Aiming to solve the problems in traditional classroom mode PBL teaching during clinical practice of oral and maxillofacial surgery,this paper investigated multi-pattern PBL teaching basing on Weblog,daily ward round and classroom discussion in the clinical practice,and focused on the practice methods,advantages and feature of this multi-pattern PBL teaching.

AIM: To evaluate the safety and efficacy of Ahmed glaucoma valve implantation for refractory glaucoma after sequential failed trabeculectomy.
METHODS: Thirty - six patients (36 eyes) with prior failed sequential trabeculectomy who underwent Ahmed glaucoma valve implantation were included. The intraocular pressure ( IOP), best corrected visual acuity (BCVA) and complications were ovserved and all the patients were followed up at least for 12mo.
RESULTS: Mean preoperative IOP was 35. 20±7. 28mmHg and reduced to 10. 15±3. 34, 11. 23±3. 56, 15. 63±5. 72, 17. 17±5. 47, 17. 73±6. 23,19. 76±5. 43mmHg at 1, 2wk, 1, 3, 6 and 12mo after surgery, which was significant different from the preoperative level (t = 12. 643, 11. 837, 10. 324, 8. 839, 8. 462, 8. 046, all P < 0. 05 ). Visual acuity was not significantly different between pre - operation and 12mo post- operation ( Z = - 0. 420, P > 0. 05). At 12mo after operation, the complete success rate reached 78% and the conditional success rate reached 92%. There were 5 eyes complicated with shallow anterior chamber, 3 eye complicated with anterior chamber hemorrhage, which all recovered after additional treatments. Late complications included valve exposure and encapsulated cystic blebs around the plate. Severe corneal endothelium loss occurred in 1 patient.
CONCLUSION: Ahmed glaucoma valve implantation is effective in reducing IOP at 1-year follow-up in refractory glaucoma patients with prior sequential failed trabeculectomy, but we should fully understand and attach great importance to all kinds of complications that may occur.

Objective To investigate the clinical effectiveness of coronary artery bypass grafting through descending thoracic aorta in elderly patients with coronary heast disease and to decrease the post-operative complication.Methods Thirteen elderly patients underwent coronary bypass surgery with minimally invasive direct coronary artery bypass (MIDCAB).Age range from 70 to 82 years with a mean of(72.1?6.0)years.Patients suffered from multi vessel disease.Many minimally invasive techniques of“Y”blood vessel graft anastomosis,anastomosis of blood vessel graft to descending aorta,minimally invasive direct,thoracoscope assist were used.Results All patients were survived.The mean duration of intubation was (6.9?0.9) hours.The average ICU stay was (2.5?0.5)days.No patients received blood transfusion.During the short-term follow-up(3 to 14 months) patients had no complaint of angina,Conclusions The technique of“Y”blood vessel graft anastomosis,descending aorta blood vessel graft,minimally invasive direct and thoracoscope assist in combination with coronary artery bypass grafting is a safe and cost-effective new procedure for elderly patients with multi-coronary artery disease.

OBJECTIVETo analyze the factors which influence the safety and prognosis of aorta replacement combined with coronary artery bypass grafting (CABG) for thoracic aortic aneurysm associated with coronary artery disease.

METHODSFrom May 1982 to October 2002, 67 patients with thoracic aortic aneurysm were admitted, and 24 of them combined with CABG. Of the 24 patients, 9 received descending aorta replacement combined with CABG, and the other 15 received the ascending aorta replacement combined with CABG. The treatment results were compared with the other 43 patients only undergoing the thoracic aortic replacement.

RESULTSThe mortality rate of the patients with aorta replacement combined with CABG was 13% (3/24). Though the descending aorta replacement combined with CABG could make the cardiopulmonary bypass time and selective cerebral perfusion time longer, (278 +/- 54) min and (188 +/- 59) min respectively, no significant difference was observed in postoperative complications, 3-year survival rate, 3-year-cardiac-event-free rate compared with the patients only undergoing the thoracic aortic replacement (P > 0.05).

CONCLUSIONSThe aorta replacement combined with CABG can be performed safely, and the revascularization for coronary artery disease is useful for preventing occurrence of cardiac events.

