Objective To observe the effect of case-based learning (CBL) applied in ward-round on residents training. Methods A total of 33 residents trained with routine ward-round and CBL ward-round in the neurological department were investigated with questionnaire. Results 30 effective answers were recalled. More of them reported that CBL ward-round was very significant in improving clinical thinking, mastering the specialized knowledge, developing autonomous learning and improving the communication with patients and their family members (P<0.05). Conclusion CBL ward-round is effective on improving the comprehensive professional abilities of residents.

AIM: To study the pharmacokinetic characteristics of domestic ofloxacin tablet. METHODS: A method of deter- mination of drug concentration in urine by UV-spectrophotometry was established. RESULTS: K = 0. 1 278/h; T1, 2 = 5. 96h, Xu0-24 = 165. 84mg; (Q) = 82. 84%. CONCLUSION: This method is simple and rapid, it is suitable for pharmacokinetics study and clinical monitoring.

Objective To study the expression of Mage A1、A2、A3 in breast cancer tissues and four breast cancer cell lines Methods The expression of Mage A1、A2、A3 in breast cancer tissues and four breast cancer cell lines, MCF 7、Sk Br 3、MDA MB 435s and TM40D was detected by reverse transcription polymerase chain reaction (RT PCR) Results The positive expression rate of Mage A in breast cancer tissues was 13/33 (39%), of Mage A1 was 4/33 (12%), of Mage A2 was 8/33 (24%), and of Mage A3 was 7/33 (21%), respectively Both Mage A1 and Mage A3 were positive in breast cancer cell line MCF 7 and Sk Br 3 MDA MB 435s expressed Mage A2 and Mage A3 Mage A3 was positive in TM40D Conclusion Mage genes were often expressed in breast cancer, but expression of Mages varies in the breast cancer cell lines Mage genes encoding proteins are eligible for Mage peptide based active immunotherapy

ObjectiveTo investigate the early clinical risk factors of severe acute inhaled organic fluorine poisoning.Methods The clinical data of patients with acute poisoning of organic fluorine inhalation admitted since 2004 in Northern Jiangsu People's Hospital were retrospectively analyzed. According toDiagnostic Criteria of Occupational Acute Fluorohydrocarbon Poisoning(GBZ66-2002), all the patients were divided into three groups: mild, moderate and severe poisoning groups, the severe cases were included in the intensive group, and the others were grouped in the non-intensive group. The contents in the survey were as follows: gender, age, vital signs on admission (body temperature, pulse rate, respiratory rate, systolic blood pressure), arterial blood gas analysis record〔arterial oxygen saturation(SaO2), oxygenation index(PaO2/FiO2), lactic acid(Lac) and arterial partial pressure of carbon dioxide(PaCO2), pH value(pH)〕. Before treatment, the white blood cell(WBC) count, platelet(PLT) count, levels of alanine transaminase(ALT), creatinine(Cr), blood glucose, electrolytes(potassium, sodium, chloride, calcium), creatine kinase isoenzyme(CK-MB), etc. were examined and recorded. All the patients were immediately arranged for bedside chest X-ray examination, and the chest X-ray lung injury scores were recorded. By univariate and multivariate logistic regression analyses, the receiver operating characteristic curve(ROC curve) was drawn to evaluate the diagnostic value of the clinical risk factors.Results Sixty-two cases consisting with the standard criteria of enrollment were collected in the study, 36 cases being in intensive group and 26 cases in non-intensive group. The univariate analysis showed that the differences in pulse rate, respiratory rate, PaO2/FiO2, WBC, SaO2, Lac, pH, and lung injury score were statistically significant(P<0.05 orP<0.01). Logistic multiple regression analysis showed that PaO2/FiO2, WBC, Lac and chest X-ray lung injury score were the four indexes for predicting the independent risk factors of severe acute inhaled organic fluorine poisoning. The area under ROC curve(AUC) of PaO2/FiO2 was the highest(0.884), 95% confidence interval(95%CI) was 0.784 - 0.984, the critical value was 96.5 mmHg(1 mmHg=0.133 kPa), with the sensitivity of 75.6%, specificity of 95.2%, positive predictive value(PPV) of 92.3% and the negative predictive value(NPV) of 71.4%, in sequence, the rest were WBC(AUC 0.846, 95%CI 0.728 - 0.965, the criticalvalue 12.15×109/L), Lac(AUC 0.800, 95%CI 0.662 - 0.938, the critical value 4.2 mmol/L), chest X-ray lung injury score(AUC 0.795, 95%CI 0.652 - 0.938, the critical value 2.50), the sensitivity of the above three items was 90.2%, 83.6%, 88.5%, specificity was 90.2%, 83.6%, 88.5%, the PPV was 86.7%, 82.4%, 85.8% and NPV was 72.0%, 73.9%, 69.2% respectively.ConclusionThe blood WBC count, Lac, PaO2/FiO2 and chest X-ray lung injury score can be used as the early clinical risk factors of severe acute inhaled organic fluorine poisoning.

