This paper introduces the ideas and methods concerning the design of network-based curriculm of hepatobiliary surgery. Design of network-based curriculm should highlight independence of online learning,emphasize network-based resources to support learning.Net-work-based curriculm should emphasize the evaluation of learning effect.

During professor SHAO Jing-ming's academic research and medical practice, his academic opinion of focusing spirit is gradually developed. In terms of nurturing the spirit, attention should be paid on persistence as well as everyday health maintenance and exercise to nurture the spirit of physician. In terms of clinical diagnosis and treatment, patients' psychology, employment and life status should be observed and experienced, which could bring more methods to take essential care of patients' spirit. The treatment should work with psychological counseling, advocating that based on patients' qi and spirit, various forms of treatment methods should be properly used, such as acupuncture or moxibustion or combination of acupuncture and medicine, along with simple acupoint selection and harmony medication. Before clinical treatment of acupuncture, calming the mind is critically emphasized to make a clear diagnosis. During the acupuncture, calming and focusing the mind is necessary as well as emphasizing the details, so acupuncture could be integrated with Chi Gong to create a new warming-sensation technique. In a word, the academic opinion of focusing spirit is shedding an inspiring light upon further study.
Acupuncture ; education ; history ; Acupuncture Therapy ; history ; psychology ; China ; History, 20th Century ; History, 21st Century ; Humans

0.05).After treatment,in neuromus- cular electric stimulation therapy group and ice-massage therapy group,SSA scores and degrade of SaO_2 were improved. There was significant difference between before and after treatment(P

Objective To study the effect of abnormal left ventricular diastolic function(LVDF)on the onset and severity of atrial or ventricular arrhythmia in elderly essential hypertensive patients.Methods The 210 elderly essential hypertensive patients were enrolled in this study. Their arrhythmias were monitored by 24-hour ambulatory electrocardiogram. The essential hypertensive patients were referred for Doppler echocardiography to evaluate left ventricular function, while patients with abnormal systolic function were excluded, and then the patients were classified as normal LVDF and abnormal LVDF including, impaired relaxation, pseudonormal, and restrictivelike filling patterns. Results In 210 elderly essential hypertensive patients, 147 (70%) cases were diagnosed as atrial arrhythmia and 102 (49%) cases as ventricular arrhythmia (χ2 = 19. 975, P ＜ 0.05 ).Morbidities of atrial (89%) or complex atrial arrhythmia (49%) as well as ventricular (63%) orcomplex ventricular arrhythmia (30%) were significantly higher in abnormal LVDN group than in normal LVDN group (40%, 13%, 26% and 7%, χ2 = 56. 723 、 28. 359 、 28. 076、15. 9102 , all P＜0. 05). The morbidities of arrhythmias were higher in hypertensive patients with pseudonormal and restrictiveike filling patterns than in other groups 93.6% and 96. 4%. Conclusions Abnormal left ventricular diastolic function affects on the onset and severity of atrial or ventricular arrhythmia in elderly essential hypertensive patients, and complex atrial or ventricular arrhythmia is easier found in hypertensive patients with pseudonormal and restrictivelike filling patterns.

Objective To investigate the application value of double-layer continuous suture in pancreatic jejunum anastomosis of pancreatoduodenectomy (PD).Methods A retrospective analysis of 114 consecutive patients (67 men and 47 women) who underwent PD from June 2012 to July 2013 were conducted. There were 79 patients who were treated by double-layer continuous suture technique and 35 patients by double-layer interrupted suture technique .The incidence of pancreatic fistula and other complications after PD with two different suture techniques were compared .Results The operation time of double-layer continuous suture group and double-layer interrupted suture group is respectively ( 284 ±5 ) and ( 288 ±7 ) mins, the intraoperative bleeding volume is respectively (236 ±29) and (282 ±49) ml, the differences between two groups were no statistical significance .The postoperative fasting time in two group was respectively (7.8 ± 0.5) and (9.7 ±0.5) days, the length of hospital stay time was respectively (14.0 ±1.0) and (17.2 ± 10.0) days, the incidence of postoperative pancreatic fistula ( POPF) was respectively 17.1%(6/35) and 39.2%(317/9 ), the differences between two groups were statistically significant (all P<0.05).Grade A POPF was found in 4 patients ( 11.4%) from the double-layer continuous suture group and in 5 patients (6.3%) from the double-layer interrupted suture group.Grade B POPF was identified only in 1 patients (2.9%) from the double-layer continuous suture group and in 23 patients (29.1%) from the double-layer interrupted suture group .The presence of Grade C POPF was only documented in 1 patient from the double-layer continuous suture group and in 3 patients from the interrupted suture group .Conclusions Continuous suture can be safely used in the duct-to-mucosa pancreatojejunostomy .The double-layer continuous suture can be more effective in reducing pancreatic fistula , improving the feeding time , and reducing the length of hospital stay, and it is worthy of clinical popularization and application .

