There has been a series of teaching innovation carried out to improve the clinical teaching of seven-year program students in the department of gynecology and obstetirics of Xinqiao hospital.By using case as a guide and problem as foundation,with multimedia and other advanced teaching plan,we paid more attention to the Chinese-English teaching to improve mixed diathesis of these medical students and find out a better teaching model.

Objective:To analyze the related risk factors for esophageal variceal bleeding(EVB)in patients with hepatocirrhosis and portal hypertension,so as to provide clinical evidences for establishing preventive measures for EVB. Methods:Using"*esophag*","varice*","bleeding","hemorrhage",and"risk factor*"as the key words,we searched the clinical studies(1986-2006)about the risk factors of EVB in hepatocirrhosis patients in PubMed,Medline,Chinese Biomedical Database,Elsevier Database,OVID Database,etc.for Meta-analysis.The odds ratio(OR)of each risk factor was estimated and the 95% confidence interval[95% CI]was calculated.Results:Totally 19 papers met our criteria and were included in this Meta-analysis.The 19 papers involved 995 EVB patients and 1854 controls.Meta-analysis revealed that a hepatic function of Child C,decreased prothrombin activity,hypoalbuminemia,severe esophageal varices,positive red-color sign,extended portal vein width and splenic vein width,thrombopenia,leucopenia and anemia were the risk factors of EVB;a hepatic function of Child A and mild esophageal varices were the protective factors of EVB.The gender,age,hepatic function of Child B,ascites, hepatic encephalopathy,hyperbilirubinemia and midrange esophageal varices were not significantly associated with EVB. Conclusion:Improvement of poor hepatic function,blood coagulation status,hypoalbuminemia and treatment & prevention of severe esophageal varices(by endoscopic variceal ligation,devascularization and shunt)can help to reduce the incidence of EVB.

Objective To study on transcatheter closure of membranous ventricular septal defect (VSD) with pseudoaneurysm by patent ductus arteriosus(PDA) occlusion devices in children and summarize the skill and clinical experience. Methods The study included 20 membranous VSD cases in children.According to the finding of the left ventricular angiography, various kinds of the PDA occlusion devices was implanted. The mean diameter of the waist of the occluder was ( 10.4 ± 2.6) mm. Examination by transthoracic echocardiography (TTE) immediately and left ventricular angiography after the occluder was implanted 15minutes later to evaluate the efficacy. Results In the 20 patients, one of the Ⅳ type VSD patient was quitted because of the significant residual shunts(≥2 mm). Slightly residual shunts ( ＜ 2 mm) was found in one Ⅲ type VSD patient with multi-outlet. And disappeared in 1 month after the procedure, which VSD patient was confirmed by TTE. Thirteen cases were normal by EKG examination (or the same before procedure).Incomplete right bundle branch block was found in 4 cases. First degree atrioventricular block was found in 1 case and paroxysmal junctional tachycardia was found in 1 case. All of them were recovered in 1 week.Conclusions Transcatheter interventional therapy with PDA occlusion devices for membranous VSD with pseudoaneurysm is safe and effective. The key of the procedure is to select suitable occluder and suitable position to plant them according to the membranous morphologic characteristics,size and position of the pseudoaneurysm. It is a facultative method for transcatheter therapy this kind of congenital heart disease.

ObjectiveTo observe the effects of XinShu parenteral solution (XSPS) on the activation of platelet, the activity of fibrinolysis system after intima denudation of rabbits.Methods20 male Japanese white rabbits (2.5±0.5)kg were randomly divided into the control group and XSPS group .The celiac arterial endothelium of all rabbits were denuded with balloon. Before the operation and 3d, 7d, after balloon denudation, vein blood samples were obtained from each group rabbits for measurement of α granule membrane protein of platelets(GMP-140), tissue-type plasminogen activator(t-PA) and plasminogen activator inhibitor-type Ⅰ(PAI-1).ResultsPlasma GMP-140 and PAI-1 activity obviously elevated after balloon injury, and there was a little elevation in plasma t-PA activity in control group. Activity of plasma GMP-140 in XSPS group remained bottom level after balloon injury, and there was a significant increase in plasma t-PA activity and a marked reduce in PAI-1 activity in XSPS group. There was a notable difference between group B and group C (P<0.05). ConclusionXSPS obviously inhibits platelet activation, and improves fibrinolysis activity after balloon injury.

