Objective To discuss the application effects of CBI teaching method in medical English Teaching of respiration medicine. Methods Dividing 120 students of Grade 2009 in Jining Medical College into two groups including control group (60) and experimental group (60). The tradi-tional teaching method was adopted in the control group and CBI teaching method was adopted in the experimental group. After finishing the courses, medical professional English level test and standard-ized patients test were applied in the two groups. Students' English studying interests and autonomous English learning ability were also investigated by questionnalres. SPSS 17.0 software was used for sta-tistical analysis, and the data were processed by t test and 字2 test, with the level of a test equal to 0.05. Results The medical professional English level test scores, standardized patients test scores and the total average scores of autonomous English learning ability in experimental group were respectively [(81.97±4.91), (80.33±5.85), (3.88±0.38)], and they were significantly higher than those in the control group [(70.40±4.78), (70.48± 4.79), (2.98±0.26), with P values below 0.01]. Satisfaction degrees in the improvement of learning motivation, learning time, learning method, learning attitude and dealing with study difficulties in experimental group were better than those of control group (χ2=13.084, 8.000, 13.297, 11.627, 13.374, P=0.000). Conclusion CBI teaching method is better than traditional teaching method and it transfers English learning into the learning of professional knowledge and skills of respiratory medicine, stirs the interests of students, improves their autonomous English learning ability and strengthens their abilities to learn and apply English language.

Objective To systematically evaluate the association between IL-6 gene rs1800796 polymorphism and febrile seizures(FS)susceptibility.Methods The related literatures on IL-6 gene rs1800796 polymorphism and febrile seizures(FS)susceptibility were retrieved from PubMed,Web of Science Embase,Cochrane Library,CNKI,WanFang,VIP and CBM Databases by computer.OR and its 95％CI were taken as the pooled effects.The RevMan 5.2 software was adopted to conduct the statistical analysis.The publication bias analysis was performed by using the STATA12.0 software.Results Seven independent case-control studies were included according to the inclusion and exclusion standard,involving 516 accumulated cases and 528 controls.The results showed that IL-6 gene rs1800796 polymorphism had a significant association with FS susceptibility in Chinese population(GG+CG vs.CC:OR=2.22,P=0.05;G vs.C:OR=2.44,P<0.01;GG vs.CC:OR=3.69,P=0.03;GG vs.CG+CC:OR=3.43,P<0.01).The subgroup analysis was conducted according to possible important confounding factors,and the results showed that this gene polymorphism had a significant association with FS susceptibility in Chinese population(GG+CG vs.CC:OR=3.32,P<0.01;G vs.C:OR=3.23,P<0.01;GG vs.CC:OR=7.27,P<0.01;GG vs.CG+CC:OR=5.17,P<0.01:CG vs.CC:OR=2.56,P=0.02).But in other populations,except recessive model(GG vs.CG+CC:OR=2.40,P<0.01),all other genetic models did not display obvious correlation.The subgroup analysis was conducted by FS diagnostic standard,and the results showed that this gene polymorphism had a significant correlation with infantile FS onset in diagnosing FS by the Chinese standard(GG+CG vs.CC:OR=4.57,P<0.01;G vs.C:OR=4.36,P<0.01;GG vs.CC:OR=12.75,P<0.01;GG vs.CG+CC:OR=8.60,P<0.01:CG vs.CC:OR=3.40,P<0.01).Conclusion IL-6 gene rs1800796 polymorphism may be associated with infantile FS susceptibility and allele G may be a risk factor for FS onset.

