Along with the mediated society,there are the problems in students'current media literacy,such as the alienation of media using,inability to distinguish'media reality'and'objective reality',lacking of media ethics and consciousness of self-discipline.Based on the analysis of these problems,in combination with the actual college education,we put forward the realization ways and the corresponding strategies to improve the students'media literacy.

Children are the main victim of anemia which is the most common disease in China.It is the first one of "Four Control Diseases" for Chinese government,as well as for WHO.This paper analyses its major epidemic factors and provides strategies on how to prevent it.

Objective To investigate the effects of oral folic acid supplementation on the expressions of heart devel-opment-related proteins GATA4 and Nkx2 . 5 of offspring in the rat models of maternal hyperglycemia during preg-nancy. Methods Forty Sprague-Dawly( SD) rats in pregnancy were randomly divided into 5 groups:control group, models group, FA3rd group, FA7th group and FA15th group. Except for the control group, maternal hyperglycemi-a was induced by a single intraperitoneal injection of streptozotocin (38 mg/kg) in SD rats of four other groups on the first day of pregnancy. And group FA3rd, FA7th, FA15th were intragastriced with folic acid (0. 8 mg/kg per day) from day 3,7,and 15 of pregnancy respectively until the end of the pregnancy. The hearts of neonates were taken on the 21st day of pregnancy and the heart tissues with haematoxylin and eosin staining were observed. The expressions of GATA4 and Nkx2. 5 proteins were detected by immunohistochemistry and Western blot. Results The blood glucose level of pregant rats intervened by streptozotocin was significantly increased(P<0. 05),and in a part of their offspring,the cardiac injury was detected. GATA4 protein was expressed in atria,ventricles, interven-tricular septum and valvular tissues. Nkx2. 5 protein was expressed in atria, ventricles and interventricular septum, while it was not expressed obviously in valvular tissues. The expression levels of GATA4 and Nkx2. 5 were de-creased in the groups intervened by streptozotocin compared with the control group(P<0. 05). The expression lev-els of GATA4 and Nkx2. 5 in FA3rd group and FA7th group were higher than that of the models group(P<0. 05). Compared with FA7th group, the expression of GATA4 and Nkx2. 5 in FA3rd group increased greatly(P<0. 05). However, it showed no significant difference between the models group and FA15th group. Conclusion Maternal hyperglycemia during pregnancy may result in offspring’ s cardiac injury and decrease their expressions of heart de-velopment-related protein GATA4 and Nkx2. 5 at the same time. Folic acid supplementation may increase the ex-pressions of GATA4 and Nkx2. 5 protein and has a protective effect on offspring’s myocardial development of mater-nal hyperglycemia in pregnancy.

Objective To understand the characteristics and related factors of adverse reactions (ADR) of anti-tuberculosis drugs among Zhuang nationality patients with smear-positive pulmonary tuberculosis (TB) and to provide basis to ADR control.Methods During Dec 2007 to May 2008,408smear-positive pulmonary TB cases of Zhuang nationality in 14 counties were selected by simple random sampling,and followed up for 6-8 months.Questionnaires were performed and liver/renal functions were tested during the research.Data were analyzed by chi square test and Logistic regression model.Results The incidence of ADR of Zhuang nationality people was 17.2％,which was higher than national level ( 12.62 ％ ).The incidence of allergic reaction was highest of all ADR ( 5.9 ％ ) and the incidences among different types of ADR were significantly different ( x2 =36.9,P=0.000).Serious ADR types were allergic reaction,gastrointestinal reaction,liver damage,nerve damage and kidney damage.And 24.3 ％ of the cases had two or three kinds of ADR.ADR occurred at the median of 21.5th day of anti-TB treatment,and the gastrointestinal reaction occurred the earliest (6th day).81.4 ％ of the ADR occurred in the first 2 months of anti-TB treatment.The rates of drug withdrawal and interruption were 11.5 ％ and 9.2 ％,respectively.Liver damage and nerve damage were the main causes of treatment withdrawal and interruption.Multiple factor non-conditional Logistic regression analysis showed that the ADR was correlated with age and the risk of ADR in ≥60years old patients was 3.3 times of that in 14-34 years old patients (OR=3.275,P=0.006).Thus,ADR incidence was increased with aging.Conclusions The incidence of ADR is higher in Zhuang nationality patients than that in general patient population.ADR monitoring and intervention must be strengthened in high-risk groups during high-risk period to reduce the adverse effect of anti-TBtreatment.

