4 ; NADPH Oxidases ; metabolism ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase Type III ; metabolism ; Oxidation-Reduction ; drug effects ; Rats ; Rats, Sprague-Dawley ; Streptozocin ; Vasodilation ; drug effects

OBJECTIVETo investigate the protective effect and mechanism of sequoyitol (Sep) on high glucose-induced human umbilical vein endothelial cells (HUVECs) injury.

METHODSHUVECs were cultured with high glucose (30 mmol/L) in the presence or absence of sequoyitol (0.1, 1 and 10 micromol/L) for 24 h. Cell proliferation was measured by BrdU marking and cell cycle was detected by flow cytometry. 2', 7'-dichlorofluorescein diacetate was used to evaluate intracellular reactive oxygen species (ROS) levels. The NO, malonydialdehyde (MDA) and H2O2 levels were determined by colorimetric method according to the manufacturer's instructions. The expression of endothelial nitric oxide synthase (eNOS) and NADPH oxidase 4 (NOX4) were measured by real-time PCR and Western blot.

RESULTSIn the present study, we found that sequoyitol pretreatment for 1 h significantly decreased cell injury, promoted cell proliferation. Meanwhile sequoyitol significantly down-regulated NOX4 expression and decreased the level of ROS, MDA and H2O2 and obviously increased NO levels and up-regulated eNOS expression.

CONCLUSIONSequoyitol alleviates high glucose-induced cell injuries in HUVECs via inhibiting oxidative stress and up-regulating eNOS expression.

Cell Proliferation ; Cells, Cultured ; Glucose ; toxicity ; Human Umbilical Vein Endothelial Cells ; drug effects ; metabolism ; Humans ; Hydrogen Peroxide ; metabolism ; Inositol ; analogs & derivatives ; pharmacology ; Malondialdehyde ; metabolism ; NADPH Oxidase 4 ; NADPH Oxidases ; metabolism ; Nitric Oxide Synthase Type III ; metabolism ; Oxidative Stress ; Reactive Oxygen Species ; metabolism

Adenocarcinoma ; metabolism ; secondary ; surgery ; Carcinoembryonic Antigen ; metabolism ; Carcinoma, Hepatocellular ; metabolism ; secondary ; surgery ; Colectomy ; Colonic Neoplasms ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Humans ; Keratin-18 ; metabolism ; Liver Neoplasms ; metabolism ; secondary ; surgery ; Male ; Middle Aged ; alpha-Fetoproteins ; metabolism

Objective To investigate the status and influencing factors of pleasant events among community-dwelling dementia patients. Methods Totally 266 community-dwelling dementia patients were recruited from Bei-jing,Guangzhou and Tianjin,and were investigated with the Chinese-version Pleasant Events Schedule-AD(PES-AD). Results The overall score of PES-AD was (14.0±6.7). The factor scores from high to low were sensory stimulation activities(0.9±0.5),family activities(0.8±0.5),emotional stimulation activities(0.8±0.4) and autonomy activities(0.6± 0.5). Multiple linear regression showed that the severity of disease,without chronic disease,educational level of de-mentia patients and their caregivers were significant influencing factors of pleasant events,which explained 41.1% of the total variance. Conclusion Sensory stimulation activities of community-dwelling dementia patients were relatively satisfactory,followed by family activities and emotional stimulation activities,but autonomy activities were relatively unsatisfactory. It is suggested to choose appropriate pleasant activities according to the severity of disease for de-mentia patients to improve their quality of life.

Objective To study the inhibitory effects of dendritic cells modified by sCD41)gene on T lymphocytes phenotypes and cytokines production and the mechanism of inducing donor-specific immune tolerance in vitro.Methods T lymphocytes prepared with Nylon Fiber Column from Balb/c mice(as reaction cells)and DCs of different groups(as stimulation cells)were subjected to primary mixed lymphocyte culture(MLC).After incubation for 7 days,the responsiveness of the cells was de- tected by MTS method at the indicated time points,and supernatants were assayed for IFN-?,IL-2, IL-4,IL-10 by ELISA kits.On the day 5,the cultured cells were assessed for the expression of CD4, CDS,CD25 and CD69 by using flow cytometry(FCM).After secondary MLC for 5 days,the same indexes were assayed hy using the same methods.Results Dendritic cells modified by sCD40 could in- duce the hyporesponsiveness to alloantigen in primary and secondary MLC.In primary MLC,the ex- pression of CD4~+ and CD8~+ T cells and CD4~+ CD25~+,CD8~+ CD25~+,CD4~+ CD69~+,CD8~+ CD69~+ T cells in IX;modified by sCD40 group were less than those in control group(P

Objective To observe the clinical efficacy of percutaneous vertebroplasty (PVP) with percutaneous kyphoplasty (PKP) in the treatment of osteoporotic vertebral compression fracture(OVCF) by systematic review. Methods From September 2005 to March 2009,46 cases of fresh OVCF were treated. Patients were divided into 2 groups (A, B), according to Jikei grade, Genant semiquantitative method, injury vertebra number. Twenty-five cases(group A)were treated by PVP,8 males and 17 females with the age of 52 - 78 years (average 69). Vertebra segment of fracture was within T6 - L5 (14 in case thoracical vertebrae and 11 lumbar vertebrae). Twenty-one cases(group B)were treated by PKP,There were 6 males and 15 females with the age of 54 - 82 years (average 71). Vertebra segment of fracture was within T6 - L4 (12 in case thoracical vertebrae and 9 lumbar vertebrae). The clinical efficacy, incidence rate of complication, the anterior height of vertebrae body,visual analogue pain scale(VAS) ,ease of pain were measured preoperatively and at 6 weeks, 3 and 6 months and 1 year postoperatively between the two groups. Results All the patients were followed up for 12 -45 months with an average of 23.5 months. The average recovery of anterior height of vertebrae body was respectively(85.95 ± 4.31) % in group A and (93.64 ± 3.35) % in group B,which statistically difference in vertebral height between two groups (P ＜ 0.05). No statistical significant difference was seen in VAS, analgesic durg (AID) and ease of pain complication between two groups (P ＞0. 05). Statistical significant difference was noted in pre-postoperatively between intra-two groups (P ＜0. 05). Conclusions PVP and PKP can quickly relieve pain and enhance vertebral stability in treating thoracolumbar OVCF according to evaluation parameter, and have the similar therapeutic efficacy in treatment of OVCF with minimal invasion. However, PKP is superior in the recovery of vertebral height.