In the course of medical education for academic degree, reforming our teaching course by trying bilingualteaching in surgery to different students is an effective way to enhance the medical staff's English level and their abilityto use English. This article has summarized the experience of our bilingual teaching from the design, preparation andimplementation of the teaching.[

Objective: To investigate the factors affecting the development of malnutrition among the elderly patients with type 2 diabetes mellitus (T2DM), so as to provide insights into the prevention of malnutrition among the elderly patients with T2DM. Methods: Elderly T2DM patients at ages of 60 years and older admitted to Hangzhou First People's Hospital affiliated to Zhejiang University School of Medicine from June 2022 to June 2023 were recruited. Patients' demographics, number of medicines administered and comorbidities were collected using questionnaire surveys, and glycosylated hemoglobin (HbA1c), serum albumin (ALB) and hemoglobin levels were collected from medical records. The nutrition status was assessed with the new version of the Mini Nutritional Assessment Short Form (MNA-SF). Factors affecting the development of malnutrition were among the elderly T2DM patients identified using a multivariable logistic regression model. Results: A total of 382 elderly T2DM patients were enrolled, including 226 men (59.16%) and 156 women (40.84%) and with a mean age of (70.06±8.41) years. The prevalence of malnutrition was 22.25% among participants. Multivariable logistic regression analysis identified age (70 to 79 years, OR=1.261, 95%CI: 1.007-1.158; 80 years and older, OR=3.285, 95%CI: 1.618-6.662), three and more types of comorbidities (OR=2.790, 95%CI: 1.254-5.191), use of multiple medicines (OR=3.501, 95%CI: 1.841-6.658), sleep disorders (OR=1.613, 95%CI: 1.120-2.322), regular exercises (OR=0.280, 95%CI: 0.115-0.614), serum ALB of 35 g/L and greater (OR=0.272, 95%CI: 0.102-0.560) and HbA1c of 7% and higher (OR=2.914, 95%CI: 1.445-5.881) as factors affecting the development of malnutrition among elderly patients with T2DM. Conclusions The risk of malnutrition is associated with age, types of comorbidities, use of multiple medicines, sleep disorders, regular exercise, HbA1c and ALB among the elderly patients with T2DM. Periodical nutrition screening and intensified health education are recommended for T2DM patients.

We defined the prerequisite managing capacity of hospital directors through a comprehensive set of methods including literature review, interview of specialists and questionnaires. There were altogether 7 assessment items with 36 assessment indexes. The acquired assessment items and indexes were edited as Likert Scales and as signed to extprts concerned. The weight ofthe assessment indexes was obtained through a statistical analysis of the results. Hence the pre iluninary establishment of the system of standards for assessing the managing capacity of hospital directors.

Objective To explore a proper method of treating and nursing glaucoma patients,Which may protect the patients’ visual function. Methods 173 patients with glaucoma were synthesized assessed according to the different glaucoma types ,developing Phases and patient compliance ,Every patient received proper psychological nursing , observation and for patients that have postoperative adverse effect special nursing was given. Results All the patients are in a stable situation with controlled intraocular pressure. The effect of therapy is satisfied without any serous complication or adverse reaction.Conclusion Series treatment and effective nursing decrease the incidence of adverse reaction of glaucoma and improve the treatment effect.

Objective To study the EEG discharge index, intelligence test and event-related potential P300 in BECT, and to analyze the change of EEG discharge index and cognitive function before and after the treatment.Methods Sixty patients with BECT were enrolled in this study, they were treated with EEG, intelligence tests and P300 before and after the treatment.Results (1) The EEG discharge index were reduced remarkly after treatment in BECT with levetiracetam and lamotrigine, the difference was statistically significant (P ＜ 0.05).(2) Comparing before and after 3 or 6 months treatment, the latency of P300 had reduced with significant difference (P ＜ 0.05).(3) After 3 months treatment, VIQ and FIQ has no obvious improvement, but PIQ has improved.After 6 months treatment, VIQ、 PIQ and FIQ were improved.The difference was statistically significant (P ＜ 0.05).(4) There was a negative correlation of EEG P300 latency (r =0.175), as well as there was a negative correlation between EEG discharge index and intelligence test (r =0.044).Conclusion There is impaired cognitive function in BECT, especially the more frequently the EEG discharge, the more extended of P300 latency, as well as the more serious damage of intelligence and cognition after treatment.The intelligence were improved after treatment with Levetiracetam and lamotrigine, the longer the treatment time, the more obvious of intelligence levels improve.

