Clinical teaching effect is directly affected by internship tutors’quality which is not very good at present. For this reason,a questionnaire on teachers and students was made and several solutions were put forward by analysis on the survey results.

Objective To evaluate HRCT typing of solitary pulmonary nodule with resected.Methods 30 cases with solitary plumonary nodules (totally 41) were undergone CT and HRCT scan befor operation.HRCT appearances were retrospectively analyzed and categorized into two types: typeⅠ ground-glass opacity (pure ground-glass opacity, mixed lower opacity, central high opacity with ground opacity ), typeⅡ pure solid opacity.Results TypeⅠ:14 nodules included bronchioloalveolar cell carcinoma (9 nodules) , adenocarcinoma (3 nodules),inflammatory granuloma (1 nodule) and adenoma (1 nodule).TypeⅡ : 27 nodules included adenocarcinoma(13 nodules),bronchioloalveolar cell carcinoma(4 nodules), squamous cell carcinoma(3 nodules),small cell lung cancer(1 nodule),adenoma(2 nodules),tuberculosis(2 nodules), inflammatory granuloma(1 nodule) and hamartoma(1 nodule). Among nodules with resected, ground-glass opacity was found more frequently in bronchioloalveolar cell carcinoma than in non- bronchioloalveolar cell carcinoma (P=0.002).No significant difference in ground-glass opacity existed between tumor lesions and non-tumor lesions (P=0.282) or adenocarcinoma and non-adenocarcinoma (P=0.146).Conclusion In the findings of HRCT in solitary pulmonary nodules,the nodules of ground-glass opacity find more frequently in bronchioloalveolar cell carcinoma than that in other lesions.

Objective To compare the effects of different antiplatelet therapy on outcomes in patients with acute coronary syndrome (ACS). Methods 338 hospitalized patients with ACS were enrolled. They were assigned to three groups: group 1, aspirin alone after discharge, n=93; group 2, dual antiplatelet treatment of aspirin and clopidogrel after discharge for 6～12 months, then aspirin, n=127; and group 3, dual antiplatelet treatment of aspirin and clopidogrel after discharge for 2 years, n=118. All the patients were followed up for 2 years. The clinical data (basic clinical data, platelet count and serum lipids indeices), primary end point (cardiovascular death, nonfatal myocardial infarction and stroke) and hemorrhagic events (major hemorrhage, moderate hemorrhage and minor hemorrhage) within 1 and 2 years were analyzed. Results During 1 and 2 years, compared with group 1, the incidence of cardiovascular death and all primary end points of groups 2 and 3 decreased significantly (P＜0.05), but the nonfatal myocardial infarction and stroke did not （P＞0.05）. The difference was not statistically significant between groups 2 and 3 in all the end points （P＞0.05）. The difference of hemorrhagic events was not statistically significant among the 3 groups（P＞0.05）. Conclusion Dual antiplatelet treatment of clopidogrel plus aspirin for 2 years may decrease the mortality of cardiovascular disease while the incidence of severe hemorrhage doesn't increase.

Animals ; Humans ; Vaccines, Virus-Like Particle ; genetics ; immunology ; Viral Vaccines ; genetics ; immunology ; Virus Diseases ; immunology ; prevention & control ; virology

Ergonomics ; Humans ; Lifting ; National Institute for Occupational Safety and Health (U.S.) ; Occupational Health ; United States

