Objective To compare the advantages and disadvantages between the discussion teaching round model and the traditional round model in the tralning of medical graduate students. Methods 38 and 41 medical graduate students were practicing under the discussion teaching round model and the traditional round model in our hospital from Jan 2012 to Dec 2012. The questionnalre and the Clinical Skill Test were used to evaluate the teaching effect. The t test group design was used to make comparison between group mean. Results Compared with the traditional round model group, the discussion teaching round model group had higher evaluation to the teaching methods, consciousness of participation, the rounds impressions and clinical thinking cultivation, with statistically significant difference (P<0.05). The total score of the Clinical Skill Test was higher in the discussion teaching round model group than the traditional round model group[(86.4±4.8) vs (78.2±6.4), P=0.02]. Conclusion The discussion teaching round model can improve the quality of clinical practice and is an effective method for the education in medical graduate students.

Objective To establish the method of content determination of chlorogenic acid in Shuanghua eardrop. Methods High performance liquid chromatography (HPLC) was adopted with Kromasil C18 column (5 ?m,4.6 mm?250 mm) and acetonitrile-0.4% phosph acid solution (10∶85) as the mobile phase. The detective wavelength was 328 nm,the flow rate was 1.0 mL/min,column temperature was room temperature. Results Average recovery was 99.8%,relative standard error was 1.51% (n =5). Conclusion The linearity relationship of chlorogenic acid was good at the range of 0.102 4～0.061 44 ?g.

Objective To develop a method for simultaneous determination of 4 compounds in Zhizhu Pills by HPLC.Method Reversed-phase HPLC was used to determine the content of the compounds such as hesperidin,naringin,neohesperidin and atractylenolideⅠ.The column was symmetry C18(250 mm?4.6 mm,5 ?m) with temperature of 30 ℃.Methanol-0.095 %phosphoric acid solution served as the mobile phase by gradient elution.The wavelength of detection was set at 283 nm and 224 nm.The injection volume was 10 ?L and the flow rate was 1.0 mL/min.Results Hesperidin,naringin,neohesperidin and atractylenolideⅠin Zhizhu Pills can be isolated completely.Three batches of samples were determined and the recoveries of naringin,hesperidin,neohesperidin and atractylenolideⅠwere 98.81 %(RSD=1.11 %,n=6),100.63 %(RSD=1.90 %,n=6),99.32 %(RSD=1.44 %,n=6) and 99.65 %(RSD=1.53 %,n=6) respectively.Conclusion This method is accurate,reliable and with good reproducibility.It can be used for the quality control of Zhizhu Pills.

Objective To investigate the relationship between diabetes and bone metabolism and the potential epigenetic mechanisms. Methods BMSCs were cultured for 7 and 15 days in cell culture medium with different concentrations of glucose. The mRNA and protein expression of HDACs and osteogenesis-related genes were detected by RT-PCR and Western blot assay ,respectively. Moreover ,the combination of HDAC to the promoter region of Runx2 was tested by the chromatin immunoprecipitation (ChIP) assay. Results ThemRNA expression of osteogenesis-related genes ,incuding OCN(P < 0.05)and Col1(P < 0.05),in the bone marrow of diabetic mice was significantly reduced compared with the control mice. The mRNA and protein expression of ALP ,OCN ,Runx2 and OSX was gradually reduced with the increasing concentration of glucose ,while HDAC2 mRNA and protein expression was increased. The binding activity of HDAC2 to the upstream and downstream of Runx2 promoter region in 25mM glucose-treated BMSCs was higher than the control group(P < 0.05). Conclusoins Diabetes might repress osteogenesis of BMSCs via inhibiting the activity of Runx2 through upregu-lating the expression of HDAC2.

Objective To investigate the weight,length and scale of normal children′ stools and discuss clinical signification.Met-(hods) The fresh stools of 60 normal children (male 34,female 26)were measured,classify the stools according to Bristol′s scale.Results 1.The average weight of stools in 60 cases was (109.53?52.00) g,of male was (123.79?55.87) g,of female was (90.12?(39.66)) g,there was significant difference between them (t=0.013 P0.05);3.The stools was classified into 7 group according to Bristol′s scale.From 1 grade to 6 grade were 3.30%,(5.10%),5.10%,64.40%,15.30% and 6.80%,respectively,but there was no 7 grade stools.Conclusion The weight,length and scales of normal children′s stools can be used as a sign to evaluate the clonic movement of children,especially in diagnosis and treatment of constipation and stools dryness

Objective To investigate the effect of dexmedetomidine combined anesthesia on postoperative delirium in the elderly patients undergoing hip joint replacement.Methods One hundred and sixty ASA Ⅱ or Ⅲ patients,aged 75-85 yr,with a body mass index of 20-25 kg/m2,scheduled for elective total hip joint replacement under general anesthesia,were randomly divided into 2 groups (n =80 each):sevoflurane-fentanyl control group (group C) and dexmedetomidine-sevoflurane-fentanyl group (group D).Dexmedetomidine was intravenously infused at 0.2 μg· kg-1 · h-1 until the end of operation after a loading dose of 0.6μg/kg over 15 min before induction of anesthesia in group D,while the equal volume of normal saline was infused in group C.Anesthesia was induced with iv injection of fentanyl 2-4 μg/kg and etomidate 0.1-0.3 mg/kg at 5 min after the end of administration of the loading dose.Tracheal intubation was facilitated with cisatracurium 0.15 mg/kg and the patients were mechanically ventilated.Anesthesia was maintained with target-controlled inhalation of sevoflurane (the end-tidal concentration 1％-3％) and intermittent iv boluses of fentanyl 0.05 mg.BIS was maintained at 40-60 during operation.The consumption of etomidate,fentanyl,and sevoflurane,agitation during emergence from anesthesia,and postoperative delirium within 24 h after operation were recorded.Results Compared with group C,the consumption of etomidate,fentanly,and sevoflurane was significantly reduced and the incidences of agitation during emergence from anesthesia and postoperative delirium within 24 h after operation were significantly decreased in group D (P ＜0.05).Conclusion Dexmedetomidine combined anesthesia can reduce the occurrence of postoperative delirium in the elderly patients undergoing hip joint replacement.

