Objective To compare the results of common PBL teaching model and modified PBL teaching model in medical information retrieval teaching .Methods The results of common PBL teaching model and modified PBL teaching model in medical information retrieval teaching were compared according to the DREEM Scale.Results The DREEM score of modified PBL teaching model was significantly higher than that of common PBL teaching model . Conclusion The modified PBL teaching model improves the activity and comprehensive ability of students more sig-nificantly than common PBL teaching model, the results of modified PBL teaching model are better than those of common PBL teaching model.

Objective To compare the efficacy and safety of the use of sheathless common 7-F guiding catheter with those of conventional 6-F sheath guiding catheter in performing transradial percutaneous coronary intervention (PCI) for coronary artery lesions.Methods The clinical data of 160 consecutive patients with coronary artery lesions,who were treated with transradial PCI during the period from January 2014 to June 2015,were retrospectively analyzed.The patients were randomly divided into sheathless group (n=80,using sheathless common 7-F guiding catheter) and sheath group (n=80,using conventional 6-F sheath guiding catheter).The accuracy of the guiding catheter placement,the compression time for the punctured radial artery,the success rate of hemostasis,the incidence of radial artery spasm,the postoperative diameter of radial artery,the fading time of swelling at distal arm,the forearm pain or discomfort,the formation of forearm hematoma,the incidence of pseudoaneurysm and radial artery occlusion,the skin ischemia necrosis,etc.were recorded,and the results were compared between the two groups.Results In the sheathless group and the sheath group,the radial artery spasm was observed in 9 patients and 2 patients respectively,the forearm pain or discomfort was seen in 7 patients and one patient respectively,the differences between the two groups were statistically significant (P＜0.05).No statistically significant differences in the accuracy of the guiding catheter placement,the compression time for the punctured radial artery,the formation of forearm hematoma,the success rate of hemostasis,the postoperative diameter of radial artery,the incidence of radial artery occlusion and the skin ischemia necrosis existed between the two groups (P＞0.05).Conclusion Compared to the use of conventional 6-F sheath guiding catheter,the use of sheathless common 7-F guiding catheter is safe and effective in treating coronary artery lesions with transradial PCI.

Objective To explore the expression profile of Wnt4 in rat kidney during renal development and its effect on renal development. Methods Rats with embryonic age of 18 days (E 18 d) , 20 days (E 20 d) as well as postnatal age of 0 day (P 0 d), 1 day (P 1 d), 3 days (P 3 d), 5 days (P 5 d) and 7 days (P 7 d) were selected. Expression levels of Wnt4 in rat kidney during renal development were quantified by immunohistochemistry and Western blot in all time points. Results Immuno?histochemistry analysis showed that during E 18 d to P 7 d, Wnt4 mainly expressed in proximal tubules, ureteric bud, comma shaped bodies and S shaped bodies of nephrogenic zone;the expression in the distal tubule was weak;the expression in renal corpuscle decreased with time;Western blot analysis showed that the expression of Wnt4 in rat kidney began to decrease from E 18 d and reached bottom at P 1 d then rise again until P 7 d when it dropped again. Conclusion During renal development, Wnt4 proteins were involved in the development of the nephrogenic zone through regulating canonical Wnt/β-catenin signaling pathway, and was involved in extension of proximal tubules by inducing the non canonical Wnt/PCP signaling pathway. Expression of Wnt4 protein in rat kidney was closely related to nephron formation and development of proximal tubules.

