Objective To systematically evaluate the application of problem-based learning (PBL)in the teaching process of health management major in China.Methods Databases including CNKI (1979 to December the 2015),VIP (1989 to December the 2015),Wanfang (1982 to December the 2015) and PubMed were systematically retrieved.Any literature about PBL of health management major was included.Seffdeveloped data extraction form was used for collecting the information.Data were input and analyzed using Excel 2007.Results 15 papers were included in the analysis.The first author mainly came from the northeast region of China (7).Most (10) papers did not get the funding support.No paper was published in the journals contained in the Guide to the Core Journals of China.6 papers of experimental studies compared the performance difference of students of the PBL and lecture-based learning (LBL),which was statistically significant.Conclusion PBL is superior to the LBL.However,due to the large difference in the quality of literature,more studies were needed to determine the effect of PBL.Moreover,we should pay attention to the combination of PBL and LBL.

Maturity onset diabetes of the young (MODY) is a monogenic autosomal dominant inherited disease. Its clinical manifestations are asymptomatic with slightly elevated fasting blood glucose and few complications. This paper reports a novel mutation W257R in glucokinase () gene from a Chinese patient with MODY. Heterozygous mutation c.769T>C (p.W257R) in exon 7 of gene (Chr744187343) was found in the proband, her father and brother. This W257R mutation was first reported in Chinese population.
China ; Diabetes Mellitus, Type 2 ; genetics ; Female ; Glucokinase ; genetics ; Humans ; Male ; Mutation ; Pedigree

OBJECTIVETo define the influence clinically related factors in the prognosis of ventilated pneumonia (VAP).

METHODSA prospective clinical study involving 120 patients with VAP was carried ont. Etiologic diagnosis was established under quantitative culture of endotracheal aspiration, a protected specimen brush and bronchoalveolar lavage. Prognostic using a statistical software package (SPSS) factors were examined for univariate and multivariate analyses.

RESULTSCase fatality directly related to the infection was 14 percent. From univariate analysis, variables that significantly associated with attributable mortality were age older than 45 years, use of corticosteroids, presence of shock, in-hospital days of VAP over as follows 9, antecedent chronic obstructive pulmonary disease, and a prior antibiotic use. Through step-forward logistic regression analysis, only prior antibiotic use (P < 0.000 1, OR = 9.2) was defined as a significant factor influencing the risk of death from VAP. The same result was obtained when severity was included in the model. However, prior antibiotic use entirely dropped out as a significant risk factor when the etiologic agent was included in the regression equation.

CONCLUSIONSDistribution of microorganisms that responsible for VAP shown different in patients who had received prior antimicrobial therapy, and this factor caused higher mortality rate. We suggested a restrictive antibiotic use strategy among mechanically ventilated patients to reduce the risk of death from VAP.

Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents ; adverse effects ; China ; epidemiology ; Cross Infection ; drug therapy ; etiology ; mortality ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Pneumonia, Bacterial ; drug therapy ; etiology ; mortality ; Prognosis ; Prospective Studies ; Respiration, Artificial ; adverse effects ; Risk Factors

OBJECTIVETo evaluate the safety and clinical efficacy of segmental radiofrequency ablation of pulmonary vein (PV) ostia for patients with refractory paroxysmal atrial fibrillation (AF) under multi-slice spiral computed tomography (MSCT) guidance before the procedure.

METHODSA series of 58 consecutive patients with refractory paroxysmal AF were enrolled to undergo segmental radiofrequency ablation of PV ostia. The 36 male and 22 female patients with mean age of (57.4+/-9.5) (32-79) years and no obvious organic heart disease. Before ablation, patients received MSCT to generate 3-dimensional image of the left atrium (LA) and proximal PVs. Patients then underwent segmental radiofrequency ablation of PV ostia using PV circular mapping catheter manipulated several times to ensure complete isolation between PVs and LA.

RESULTSNo complications occurred during the procedure. One patient developed delayed cardiac tamponade, which was drained percutaneously. The mean follow-up time was (17.1+/-9.3) months. Forty-one patients (95%) experienced improved quality of life one month after the procedure. Thirty-six patients (83%) showed stable sinus rhythm, while 10 patients (23%) required additional anti-arrhythmic drugs. AF returned> or =1 time in 6 (14%) patients who underwent anti-arrhythmic drug therapy, but the number of episodes was less than that before the procedure. However, one patient experienced recurrent episodes of atrial flutter.

