Autoimmune Diseases ; classification ; Child ; Humans ; Immune System Diseases ; classification

Objective]Help students to construct the system of TCM clinical thinking and to cultivate the ability of differential diagnosis and prescription. [Methods]In the late clinical teaching, make junior doctor with a high grade of students, graduate students, or some clinical experience as a research object, designing as a medical record has gradually evolved into a number of different medical records dynamic group, let students practice the tentacles medical records. [Results]Gradually,students learned to distinguish the different parties in the different clinical symptoms, and enhance the understanding of drugs and prescriptions. [Conclusion] The tentacles medical records practicing can cultivate the students' ability of dialectical thinking integration.

Objective:To study the relationship between genetic diversity within S.mutans and dental caries.Methods:Isolates of S.mutans were obtained from 10 caries active children and their mothers,and were originally isolated on mitis-salivarious-bacitracin agar.A total of 800 isolates were biochemically confirmed as S.mutans.Chromosomal DNA was extracted from those isolates with an extraction kit.By AP-PCR,the genetic diversities of S.mutans were examined respectively in 10 caries active children,10 caries-free children,and their mothers.DNA fingerprints were obtained by electrophoresis on 15 g/L agarose gel and analyzed for genotypics similarities.Results:The number of distinct genotypes of S.mutans harbored in caries active children were,on average,greater than that presented in children without caries(P

Objective To explore the preventive effect of early bowel intervention on the gastrointestinal dysfunction in patients with invasive mechanical ventilation.Methods Sixty patients with invasive mechanical ventilation were equally randomly divided into the observation group and the control group.patlents in the control group were treated by conventional nursing care,while Patients in the observation group were given the early bowel intervention including abdominal massage and stimulation of rectum.The two groups were compared in terms of gastrointestinal dysfunction.Result The rate of gastrointestinal dysfunction in the observation group was significantly lower than that of the control group(P<0.05).Conclusion The early bowel intervention may effectively promote intestinal peristalsis,protect the intestinal digestion, absorption of nutrients and mucosal barrier function and prevent gastrointestinal dysfunction in patients with invasive mechanical ventilation during enteral nutrition.

Objective To observe the clinical efficacy of acupuncture plus Paroxetine in treating depression due to liver-qi stagnation, for seeking a more effective treatment for this disease.Method Sixty patients with depression due to liver-qi stagnation were randomized into a treatment group and a control group, 30 cases in each group. The treatment group was intervened by acupuncture plus Paroxetine, while the control group was by Paroxetine alone, successively for 8 weeks. Hamilton Depression Scale (HAMD), Chinese medicine syndrome and sign score, and central neurotransmitters were observed before and after the treatment, for evaluating the therapeutic efficacy.Result The total effective rate was 96.6% in the treatment group versus 71.4% in the control group, and the treatment group was superior to the control group (P<0.05).Conclusion Acupuncture plus Paroxetine is an effective method in treating depression due to liver-qi stagnation.

Objective To investigate the diagnostic value of breast MRI in patients presenting with microcalcifications on mammography.Methods Eight four patients were retrospectively analyzed,who had mammographically detected BI-RADS (breast imaging reporting and data system) 3 to 5 microcalcifications and underwent breast MRI before surgical biopsy.All mammography and MR images were reviewed with BI-RADS.With histopathological diagnosis as golden standard,the sensitivity,specificity and accuracy of the two methods were calculated and compared with x2 test or Fisher exact test.The diagnostic efficacy of the two methods was compared with ROC curve.Results Pathologic examination revealed 91 lesions in 84 patients including 49 benign lesions and 42 malignant lesions.For 21 lesions of category 3 microcalcifications,the specificity of mammography and MR was 100.0％ (21/21) and 95.2％ (20/21),which had no significant difference (P=1.000).For 51 lesious of category 4,sensitivity,specificity and accuracy of mammography were 100.0％(23/23),0 and 45.1％(23/51).The corresponding values for MR were 91.3％(21/23),82.1％ (23/28) and 86.3％ (44/51).The difference for specificity and accuracy between the two methods was statistical significant(x2 value was 30.030 and 19.182,respectively,with P＜0.01),but not for sensitivity(x2=0.523,P=0.470).Nineteen lesions of category 5 were all correctly diagnosed on mammography and MRI.For all the 91 lesions,the sensitivity,specificity and accuracy of mammography were 100.0％(42/42),42.9％(21/49) and 69.2％(63/91),respectively.The corresponding values for MRI were 95.2 ％(40/42),87.8％(43/49) and 91.2％(83/91).There was significant difference for specificity and accuracy between the two methods (x2 value was 21.798 and 13.851,respectively,with P＜0.05),but not for sensitivity (x2=0.512,P=0.474).The areas under ROC curve for mammography and MR were 0.844,0.945(P＜0.01),for the estimation of the benign and the malignent.Conclusions Compared with mammography,breast MRI significantly improved the diagnosis of category 4 microcalcifications with increased specificity and accuracy.But for microcalcifications of category 3 and 5,MR didn't improve the diagnostic effect.

