Objective To evaluate the results of Four-Step methods in traditional Chinese medicine Course.Methods 40 five-academic-year clinical medical students and 40 seven-academicyear undergraduate students were randomized assigned into experimental group (n=40, 20 five-academicyear clinical medical students and 20 seven-academic-year students) and control group (n=40, 20 five-academic-year students and 20 seven-academic-year students).The control group received conventional teaching, while four-step teaching break the gap between Chinese medicine and western medicine, build the base, form the framework of Chinese medicine and extend knowledge was implemented in the experimental group.Through questionnaire score, group discussion, the final evaluation of the theory and clinical training evaluation, the learning of the experimental group students and the control group students was compared.SPSS 18.0 statistical software was used and t test was employed to make analysis of the relevant data.Results The questionnaire at the end of the semester showed that the average score of students in the experimental group (36.18 ± 0.96) was higher than that in the control group (26.62 ± 1.00), and the difference was statistically significant (P=0.017).In the discussion at the end of the semester, the experimental group paid more attention to the theory and technology of traditional Chinese medicine's learning persistence in future and its application in their professional practice.Scores in theory test were higher in seven-academic-year students in experimental group (88.40 ± 8.79) than in control group (82.15 ± 6.83) and the difference was statistically significant (P=0.017), but there was no difference in five-academic-year students between experimental group (75A0 ± 12.09) and control group (77.85 ± 11.99), which was not considered statistically significant different (P=0.524).In clinical practice, the rate of outstanding students in the experimental group of seven-academic-year was five percentage points higher than the control group, while the rate of outstanding students in the experimental group of five-academic-year was 10 percentage points higher than the control group.Conclusions Four step teaching is helpful to stimulating the learning enthusiasm of the students of traditional Chinese medicine, expanding students' vision of medical field, and promoting their construction of a more comprehensive medical knowledge framework.

Anthracosis ; complications ; microbiology ; Anti-Bacterial Agents ; pharmacology ; Drug Resistance, Bacterial ; Humans ; Imipenem ; pharmacology ; Microbial Sensitivity Tests ; Pseudomonas Infections ; complications ; drug therapy ; microbiology ; Pseudomonas aeruginosa ; drug effects ; Pulmonary Heart Disease ; complications ; microbiology

Adult ; Brain Abscess ; Cholesteatoma ; surgery ; Endoscopy ; Female ; Humans ; Maxillary Sinus ; surgery

Objective Preparation of a stable and reliable atrioventricular blockage ( AVB) animal model is of great im-portance to anti-arrhythmic drugs and biological engineering research .The aim of the article was to establish a rat model of AVB in-duced by chemical ablation, providing an effective animal model for the development of new drugs . Methods 60 adult SD rats were randomly divided into 4 groups(n=15): normal saline (NS) group, Verapmil (Ver) group, chemical ablation group 1 and chemical ablation group 2.0.9%NaCl (5 mg/kg) was injected into caudal vein of each rat in NS group .Verapmil (5 mg/kg) was injected into the caudal vein in Ver group.Anhydrous ethanol(50μL)was injected into atrioventricular groove area in chemical abla-tion group 1.Anhydrous ethanol(50μL) was injected into atrioventricular node area in chemical ablation group 2.The electrocardio-grams of the rats were examined by electrophysiological recorder.HE staining and Connexin 43 (CX43) immunohistochemical tech-nique were applied to atrioventricular junctions of the rats . Results A rat model of AVB was successfully established .Compared with NS group([45 ±2.24]per field of view), there was a significant decrease in the CX43 expressions of chemical ablation group 1 and group 2 ([15.20 ±2.23]per field of view, [22.10 ±4.70]per field of view)(P<0.05).Concerning NS group and Ver group, myocyte tissues of the atrioventricular nodal region were detected to remain in order without obvious changes and the expres-sion of CX43 immunoreactive protein was obvious under light microscope.As to chemical ablation group 1 and group 2, myocyte tissues were in degenerative necrosis and the expression of CX43 im-munoreactive protein was in lighter staining.Compared with Ver group, the incidence rate(73.3%, 60.6%) and the mortality rate (33.3%, 26.7%)of third-degree AVB decreased remarkably(P<0.05). Conclusion Chemical ablation can be induced to estab-lish a stable and reliable rat model of AVB , providing an effective
animal model for the research and development of new anti-arrhythmic drugs.