Objective To study the relationship of abnormal family history in the first degree relatives and the clinical phenotype of patients with polyeystic ovary syndrome(PCOS).Methods Clinical data of first degree relatives of 139 women with PCOS were collected by questionnaires,including body mass index(BMI),waist hip ratio(WHR),and hursutism score.Follicle stimulating hormone(FSH), luteinizing hormone(LH),prolactin(PRL),testosterone(T),androstenedione(A),oral glucose tolerance test(OGTT)and insulin releasing test were measured.Results(1)Compared with patients with a negative family history of diabetes mellitus,for women with a positive family history,WHR(0.99?0.10 vs 0.79?0.08)and score of hirsutism(1.9?1.2 vs 1.8?1.2)were increased,the duration of menstruation was longer[(108?10)vs(92?19)days];A[(11?6)vs(8?5)nmol/L],homeostasis model assessment of insulin resistance(HOMA-IR,3.5?2.0 vs 2.7?1.6),area under curve(AUC) glucose[(836?245)vs(748?139)nmol?L~(-1)?min~(-1)],AUC insulin[(9670?4582)vs(7330?4311) mIU?L~(-1)?min~(-1)],fasting glucose[(5.0?1.1)vs(4.8?0.5)mmol/L]and fasting insulin[(15?8)vs (11?8)mIU/L]were increased,while early insulin secretion function index(?I60/?G60,32?22 vs 52?30),insulin sensitive index(ISI,0.019?0.011 vs 0.033?0.014)and disposition index(DI,18? 10 vs 30?22;P

OBJECTIVE: To investigate the clinical diagnosis, treatment and prognosis of carcinoma showing thymus-like differentiation (CASTLE) of thyroid, and to improve the understanding of CASTLE. METHOD: In 6 patients with CASTLE, we performed region VI lymph node dissection, the lesion resection of thyroid lobe and isthmus. After the operation, except one case of 68 years old patient, the rest patients were treated with radiotherapy 60 Gy in anterior cervical region after third week of operation and 5 courses of chemotherapy with cisplatin, each interval of 2 weeks. Insist on the oral Euthyrox. RESULT: All patients were alive without recurrence and metastasis. CONCLUSION The diagnosis of CASTLE depends on the histology and immunohistochemistry. Operation was the main treatment. CASTLE is a rare type of thyroid carcinoma with slow progress and good prognosis.
Carcinoma ; diagnosis ; therapy ; Humans ; Immunohistochemistry ; Neck Dissection ; Neoplasm Recurrence, Local ; Prognosis ; Thyroid Neoplasms ; diagnosis ; therapy

0.05).There was significant difference in the 3-year survival rate between A and C group. Conclusions The 3-year survival rate was dramatically increased with combined therapy mainly by cisplatin, the dose of 60～80mg is tolerant for the elderly aged above seventy years, and perioperation complications can be cured.

OBJECTIVETo explore the ultrastructural changes of hepatocyte fibrogenesis in cholelithiasis in biliary tract.

METHODSl0 liver biopsies were taken from the patients suffered from gallstone and choledocholithiasis during surgical treatment and the ultrastructural changes were observed under electromicroscope.

RESULTSThere were plentiful collagenous microfibrils (CMFs) grown within some hepatocytes. These CMFs distributed locally or diffusely in cytoplasm even extended into nucleus. In 7 cases numerous megamitochondrias appeared in several hepatocytes, the inclusions mimicking fibrils could be frequently seen and grew beyond the envelope. Furthermore, typical CMFs could be seen in the large microbodies, and several vesicular or cystic structures similar as fibroblast were presented in marginal areas of the hepatocytes.

CONCLUSIONSWe deduce that the fibrosed hepatocytes may be remained and take part in the hyperplasia of hepatic fibrous tissue.

Adult ; Cholelithiasis ; pathology ; ultrastructure ; Female ; Hepatocytes ; pathology ; ultrastructure ; Humans ; Liver Cirrhosis ; pathology ; Male ; Middle Aged

