Case analysis method,which was a new teaching mode,was proposed for some problems in current traditional teaching mode.The concrete operation content of case analysis method in lemological teaching was described.The results of the survey analysis showed that the teaching effectiveness of the new teaching mode was obviously better than that of traditional teaching mode.

Objective To compare the differences of epidemiology, clinical characteristics, laboratory results and prognosis between patients with severe fever with thrombocytopenia syndrome bunyavirus (SFTSV) infection and those with hemorrhagic fever with renal syndrome (HFRS).Methods Medical records of 16 hospitalized cases with SFTSV infection and 28 hospitalized HFRS cases from January 2012 to June 2016 were reviewed in affiliated Yijishan Hospital of Wannan Medical College.In details, the comparative analysis of patients between the two groups were conducted in sex, age, occupation, onset season, contact history, underlying diseases, fever duration, oliguria, bleeding (including petechiae, ecchymoses, gum bleeding, bloody stool and hematuria), secondary infection, consciousness disturbance, dialysis treatment, length of hospital stay, laboratory results and prognosis.Continuous variables of normal, non-normal distribution data were compared using two-sample t test and rank sum test, respectively.Categorical variables were showed in rate and compared using chi-square test.Results The differences between the two groups in age (t=2.585), occupation (χ2=4.914), onset season (χ2=4.325) and contact history (χ2=9.617) were all statistically significant (all P<0.05).In SFTSV infection group, the mean fever duration was (8.81±3.17) d.There were 2 cases of oliguria, 10 cases of bleeding, 7 cases of secondary infection, 5 cases of consciousness disturbance.No patient received dialysis.The average length of hospital stay was (13.44±7.91) d.In HFRS group, the mean fever duration was (5.96±2.20) d.In addition, there were 24 cases of oliguria, 25 cases of bleeding, 9 cases of secondary infection, 3 cases of consciousness disorder.Twelve cases received dialysis treatment in this group.The average length of hospital stay was (18.04±15.75) d.Furthermore, there were significant differences between the two groups in fever duration (t=3.511), oliguria (χ2=22.578), bleeding (χ2=4.490) and dialysis (χ2=7.392) (all P<0.05).The significant differences were also found in white blood cell count, blood urea nitrogen, serum creatinine, albumin, amylase, lipase, creatine kinase, serum sodium, chloride, calcium, carbon dioxide combining power and blood glucose between the SFTSV infection group and HFRS group (all P<0.05).However, there was no significant difference in prognosis between the two groups (Z=1.574, P=0.115).Conclusions There are differences in epidemiological history, clinical manifestations and laboratory findings between the SFTSV infection group and HFRS group, which may help differential diagnosis and treatment of these two diseases.

Objective To explore the changes of etiological factors,age of onset,misdiagnosis rates,length of stay and prognosis in central nervous system (CNS) infections between the near 2 decades.Methods A retrospective analysis was conducted between hospitalized patients with CNS infections in affiliated Yijishan Hospital of Wannan Medical College from January 1993 to December 2002 (group A,n =346) and from January 2003 to December 2012 (group B,n =412).The proportions of bacterial infections,Mycobacterium tuberculosis infections,Cryptococcus infections and viral infections between the 2 groups were comparable.Age,gender,underlying diseases and prehospitalization applications of immunosuppressant in two groups were analyzed.The data of prehospitalization misdiagnosis rates,length of stay and prognosis of the two groups were also compared.Measurement data were analyzed by variance analysis or t test,and enumeration data were analyzed by x2 test.Results The proportions of bacterial infections,Mycobacterium tuberculosis infections,Cryptococcus infections and viral infections in two groups were 24.3％ vs 20.1％,29.5 ％ vs 35.7 ％,6.6％ vs 11.4％ and 39.6％ vs 32.8％,respectively (x2 =10.61,P＜0.05).Compared with group A,patients in group B were older [(38.8±8.9) years vs (43.8±11.4) years,t=6.73,P＜0.05],with greater numbers of underlying diseases (1.21 ± 0.34 vs 1.72 ± 0.41,t=18.41,P＜ 0.05) and longer pre-use of immunosuppressants [(7.76 ± 3.58) d vs (12.43 ± 5.96) d,t =12.77,P＜ 0.05].There was no significant difference in sex distributions between the two groups (x2 =0.97,P＞0.05).In group A,the misdiagnosis rates for bacterial infections,Mycobacterium tuberculosis infections,Cryptococcus infections and viral infections were 9.5％,42.2％,69.6％ and 12.4％,respectively; average length of stay was (11.02±5.13) d,(19.18±8.34) d,(21.12±9.26) d and (8.24±3.17) d,respectively; and remission rates were 88.1％,60.8％,34.8％ and 80.3％,respectively.In group B,the misdiagnosis rates for bacterial infections,Mycobacterium tuberculosis infections,Cryptococcus infections and viral infections were 8.4％,29.3％,42.6％ and 11.1％,respectively; average length of staywas (10.13±4.25) d,(17.26±5.82) d,(23.05±7.97) d and (7.05±2.94) d,respectively; and remission rates were 90.4％,72.8％,61.7％ and 84.4％,respectively.The misdiagnosis rates and remission rates of Mycobacterium tuberculosis infections and Cryptococcus infections between group A and group B were of statistical significance (both P ＜ 0.05).Conclusions With the increase of underlying diseases and wide use of immunosuppressants,the causes of CNS infections are changing,among which Mycobacterium tuberculosis infections and Cryptococcus infections are increasing,with a tendency of misdiagnosis and poor prognosis.