CONCLUSIONIt is safe and effective to perform segmental radiofrequency ablation of PV ostia for patients with refractory paroxysmal AF using MSCT guidance mappening.

Adult ; Aged ; Atrial Fibrillation ; diagnostic imaging ; surgery ; Catheter Ablation ; adverse effects ; methods ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Pulmonary Veins ; diagnostic imaging ; surgery ; Risk Assessment ; Surgery, Computer-Assisted ; methods ; Tomography, Spiral Computed ; methods ; Treatment Failure ; Treatment Outcome

BACKGROUNDNumerous studies from Europe and North America have provided a wealth of information regarding the epidemiological and clinical characteristics of inflammatory bowel disease (IBD) in Caucasians. Previous studies in mainland China have been limited by small patient numbers or by lack of detailed information about clinical subgroups of the disease. This study was carried out to assess the demographic and clinical characteristics of IBD in Chinese patients.

METHODSIn the Sir Run Run Shaw Hospital between 1994 and 2003, 379 patients were diagnosed as IBD. Demographic and clinical data were collected and analysed.

RESULTSOf 379 patients, 317 had ulcerative colitis (UC) (83.6%, 168 male, 149 female, male-female ratio 1.13:1, age range at diagnosis 14-79 years, mean age 44 years) and 62 had Crohn's disease (CD) (16.4%, 39 male and 23 female, male-female ratio 1.70:1, age range at diagnosis 13-70 years, mean age 33 years). In UC, 11.4% of patients had proctitis, 25.2% had proctosigmoiditis, 18.6% were diseased to the splenic flexure and 44.8% had extensive colitis. Nine patients with UC (2.8%) had arthritis, three patients (0.9%) had iritis or conjunctivitis. Of the 62 CD patients, 16 (25.8%) had diseases restricted to the terminal ileum; 15 (24.2%) had colonic diseases; 20 (32.3%) had ileocolonic disease and 11 (17.7%) had disease involving the upper gastrointestinal tract.

CONCLUSIONSThis study shows similar characteristics of IBD to that in the West but there are some differences with respect to severity and extraintestinal manifestations. The ethnic and geographic differences may give important clues to the aetiology of IBD.

Adolescent ; Adult ; Aged ; China ; epidemiology ; Female ; Humans ; Incidence ; Inflammatory Bowel Diseases ; complications ; epidemiology ; genetics ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVETo compare the efficacy of a short messaging service (SMS) text messaging and phone reminder to improve attendance rates at a health promotion center.

METHODSA total of 1 859 participants who had scheduled appointments in the health promotion center of our hospital from April 2007 to May 2007 were enrolled in the study and randomly assigned into 3 groups: control (no reminder) group, SMS text messaging reminder group and telephone reminder group. Attendance rates and costs of interventions were collected.

RESULTSA total of 1848 participants were eligible for analysis. Attendance rates of control, SMS and telephone groups were 80.5%, 87.5% and 88.3%, respectively. The attendance rates were significantly higher in SMS and telephone groups than that in the control group, with odds ratio 1.698, 95% confidence interval 1.224 to 2.316, P=0.001 in the SMS group, and odds ratio 1.829, 95% confidence interval 1.333 to 2.509, P<0.001 in the telephone group. However, there was no difference between the SMS group and the telephone group (P=0.670). The cost effectiveness analysis showed that the cost per attendance for the SMS group (0.31 Yuan) was significantly lower than that for the telephone group (0.48 Yuan).

CONCLUSIONSMS and telephone are effective reminders for improving attendance rate at a health promotion center. SMS reminder may be more cost-effective compared with the telephone reminder.

Adult ; Aged ; Female ; Health Promotion ; Humans ; Male ; Middle Aged ; Patient Compliance ; Reminder Systems ; Telephone

OBJECTIVECentral obesity is considered to be a central component of metabolic syndrome. Waist circumference (WC) has been widely used as a simple indicator of central obesity. This study is aimed to evaluate the sensitivity of WC cut-off values for predicting metabolic risk factors in middle-aged Chinese.

