Teaching feedback has been affected by many factors including education theory, culture diversity and so on.Article analyized the teaching feedback in United States clinical education in a group of the visiting student’s experience in Harbor-UCLA Medical Center.In clinical education, the aim of teaching can only be could be successfully reached by consideration the specific teaching contact and students’idiosyncrasy and flexible teaching feedback utilization.

Objecive:To observe the incidence of early enteral nutrition-related complications in severe brain-injured patients in ICU and its associated factors.Methods:78 nutrition severe brain-injured patients(GCS 4-8) in ICU receiving enteral nutrition were all carried out for GCS scoring.The enteral feeding amount and speed,serum albumin(ALB) and intestinal feeding tolerance were observed.The incidence rate of all kinds of complications related to enteral nutrition was summarized.Results:The patients with lower GCS had lower total feeding amount,prolonged feeding duration and higher incidence rate of complications.The diarrhea was negatively related with serum ALB level and GCS. Conclusion :Enteral nutrition-related complications are related with the severity of disease and Alb level.Some critically ill patients can not sustain total enteral nutririon(TEN),and parenteral nutrition is necessary.

Objective To investigate the feasibility and efficacy of combined preoperative chemora- diation program followed by radical surgery in bulky early or moderate uterine cervical cancer.To determine the incidence and predictive value of rasidual disease in the radical hysterectomy specimens after CCR. Methods Thirty-five patients with uterine cervix carcinoma from January 2001 to September 2003 were treated with preoperative external beam radiotherapy to 3060 cGy in 4 weeks.Patients received concurrent continuous infusion cisplatin(20 mg/m~2)on day 1,8,15,22 of four weeks and 5-Fu(4 g)chemotherapy during the first four days and the last four days of the radiation course.Radical surgery was not performed until 4 weeks after the completion of the preoperative treatment.Results Clinical response was 85.71%,complete response,54.29 %;partial response,31.43 %.The analysis of the surgical specimens showed 19 patients had revealed residual disease and 16 patients had revealed no residual disease,the complete pathological response hed been 45.71%.Three-year survival rate was 87.14 % in 35 patients.Three-year survival rate of residual disease patients(76.32 %)was significantly lower than that of no residual disease(100.0 %)(P=0.0358). Three-year survival of cervical stromal invasion less than 1/2 and invasion extra stromal was 100.0 %, 41.67 % respectively(P=0.0109);three-year survival of lymph-vascular space involvement and no lymph- vascula space involvement was 0,85.29 %,respectively(P=0.0148).Conclusion Combined preoperative chemoradiation program followed by radical surgery in bulky early or moderate cervical cancer could reveal an effective efficacy with a tolerant complication.Residual disease is an independent and strong predictive factor.

In order to determine the challenge dose of pigeon paramyxovirus type 1 (PPMV-1) inactivated vaccine (S-1 strain). The virus titer of PPMV-1 E5 allantoic fluid (Chuansha strain) was determined using SPF chicken embryos in this research. After inoculating 30-day-old and 120-day-old pigeons with low-HI antibody against PPMV-1 (HI antibody < or =2) with different doses of PPMV-1 (Chuansha strain), the clinical symptoms and histopathological lesions of the challenged pigeons were examined. The results showed that the minimal lethal dose (MLD) of PPMV-1 (Chuansha strain) was 102.5 ELD50, so we determined that 10(5.5) ELD50, which was 1000 times the MLD, could be taken as the challenge dose in the vaccine efficacy test for PPMV-1 inactivated vaccine (S-1 strain).
Animals ; Antibodies, Viral ; immunology ; Bird Diseases ; immunology ; mortality ; virology ; Chick Embryo ; Columbidae ; immunology ; virology ; Newcastle Disease ; immunology ; mortality ; virology ; Newcastle disease virus ; immunology ; pathogenicity ; Phylogeny ; Viral Vaccines ; immunology ; Virulence

OBJECTIVETo study the influence of bone marrow mesenchymal stem cells (MSCs) transplantation on hypoxic pulmonary hypertension (HPH) in rats.