Objective To assess the effects of dynamic monitoring of plasma Pro-B-type Natriuretic Peptide(Pro-BNP) in the evaluation of prognostic value and myocardial dysfunction in patients with septic shock.Methods The levels of plasma Pro-BNP were tested in 102 patients with septic shock on the 1,3,and 5 days.Data on ICU mortality and 28-day mortality were collected.The patients were divided into non-dysfunction group (CI＜3.0) and cardiac dysfunction group (CI≥3.0) according to levels of hemodynamic variables ( CI level).The prognostic value of plasma Pro-BNP was analyzed.Results Plasma Pro-BNP levels on the 1,3 and 5 days in 28-day survivors have a significant declining trend [( 1649.0 ± 257.5 ) ng/L,( 1867.6 ± 291.7 ) ng/L vs.(1229.9 ± 194.5) ng/L),while plasma Pro-BNP levels in non-survivors have an increasing trend [(4128.8 ± 1051.1),( 5315.9 ± 925.4 ) vs.( 6899.9 ± 1327.9 ) ng/L].There is statistical significance of plasma Pro-BNP levels at day 1,3 and 5 for the two groups ( t=3.057,5.083,and 6.290 respectively,P＜0.01 ).The 28-day mortality and Plasma Pro-BNP levels in cardiac dysfunction group were higher than of non-dysfunction group ( 28-day mortality:62.1％ vs.20.0％;Pro-BNP1:( 1592.8 ± 362.2 )ng/L vs.( 4556.6 ±732.7 ) ng/L;Pro-BNP3:( 2933.6 ± 421.7 ) vs.( 5768.5 ± 793.7 ) ng/L,Pro-BNP5:( 3014.5 ± 587.5 ) ng/L vs.(8873.9 ± 1670.1) ng/L ( x2=20.635,P=0.000,t=3.626,3.154,3.310,P＜0.01].Pro-BNP level greater than 3053 ng/L on the 5-day was an independent prognostic indicator of 28-day mortality ( sensitivity:88.4％;specificity:91.5 ％ ).Pro-BNP level greater than 2378 ng/L on the 5-day was an independent prognostic indicator of hospital mortality ( sensitivity:84.9％;specificity:91.8％ ).In multivariate logistic regression analyses,Pro-BNP level and APACHE score were independent predictors of 28-day mortality and hospital mortality.Conclusion Plasma Pro-BNP level shows obvious significance in evaluation of sepsis-induced myocardial depression severity in patients with septic shock.Pro-BNP level in ICU at day 5 after inclusion is an independent prognostic marker of mortality in septic shock.

Objective To design and develop a kind of venipuncture auxiliary device to use in the absence of light condition or patients with poor vein condition, and validate its clinical effect. Methods A total of 70 patients with shock were divided into experimental group (venipuncture auxiliary device group with 37 cases) and control group (non-device group with 42 cases) by random digits table method. The one-time puncture success rate and operating time were compared between two groups. Results The one-time puncture success rate was 94.59%(35/37) in experimental group and 78.57%(33/42) in control group, and there was significant difference, χ2=4.214, P<0.05. The time of establishing a single vein passage was (73.63±29.35) s in experimental group and (107.61±45.94) s in control group, and there was significant difference, t=3.656, P<0.05. Conclusions The device is small in size, low cost, easy to carry, the screen is clear, is a rapid infusion with explore vascular equipment. It can guide nurses accurately on vascular puncture, fast, smooth and effective transfusion puncture process.

Objective To discuss the MRI features and its clinical significance of bone contusion in knee joint.Methods MR images of injuries of knee in 40 cases were retrospectively analyzed,the complications were reviewed simultaneously.Results 69 lesions of bone contusion in 40 cases were discovered,of them,Ⅰ type was in 38 and Ⅱ type was in 31, in company with fractures were 24 in 22 cases and ligament injury was in 33 cases.Conclusion The present of bone contusion is prompt to the bone injuries,MRI is of significant value in showing bone contusion and its complications in knee.

In this case-control study, the effect of insulin sensitivity on the genesis of cholesterol gallstones was not affirmed. However, raised 2h insulin level during glucose tolerance test and systolic blood pressure were risk factors in gallstone formation. Besides, less physical activity, lower serum total cholesterol and lower HDL-C concentration were found in patients with cholesterol gallstone.

Objective To investigate the effect of high pressure distention on the expression of stenosis-related genes of saphenous vein graft(SVG) during the coronary artery bypass grafting(CABG).Methods The biopsy specimens of saphenous vein collected from 10 patients who have undergone CABG,were divided into expansion group and no-expansion group.Real-time PCR and immunohistochemical staining were performed for examination of mRNA and protein expression of VE-cad,Egr-1,VCAN respectively.Student's t and Chi-square test were used to do statistic analysis.Results The results of RT-PCR showed that the mRNA transcription of Egr-1,VCAN in the expansion group were statistically significantly higher than those in no-expansion group(P<0.05).The mRNA transcription VE-cad in expansion group was statistically significantly lower than that in the no-expansion group(P<0.05).The immunohistochemical staining results showed that the expression of Egr-1 and VCAN in expansion group were significantly stronger than those in no-expansion group,while the expression of VE-cad was significantly lower than no-expansion group.Conclusion The intraoperative expansion of SVG can increase the expression of stenosis-related genes Egr-1 and Versican,and decrease the expression of stenosis-related gene VE-cad,which may be related with the SVG stenosis after CABG.