Objective To study the seasonal changes of glucose levels per unit soft tissue of Oncomelania hupensis. Meth-ods O. hupensis snails were collected from the beach of the Qingyi River in Wuhu City,Anhui Province from August 2012 to July 2013. They were kept in minus 80℃refrigerator immediately. The male snails were distinguished from female,and their soft tissues were collected separately after crushing their shells. The hexokinase method was used to measure the glucose concen-trations,and the results were analyzed statistically. Results The contents of glucose decreased from March to July. The lowest glucose content in the female was 1.87μg/mg in March,and that in male was 3.70μg/mg in July. Both of them increased from August and reached peak levels in September(♀=57.38μg/mg,♂=44.39μg/mg),and then gradually decreased from Octo-ber to next January and increased in February. Conclusion The contents of glucose have seasonal changes regularly in O. hu-pensis.

To determine whether the targeting inhibition of Kupffer cellsfunction mediated by gadolinium chloride (GdCl_3) could interfere with the CD4~+CD25~+ regulatory T cells of mice at the granuloma stage of schistsomiasis, female C57BL/6 mice of 6-8 weeks old were divided randomly into 3 groups, i.e. control group. group infected with cercariae of Schistsoma japonicum and group of infection plus GdCl3,. GdCl3 in a dosage of 15 mg/kg was introduced into mice through penile vein twice per week. The number of CD4~+CD25~+ T cells was determined using flow cytometry and the number of cells with Fox p3 was detected by using immunohistochemical methods. For detection of cytokines, such as IL-4, IL-5, IL-10, TGF-β1, ,IFN-γ in mouse sera, a DuoSer ELISA development kit was used, It was found that the number of CD4~+CD25~+ T cells and level of IL-10 in Schistosomiasis granuloma stage were decreased in the S.japonicum cercariae infected mice injected with GdCl_3 in comparison with the infection group. The percentages of CD4~+CD25~+ T cells of infection group and infection plus GdCl_3 group were 13.8%, 9.3% and 6.4% respectively, while the levels of IL-10 of these 3 groups of rats were 41.4 pg/mL, 22.6 pg/mL and 11.5% respectively. In addition, treatment with GdCl_3 could down-regulate the expression of Fox p3 and reduce the inflammatory reactions in Schistosomiasis granuloma. It is evident that the targeting inhibition of Kupffer cellsfunction mediated by GdCI_3 interfere with the production of the regulatory T cells and reduce the inflammatory responses in Schistsomiasis granuloma.

Objective To explore the effect of targeting Kupffer ceHs on CD4~+ CD25~+T cells in schistosome gramtloma.Methods A total of 30 six-to eight-week-old C57BL/6 female mice were divided into three groups equally,namely a control group,an infection group with S.japonicum cercariae(10 cercariae per mouse) and an infection group injected with GdCl_3 through the penile vein(15 mg/kg)twice perweek.After8 weeks of theinfection,the number of CD4~+ CD25~+T cells was detected by using flow cytometry and the number of Foxp3 was detected by using immunohistochemistry.For the detection of murine IL-4,IL-5,IL-10,TGF-β1 and IFN-γ,a DuoSet ELISA development kit was used.Results The number of CD4~+ CD25~+T ceils and the level of IL-10 decreased significantly in the infection group injected with GdCl_3 compared with the infection group.GdCl_3 treatment decreased Foxp3 production and the level of ALT,and reduced the inflammatory response in schistosome Granuloma.Conclusion Kupffer ceils Can regulate the response of CD4~+ CD25~+T cells in schistosome granuloma.

