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 discuss the scoring formula and evaluate the lists equivalence of Mandarin Quick Speech-in-Noise (M-Quick SIN) test materials in mainland China, and for standardizing our research. METHOD: Double 39 subjects with normal hearing were participated in part one and part two of our experiments, respectively. 20, 18, 15, 13, 10, 8, 5, 3, 0, -2, -5, -7, -10 dB SNR were presented in part one; and 20, 15, 10, 5, 0, -5 dB SNR were presented in part two. The results were analyzed by SPSS 13.0. RESULT: SNR-50 was -2.24 dB SNR and "SNR loss = 24.5--correct words" was defined as the scoring formula. All the 13 lists had the e quivalent difficulty. CONCLUSION Defined "SNR loss = 24.5--correct words" as the scoring formula of M-Quick SIN, and the 13 lists had better difficulty equivalence, which could be used in our further clinical research.
Adolescent ; Adult ; Female ; Humans ; Male ; Noise ; Speech ; Speech Discrimination Tests ; standards ; Young Adult

OBJECTIVE: To analyze the short monosyllabic list of Mandarin speech test materials (MSTMs) which have been evaluated the equivalence of difficulty, and to establish the performance-intensity function (P-I function) for people with normal hearing as clinical reference of hearing recovery and individuals ability to perceive and process speech. METHOD: Thirty-seven subjects (the age ranged from 18 to 26 years old) who speak Mandarin well in their daily lives with normal hearing participated in this study. Eight lists of the Short Mandarin Monosyllabic materials (20 words per list) with equal difficulty were utilized. The results were analyzed by Statistical Package for the Social Sciences (SPSS) software version 17.0. RESULT: P-I function for short monosyllabic word list was x = 98.557/(1 + 12.243 exp (-0.17(P-15, x(max) = 98.557. And the sound pressure level of speech corresponding to a 50% recognition score was 29.6 dB SPL or 9.6 dB HL. The results showed P-I function of 3.1 per dB for Mandarin materials. CONCLUSION The study established the P-I function of the Mandarin short monosyllabic word list materials with equal difficulty, which provides the normative data for identifying the normal hearing in a clinical setting.
Adult ; Auditory Perception ; Female ; Hearing Tests ; methods ; Humans ; Male ; Speech ; Speech Perception ; physiology

Objective To evaluate the test -retest reliability of sentence materials, and to standardize Man_darin Speech Test Materials (MSTMs). Methods Forty normal-hearing subjects aged from 18 to 30 years old were recruited in this study. The sentence materials were tested at 9 dB HL to these subjects according to the prepare ex_periment. The retest was carried out in the same condition after an interval of 14~28 days. The difference between test and retest score was examined by t-test, and the critical difference (CD) was analyzed with 95% confidence in_terval (CI). ResuIts There was no significant difference between the test and retest scores about speech perception performance. The critical difference was 18. 93% at 95% confidence interval, and the number of the corresponding key words was 10. ConcIusion The results showed that sentence materials of MSTMs have good test-retest relia_bility except list 6. The interventions could be considered effective just when the difference of the same subject's score exceed 18. 93%, that means 10 key words are necessary to improve that the intervention is effective.

Objective The aim of this study is to analyze the relationship between the development of audito‐ry and speech in infants with hearing loss after hearing aid fitting and discuss the development of speech with the a‐bility of auditory in infants with different degree of hearing loss and different stage of evaluation after hearing aid fit‐ting .Methods A total of 32 infants (17 boys and 15 girls) with prelingual hearing loss participated in this study . The age at hearing aid fitting ranged from 3 to 34 months with a mean of 15 .6 months .According to their hearing level ,all infants in this study were divided into three groups :group of profound hearing loss(16) ,group of severe hearing loss(11) ,group of moderate hearing loss(5) .CAP and SIR were used to evaluate their abilities of auditory and speech at pre -fitting ,1 ,3 ,6 ,9 and 12 months after hearing aid fitting respectively .A linear and regression a‐nalysis was done in the statistic procedure .Results There was a significant correlation between the scores of CAP and SIR for the three groups respectively .The correlation from low to high followed by the group of profound hear‐ing loss (R=0 .656 ,P=0 .000<0 .05) ,group of severe hearing loss (R=0 .758 ,P=0 .000<0 .05) ,group of mod‐erate hearing loss (R=0 .849 ,P=0 .000<0 .05) .There was also a significant correlation between the scores of CAP and SIR for the different evaluating stages respectively .The correlation from low to high followed by pre -fitting (R=0 .559 ,P=0 .000<0 .05) ,1 month after hearing aid fitting (R=0 .575 ,P=0 .000<0 .05) ,3 months after hearing aid fitting (R=0 .726 ,P=0 .000<0 .05) ,6 months after hearing aid fitting (R=0 .823 ,P=0 .000<0 .05) , 9 months after hearing aid fitting (R=0 .838 ,P=0 .000<0 .05) ,12 months after hearing aid fitting (R=0 .855 ,P=0 .000<0 .05) .Conclusion The development of auditory ability is closely related to speech ability which increases with the improvement of auditory ability .The less the infants have the hearing loss and the longer the infants use the hearing aids ,the higher the auditory ability is related to speech ability in infants after hearing aid fitting .