Objective To evaluate the effect of dexmedetomidine on intraoperative wake-up test in patients undergoing scoliosis surgery.Methods Sixty ASA Ⅰ patients,aged 13-18 yr,scheduled for elective scoliosis surgery,were randomly divided into 2 groups (n =30 each) ∶ sufentanil group (group S) and dexmedetomidine combined with sufentanil group (group DS).Anesthesia was induced with sufentanil,etomidate and cisatracurium,and maintained with target-controlled inhalation of sevoflurane combined with target-controlled infusion of sufentanil in both groups.In group DS,dexmedetomidine 0.2 μg·kg-1 · h-1 was infused during operation,while the equal volume of normal saline was given instead in group S.Before the wake-up test,cisatracurium infusion was stopped,the end-tidal concentration of sevoflurane was adjusted to 0,and the target effect-site concentration of sufentanil was adjusted to 0.1 and 0.08 ng/ml in groups S and DS,respectively.The wake-up test was performed 5 min later.The wake-up time and bucking/restlessness and cardiovascular events during the wake-up test were recorded.The occurrence of intraoperative awareness was recorded in the patients who were followed up after operation.Results No cardiovascular events occurred during the wake-up test in group DS.The wake-up time was significantly shorter and the incidences of cardiovascular events and bucking/restlessness were significantly lower in group DS than in group S (P ＜ 0.05).No intraoperative awareness occurred in the patients.Conclusion Dexme-detomidine can be used for intraoperative wake-up test in patients undergoing scoliosis surgery,with shorter wakeup time,stable hemodymamics and fewer adverse reactions.

Objective To set up the quality standard of Renqing Mangjue capsules. Methods TLC was used for qualitative identification of Crocus sativus, Zingiberaceae, Syringa oblata, Radix Aucklandiae and Borneolum. The content of Brucine and Strychnine were determined by HPLC, which conducted with CAPCELL PAK MG C18 column (4.6 mm×250 mm, 5μm). The mobile phase consisted of methanol∶0.01 moL/L potassium dihydrogen phosphate (with 10%phosphoric acid to adjust the pH 2.5)=25∶75 and the flow rate was 1.0 mL/min. The detection wavelength was set at 254 nm and 260 nm. The column temperature maintained at 30 ℃. Results TLC could detect qualitatively Crocus sativus, Zingiberaceae, Syringa oblata, Radix Aucklandiae and Borneolum. The spots were clear and the negative controls had no interference. HPLC determined that Brucine presented a good linear relationship in the range of 0.012 1-0.072 8 μg (r=0.999 1). The average recovery was 97.27%, RSD was 1.20%. Strychnine presented a good linear relationship in the range of 0.045 4-0.272 4 μg (r=0.999 8). The average recovery was 98.69%, RSD was 1.17%. Conclusion The method is simple in operation. The results are accurate, reliable and good in reproducibility. The method can effectively control the quality of Renqing Mangjue capsules.

BACKGROUND: Embryonic pancreatic tissue is characterized by its abundance, potent in proliferation & differentiation, and minimal immunological rejection. It is widely considered as potential pancreatic endocrinological stem cells resource for treating diabetes mellitus.OBJECTIVE: To investigate the embryonic mouse pancreatic tissue isolation technique and observe the recipients' blood glucose regulatory effects of the grafted embryonic pancreas in an experimental diabetes mellitus mouse model.METHODS: Pancreatic tissue from C57B1/6 mouse embryos at embryonic days 11.5-16.5 was isolated under the stereomicroscope. C57BL/6 mouse models of streptozocin-induced diabetes mellitus were established and then randomly divided into two groups: transplantation group, in which, five pieces of pancreatic tissue of mice at embryonic 16.5 days were transplanted into mouse renal capsule, and sham-operated control group, in which, 0.05 mL RPMI1640 culture medium was injected into mouse renal capsule. When blood glucose level of the transplantation group mouse was≤ 11.2 mmol/L, the endocrine function of embryonic pancreatic tissue transplanted was detected by IPGTT and IPITT methods and then the transplanted graft was removed for observing the blood glucose relapse.RESULTS AND CONCLUSION: Nearly intact pancreatic tissue of mice at embryonic days 11.5-16.5 could be isolated through the use of stereomicroscope. Pancreatic tissue morphology and color of mice ≤ embryonic 12.5 days were difficultly distinguished from adjacent tissue and they could only be isolated carefully according to the relationship with adjacent organs. Pancreatic tissue of mice > embryonic 12.5 days exhibited initial endocrinological tissue morphology mimic white cauliflower. Histological and ELISA examinations showed that embryonic pancreatic tissue could express and secrete insulin and the insulin level was gradually increased with developmental time. Embryonic pancreatic tissue could grow beneath the recipient renal capsule. The insulin and glucagon expression in the post-transplantational pancreatic tissue graft was increased compared with prior to transplantation. These results suggest that pancreatic tissue is a potential stem cell resource for treating the diabetes mellitus.

Cutaneous Fistula ; etiology ; surgery ; Female ; Humans ; Laryngectomy ; adverse effects ; Male ; Middle Aged ; Pharyngeal Diseases ; etiology ; surgery ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps