Clinical practice was an important part in the medical education.To improve the clinical education quality of obstetrics and gynecology,several methods were chosen to settle the problems such as setting up and perfecting the management mechanism,strengthening the construction of teachers and the cultivation of students’overall quality.

BACKGROUND:Previous studies have shown that continuous administration of 1×107 of bone marrow mesenchymal stem cel s can induce immune tolerance in rats undergoing kidney transplantation, but it is not yet found clinical y that curcumin exerts an on immunomodulatory effect on kidney transplantation.
OBJECTIVE:To investigate the effects of different concentrations of curcumin on bone marrow mesenchymal stem cel s-induced immune tolerance in rats after kidney transplantation.
METHODS:Rat model of kidney transplantation was made, and rat models were randomly divided into four groups:transplantation group with no treatment;bone marrow mesenchymal stem cel s group (cel group) injected with 1×107/kg bone marrow mesenchymal stem cel s via the left iliac vein (before peritoneal suture) and tail vein (from the 2nd day) for 10 days;bone marrow mesenchymal stem cel s+low/high dosage of curcumin groups (low/high dosage curcumin groups) injected intragastrical y with 2 or 10 mg/kg curcumin combined with injection of bone marrow mesenchymal stem cel s for 10 days. Transforming growth factor-β1 protein expression in the kidney tissues was examined by immunohistochemical staining. The concentrations of interleukin-2 and interleukin-6 in serum were detected by ELISA assay.
RESULTS AND CONCLUSION:After kidney transplantation, the protein expression of transforming growth factor-β1 in renal tubular epithelial cel s and renal interstitial cel s as wel as the concentrations of interleukin-2and interleukin-6 in serum were significantly higher in the transplantation group than the other groups (P<0.05). Compared with the cel transplantation group, the protein expression of transforming growth factor-β1 as wel as the concentrations of interleukin-2 and interleukin-6 reduced significantly in the low/high dosage curcumin groups (P<0.05). These findings indicate that simultaneous administration of curcumin and bone marrow mesenchymal stem cel s can effectively inhibit immune rejection reaction and improve renal function in rats after kidney transplantation.

Objective To evaluate the feasibility of community treatment and management mode in elderly patients with hypertension.Methods A total of 286 elderly patients with hypertension were treated with community therapy and management for 6 months.The improvements in life style and hypertension control were observed before and after the community treatment and management.Results There were significant differences in systolic blood pressure and diastolic blood pressure in the elderly patients before and after the treatment and management [(158.4± 11.3) mm Hg vs.(131.3±5.9) mm Hg,(99.6±8.9) mm Hg vs.(81.5±5.6) mm Hg,respectively,both P＜0.05].Compared with pretreatment,the blood pressure control rate,the awareness rate of diagnostic criteria and the drug compliance were significantly increased after the treatment and management [38.5％ (110/286) vs.96.9％ (277/286),66.4％ (190/286) vs.100％ (286/286),49％ (140/286)vs.91.3％ (261/286),x2 =98.87,115.36,122.13,respectively,all P＜0.01].Conclusions The community treatment and management can increase the blood pressure control rate and improve the quality of life in elderly patients with hypertension.It is a feasible method to comprehensively prevent and control hypertension.

