Objective To explore the effect of TBL based on evidence-based medicine PICOS model in practice teaching of neurology. Methods Totally 47 medical undergraduates in our department were chosen and randomly divided into 2 groups during March 2016 to April 2016. 24 students in the trial group were taught with TBL based on PICOS, while other 23 students in the control group were only taught with conventional TBL method. After three times clinical practices, the test referring to disease pathogenesis, clinical manifestations, auxiliary examinations, diagnosis and treatments of related diseases was performed, and meanwhile, questionnaires were distributed to students in order to survey their satisfaction degree of teaching methods. All the evaluation results and scores of two groups were compared. Statistical data were analyzed by using t-test or Chi-square test with SPSS 17.0 software. Results The score of the theoretical test of trial group was significantly superior to the control group [(89.08±3.60) vs. (79.09±7.75), t=5.707, P=0.03 ]. Survey showed that in the experimental group , the number of students in the trial group who thought teaching method could help understand clinical thinking of neurology and could help integrate the theory into clinical practicewas significantly higher than that in the control group (P<0.05). Conclusion In the clinical teaching of neurology, the TBL based on PICOS model is more effective than conventional TBL method for medical undergraduates.

Objective To investigate the risk factors of wound healing 30 days after treatment in patients with pressure ulcer. Methods Two hundred and forty-five hospitalized patients with pressure ulcer between January 2015 and October 2016 were selected. They were divided into the healed group and the unhealed group 30 days after the treatment. The influencing factors 13 indexes including age, gender, edema, the number of diseases, the number of pressure ulcer, the size of pressure ulcer, PUSH score (Pressure Ulcer Scale Healing), hemoglobin, serum albumin, low density lipoprotein cholesterol and blood homocysteine underwent single factor and Logistic regression analysis. Results Single factor analysis of 12 indicators of risk factors affecting healing were age, Hb, Alb, Hcy, area of ulcer and PUSH scores of the 6 indicators in the regression equation (Z=3.11-6.63, All P < 0.01), gender also entered the regression equation (χ2=0.19, P<0.01);further multivariate regression analysis showed that there were statistically significant differences in PUSH score index (χ2=10.47, P<0.01, OR=0.001, 95%confidence interval were 0.001-0.037). Conclusions Age, gender, Hb, Alb, Hcy and PU area were the risk factors of pressure ulcer healing.

Acupuncture Therapy ; methods ; Adult ; Craniocerebral Trauma ; complications ; therapy ; Electroacupuncture ; Female ; Hearing Loss, Sensorineural ; etiology ; therapy ; Humans ; Male ; Middle Aged ; Scalp ; Young Adult

OBJECTIVETo explore the possible relationship between recurrent aphthous ulcer (RAU) and single nucleotide polymorphism (SNP) of transforming growth factor-β1 (TGF-β1)-509T/C and interleukin-10 (IL-10)-1082A/G sites.

METHODSA total of 138 RAU patients were recruited for this study. The control group consisted of 124 subjects. TGF-β1-509T/C and IL-10-1082A/G sites were detected by restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR) and sequence specific primer-polymerase chain reaction (SSP-PCR). Relative risk ratios were estimated by odds ratios (OR) and 95% confidence interval (95%CI).

RESULTSSignificant differences were found in the genotype frequencies or allele frequencies of TGF-β1-509T/C and IL-10-1082A/G sites between the RAU patients and controls (P < 0.05). CT genotype (OR = 1.231, 95% CI = 0.702-2.160), TT genotype (OR = 2.482, 95% CI = 1.250-4.927), and T allele (OR = 1.465, 95% CI = 1.036-2.074) at the TGF-β1-509 site exhibited high risks. AG genotype (OR = 1.391, 95% CI = 0.808-2.396), GG genotype (OR = 4.165, 95% CI = 1.944-8.924), and G allele (OR = 2.134, 95% CI = 1.474-3.089) at the IL-10-1082A/G site also showed high risks.

CONCLUSIONTGF-β1-509T/C and IL-10-1082A/G sites are associated with the risk of RAU. The TGF-β1 gene-509T allele and IL-10 gene-1082G allele may serve as genetic determinants for RAU.

Alleles ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Humans ; Interleukin-10 ; Polymorphism, Single Nucleotide ; Stomatitis, Aphthous ; Transforming Growth Factor beta1 ; Transforming Growth Factors

Objective:To explore the possible relationship between recurrent aphthous ulcer( RAU) and the single nucleotide polymor-phism(SNP)of IFN-γ+874A/T site and IL-2-330T/G site. Methods:138 RAU patients and the 124 health control subjects were in-cluded. IFN-γand IL-2 serum concentration were detected by ELISA. IFN-γ+874A/T site and IL-2-330T/G site of the whole blood were detected by RFLP-PCR and SSP-PCR. Results:IFN-γand IL-2 levels in serum of the patients were significantly lower than those of the controls(P<0. 05). There was significant difference in the genotype frequencies and allele frequencies of IFN-γ+874A/T site between the 2 groups(P<0. 05). The AA genotype(OR=9. 964)and the A allele (OR=3. 801) at the IFN-γ+874A/T site was with high-risk of RAU. Carry A allele in patients with risk of RAU was to carry the T allele of 3. 801 times. There was no significant differ-ence in the genotype frequencies or allele frequencies of IL-2-330T/G site between the 2 groups(P>0. 05). Conclusion: IFN-γ+874A/T site was associated with the risk of RAU. But,IL-2-330T/G site was not.

