To evaluate the effect of problem-based learning (PBL) in internal medicine teaching for residency training of general medicine.Fifty two residents of general medicine were divided randomly into PBL teaching and traditional teaching groups with 26 in each.The evaluation was conducted in combination of examination scores and questionnaire survey in both groups.In questionnaire survey the residents of PBL group responded positively about the use of PBL in teaching, and rated themselves as having much better competencies in problem solving and self-directed learning.The scores of case analysis examination in PBL group were higher than those in traditional teaching group ( 73.7 ± 4.1 vs.71.1 ± 4.8, P ＜ 0.05 ).The results suggest that the application of PBL has better effect than traditional teaching in residency training of general medicine.

Objective　To evaluate the role of transvaginal sonography in diagnosing the normal cervix and its benign lesions.Methods　The one handred and thirty-eight women without malignant findings by colposcopy examination underwent transvaginal sonography within 2 weeks before hyterectomy. The sonography findings were compared with the pathology report.Results　Cervical cysts(39 cases) were the most common sonography findings. In 17 cases, endocervical polyps were found sonographically,in 14 cases, myomas were found,and in 27 cases cervicitis were found. The cervix showed no sonographic abnormal in 41. Pathologic results showed 42 cervical cysts, 14 cervical polyps, 16 myomas, 17 cervicitis and 49 normal cervices.Conclusions　The sensitivity and specificity of transviginal sonography are high in diagnosing normal cervices and benign cervical lessions. Transviginal sonography provides reliable diagnosing information about the cervix for clinic.

AIM: To investigate the effect of exercise training(EX) on the arterial baroreflex and possible mechanisms in rats with chronic heart failure(CHF).METHODS: Experiments were carried out in four groups: EX-CHF,CHF,EX-sham,and sham. CHF was induced by left coronary artery ligation,and EX consisted of 4 weeks of treadmill running. Baroreflex function,plasma angiotensin II(Ang II) and central AT1 receptor expression were determined.RESULTS: (1) The average slope and maximal gain of the baroreflex curve in CHF rats were lower than those in sham rats(P<0.01). EX significantly enhanced baroreflex parameters in CHF group but not in sham group.(2) EX decreased plasma Ang II in CHF rats ［(137±27)ng/L vs (263±55)ng/L,P<0.01］,but had no significant effect on plasma Ang II in sham rats ［(75±17)ng/L vs (92±21)ng/L］.(3) Expression of AT1R protein in the PVN of CHF rats was higher than that in sham rats(1.20±0.21 vs 0.70±0.14,P<0.01). EX reduced AT1R protein level in CHF rats(0.90±0.13),but had no impact in sham rats(0.60±0.16).CONCLUSION: EX restores the attenuated arterial baroreflex function in CHF rats,involving in decrease of plasma Ang II and downregulation of AT1R in the PVN.

BACKGROUND: Researches suggest that ginseng saponin (GS) has protective effect on central nerve, but the effect on spinal nerves is reported rarely.OBJECTIVE: To investigate the relationship between effect of GS on spinal nerve and level of nitrogen monoxide (NO) and its mechanism.DESIGN: Randomized controlled animal study.SETTING: Military Hyperbaric Oxygen Center of Navy General Hospital of Chinese PLA.MATERIALS: The experiment was completed at Clinical Anatomy Institute (National Key Laboratory) of the First Military Medical University of Chinese PLA in 2000. Forty SD foetus rats with 15-day conception were selected.METHODS: Study Ⅰ: Embryo-spinal nerve cells of SD rats were separated, extracted and modeled with DMEM/F12 culture medium. On the fourth day of inoculated culture, axon of spinal nerve (simulation of peripheral nerve injury) was damaged with scarification method in injury group, but that in non-injury group was not treated. 150 μL cell culture medium and 100 mg/L Griess solution were mixed at 0, 0.5 1, 1.5, 2, 2.5, and 3 hours after injury respectively. Absorbency (A) was assayed with Σ960 (λ=570 nm) enzyme-linked immunoadsordent assay (ELISA) symbolic device 10 min-utes after reaction at room temperature. Study Ⅱ: Embryo-spinal nerve cells of SD rats were separated and extracted. Those in the experimental group were treated with GS + DMEM/F12 culture medium, but with DMEM/F12 culture medium in the control group. A value was assayed with the same method.MAIN OUTCOME MEASURES:① Relationship between injury of spinal neurons and level of NO;② Relationship between protective effect of GS and level of NO.RESULTS:① Relationship between injury of spinal neurons and level of NO: In the injury group, NO secretion was increased after injury of spinal neurons, reached peak 2 hours later, and decreased 3 hours later. There was significant difference as compared 0.5 hour with 0 hour (P ＜ 0.01),and also there was significant difference as compared 2 hourswith 0 hour (P ＜ 0.01).② Relationship between protective effect of GS and level of NO: In the control group, A value was increased with time passing, reached peak 2 hours later, and decreased 3 hours later; but A value in the experimental group was not changed generally. There was significant difference between the two groups at 2-hour point (P ＜ 0.01).CONCLUSION: NO liberation is increased after peripheral nerve injury.GS can inhibit NO liberation so as to protect peripheral nerve.

