Using the information metrology's correlation theories and literature measurement method, this article makes statistics of the PBL related research papers in our country's medical education published in 1979-2010 and analyzes this domain's distribution of time, article quantity, authors'units and key word term frequency. We propose that PBL research should be further standardized in the concept aspect and the research technique as well as the discipline involved should be further multiplied in our country.

In the current multimedia application of medical theory teaching there exist many problems such as infusion,relation estrangedness between teachers and students,the moral education marginalization,the abstract thinking ability attenuation and so on.Facing these problems,in the medical theory teaching,the multimedia application should take"help","reality","transfer"as the value pursue,and be located in the exaggeration atmosphere,the interest stimulation,induction inspiration,difficulty breakthrough,thought expansion and memory optimization,emotion cultivation and moral promotion.

Teaching resource sharing refers to the process and mode of sharing teaching resources among various universities.The problems existed are:traditional thought restriction,realistic system obstacles,defensive mentality of competitors etc.These problems can be resolved by establishing the highest leadership,setting up joint academic evaluation mechanism,setting up teaching operation monitoring institution,applying organizational management means (such as mobilizing more support form government).Meanwhile,these problems can be tackled by through achieving objectives of course sharing,exploring mode of course sharing,establishing responsibility system of course sharing and establishing credit parallel recognition mechanism.

Objective To observe the effect of acupoint magnetic therapy on coronary heart disease.Methods 80 patients with coronary heart disease were divided into treatment group( n =40) and control group( n =40).The treatment group was treated with acupoint magnetic therapy on the basis of conventional treatment,and the control group with conventional treatment.Clinical therapeutic effect,the scores of traditional Chinese medicine symptom were observed.Results There was significant difference between the two groups in the total effective rate and the scores of traditional Chinese medicine symptom[90.0％ vs 72.5％,(13.25 ± 3.68 ) vs (15.18 ± 4.16),all P ＜0.05].Conclusion Acupoint magnetic therapy for treatment of coronary heart disease has an obvious therapeutic effect.

The construction of "New Medical Education" is an important task and a special mission for the innovation of medical education in China in the new era. And the enhancement of humanities education is not only the requirement of "New medical education", but also a natural pursuit and a core of strengthening ideological and political education of medical students in the new era. Chongqing Medical University adheres to people's long-term health needs and centers on students' life-long development to rebuild the logic route of education and teaching and promote the integration of "ideological and political education" and "humanities education" through strengthening the arrangement in the top with systematic planning. In this paper, the cultural resources in the school's history was explored in combination with the advantages of media convergence as well as school's functions of education practice, therefore, a new special mode of "ideological and political education integrated with medical humanities education was proposed with efforts.

Objective:To investigate the anticoagulant causes, hemorrhagic susceptibility factors and clinical characteristics of patients with warfarin-related major bleeding in the emergency department of a general hospital.Methods:In a registry study from January 2017 to February 2020, 114 cases of warfarin-related major bleeding patients admitted to Department of Emergency Medicine, the First Affiliated Hospital of Wenzhou Medical University were enrolled. The descriptive methods were used to analyze anticoagulant causes, hemorrhagic susceptibility factors and clinical characteristics. Patients were divided into the international normalized ratio (INR) overrange group and the INR non-overrange group according to INR value during bleeding. The Chi-square test, Student’s t test, and Wilcoxon rank sum test were used to compare the differences between the INR overrange group and the INR non-overrange group. The Wilcoxon rank sum test and Student’s t test were used to analyze the characteristics of gastrointestinal tract bleeding and cerebral hemorrhage. Results:Warfarin-related major bleeding accounted for 0.36% (114/32 040) of first aid cases and 9.84% (114/1 158) of warfarin-taking cases, respectively. Seventy-seven cases (67.5%) of anticoagulant causes were related to atrial fibrillation (AF) and 32 cases (28.1%) were related to post-operative cardiac valve replacement. Of the bleeding susceptibility factors, HAS-BLED scored at 4.0 (3.0, 5.0), 84 cases (73.7%) had a history of drug use, 77 cases (67.5%) aged older than 65 years old, 65 cases (57.0%) had irregular INR monitoring, and 29 cases (25.4%) had recent increase in dose. Forty cases (35.1%) were gastrointestinal tract bleeding with the lowest hemoglobin (Hb) value and the highest score of HAS-BLED. Twenty-one cases (18.4%) were cerebral hemorrhage with the shortest prothrombin time (PT), the lowest INR value, the highest Hb, and the lowest score of HAS-BLED. Twelve cases (10.5%) died or gave up treatment in critical condition, including 6 cases of cerebral hemorrhage, 5 cases of gastrointestinal tract bleeding, and 1 case of hemoptysis. There were statistically significant differences in previous history of antiplatelet therapy, recent increase in dose, HAS-BLED score and bleeding site between the INR overrange group and the INR non-overrange group (all P<0.05). Conclusions:Among patients with warfarin-related major bleeding, AF and post-operative cardiac valve replacement are the main causes of warfarin anticoagulation. INR overrange is related to the previous history of antiplatelet therapy, recent increase in dose, and the high score of HAS-BLED. The gastrointestinal tract bleeding is the most common, with the lowest Hb value and the highest score of HAS-BLED. Cerebral hemorrhage is the second common, with the shortest PT, the lowest INR value, and the highest Hb. The incidence and mortality rates of warfarin-related major bleeding are relatively high.