Objective To explore the causes of subclinical hypothyrodism in children and the effects of the interventional therapy with thyroixine on the course of it.Methods Two hundreds children with subclinical hypothyroidism were measured for thyroglobulin antibody(TGAb),thyroid microsomal antibody(TMAb) in the blood serum,examined by colord Dopplor ultrasonic,examined by fine needle aspiraton cytology of the throid and measured the rate of 131I absorbed by thyroid in order to find out the causes of the disease.Two hundreds cases were randomly divided into two groups on the base of the cause of diseases,treatment group 100 cases and control group 100 cases.The treatment group were treated by throxine 25-75 ?g/d and the therapeutic dosage were chosen with the normal value of free triiodothyronine(FT3),free thyroxine(FT4)and high sensitive thyrotropin(sTSH) in the blood serum .After one year thyroxine therapy were stopped.Thyroid function was examined 6 months later after stopping the thyroxine.Results Among all of the causes of subclinical hypothyroidism in children,Hasgumoto′s thyroiditis accounts for 56%,simple goiter accounts for 26%,antithyroid drug accounts for 6%,the lack of thyroxine substitution therapy on the hypothyroidism accounts for 5% and undefined causes accounts for 7% .The thyroid function could keep normal for 1 year with an alternative therapy with thyroxine on subclinical hypothyroidism in children.Half a year later after stopping thyroxine,the thyroid function turned normal in most of the children.There were obvious differences in the ratio of cure and the ratio of effectiveness between treatment group and control group (t=20.2,3.2 Pa

Objective To observe the expression of STEAP4 gene(a novel obesity-related gene) during the period of human preadipocyte differentiation and to explore the relationship between the STEAP4 gene expression and adipocytes differentiation,adipogenesis.Methods Human preadipocytes were cultured and differentiated into the matured adipocytes in vitro.Adipocytes morphology and lipid accumulation were observed during this process.Total RNA was extracted from adipocytes at various time points (preadipocyte,Day 0,Day 4,Day 6,Day 8,Day 11,Day 14,and Day 17) and the level of STEAP4 mRNA expression was measured by fluorescent real-time quantitative reverse transcriptase-polyme-rase chain reaction(RT-PCR).Results The level of STEAP4 mRNA expression remained high in preadipocytes.In the presence of differentiation medium (Day 4),there was a transient upregulation in the expression of STEAP4 gene.After that,with the human preadipocytes being differentiated into matured adipocytes,the expression of STEAP4 mRNA was downregulated and reached the lowest level in fully differentiated adipocytes.There was a significant difference between any 2 detected phases in the level of STEAP4 mRNA expression (Pa

BACKGROUND:Atopic individuals predispose to alergic rhinitis after contacting with an alergen, which is mainly released by IgE-mediated histamine. Alergic rhinitis is a kind of non-infectious inflammatory disease that involves a variety of immune cels and cytokines and is related to Th1 and Th2 immune imbalance. Interferon γ is a cytokine secreted by Th1 cels, while interleukin-4 is a cytokine secreted by Th2 cels. OBJECTIVE:To establish a stable 129Sv mouse model of alergic rhinitis, so as to lay the foundation of establishing gene knockout 129Sv mouse models of alergic rhinitis, and to observe the concentration variation of IgE, interleukin-4 and interferon γ. METHODS: Twenty-four mice were randomly divided into 2 groups: model and control groups. Mice in the model group were sensitized by intraperitoneal injection of ovalbumin to establish mouse models of alergic rhinitis. Mice in the control group were subjected to intraperitoneal injection of PBS. After successful modeling, pathological changes of nasal eosinophils and plasmocyte infiltration were evaluated by nasal mucosa staining. Interleukin 4 and interferon γ levels and ovalbumin-specific IgE antibody concentration were detected by enzyme-linked immunosorbent assay. RESULTS AND CONCLUSION:Enzyme-linked immunosorbent assay showed that compared with the control group, serum ovalbumin-IgE and interleukin-4 concentrations were significantly increased, and Interferon γ concentration was significantly lower in the model group (P < 0.05). Hematoxylin-eosin staining results showed that cilia lodging and submucosal serous gland hyperplasia, eosinophils and plasmocyte infiltration were obvious. These results confirm that a mouse model of allergic rhinitis was successfully constructed in this study and the pathogenesis of allergic rhinitis was related to Th1/Th2 imbalance.

