Problem based Learning(PBL) was applied in probation of 2001 grade with satisfactory results in clinical education of otorhinolaryngology.It could inspire students' interest,cultivate their clinical thinking,enhance their comprehensive ability,improve their synthetical ability,elevate their ability of analysis and teaching efficiency.It has significant advantages than that of traditionary teaching method(P

The essay explained the excellent ability of multimedia technique in audiology clinical education for managing the information about abstract figures,letters and so on,and expounded the multimedia technique was a kind of distinguished means about sense of sight,sound perception during synchronous audiological clinical education.The essay elucidated the multimedia technique was more intuitional and straightforward in audiology clinical education.Meanwhile,the essay analyzed limitations of the multimedia technique in audiology clinical education also,and put forward some suggestions about how to manage the relationship between content and significance,main body of clinical education and multimedia technique.

Humans ; Vertigo ; therapy

Objective To explore the clinical significance of the three indicators combined detection that plasma endotoxin,pro-calcitonin (PCT)and (1,3)-β-D-glucan(BG)in pulmonary tuberculosis patients complicated with bacterial,fungal infection.Methods Retrospective investigation was conducted in 240 pulmonary tuberculosis patients,who were divided into gram negative bacteria (G- )group(39cases),gram positive bacteria (G+ )group(45 cases)including fungal,germ-free group(156 cases).Other 45 healthy people were selected into control group.The levels of plasma endotoxin,PCT and BG in the four groups were compared.Results The levels of plasma endotoxin(0.682±0.418)EU/mL,PCT(2.93±0.87)μg/L in the G- group were significant higher than those of the G+ group (0.063±0.034)EU/mL,(0.85±0.52)μg/L,the difference was significant (P <0.05).The levels of the plasma endotoxin,PCT in the G- group were higher than those of the germ-free group.The levels of plasma endotoxin,PCT and BG in the control group had no significant difference with those of the germ-free group.Conclusion The combined detection of plasma endo-toxin,PCT and BG have some clinical value on the early diagnosis of the patients with pulmonary tuberculosis complicated with G-fungal infection for the advantages of fast and sensitiveness.

Objective To improve the cleaning quality of reusable medical instruments continuously through root cause analysis,reduce healthcare-associated infection(HAI)and the wear and tear of instruments.Methods The major factors influencing the cleaning quality of instruments were analyzed and clarified by fishbone diagram,contin-uous quality improvement was carried out based on 5 terminal factors,the rate of rusting,stain,repeated cleaning, damage,and clinical department satisfaction before and after the implementation of continuous improvement were compared.Results The qualified rate of instrument clean increased from 94.24% before implementing measures to 97.60% after implementing measures,the rate of rusting,stain,repeated cleaning,damage decreased from 3.39%, 2.37%,5.76%,and 2.08% to 1 .55%,0.85%,2.40%,and 0.48% respectively,there were significant difference among different groups(all P <0.001 );the score of satisfaction rate to central sterile supply department elevated from(93.87±3.87)before implementing measures to (98.08 ±0.59)after implementing measures(t =6.80,P <0.001).Conclusion Root cause analysis is important in improving cleaning quality of reusable instruments continu-ously,as well as reducing HAI and the wear and tear of instrument,it can save medical cost.

Objective To explore the continuous improvement to reduce the suctioning pediatrics lumen instruments return-cleaning rate of the first time washing, improve work efficiency and reduce the cost by applying root cause analysis. Methods Using causal analysis of fishbone diagram to analysis and verify the main reason of leading to high lumen instruments return-cleaning rate. According to the three terminal factors of continuous quality improvement, quality control group was set up, lumen instruments cleaning quality control standards was made, water flow mode of lumen instruments cleaning was changed, selected the appropriate cleaning tools and real picture show, synchronize quality control measures of publishing the quality and safety board. Compared before and after return-cleaning rate of three different detection methods and the different parts of the same suction lumen instruments. Results Before carrying out eye-measurement, cotton swab to wipe, ATP bioluminescence back washing rate was 0.89% (2/225), 7.11%(16/225), 27.11%(61/225), respectively after implementation of 0, 0.44%(1/226), 3.98%(9/226), visual observation before and after the return rate of washing was no statistically significant difference (χ2=2.018, P>0.05);Cotton swab to wipe, ATP bioluminescence back washing rate difference was statistically significant (χ2=13.820, 45.999, P<0.01). The lumen instruments total return-washing rate was decreased from 35.11% (79/225) to 4.42% (10/226). Among them, the return- washing rate of the inside surface of lumen instruments was decreased from 32.89% (74/225) to the 3.10% (7/226) and the difference was statistically significant(χ2=67.028, 67.915,P<0.01). By contraries, the thread interface and the outside surface of lumen instruments return- cleaning rate before and after the implementation has no statistical significance (P>0.05). Conclusions ATP bioluminescence assay has fine effects to detect the return-washing rate of the inner wall of the lumen instruments. The Root Cause Analysis method significantly reduced the return-washing rate of the inside surface of the suction lumen instruments, improve the efficiency, save the medical cost and reduce the hospital infection.