Objective:To investigate the changes of cardiomyocyte apoptosis after hypoxia/reoxygenation (H/R) regulated by microRNA-1 (miR-1).Methods:Cardiomyocyte strain H9c2 derived from rat embryonic heart tissue were cultured in vitro. The cells in logarithmic growth phase were divided into blank control group, H/R group, miR-1 mimics+H/R group, miR-1 inhibitor antisense oligonucleotide (ASO)+H/R group and microRNA negative control fragment (miRNA NC)+H/R group. The low sugar DMEM medium containing low concentration of fetal bovine serum (FBS) was used as the medium under anoxic condition. After being cultured in a closed anaerobic incubator at 37 ℃ (95% N 2 and 5% CO 2) for 12 hours, the cells were cultured with the fresh high sugar DMEM medium containing 5% FBS in a closed incubator at 37 ℃ for reproducing cardiomyocyte H/R model. The blank control group was cultured in high glucose DMEM medium containing 10% FBS in 37 ℃ and 5% CO 2 incubator. In miR-1 mimics+H/R group, miR-1 ASO+H/R group and miRNA NC+H/R group, the corresponding transfectants were mixed in high glucose DMEM medium and transfected into cells before H/R model was established, and the final concentration was 50 nmol/L. The blank control group and H/R group were added with DMEM medium at the same time. After the establishment of the model, the expression level of miR-1 was detected by real-time fluorescence quantitative polymerase chain reaction (qPCR). The expression levels of apoptosis-related proteins caspase-9, Bcl-2 and Bax were detected by Western blotting, and cardiomyocyte apoptosis was detected by flow cytometry. Results:Compared with the blank control group, the expression levels of miR-1, caspase-9 and Bax protein and the apoptosis rate of cardiomyocytes were significantly increased, while the expression level of Bcl-2 was significantly decreased, which indicated that the expression of miR-1 and the level of apoptosis were increased in H/R group. Compared with H/R group, the expressions of miR-1, caspase-9 and Bax and the apoptosis rate of cardiomyocytes in miR-1 mimics+H/R group were further increased [miR-1 (2 -ΔΔCt): 11.59±1.48 vs. 2.57±0.38, caspase-9 protein (caspase-9/β-actin): 2.59±0.12 vs. 1.56±0.20, Bax protein (Bax/β-actin): 4.09±0.38 vs. 1.97±0.13, apoptosis rate: (25.23±0.87)% vs. (17.86±0.73)%, all P < 0.01], while the expression of Bcl-2 was decreased (Bcl-2/β-actin: 0.37±0.02 vs. 0.49±0.03, P < 0.01). The expressions of miR-1, caspase-9 and Bax and the apoptosis rate were significantly decreased in miR-1 ASO+H/R group [miR-1 (2 -ΔΔCt): 1.16±0.06 vs. 2.57±0.38, caspase-9 protein (caspase-9/β-actin): 1.05±0.24 vs. 1.56±0.20, Bax protein (Bax/β-actin): 0.93±0.11 vs. 1.97±0.13, apoptosis rate: (11.19±0.85)% vs. (17.86±0.73)%, all P < 0.05], while the expression of Bcl-2 was increased (Bcl-2/β-actin: 0.84±0.17 vs. 0.49±0.03, P < 0.05). There was no significant difference in miR-1 expression, caspase-9, Bax and Bcl-2 protein expressions, and apoptosis rate between H/R+miRNA NC group and H/R group. Conclusion:The expression of miR-1 and level of apoptosis were increased in H/R cells, and miR-1 could aggravate cardiomyocyte apoptosis.