PURPOSE: The purpose of the study was to investigate how much understand about artificial hydration in patients with terminal cancer, according to the subject groups, including patients, families, and general public. METHODS: Data were collected from June 2007 to December 2007 and the participants included 22 hospitalized patients in the hospice unit of S Hospital, 100 families, and 101 participants who participated in a hospice education program for the general public. The questionnaire was developed through literature review, interview with patients' families, and expertise consultation. Data were analyzed using descriptive statistics with an SAS program. RESULTS: Understanding of artificial hydration among patients, families and general public was examined from three perspectives. From an ethical perspective, 'if you receive artificial hydration, you can live longer', 45.5%, 63%, and 52.4% of the above three groups, respectively, answered "yes". From an emotional perspective, 'artificial hydration must be provided', 81.8%, 70% and 58.4%, respectively, agreed. From a cultural perspective, 'if artificial hydration is not provided for the patient, the families will feel painful', 95.5%, 83%, and 88.2%, respectively, answered "yes". CONCLUSION: This study found the differences in understanding of artificial hydration among patients, families and general public, and also found that less than 50 percent of the participants understood artificial hydration appropriately. We suggest, therefore, that patients' understanding about artificial hydration should be determined in the clinical setting and then followed by individualized education according to given medical situations.
Fluid Therapy ; Hospices ; Humans ; Phenothiazines ; Terminally Ill ; Surveys and Questionnaires

PURPOSE: The aim of this study was to evaluate whether the perioperative carcinoembryonic antigen (CEA) ratio could be used as a determinant for adjuvant therapy after curative surgery in stage II colorectal cancer. METHODS: Data for 119 patients with stage II colorectal cancer who underwent radical surgery between 2010 and 2013 were collected. The perioperative CEA ratio was defined as the postoperative/preoperative serum CEA level, and the patients were grouped according to their perioperative CEA ratios: high ratio (≥0.5) and low ratio ( < 0.5). Overall survival rates were calculated, and their prognostic significances were analyzed. RESULTS: The overall survival rates of the high and the low perioperative CEA groups were 68.2% and 86.8%, respectively (P = 0.033). In patients with normal preoperative CEA levels ( < 5 ng/mL), the high perioperative CEA ratio group showed a worse survival rate than the low perioperative CEA ratio group (71.7% vs. 100.0%, P = 0.007). In patients with high preoperative CEA levels (≥5 ng/mL), the high perioperative CEA ratio group showed a worse survival rate than the low perioperative CEA ratio group (33.3% vs. 75.0%, P = 0.036). In the multivariate analysis, perioperative CEA ratio (P = 0.046), age (P = 0.034), and venous invasion (P = 0.015) were independent prognostic factors for survival. CONCLUSION: The perioperative CEA ratio is a prognostic indicator for stage II colorectal cancer. Patients with normal preoperative serum CEA levels might also be considered for adjuvant therapy if their perioperative CEA ratios are higher than 0.5.
Carcinoembryonic Antigen ; Chemotherapy, Adjuvant ; Colorectal Neoplasms ; Humans ; Multivariate Analysis ; Neoplasm Staging ; Prognosis ; Survival Rate

Objective To analyze and study the epidemic and clinical characteristics of hemorrhagic fever with renal syndrome in Southern Anhui Province during 2010-2020. Methods The epidemiological and clinical data of HFRS patients hospitalized in Yijishan Hospital of Wannan Medical College from 2010 to 2020 were collected and statistically analyzed. Results The temporal distribution of HFRS epidemic in Southern Anhui Province showed that HFRS were more frequent during spring and summer, and HFRS morbidity was highest in June. The population distribution characteristics showed that the ratio of male to female patients was 4.7:1. The main age group of patients was 40-50 years old (50 cases, 33.8%), and a majority of patients were farmers (87 cases, 58.78). Analysis of clinical characteristics showed that fever, backache, anorexia and hypodynamia, diarrhea, emesis and headache were the main frequent symptoms of HFRS patients, and 88.52% of HFRS patients were cured or improved. Conclusion The high incidence period of HFRS is spring and summer in Southern Anhui Province from 2010-2020. HFRS patients in Southern Anhui Province have typical clinical symptoms and good prognosis.

Esophageal perforation can lead to serious complications, and rapid diagnosis and treatment significantly affect the prognosis. Endoscopic vacuum-assisted closure (EndoVAC) therapy is widely accepted as a safe, well-tolerated, effective, versatile and practical procedure for the management of esophageal perforation in selected patients. We report the successful use of EndoVAC therapy for management of an esophageal perforation secondary to foreign body removal. A 56-year-old man presented to the emergency department for evaluation of chest pain after swallowing the plastic shell of a pill. Emergency endoscopy revealed an esophageal wall laceration (approximately 3 cm) and microperforation. The esophageal laceration and microperforation were limited to the mid-esophagus. The patient underwent EndoVAC therapy, which was repeated every 3–4 days for a total of six sessions over a period of 21 days. We observed improvement in the esophageal injury with granulation tissue formation during the fifth session. Subsequent follow-up evaluation, including esophagography and chest computed tomography confirmed complete healing of the esophageal injury. Following resumption of diet, the patienton a was discharged without any complications.