Objective To assess the applicative effect of the flipped classroom in nutrition and food hygiene. Methods 48 students of Class One from Grade 2011 majoring in preventive medicine were taken as the TBL group, with 49 students of Class Two as the flipped classroom group. The TBL group used TBL and the formative assessment, while the flipped classroom group used the flipped classroom and the forma-tive assessment. The teaching effect was evaluated through the unified examination and teaching satisfaction questionnaire survey. SPSS 17.0 statistical software was used for the data t test between the groups, and Wilcoxon test, chi square test were used for the linear correlation analysis of the usual grade and final grade of the flipped classroom group. Results The experimental scores (9.21 ±1.14) and the final scores (66.76±4.53) of the flipped classroom group students were significantly higher than the experimental scores (8.31±1.01) and final scores (61.31±4.37) of the TBL group and the difference was statistically significant (t=4.50, P=0.004; t=5.45, P=0.003). The excellent distribution of the flipped classroom group's overall results were higher than that of the TBL group (u=21.36, P=0.002). The usual scores and the final scores were positively correlated (r=0.960, P=0.000) in the flipped classroom group. The results of the question-naire showed that the flipped classroom group students' satisfaction with the positive impact the teaching methods had on all aspects of their own was higher than that of TBL group (P<0.05). Conclusion The flipped classroom teaching can help improve the students' learning enthusiasm, thinking activity and com-municative competence.

Objective To elucidate the effects of different modes of partial parenteral nutrition (PPN)on immunological function of T-lymphocyte in non small cell lung cancer(NSCLC)patients during chemotherapy.Methods Ninety-three patients with non-small cell lung cancer were randomly divided into three groups:the control group(30 patients),the low dose of PPN(32 patients) and the high dose of NNP(31 patients).Exactly the same chemotherapy was applied to each of three groups.During chemotherapy,three groups were supplied the same diet,the control group received conventional treatment;the low dose group and the high dose group received additional parenteral nutritional support besides diet.The low dose group was given 250 ml 9-AA daily and the high dose group was given 500 ml 9-AA daily.The T lymphocyte subsets CD3~+,CD3~++CD4~+ ,CD3~++CD8~+ and cells were detected respectively before and after chemotherapy.Results In all of the three groups,the percentage of NK cells,CD3~+ and CD3~++CD4~+ cells were decreased significantly before and after chemotherapy(all P＜0.05),In the control and low dose groups,NK cells changed more significantly after chemotherapy(P＜0.01).The percentages of CD3~+,CD3~++CD4~+,CD3~++ CD4~+/CD3~++CD8~+ of the low dose group and high dose group were higher than those of the control group before and after chemotherapy(all P＜0.05),the percentage of CD3~++CD8~+,CD3~++CD4~+/ CD3~++CD8~+ of the low dose group and hight dose group did not change notably(all P＞0.05). Conclusions The chemotherapy on patients with NSCLC will possibly cause malnutrition and immunosuppression.The benefits of giving 9-AA to NSCLC patients who were applying PPN and undergoing chemotherapy may include antagonizing immunological function aggravation,improving nutrition status and improving immunological functions of the T lymphocytes during chemotherapy.

The paper analyzes the difficulties in reading promotion of libraries of medical colleges,states the countermeasures,and indicates that libraries of medical colleges shall perfect the reading promotion system,improve the reading promotion mechanism,set up the reading promotion department,innovate the reading promotion activity mode,enrich featured medical reading promotion activities,and construct the reading culture for medical students.

Objective The 4-and 16-hydroxylated metabolites of estrogens have been implicated in carcinogenesis,whereas its 2-hydroxylated metabolites have been shown to have antiangiogenic effects.We aimed to examine whether the polymorphisms of catechol-O-methyltransferase(COMT)involved in the estrogen metabolism are associated with endometrial cancer risk.Methods Polymerase chain reaction- restrictive fragment length polymorphism(PCR-RFLP)analysis was used to study the variant allele frequency distributions of COMT Val158Met genetic polymorphism in a population based case-control study with 132 endometrial cancer cases and 110 controls.Odds ratios(OR)and 95% confidence intervals(CI) were estimated by unconditional logistic regression after adjustment for known or suspected risk factors for endometrial cancer.Results The most frequent genotype was COMT~(Val/Val)(47.2%,52/110)in control group and COMT~(Mal/Met)(58.3%,77/132)in endometrial cancer group.The difference between the two groups was of statistical significance(P

