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.

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

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.

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 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 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

OBJECTIVETo study the effects of Erlong Zuoci Pill (, ELZCP) and its disassembled: prescriptions on gentamicin (GM)-induced ototoxicity model in vitro.

METHODSAfter the spiral organ of cochleae: of newborn mice (postnatal days: 2-3) cultured for 24 h, GM alone or combined with water extracting-alcohol precipitating solution of ELZCP or with its disassembled prescriptions was added. Hair cells were observed under a fluorescence microscope after TRITC-phalloidin staining, and the cochlear hair cell loss rate was calculated by counting the whole cochlear hair cells and analyzed by whole cochlear hair cells analyzing software.

RESULTSGM induced cochlear outer hair cells (OHCs) and inner hair cells (IHCs) injuries in a dose-dependent manner, and they were significantly different as compared with those in the normal control group (P<0.05, P<0.01). ELZCP at the concentration of 0.003-3 mg/mL could decrease the hair cells loss induced by the 0.3 mmol/L GM (P<0.05, P<0.01), the effects was in a dose-dependent manner, and the concentration of 0.3 mg/mL showed the optimal protective effect. For the ELZCP disassembled prescriptions, Liuwei-Dihuang could decrease OHC loss rate than that in the 0.3 mmol/L GM model group (P<0.05), but the OHC loss rate was still higher than that in the ELZCP group (P<0.01), which indicated that the protective effect of hair cells by Liuwei-Dihuang was not better than that of ELZCP. Poria decreased OHC loss rate from 72.1 % +/-3.7 % to 58.8 %+/- 8.2 % (P<0.05).

CONCLUSIONSELZCP could play a role in antagonizing the injury of cochlear hair cells induced by GM ototoxicity,: and its disassembled prescriptions, Liuwei-Dihuang was the main component to protect the cochlear hair cells from GM-induced ototoxicity, and Magnetitum combined with Radix Bupleurui could strengthen the action of the whole prescription; Poria could reduce GM-induced OHC loss.

Animals ; Dose-Response Relationship, Drug ; Drugs, Chinese Herbal ; pharmacology ; Gentamicins ; toxicity ; Hair Cells, Auditory, Inner ; drug effects ; pathology ; Hair Cells, Auditory, Outer ; drug effects ; pathology ; Mice ; Organ of Corti ; drug effects ; pathology ; Prescriptions ; Tablets

Animals ; Extremities ; blood supply ; Heparin ; pharmacology ; Male ; Mesentery ; blood supply ; Microcirculation ; drug effects ; Rats ; Rats, Wistar ; Reperfusion Injury ; Splanchnic Circulation ; drug effects

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