Objective:Research on the feasibility and the availability of problem-based learning(PBL) for electrocardiogram(ECG).Method:The experiment group received PBL while the control group took completely traditional teaching method.The evaluation approaches included examination,questionnaire.Results:It is significant difference in the theoretical record and case analysis(t=2.76,P

T-cell acute lymphoblastic leukemia (T-ALL) is one of the most common types of leukemia in children. With over 50 ％ of activating Notch1mutations in T-ALL,identification of activating Notch1mutations has brought interest toward targeting the Notch signaling pathway in this disease.Small-molecule γ-secretase inhibitors (GSI) can block a critical proteolytic step required for Notch1activation,but the clinical application of GSI has been hindered. Therefore, new therapeutic strategies aim to design of effective antiNotch1therapies in T-ALL are needed, including combination therapies with molecularly targeted drugs and glucocorticoids. This review put emphasis on the molecular basis of Notch1, the mechanisms of action of oncogenic Notch1and clinical significance of Notch 1mutations in T-ALL.

Neuromyelitis optica spectrum disorder (NMOSD) is a kind of demyelinating disease of central nervous system which mainly affect optic nerve and spinal cord. Because of its serious blindness and disability, how to effectively prevent relapse has become the focus of ophthalmologists. With the deep understanding of the pathogenesis and the progress of scientific and technological means, more and more monoclonal antibodies(mAb) continue to enter clinical trials. B cell surface antigen CD20 blocker, rituximab, has become a first-line drug for the treatment of NMOSD. CD19 blocker, inebilizumab, can reduce the recurrence and disability of NMOSD patients. The addition of interleukin 6 receptor blocker, satralizumab, and complement C5 inhibitor, eculizumab, reduce the recurrence. Some mAbs such as natalizumab and alemtuzumab may not be effective for the treatment of NMOSD. The expansion of mAb treatment indications and the launch of new drugs still require more clinical trials which are large-scale and international cooperation. At the same time, its potential adverse events and cost issues cannot be ignored.

Objective To explore the relationship between the protein expression of PCNA and biological behavior science in benignant pituita ry adenoma.Methods The protein expression of PCNA in 58 patien ts with pituitary adenoma were determined by ABC immunohistochemical method.Results The PCNA index was significantly higher in the patients with recurrent pituitary adenomas than in nonrecurrent ones(P<0.05).There was no significantly difference between bleeding and unbleeding group,cystic and noncystic group,large type and unlarge type group(P>0.05 respectively) .Conclusion The protein expressions of PCNA reflected the proli ferative activties of pituitary adenomas, and could be taken as one of the indic ators to evaluate recurrence and prognosis of the tumor.

The incidence of macrosomia was increasing year by year, which may be associated with gestational diabetes, obesity and pregnancy weight gain. The study showed that macrosomia was prone to obesity in childhood, and diabetes, hypertension and cardiovascu-lar disease in adulthood. The growth and development status of macrosomia in childhood is worthy of attention.

Objective To assess the construction quality of sanitary latrines in schistosomiasis endemic areas of China. Methods Two counties per province were sampled randomly from total 7 provinces with schistosomiasis endemic including Hunan, Hu-bei, Jiangxi, Anhui, Jiangsu, Yunnan and Sichuan, then 2 villages with schistosomiasis endemic were selected from each target county as research sites, and 30 households per village were randomly selected as respondents. Results Among the sanitary latrines being constructed and on-going used in schistosomiasis endemic areas, 64.8% of them were built indoor or inside of yards, and 52.6% of the above household latrines were constructed keeping away from water sources beyond 10 meters. In addition, the latrines with curb height of feces outlet over 100 mm accounted for 75.0% , and 96.1% of the total sanitary latrines were equipped with urinals made of pottery, plastic and cement. There were 98.2% of the latrines with an area more than 1.2 m~2, and 95.8% with structure of the whole room. Among those sanitary latrines with three-case-cesspools, merely 23.1% reached or closed to the design and implementation requirements of Technical criterion of sanitary construction in schistosomiasis endemic areas (protocol) on the part of underground. Conclusions The sanitary latrine with three-case-cesspools and three-unit methane pool is the main type of the household latrine recommended in countryside in schistosomiasis endemic areas. The construction of sanitary latrines meet the requirements of relevant standards in general, however, the design and implementation of underground parts of the latrines with three-case-cesspools need to be improved.

Objective To compare the effect of atropine sulphate and cyclopentolate hydrochloride in the treatment of youth hyperopia cycloplegic refraction,and provide the basis for a reasonable choice of the youth cycloplegic refraction drugs.Methods Ninety hyperopia children met inclusion criteria with refractive errors (180 eyes) were subjected to cycloplegic refratometry by 1％ cyclopentolate hydrochloride followed with 1％ atropine sulphate eye used gel.The refractive results,pupil size,residual adjustment amount and systemic side reactions were measured and compared by TOPCON.Results The coincidence rate of spherical lens degrees,cylinder lens degrees and axis of astigmatism degrees respectively was 84.44％ (152/180),92.78％ (167/180) and 92.78％ (167/180) between atropine sulphate and cyclopentolate hydrochloride.The spherical lens degrees of cyclopentolate hydrochloride was lower than atropine sulphate,the difference was statistically significant (P ＜0.01),the cylinder lens degrees and axis of astigmatism degrees had no significant difference between two drugs (P＞ 0.05).The pupil size and residual adjustment amount of cyclopentolate hydrochloride had no significant difference with atropine sulphate (P ＞ 0.05).The incidence of adverse reactions of cyclopentolate hydrochloride was 3.33％ (3/90),atropine sulphate was 13.33％ (12/90),the cyclopentolate hydrochloride was significantly lower than atropine sulphate (P ＜ 0.05).Conclusion The cyclopentolate hydrochloride has powerful,fast and secure feature in the treatment of youth hyperopia cycloplegic refraction,has good ciliary muscle paralysis effect,has longer paralysis time,as effective as the atropine sulphate,and has a shorter recovery time and better security,is ideal cycloplegic drugs for youth hyperopia cycloplegic refraction.

Objective To provide a theoretical reference for building a discharge planning program suitable for China's national conditions based on a comprehensive content analysis of international discharge planning guidelines.Methods Discharge planning guidelines from 1995 to 2012 which were retrieved from PubMed,NGS (National Guideline Clearinghouse),google were analyzed by 5W1H method.Results A total of 11 discharge planning guidelines were collected from 21 through the full text screening.Conclusions This study shows that discharge planning should focus on patients with their needs as orientation,to provide continuous care through interdisciplinary and interagency coordination and cooperation,and an effective planning should be implemented standardized management and carried out early on admission.

The success of organ transplantation depends on the prevetion of acute rejection. T and B lymphocytes, the major components of the cellular and humoral immunization mediating the rejection response, respectively, have been extensively studied. The importance of matural killer(NK) cells in transplantation has become an increasing area of interest as reagents for their study have become available. Basing on this on the killer immunoglobulin-like receptor in the acute rejection response with kidney transplantation.