Astrocytoma ; metabolism ; pathology ; surgery ; Brain Neoplasms ; metabolism ; pathology ; surgery ; Child, Preschool ; Diagnosis, Differential ; Ependymoma ; metabolism ; pathology ; Female ; Follow-Up Studies ; Glial Fibrillary Acidic Protein ; metabolism ; Humans ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Neurofibroma, Plexiform ; metabolism ; pathology ; S100 Proteins ; metabolism ; Vimentin ; metabolism

The article reviewed the concept,characteristics,basic steps and main form of PBL as well as the wide application and superiorities in nursing courses teaching.It also analysed the deficiencies of teaching courses,raised the proposal or advice on how to improve from 3 following aspects and explore the possibilities of application in nursing filed.

Objective To investigate the efficacy and safety of the segmental electrical isolation of pulmonary veins (PVs) in patients with paroxysmal atrial fibrillation (PAF). Methods Thirty-nine patients (28 males, 11 females) with recurrent documented symptomatic PAF were included. In order to avoid the risk of cardiac tamponand, we adopted one transseptal procedure and obtained unselective angiography of all PVs and left atrial appendage using pigtail catheter. Lasso mapping catheter and ablation catheter were put into target pulmonary vein ostium through the same site of atrial septum. We routinely mapped the right inferior PV lest any pulmonary vein potential (PVP) that triggered PAF should be omitted. RF ablation was applied at the PVP breakthrough and slightly right and left by moving the RF catheter. Results Eighty-five PVs were targeted for segmental RF ablation. Eight-one were isolated completely. Immediate successful rate was 95%. There was not any complication associated with the procedure. Conclusion It is suggested that the method of segmental PV isolation has a higher cure rate and a shorter procedure time compared with other traditional methods. It can minimize the lesion of pulmonary veins and avoid PV stenosis.

0 05 There was 1 case of cardiac tamponand and 1 case of 60% stenosis of the left superior PV associated with the procedure Conclusion ERAF after segmental PV isolation is common, occurring in approximately 39% of patients with paroxysmal AF However, approximately 35% of ERAF patients without early repeat ablation have no further AF during long term follow up It is suggested that temporary antiarrhymic drug therapy may be more appropriate than early repeat ablation in patients with ERAF

Objective To analyze the electrophysiological characteristics of atrioventricular nodal reentrant tachycardia(AVNRT) requiring ablation at the mitral annulus.Methods Ablation was carried out at the mitral annulus by mapping the slow pathway with resetting method in order to acquire the electrophysiological parameters needed for successful ablation of AVNRT.Results Three cases with AVNRT who had prior failed ablation were successfully ablated by targeting the slow pathway located at the mitral annulus.The location of the left-sided slow pathway was selected by a positive resetting response and verified by junctional automaticity elicited by radiofrequency application and elimination of tachycardia.Conclusion AVNRT refractory to ablation of slow pathway at the posteroseptal area may require ablation at the mitral annulus.Resetting response may help to locate the slow pathway along the mitral annulus.

Objective To investigate electrophysiologic characteristics,the original site of atrial tachycardia(AT)and the results of radiofrequency catheter ablation(RFCA)in children without structural heart disease.Methods Electrophysiologic study and RFCA were performed in 46 children with AT.The site of origin of AT was mapped by using activation mapping during tachycardia.Magnetic electroanatomical mapping(CARTO system)for ablation of atrial tachycardia was performed in 4 patients.Preselecting a temperature of 50~60 ℃ was selected for ablation.Results Electrophysiologic study verified that the mechanism of all the tachycardias in 46 children was focal AT,which might be short paroxysmal,paroxysmal or persistent.1 child also had atrioventricular nodal reentrant tachycardia.ATs were successfully ablated in 41 children(89%),in which 39 had one original site(27 foci in right atrium and 12 foci in left atrium),2 had at least two original sites.Conclusion The success rate of RFCA in ATs of children without structural heart disease was relatively high.Atrial taclycardia could be eliminated by radiofrequency current with safety and efficacy.

0.05].Conclusion To the middle-and old-aged GI cancer patients without organ dysfunction,lowering blood transfusion trigger from Hb 100 g/L to Hb 80 g/L during operation can meet the requirement of oxygen,reduce blood transfusion,and do not increase the rates of wound infection or delay wound healing.

OBJECTIVE:To explore the role of clinical pharmacists in the therapy for patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with allergic bronchopulmonary aspergillosis (ABPA). METHODS:Clinical pharmacists participated in the therapy for a AECOPD patient with ABPA. According to patient's con-dition,clinical pharmacists suggested adjusting the inhalation order of salbutamol and budesonide aerosol inhalation;stop-ping cefatriaxone and adjusting to intravenous injection of voriconazole;and then adjusting voriconazole to oral dosage form timely,monitoring therapy duration. Clinical pharmacists paid close attention to therapeutic efficacy and ADR,and provided medication education for patients. RESULTS:Physicians adopted the suggestion of clinical pharmacists to adjust inhalation order of aerosols,the dosage and route of administration of voriconazole. The patient's condition was improved obviously,and the drug therapy was continued after discharge. CONCLUSIONS:Clinical pharmacists participating in the whole process of treatment improves therapeutic efficacy,reduces the occurrence of ADR and promotes rational drug use in clinic.

Objective To study the effects of small dosage insulin on intestinal inflammatory responses to endotoxin rats. Method Thirty two male SD rats were randomly divided into 4 groups (n = 8): control group, endotoxin (LPS,6 mg/kg i.p.)group, regular insulin(RI,0.5 IU/kg hypodermic) group and LPS(6 mg/kg i.p) + RI (0.5 IU/kg hypodermic)group. Six hours after LPS or saline injection,all rats were laparotomized to observe the congestion in intestinal mucosa with naked-eyes and photography.Then a segment of intestine was stained with HE to observe the pathological changes. The expressions of IL-6 and TNF-α were detected by RT-PCR.The systemic inflammatory response,blood sugar and food taken in rats were observed simultaneously. Software SPSS 13.0 was used to perform ANOVA and Chi-square test for statistical analysis. Results Compared with LPS group, the differences in hyperemia and inflammatory cell infiltration in intestinal tissue were not noticeable in LPS + RI group. The expression of IL-6 and TNF-α were significantly attenuated in RI + LPS group (P < 0.01). All rats in LPS group manifested systemic inflammatory response syndrome (SIRS) four or five hours after LPS treatment, while there was none in LPS + RI group. Rats in LPS group took less food than rats of other groups while the blood sugar had litter difference in all groups (P > 0.05). Conclusions Small dosage of insulin could reduce intestinal inflammation caused by endotoxemia. Early administration of insulin ould prevent the presence of SIRS while it has no obvious influence on blood sugar.

Objective To determine the genotypes and distribution of MSP2 of Plasmodium falciparum isolates in Yunnan and Hainan provinces, China.Methods The central polymorphic region of MSP2 allele was amplified by the nested PCR for genotyping of P.falciparum. Results The higher degree of polymorphism of MSP2 of P.falciparum was observed in Yunnan and Hainan. Distribution and allele frequencies differed in both provinces, indicating considerable geographical heterogeneity of parasite populations. The mixed infection of different allele type and multiplicity of infection was more frequent in Hainan than in Yunnan.Conclusion There were obvious differences in the distribution and frequencies of MSP2 alleles between Yunnan and Hainan endemic areas. MSP2 is suitable to be used as a marker gene for the genotyping of P.falciparum infection.