Diversified teaching methods including traditional teaching,problem based learning,interactive teaching and team cooperation teaching were adopted in the process of teaching.Problem based learning can stimulate students' learning interests; interactive teaching can improve the students' hands-on ability and team cooperation teaching can cultivate students' cooperation spirits.Diversified teaching mode made different teaching methods integrated and complemented each other,forming a special teaching mode for the course of functional experiment.

Adult ; Female ; Humans ; Hyperlipoproteinemia Type III ; pathology ; Male ; Middle Aged ; Nephrosis, Lipoid ; pathology

BACKGROUND: Animal experiments showed that recruitment maneuver (RM) and protective ventilation strategy of the lung could improve oxygenation and reduce extravascular lung water. This study was to investigate the effects of RM on respiratory mechanics and extravascular lung water index ( EVLWI) in patients with acute respiratory distress syndrome (ARDS). METHODS: Thirty patients with ARDS were randomized into a RM group and a non-RM group. In the RM group, after basic mechanical ventilation stabilized for 30 minutes, RM was performed and repeated once every 12 hours for 3 days. In the non-RM group, lung protective strategy was conducted without RM. Oxygenation index (PaO2/FiO2), peak inspiratory pressure (PIP), Plateau pressure (Pplat), static pulmonary compliance (Cst) and EVLWI of patients before treatment and at 12, 24, 48, 72 hours after the treatment were measured and compared between the groups. Hemodynamic changes were observed before and after RM. One-way ANOVA, Student's t test and Fisher's exact test were used to process the data. RESULTS: The levels of PaO2/FiO2 and Cst increased after treatment in the two groups, but they were higher in the RM group than in the non-RM group (P<0.05). The PIP and Pplat decreased after treatment in the two groups, but they were lower in the RM group than in the non-RM group (P<0.05). The EVLWI in the two groups showed downward trend after treatment (P<0.05), and the differences were signifcant at all time points (P<0.01); the EVLWI in the RM group was lower than that in the non-RM group at 12, 24, 48 and 72 hours (P<0.05 or P<0.01). Compared with pre-RM, hemodynamics changes during RM were significantly different (P<0.01); compared with pre-RM, the changes were not significantly different at 120 seconds after the end of RM (P>0.05). CONCLUSIONS: RM could reduce EVLWI, increase oxygenation and lung compliance. The effect of RM on hemodynamics was transient.

Objective: To observe the clinical efficacy of acupuncture plus navel acupuncture for patients with urinary retention after radical hysterectomy for cervical cancer. Methods: A total of 64 patients with urinary retention after radical hysterectomy for cervical cancer was divided into a navel acupuncture group (22 cases), an acupuncture group (18 cases) and an acupuncture plus navel acupuncture group (24 cases). All three groups received bladder function training and neuromuscular electrical stimulation. In addition, navel points were combined in the navel acupuncture group. Electroacupuncture was conducted to Qihai (CV 6), Zhongji (CV 3), Dahe (KI 12), Shuidao (ST 28), Ciliao (BL 32) and Huiyang (BL 35) in the acupuncture group. The acupuncture plus navel acupuncture group received both treatments. The catheter was removed after 3 d of treatment. Spontaneous urination, residual urine volume, urinary catheter dependence and recurrence after 3 d, 6 d and 9 d of treatment in each group were observed, respectively. Results: In the acupuncture plus navel acupuncture group, the markedly effective rates after 3 d, 6 d and 9 d of treatment were significantly higher than those in the navel acupuncture group and the acupuncture group; the urinary catheter dependence was lower than that of the other two groups, and the differences were statistically significant (P<0.05, P<0.01); the spontaneous urination time was shorter than that of the navel acupuncture group and the acupuncture group, and the differences were statistically significant (P<0.05, P<0.01); the residual urine volume was significantly less than that of the navel acupuncture group and the acupuncture group, and the differences were statistically significant (both P<0.01). After the catheter was removed, recurrence was observed from the next day after spontaneous urination was resumed. There were 2 cases of recurrence in the navel acupuncture group, 2 cases in the acupuncture group and 1 case in the acupuncture plus navel acupuncture group. The recurrence rate of the acupuncture plus navel acupuncture group was significantly lower than that of the navel acupuncture group and the acupuncture group (both P<0.01). Conclusion: Acupuncture plus navel acupuncture has satisfactory efficacy for urinary retention after radical hysterectomy for cervical cancer. It can significantly shorten the urinary retention time, reduce the patient's dependence on urinary catheter, and reduce the residual urine volume.