METHODSThe study involved 923 subjects aged 40-65 years. The metabolic risk factors were defined according to the Chinese Joint Committee for Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults. WC cut-off 85-90 cm and ⋝90 cm were used as cut-off values of central pre-obesity and central obesity in males, respectively, while WC 80-85 cm and ⋝85 cm were used as cut-off values of central pre-obesity and central obesity in females.

RESULTSFirst, WC values corresponding to body mass index (BMI) 24 kg/m2 and visceral fat area (VFA) 80 cm2 were 88.55 cm and 88.51 cm in males, and 81.46 cm and 82.51 cm in females respectively. Second, receiver operating characteristic curves showed that the optimal WC cut-off of value was 88.75 cm in males, higher than that in females (81.75 cm). Third, the subjects with higher WC values were more likely to have accumulating metabolic risk factors. The prevalence of metabolic risk factors increased linearly and significantly in relation to WC levels.

CONCLUSIONWC cut-off values of central pre-/central obesity are optimal to predict multiple metabolic risk factors.

Aged ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Intra-Abdominal Fat ; physiopathology ; Male ; Metabolic Syndrome ; diagnosis ; epidemiology ; physiopathology ; Middle Aged ; Obesity ; diagnosis ; ROC Curve ; Waist Circumference

Liver is the most common metastatic site for colorectal cancer (CRC), there is no satisfied approach to treat CRC liver metastasis (CRCLM). Here, we investigated the role of a polycomb protein BMI-1 in CRCLM. Immunohistochemical analysis showed that BMI-1 expression in liver metastases was upregulated and associated with T4 stage, invasion depth and right-sided primary tumor. Knockdown

OBJECTIVETo investigate the therapeutic efficacy and adverse reactions of Aidi Injection (AI) combined with percutaneous cool-tip radiofrequency ablation (CRFA) in treatment of primary liver cancer and to explore its effect on immune function.

METHODSEighty-nine patients with primary liver cancer at middle-late stage were assigned to the control group with CRFA alone and the treatment group treated with CRFA and intravenous dripping of AI 50 mL once every day for succesive 20 days.

RESULTSCompared with those before treatment, the alanine aminotransferase (ALT) and albumin (ALB) levels showed no marked change, and CD4 subgroup of T lymphocyte and CD4/CD8 ratio elevated in the treatment group (P<0.01), while the ALT level elevated (P<0.05), ALB level decreased (P < 0.01), CD4 and CD4/CD8 ratio showed no change in the control group. The relapse rate was 20.0% (3/15) in patients with tumor more than 3 cm in diameter of the treatment group, which was obvious lower than that in the control group (55.0%, 11/20, P < 0.05).

CONCLUSIONAI treatment could relieve the impairment of CRFA on hepatic function, improve immune function and reduce relapse rate in patients with primary liver cancer.

Adult ; Aged ; CD4-CD8 Ratio ; Carcinoma, Hepatocellular ; immunology ; therapy ; Catheter Ablation ; methods ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Female ; Humans ; Infusions, Intravenous ; Liver Neoplasms ; immunology ; therapy ; Male ; Middle Aged ; Phytotherapy ; Treatment Outcome

A strain KX6,producing thermotolerant endoglucanase,was isolated from compost. The morpholo-gical identification and 16S rRNA sequence analysis showed it belongs to Streptomyces xylophagus. The production and characterization of endoglucanase from Streptomyces xylophagus KX6 was studied. Maximum endoglucanase yield of 0.538 IU/ml was achieved with medium pH8.0,containing CMC2Na 1.0% as carbon resource,soybean meal 1% as nitrogen resource,2% inoculating volume,30% 250 ml triangle flask bulk for medium volume at 40℃ 200r/min shaker for 48h. The endoglucanase exhibited optimum catalytic activity at pH7.0 and 50℃. The enzyme was stable at 50℃,and able to retain 60% of the full activity,when it was incubated at 60℃ for 1h.The enzyme was stable at pH6.0~7.0. All these findings suggest that the enzyme is a thermotolerant neutral endoglucanase.