Aorta, Thoracic ; surgery ; Aortic Aneurysm, Thoracic ; complications ; surgery ; Blood Vessel Prosthesis Implantation ; Coronary Artery Bypass ; Coronary Artery Disease ; complications ; surgery ; Female ; Humans ; Male ; Retrospective Studies ; Time Factors

AIM: To observe the efficacy of surgical excision combined with autologous limbus conjunctival flap transplantation in the treatment of pterygium accompanied with conjunctival cyst.METHODS: Totally 126 patients 188 eyes with pterygium were hospitalized in Department of Ophthalmology of Tongji Hospital of Huazhong University of Science and Technology during August 2013 and August 2015.The patients were divided into two groups: observation group (11 eyes of 11 patients) with pterygium accompanied with conjunctival cyst and control group (177 eyes of 115 patients) with primary pterygium.All patients underwent slit lamp microscope examination, anterior segment photography, and anterior segment optical coherence tomography(OCT).The size of pterygium was calculated by multiplying neck width and length of the covered corneal.All patients underwent excision combined with autologous conjunctival flap transplantation, and the resections were performed pathological section with hematoxylin and eosin staining.All patients were followed up postoperatively for 4-28mo.RESULTS: All cases in the observation group were confirmed by postoperative pathological examination.All cyst walls were complete, and containing single layer of epithelial cells.The mean size of pterygium of the observation group was 6.9±1.7mm2, and 6.3±1.8mm2 for the control group.There was no significant difference between the two groups (P>0.05).The mean postoperative healing time of observation group was 2.1±0.9d, and 1.9±0.8d for the control group.There was no significant difference between the two groups (P>0.05).Recurrence was seen in two eyes within the follow-up period in the control group, and no recurrence in the observation group.CONCLUSION: Surgical excision combined with autologous limbus conjunctival flap transplantation is a safe and effective treatment for pterygium accompanied with conjunctival cyst.

An apparatus based on a high sensitive sensor which detects cardiovascular functions is introduced in this paper. Some intelligent detecting technologies, such as syntactic pattern recognition and a medical expert system are used in this detector. Its embedded single-chip microcomputer processes and analyzes pulse signals for gaining automatically the parameters about heart, blood vessel and blood etc., so as to get the health evaluation, correct medical diagnosis and prediction of cardiovascular diseases.
Algorithms ; Artificial Intelligence ; Biosensing Techniques ; instrumentation ; Cardiovascular Diseases ; diagnosis ; Computer Systems ; Equipment Design ; Hemorheology ; Humans ; Pattern Recognition, Automated ; Pulse ; Radial Artery ; physiology ; Signal Processing, Computer-Assisted ; instrumentation ; Software

Transbronchial lung biopsy(TBLB)has been widely used and has successfully helped in the diagnosis of lung diseases in adults. However,TBLB is less used in children with lung diseases. In order to recognize the skills of TBLB,the authors introduced the applications of TBLB in interventional respiratory diseases in children.

OBJECTIVE: To investigate the changes of C-reactive protein (CRP) level in patients with chronic obstructive pulmonary diseases (COPD) and to analyze the correlation between the lung function and CRP levels. METHODS: Sputum and serum specimens were obtained from 30 COPD patients diagnosed according to the national criteria. The CRP level was measured by enzyme-linked immunosorbent assays. The lung function indexes such as the forced expiratory volume in one second (FEV1) and the forced expiratory volume in one second/forced vital capacity (FEV1/FVC) were also determined. RESULTS: The sputum CRP level in COPD patients was 30-50 times higher than that of the health controls. The sputum CRP level in COPD patients is significantly higher than that of serum in these patients (P < 0.05). The correlation between changes of serum and sputum CRP levels and sputum CRP levels was positive (r = 0.625, P < 0.05). The correlations between changes of serum CRP levels and FEV1 were negative (r = -0.610, -0.725, respectively, P < 0.001). And the correlations between changes of serum and sputum CRP levels and FEV1/FVC were negative (r = -0.639, -0.600, respectively, P < 0.05). CONCLUSION The CRP may be secreted from the local respiratory tract. The damage of lung function in COPD patients is associated with the increase of CRP level.
Adult ; Biomarkers ; C-Reactive Protein ; metabolism ; Female ; Forced Expiratory Volume ; Humans ; Lung ; physiopathology ; Male ; Middle Aged ; Pulmonary Disease, Chronic Obstructive ; blood ; physiopathology ; Respiratory Function Tests ; Vital Capacity