Objective To explore the effects of chronic electrical stimulation (ES) on Nogo-A expression in the hippoeampus of rats.Methods Thirty male Wistar rats were randomly divided into a control group and 4 exper- imental groups.The rats in the control group were given sham ES,while those in the experimental groups received 1, 3,6,or 9 days of ES before being sacrificed for the detection of Nogo-A expresson in the hippoeampus by immunohis- tochemistry and Western plotting.Results There was a positive correlation between the level of Nogo-A expression and the duration of ES,as shown by the immunohistochemistry technique.Western blotting showed the same result. Conclusion In general,seizure occurred 8 days after electrical stimulation began.Elevated Nogo-A expression in the hippocampus began earlier than seizures in the epilepsy model groups.

Objective To compare the biomechanical performance of three different fixation instruments for tibial fractures.Methods Fourteen fresh tibial specimens were made into models of oblique fracture.Seven models were fixed with unilateral axial dynamic fixation(UADF),and seven with limited contact dynamic compression plate(LC-DCP).After biomechanical tests had been done for the UADF group,an extra screw was used at the oblique fracture site to reinforce the fixation with extra limited internal fixation.Each model was tested for its hiomechanical performance in resisting compression,bending and rotation.Results The performance of UADF was significantly poorer than that of LC-DCP and UADF with limited internal fixation in anti-compression,an- ti-bending and anti-rotation(P＜0.05).There was no significant difference in the rigidity between LC-DCP and UADF with limited internal fixation(P＞0.05).Conclusion UADF with extra limited internal fixation is a recommendable method for tihial fractures because it cart provide the same effective fixation as LC-DCP does.

Adult ; Air Pollutants ; adverse effects ; Humans ; Male ; Military Medicine ; Monitoring, Physiologic ; Noise, Occupational ; adverse effects

Objective To investigate the temporal and spatial distribution of Schistosoma infection of population and its risk factors in Eastern Dongting Lake area in 2012 and 2014,so as to provide the reference for formulating effective intervention mea-sures. Methods Junshan District was selected as a study field in Eastern Dongting Lake area. The method of spatial autocorre-lation analysis was applied to analyze the change of spatial distribution of Schistosoma infection in Junshan District in 2012 and 2014. The spatial regression model was fitted to detect the risk factors for human infection. Results The livestock infection rate in 2013 was lower than that in 2011. The average infection rate of schistosome was reduced to 0.55%in 2014. The spatial auto-correlation existed on the distribution of schistosomiasis in Junshan District in both 2012 and 2014 and 4 high incidence villages were identified. The results of the spatial error model showed that the prevalence of human infection was positively correlated with the infection rate of the livestock and the area of the susceptible environment in 2012. The spatial lag model showed that the prevalence of human schistosomiasis was positively correlated with the area of the susceptible environment ,but not with the in-fection rate of livestock. Conclusion The measures involving grazing prohibition and phasing out cattle and sheep are remark-ably effective and should continue on the basis of the current spatial distribution of schistosomiasis in this area.

Objectives To construct a cDNA subtractive library of dermal papilla cells (DPCs) in anagen with suppression subtractive hybridization (SSH) and clone differentially expressed genes related to DPCs in anagen. Methods Total RNA was isolated from DPC of anagen and telogen follicles. Then ds cDNAs were synthesized in turn using SMART cDNA synthesis technique. After cDNAs from anagen and telogen follicle DPCs were hybridized with each other twice and underwent two rounds of nested PCR, PCR products were ligated with arms of T/A plasmid vectors to set up the subtractive library. Selected clones were verified by reverse Nothern blot and DNA sequencing, and the acquired sequences were analyzed for homology based on Genbank nucleotide database. Results cDNA subtractive library of DPCs in anagen follicle was set up successfully with high subtractive efficiency. Thirty-five genes were identified with 22 known functional genes and 13 unknown functional genes. Conclusions These results demonstrate the effectiveness and sensitivity of SSH in detecting differentially expressed genes from a small amount of clinical samples. Information about such alterations in gene expression might be useful for elucidating the genetic events in hair follicle growth regulation.

ObjectiveTo investigate the loss of heterozygosity (LOH) on 6q in bladder tumor.MethodsD6S404 and D6434 microsatellite markers near 6q21 were tested by PCR-SSLP-stain method on tumor DNA from 31 cases of bladder tumor.ResultsAmong these 31 cases of bladder tumor,LOH was detected in tumor tissues on site for D6S404 (35.5%) and D6S434(22.6%).ConclusionOne or more tumor suppressor gene near 6q21 maybe relevant for the development of bladder tumor.