Objective To study the relationship between the development of auditory and speech in children with hearing loss after hearing aid fitting and discuss the development of speech with the ability of auditory in children at different stages of evaluation, with different degrees of hearing loss and different ages respectively.Methods A total of 19 children (14 boys and 5 girls) with hearing loss participated in this study.The age at hearing aid fitting ranged from 3 to 8 years old with a mean of 5.42±1.86 years old.According to their hearing levels, the children in this study were divided into two groups: the moderate hearing loss group (n=10) and the severe group (n=9).According to their ages at hearing aid fitting, all children in this study were divided into two groups: the less than or equal to six years old (n=11) and greater than six years old (n=8).MAIS and MUSS were used to evaluate their abilities of auditory and speech at pre-fitting, 1, 3, 6, 9 and 12 months after hearing aids were worn respectively.A linear and regression analysis was done in the statistic procedure.Results There was a significant correlation between the scores of MAIS and MUSS (R=0.774,P<0.05).There was also a significant correlation between the scores of MAIS and MUSS for the different evaluating stages respectively.The correlations were pre-fitting (R=0.710,P<0.05), 1 month after hearing aid fitting (R=0.774,P<0.05), 3 months after hearing aid fitting (R=0.814,P<0.05), 6 months after hearing aid fitting (R=0.819,P<0.05), 9 months after hearing aid fitting (R=0.707,P<0.05), 12 months after hearing aid fitting (R=0.649,P<0.05).There was also a significant correlation between the scores of MAIS and MUSS for MAIS (items 3~6) (Sound awareness) and MAIS (items 7~10) (Sound understanding).The correlations for MAIS (items 3~6) were (R=0.768,P<0.05), and for MAIS (items 7~10) (Sound understanding) (R=0.794,P<0.05).There was also a significant correlation between the scores of MAIS and MUSS for different group of ages.The correlations for the group of <6years old were (R=0.808,P<0.05), and for the group of the ≥6 years old (R=0.775,P<0.05).There was also a significant correlation between the scores of MAIS and MUSS for different groups of hearing loss levels.The correlation for the group of moderate hearing loss was (R=0.771,P<0.05), and the group of severe hearing loss (R=0.787,P<0.05).Conclusion The development of auditory ability is closely related to the speech ability.The speech abilities increase with the improvement of auditory abilities.The less severe the hearing loss is, the longer the use of hearing aids, the younger the children are, the better the speech ability improved with auditory ability development after hearing aid fitting.

Objective:To investigate the effect and related mechanism of TRAP1 on the invasion and migration of human bladder cancer through TGF/Smad3 signal path.Methods: Selected from BIU-87 of high expression of TRAP1 in bladder cancer cell lines through Western blot techniques.TRAP1 knockdown lentivirus (LV3-TRAP1) was used to silence the expression of TRAP1.GFP fluorescene and PCR detector was used to detected the efficiency of gene silencing and the effectiveness of gene silencing;effect of TRAP1 on the invasion and migration ability of BIU-87 were detected by Transwell matrigel invasion assays and wound healing assays,CM-H2DCFDA fluorescent staining was used to deteced the cell ROS of BIU-87 with LV3-TRAP1.Detected the level of TGF/Smad3 signal protein by Western blot.Results: LV3-TRAP1 lentivirus could effectively inhibit the expression of TRAP1 compared with LV3-NC.LV3-TRAP1 lentivirus could effectively inhibit the cell RPS of BIU-87.Knockdown the expression of TRAP1 could inhibit the invasion and migration of BIU-87.Knockdown the expression of TRAP1 in BIU-87 could reduce the protein level of TGF/Smad3.Conclusion: Silencing TRAP1 could inhibit the invasion and migration of bladder cancer cell through TGF/Smad3 signal pathway.