Objective To estimate the immune function changes of zonisamide treatment as a new antiepileptic drug monotherapy on epileptic children.Methods Forty children with epilepsy (25 girls and 15 boys,aged from 1 to 6 years old) were enrolled in the Children' s Hospital of Hebei Province as our subjects and they were followed 3 and 6 months after treatment.The venous blood sample was collected respectively from the children on empty stomach.Applying automatic biochemical analyzer to detect serum immunoglobulin.IgG,IgA,IgM through immune turbidimetry methods.While CD3,CD4,CD8 were detected through the application of flow cytometry.Results Compared with the healthy control group,IgA,IgG,CD8 levels increased and the level of CD3,CD4 decreased in epileptic children and there were significant differences (F=160.94,262.66,539.09,634.36,164.27;P＜0.05).The level of IgM between epilepsy group and control group did not showed difference (P＞0.05).After 3 months and 6 months treatment of zonisamide,the level of IgA,IgG,CD8 were decreased,while CD3,CD4 levels increased than those in epilepsy group before treatment (P＜ 0.05).Conclusion Zonisamide may play a role of the antiepileptic mechanism by improving children' s immune function.

Objective The continuous nursing model was introduced into nursing of type 2 diabetes mellitus in order to improve the self-management ability and behavior.Methods One hundred and fifty eight patients with type 2 diabetes mellitus in endocrine department of our hospital from January to December 2013 were selected and divided into the control group and experimental group randomly.There were 79 patients in the control group,5 patients were lost to follow-up and 79 patients in the experimental group,4 patients were lost to follow-up.Traditional nursing were only done in the control group,while continuous nursing model was adopted in the experimental group.The self management ability and behavior were compared between two groups of patients.Results By took the continuous nursing model in our hospital,diet control,sports management,blood glucose monitoring,medication management compliance in the experimental group were better than those of the control group patients,x2 values were 9.86,9.37,10.12 and 17.52.The ratio of patients with better self-management behavior in diet control,sports management,medication management and blood glucose control had significant difference compared with those of the control group,x2 values were 9.497,10.285,10.016 and 13.513.Conclusions The self-management ability and behavior of type 2 diabetes mellitus patients were improved by continuous nursing model.

Breast cancer,with a high incidence rate,is one of the malignant cancers that threatens women health.Clinically,methods such as image examinations,needle aspiration cytology and pathology are used in its early diagnosis and treatment.However,the genetic heterogeneity of breast cancer has made patients in the same pathological stage respond differently to clinical treatment.So it ia important to formulate a molecular and genetictyping method which can accurately reflect the clinical types and prognoses of breast cancer.This paper reviews the research on gene chips applied to molecular and genetic typing methods of breast cancer and also discusses their applications in individualized treatment.typing method which can accurately reflect the clinical types and prognoses of breast cancer.This paper reviews the research on gene chips applied to molecular and genetic typing methods of breast cancer and also discusses their applications in individualized treatment.

10.3969/j.issn.1000-3606.2013.06.015

This paper presented the hereditary pattern of otosclerosis in families. Among 1500 cases there were 13 patients, belonging to 6 families, and 20 ears were surgically treated. There was often a marked similarity in clinical features of affected siblings within the same family.The clinical characteristics are as following: (1) The age at inset of hearing loss seems similar. There is a difference of 1 or 2 years in two families znc 3 to 10 years in the other four. (2) The side of first hearing loss is the same in affected individuals of 6 families. (3) The propositi are females in 5 families (83.3%). (4) Auditory curve of hearing loss is similar in 4 familiers, and different in the other two. (5) The footplate lesions are similar in macroscopic features, thin footplate in two fimalies and thick footplate in the other four.