Objective To investigate the relationship between H-type hypertension and unstable angina (UA).Methods Totally 147 elderly inpatients with hypertension and angina in our hospital were selected.Patients were divided into H-type hypertension group [n=72,serum homocysteine (Hcy) level ≥10 μmol/L] and primary hypertension group [n=75,serum homocysteine (Hcy) level ＜10 μmol/L].All patients underwent coronary angiography.Serum Hcy level was measured by enzyme method and compared between groups.Results There were statistical differences in the UA incidence,Gensini's score and high sensitive C-reactive protein (hsCRP) level between the H-type hypertension group and primary hypertension group [(44.4％ (32/72) vs.12.0％ (9/75),(44.2± 21.3) vs.(31.9±18.4),(4.3±2.1) μg/L vs.(2.0±1.9) μg/L,respectively,all P＜0.01].Serum Hcy level in H-type hypertension group was higher during UA attack than during UA remission [(22.2±7.1)μmol/L vs.(13.7±3.7)μmol/L,P＜ 0.01].Serum Hcy level during UA attack was increased in H-type hypertension group than in stable angina group [(22.2±7.1)μmol/L vs.(12.0± 4.2) μmol/L,P ＜ 0.01].Serum levels of Hcy,total cholesterol and low density lipoprotein cholesterol in primary hypertension group were higher in UA patients than in stable angina patients [(8.9±2.2)μmol/L vs.(6.6± 1.2)μmol/L,(6.9±0.7)mmol/L vs.(4.5±0.5)mmol/L,(4.6±0.8)mmol/L vs.(2.7 ± 0.6) mmol/L,respectively,P＜ 0.01 or P＜0.05].Logistic regression analysis showed that H-type hypertension was the independent risk factor for unstable angina in the elderly (OR =5.691,P ＜ 0.01).Conclusions H-type hypertension is closely correlated with unstable angina,which is the independent risk factor for unstable angina in the elderly.Serum Hcy level has significant correlation with coronary atherosclerotic plaque stability and the severity of coronary artery disease.

Objective To observe the effect of muscone on the blood-brain barrier and neuropathological changes after complete cerebral ischemia/reperfusion of rats.Methods The global cerebral ischemia/reperfusion injury model was established by the four-vessel occlusion(4VO) method,and then the model animals were given high-,middle-and low-dose muscone.Meanwhile,sham-operation group,model group,and positive control group were also set up.The rats neuroethology behavior,and the contents of superoxide dismutase(SOD),malondialdehyde(MDA) and excitatory amino acid(EAA) in ischemic brain tissue were examined.Results Muscone increased SOD content,lowered MDA content,reduced the increase of EAA content caused by ischemia and hypoxia,and inhibited the excitatory neurotoxicity caused by EAA.Conclusion Muscone has obvious protective effect on rats with complete cerebral ischemia/reperfusion injury.

To meet the need of cultivating the high-quality medical personnel,we have ad-justed and reformed the content of the "Clerkship" teaching in obstetrics and gynecology and conducted the survey and research among teaching philosophy,training mode and management mechanism,and have obtained more satisfactory teaching result.

Objective To investigate effect of single anterior decompression and fusion for pinching cervical spondylosis myelopathy.Methods 82 patients with pinching cervical spondylosis myelopathy,treated with single anterior decompression and fusion,were analyzed,including 43 males and 39 females,with an average age of 54.4 years (range,33-79 years).Occupying rate,anterior occupying rate and posterior occupying rate were measured on pre- and post-operative midsagittal MRIs.Multiple regression analysis was performed between preoperative occupying rate,intervertebral space height,postoperative imaging changes and neural function recovery.Results All patients were followed up for an average of 25.8 months (range,9-72 months).Significant differences were found between pre- and postoperative Japanese Orthopaedic Association (JOA) scores,anterior occupying rate,posterior occupying rate,and intervertebral space height,respectively.Pre- and post-operative posterior occupying rate was averagely 29.0％±10.5％ and 19.9％+11.6％,respectively,and improvement rate of posterior occupying rate was 9.0％±6.1％.Regression analysis found that preoperative intervertebral space height did not relate to posterior occupying rate,while preoperative posterior occupying rate related to improvement rate of posterior occupying rate.JOA scores improved significantly after operation in patients with preoperative posterior occupying rate between 20％ and 40％.However,the decompression results were poor in patients with preoperative posterior occupying rate ≥40％.Conclusion Anterior decompression and fusion can achieve satisfactory results in patients with pinching cervical spondylotic myelopathy.For patients with preoperative posterior occupying rate between 20％ and 40％,the decompression results are better.