Objective:To observe the effect of fluid therapy on volume and coagulation function in patients with severe postpartum hemorrhage during cesarean section of placenta accreta under the guidance of inferior vena cava diameter (IVCD) and inferior vena cava collapse index (IVC-CI).Methods:A prospective randomized controlled study was conducted in 60 pregnant women with severe postpartum hemorrhage (blood loss ≥ 1 000 mL) who were hospitalized for delivery or referred for delivery in the Peking University Third Hospital from December 2018 to July 2019. The patients were divided into routine fluid replacement group and goal-oriented fluid resuscitation group (goal-oriented fluid replacement therapy was given) according to the different ways of fluid replacement. The hemodynamics, blood gas analysis, coagulation function, total fluid replacement, urine volume, prognosis, intraoperative vasoactive drugs utilization rate and postoperative adverse events were recorded before skin incision, after the fetus delivered, postpartum hemorrhage and at the end of operation, and the differences of these indices between the two groups were compared.Results:① Hemodynamics: the heart rate (HR) of the two groups were reached the peak during postpartum hemorrhage, but there was no significant difference in HR at each time point between the two groups. The mean arterial pressure (MAP) was decreased at first and then increased in both groups, and reached the trough at postpartum hemorrhage, but the MAP in the goal-oriented fluid resuscitation group was significantly higher than that in the routine fluid replacement group [mmHg (1 mmHg = 0.133 kPa): 75.6±10.7 vs. 69.2±8.9, P < 0.05]. In the goal-oriented fluid resuscitation group, the central venous pressure (CVP) was increased slightly after the fetus delivered and then stabilized, while in the routine fluid replacement group, the CVP was increased at first and then decreased, and reached the peak in postpartum hemorrhage. During postpartum hemorrhage, CVP in the goal-oriented fluid resuscitation group was significantly lower than that in the routine fluid replacement group [cmH 2O (1 cmH 2O = 0.098 kPa): 9.5±3.9 vs. 11.4±3.4, P < 0.05]. ② Arterial blood gas: partial pressure of oxygen (PaO 2) and partial pressure of carbon dioxide (PaCO 2) in arterial blood at the end of operation in both groups were higher than those in postpartum hemorrhage. There was no significant difference in PaO 2 at the end of operation between the goal-oriented fluid resuscitation group and routine fluid replacement group (mmHg: 189.3±100.5 vs. 240.2±126.3, P > 0.05). The PaCO 2 in the goal-oriented fluid resuscitation group was significantly lower than that in the routine fluid replacement group (mmHg: 34.6±4.6 vs. 36.8±4.1, P < 0.05). The lactic acid (Lac) at the end of operation of the goal-oriented fluid resuscitation group was significantly lower than that of the routine fluid replacement group (mmol/L: 2.2±0.6 vs. 2.6±1.1, P < 0.05). ③ Liquidintake and output volume: the total infusion volume, crystal fluid infusion volume and suspended red blood cell infusionvolume in the goal-oriented fluid resuscitation group were significantly less than those in the routine fluid replacement group [total infusion volume (mL): 3 385.9±1 144.1 vs. 4 448.3±1 194.4, crystal infusion volume (mL): 2 635.6±789.7 vs. 3 160.0±860.3, suspended red blood cell input volume (mL): 695.6±366.2 vs. 911.1±284.7, all P < 0.05], and the utilization rate of vasoactive drugs in the goal-oriented fluid resuscitation group was decreased significantly during operation [13.3% (4/30) vs. 60.0% (18/30), P < 0.05]. The amount of bleeding in the goal-oriented fluid resuscitation group was also significantly less than that in the routine fluid replacement group (mL: 1 451.7±373.8 vs. 1 725.9±372.8, P < 0.05), but there was no significant difference in urine volume between the goal-oriented fluid resuscitation group and the routine fluid replacement group (mL: 369.0±262.7 vs. 485.0±286.8, P > 0.05). ④ Coagulation function: at the end of operation, the prothrombin time (PT) in the goal-oriented fluid resuscitation group was significantly shorter than that in the routine fluid replacement group (s: 10.9±0.6 vs. 11.2±0.6), and the fibrinogen (Fib) in the goal-oriented fluid resuscitation group was significantly higher than that in the routine fluid replacement group (g/L: 3.7±0.5 vs. 2.9±0.8), and the differences were statistically significant (both P < 0.05).⑤ Prognostic index: compared withthe routine fluid replacement group, the proportion of patients transferred to intensive care unit (ICU) at the end of operation in the goal-oriented fluid resuscitation group was significantly lower [16.7% (5/30) vs. 66.7% (20/30), P < 0.05], and ICU length-of-stay was significantly shorter [hours: 0 (0, 24) vs. 24 (0, 24), P < 0.05], but there was no significant difference in the incidence of disseminated intravascular coagulation (DIC), acute renal injury (AKI) or hysterectomy between the goal-oriented fluid resuscitation group and the routine fluid replacement group [the incidence of DIC: 0% (0/30) vs. 6.7% (2/30), the incidence of AKI: 0% (0/30) vs. 3.3% (1/30), the hysterectomy rate: 10.0% (3/30) vs. 26.7% (8/30), all P > 0.05]. Conclusion:Fluid resuscitation guided by IVC-CI can effectively reduce the volume of blood and fluid transfusion and blood loss in patients with severe postpartum hemorrhage and improve their blood coagulation function.

The inflammation factors and roles of them in acute coronary syndrome (ACS) were explored. The similarity between the theory of pathogenic toxin in Chinese Medicine and the inflammation response theory in ACS was discussed. The exploration of new inflammatory factors may be helpful for Chinese Medicine in the research of ACS.
Acute Coronary Syndrome ; complications ; diagnosis ; prevention & control ; therapy ; Humans ; Inflammation ; complications ; etiology ; pathology ; therapy ; Inflammation Mediators ; physiology ; Medicine, Chinese Traditional ; Prognosis ; Toxins, Biological ; adverse effects

Objective To investigate the dynamic distribution changes of fungi responsible for the deep infection and antifungal susceptibility to provide a basis for the empirical antifungal treatment.Methods Medical records were reviewed from cases suspectedof deep fungal infection at our hospital from January 1998 to December 2004.3122 isolates of 13 species were analyzed with SPSSll.0.Etest was used for the antifungal susceptibility test.Results Candida albicans was the most commonly isolated organism,while the prevalence of Candida albicans decreased(76.3% vs 66.8%,x~2=34.33,P