Background The usual transbronchial coagulation techniques include microwave,argon plasma coagulation (APC),electrocautery and cryotherapy.However,there are serious clinical problems in the safety of each.By analyzing the experimental data and clinical observations,we observed the variable effects of different coagulation techniques via bronchofibroscopy,to look for an optimal interventional management of luminal bronchus diseases,and evaluate the safety and the equivalent point.Methods Four kinds of coagulation techniques under bronchoscopy were performed on the fresh bronchus of healthy sheep,and the pathologic changes in all groups were observed under the microscope.The different treatment parameters were as follows:microwave 60 W×1 second,3 seconds,5 seconds and 40 W×1 second,3 seconds,5 seconds; APC 40 W×1 second,3 seconds,5 seconds; electrocautery 40 W×1 second,3 seconds,5 seconds;cryotherapy 100 Ω×60 seconds,120 seconds.Results After treatment,ovine bronchial mucosa in all groups showed pathologic changes such as local necrosis and amotio of the mucosa lining epithelium,local submucosa coagulative necrosis or tissue defects,while inflammation in the surrounding tissue was not obvious.Under the same output power and action time,different methods had different outcomes.The damage by APC was the most superficial,microwave was the second,and electrocautery caused the worst damage.The study also found that effects of electrocautery at 40 W×3 seconds,microwave at 40 W×5 seconds or 60 W×3 seconds,APC at 40 W×5 seconds and cryotherapy at 100 Ω×120 seconds were the equivalent point conditions.The appearance included mucosa absence,partial submucosa absence,and collagen fiber coagulation in treatment areas.Conclusions Each coagulation technique has its own characteristic.It is very important to choose the appropriate power and action time of the suitable method according to the therapy requirement.

OBJECTIVETo review the literature on the clinical progress in cauda equina syndrome (CES), including the epidemic history, pathogenesis, diagnosis, treatment policy and prognosis. Data sources All reports on CES in the literature were searched in PubMed, Ovid, Springer, Elsevier, and the Chinese Biomedical Literature Disk using the key terms "cauda equina syndrome", "diagnosis", "treatment", "prognosis" and "evidence-based medicine". Study selection Original milestone articles and critical reviews written by major pioneer investigators about the cauda equina syndrome were selected.

RESULTSCES is rare, both atraumatically and traumatically. Males and females are equally affected. The incidence of CES is variable, depending on the etiology of the syndrome. The most common cause of CES is herniation of a lumbar intervertebral disc. CES symptoms may have sudden onset and evolve rapidly or sometimes chronic ally. Each type of CES has different typical signs and symptoms. Low back pain may be the most significant symptoms, accompanied by sciatica, lower extremities weakness, saddle or perianal hypoesthesia, sexual impotence, and sphincter dysfunction. MRI is usually the preferred investigation approach. Patients who have had CES are difficult to return to a normal status.

CONCLUSIONSThe diagnosis of CES is primarily based on a careful history inquiry and clinical examination, assisted by elective radiologic investigations. Early diagnosis and early surgical decompression are crucial for a favorable outcome in most CES cases.

Evidence-Based Medicine ; methods ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Polyradiculopathy ; diagnosis ; etiology ; pathology

OBJECTIVETo investigate the effect of amino acid parenteral nutritional (PN) support on serum tryptophan and melatonin in non-small cell lung cancer (NSCLC) patients receiving chemotherapy.

METHODSSeventy-two patients with inoperable NSCLC were divided into three groups randomly: control group, 250 ml/d amino acids PN therapy group and 500 ml/d amino acids PN therapy group. The same NP (cisplatin + vinorelbine) chemotherapy was carried out in all the three groups. During three sessions of chemotherapy,amino acids PN therapy was given to the amino acids PN therapy groups. Serum tryptophan and melatonin concentration changes were assessed before and after chemotherapy.

RESULTSAfter chemotherapy the concentration of MT and Try were much lower than that before chemotherapy in the three group patients (P < 0.05). But the concentration of MT and Try in the PN group patients was higher than that in control group patients. The concentration of MT and Try in the 500 ml/d amino acid parenteral nutritional support group patients were significantly higher than that in the 250 ml/d group patients, the difference was significant (P < 0.05).

CONCLUSIONAmino acid parenteral nutritional support is beneficial to improve the lower concentration of serum MT and Try in NSCLC patients receiving chemotherapy, and a more significant effect can be achieved by the 500 ml/d amino acid parenteral nutritional support treatment.

Aged ; Amino Acids ; administration & dosage ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma, Non-Small-Cell Lung ; blood ; drug therapy ; therapy ; Cisplatin ; administration & dosage ; Female ; Humans ; Lung Neoplasms ; drug therapy ; pathology ; therapy ; Male ; Melatonin ; blood ; Neoplasm Staging ; Parenteral Nutrition ; Treatment Outcome ; Tryptophan ; blood ; Vinblastine ; administration & dosage ; analogs & derivatives

OBJECTIVETo investigate the effect of operative treatment of scapular fractures through modified Judet approach.

METHODSFrom January 1997 to October 2005, 21 patients (15 females, 6 males; mean age 34 years) of scapular fractures were treated by open reduction and internal fixation through the modified Judet approach. According to Hardegger classification system, there were 11 patients of scapular body fractures, 10 patients of scapular neck fractures, 8 patients of glenoid rim fractures, 7 patients of glenoid fossa fractures, 9 patients of scapular spine fractures, and 6 patients of scapular acromion fractures.

RESULTSEighteen patients were followed up with an average of 21 months (range 6 months-4 years). According to Rowe scores system, 12 patients showed excellent, 3 showed good, 2 showed fair, and 1 showed poor.