This study was purposed to investigate the expression and significance of glycosylphosphatidylinositol-specific phospholipase D (GPI-PLD) in bone marrow mononuclear cells (BMMNC) isolated from patients with acute myeloid leukemia (AML), GPI-PLD activity in BMMNC isolated from 78 patients with AML and 15 normal persons was measured by using GPI-anchored placental alkaline phosphatase (PLAP) as a substrate and Triton X-114 phase partitioning. The GPI-PLD mRNA expression was measured by semi-quantitive reverse transcription-polymerase chain reaction (RT-PCR). The results showed that the mRNA expression level and activity of GPI-PLD in BMMNC from de novo AML patients were 1.86 +/- 0.32 and 46.96 +/- 7.15% respectively; the mRNA expression level and activity of GPI-PLD in BMMNC from completely remission and refractory or relapsed patients were 1.26 +/- 0.29, 33.36 +/- 5.13%and 1.79 +/- 0.19, 44.31 +/- 7.22%, while those in BMMNC from normal controls were 1.27 +/- 0.23, 35.38 +/- 5.15% respectively. The mRNA expression level and activity of GPI-PLD in de novo and refractory or relapsed patients were obviously higher than those in normal controls with significant difference (p < 0.01), while the comparison between remitted patients and normal controls showed no statistical difference (p > 0.05). It is concluded that the expression level of GPI-PLD mRNA coincides with GPI-PLD activity. The mRNA expression and activity of GPI-PLD in de novo and refractory or relapsed patients are obviously higher than those in normal controls. It is worthy of further exploring whether GPI-PLD plays a certain role in process of leukemia pathogenesis.
Adolescent ; Adult ; Bone Marrow Cells ; cytology ; metabolism ; Case-Control Studies ; Child ; Female ; Humans ; Leukemia, Myeloid, Acute ; metabolism ; pathology ; Male ; Middle Aged ; Phospholipase D ; genetics ; metabolism ; RNA, Messenger ; genetics ; Young Adult

Objective To research the effects of mechanic auxiliary expectoration on prevention of pneumonia of patients with artificial airway.Methods According to the admission number,116 patients with establishment of artificial airway were divided into treatment group and control group,and 58 cases in each group.Hama mechanic assisted expectoration was used in the treatment group,while traditional chest percussion in the control group.Then,expectoration effect,pulmonary infection,comfort of patients and operation feeling of nursing staff were observed and statistical analyzed.Results The incidence of pneumonia (5 vs 14),sputum volume [(38.6 ± 4.1 ml/d vs 33.8 ± 3.3 ml/d)],expectoration effective cases (18 vs 12),expectoration markedly effective cases (32 vs 26) between treatment group and control group were significantly significant (t/x2 =5.098,2.021,-2.334,respectively; P ＜0.05).Significant difference were found in the comfort of the patients and operating experience of nursing staff (x2/Z =-5.097,11.226,-3.250,respectively; P ＜ 0.01).Conclusions Mechanic auxiliary expectoration can improve sputum drainage of patients with artificial airway,reduce the rates of lung infection and nursing workload,improve patient comfort.It' s worth popularizing in the clinical application.

Objective To evaluate the effectiveness of oropharynx airway in post-thoracotomy patients with sputum drainage difficulties. Methods 96 post-thoracotomy patients with sputum drainage difficulties were divided randomly into control group and test group: expectoration through oropharynx airway group and expectoration through nasal cavity group. Heart rate, blood pressure, PO2, SpO2, sputum suction time,successful intubation rate, effect of sputum suction and pulmonary associated complications before and after sputum aspiration between two groups were analyzed. Results There are significant differences in SpO2,PO2 , sputum suction time, successful intubation rate, effect of sputum suction and pulmonary associated complications before and after sputum aspiration between two groups ( t = 11. 16,11. 15, 15.20,8.18,6. 10,6.56,16.70,4.89 ;x2 = 5.76,4.44; P ＜ 0. 05 ), while there are no significant differences in HR and BP (P ＞0. 05 ). Conclusions Sputum suction through oropharynx airway is benefit to keep airway clean,improve respiration and relieve hypoxia.

OBJECTIVETo evaluate the ancillary diagnostic value of IgH gene rearrangements in those B-cell lymphoproliferative disorder cases whom are difficult in making a final diagnosis.

METHODSIgH gene clonal rearrangements were retrospectively analyzed in a total of 77 diagnostically difficult B-cell lympho-proliferative patients. Standardized BIOMED-2 system IgH gene clonality assay kit targeting FR1, FR2, FR3 was used, followed by heteroduplex-polyacrylamide gel electrophoresis (PAGE) and silver nitrate staining.

RESULTSThe final diagnoses of the 77 cases were: 12 cases of reactive lymphoid hyperplasia, 20 cases of atypical lymphoid hyperplasia or suspicious lymphoma, and 45 cases of B-cell lymphoma. Detection rates of at least one positive reaction were 2/12, 11/20 (55%), 36/45 (80%) in the three groups, respectively. In B-cell lymphomas, the clonality detection rate of FR1, FR2 and FR3 was 60% (27/45), 60% (27/45) and 56% (25/45), respectively. The type distribution were: 20 marginal zone lymphomas, including 18 extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue, 7 diffuse large B-cell lymphomas, 7 follicular lymphomas, 1 mantle-cell lymphoma, 1 Burkitt's lymphoma, 4 plasma cell neoplasms and 5 unclassified B-cell lymphomas. Rearrangements of FR1, FR2 or FR3 were not detected in 9 (20%) of the B cell lymphoma cases, nevertheless, one of them had developed liver lesion later, and was confirmed finally to be B cell lymphoma. Fourteen patients of reactive lymphoid hyperplasia with positive IgH gene clonal rearrangements, and atypical lymphoid hyperplasia had follow-up history available. Four of them were diagnosed as lymphoid malignancies upon further biopsy, and in three of them, clonal IgH gene rearrangements were detected.