AIM: To establish methods of determing ?-eudesmol in atractylis oil from Ermiao Pills(Rhizoma Atractylodis and Cortex Phellodendri Chinensis) by gas chromatography and determing and comparing the chemical compositions between atractylis oil and poultice of Ermiao Pills by decocting separately and together. METHODS: ?-eudesmol content in Ermiao Pills decocting separtely and together was determined and compared by GC using paeonol as the internal standard substance,and contents of berberine,palmatine,jatrorrhizine in Ermiao Pills decocting separately and together were determined and compared by HPLC. RESULTS: The ?-eudesmol content in the volatile oil of decoction together was more than that of the decoction separately.But there was no remarkable difference.Berberine,palmatine,jatrorrhizine contents of decoction separately were more than that of the together. CONCLUSION: The method of determing ?-eudesmol in Ermiao Pills is established.And it has mutual effect in compatibility with Cortex Phellodendri Chinensis and Rhizoma Atractylodis.

This paper aims to retrospectively analyze the nursing management of one-stop hybrid procedures and to sum up the clinical experience.The key point of successful implementation of nursing management of one-stop hybrid procedures lies in the layout of hybrid operation room,in the intraoperative nursing cooperation and the professional nursing personnel training,and in the establishment of a new talent training mode that contains flexible allocation mechanism of nursing human resources as well as short-term post rotation of professional nursing staff.The one-stop hybrid operation is a minimally-invasive procedure for the treatment of complex diseases.Scientific nursing management is the strong guarantee to ensure a successful “one-stop” hybrid operation.

Objective To compare the accuracy of jugular venous oxygen saturation (SjvO2),somatosensory evoked potentials (SSEPs) and motor evoked potentials (MEPs) in estimation of the occurrence of intraoperative cerebral ischemia in patients undergoing clipping of intracranial aneurysm.Methods Forty-three ASA Ⅰ or Ⅱ patients of both sexes,aged 18-64 yr,with a body mass index of 20-25 kg/m2,undergoing clipping of intracranial aneurysm,were studied.Anesthesia was induced with sufentanil,rocuronium and propofol.The patients were tracheal intubated and mechanically ventilated.Anesthesia was maintained with remifentanil and propofol.Blood samples were taken from the jugular bulb for detection of SjvO2 before aneurysm clipping or temporary occlusion of parent artery and at 1,3,10,20 and 30 min after clipping aneurysm or temporary occlusion of parent artery.The amplitude and latency of SSEPs and MEPs were recorded simultaneously.The occurrence of cerebral ischemia estimated by SjvO2,SSEPs and MEPs was recorded.The condition of nerve defect was recorded within 3 days after operation and the gold standard of cerebral ischemia was defined as the occurrence of nerve defect.Results Among 43 patients,14 cases were diagnosed as having brain ischemia.The sensitivity and specificity of SjvO2 in estimation of the occurrence of intraoperative brain ischemia were 71％ and 93％,respectively (P ＜ 0.01).The sensitivity and specificity of SSEPs in estimation of the occurrence of intraoperative brain ischemia were 71％ and 62％,respectively (P ＜ 0.05).When the diagnostic criterion of cerebral ischemia was defincd as a decrease in the amplitude of MEPs or prolongation of the latency MEPs,the sensitivity and specificity of MEPs in estimation of the occurrence of intraoperative brain ischemia were 79 ％ and 52 ％,respectively (P ＞ 0.05).When the diagnostic criterion of cerebral ischemia was defined as a loss of the amplitude of MEPs,the sensitivity and specificity of MEPs in estimation of the occurrence of intraoperative brain ischemia were 57％ and 93％,respectively (P ＜0.05).Conclusion The sensitivity of SjvO2 and SSEPs in estimation of the occurrence of intraoperative brain ischemia is higher,however,the specificity of SjvO2 and MEPs is higher,indicating that SjvO2 is a reliable criteria for estimation of the occurrence of intraoperative brain ischemia in patients undergoing clipping of intracranial aneurysm.