Objective The article was to analyze the payment structure of hospitalized urban employees receiving basic medi -cal insurance and the factors affecting the payment structure , resulting in measures to control the in-hospital fee of Medicare patients . Methods Statistical analysis was done on hospitalization expenses , expense composition and payment structure of hospitalized Medi-care patients in a first-class comprehensive hospital from 2002 to 2012 .The analysis of multiple stepwise regression were done on possi-ble influencing factors of hospitalization expenses and payment structure . Results With the adjustment of health policy , the propor-tion of medical insurance fund payment in the hospitalization expenses increased year by year , while the individual payment-scale re-duced accordingly .The hospitalization expenses and payment structure of Medicare patients were correlated with Medicare payment pol -icy, social demographic characteristics and clinical disease features . Conclusion By rational control on controllable factors , empha-sis on health care education , adjustment on Medicare payment policy and promotion on two way referral system , it is hopeful to realize the effective utilization of health resources , to achieve reasonable control on medical costs , and to reduce patients'economic burden .

Objective To investigate the role of intra-operative and percutaneous three-dimensional contrast-enhanced ultrasonic cholangiography (3D-CEUSC) in the diagnosis of biliary anomalies. Methods Diluted SonoVue, an ultrasonic contrast agent, was injected into the cystic duct of 13 living liver donors via a cannula for intra-operative 3D-CEUSC, while injection via a T tube or a PTCD tube were done in 14 patients for percutaneous 3D-CEUSC. The maximum branching order of the intra-hepatic bile ducts, the percentages of display of the first-, second-, and third-order intra-hepatic bile ducts, and the rates of detection of biliary anatomical anomalies were evaluated. Results The median of the maximum branching order of the intra-hepatic bile ducts shown was fourth-order on intraoperative 3D-CEUSC and third-order on percutaneous 3D-CEUSC, respectively. The difference was significant (P=0.01). From the first- to the third-order of intra-hepatic bile ducts, the percentages of display for intra-operative 3D-CEUSC were 100% (23/23), 96.2% (50/52) and 82.7% (86/104),respectively, while they were 100% (24/24), 94.6% (54/56) and 60. 7% (68/112) for percutaneous 3D-CEUSC. The differences were not significant when comparing the first- and the second-order branches of intra-hepatic bile ducts as shown either on intra-operative or percutaneous 3D-CEUSC (P=1).The percentages of display of the third-order branches using intra-operative 3D-CEUSC was higher than that of percutaneous 3D-CEUSC (P＜0. 0001). Three biliary anatomical anomalies were detected by intra-operative 3D-CEUSC and 4 anomalies were detected by percutaneous 3D-CEUSC. All of these anomalies were confirmed by X-ray cholangiography. Conclusion Both intra-operative and percutaneous 3D-CEUSC could diagnose biliary anatomical anomalies accurately. These procedures may become important techniques to evaluate the biliary anatomy in hepatobiliary surgery pre-operatively or intraoperatively.

Objective To investigate the value of the intraoperative real-time three-dimensional transesophageal echocardiography (RT 3D-TEE) in therapeutic application of surgery for the mitral valve prolapse.Methods Thirty-five patients underwent surgical treatment were diagnosed as mitral valve prolapse by 2-dimensional transthoracic echocardiography (2D-TTE),with or without ruptured chordae tendineae.RT 3D-TEE was performed for assessing the segment of prolapse and its complications before cardiopulmonary bypass and after heart resuscitation respectively.The echocardiographic results were compared with the surgical findings.Results The accuracy of RT 3D-TEE to identify segments with prolapse was significantly higher than that of 2D-TTE (91.4％ vs 82.9％,P =0.003).RT 3D-TEE was more accurate than 2D-TTE for identifying ruptured chordae tendineae,vegetation and thrombus since higher sensitivity,specificity and Youden index.Among all 35 patients,valvuloplasty was performed in 28 cases,whereas,only 7 cases underwent replacement of prosthetic valves.Three patients were benefited by accurate evaluation of therapeutic effect using RT 3D-TEE in time.ConclusionsIntraoperative RT 3D-TEE can be used to provide “ surgical view”,acquired adequate valuable information of mitral valve,and more reliable functional and anatomical assessment of the mitral valve components and its geometry.Suitable surgical intervention can be designed for improving outcomes of patients.

efore graft harvesting in living donor liver transplantation.