AIM: To study the effect of L-Arg on plasma content of endothelin (ET) and the expression of proto-oncogene c-fos mRNA in the left ventricle of rats with renovascular hypertensive hypertrophy. METHODS: The level of c-fos mRNA were measured by in situ hybridization. The ET in plasma were measured by radioimmunoassay. RESULTS: After eight weeks of treatment with L-Arg, the expression of c-fos decreased markedly ( P

AIM To investigate the preventive effects of taurine on the left ventricle hypertrophy in renovascular hypertensive rats. METHODS Two-kidney 1-clip (2K1C) rats were used to establish the model of renovascular hypertension. The myocardial local aldosterone(Ald) and AngⅡconcentration (MDC,MAC) were measured by radioimmunoassay. Expression of oncogene c-fos mRNA was analyzed by means of in situ hybridization. The myocardial collagen concentration (MCC) was measured by biochemical method. The myocardial tissue structure was observed under the microscope ,and the myocardial fiber diamension (MFD) was measured with micrometer. The linear correlation between MCC, MFD and MAC or MDC was analysed respectively. RESULTS Compared with sham operated rats ,the MCC, MAC, MDC and MFD were significantly increased in 2K1C rats ( P

Objective To investigate whether blocking NR2B receptor can reverse the process of cytotoxicity to spiral ganglion neurons induced by sodium salicylate in guinea pig by applying ifenprodil (a NR2B antagonist) at the round window niche .Methods Sixty healthy guinea pigs provided by the experimental animal center of Guangxi medical university were randomly and evenly divided into a control group (Group I ,no treatment) ,an APL group (Group II ,60μl APL directly applied to the round window ) ,a sodium salicylate group (Group III ,60 μl APL di-rectly applied to the round window and then be given intraperitoneal sodium salicylate injection ) ,and an ifenprodil group (Group IV ,60μl of 10μmol/l ifenprodil in APL directly applied to the round window and then be given intra-peritoneal sodium salicylate injection ) .Sodium salicylate was given at 400 mg · kg -1 · d-1 for 7 days .Auditory brainstem responses (ABRs) were recorded before animal sacrifice by decapitation .The left cochlea was removed and prepared for detection of caspase -3 expression in spiral ganglion neurons via immunohistochemistry .From each group ,6 cochleae were used to test apoptosis index in spiral ganglion neurons using the TUNEL technique .Results Before salicylate administration ,the ABR threshold was less than 40 dB SPL in all animals .After salicylate ad-ministration ,the ABR threshold was 33 .33 ± 5 .17 dB SPL in Group II ,64 .17 ± 7 .36 dB SPL in Group III and 49 .17 ± 5 .85 dB SPL in Group IV ,in contrast to 31 .67 ± 5 .16 dB SPL in Group I (controls) .The caspase -3 ex-pression was not changed obviously in Group I and Group II ,but was significantly changed in Group III and Group IV (P<0 .01) .The caspase-3 expression appeared to be decreased in Group IV compared to those in Groups III (P<0 .05) ,but still increased compared to those of in Group I and II (P<0 .05) .The apoptosis index among spiral ganglion neurons in Groups III and IV increased significantly compared to those of in Group I and II (P<0 .001) .It was however ,lower in Group IV than in Group III (P<0 .01) .Conclusion Blocking NR2B receptor with specificity can reverse the process of cytotoxicity to spiral ganglion neurons induced by sodium salicylate in guinea pig .

The paper presented the implementation of the healthcare reform policy and initial success of Xinyu TCM Hospital in its reform pilot work of public hospital reform in Xinyu city ,Jiangxi province. The authors also analyzed problems and causes of the hospital in business development and cost control during the reform ,proposing to carry out TCM development policy ,enhance government investment ,streamline TCM service pricing ,and innovate TCM supporting model. In addition ,they also proposed TCM hospitals to enhance management ,and reform their mechanism to resolve such problems as high operating costs ,and poor talent development and lack of feature disciplines .