In this article,from the view of the cognitive structure,we talk about the role of transfer of learning in medical innovative education,and propose the strategies on how to increase the positive transfer of learning through the rational organization of teaching contents,improved teaching methods,highlighting the dominant status of student to raise innovative talents.

The JC virus is a widely infected human polyomavirus. Recent foreign researches showed that the JC virus infection is correlated with tumors of nervous system and digestive system, while, and study on the relationship between JC virus infection and gynecological tumor is seldom reported. In this study, we first establish the nucleic acid detection methods and procedures for JC virus and its highly homologous BK virus. The JC and BK viruses infection was evaluated by detect the viral DNA in samples including biopsy tissues, serum as well as urine of myoma of uterus (98 cases), cervical cancer (84 cases), endometrial cancer (40 cases) and ovarian tumor (72 cases) patients. The BK viral DNA positive rate was significantly higher in urine samples than that of blood and biopsy samples, and there is no significant difference of the BK viral DNA positive rate among all patient groups. The JC viral DNA positive rate is almost 0 in serum samples and biopsy. tissues, however, viral DNA positive rate is more than 50% in urine samples. In fibroids group, the JC viral DNA positive rate is up to 65. 3% which is significantly higher than that in other patients groups and healthy control. Further gynecological tumor associated viruses detection showed that only human papilloma virus infection is associated with cervical cancer, the herpes simplex virus, EB virus and cytomegalovirus infection is extremely low in our patient groups. No synergistic effect on gynecological tumor caused by viruses co-infection was observed. Our study showed that JC virus infection is highly related to the pathogenesis of uterine fibroids.
Adult ; Female ; Genital Neoplasms, Female ; virology ; Humans ; JC Virus ; classification ; genetics ; isolation & purification ; Middle Aged ; Polyomavirus Infections ; virology ; Tumor Virus Infections ; virology ; Young Adult

A percutaneous visceral tumor puncture director is introduced in this paper, which can be used for needle biopsy and brush biopsy in kinds of visceral tumor. The clinical informations show that the application of the director can increase the positive ratio of puncture, and it has important clinical value. The director is safe, practical and easy to operate.
Biopsy, Needle ; instrumentation ; methods ; Equipment Design ; Humans ; Neoplasms ; pathology ; Sensitivity and Specificity

Adolescent ; Antigens, CD34 ; metabolism ; Bone Neoplasms ; diagnostic imaging ; metabolism ; pathology ; Chondrosarcoma, Mesenchymal ; metabolism ; pathology ; Diagnosis, Differential ; Hemangiopericytoma ; diagnostic imaging ; metabolism ; pathology ; Humans ; Male ; Platelet Endothelial Cell Adhesion Molecule-1 ; metabolism ; Sarcoma, Synovial ; metabolism ; pathology ; Tomography, X-Ray Computed ; Vimentin ; metabolism

Objective To analyze the serum level of 25-hydroxy vitamin D [25-(OH) D] in pregnant women in Nanjing and its relationship with age,gestational week,pre-pregnancy body mass index (BMI) and season,so as to provide some guidance on clinical application of vitamin D measurement and supplementation.Methods 880 pregnant women (in 21-36 gestational weeks) regularly visiting antenatal clinic in Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University were selected from January to December 2015.Their serum 25-(OH)D concentrations were measured by enzyme-linked immunosorbent assay (ELISA).Results The mean serum 25-(OH) D concentration in these pregnant women was (42.03 ± 19.22) nmol/L and sufficient in only 42 (4.77％).Vitamin D levels showed seasonal variation (P =0.0164),with the levels in summer [(44.61 ±23.57) nmol/L] and autumn [(43.43 ± 19.31) nmol/L] being higher than spring [(39.68 ± 16.91) nmol/L] and winter [(39.65 ± 13.36) nmol/L].There was no statistically significant difference in serum vitamin D level among different gestational weeks (P =0.929 4).There was statistically significant difference in serum vitamin D level among different age groups (P =0.038 3).Vitamin D level was not associated with pre-pregnancy BMI.Conclusions Vitamin D deficiency is highly prevalent among pregnant women in Nanjing.We suggest vitamin D testing be carried out more actively.

Objective:To investigate the efficacy and safety of less invasive surfactant administration(LISA) of neonatal respiratory distress syndrome(NRDS).Methods:From July 2017 to December 2018, 50 premature infants with birth weight ≤1 500 g and/or gestational age≤32 weeks diagnosed as NRDS at the Fifth Medical Center of PLA General Hospital were randomly divided into LISA group( n=25)and INSURE group( n=25). The patients in LISA group was inserted fine duct into the trachea through direct laryngoscope under nasal continuous positive airway pressure (nCPAP) and pulmonary surfactant was injected.The INSURE group adopts endotracheal intubation-pulmonary surfactant-nCPAP was performed after unplugging.The changes of vital signs, blood gas indexes, adverse reactions and the incidence of complications were compared between two groups at different time points. Results:There was no significant difference in respiration, heart rate, systolic blood pressure, diastolic blood pressure and PaO 2, PaCO 2, BE, SpO 2 between two groups at different administration time points.Although the pH value of LISA group was lower than that of INSURE group, it was within the normal range.There was no significant difference in bronchopulmonary dysplasia, intraventricular hemorrhage, periventricular leucomalacia and other complications between two groups, and there was no death, air leakage, retinopathy of prematurity and pulmonary hemorrhage in both two groups.In addition, there was no significant difference in hospitalization days, total medical expenses, oxygen use time between the two groups(all P>0.05). Conclusion:Compared with INSURE technology, LISA technology has its feasibility for premature infants with NRDS, but the effectiveness and safety in the practical application need to be further confirmed.