ObjectiveTo compare the surgical outcomes of total abdominal hysterectomy (TAH) and total vaginal hysterectomy (TVH).MethodsThe clinical data of 509 TAH cases and 799 TVH cases including operating time, bleeding volume, days being in hospital and outcome of 3 months following-up were analyzed retrospectively.ResultsThe average operating time and bleeding volume of TVH were 47.6 minutes and 199 ml respectively, less than that of TAH (128 minutes and 241 ml). The days being in hospital of TVH were also less that of TAH, and 12-Short Form Health Survey (SF-12) scores of TVH were higher than that of TAH.ConclusionTVH has minor lesion and is helpful for improving the quality of patients' life.

Objective To study the relationship between long-term high-salt water and the morbidity mechanism of chronic atrophic gastritis (CAG), The expression of HSP60 and ras protein were detected in the gastric mucosa of CAG rates induced by high-salt water.Methods The atrophic gastritis rat model was made by high-salt-hot water perfusion and the ultrastructure of gastric mucosa was observed by Laser Scanning ConfocaI Microscopy. Results There was no expression in gastric mucosa in normal group. The expression of HSP60 and ras was observed in the cell plasm of rats at 12 weeks. The higher expression was observed in the rats at 24, 32 and 65 weeks. Using laser scanning confocaI microscopy and immunofluorescence technique had observed coexistence of HSP60 and ras.Conclusion Long time high-salt-hot water can induce CAG and increasing the expression of HSP60 and ras. HSP60 and ras play an important role in the formation of atrophic gastritis.

Objective To investigate the significance of overexpression of P53 and bcl-2 protein in carcinogenesis of cervix. Methods 10 cases of cervical intraepithelial neoplasis(CIN) and 57 cases of invasive cancer were investigated with immunohistochemistry technique. Results The overexpresion of P53 protein in CIN and cervical cancer was significantly higher than that of control, respectively (P＜0.01). But there was no significant difference between CIN and cervical cancer(P＞0. 05). The immunoreactivity of bcl-2 in CIN was much more higher than that of control (P＜0.05). The positive rate and immunoreactivity of bcl-2 in cervical carcinoma were both remarkably higher than those of control (P＜0. 01) ,but there was no significant difference between CIN and cervical carcinoma (P＞0. 05). It was also found that there was a remarkably positive correlation between the overexpression of bcl-2 and P53 (P＜0.01). Conclusion Because of the loss of wtP53 function,the expression of bcl-2 can not be down-reguated,which is associated with the pathogenesis and development of cervical carcinoma.

In the ApoE(-/-) mouse model of atherosclerosis (AS) stable plaque, the expression and location of intracellular tissue factor (TF) in the cellular components of AS stable plaque were investigated in order to explore the cellular mechanism of AS thrombosis. Pathological changes of the stable plaque were observed under a microscope. The expression of TF protein was examined in aortic stable plaque of mice by using immunohistochemistry. Color image planimetric system was used to analyze the histological components of the stable plaque and the TF distribution. Under the confocal microscope, the intracellular TF location in the stable plaque of mice was observed. The results showed the cellular area was the major part of stable plaque (67.36%+/-6.52%, P<0.01). The percentage of total area occupied by cellular area was significantly larger than atheromatous gruel and acellular area (P<0.01). Macrophages and smooth muscle cells (SMC) were major cells in the cellular area. The percentage of total area occupied by SMC was significantly larger than by macrophages (P<0.01). Multiple linear regression analysis showed there was a positive correlation between TF area and SMC area (r=0.616, P=0.008), and no correlation was found between TF area and macrophage area (r=0.437, P=0.08). Pictures of color image planimetric analysis of TF and SMC were merged to highlight areas with co-localization (yellow), it was concluded that the process could be a cell-mediated TF expression in the stable plaque. SMC may be the major source of TF in AS without plaque rupture.