Objective Toanalyze and evaluate the value ofthe method ofmedical simulation technique combined with PBL pattern in the training before clinical practice. Methods 80 students were divided into two groups:the experimental group and the control group. The PBL method was used in the experimental group,while the control group was taught by traditional method. Results The students in experimental group had a significant higher score than those in control group. Conclu-sion It means that the method of medical simulation combined with PBL teaching is an effective leaning method and should be widely used in the training before clinical practice.

Adolescent ; Adult ; Diabetes Mellitus, Type 1 ; blood ; complications ; genetics ; Diabetic Angiopathies ; blood ; complications ; Female ; Gene Frequency ; Genotype ; Homocysteine ; blood ; Humans ; Male ; Methylenetetrahydrofolate Reductase (NADPH2) ; genetics ; Mutation ; Polymorphism, Genetic ; Regression Analysis

Objective To investigate the feasibility of laparoscopic repair for ingunal hernia after peritoneal dialysis. Methods Laparoscopic repair of inguinal hernia was conducted in 26 patients with chronic renal insufficiency who had received peritoneal dialysis for a long time. For indirect inguinal hernia, a piece of mesh was placed in the abdominal cavity and the internal ring was sutured and ligated under laparoscope. For direct inguinal hernia, the hernia sac was high suspended and then the mesh onlay was placed under laparoscope. Results The laparoscopy was successfully performed in all the 26 patients, without conversions to open surgery. No postoperative hematoma of scrotum or refractory neuralgia was observed. Follow-up examinations for 6~12 months (mean, 9 months) showed no recurrence. Conclusions Laparoscopic herniorrhaphy for inguinal hernia after peritoneal dialysis is feasible, effective, and safe.

Objective To stuey effects of coloprotectomy under colonoscopy combined with laparoscope on exfoliated tumor cells in abdominal cavity.Methods 42 cases of colorectal cancer proved by pathologic histology were devided into two groups randomly: Laparoscope Group(laparoscopic surgery) and Combined Group(colonoscopy combined with laparoscope surgery).Operation time,the positive rate of exfoliated tumor cells in abdominal cavity after and before operation,the positive rate of residual tumor cells in resection of operation specimen and postoperative complications between 2 groups were compared.Results Operation time of the Combined Group was shorter than that of the Laparoscope Group [(160.5?12.6) min vs.(201.2?18.4) min,t=-8.363,P=0.000].The positive rate of exfoliated cells in abdominal cavity before operation had no significant difference between the 2 groups[9.5%(2/21) vs.19.0%(4/21),?2=0.194,P=0.659],but the postoperative positive rate of exfoliated cells in the Combined Group was significantly lower than that in the Laparoscope Group[14.3%(3/21) vs.42.9%(9/21),?2=4.200,P=0.040].There were no residual tumor cells in resection of operation specimen of 2 groups.No infection of incisional wound and lung occurred.A follow-up for 6-24 months in the Laparoscope Group showed abdominal metastasis in 1 case.Conclusions Coloprotectomy for colorectal cancer under colonoscopy combined with laparoscope can decrease exfoliated tumor cells in abdominal cavity and shorten operation time.

While the field of ATP synthase research has a long history filled with landmark discoveries, recent structural works provide us with important insights into the mechanisms that links the proton movement with the rotation of the Fo motor. Here, we propose a mechanism of unidirectional rotation of the Fo complex, which is in agreement with these new structural insights as well as our more general ΔΨ-driving hypothesis of membrane proteins: A proton path in the rotor-stator interface is formed dynamically in concert with the rotation of the Fo rotor. The trajectory of the proton viewed in the reference system of the rotor (R-path) must lag behind that of the stator (S-path). The proton moves from a higher energy site to a lower site following both trajectories simultaneously. The two trajectories meet each other at the transient proton-binding site, resulting in a relative rotation between the rotor and stator. The kinetic energy of protons gained from ΔΨ is transferred to the c-ring as the protons are captured sequentially by the binding sites along the proton path, thus driving the unidirectional rotation of the c-ring. Our ΔΨ-driving hypothesis on Fo motor is an attempt to unveil the robust mechanism of energy conversion in the highly conserved, ubiquitously expressed rotary ATP synthases.
Membrane Potentials ; physiology ; Membrane Proteins ; chemistry ; metabolism ; Mitochondrial Proton-Translocating ATPases ; chemistry ; metabolism ; Protein Conformation

