Internet based problem-based learning (PBL) mode was used in teaching of ophthalmology in order to increase the quality of ophthalmology teaching and to raise the student's ability of problem solving.The method and requirements of teaching were discussed based on the teaching schema.Examples of cataract teaching using internet based PBL mode was performed.The characteristics and merit of the mode were summarized in the end.

Objective To discuss the value of MRI in clinical diagnosis.Methods Images between CR excretory urography and MRU were compared,which came from the results of 36 cases who were examined by both CR and MRU.Results The spiral MRU images were better than those of the CR excretory urography,and at the same time,the relationship between the parenchyma of the renal,renal pelvis,ureter,bladder and the urinary organs and adjacent tissues were displayed clearly.Conclusion The scanning time of MRI is shorter.The machine can not only reconstruct powerfully but also work out better images,and the result is better than MRI which can't detect pathological changes in detail in its images.Therefore MRI can be replaced by MRU if the higher cost can be afforded.[Chinese Medical Equipment Journal,2008,29(2):80-81]

Objective To explore the clinical application of two different fixation methods for nasal continuous positive airway pressure (NCPAP) in newborns. Methods One hundred and forty newborns who had NCPAP treatment were selected and divided into experimental group and control group with 70 cases in each group by random digits table method.The newborns in experimental group received self- made caps to fix the prong systems,while the newborns in control group received U shape towel. The incidence of nose, head of facial skin injury, frequency of detachment for nasal prongs and duration mechanical ventilation were compared between two groups. Results The frequency of detachment for nasal prongs per 24 h was (0.65±0.18) times in experimental group and (1.64±0.22) times in control group, and there was significant difference (t=28.68, P<0.01). The incidence of nose, head of facial skin injury were 8.6%(6/70), 2.9%(2/70) in experimental group and 27.1%(19/70), 14.3%(10/70) in control group,and there were significant differences ( χ2 =8.23, 5.83, P<0.01 or 0.05). There was no significant difference in duration mechanical ventilation between two groups(P>0.05). Conclusions Use of the self- made caps for NCPAP in newborns is associated with significant reduction in the incidence of nose, head of facial skin injury,and the frequency of detachment for nasal prongs.The fixation should be prompted in clinic.

Objective To determine the relationship between serum adiponectin level and chronic inflammation,atherosclerosis in maintenance hemodialysis(MHD)patients.Methods Totally 60 MHD patients and 30 healthy volunteers were included in this study.Serum adiponectin level(ADPN)and C-reative protein(CRP),interleukin-6(IL-6)were measured.Carotid initial-medial thickness(IMT)and brachial arterial vasodilation were determined by echocardiography.Results Serum ADPN level(0.99?0.37)was higher in MHD patients than that(0.39?0.14)in controls.The ADPN level of higher IMT group was lower than that in normal IMT group.CRP,IL-6 and Cartid IMT were negatively correlated with ADPN(r=-0.22,-0.31-0.26,P

AIDS has become a global disease,and a variety of drugs are used in the treatment of AIDS ,but the interindividual variabilities in efficacy and toxicity remain important limitations for the use of these drugs.Studies have shown genetic polymor-phism is the main reason for interindividual variabilities of drug reaction.In recent years,scholars focused on the pharmacog-enomics of anti-AIDS drugs and found that genetic polymor-phisms,in large part,determine the interindividual variabilities of the responese of these drugs.This paper reviews the research progress on pharmacogenomics of the four types of anti-AIDS drugs commonly used in China,including nucleoside reverse transcriptase inhibitors (NRTIs),non-nucleoside reverse tran-scriptase inhibitors (NNRTIs),protease inhibitors (PIs)and integrase inhibitors (raltegravir).

AIM:To investigate the differences of clinical signs and pathological structure of unilateral nasal pterygium and unilateral double pterygium.METHODS:Retrospective study.Totally 11 unilateral nasal pterygium and 11 unilateral double pterygium were collected to observe the size of the tissue area, the classification of blood vessels, the transparency and the break-up time of tear film.The 11 surgically excised double pterygia (11 eyes) and 6 samples of normal conjunctiva were collected for the study.With 40g/L paraformaldehyde fixation, paraffin sections were stained with Haematoxylin-Eosin, to observe the differences with nasal and temporal pathology under light microscope.RESULTS:In unilateral double pterygium, the tear break-up time was significantly shorter than that of unilateral nasal pterygium (t=3.410, P=0.003).In unilateral nasal pterygium, there was a significant negative correlation between tear film break-up time and tissue size(r=-0.927, P<0.01) and transparency(r=-0.764,P<0.01).In unilateral double pterygium, the tear break-up time was significantly negatively correlated with the growth time (r=-0.661, P<0.05), tissue size (r=-0.775, P<0.01) and transparency (r=-0.671,P<0.05).In unilateral double pterygium, compared with the temporal side, the quantity of the layers of corneal epithelial cells (t=-7.351, P<0.05), vessels (t=-7.400, P<0.05) and inflammatory cells (t=-7.481, P<0.05) increased.CONCLUSION:Compared with unilateral nasal pterygium, the tear film break-up time of unilateral double pterygium was poor.In unilateral double pterygium, with high activity, the degree of proliferation of squamous epithelium, hyperplasia and inflammatory reaction are significantly higher than those of the temporal side.