Objective To evaluate the repair of abdominal complicated incisional hernia using acellular dermal matrix (ADM).Methods Retrospective analysis was made on 7 cases with abdominal complicated incisional hernia treated by ADM in our hospital from January 2008 to June 2010,among them there were 4 males and 3 females.Age ranged from 43 to 83 years and the median age was 53 years.Two concurrent indirect inguinal hernia cases were repaired and concurrent gastrointestinal tract problems including 2 small bowd fistulas were operated one stage in 5 cases.Mean diameter of hernia ring was ( 11.6 ± 2.8 ) cm,ranged from 9.2 to 16.5 cm.5 cases were repaired by using intraperitoneal onlay mesh,others using total extraperitoneal prothesis.Results All patients were operated on successfully.Average time was (33 ±12) min.Blood loss was (16 ±4) ml.Hospital stay was 7 - 12 d.7 patients repaired by ADM fully recovered.There were no chronic pain,paresthesia,pneumonia and urinary tract infection cases,no incision swelling,seroma or infection.All patients were followed up with median time of 14 months,ranging from 5 to 26 months.There were not hernia recurrence,nor surgical site infection during follow-up period.Conclusions For the repairing of abdominal complicated incisional hernia,the application of acellular dermal matrix is safe and effective method especially in those of incisional hernia complicated by infection.

Objective To investigate the effects of oral folic acid on cardiac development related gene expression of offspring in an experimental model of coxsackievirus B3(CVB3) infection of pregnant rats. Methods SD female rats were randomized into control group, folic acid group, CVB3 group and CVB3+folic acid group. The female rats were given folic acid by gavage for 2 weeks before pregnancy in folic acid group and CVB3+folic acid group. After conception for 7 days, rat model was established by intraperitoneal injection of CVB3 for 5 days in CVB3 group and CVB3+folic acid group. After nat-ural childbirth neonatal heart was taken and stored in liquid nitrogen. The morphological changes of neonatal rat myocardial tissues were observed by HE staining. The expressions of GATA-4 and NKx2.5 mRNA were detected by RT-PCR and West-ern blot assay. Results There was significant myocardial injury, such as myocardial fiber disarray and myocardial fiber breakage, in neonatal rats in CVB3 group. These damages were improved in CVB3+folic acid group. The expression levels of GATA-4 and NKx2.5 genes in myocardial tissues were significantly lower in CVB3 group than those of control group (P<0.05). The expression levels of GATA-4 and NKx2.5 proteins in myocardial tissues were significantly higher in CVB3+folic acid group than those of CVB3 group (P<0.05). Conclusion CVB3 infection in the early pregnancy inhibited the expres-sion of neonatal rat cardiac development factor. Folic acid supplementation has obvious protective effects on the neonatal rat cardiac development.

objective:To investigate the cause,pathogenesis,diagnosis and treatment of Wernicke encephalopathy(WE) after total parenteral nutrition(TPN). Methods:A retro spective study was conducted on 20 cases of clinical data about WE after long period of TPN. Results:WE usually occurred in the 2th～3th week of TPN support.18 cases of WE were treated with vitamin B_(1) in time,their symptoms disappeared and survived.2 patients died with misdiagnosis. Conclusion:Vitamin B_(1) is the key point to prevent and treat WE after long period of TPN.

10.3969/j.issn.1007-3969.2013.04.005

Objective To investigate the expression of DNA binding protein A (dbpA) in patients with colorectal carcinoma of different stages and its significance.Methods Expression of dbpA protein and mRNA in specimens of normal tissues and colorectal cancer were detected by immunohistochemistry,expression of dbpA mRNA and protein of colorectal cancer cell lines SW480,RKO,SW620,DLD-1,HT-29,SW1463 and tissues were detected by immunohistochemistry,RT-PCR and Western blot.Results There was no positive staining dbpA protein and mRNA in normal colorectal tissues.However,dbpA was expressed in epithelial cells of colorectal mucosa [dbpA mRNA:80.0 ％ (48/60),10.0 ％ (6/60);dbpA protein:83.3 ％ (50/60),10.0 ％ (6/60),P ＜ 0.01].And there was no expression in normal colorectal cell,but its expression was high in 6 colorectal cancer cells (P ＜ 0.05).The high expression of dbpA was correlation with the infiltration depth,lymph node metastasis and type of histology (P ＜ 0.05),and had effect in prognosis of colorectal cancer (P ＜ 0.05).Conclusion Elevated dbpA may be related to the pathogenesis and development of colorectal carcinoma,and dbpA may be a prognostic factor of colorectal carcinoma.