Objective To investigate the common risk factors of primary hepatocellular cancer (PHC) in Guizhou province . Methods The group case-control study was adopted .The main related-factors of primary PHC in Guizhou provincial population and the relation between drinking combined hepatitis B viral infection with the PHC occurrence were analyzed by the unconditional Logistic regression analysis and the stratification analysis .Results Drinking(OR=2 .948 ,95% CI 2 .096-4 .146 ,P=0 .000) ,eco-nomic status 5 years ago(OR=0 .386 ,95% CI 0 .279 -0 .534 ,P= 0 .000) ,family history of PHC(OR= 2 .402 ,95% CI 1 .372 -4 .206 ,P=0 .002) ,cigarette smoking (OR=3 .468 ,95% CI 2 .265 -5 .311 ,P=0 .000) ,chronic liver disease(OR= 1 .502 ,95% CI 1 .054-2 .141 ,P=0 .024) ,HBV infection(OR=31 .999 ,95% CI 19 .318 -53 .002 ,P=0 .000) and diabetes mellitus(OR=4 .750 , 95% CI 2 .761-8 .171 ,P=0 .000) ,the differences between the patients group and the control group had statistical significance ;the OR value of drinking combined with HBV infection was 96 .903(95% CI 35 .265-266 .275 ,P=0 .000) .Conclusion HBV infection is still the common risk factor of PHC in Guizhou provincial population .Drinking can increase the risk in the individuals infected with HBV .

Millettia nitida var.hirsutissima is a Chinese herbal medicine used for the treatment of gynecological diseases.An HPLC/DAD/ESI-MSn method was established for the rapid separation and characterization of bioactive flavonoids in M.nitida var.hirsutissima.A total of 32 flavonoids were detected,of which 14 compounds were unambiguously characterized by comparing their retention time,UV,and MS spectra with those of the reference standards,and the others were tentatively identified based on their tandem mass spectrometry fragmentation data obtained in the negative ionization mode on line.Nineteen of these compounds characterized were reported from this plant for the first time.

OBJECTIVETo evaluate the accuracy of echocardiography in identifying aortic valve structures and determine the prevalence of bicuspid aortic valves (BAV) in severe aortic stenosis (AS) population to provide useful information for transcatheteraortic valve replacement (TAVR).

METHODSA total of 300 AS patients undergoing surgical aortic valve replacement were included to determine the accuracy of transthoracic echocardiography in indentifying BAV from January 2009 to July 2013. The echocardiographic data of our hospital from 2004 to 2012 was retrospectively reviewed. 1 371 patients with isolated severe native aortic valves stenosis were consecutively enrolled.

RESULTSThe aortic valve structures could be defined by transthoracic echocardiography in 75.7% (227/300) patients with severe AS. With BAV diagnosis during operation as gold standard, the accuracy of transthoracic echocardiography in identifying BAV was 89.4% (203/227). Among 1 371 patients with severe AS, the percentage of BAV in patients aged <40 years, aged 40-59 years, aged 60-69 years, aged 70-79 years and aged ≥ 80 years was 60.0% (57/95), 57.5% (262/456), 42.7% (184/431), 43.2% (133/308) and 21.0% (17/81), respectively. Incidence of BAV in patients with degenerative calcific valve was significant higher than in those with rheumatic heart disease (44.3% (552/1 246) vs. 4.0% (3/76), P<0.01). Proportion of combined aortic regurgitation ≥ grade 2 was significantly lower, ascending aortic diameter was larger and left ventricular end-diastolic dimension was smaller in BAV patients compared to severe AS patients with tricuspid valves (all P<0.01), while aortic valve annuals diameter and accompanying cardiovascular diseases between BAV and tricuspid aortic valve groups were similar (all P>0.05).

CONCLUSIONSTransthoracic echocardiography could accurately identify aortic valve structures in about 76% patients. BAV is common in severe AS patients across all ages. These results provide important information for the popularization of TVAR.

