Debates over PBL have never stopped since its introduction to medical education in 1969 and are even becoming more heated.This paper expounds on the origin and definition of PBL,and then describes and analyzes the application of the clinical teaching in orthopedic surgery.

Objective To explore the CT features in CD_(117)-weak and CD_(117)-negative gastrointestinal stromal tumors(GIST).Methods The CD_(117)-weak and CD_(117)-negative Gist proved by pathologically and sur- gically in 13 cases were retrospectively analyzed.Results The tumor was located in the stomach in 6 cases, small intestine in 4 cases,colorectum in 2 cases,greater omentum in one case.The most common clinical manifestations were abdominal pain or discomfort in 6 cases,hematemesis or melena in 3 cases.Malignant tu- mors occurred in 8 cases.Benign tumors occurred in 5 cases.A soft tissue was identified in all 13 cases in CT examination.The CT examinations revealed cystic regions and bleeding in 5 cases.Calcification was not noted within the masses in all cases.The mean diameter of benign tumors was 3.4 cm?2.8 cm while that of malig- nant tumor was 7.5 cm?6.2 cm.All the cases underwent operation,the resection rate was 100%.After follow up from 6 months to 4 years in 10 cases,1 case died of tumor recurrence and metastasis,the others survived. Conclusion CD_(117)-weak and CD_(117)-negative Gist occurred more common in the stomach.CT is useful in lo- cation and differentiation of CD_(117)-weak and CD_(117)-negative gastric stromal tumors with regard to benign or malignant.Surgery is the main method for final diagnosis and treatment.

Coronary Artery Disease ; complications ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; etiology ; Spasm ; complications

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cisplatin ; administration & dosage ; Cyclophosphamide ; administration & dosage ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Fluorouracil ; administration & dosage ; Humans ; Injections, Intra-Arterial ; Lung Neoplasms ; drug therapy ; Male ; Middle Aged ; Mitomycin ; administration & dosage ; Phytotherapy

Adenoma ; pathology ; Brain Neoplasms ; secondary ; Chromogranin A ; metabolism ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Pituitary Neoplasms ; diagnosis ; metabolism ; pathology ; surgery ; Reoperation ; Synaptophysin ; metabolism ; Temporal Lobe ; pathology

Adult ; Breast Neoplasms ; metabolism ; pathology ; surgery ; Carcinoma, Squamous Cell ; metabolism ; pathology ; surgery ; Female ; Humans ; Keratin-5 ; metabolism ; Lymph Node Excision ; Lymphatic Metastasis ; Mastectomy, Radical ; methods ; Middle Aged ; Transcription Factors ; metabolism ; Tumor Suppressor Proteins ; metabolism

Objective To identify the clinical profile and neuro-imaging findings of the right temporal lobe variant of semantic dementia (RTLV),and to understand the relationship between anatomic and function by comparison to the left temporal lobe atrophy.Methods Of 70 patients with diagnosis of frontotemporal dementia in our memory clinic,three patients with right temporal lobe atrophy were identified based on the MRI scans.We obtained the profile of cognitive function,behavior and personality changes in these 3 patients and compared them with those in 5 semantic dementia (SD) patients with predominant leftsided temporal lobe atrophy.We also underwent 18F-fluoro-2-deoxy-D-glucose positron emission tomography (18F-FDG-PET) with statistical parametric mapping analysis in these 3 patients.Results In RTLV patients,the most prominent cognitive deficits were impairment of prosopagnosia,and getting lost.Variety behavioral symptoms including apathy,social disinhibition,stereotypy,compulsive behaviors were more prevalent in early course for patients with RTLV,which were different from SD patients with semantic loss began with anomia or single-word comprehension.18F-FDG-PET scan showed decreased metabolism mainly in right temporal lobe and in other brain regions with varying degrees.Conclusions The RTLV is clinical heterogeneous.Prosopagnosia,behavioral changes and getting lost are the main features in the early course.It therefore,might be proposed a separate clinical entity.

Adult ; Brain Neoplasms ; pathology ; Glioblastoma ; pathology ; Humans ; Male ; Pineal Gland ; pathology

Objective To explore the relationship of a polymorphism c.757T ＞ C in C-reactive protein gene (CRP) and carotid artery atherosclerosis in patients with ischemic cerebrovascular disease (ICVD).Methods A case-control study investigated 276 ICVD patients and 125 controls matched for age and sex.Genotypes of-757T/C in CRP were analyzed in patients with ICVD using polymerase chain reaction-restriction fragment length polymorphism.The level of serum C-reactive protein was detected by using immune scatter turbidimetry and the intima-media thickness of common carotid artery and internal carotid artery were measured by color Doppler ultrasonography.The relationship between the polymorphism -757T/C in CRP and carotid atherosclerosis was assessed.Results The genotypes of the polymorphism -757T/Cin CRP in the ICVD group (207/276(75.0％),65/276(23.6％),4/276(1.4％)) was significantly different from the control group (75/125 (60.0％),46/125 (36.8％),4/125 (3.2％) ; x2 =9.531,P =0.008),the frequence of T allele in patients with ICVD (479/552(86.8％)) was increased significantly compared to the control group (196/250 (78.4％)),the frequence of C allele in the ICVD group (73/552(13.2％)) was decreased significantly in contrast to the control group (54/250 (21.6％) ;x2 =9.056,P =0.004).Among the patients with ICVD,the level of serum C-reactive protein in patients with-757TC/CC genotype was elevated significantly than that with-757TC/CC ((4.2± 1.6) mg/L vs (2.7 ± 1.9) mg/L; t =5.900,P ＜ 0.01).Logistic regression analysis demonstrated that the-757C allele in CRP was related to the carotid artery atherosclerosis (OR =1.379,95％ CI 0.852-0.864,P =0.023).Conclusions The polymorphism-757T/C in CRP maybe related to the risk of developing ICVD.The frequency of the-757C allele can increase the level of serum C-reactive protein.And this polymorphism may be associated with carotid artery atheroselerosis in patients with ICVD.

Objective To complete the large international cooperation nursing research project Adapting a Smoking Cessation Intervention Distance Learning Program to Educate Nurses in China(CRN-HSQ) cooperating with International Society of Nurses in Cancer Care (ISNCC).Methods The contact team was formed,convenience sampling method was used to choose 350 clinical nurses in our hospital.They were trained and investigated by web-based education mode.Results The contact team finished the project tasks smoothly.The satisfaction degree of research object with the contact team was high.Conclusions Establishment of contact team is good for shortening the information flow path,reducing the information transmission error,increasing the research objects' confidence and reducing the research objects turnover.It is very helpful for project with long period and large number of research objects.