The care and support for the patient of AIDS is a vital content,we should enhance international collaboration and intercourse of information,which can promote efficiency.This text shows an analysis on the actuality and characteristic of the support mode of the AIDS community in British.Its purpose is to summarize the successful experience for china and improve the support mode for AIDS.

ObjectiveTo investigate the effects of cannabinoid receptor 2 (cannabinoid receptor 2,CB2R) agonist JWHO15 on the hyperalgesia induced by remifentanil in a rat model of postoperative pain.Methods Sixty SD rats were randomly divided into 10 groups ( n =6 each ):control groups ( C1 and C2 ),incisional pain groups (I1 and I2),incisional pain plus JWHO15 groups (QI and FI),remifentanil groups (R1 and R2),and JWHO15 plus remifentanil groups ( QR and FR).Rats in group QL/QR and FI/FR were intrathecal injection with 10μg JWHO15 ( diluted in 10μl 20％ DMSO solution) and intraperitoneal administration with 100μg JWHO15 ( diluted in 10μl 4％ DMSO solution) respectively 30 min before plantar incision while rats in group C,I and R were received with the same volume of DMSO solution.Plantar incision surgery was operated in rats of group I,R,QI/FI,and QR/FR.In group R and QR/FR,remifentanil (0.04 mg/kg) was infused subcutaneously to rats with a pump for 30 min at the moment of surgical incision.The paw withdrawal mechanical threshold (PWMT) and paw withdrawal thermal latency (PWTL) at 24 h before incision and at 2 h,6 h,24 h and 48 h after incision were tested to evaluate the behavioral changes.ResultsCompared with group C and baseline,the level of PWMT and PWTL decreased at 2 h,6 h,24 h and 48h after incision in group Ⅰ (P＜ 0.01 ) ;Compared with group Ⅰ,the significant decrease of PWMT and PWTL were observed after incision in group R (P ＜ 0.05 ) ; Compared with group R,the significant increase of PWMT (7.78 ± 1.09) and PWTL ( 17.28 ± 1.58) were observed from 6 h after incision in group QR(P＜0.05).And the increase of PWMT (7.79 ±0.72,9.50 ± 1.17,7.86 ± 1.16) and PWTL ( 16.23 ± 1.50,19.53 ± 1.63,18.10 ± 0.93) were observed at 6 h,24 h and 48 h after incision in group FR(P＜0.05).ConclusionIntrathecal and intraperitoneal administration of JWHO15 in this investigation dose could relief remifentanil-induced hyperalgesia in a rat model of postoperative pain.

ObjectiveTo analyze the treatment of pediatric unstable pelvic fractures retrospectively and sum up the experiences and lessons.MethodsFrom October 1998 to March 2011,30 patients of unstable pelvic fractures with an average age of 7.9 years were admitted.All these cases were Torode-Zieg type Ⅳ.Hemorrhagic shock was determined in 14 patients,and associated with other fractures in 11,urogenital system injuries in 14,sacral plexus injuries in 3,iliac vascular injuries in 2,and diaphragm rupture in one patient.Blood transfusion was done as a component of damage control in 13 cases.The pelvic fractures were treated conservatively in 15 patients,with external fixation in 9,with internal fixation in 4,and with combined external and internal fixation in 1 patients.Hemipelvectomy was performed in the remaining one case.Results One patient died during the emergent surgery due to severe hemorrhage.Thirteen patients werelost follow-up.Sixteen patients were followed up for 3 months to 11 years.According to Cole's grading scale,functional outcome was excellent in 12,good in 1,fair in 2,and poor in 1.Residual vertical displacement after skeletal traction caused inclination of pelvis and leg length discrepancy in one patient.Hip subluxation caused by sciatic nerve injury was found in one patient who severely limped in the last follow-up,and slight gait abnormality due to associated lumbosacral plexus injury was determined in one patient.Conclusion Treatment of pediatric unstable pelvic fractures is different with that of adult cases.Damage control is more significant for children than for adults.Skeletal traction remains one of the main resorts of managing pediatric unstable pelvic fracture,often predicting good functional outcomes.Surgical fixation should be adopted if residual vertical displacement cannot be corrected by skeletal traction,and should be minimal invasive as soon as possible.In addition,associated nerve injury is closely related to the functional prognosis and should be detected carefully and followed up closely.

OBJECTIVETo study the effect of coixenolide on Foxp3+ CD4+ CD25+ regulatory T cells (Treg) in collagen induced arthritis (CIA) mice, and to explore its possible mechanism for treating rheumatiol arthritis.

METHODSFive mice were recruited as a normal control group from 25 mice, and the rest 20 were used in CIA modeling. After successful modeling they were randomly divided in the model control group and the coixenolide group, 10 in each group. Coixenolide injection at 25 mL/kg was intraperitoneally injected to mice in the coixenolide group, while normal saline at 25 mL/kg was intraperitoneally injected to mice in the normal control group and the model control group. The injection lasted for 21 days. Scoring for CIA was performed after injection and arthritis index was calculated. The peripheral blood Foxp3+ CD4+ CD25+ Treg ratio was determined by flow cytometry (FCM).

RESULTSCompared with the normal control group, the arthritis index obviously increased in the model control group (P < 0.01). The arthritis index obviously decreased more in the coixenolide group than in the model control group (P < 0.01). Foxp3+ CD4+ CD25+ Treg levels obviously decreased more in the model control group than in the normal control group (P < 0.01 ). Foxp3+ CD4+ CD25+ Treg levels obviously increased more in the coixenolide control group than in the model control group (P < 0.01).

CONCLUSIONCoixenolide could up-regulate Foxp3+ CD4+ CD25+ Treg ratios in CIA mice, which might play certain immunoregulation roles in the incidence of CIA.