Objective To investigate the value of laparoscopy in the treatment of liver cancer.Methods The clinical data of 128 liver cancer patients who received laparoscopic surgery at Southwest Hospital from March 2007 to October 2009 were retrospectively analyzed.Of all patients,116 were with primary liver cancer,and 12 with metastatic liver cancer.There were 107 patients who received laparoscopie bepatectomy,15 received laparoscopic radiofrequency ablation(RFA)and 6 received laparoscopic ligation of the right branch of portal vein.Results Of the 107 patients who received laparoscopic bepatectomy,7 were converted to open surgery,and 5 were converted to hand-assisted laparoscopic hepatectomy.Anatomical hepatectomy was performed on 88 patients,including left lateral lobectomy on 21,left hemihepatectomy on 15,extended left hemihepatectomy on 2,medial lobectomy on 1,right hemihepatectomy on 11,right posterior lobeetomy on 9 and hepatic segmentectomy on 29.Combined hepatic resection was performed on 4 patients,and nonanatomical hepatectomy on 15.The mean oporatire time and blood loss were(228±92)minutes and(393±213)ml,with no operative mortality.The mean postoperative hospital stay was(8±4)days,and the incidence of complications was 15%(16/107).A total of 126 patients were followed up for 1-42 months,12 patients with laparoscopic hepatectomy died within 16 months,with the mean survival time of(118±7)weeks and the mean tumor free survival time of(105±7)weeks;2 patients with laparoscopic RFA died within 11 months:2 patients with laparoseopie ligation of the right branch of portal vein received two-stage radical resection.Conclusion Laparoscopic surgery is safe and feasible with the advantages of minimal operative trauma and quick recovery of patients when it is applied to the treatment of liver cancer.

Objective To evaluate the influence of grape seed proanthocyanidin extract (GSPE) on sunburn cell formation and p53 protein expression induced by acute ultraviolet injury. Methods Ten volunteers were enrolled in this study. The buttock region served as the exposed region. Four areas were randomized and delineated on the buttock: one area (control area) received no exposure or product, the other 3 areas were exposed to two minimal erythema doses (MED) of simulated solar radiation (SSR) for 3 days. Of the 3 exposed areas, one area (SSR) received no product before exposure, one area (SSR + Veh) was pretreated with vehicle, the third area (SSR + GSPE) with the samples of GSPE. GSPE or vehicle was applied 30 minutes before each exposure at 2 μL/cm2. Skin biopsy was performed 24 hours after the last exposure, and skin specimens were subjected to hematoxylin eosin (HE) staining and histochemical analysis for p53 protein. Results There was a statistical difference in the number of sunburn cells per high power field (×200) between SSR sites and SSR + GSPE sites (29.8±11.1 cells vs 2.2±0.2 cells, P<0.01). A significant decrease was noticed in the account of p53 protein-positive cells per high power field (×200) in SSR + GSPE sites com-pared with the SSR sites (4.6±0.7 cells vs 19.3±3.4 cells, P<0.05). Conclusion GSPE exerts a poten-tial protective effect against acute ultraviolet injury and can serve as a natural sunscreen.