ObjectiveTo investigate the status and explore methods to improve the quality of diabetic education for young and middle-aged patients.MethodsOutpatients took part in diabetic education program and young and middle-aged diabetic patients that visited the eastern district of affiliated hospital of Qingdao university medical college from May 1st,2010 to Oct.30th,2010 were investigated with questionnaire for their diabetic education status and demands.ResultsA total of 381 patients were enrolled in this study.59.1％ clinical diabetic education program participants were aged 60 or older and only 40.9％ were aged 20 to 59 years,of whom 66.7％ had been diagnosed with diabetes more than 5 years and only 33.3％ had been diagnosed with diabetes less than 5 years.According to the survey of 101 young and middle-aged diabetic patients,only 16.8％ patients younger than 60 took part in different kinds of diabetic education programs but about 95％ young and middle aged patients wished to participate in diabetic education programs.ConclusionYoung and middle-aged diabetic patients have received much less diabetic education than elderly patients.Diabetic education for young and middle-aged patients needs to be strengthened urgently.

Objective To analyze the influencing factors on hospitalization costs of osteoporosis hip fracture in elderly patients.Methods The hospitalization expenses of patients with osteoporotic hip fracture and influencing factors were analyzed by single factor analysis of variance and multiple regression analysis method in Beijing Ji Shuitan Hospital from 2009 July to 2010 December.Results Among 565 patients who underwent operation treatment,hospitalization costs of femoral neck fracture was (42 127±20 821) yuan,wherein the treatment fee was (27 283± 14 959) yuan,other expenses (expenses for medicine,examination and chemical examination) were (14 844 ± 8717) yuan.The above values of intertrochanteric fracture were (52 965± 15 901) yuan,(36 872±11 763) yuan and (16 093±7793) yuan,respectively.Treatment fee occupied 65％ of hospitalization expenses.Multivariate regression analysis of influencing factors of costs intertrochanteric revealed that femoral neck fractures hip arthroplasty,femoral intertrochanteric fracture,venous thrombosis of the lower extremity,and albumin infusion in perioperative period were correlated firmly with the increased hospitalization expenses and treatment expenses (P＜0.001).Comorbidities such as diabetes and anemia,perioperative complication such as delirium,cardiac disease,pulmonary embolism,pulmonary infection were related to the other higher expenses (P＜0.05).The longer of hospital stay resulted in higher cost of hospitalization (P ＜ 0.001).Conclusions Comorbidities and preoperative complications can increase other expenses.Osteoporotie hip fracture,with a high hospitalization cost,is a heavy economy burden.It is important to emphasize the disease prevention of both osteoporosis and aging chronic illness.

Objective: Numerous studies have shown that bone marrow-derived mesenchymal stem cells (MSCs) enhance neurological recovery after cerebral ischemia. However, the mechanisms are still not clear. The present study aimed to investigate the beneficial effects of MSCs on global cerebral ischemia induced by cardiac arrest (CA) and the underlying mechanisms. Methods: Rats subjected to asphyxial CA were injected intravenously with MSCs (5×106 ) at 2 hours after resuscitation. Whole brain histopathologic damage scores (HDS) were assessed by histopathology at 3 and 7 days after resuscitation. The distribution of donor MSCs in the brain was evaluated. The expression of tumor necrosis factor-α-induced protein 6 (TSG-6) and pro-inflammatory cytokines in cerebral cortex was assayed. After intravenous infusion of TSG-6 siRNA-MSCs, HDS and pro-inflammatory cytokines were reevaluated at 7 days after resuscitation. Results: Intravenously administered MSCs significantly reduced whole brain HDS after global cerebral ischemia. Immunofluorescence microscopy revealed that donor MSCs were primarily found in cerebral cortex and expressed TSG-6. MSCs treatment significantly increased the expression of TSG-6 and reduced the expression of pro-inflammatory cytokines in cerebral cortex. In addition, intravenous infusion of TSG-6 siRNA-MSCs failed to attenuate brain inflammation. Conclusion: Systemically administered MSCs reduced inflammatory damage to brain in rats with global cerebral ischemia via secretion of TSG-6.
Heart Arrest ; Mesenchymal Stromal Cells