METHODSSD rats MSCs were separated, cultivated, identified and labeled by the green fluorescence protein (GFP) gene virus and transplanted in vitro. Healthy male SD rats were randomly divided into four groups: Normal control group (NC group) and HPH group (eight rats respectively), HPH+ MSCs transplantation group and HPH+ VEGF+ MSCs transplantation group (twenty-four respectively). The test employed atmospheric intermittent low oxygen method to establish the rat model of pulmonary hypertension and stem cells were transferred and transplanted. The rats' mean pulmonary artery pressure (mPAP) was observed; right ventricular hypertrophy index (RVHI) was calculated; the morphological change of lung small artery in various groups of rats was observed under the microscope; the distribution of lung small artery and adenovirus transfection fluorescently labeled MSCs was observed under a fluorescent microscope after 7, 14 and 28 days when stem cell was transplanted.

RESULTSFor NC group, the mPAP (mmHg) was 15.5 +/- 1.5 after twenty-eight days while the mPAPs for HPH , MSCs and MSCs+ VEGF were 26.1 +/- 1.9, 21.6 +/- 2.7 and 20.1 +/- 2.9 respectively which were apparently higher than that of NC group (P < 0.01) and compared with HPH group (P < 0.01), which declined clearly. There was no significant difference between MSCs and MSCs+ VEGF. After twenty-eight days, RVHI for NC group was 0.28 +/- 0.02 while the RVHI for HPH, MSCs and MSCs + VEGF were 0.43 +/- 0.07, 0.34 +/- 0.03 and 0.35 +/- 0.01 respectively which was apparently higher than that of NC group (P < 0.01) but which was clearly lower than that of MSCs and MSCs+ VEGF (P < 0.05) and there was no significant difference between MSCs and MSCs + VEGF. For HPH group, pulmonary arteriole wall became apparently thicker, the lumen became significantly narrow and nearly obstructed after twenty-eight days, the endothelial cells were incomplete; compared with HPH group, pulmonary arteriole wall of MSCs group became thin, the lumen was smooth and the completeness of endothelial cells was improved. Whereas for MSCs and MSCs + VEGF, these changes were not significantly clear.

CONCLUSIONAfter MSCs transplantation, mPAP and RVHI decline sharply and lung small artery remodeling is improved which partially reverses HPH process; there is no significant difference between VEGF together with MSCs transplantation group and pure MSCs.

Animals ; Disease Models, Animal ; Hypertension, Pulmonary ; etiology ; metabolism ; surgery ; Hypoxia ; complications ; Male ; Mesenchymal Stem Cell Transplantation ; Rats ; Rats, Sprague-Dawley ; Vascular Endothelial Growth Factor A ; pharmacology

Acupuncture Therapy ; Adult ; Aged ; Heart Diseases ; etiology ; therapy ; Humans ; Male ; Middle Aged ; Spondylosis ; complications

Objective To investigate the effect of different doses of dexmedetomidine combined with intercostal nerve block in regional adenomammectomy.Methods 112 patients receiving regional adenomammectomy and meeting criterions were selected from Oct.2013 to Oct.2016.And they were divided into control group and low,medium,and high dose group according to table of random number,with 28 cases in each group.Patients of the control group only received intercostal nerve block.Patients of low dose group received low dose of dexmedetomidine (0.7 μg/kg load dose and 0.25μg· kg-1·h-1 maintenance doses) combined with intercostal nerve block.Patients of medium dose group received medium dose of dexmedetomidine (0.7 μg/kg load dose and 0.5 μg·kg-1·h-1 maintenance doses) combined with intercostal nerve block.Patients of high dose group received high dose of dexmedetomidine (0.7 μg/kg load dose and 1 μg· kg-1·h-1 maintenance doses) combined with intercostal nerve block.Mean arterial pressure,heart rate,VAS score and sedation score of the four groups were detected and compared at T0,T1,T2,T3 and T4.Results The mean arterial pressure and heart rate of medium and high dose group were lower than those of the control group and low dose group at T1,T2,T3 (P＜0.05).The mean arterial pressure and heart rate of high dose group were lower than those in medium dose group at T1,T2,T3 (P＜0.05).VAS score of medium and high dose group were lower than those of the control group and low dose group (P＜0.05),while the difference was not statistically significant between medium and high dose group(P＞0.05).The sedation scores of low,medium and high dose groups were higher than those of the control group at T1,T2,T3 and T4 (P＜0.05),while the sedation score of high dose group were higher than those of low and medium dose groups at T1,T2,T3 and T4 (P＜0.05).Conclusion Medium and high dose of dexmedetomidine combined intercostal nerve block can effectively relieve pain for patients undergoing regional adenomammectomy,while high dose of dexmedetomidine is likely to cause bradycardia,hypotension and excessive sedation.Appropriate dosage should be chosen in clinical practice.