Aorta ; Aortic Valve ; abnormalities ; Aortic Valve Stenosis ; Echocardiography ; Heart Valve Diseases ; Heart Valve Prosthesis ; Humans ; Incidence ; Prevalence ; Retrospective Studies

Objective: To investigate the comprehensive nutritional status and diet behavior of middle aged and elderly women with osteoporosis, and thereby to explore the relationship between diet behavior and comprehensive nutritional status. Methods: 311 middle-aged and elderly women with osteoporosis in Chengdu were included in this study. Mini Nutritional Assessment (MNA) was applied to assess their comprehensive nutritional status. Information of social-demographic characteristics and diet behavior (about meals, snacks and water drinking, etc.) of the subjects was collected by questionnaire. Chi square test was used to assess the differences in nutritional status among patients who have different eating behaviors. Logistic regression analysis was performed to evaluate the relationship between diet behaviors and comprehensive nutritional status. Results: The mean MNA score of subjects was 25.8±2.5. 20.3% (63/311) of the subjets were at risk of potential malnutrition, but there was no malnourished subjects found. 46.9% (46/311) of the subjects were in good appetite. 95.2% (296/311) of them had a fixed food intake each meal. 65.8% (198/311) of them had snacks every day, and the most common choice was fruit (86.4% (248/287)). 54.8% (165/311) of them had initiative drinking water habits, and the most common choice was plain boiled water (79.9%, 246/308). 76.5% (238/311) of them had daily portable water less than 1 500 ml. After adjusting the effects of age, occupation and education level, bad appetite (OR=3.50, 95%CI: 1.18-10.62), unfixed food intake (OR=7.27, 95%CI: 1.40-35.83), and seldom or never intake of snack (OR=3.71, 95%CI: 1.42-9.72) were risk factors for malnutrition risk, while tea drinking was protective factor(OR=0.31, 95%CI: 0.11-0.93). Conclusion Risk of potential malnutrition and unhealthy diet behavior among the middle aged and elderly women with osteoporosis should be paid more attention. Unhealtghy diet behavior has a negative effect on their comprehensive nutritional status.

Objective:To review and analyze the clinical experience of children with aortic valve stenosis and/or insufficiency treated with autologous pulmonary valve for aortic valve replacement procedure(Ross operation) with ePTFE artificial valve for right ventricular outflow tract reconstruction.Methods:From 2015 to 2020, 8 cases of aortic stenosis and/or aortic insufficiency treated by Ross operation in our center were collected, with an age of 0.5-13.2 years old. 4 cases of aortic stenosis were diagnosed preoperatively, 3 cases of aortic stenosis with aortic insufficiency, and 1 case of infective endocarditis involving the aortic valve. The operation was carried out in three steps: Harvest autologous pulmonary valve; the diseased aortic valve was resected and autologous pulmonary valve was transplanted to the aorta by aortic root transplantation; the right ventricular outflow tract was reconstructed by a handmade ePTFE artificial flap blood vessel.Results:In 6 cases, the right ventricular outflow tract was reconstructed by hand-sewn ePTFE trileaflets, and artificial univalve in 2 cases, no death occurred during operation; all patients were cured and discharged. The patients were followed up for 1 to 36 months, with mean of(12.63±12.19) months. There was no long-term death or valvular complications. During follow-up echocardiography indicated 1 case of moderate aortic regurgitation, 1 case of mild-moderate regurgitation, and moderate regurgitation was found in 2 patients with artificial single pulmonary valve. For the remaining patients, they were mild aortic regurgitation, and a trivial or mild pulmonary artery regurgitation with hand-sewn three-leaflets ePTFE artificial vessel; All patients were followed up at the last time with a peak pressure of(6.63±3.46) mmHg(1 mmHg=0.133 kPa) across the aortic valve. The left ventricular outflow tract and aortic annulus shrank slightly after surgery(the diameter of one patient with Ross-Konno operation increased), but the annulus diameter increased with age. There was no need for further intervention.Conclusion:The Ross operation is safe for the treatment of aortic valve disease, it has good hemodynamic effect, and the autologous pulmonary artery has growth potential, especially suitable for children and young patients. Hand-sewn ePTFE with trileaflet vessels for reconstruction of right ventricular outflow tract performs well in anti-regurgitation function in the short term or may be used as a replacement material for the homograft/heterograft vessel, but longer follow-up and more cases are needed.

