OBJECTIVE:To explore the importance of self-supervision spirit in the PIVAS.METHODS:According to the characteristics of PIVAS in our hospital,the importance of self-supervision spirit in PIVAS was introduced and the methods to cultivate the spirit were evaluated.RESULTS & CONCLUSIONS:Self-supervision spirit of staff can reduce mistakes and improve the working of PIVAS to promote the safety of clinical drug use.

OBJECTIVETo study the effect of ginsenoside Rb1 on GSKbeta/IDE signal transduction pathway and Abeta protein secretion in hippocampal neurons of high glucose-treated rats.

METHODHippocampal neurons of 24 h-old newly born SD rats were primarily cultured, inoculated in culture medium under different conditions, and then divided into the normal group, the high glucose group, the LiCl group and the Rb1 group. After being cultured for 72 h, the expressions of their phosphorylated GSK3beta, total GSK3beta and IDE protein were detected by Western blotting analysis. The mRNA expressions of GSK3beta and IDE were determined by RT-PCR. The ELISA assay was used to detect the secretion of Abeta protein in cell supernatant.

RESULTCompared with the normal group, the high glucose group showed increase in the p/tGSK3beta protein ratio and the secretion of Abeta protein and decrease in IDE protein and mRNA (P < 0.05). Compared with the high glucose group, both Rb1 and LiCl groups showed decrease in the p/tGSK3beta protein ratio and the expression of Abeta protein and increase in IDE protein and mRNA expression (P < 0.05). Compared with the LiCl group, the Rb1 group showed no significant difference in the expressions of p/tGSK3beta protein, IDE protein, mRNA and Abeta protein expression. In addition, the GSK3beta mRNA expression of the four groups had no significant difference.

CONCLUSIONGinsenoside Rb1 may reduce the secretion of Abeta protein in hippocampal neurons by reducing the phosphorylation of GSK3beta, down-regulating the ratio of pGSK3beta/GSK3beta and upregulating the expression of IDE.

Amyloid beta-Peptides ; genetics ; metabolism ; secretion ; Animals ; Dietary Carbohydrates ; adverse effects ; Gene Expression Regulation ; drug effects ; Ginsenosides ; pharmacology ; Glucose ; adverse effects ; Glycogen Synthase Kinase 3 ; genetics ; metabolism ; Glycogen Synthase Kinase 3 beta ; Hippocampus ; cytology ; Insulin ; metabolism ; Insulysin ; genetics ; metabolism ; Neurons ; cytology ; drug effects ; metabolism ; secretion ; Rats ; Rats, Sprague-Dawley ; Signal Transduction ; drug effects

Objective To investigate the application value of real clinical case centered situation simulation examination model in clinical medicine. Methods Two classes were randomly selected from 2008 grade clinical medicine majors, respectively as test group(n=158) and control group(n=156). Final examination of test group includes usual performance, case-oriented situation simulation examination (COSSE) and final written examination. Traditional methods were used in control group. The same paper was used in final written examination of the two groups. Scores of written examination and question-naires were used to evaluate the COSSE model. Data were processed using SPSS 16.0 statistical software;t and chi-square tests were used to analyze the data;P<0.05 signifies that the difference is statistically sig-nificant. Results Scores of final examination in test group were higher than those in control group(P<0.001). Times of independent completion of history taking, physical examinations and medical record writing were more in test group than in control group(P=0.002,0.017,0.048). Conclusions Contents and methods of COSSE is conducive to improving student's professional comprehensive ability.

Objective To investigate the influence of fixation of both lower limbs with negative pressure vacuum cushion and fixation of both ankles with self-made foam mat on setup errors in radiotherapy for rectal cancer.Methods A total of 12 patients with rectal cancer were enrolled in 2014 and randomly divided into group A (using negative pressure vacuum cushion) and group B (using self-made foam mat).An offline registration analysis was performed for the images of 108 times (A,B group of 54 times) of kilovoltage cone-beam CT (CBCT) before and after treatment.Grey scale translation error registration was used,and the results of registration were analyzed.The setup errors in x-axis (left-right direction),y-axis (cranial-caudal direction),and z-axis (anterior-posterior direction) were compared between the two groups.Results There was no significant difference in the absolute setup error in the y-axis between the two groups (2.13±0.64 mm vs.2.61±1.17 mm,P=0.399),while group A showed significantly lower absolute setup errors in the x-axis and z-axis than group B (x-axis:1.51±0.28 mm vs.2.70±1.05 mm,P=0.039;with an error rate of 7.41％ vs.42.59％;z-axis:1.10±0.29 mm vs.2.37±0.71 mm,P=0.002;with an error rate of 1.85％ vs.35.19％).Conclusions In the radiotherapy positioning for rectal cancer,fixation of both lower limbs with negative pressure vacuum cushion effectively avoids the translation and rotation of both lower limbs,reduces absolute setup errors,and has higher accuracy than fixation of both ankles with self-made foam mat.