Objective To investigate the in vitrointervening effect of ratserum effector substances on vascular endothelial cell proliferation and migrationafter stasis-eliminating and meridian-unblocking moxibustion and explore the possible proangiogenic mechanism of stasis-eliminating and meridian-unblocking moxibustion treatment for vascular dementia.Method Male adult Wistar rats were used.Arat model ofvascular dementia was made by four-vessel occlusion(4-VO).The rats were randomized to moxibustion,Western medicationand model groups.Asham operation group was established as a control.There was a total of four groups.The moxibustion group received aconite cake moxibustion on point Baihui(GV20)and suspended moxibustion on points Dazhui(GV14)and Shenting(GV24) and the Western medication, an oralgavage of aniracetam tablets.Treatment was given 15 days as one course for a total of two courses.Blood was taken from the Orbital cavity in the moxibustion, sham operation and model groups after each course of treatment.After stasis-eliminating and meridian-unblocking moxibustion, animal serum was prepared tointervene in human umbilical vein endothelial cell (HUVEC-12) culture.Another parallel liquid group was set up. RPMI-1640 culture medium containing 10% fetal bovine serum (FBS) was prepared.Endothelial cell proliferationwas examined bymethyl thiazolyl tetrazolium (MTT) colorimetric assay.Endothelial cell migration was examined by cell scratch labeling.Result After two courses of treatment, the examination of endothelial cell proliferation by methyl thiazolyl tetrazolium (MTT) colorimetric assay showed that rat serum intervened significantly in human umbilical vein endothelial cell (HUVEC-12) proliferation in the moxibustion serum group compared with the model serum, sham operation serum and parallel liquid groups (P<0.01).At 24 hrs after two courses of treatment, the examination of endothelial cell migrationby cell scratch labelingshowed that rat serum intervention significantly increased the HUVEC-12 migration rate in the moxibustion serum group compared with the model serum, sham operation serum and parallel liquid groups (P<0.01).Conclusion Stasis-eliminating and meridian-unblocking moxibustion has a marked improving effect on vascular endothelial cell proliferation and migration in vascular dementiarats, which provides strong evidence for its in vitro proangiogenic effect.

Objectives:To investigate the nutrition support in patients with severe neurosurgical disease. Methods:Enteral nutrition(EN) was used in early phase(48～72 h, postoperatively or after trauma) in 28 cases with severe neurosurgical disease.Parenteral nutrition was adopted when EN was insufficient.Dose of glucose was limited at early period(acute phase,5～7 days after occurrence). Results:23 cases were cured and 5 cases died.During the period of EN,glucose and lipid metabolic abnormality or liver enzyme change were not found.There was no complication such as severe diarrhea,belly bulge.All patients who were on respiration machine were all taken off successfully. Conclusions:Early EN can improve the rate of cure and reduce the complication and mortality.

Objective To explore a kind of modified peritoneal dialysis (PD) adapt for acute renal failure (ARF) in children. Methods After punctured many pinholes in tail end and sterilized by ethylene oxide the ID 2. 5 tracheal tube and urinary catheter were used as PD - catheter for children. The tracheal tube or urinary catheter was placed in abdomen with Seldinger's techniques Then the PD was carried out in the way that dialysis solution passing in and out of abdomen in two different pipelines Results The edema, circulation and respiration of the 21 children with ARF were improved after PD in this way and the urine quantity increased too, although 5 of them died of D1C and MOSF. No peritonitis or leakage of PD solution was taken place. The Scr.BUN,UA,K + ,CO2- CP of the chidren were decreased from(424? 133)?mol/L,(41.5? 12 6) mmol/L, (764 ? 187) ?mol/L,(6 7 ?2. 1) mmol/L, (14 5 ? 3.7) mmol/L before PD to( 166?37) ?mot/L,(8.9?3 1) mmol/L,(350?74) ?mol/L,3.7?0 4 mmol/L,(23.0? 1. 8) ?mol/L.Conclusion Tracheal tube or urinary catheter may be used as PD- catheter for ARF in children.