Objective To evaluate the expression level of cathepsin D protein in nasopharyngeal carcinoma (NPC) and to determine its relationship with clinic pathological characters. Method Immunohistochemistry was performed to detect the expression of cathepsin D in 72 cases of primary NPC and 28 cases of normal nasopharyngal epithelial tissue ( NNET), and the correlation of its expression level with clinicopathologic features and clinical outcomes was evaluated. Results Significant down-regulation of cathepsin D was observed in NPC versus NNET(x2 = 13. 55, P ＜0. 01 ). In addition, cathepsin D down-regulation was significantly correlated with poor histological differentiation ( x2 =41.47, P ＜0. 01 ). Type Ⅰ and Ⅱ (well-moderately differentiated) NPC showed more intense immunoreactivity of cathepsin D compared with type Ⅲ (poorly differentiated) NPC. Cathepsin D up-regulation was significantly correlated with clinical stage, recurrence, and lymph node and distant metastasis (x2 = 13.43,22. 86,21.61,14. 32, P ＜0. 01 ).Tumors with cathepsin D up-regulation tended to have advanced clinical stage, frequent recurrences, and metastasis to lymph node and distant organ. Conclusion The expression of cathepsin D was closely related with the differentiation, clinical stage and pathological grade of NPC. Cathepsin D could be served as an effective differentiation marker for the histopathological grading of NPC and a possible therapy target.

Objective To explore the application of integrating 64-slice CT image with three-dimensional electroanatomic mapping(Carto-Merge) in guiding catheter ablation of atrial fibrillation(AF).Methods Fifteen patients with drug-refractory AF received catheter ablation of AF.64-slice CT scan was performee 1-3 days prior to the ablation procedures.Using a novel software package,the left atrium(LA)with PVs was segmented and extracted for image registration with a combination of landmark registration and surface registration.Results The integration of the CT image into the electroanatomic mapping system was performed successfully in all patients with an error of 2.11?0.82 mm.Thirty pairs of PVs were electrically isolated after circumferential rediogrequency pulmorary rein ablation.The mean procedure time was 170.51?38.47 minutes.Cardiac tamponade occurred in one patient.All the fifteen patients were free of AF recurrence after 3 months of follow up including the 2 cases of persistent AF who required antiarrhythmic drugs.No thromboembolic events or stenosis were observed.Conclusion Integration of 64-slice CT image into the CARTO system successfully performed in patients undergoing catheter ablation of AF and enhance the ablation success rate.

Objective To analyse the prognostic value of serumal copeptin in patients with acute exacerbation of COPD compli-cated withrespiratory failure.Methods The serumal copeptin were detected in 60 hospitalized AECOPD patients before and after the treatment and in 30 healthy controls.Results Comparing with control groups,the serumal levels was significantly elevated in the patient with AECOPD before thetreatment and declinied two months later(P <0.05).The level of serum copeptin wereincreasing with the increase in the severity of the disease in acertain extent;The serumalcopeptin were positively correlated with lung function and CAT (r=0.058 and 0.821,P =0.00)and were negativelycorrelated with 6MWD(r=-0.652,P =0.00).Conclusion Serum copeptin could as-sess the incidence of acute exacerbations ofchronic obstructive pulmonary disease and its therapeutic effect;Serum copeptin can reflect the se-verity of AECOPD patients in a certain extent,and has certain clinical value to evaluate the quality of life in patients.

Objective:To study the pupils' anxiety and related factors.Methods:6994 pupils and their were investigated using Conners Behavior Checklist(PSQ).Results:The pupils above 8 years old were more anxious.The economic state of family played an important role in pupils' anxious.Their existed significant age difference in boys but not in girls.Level of farther's and mother's education has obvious influences in their anxiety.Conclusion:The effect facts of anxiety include the age of students,economic state of family,the level of parent's education.