Acupuncture Therapy ; Cerebral Hemorrhage ; complications ; Cerebral Infarction ; etiology ; therapy ; Humans ; Male ; Middle Aged

Malignant gliomas are the most common intracranial tumors,with a highly invasive nature and a poor prognosis. The invasion of malignant gliomas is a complicate and consecutive multi-step process that includes adhesion, degradation and migration and involves various factors such as cell adhesion molecules, enzymes, and cytokines. Research on the invasive properties of malignant gliomas will advance our understanding of their underlying biological behavior and improve clinical treatment.

Tinnitus is a subjective sensation of sound without external stimulation. It has become ubiquitous and has therefore aroused much attention in recent years. According to the survey, ameliorating tinnitus based on special music and reducing pressure have good effects on the treatment of it. Meantime, vicious cycle chains between tinnitus and bad feelings have been broken. However, tinnitus therapy has been restricted by using looping music. Therefore, a method of generating fractal tones based on musical instrument digital interface (MIDI) technology and pink noise has been proposed in this paper. The experimental results showed that the fractal fragments were self-similar, incompletely reduplicate, and no sudden changes in pitches and would have a referential significance for tinnitus therapy.
Acoustic Stimulation ; Fractals ; Humans ; Music ; Noise ; Tinnitus ; rehabilitation

Adult ; Cardiac Catheterization ; Female ; Heart Septal Defects ; therapy ; Humans

Objective To investigate the clinical and pdysomnographic characteristics and related factors of obstructive sleep apnea hypopnea syndrome (OSAHS) in elderly patients. Methods The 163 elderly patients with OSAHS confirmed by polysomnography were classified into obesity group and non-obesity group according to body mass index (BMI). All cases were grouped into mild,moderate and severe groups according to the apnea hypopnea index (AHI) and night SaO2. The 190non-elderly OSAHS patients were as control group at the same time. The clinical and polysomnographic characteristics were recorded and analyzed. Results (1)The proportion of obesity in OSAHS patients was 79. 1%, there was significant difference between the elderly-obesity group and non-elderly-obesity group (70.3% vs. 83.6%, P＜0.05). (2)The proportions of moderate and severe OSAHS patients were lower in elderly group than in non-elderly group. There were significant differences in AHI, the lowest arterial O2 saturation (LSaO2) and % TRT SaO2 ＜90% between the two groups (all P＜0.05). (3)The sleep architecture disturbance was significantly severer in elderly group than in non-elderly group. The percentages of non-rapid eye movementsleep (NREM sleep)stage Ⅲ-Ⅳ sleep were significantly decreased, and the arousal was significantly increased. (4) The syndrome of OSAHS in elderly group was untypical and the clinical complication was increased.Conclusions The elderly OSAHS patients are less severe than non-elderly group, but the elderly patients have worse sleep architecture disturbance and more complications such as hypertension and other cardiovascular diseases.

Objective To investigate the effects of hydroxyethyl starch 130/0.4 (HES) used as priming fluid for cardiopulmonary bypass (CPB) on the plasma colloid osmotic pressure (COP) and lactic acid (LAC) concentration in infants undergoing cardiac surgery.Methods Forty infants of either sex with age ≤6 yr undergoing cardiac surgery with CPB were randomly divided into 2 groups (n =20 each): HES group and control group. The left radial artery and the right internal jugular vein were cannulated for blood pressure (BP) and the central venous pressure (CVP) monitoring. Arterial blood gases, blood LAC concentration, hemoglobin (Hb), hematocrit (Hct), mean arterial pressure (MAP) and nasopharyngeal temperature were measured and recorded immediately before and 5 min after aortic cross-clamping, at the end of CPB and operation. Plasma COP was measured before induction of anesthesia (T1), at 5 and 30 min of CPB (T2 and T3, respectively), before routine ultra-filtration (T4), at the end of CPB (T5) and2 h in ICU (T6).Results The plasma LAC concentration was significantly lower and the COP significantly higher in HES group than in control group (P＜0.05 or 0.01).The plasma LAC concentration increased after aortic cross-clamping, reached the peak at the end of CPB and then declined at the end of operation, but was still higher than that before aortic cross-clamping in both groups. Plasma COP was significantly decreased during CPB as compared with the baseline at T1, but increased at T6 in both groups.Conclusion Using HES 130/0.4 as pdming fluid for CPB can effectively improve plasma COP and reduce blood LAC level in infants undergoing cardiac surgery with CPB.