OBJECTIVE: To examine AMCase mRNA expression levels in nasal mucosa of allergic rhinitis SD rats. METHOD: Thirty SD rats were chosen and randomly divided into the experimental group and the control group. 20 in experimental group and 10 in the control group. AR model rats were established through repeated intraperitoneal shot of ovalbumin (OVA) for 2 weeks and consequently confirmed by local challenge with OVA for 1 week. The control group was treated by the same method with Physiological saline water instead of OVA. After the last excitation allergic rhinitis was diagnosed according to the accumulation score about nasal symptom. The septal mucosa of all rats were used to diagnose pathologically by HE dyeing. AMCase mRNA in nasal mucosa, obtained from the bilateral nasal mucosa in two groups, were used to do reverse transcriptive polymerase chain reaction. Real-time polymerase chain reaction was used to examine AMCase mRNA expression levels. RESULT: (1) The results showed definitely that there were positive expression of AMCase mRNA in normal nasal mucosa. This expression increase significantly during nasal allergy (P < 0.05). (2) The increased expression of AMCase mRNA in allergic rhinitis are related with the nasal symptoms score (r = 0.411, P < 0.05). CONCLUSION Increased expression of AMCase mRNA in nasal mucosa in allergic rhinitis model might play roles in the pathogenesis of AR, and Restrain the enzyme activity could become new treatment targets of allergic rhinitis.
Animals ; Chitinases ; metabolism ; Nasal Mucosa ; metabolism ; Ovalbumin ; RNA, Messenger ; metabolism ; Rats ; Rats, Sprague-Dawley ; Rhinitis, Allergic ; enzymology ; metabolism

Objective To evaluate the precipitating factor,mortality,complications of myasthenia gravis crisis and risk factors of prolonged intubation.Methods Totally 82 case records of patients who had been adimitted for having 87 episodes of myasthenia crisis over a period of 15 years from January 1985 to February 2000 and their age, gender, precipitating factors, complications of intubation, and prolonged intubation factors were retrospectively reviewed. Results In 75% of myasthenic crisis patients having precipitating factors, infection was the most often served as the precipitating factors, and then the wound, fatigue, manopause and delivery came the next, 24% of precipitating factors were related to medication. Nine were identified with independent predictors of prolonged intubation. Among the 82 myasthenia crisis patients, 12 died, with a mortality of 14%.Conclusion The prevention and treatment for intubation complications may be the best way for further shortening intubation time and reducing the mortality.

OBJECTIVE:To introduce the Fair PharmaCare program of BC Canada for the reference of the reform of China's medical insurance system.METHODS:The running procedure of Fair PharmaCare program of BC Canada was introduced in detail and its characteristics were analyzed.RESULTS & CONCLUSIONS:Fair PharmaCare program covers all BC residents and protects them against economic difficulties in pharmacare.The program serves as a reference for the reform of China's medical insurance system.

Objective To investigate the effects of autologous blood transfusion on serum neopterin and IL-2 concentrations after radical gastrectomy. Methods Sixty ASA Ⅰ or Ⅱ patients of both sexes (33 male, 27 female) aged 40-65 yrs weighing 51-70 kg undergoing radical gastrectomy for stomach cancer were randomly divided into 2 groups (n = 30 each):homologous blood transfusion group (H) and autologous blood transfusion group (A). The patients were premedicated with intramuscular diazepam 10 mg and atropine 0.5 mg. Anesthesia was induced with midazolam 0.1 mg?kg-1, fentanyl 5 ?g?kg-1, propofol 1 mg?kg-1 and vecuronium 0.12 mg? kg-1 and maintained with isoflurane inhalation (1 % -2 %) and intermittent i. v. boluses of fentanyl and vecuronium. In group H homologous blood 400 ml was infused during gastro-intestinal anastomosis. In group A 400 ml of blood was removed from radial artery after induction of anesthesia, before surgery. Blood volume was maintained by simultaneous infusion of succinylated gelatin 500 ml. The 400 ml autologous blood was infused also during gastrointestinal anastomosis. Venous blood samples were taken before operation (baseline) , at the end of operation and on the 5th postoperative day for determination of serum concentrations of neopterin and IL-2 (ELISA) Results The two groups were comparable with regard to sex (M/F ratio), age, body weight, duration of operation and total blood loss. The serum concentrations of neopterin and IL-2 were significantly decreased after operation compared to the baseline values before operation in group H (P

Objective To explore the effects of chlamydia and mycoplasma infections on the healing of wounds after surgical operation for haemorrhoids,fistula and anoschisis.Methods Sixty-two patients with haemorrhoids,fistula and anoschisis undergoing the surgical operation during 2000.1 to 2008.10 were collected,and wounds did not heal 40 days after operation and the wound's surface infection occurred after postoperative anti-inflammatory therapy and dressing change.All patients were positive at least for laboratory Ct or Uu,and those with infections caused by other fungi,bacteria,viruses and the other systemic diseases were excluded.The correlation between the infections in 62 cases and sex,surgical types was analyzed.Results In 62 patients,there were 30 cases (48.4%) positive for both Ct and Uu,22 cases for single Ct (35.5%),and 10 cases for single Uu (16.1%),respectively.The infection rate in females was higher than in males (P<0.01).The surgical types included:surgery for 8 cases of haemorrhoids (12.9%),for 18 cases of fistula(29.0%),and for 36 cases of anoschisis(58.1%).respectively.Conclusion There is the possibility of chlamydia and mycoplasma infections in the patients with delayed healing of wounds following the surgical treatment on the anal region.Early diagnosis,early treatment,avoidance of ineffective medicines and repeatedly management of the wounds can shorten the healing period.