In combination with the experience in teaching practice,we discuss medical lit-erary teaching reform,method and the significance and sparkplug exhibiting the knowledge forming process,cultivate managing the information ability,inspire creative interest,and form the style of study as "to study the phenomena of nature in order to acquire knowledge"and"reasonable doubt".

Objective To investigate the myocardial protective effects ,mechanism and safety of recombinant human erythropoie-tin(rHuEPO) pretreatment in the patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) .Methods Thirty pa-tients with rheumatic heart disease undergoing valve replacement surgery were randomly divided into the observation group and the control group ,15 cases in each group .The observation group was given rHuEPO 300IU/kg by hypodermic injection on preoperative 2 d ,once daily for twice .The control group was given the same dose of normal saline .The blood routine was performed before sur-geryandonpostoperative7d.Thelevelsofcreatinekinaseisoenzyme(CK-MB)andtroponinT(cTnT)weredetectedbeforeopera-tion ,at 6 ,24 ,72 h after the aorta opening (T0 ,T6 ,T24 ,T72 ) .At the end of CPB ,myocardial biopsy was conducted for detecting the myocardial apoptosis index (AI) .The CPB time ,aortic cross clamp(ACC) time ,postoperative ICU stay ,blood transfusion and post-operative complications were recorded .Results The level of postoperative CK-MB and cTnT in the two groups were significantly increased after the aorta opening ,which at T6 was highest ,followed by a downward trend .The levels of CK-MB and cTnT at vari-ous time points in the observation group were significantly lower than those in the control group .The main effect of rHuEPO pre-treatment had statistical difference between the two groups (P= 0 .01) .Myocardial AI in the observation group was significantly lower than that in the control group ,the difference showing statistical significance (P<0 .01) .The observation group had no risk leading to obviously increase postoperative Hb ,Hct values and thromboembolism ,but the postoperative blood transfusion amount was reduced .Conclusion rHuEPO pretreatment has the protective effect on myocardium in the patients undergoing cardiac surgery under CPB ,which can reduce myocardial apoptosis and has safe reliability .

Objective To explore the prenatal indications and pregnant outcome of balanced transloca-tion at amniocentesis, so as to provide scientific guidelines of prenatal diagnosis for local pregnant women. Methods Retrospective review was made on 76 cases of balanced translocation at amniocentesis from 2011 to 2015 at our hospital. Results In 76 cases, 38 cases were aged pregnancy prenatally, 20 cases carriers, 9 cas-es abnormal serum screening , 5 cases with previous abnormal births , 2 cases with abnormal ultrasound findings and 2 cases with other problems. Conclusion Balanced translocation concomitant aneuploidy , de novo X-auto-some translocation or de novo complex chromosome rearrangements can cause fetal abnormalities on prenatal di-agnosis. The results of ultrasound, FISH and array-CGH could provide for de novo simple translocation at amnio-centesis.

Objective To investigate the effect of Qingjing Capsule (QC) in treating advance menorrhea (AM) and to evaluate its safety. Methods Double- blind, double- imitating, parallel- controlled and randomized trial was performed in 63 cases of AM with deficiency- heat syndrome.Thirty- two cases was in QC group(Group A) and other 31 in Gujing pill group(Group B).The menstrual cycle, clinical symptoms and signs, basal body temperature (BBT), serum levels of estradiol (E2) and progesterone and endometrium biopsy were observed to evaluate the effects of QC. Results The short- term markedly- effective rate was 90.63% and 77.42% and the short- term effective rate was 96.88% and 93.55% in Group A and Group B respectively. The long- term markedly- effective rate was 83.87% and 67.74% and the long- term effective rate was 93.55% and 80.65% in Group A and Group B respectively. The long- term markedly- effective rate in QC group is superior to that in Gujing pill group, the differences being significant(P

OBJECTIVE To investigate the distribution of bacteria in general ICU then discuss the susceptible factors and the treatment.METHODS A retrospective analysis of clinical information was performed on 123 patients diagnosed infection who stayed in ICU from May 2002 to May 2004.RESULTS Most of bacteria resulted in infection of general ICU were Gram-negative(62.88%) and then Gram-positive(19.65%). Fungal infection accounted for 17.47%.Pseudomonas aeruginosa occupied the highest percentage among Gram-negative bacteria.Most of Gram-positive bacteria were Staphylococcus aureus and all of them were MRS.The infection site in ICU focused on lower respiratory tract(89.09%).The second was urinary tract(11.79%).CONCLUSIONS Most of the bacteria causing infection in general ICU locate in respiratory tract.They are mainly Gram-negative.All of the Gram-positive bacteria are MRS.The risk factors of hospital-acquired infection are related with patient′s age,underlying disease,intensive care time,ventilation time and invasive operation.