Objective:To evaluate the clinical efficacy of transanal total mesorectal excision (taTME) on transanal endoscopic microsurgery (TEM) platform in the treatment of middle and low rectal cancer.Methods:The retrospective and descriptive study was conducted. The clinico-pathological data of 28 patients with middle and low rectal cancer who underwent taTME on TEM platform in the Peking Union Medical College Hospital of Chinese Academy of Medical Science from October 2014 to October 2017 were collected. There were 21 males and 7 females, aged 59 years (51 years, 68 years). Observation indicators: (1) surgical and postoperative situations; (2) follow-up. Follow-up was conducted using outpatient examination or telephone interview to detect post-operative defecation function and survival of patients up to October 2020. Patients underwent physical examination, examination of tumor markers including carcinoembryonic antigen and CA19-9, colonoscopy, rectal magnetic resonance imaging, thoracoabdominal and pelvic enhanced computed tomography (CT) and (or) PET-CT examination during the follow-up. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was analyzed using the independent sample t test. Measurement data with skewed distribution were represented as M( P25,P75) or M (range), and comparison between groups was analyzed using the non parameter Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Results:(1) Surgical and postoperative situations: 28 patients underwent successful surgery, without intra-operative conversion to laparotomy. Of 28 patients, 24 cases underwent colorectal anastomosis and 4 cases underwent colon-anal anastomosis. Twenty-six cases underwent primary protective enterostomy and 2 cases didn't undergo primary protective enterostomy. The operation time of 28 patients was (182±37)minutes and the volume of intraoperative blood loss was 40mL(30 mL, 55 mL). One patient with intraoperative presacral hemorrhage received compression hemostasis. Eleven patients had postoperative complications, including 4 cases with anastomotic leakage, 2 cases with alteration of intestinal flora, 2 cases with paralytic ileus, 2 cases with urinary retention, 2 cases with urinary infection, 1 case with prolapse necrosis of small intestinal stoma, 1 case with anal hemorrhage, 1 case with rectovaginal fistula, 1 case with pelvic infection; some patients had multiple complications. Three patients had non-planned reoperation. One case without primary protective enterostomy had anastomotic leakage at postoperative 3 days, and was improved after emergency transversostomy. One case had prolapse necrosis of small intestinal stoma at postoperative 3 days and was improved after emergency enterostomy and reconstruction. One case with anal hemorrhage was stopped hemorrhage under anoscopy. Patients with other complications were cured after conservative treatments. The duration of postoperative hospital stay of 28 patients was 8 days(7 days, 9 days). Results of pathological examination in 28 patients showed 16 cases of moderately differentiated adenocarcinoma, 3 cases of moderately to highly differentiated adenocarcinoma, 5 cases of highly differentiated adenocarcinoma, 1 case of mucinous adenocarcinoma, 3 cases of pathological complete response. TNM staging of 28 patients showed 3 cases in stage T0N0, 4 cases in stage T1N0, 6 cases in stage T2N0, 4 cases in stage T2N1, 7 cases in stage T3N0, 3 cases in stage T3N1, 1 case in stage T4N1. The distance from tumor to distal margin was (2.2±1.7)cm. The surgical specimens of 28 patients showed negative for proximal, distal and circumferential margins. The number of lymph node dissection was 15±7. The complete rate of total mesorectal excision was 100%(28/28). Eleven of 28 patients underwent neoadjuvant therapy and 17 patients didn't receive neoadjuvant therapy. The tumor diameter, distance from tumor to anal margin, operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 2 cm(1 cm, 4 cm), 5 cm(4 cm, 6 cm), (187±25)minutes, 45 mL(38 mL, 53 mL), 8 days(7 days, 12 days) for patients with neoadjuvant therapy, respectively, versus 3 cm(2 cm, 4 cm), 5 cm(4 cm, 6 cm), (177±35)minutes, 40 mL(30 mL, 60 mL), 8 days(7 days, 8 days) for patients without neoadjuvant therapy, showing no significant difference between the two groups ( Z=-1.127, -0.293, t=0.590, Z=-0.790, -0.876, P>0.05). (2) Follow-up: 23 of 28 patients were followed up for (44±14)months. Of the 23 patients,11 cases were classified as grade A of Williams score for defecation function at postoperative 6 months, 8 cases were classified as grade B and 4 cases were classified as grade C. Eighteen of 23 patients with follow-up had disease-free survival, 1 of whom didn't undergo stoma closure due to anastomotic stenosis at postoperative 6 months. Three patients had distant metastasis, including 1 case with parastomal implantation metastasis, 1 case with sacral metastasis, 1 case with pulmonary metastasis. Two patients died, 1 case of whom died of urinary obstruction and 1 case with mucinous adenocarcinoma died at postoperative 24 months. Conclusion:TaTME based on TEM platform is feasible for middle and low rectal cancer, which has the advantages of preserving anus and negative circumferential margin.