CONCLUSIONSThe modified Judet approaches have the advantages of wide exploration, safety, and easy fixation. It is a good choice to the operation for most types of scapular fractures through the modified Judet approach.

Adolescent ; Adult ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; Fractures, Bone ; surgery ; Humans ; Male ; Middle Aged ; Scapula ; injuries ; Treatment Outcome

Objective To explore the causes,clinical manifestation and therapy of frontal sinusitis after transfrontal craniotomy.Methods Thirty-three patients with frontal sinusitis after transfrontal craniotomy were included in the study.Among them,7 cases had frontal sinus abscess and 4 cases had frontal sinus fistula.Twenty-three patients were treated with traditional frontal sinus surgery with facial incision.The nasofrontal dilatation tube was positioned for more than 3 months.Nine patients were treated with endoscopic frontal sinus surgery,and 1 patient was treated with combined endoscopic and traditional frontal sinus surgery,with nasofrontal dilatation tube positioned for less then 1 month.In the revision surgery,the bone wax and phlogistic acestoma were cleaned out in both operational methods.The causes of frontal sinusitis after transfrontal craniotomy were discussed by studying the frontal sinus CT image,and prior surgical data.Results All patients were followed up for more than 6 months after the nasofrontal dilatational tube was removed.Among 33 patients,two cases with traditional frontal sinus surgery were operated twice due to nasofrontal dilatation tube fall off in 1 month.In all 33 patients,30 cases cured and 3 cases got better.There were no curative difference between two operational methods.Conclusions The causes of frontal sinusitis after transfrontal craniotomy were inadequate sinus management in craniotomy and bone wax tamping in frontal sinus.There was more frontal sinus abscess and fistula occurring in frontal sinusitis after transffontal craniotomy than that in ordinary frontal sinusitis.The therapy included cleaning out bone wax and phlogistic acestoma,and expanding the frontal sinus ostium.The satisfying curative effect was obtained in both operational methods,but endoscopic frontal sinus surgery Was better because it is minimally invasive,no facial incision and quick recovery with less nasofrontal dilatational tube posting time.

BACKGROUNDDue to the controversy of the oral glucose tolerance test (OGTT), diagnostic criteria for gestational diabetes mellitus (GDM) in the world and researches on GDM remain undeveloped in China. American Diabetes Association recently recommended the clinicians to diagnose GDM by OGTT results without the third-hour glucose value. This new criteria has not been used in China. Research on the value and sensitivity of the criteria in detecting GDM is rare. The aim of our study is to analyze the characteristics of OGTT in Chinese women with GDM or gestational impaired glucose tolerance (GIGT) and to evaluate the effect of omission of the third-hour plasma glucose (PG) level in OGTT on the sensitivity of diagnosing GDM and GIGT, and the relationship between PG values of 50 g GCT or OGTT and insulin therapy.

METHODSA retrospective analysis was performed on medical records of 647 cases with GDM from January 1, 1989 to December 31, 2002, and 233 with GIGT. Among 647 cases of GDM, 535 cases were diagnosed by 75 g OGTT. All OGTT results including 535 cases of GDM and 233 patients with GIGT were evaluated.

RESULTSThere were 112 cases of GDM diagnosed by elevated fasting PG (FPG) without OGTT performed. Of 535 cases of GDM diagnosed by OGTT, 49.2% (263/535) women had FPG value >/= 5.8 mmol/L; 90.1% (482/535) women with 1-hour PG values >/= 10.6 mmol/L; 64.7% (359/535) with 2-hour PG levels >/= 9.2 mmol/L. There were only 114 cases (21.3%) with abnormal 3-hour PG levels among 535 women with OGTT. Among those with abnormal 3-hour PG level, 49.1% (56/114) had abnormal glucose values in the other three points of OGTT, and 34.2% (39/114) with two other abnormal values of OGTT. Our study showed that omission of the 3-hour PG of OGTT only missed 19 cases of GDM and they would be diagnosed as GIGT. Among the 233 women with GIGT, only 4 cases had abnormal 3-hour PG. So, omission of the third-hour glucose value of OGTT only resulted in failure to diagnose 3.6% (19/535) women with GDM diagnosed by OGTT, which means 2.9% (19/647) of all the GDM and 1.7% (4/233) of GIGT in Chinese women. PG levels >/= 11.2 mmol/L following 50 g GCT was highly associated with GDM necessitating insulin therapy (75.4%). An elevated FPG level was also associated with insulin therapy (59.7%).

CONCLUSIONSOmission of the third-hour glucose tolerance test value still yield a higher sensitivity in diagnosing GDM and GIGT. In Chinese women, it is practicable to omit third-hour post-glucose ingestion value of the OGTT in Chinese women. PG levels >/= 11.2 mmol/L following 50 g GCT mostly indicates that the requirement of insulin therapy.

Blood Glucose ; metabolism ; Diabetes, Gestational ; diagnosis ; epidemiology ; metabolism ; Female ; Glucose Tolerance Test ; Humans ; Incidence ; Pregnancy ; metabolism ; Retrospective Studies