The application of Problem-based Learning(PBL) in prosthodontics accommodates the request of teaching reformation and also elevates the quality of students and teachers.PBL is a fine teaching method and deserves popularization.

Objective To explore the dynamic changes of CD34 + cells and T lymphocyte subsets and best time of harvesting peripheral blood stem cell when G-CSF was used for peripheral blood stem cell mobilization in donors and patients. Methods A total of 12 donors and 16 patients who received chemotherapy for 7 d were injected G-CSF of 300 ?g/d to mobilize peripheral blood stem cells for 5 d and flow cytometry were used to detect the changes of CD34 + cells and T lymphocyte subsets everyday for 5 d. Results ① Before G-CSF treatment, there were obvious differences in bone marrow CD34 + cells between patients and donors (P

Objective To explore the effects of different body positions at the expiratory phase thinsection multi-slice spiral CT on the diagnosis of pulmonary air trapping after allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods Thirty-one allo-HSCT patients underwent the expiratory phase low-dose MSCT lung scanning at supine and prone positions to detect whether they have air trapping lesion,the volume percent of air trapping region (CT value ≤-700 HU at expiratory phase) against the whole lung was measured by using GE workstation after grading.Statistical analysis on lesion detection rate was performed with McNemar test and volume percent with rank sum test.Results Air trapping regions were observed in 8 patients (25.8％,8/31) who performed CT scan at the supine position,while 15 cases (48.4％,15/31)were positive for prone position CT scan.Seven cases showed positive results at both body positions.Statistical significance in the positive detection rate at supine and prone positions was found (x2 =4.00,P =0.039).The volume fraction of the two positions was 13 for supine position and 21 for prone position with statistical significance (Z =-3.37,P =0.001).Sensitivity at prone position CT scan to detect air trapping was much higher than that at supine position CT scan.Conclusion For allo-HSCT patients with chronic rejection reaction,performing expiratory phase thin-section CT scan and prone position scan can not only improve the detection rate of lung forepart lesions,but also preliminarily evaluate the severity of the air trapping,which can provide a basis for the early diagnosis and treatment in clinics.

Objective:To observe the effect of Jieyu Anmian prescription of Chinese medicine foot bath on gastrointestinal function in patients with digestive system tumor during perioperative period.Methods:A total of 130 patients with digestive system tumors were chosen from January 2019 to March 2020 for the first time visits to the first hospital of lanzhou university for surgical treatment, 15 cases lost follow-up, and the rest 115 cases of patients were divided into the experimental group (59 cases) and the control group (56 cases) according to random number table method. The control group using conventional care method, the experimental group was treated with Jieyu Anmian washing formula on the basis of routine nursing care for 10 days. During the foot bath, the recovery of gastrointestinal function, the time of the first exhaust and defecation, the length of stay, the cost of stay and the satisfaction of patients were compared between the two groups.Results:The recovery time of bowel sounds, anal exhaust time and first defecation time of the experimental group were all earlier than those of the control group (16.21±11.81) h, (19.64±12.40) h and (41.98 ±19.16) h, respectively, while those of the control group were (27.34±31.47) h, (35.81±18.26) h and (34.47±16.41) h, respectively. The differences were statistically significant ( t value was -2.41, -5.33, 2.17, P< 0.05). The results of the survey of patient satisfaction showed that the experimental group was superior to the control group, with 97.47 ± 4.37 in the experimental group and 94.19 ± 3.29 in the control group, with statistically significant differences ( t value was 3.89, P<0.01). The satisfaction of doctors in the experimental group was 97.41 ± 6.25 and 94.21±5.91 in the control group, with statistically significant difference ( t value was 3.95, P<0.05). The satisfaction of nurses in the experimental group was 97.58 ± 4.53 and 93.85±5.23 in the control group, and the difference was statistically significant ( t value was 4.12, P<0.05). There was no significant difference between the two groups in terms of length of stay and hospitalization expenses ( P>0.05). Conclusions:Jieyuanmian prescription of Chinese medicine foot bath can promote the recovery of gastrointestinal function, promote the exhaust and defecation, and improve the satisfaction of patients and nurses.

Objective To explore the distribution of prenatal indications , clinical features and pregnant outcomes of chromosomal unbalanced reciprocal translocations atthe second trimester. Methods The data on 35 fetuses with unbalanced reciprocal translocations between May 2011 and March 2016 were retrospectively analyzed and reviewed. Results Of 35 fetuses with unbalanced translocations , 29 (82.86%) showed ultrasound abnormalities,and 6 (17.14%) had no significant clinical features. 8 were de novo, and the other 27 were parental inherited. All the 35 women had to terminate the pregnancy. Conclusions Ultrasound abnormalities are associated with chromosomal unbalanced reciprocal translocations at the second trimester , and most unbalanced translocations fetuses origin from parental carrier of balanced translocations.