Objective To explore the clinical efficacy of navigation of sentinel lymph node (SLN) combined with endoscopic submucosal dissection (ESD) for non curative treatment of early gastric cancer.Methods Clinical data of 9 cases with early gastric cancer treated with ESD from August 2015 to December 2015 were enrolled.The SLNs were explored by laparoscopy after nano carbon or indocyanine green(ICG) was injected under endoscopy.Then all stained nodes were resected by laparoscopy.Results The mean number of SLN were 2.75±1.50 in ICG group,which was significantly smaller than the number in nano carbon group(8.40±4.93) according to the laparoscopic pathology,so the accuracy of ICG was higher than that of nano carbon.But ICG performed better in development.The postoperative complications such as postoperative intestinal obstruction,enteritis and gastric paralysis were found in 5 patients of nano carbon group.But no serious complications after operation were found in patients of ICG group.Conclusion Application of ICG can help avoid the excessive removal of tissue,and reduce the incidence of complications.ICG,as a new type of tracer for early gastric cancer,shows good application prospects.

In recent years,liver transplantation donor shortage as one of world medical problems is paid more attention by domestic and overseas scholars.In view of that,heterotopic auxiliary liver transplantation emerges which transplants the whole or some parts of a donor liver outside the original liver position on the condition that some parts or the whole of the original liver were retained.As for the liver transplantation with poor conditions on portal vein,reconstruction of portal vein has become an aporia.Based on this,some scholars put forward the theory——arterialization of portal vein(PVA),namely a method to increase arterial blood supply or replace portal vein blood perfusion of liver by establishing some pathes among artery and portal vein or its branches.The research background and current situation of heterotopic auxiliary liver transplantation with portal vein arterialization,the transplanting position of donor liver,vessel reconstruction,dynamics mechanism after reconstruction and liver regene-ration are summarized in this review.

Basic surgical skills tralning which belongs to the basic course of surgery, is clini-cal basis for the medical students. The teaching practice of basic surgical skills tralning was explored by the Affiliated Hospital of Inner Mongolia Medical University, the theoretical teaching was combined with skills tralning practice, three kinds of means which contalned the model, animal tissues and or-gans in vitro and animal experiment were used to carry out systemic and standardized tralning. Finally, the basic surgical skills of postgraduate in surgery were improved, and the expected alm of teaching was achieved.

Objective To evaluate the diagnostic and therapentic value of ERCP for choledocholithiasis.Methods ERCT and EST in 142 cases with suspected choledoholithiasis were performed for treating choledocholithiasis.All the imaging data were analyzed retrospectively.Results Among 142 cases,128 cases were choledocholithiasis,3 cases were suspected choledocholithiasis,6 cases were normal and 5 cases were miss-diagnosis.The diagnostic accuracy of ERCT was 90.1%(128/142).EST were successful in 129 cases,and 4 cases were failure,the successful rate was 96.9%.Conclusion ERCT is of important value in diaguosing choledocholithiasis and EST is safe and reliable for treating choledocholithiasis.

Objective Atrioventricular block (AVB) is a common and serious arrhythmia. At present, there is no perfect method of treatment for this kind of arrhythmia. The purpose of this study was to regenerate cardiac atrioventricular conduction by autologous transplantation of bone marrow mesenchymal stem cells (MSCs), and explore new methods for therapy of atrioventricular block. Methods Eleven Mongrel canines were randomized to MSCs transplantation (n=6) or control (n=5) group. The models of permanent and complete AVB in 11 canines were established by ablating His bundle with radiofrequency technique. At 4 weeks after AVB, bone marrow was aspirated from the iliac crest. MSCs were isolated and culture-expanded by means of gradient centrifugal and adherence to growth technique, and differentiated by 5-azacytidine in vitro. Differentiated MSCs (1ml, 1.5×107cells) labeled with BrdU were autotransplanted into His bundle area of canines by direct injection in the experimental group, and 1ml DMEM in the control group. At 1-12 weeks after operation,the effects of autologous MSCs transplantation on AVB models were evaluated by electrocardiogram, pathologic and immunohistochemical staining technique. Results Compared with the control group, there was a distinct improvement in atrioventricular conduction function in the experimental group. MSCs transplanted in His bundle were differentiated into analogous conduction system cells and endothelial cells in vivo, and established gap junction with host cardiomyocytes. Conclusions The committed-induced MSCs transplanted into His bundle area could differentiate into analogous conduction system cells and improve His conduction function in canine AVB models.

OBJECTIVE:To promote the safety and effectiveness of clinical medication.METHODS:In drug dispension process,operation procedure was carried out strictly and different dispensing methods were adopted according to the characteristics of drugs.RESULTS & CONCLUSIONS:Dispensing guidelines for common injection,insoluble drug and chemotherapy drugs were summarized and improved to promote quality of intravenous drugs dispension.