BACKGROUND: Peak bone mass and standard deviation (SD) in different regions are varied, which have great influence on diagnosis of osteoporosis. To establish a complete database can provide accurate evidence for osteoporosis diagnosis. OBJECTIVE: To investigate the influence of bone mineral densities (BMD) and their SD of young people on the detective rate of osteoporosis in general population. DESIGN, TIME AND SETTING: Investigation analysis was performed at Beijing, Shanghai, Guangzhou, Nanjing, Jiaxing and Chengdu between January 1997 and December 1999. PARTICIPANTS: 11418 subjects from related 6 centers of BMD reference database in China were investigated and analyzed using prospective and retrospective methods, including 3 666 males, and 7 752 females aged 20-90 years. Of them, 2385 were from Beijing, 1178 from Guangzhou, 1404 from Shanghai, 2938 from Nanjing, 1425 from Chengdu, and 2088 from Jiaxing. The subjects were selected from community investigation, physical examination volunteers. METHODS: BMD of the lumbar spine (L2-4) and the hip in 11, 418 subjects from the related 6 centers in China was measured with GE-Lunar dual energy X-ray absorptiometry (DXA) and the BMD reference database was established. The accuracy rate of the inner machine was 0.3%-0.7%, and the accuracy of different machines averaged 1.1%. MAIN OUTCOME MEASURES: Lumbar BMD distribution of different age groups from 6 centers; influence of young people's BMD and its SD on detective rate of osteoporosis. RESULTS: Different BMD and SD were found in the individual subject from 6 centers, and the maximum differences were 0.098 g/cm2 and 0.027 g/cm2. With mean BMD and SD of the individuals from 6 centers as references, different T-scores and the detective rates of osteoporosis derived from the T-scores were found in the same group. The detective rate increased by 1.6% when BMD of the young people increased by 0.01 g/cm2 (positive correlation), but the detective rate decreased by 4% when SD increased by 0.01g/cm2 (negative correlation). CONCLUSION: Changes in BMD and SD of the young people can influence the detective rate of osteoporosis. To achieve comparability for the detective rate of osteoporosis in different centers, the specific reference database should be established for the same race, the same area, and the same bone densitometry machine. The T-score should be determined with the normal BMD and SD of the young, people as the reference database.

OBJECTIVETo determine the risk factor of HCC in Guizhou.

METHODSA group case-control study design was conducted between 762 cases and 798 controls in Guizhou province. The main related-factors were analyzed with unconditional logistic regression model and evaluated by odds ratio (OR) and 95% confidence interval (95% CI).

RESULTSThere are significant differences between cases and controls in regarding to cigarette smoking 210 (27.6%),non-alcoholic fatty liver disease 336 (44.1%), alcoholic liver disease 245 (32.2%), family history of HCC 141 (16.5%), alcohol consumption 300 (39.4%), HBV infection 436 (57.2%), pickled food 290 (38.1%), and economic status 5 years ago 420 (55.1%) in cases,and cigarette smoking 116 (14.5%),non-alcoholic fatty liver disease 160 (20.1%), alcoholic liver disease 101 (12.7%), family history of HCC 40 (5.0%), alcohol consumption 180 (22.6%), HBV infection 82 (10.3%), pickled food 225 (28.2%), and economic status 5 years ago 647 (81.1%) in controls, with OR of each variable was 3.520, 2.464, 4.330, 2.219, 2.451, 19.245, 6.212, 0.174 respectively, P less than 0.01.

CONCLUSIONHBV infection and pickled food were the most common risks for HCC in Guizhou. Alcohol consumption excessively and cigarette smoking may increase the risk too.

Adult ; Aged ; Aged, 80 and over ; Alcohol Drinking ; Carcinoma, Hepatocellular ; epidemiology ; etiology ; Case-Control Studies ; China ; epidemiology ; Feeding Behavior ; Female ; Hepatitis B ; epidemiology ; Humans ; Liver Neoplasms ; epidemiology ; etiology ; Male ; Middle Aged ; Risk Factors ; Young Adult