Objective To study the diagnosis and operative treatment of redundant sigmoid colon in children.Methods The length of sigmoid flexure was measured by enema examination in children with constipation,if it was over the normal scope,redundant sigmoid colon were come into existence.Twenty-three cases were treated by operated,hemicolectomy were done in 14 of 23 cases,others were treated by Soave′s procedure through transanal local excision.Results Symptoms disappeared completely in 18 of 23 cases and decreased in 5 cases.Nine cases were cured after Soave's procedure through transanal local excision.There were significant differences between 2 groups(P

The pol gene of HIV-1 encodes mainly three enzymes: reverse transcriptase (RT), protease (PR) and integrase (IN). Currently, FDA approved drugs targeting RT and PR are available and administered in various combinations, while no anti-IN drug was approved. HIV-1 integrase is an essential enzyme for the viral replication and an interesting target for the design of new pharmaceuticals for multi-drug therapy of AIDS. The 288 amino acids of IN (32kDa) recognizes specific sequences in the long terminal repeats (LTRs) of the retroviral DNA. The IN protein catalyzes the 3′-processing step and the 5′-strand transfer step reaction in vivo, which was called integration and this reaction could be analysed by ELISA Assay in vitro. It has been reported that F185K and C280S mutations of HIV-1 integrase would improve the enzyme solubility, and the catalytical activity of the enzyme was the same as that of the wild-type enzyme in vitro. In order to build the platform of screening inhibitor against integrase of HIV-1 virus, the IN enzyme was expressed and the function of integrase protein was assayed. The cDNA of clade B HIV-1 genome was used as a template, overlapped PCR was used to construct site mutagenesis of F185K/C280S and NdeI/Xho I restriction sites were brought in. The PCR product was cloned into the prokaryotic vector pET-28a(+) to form a recombined plasmid, transferred into the host cell E.coli(BL21 DE3). The recombined clones were identified by PCR and Nde I/Xho I digestion .The positive plasmid was sequenced, and the successfully recombined plasmid in the host cell was induced by IPTG. The expressed IN protein was puriied sy the Co+ affinity chromatography column and SDS-PAGE was used to analyze the molecular weight and specificity. In addition, ELISA assay was used to analyze the function of the recombined IN protein. The recombinant protein was soluble, and expressed highly and stably in E.coli. The molecular weight of the expression product was identical to the expectation. The IN protein was proved to be functional in 3′ processing and 5′strand transfer by ELISA. It will be helpful to build the platform of screening inhibitors against HIV-1 integrase.

OBJECTIVEThis study aimed at exploring the feasibility of using dried blood spots (DBS) to detect HIV drug resistance genotyping in China by comparing the results of drug resistance from DBS, plasma and whole blood samples.

METHODSBlood samples were collected from 39 AIDS patients from Anhui (10), Yunnan (13), Hunan (6) and Xinjiang (10) provinces and autonomous regions. The HIV strains that infected these patients covered all the major HIV-1 subtypes prevailing in China (B, CRF01_AE, CRF07_BC). HIV drug resistance genotyping assay was performed on DBS as well as on the whole blood and plasma samples from the same patients simultaneously by using an in-house nest RT-PCR method. Drug resistance levels were determined based on Stanford University HIV drug resistance database, and the results from these three types of samples were compared.