Objective To examine the reliability and validity of the Chinese version of the perineal assessment tool (PAT),and explore its applicability in domestic patients with incontinence.Methods A convenience sample of 100 patients were recruited for evaluation.The patients with incontinence were assessed for lAD risk using the Chinese version of PAT.The reliability tests were conducted on internal consistency,interrater,test-retest,and the validity tests were conducted on content validity index(CVI),exploratory factor analysis,receiver operator characteristic curve (ROC).Results The Chinese version of PAT comprised 4 items,Cronbach's α was 0.512,and items related to the total score was appropriate; inter-rater reliability was 0.889; test-retest reliability was 0.791.CVI was 0.95.Exploratory analysis showed that the most interpretable solution consisted of 2 factors.The accumulative variance contribution explained 67.397％ of variance of the total scale.Predictive validity was moderate,the best cut-off point was determined at 6.5 points.Conclusions Due to the special design,its internal consistency reliability was low; content validity was relatively sufficient,but it still needs further revision and test.Inter-rater reliability,test-retest reliability,construct validity,predictive validity was generally good,and it could be used as the screening tool of IAD risk.The results prompt PAT could be used as a benchmark,and we can adjust the entry of PAT to provide a more accurate IAD predicting tool by studying the IAD risk factors.

Recent studies show that post-activation depression is highly correlated with the severity of spasticity in patients with stroke or cerebral palsy, which may be potentially used in the evaluation of spasticity. This article reviewed the concept, mechanism and related factors of post-activation depression.

Objective To explore the effect of Botulinum toxin-A (BTX-A) injected into the contralateral facial muscle on central facial palsy post stroke. Methods 30 stroke patients with moderate to severe central facial palsy were recruited (course of 3~10 months). They were divided into control group (n=15) and treatment group (n=15), who accepted facial training and BTX-A injection in addition, respectively.The bilateral deference of distance from angulus oris to the midline of the teeth(D1) and from the paropia to the angulus oris (D2) were measured before and 4 weeks after injection. Results The D1 and D2 both at resting and movement all decreased after injection in the treatment group, and decreased more than those in the control group. Conclusion BTX-A injection can further correct central facial palsy post stroke.

Adolescent ; Adult ; Eye Injuries ; epidemiology ; etiology ; therapy ; Facility Design and Construction ; Female ; Humans ; Male ; Middle Aged ; Occupational Exposure ; Retrospective Studies ; Visual Acuity

BACKGROUND: The effective therapy of artificial liver for severe hepatitis needs an absorbing material which possesses strong adsorptive property, high adsorption rate and good blood compatibility.OBJECTIVE: To study the adsorptive property of eight novel adsorbents for plasma bilirubin and cytokines in severe hepatitis patients. DESIGN: A controlled observation.SETTINGS: Graduate School of Tianjin Medical University, Tianjin Haihe Hospital, Tianjin Third Central Hospital and the Institute of Polymer Chemistry in Nankai University.PARTICIPANTS: All plasma was collected from 30 severe hepatitis patients hospitalized in Tianjin Third Central Hospital from November 2004 to November 2005. Informed consent was obtained from each patients. This experiment was approved by the hospital ethical committee. All the patients were divided into two groups at random: group 1 (n=10) and group 2 (n=20). The level of total bilirubin (TBiL) before therapy in two groups was (377.3±147.5) μmol/L and (327.6±140.1) μmol/L, respectively.METHODS: ①Adsorbents: Chitosan (Qingdao Lizhong Chitosan Factory, Shandong) with relative molecular weight 97 000 and de-acetyl grade 85%; Adsorbents No.1-3 were prepared by using 1%, 3%, 5% polyethyleneglycol (relative molecular weight 600) as porogenic agent. Adsorbent No.4 was aminated crosslinked chitosan microspheres; Adsorbent No.5 was divinyl-benzene crosslinked macroporous polystyrene microspheres; Adsorbent No.6 was post-crosslinked macroporous divinyl-benzene styrene copolymer microspheres; Adsorbents No.7 and 8 were chitosan wrapped adsorbent No.5 and 6.②Detection: Step 1: 3 mL plasma collected from each severe hepatitis patient in group 1 was absorbed with 1 mL of 8 kinds of adsorbents. Levels of plasma TBiL, direct bilirubin (DBiL) and indirect bilirubin (IBiL) before and after adsorption were determined by using the vanadate oxidation method to analyze the average adsorption capacity so as to screen the adsorbents with the better adsorptive properties. Step 2: 3 mL plasma collected from each severe hepatitis patient in group 2 was absorbed with 1 mL of two adsorbents selected from the step 1. The levels of bilirubin, interleukin-6 and tumor necrosis factor-α before and after the adsorption were analyzed by ELISA method.MAIN OUTCOME MEASURES: The levels of bilirubin and cytokines before and after the adsorption were determined.RESULTS: ①The data in the first step experiment showed that after No.4 and No.5 adsorbents were used, the level of plasma TBiL, DBiL and IBiL were significantly decreased (P < 0.01); no differences were found for other six kinds of adsorbents (P > 0.05).②The data in the second step experiment showed that the average levels of plasma TBiL, DBiL, IBiL, interleukin-6 and tumor necrosis factor-α were remarkably reduced after using adsorbents No.4 and No.5 (P < 0.01). Compared with adsorbent No.5, there were significant decrements for adsorbents No.4 (P < 0.01).CONCLUSION: Aminated chitosan microsphere has significant effects on adsorbing bilirubin and cytokines in plasma of severe hepatitis patients in vitro.