Objective To explore the correlations of biochemical factors as gamma-aminobutyric acid (GABA) level with amino acid metabolism level in the blood, levels of intestinal immunoglobulin A (IgA)+complement factor 3 (C3), feeding intolerance and fatiguability in children with hypotonia cerebral palsy. Methods Ninety-six children with hypotonia cerebral palsy,admitted to our hospital from January 2009 to January 2012,were chosen in our study; questionnaire was used to understand the clinical symptoms of the children; the blood ammonia level,hepatic function and IgA+C3 level were obtained from routine blood chemistry testing, and amino acid metabolism was detected by blood tandem mass spectrometry; the correlations of GABA level with amino acid metabolism level in the blood, levels of IgA+C3, feeding intolerance and fatiguability were statistically analyzed. Results In all the 96 children with hypotonia cerebral palsy,63 (65.63％) had low arginine; 52 had both decreased arginine and elevated blood ammonia levels, enjoying negative correlation (r=-0.776,P=0.000); 42 had decreased arginine and reduced levels of IgA+C3 enjoying positive correlation (r=0.351,P=0.000); both decreased arginine level and feeding intolerance were noted in 47 with positive correlation (r=0.372,P=0.000).In these 96 children,30 (31.25％) had carnitine metabolism abnormality,including decreased propionyl carnitine/free carnitine or propionyl carnitine/acetylcarnitine levels in 21 (21.88％),increased hydroxyl palmitoyl carnitine/hydroxyl Palm enoyl carnitine level in 9 (9.37％),and decreased cysteine content in 3 (3.12％). Conclusion Metabolic abnormalities of arginine,carnitine and cysteine are noted in children with hypotonia cerebral palsy; a lot of exercise will consume arginine,carnitine and cysteine,which causes fatigue; children with low blood arginine content might also have increased blood ammonia level,reduced IgA+C3 level,trends of vomiting,susceptibility to infection and feeding difficulties,and therefore,children's mental state,immune function and exercise tolerance ability are affected.

OBJECTIVETo investigate the proliferation-inhibiting and multidrug-resistant reversing effect of bortezomib on human HL-60 cells, and to explore the mechanism of bortezomib-induced proliferation inhibition in human leukemia cells.

METHODSThe multidrug resistant leukemia cell lines HL-60/DNR and HL-60/VCR cells were used as models, and sensitive HL-60 cells as a control. The cytotoxicity of bortezomib on HL-60, HL-60/DNR, HL-60/VCR cells were measured by MTT method, and the non-cytotoxicity dose was determined as reversible dose. The cells were divided into 4 experimental groups: HL-60/DNR + DNR, HL-60/DNR + DNR + bortezomib, HL-60/VCR + VCR, HL-60/VCR + VCR + bortezomib. The bortezomib resistant reversal fold was calculated. The levels of XIAP, cIAP-1, and cIAP-2 mRNA and proteins expression and the activation of NF-κB of the HL-60/DNR, HL-60/VCR cells were examined by quantitative real time RT-PCR and western blot respectively after treated with gradually increasing concentrations of bortezomib (10, 40, 80 nmol/L) for 48 hours.

RESULTSBortezomib inhibited the cell growth of HL-60, HL-60/DNR, and HL-60/VCR in a concentration-dependent manner. The IC(50) values were (28.90 ± 3.99), (81.19 ± 9.34), and (73.48 ± 8.94) nmol/L, respectively. After treated with 10nmol/L bortezomib for 48 hours, the IC(50) value of DNR to HL-60/DNR decreased from (12.90 ± 1.75) µmol/L to (3.54 ± 0.57) µmol/L (P < 0.01), and that of VCR to HL-60/VCR from (33.25 ± 7.28) µmol/L to (9.97 ± 1.15) µmol/L (P < 0.01). The reversal fold (RF) values were 3.32 ± 0.53 and 2.64 ± 0.28, respectively. Bortezomib down-regulated the levels of XIAP, cIAP-1, and cIAP-2 mRNA and protein expression and inhibited the NF-κB activation in a concentration-dependent manner.

CONCLUSIONBortezomib can inhibit the proliferation of HL-60 cells and reverse multidrug-resistance in the cells. The possible mechanism is associated with down-regulation of IAPs expression.

Boronic Acids ; pharmacology ; Bortezomib ; Cell Proliferation ; drug effects ; Drug Resistance, Multiple ; Drug Resistance, Neoplasm ; HL-60 Cells ; Humans ; Leukemia ; genetics ; metabolism ; pathology ; NF-kappa B ; metabolism ; Pyrazines ; pharmacology ; RNA, Messenger ; genetics