RESULTSThe percentages of successful amplification of protease and reverse transcriptase regions in the pol gene were 95% (37/39) from DBS, 92% (36/39) from whole blood and 100% (39/39) from plasma samples. The sequences from the three types of samples showed more than 99% identity.86% (31/36) of the DBS samples had the same set of drug resistance mutations as those which were detected from plasma samples. The differences probably resulted from mixed bases.

CONCLUSIONSThere was no major difference in detecting HIV drug resistance genotyping among DBS, plasma and whole blood samples. Therefore, DBS is useful for detection of HIV drug resistance genotyping and is particularly valuable in developing countries like China, especially in remote rural regions.

Dried Blood Spot Testing ; Drug Resistance, Viral ; genetics ; Feasibility Studies ; Genotype ; HIV Infections ; blood ; genetics ; virology ; HIV Seropositivity ; blood ; genetics ; virology ; HIV-1 ; drug effects ; genetics ; Humans ; Reverse Transcriptase Polymerase Chain Reaction ; Viral Load

OBJECTIVETo understand the current status and risk factors of "subhealth" in college and university staff in Guangdong province.

METHODSEight thousand four hundred and seventeen staff in 19 colleges and universities in Guangdong were investigated through a self-developed questionnaire, and statistically analyzed using chi(2) test, chi(2)(strand) test and odd ratio. Judgement was based on the criteria on "subhealth" through Delphi method.

RESULTSOverall incidence of "subhealth" was 69.18% in 8,417 staff members, and the highest was in the age group of 30 - 40 year olds (totally 79.17%). The prevalence of severe "subhealth" in females was significantly higher than that of males (chi(2) = 14.19, P < 0.01). The main risk factors of "subhealth" were occupational stress, psychological factors, bad habits and behaviors. 44.21% of the 8,417 staff were aware of the terminology "subhealth", and 36.84% thought themselves under "subhealthy" condition.

CONCLUSIONThe health condition of college and university staff in Guangdong was not satisfactory, thus it was essential to carry out active measures of prevention and intervention among this population.

Adult ; Aged ; Female ; Health Status ; Humans ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Universities

OBJECTIVETo review the experience in the treatment of low-grade malignant endometrial stromal sarcoma.

METHODSThe data of 41 patients with low-grade malignant endometrial stromal sarcoma surgically treated between 1982 and 2004 were reviewed. Statistical analysis was carried out using chi(2) and Kaplan-Meier life table.

RESULTSOf these 41 patients, 24 suffered from irregular vaginal bleeding, and 30 had been diagnosed to have leiomyoma before treatment. Thirty patients but 11 underwent surgical management with uterus removed. Thirty-three patients received postoperative adjuvant therapy including radiation and/or chemotherapy. The 5-year and 10-year actuarial survival was 87. 5% and 77. 8%, respectively. Eighteen patients (43. 9%) developed recurrent disease, most of which in the pelvis. The mean time to recurrence was 31 months (range 6 to 78 months) with the median time of 26 months. The recurrent rate was 66.7% for patients whose ovarian function was reserved versus 37. 5% for those without reservation. Patients who received adjuvant therapy had a lower recurrent rate (30. 3%) than those who did not (87. 5%). The recurrent rate of the patients treated with postoperative adjuvant radiation was 32. 3% (10/31) versus 80% (8/10) for those patients without. The 5-year actuarial survival rate of patients with recurrent disease was 71. 8%.

CONCLUSIONLow-grade malignant endometrial stromal sarcoma has a good prognoses though dwarfed by higher late recurrence after initial treatment. Postoperative adjuvant radiation is helpful to reduce local recurrence. Endometrial stromal sarcoma;

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Brachytherapy ; methods ; Cesium Radioisotopes ; therapeutic use ; Chemotherapy, Adjuvant ; methods ; Combined Modality Therapy ; Endometrial Neoplasms ; pathology ; therapy ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; methods ; Kaplan-Meier Estimate ; Lung Neoplasms ; secondary ; therapy ; Middle Aged ; Neoplasm Recurrence, Local ; Prognosis ; Radiotherapy, Adjuvant ; methods ; Retrospective Studies ; Sarcoma, Endometrial Stromal ; secondary ; therapy