Objective: To investigate the relation between serum markers, the degree of lesions and the active period of chronic periodontitis in patients with type 2 diabetes mellitus. Methods: A total of 595 patients with type 2 diabetes mellitus were selected, and oral examinations and laboratory tests were conducted. The patients were divided into a periodontally healthy group mild, moderate and severe periodontitis groups depending on the diagnostic criteria for chronic periodontitis. The patients were also divided into periodontally healthy, resting and active groups depending on the diagnostic criteria of the active period. The relationships between serum biochemical indices, the degree of lesions and chronic periodontitis activity were analyzed. Results: The prevalence of chronic periodontitis in patients with type 2 diabetes was 74.6%, and the proportions of patients with mild, moderate, and severe chronic periodontitis were 44.9%, 16.1% and 13.6%, respectively. The composite ratio of active periodontal chronic periodontitis was 33.1%. Compared with the patients in the control group, the fasting plasma glucose and HbA1c levels were more poorly controlled in the type 2 diabetes mellitus groups with chronic periodontitis (P < 0.05). There were significant differences in fasting blood glucose levels between mild periodontitis group and moderate, severe periodontitis group (P < 0.05). There was no significant difference in HbA1c levels among the mild, moderate and severe groups (P>0.05). However, there were significant differences in fasting blood glucose levels between the groups with various degrees of progression in the following order: active (11.24 mmol /L) > resting (9.64 mmol/L) > control (8.82 mmol/L) (P < 0.05). Conclusion The severity of chronic periodontitis plays no role in the level of HbA1c, instead, the level of fasting plasma glucose changes with the severity and progression of chronic periodontitis.

Objective: The study aimed to investigate the diurnal variation in cervical disc hydration and its relationship with cervical degeneration. Materials and Methods: C3–C7 discs of 86 prospectively enrolled participants (37 males, 49 females; mean age ± standard deviation, 23.5 ± 2.5 years) were assessed using T2 mapping in the morning and evening. All discs were stratified by Miyazaki grade or C2–C7 Cobb angle and T2 values (T2). The degree of diurnal T2 variation (T2-DDV), defined as (morning T2 – evening T2)/morning T2 x 100%, was measured for the entire disc, annulus fibrosus (AF), nucleus pulposus (NP), and endplate zones. Results: T2 of the entire disc decreased significantly after the daytime load (p < 0.001), with a T2-DDV of 13.3% for all discs and 16.0%, 12.2%, and 13.0% for healthy (grade I), mild degenerative (grade II), and advanced degenerative (grade III/IV) discs, respectively. T2 of regional NPs and AFs decreased significantly from morning to evening (p ≤ 0.049) except in the healthy anterior inner AF (p = 0.092). Compared with healthy discs, mild degenerative discs displayed lower T2 and T2-DDV in regional NPs (p < 0.001). Advanced degenerative discs showed higher T2-DDV in the anterior inner AF compared with healthy discs (p = 0.050). Significant diurnal T2 changes in the endplate zones were observed only in healthy discs (p = 0.013). Cervical discs in the low Cobb angle group showed higher T2-DDV in the anterior AFs and anterior NP and lower T2-DDV in the posterior AF than those in the high Cobb angle group (p ≤ 0.041). Conclusion This study characterized the diurnal variation in hydration of the cervical discs as assessed using T2 mapping and revealed early chemo-mechanical coupling dysfunction in degenerating discs. Cervical sagittal alignment on MRI can affect the diurnal stress patterns of the cervical discs. T2 mapping is sensitive to disc biomechanical dysfunction and offers translational potential from biomechanical research to clinical application.

Objective:To explore the surgical outcomes of focal cortical dysplasia (FCD) patients with "difficult to locate" intractable epilepsy and their influencing factors.Methods:Thirty-five FCD patients with "difficult to locate" intractable epilepsy, underwent surgical treatment after intracranial electroencephalogram (iEEG) evaluation in our hospital from January 2011 to December 2018, were chosen in our study. Engel grading was used to evaluate the surgical efficacies of these patients, and they were divided into a satisfied efficacy group (Engel grading I) and an incomplete satisfied efficacy group (Engel grading II-IV). The clinical data of patients from the 2 groups were compared. Multivariate Logistic regression analysis was performed to explore the influencing factors for surgical outcomes of FCD patients with "difficult to locate" intractable epilepsy.Results:Of these 35 patients, 26 patients (74.3%) achieved satisfied efficacy, and 4 had incomplete satisfied efficacy. As compared with those in the satisfied efficacy group, patients in the incomplete satisfied efficacy group had significantly lower total resection rate of epileptogenic foci ( P<0.05). Multivariate Logistic regression analysis showed that incomplete resection of epileptogenic foci was the influencing factor for surgical outcomes of FCD patients with "difficult to locate" intractable epilepsy ( P=0.014, OR=0.050, 95%CI: 0.005-0.547). Conclusion:The FCD patients with "difficult to locate" intractable epilepsy can achieve satisfactory results by surgical resection of epileptogenic zones after iEEG monitoring; these FCD patients with "difficult to locate" intractable epilepsy with incomplete resection of epileptogenic foci often have poor surgical outcomes.