CBS(Case Based Study)is a new teaching method,which is based on the case given.It requires students to answer questions according to the case. In the teaching,the students who are divided into groups,seek for resolvent by themselves. They should combine the information provided in the case,find the key answer and the relationship.The students gain the knowledge by reviewing and studying in the textbook,then analyse and solve questions with them. The application of CBS could make knowledge more relatively and systematic, moreover,it also make study more actively and initiatively.

Objective To evaluate the preoperative diagnosis and treatment of primary non-specific ureteritis,and to better understand this disease.Methods Three cases of primary non-specific ureteritis (1 man and 2 women)were reported.Their age was 28,38,68 years,respectively.One ease was found to have hydronephrosis on B-ultrasound at physical examination with no symptoms,and 2 had abdominal pain. The lesions were detected in lower part of the ureter in 2 cases,and in middle in I.The patients were diag- nosed preoperatively with combined use of MRU and ureteroscopy.Partial resection of the diseased part of the ureter was performed in all the cases.Results Pathological findings confirmed the diagnosis of non-spe- cific ureteritis.Microscopy showed necrotic tissue and inflammatory cell infiltration of ureteral mucosa,dilated and congested blood vessels,hypertrophic muscular layer,and proliferation of fibrous tissue.During the fol- low-up of 2 years,the patients had no symptoms and were free from hydronephrosis.Conclusions The eti- ology of primary non-specific ureteritis is unclear,and no typical symptoms can be found clinically.Combined use of MRU and ureteroscopy is helpful for definite diagnosis of the disease.Partial resection of the diseased part of the ureter has good results.

Objective To explore the clinical feature of acquired pure amegakdryocytic thrombocytopenic purpura(AATP).Methods 18 patients were analyzed retrospectively.And 112 patients with ITP in the same term were to be control group.Each group's megakaryocytic (MK),platelet (PLT) count,mean platelet volume (MPV) and platelet associated immunoglobulin G(PAIgG) were rested.Results The MK total number of AATP group was obvious decreased or even absent,while the ITP group was increased[(0.8?1.5) vs (195.0?47.3),P0.05).About the PAIgG posi- tive rate,AATP group was 55.6 % while ITP group was 83% (P

Objective To observe the control efficacy of community health education on population with metabolic syndrome (MS).Methods 56 cases of metabolic syndrome patients treated in the community were selected as the research object from June 2012 to 2013,and were randomly divided into the observation group (30 cases) and the control group (26 cases).The patients in the observation group received systematic community health education,and patients in the control group received regular treatment.The blood pressure,BMI Level,abdominal circumference,FPG level,TC,TG,LDL,HDL,2hPG,and HbAlc level of patients from both groups were compared one year later.Results Compared with the result before treatment,the abdominal circumference,blood pressure,blood glucose and lipid levels of patients in the observation group were all superior to the control group; the reasonableness for food taken was compared one year later,the observation group was also superior to the control group.Statistical significancc cxistcd in the differences between both groups.Conclusions The implementation of community health education has a positive significance in promoting the rehabilitation of people with metabolic syndrome,which is worth being promoted.

Retinal vessel is the only visible vessels in human body and systemic microvascular lesions could be evaluated by the degree of retinal vessels. ln this article, the progress of retinal vascular caliber measuring method and its influencing factors were briefly reviewed.

It has been recognized only in the past 15 years that the major pathological mechanism of asthma is inflammation, which has a hallmark of focal leukocyte extravasation. The different recruitment behaviors of inflammatory cells depend on the expression of specific adhesive molecules on both leukocytes and endothelial cells(EC). Intercellular cellular adhesion molecule-1(ICAM-1) plays a major role. In the previous detailed in-vivo study of asthmatic models, we have proved the significant pathological increase of both the leukocyte-endothelium adhesion phenomenon and the ICAM-1 expression in the tissues of asthmatic lung. It may be due to an ICAM-1 accumulation on the microvascular endothelial cells and thus an enhancement of adhesion force during the course of disease. In this study, endothelial cells were obtained from rats by mechanical isolation of lung tissues and in vitro culture on glass. Confluent endothelial cells were incubated with serum collected from rat blood of normal and asthmatic models and were used for in vitro study of endothelial cell adhesion. The effect of pathological serum stimulation was examined on the expression of ICAM-1 of the pulmonary microvascular endothelial cells (PMEC). The expression of ICAM-1 on PMEC was measured by indirect immuno-fluorescence with flow cytometry. We found that the surface expression of ICAM-1 was obviously increased on serum-incubated EC as compared with that on the culture solution-incubated one, and that asthmatic serum increased the expression of ICAM-1 on EC to a peak in 4 hours and then decreased it rapidly,the expression level remained the same in the whole course when EC was treated with culture solution or normal serum.