CONCLUSIONSB-cell lymphoproliferative disorder requiring a detection of clonal IgH gene rearrangement for making a final diagnosis. Combined detections of three IgH FR1, FR2 and FR3 rearrangements provide important ancillary diagnostic value in confirming suspected B-cell lympho-proliferative disorders. It is important to take an additional biopsy or to follow-up those patients who that have a detectable IgH gene clonal rearrangement but without apparent morphological evidence of lymphoma. For cases with a negative IgH gene rearrangements, it might be necessary to perform clonality analysis for other forms of gene rearrangements including IgH or IgK and IgL in order to further improve the detection sensitivity.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Follow-Up Studies ; Gene Rearrangement, B-Lymphocyte, Heavy Chain ; Humans ; Lymphoma, B-Cell ; diagnosis ; genetics ; pathology ; Lymphoma, B-Cell, Marginal Zone ; diagnosis ; genetics ; pathology ; Lymphoma, Follicular ; diagnosis ; genetics ; pathology ; Lymphoma, Large B-Cell, Diffuse ; diagnosis ; genetics ; pathology ; Lymphoproliferative Disorders ; diagnosis ; genetics ; pathology ; Male ; Middle Aged ; Neoplasms, Plasma Cell ; diagnosis ; genetics ; pathology ; Pseudolymphoma ; diagnosis ; genetics ; pathology ; Retrospective Studies ; Young Adult

OBJECTIVETo evaluate the outcome of precision-fit surface hemiarthroplasty in the treatment of femoral head osteonecrosis.

METHODSThe clinical data of 41 patients (48 hip joints) with femoral head osteonecrosis were reviewed. Of them, 30 were male and 11 were female, average age was 37 years old (ranging from 29 - 49). Thirty-five patients were at Ficat stage III and 13 at Ficat stage IV, their acetabula were relatively normal. The 41 patients (48 hip joints) underwent precision-fit surface hemiarthroplasties.

RESULTSThe mean duration of follow-up was 5.2 years. The average UCLA hip score at follow-up was improved significantly from 3.1 to 9.1 points for pain, 4.4 to 9.2 points for walking, and 5.5 to 7.1 points for activity (P = 0.001). The satisfaction rate was 88.6% for 35 at Ficat stage III, 69.2% for 13 at stage IV (P = 0.25). Eight hips failed; the UCLA hip score was not improved significantly; the postoperative X-ray examination showed that 7 femoral prostheses were implanted in a varus orientation (the angle between the femoral prosthesis stem and the anatomic axis of the femoral shaft was lower than angle of 130 degrees). Five-year survival rate was 83.0%.

CONCLUSIONSPrecision-fit surface hemiarthroplasty of the hip has the satisfactory result in treatment of the femoral head osteonecrosis on the basis of observing strictly operative indications and improving operative technique.

Adult ; Arthroplasty, Replacement, Hip ; methods ; Female ; Femur Head Necrosis ; surgery ; Hip Prosthesis ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo investigate the prevalence of chronic obstructive pulmonary disease (COPD) and its risk factors in population over 40 years old in northern part of Guangdong province.

METHODSUsing uniform scheme, procedures and questionnaire, a cluster-randomized-sampling survey for the population aged over 40 years in a rural area of Shaoguan in the northern part of Guangdong province was performed. Spirometry was performed for every participant, followed by a bronchodilatation test when bronchial obstruction was present.

RESULTSThere were 1468 cases with complete data from 1498 people aged >or= 40 years including 640 males, 828 females with an average age of 54.3 years old. The total prevalence of COPD was 12.0%. The prevalence of COPD in males was significantly higher than that in females (18.3% vs. 7.1%, P < 0.01). Only 80.7% of the patients with COPD presented one or more symptoms as cough, phlegm, or dyspnoea. Underdiagnosis of COPD would be quite serious. Only 26.1% of the cases was previously diagnosed to have chronic bronchitis, emphysema, or COPD. Smoking was an important risk factor to COPD and 78.4% of the patients with COPD were smokers. However, relation of biomass and COPD called for further investigation.

CONCLUSIONPrevalence of COPD was much higher than expected in the northern part of Guangdong while smoking was an most important risk factor of COPD. Lung function test seemed to be of great importance to COPD diagnosis, especially in the earlier period of COPD.

Adult ; China ; epidemiology ; Female ; Humans ; Male ; Mass Screening ; Middle Aged ; Prevalence ; Pulmonary Disease, Chronic Obstructive ; epidemiology ; Risk Factors ; Sex Factors ; Smoking ; adverse effects ; Surveys and Questionnaires