Objective To investigate the effects of initiating oral-medication and insulin-treatment to residual islet function in adult patients with latent autoimmune diabetes in adults (LADA).Methods Fifty nice inpatients and 11 outpatients of LADA were enrolled from the Peking Union Medical College Hospital from January 1981 to October 2014,including 34 cases with initiating insulin therapy and 36 cases with initiating oral medication.Patients were followed up at least twice and with a 6-month interval.The age,body mass index (BMI),diagnosis time,fasting C peptide (FCP),2-hour postprandial C peptide (2 hCP),glycosylated hemoglobin (HbA1c) were compared between two groups.Results The age of disease onset in insulin-treatment group was significantly lower than that in oral-medication group (t =2.049,P =0.045).The proportion of patients complicated with other autoimmune diseases in oralmedication group were higher than that in insulin-treatment group [24％ (8/34) vs.47％ (17/36),x2=4.275,P=0.039].The FCP and 2 hCP in insulin-treatment group were significantly higher than those in oral-medication group [FCP:0.25 (0.00-0.80) vs.0.00 (0.00-0.60) μg/L,Z =3.498,P =0.030,2 hCP:0.42(0.02-1.20) vs.0.14(0.02-0.19) μg/L,Z =3.235,P=0.001] on 6 month after treatment;however,there were no significant differences on 6-12 months,13-36 months or 37-60 months after treatment between two groups.No antibody negative conversion was detected in 10 inpatients,who were reexamined with glutamic acid decarboxylase antibody (GADA) more than twice.The detection rate of diabetes retinopathy was 4％ (1/26) in insulin-treatment group and 28％ (8/29) in oralmedication group (x2 =6.179,P =0.013).Conclusion Initiating insulin therapy at first diagnosis of LADA can protect the residual islet function,and may reduce the rate of diabetic retinopathy.

The daily life information needs of elderly people in different areas of China were analyzed , which showed that the elderly people are most concerned about TV news information, health information, recreation infor-mation, welfare information , and popular science knowledge .

AIM: To determine the effect of endogenous histamine on transient forebrain ischemia-induced neuronal injury at the late phase of reperfusion using histidine decarboxylase knockout ( HDC-KO) mice.METHODS:Wild-type (WT) and HDC-KO mice were subjected to bilateral common carotid artery occlusion for 30 min followed by 3 d or 15 d of reperfusion.At different time points after reperfusion, the body weight, mortality rate, learning and memory in fear conditioning test and hippocampal CA 1 neuronal density were evaluated .RESULTS: At 1 d after reperfusion , the body weight loss was observed in both WT and HDC-KO mice.At 4 d, 5 d, 6 d and 7 d after reperfusion, the increment in the body weight of the HDC-KO mice was significantly smaller than that of the WT mice .During the period between 8 d and 14 d after reperfusion, the mortality rate of the HDC-KO mice was higher than that of the WT mice (P<0.05).At 14 d after reperfusion , the HDC-KO mice exhibited more aggravated deficits in contextual and cue memory compared with the WT mice.Correspondingly , a more severe CA1 neuronal injury in the HDC-KO mice than that in the WT mice was ob-served at 15 d but not at 3 d after reperfusion (P<0.05).CONCLUSION:Endogenous histamine may attenuate learn-ing/memory deficits and neuronal injury at the late phase of ischemia /reperfusion.However, the involved mechanisms need to be further investigated .

ObjectiveTo evaluate the feasibility and efficacy of ex-vivo liver resection combined liver autotransplantation for patients with massive primary liver cancer who underwent complex liver resection.Methods The clinical data of 4 patients suffering from massive primary liver cancer who were admitted to the Beijing Chaoyang Hospital from January 2008 to May 2010 were retrospectively analyzed.Regular liver resection could not be carried out because the first,second and third hepatic hilum of the 4 patients were invaded by the tumors,so ex-vivo liver resection combined liver autotransplantation were performed.ResultsThe operation was successfully carried out for the 4 patients.The operation time,the duration of anhepatic phase and the volume of operative blood loss were 690-840 minutes,250-300 minutes and 400-1400 ml,respectively.Portacaval bypass operation was not performed.After ex-vivo liver resection,the inferior vena eava or hepatic vein and portal vein of the 4patients were repaired,and the allogenous blood vessels were kept to extend the superior vena cava of the remnant liver so as to facilitate the anastomosis of blood vessels and reconstruction of the first hepatic hilum. After operation,the hepatic function of 1 patient was back to normal; 1 patient who stfffered from abdominal hemorrhage received reoperation for hemostasia; 1 patient was found with hepatic dysfunction; 1 patient died of hepatorenal dysfunction at postoperative day 5.Compensatory hypertrophy was observed in the 3 patients who survived at postoperative months 1-2.Of the 3 patients,2 were found with multiple pulmonary metastases at postoperative months 8 and 9,and they died at postoperative mouths 13 and 15.Until April 2012,1 patient survived for 37 months with no tumor recurrence or metastasis. ConclusionsEx-vivo liver resection combined liver autotransplantation provides the technical feasibility for performing complex liver resection for patients. The incomplete compensation of liver function and the short-term recurrence of tumors after operation are still the main issues which hinder the development of this technique.