Adult ; Biopsy ; DNA ; genetics ; Female ; Gene Expression Profiling ; Glomerulonephritis, IGA ; genetics ; pathology ; Humans ; Kidney ; pathology ; Male ; Middle Aged ; Young Adult

Objective To retrospectively analyse the anaesthetic management of Norwood Stage Ⅰ.Methods Between June 2010 and August 2014, totally 5 small infants with HLHS underwent the standard Norwood Stage I procedure .They were all boys.Age at surgeries ranged from 29 to 75 days with median 36 days, and weight from 2.57 -3.50 kg with median of 3.13kg.The first three cases were received intravenous prostaglandin E1 before they were sent to the operation theatre and were under mechanical ventilation .They were received emergent operations because of unstable hemodynamic situation .The other two cases were relatively stable without mechanical ventilation and were received restrict surgery .All 5 cases received the stand-ard Norwood Stage Ⅰprocedure under intravenous-inhalation balance-general anaesthesia with cardiopulmonary bypass.The technique of deep hypothermia and circulatory arrest were used in all five cases .Results The fourth case died from low cardi-ac output syndrome after cardiopulmonary bypass .The other 4 cases were transferred to the paediatric intensive care unit after withdrawal from bypass.One of the four cases died after 32 h after surgery.Conclusion The standard Norwood Stage Ⅰ pro-cedure is aquite complex procedure, which demands multidisplinary cooperation, to palliatively correct HLHS.We retrospect the experiences of the anesthetic management in our centre and hope it will be helpful to decrease the mortality and morbidity in relatively short period.

Objective To introduce the technique and experience in reconstruction of posterior crueiate ligament-posterolateral comer(PCL-PLC)injuries with only one allograft of Achilles tendon. Methods The instable knees in 12 cases with PCL injury combined with three degree chronic PLC injury were treated with PCL reconstruction under arthroscope and PLC reconstruction through posterolateral arc incision.Single bundle grafts of PCL reconstructions in tibial and femoral tunnels were fixed by resorption screws.Fibular collateral ligament(FCL)and popliteofibular ligament(PFL)were reconstructed with reforming Larson(?)method.All reconstruction grafts only needed one Achilles tendon as donator.Total op- eration time was 130 minutes including 90 minutes of PCL reconstruction and 40 minutes of PLC recon- struction.Gradual weight loading was allowed after six weeks of bracing.Results Follow-up for mean 12 months(5-24 months)indicated that tibial“step off”reduction was 83%(10/12)and posterior drawer test of 0-1~+ 75%(9/12).Dial sign evaluated that normal external rotation angle was 75%(8/12).Nor- real varus stress test at 30?knee flexion accounted for 83%(10/12).Scores of Lysholm,Tegner and HSS were 90.5,5.1 and 84.5,respectively(P＜0.01=.Conclusion Synchronized reconstruction of PCL and PLC injuries with only one Achilles tendon can obtain satisfactory clinical result,with less expense and shorter operation time.

Objective To investigate the clinical distribution and antimicrobial resistance of Streptococcus agalactiae(S.agalactiae) in neonatal intensive care unit(NICU), and provide reference for antimicrobial use and intervention measures.Methods Specimens from neonates in the NICU of a hospital in 2010-2014 were collected, the department sources and antimicrobial susceptibility testing results of 62 strains of S.agalactiae isolated from children were analyzed.Results 62 strains of S.agalactiae were mainly distributed at full-term NICU, accounting for 64.52％;the main source of specimens was blood, accounting for 90.33％, followed, by cerebrospinal fluid (6.45％), sputum, and secretion(both were 1.61％).S.agalactiae had the highest resistance rate to tetracycline(79.03％);resistance rates to erythromycin and clindamycin were both 74.19％, resistance rate to levofloxacin was 40.32％, susceptibility rates to penicillin and ampicillin were both 100％.Conclusion S.agalactiae infection mainly occurred in neonates in full-term NICU, and has high resistance rate to multiple antimicrobial agents, penicillin and ampicillin can be used as the preferred antimicrobial agents for the treatment of S.agalactiae infection.