Problem-based learning(PBL) teaching mode was applied in Urology practice of the medical students.The externs were organized to analyze and discuss a real case,having grasped enough knowledge of relative diseases,and to provide their advice about the diagnosis and treatment,changing question mark into a full stop.And then their conclusions were verified by post-operational follow-up.PBL teaching mode can increase the students'study motivations and interests and the ability to resolve practical problems,master medical knowledge,train their clinical thinking and enhance the quality of teaching and thus it is an effective teaching mode.

Objective To investigate clinical effect of esomeprazole, mosapride, magnesium plus aluminum in patients with reflux esophagitis. Methods 98 patients with reflux esophagitis who were treated in our hospital from October 2014 to October 2016 were selected and randomly divided into control group and observation group, with 49 cases in each group.In the control group, patients were treated with esomeprazole and mosapride.In the observation group, patients were given esomeprazole, mosapride and magnesium plus aluminum.The levels of serum gastrin, serum motilin and 24-hour pH in the esophagus were compared before and after treatment .Results After treatment,The levels of serum gastrin and serum motilin in the observation group were significantly higher than those in the control group, the difference was statistically significant (P<0.05), while the total time percentage of pH<4 at standing position, total time percentage of pH <4 at supine position, total reflux time percentage of pH <4, and the duration of continuous reflux≥five mins in the observation group were significantly lower than those in the control group, the difference was statistically significant (P<0.05). Conclusion Esomeprazole, mosapride and magnesium plus aluminum have significant clinical effect in patients with reflux esophagitis, and can effectively reduce 24-hour pH in the esophagus, decrease the number of reflux, increase serum gastrin and serum motilin levels.

Objective To observe the effect of omeprazole combined with Kangfuxin liquid on immune function,gastrin family and NO levels in patients with gastric ulcer.Methods 120 cases of patients with gastric ulcer from October 2014 to September 2016 in our hospital were selected and randomly divided into the observation group and the control group with 60 cases in each group.The control group was given omeprazole based on conventional treatment, and the observation group was given Kangfuxin liquid based on the control group.For four weeks, to observe the differences of immune function (CD3 +,CD4 +,CD8 +,CD4 +/CD8 + and CD4 +CD25 +FoxP3 +Treg), gastric gastrin family (GAS, CCK, MTL) and NO levels between the two groups.Results After treatment, the CD3 +, CD4 +, CD8 +, CD4 +/CD8 +and CD4 +CD25 +FoxP3 +Treg levels of the two groups were compared, the difference was statistically significant (P<0.05), CD3 +, CD4 +, CD4 +/CD8 + of the groups showed a gradually increasing, the difference was statistically significant (P<0.05) and CD8 +, CD4 +CD25 +FoxP3 +Treg showed a gradually decreasing, the difference was statistically significant (P<0.05), and the change range of the observation group was more than that of the control group, the difference was statistically significant (P<0.05), the GAS,CCK,MTL levels of the two groups were compared, the difference was statistically significant (P<0.05), the GAS, CCK of the two groups showed a gradually decreasing, the difference was statistically significant (P<0.05), and MTL showed a gradually increasing, the difference was statistically significant ( P<0.05 ) , and the change range of the observation group was more than that of the control group , the difference was statistically significant (P<0.05), the NO levels of the two groups were compared, the difference was statistically significant (P<0.05), NO of the groups showed a gradually increasing, the difference was statistically significant (P<0.05), and the change range of the observation group was more than that of the control group, the difference was statistically significant (P<0.05).Conclusion Omeprazole combined with Kangfuxin liquid can get better regulating results of immune function and gastrin family, NO in patients with GU, and have more effective than omeprazole alone.

Objective To evaluate the efficacy of retroperitoneoscopic radical nephrectomy.Methods From October 2001 to September 2006,a total of 108 patients underwent retroperitoneoscopic radical nephrectomy in our department.The tumors sized 1.0-8.0 cm in diameter with a mean of(4.3?2.9)cm.Before the operation,42 patients were in stage T1N0M0,54 in stage T2M0N0,and 12 in stage T3aN0M0.Results The operation time was 35-180 min with a mean of(63.5?30.3)min,and the blood loss was 20-1500 ml [mean,(75?23)ml].Totally 3 patients were converted to open surgery.The intra-and postoperative complications included hemorrhage caused by the injury of the inferior vena cava or renal artery(4 cases),wound infection(3 cases),and hypercapnia(8 cases).The patients were followed up for 6-36 months(over 12 months in 61 cases),during which 2 patients died of pulmonary metastasis one year after the surgery,1 patent died of liver metastasis 7 months after postoperation,the other 105 patients survived without tumor.The 1-year survival rate was 98.4%(60/61);and 3-year survival rate was 85.7%(18/21).Conclusions Retroperitoneoscopic radical nephrectomy is mini-invasive and effective for renal carcinoma.The patients recover quickly after the surgery.The procedure is worth being wildly used.

Shenjufencilu (SFL) is a liniment prepared from Dedsnthema mordelium,Angelica dahurica,Sophora fiavescens,Dictamnus dasycarpus and a mumber of other herbal midicines for the treatment of puberal acne.The presence of the above four contituents was identified by TLC and the content of matrine,the active principle from Sophora fiavescens was determined quantitatively by TLC scanning,to establish the quality standard of SFL. The methods were simple,sensitive,reproducible and accurate

Objective To explore the diagnostic and therapeutic value of endoscopic retrograde cholangiopancreatography ( ERCP) in teenagers with chronic pancreatitis. Methods Thirteen teenagers with chronic pancreatitis diagnosed and treated by consecutive ERCP procedures in our hospital from Feb 1997 to Feb 2002 were studied retrospectively. Results Of the 13 patients 12 had abdominal pain and 10 had history of acute/chronic pancreatitis. The ERCP findings were as follows: pancreatic duct stricture and/ or dilation 12, pancreatic duct stones 7, pancreatic pseudocysts 2, pancreas divisum 3, and cholecystolithia-sis 1. Therapeutic interventions included EST 7 , basket stone extraction 6, placement of pancreatic duct stent 5 , pancreatic duct stricture bougie or balloon dilation 4, accessory papillotomy 2 and endoscopic papillary dilation 1. In the 6 - 68 months follow - up, 11 (84. 6% ) never had recurrence of pancreatitis or abdominal pain ,2 patients had no abdominal pain after the second ERCP procedure. There were procedure -related complications of hyperamylasemia in 4 cases(30. 8% ) and pancreatitis in 3 cases(23. 1% ). Conclusion ERCP has significant value in diagnosing and treating chronic pancreatitis in teenagers, but has a rather high rate of complication . It suggested that the restrict selection of indication and safe application of the procedures in pediatric patients may be expected to decrease the adverse events of ERCP.

BACKGROUND: Previous studies demonstrated that recombinant human bone morphogenetic pretein-7 (hBMP-7) can effectively promote the synthesis of extracellular matrix, repair of damaged disc matrix, restore of degenerative disc height. It is hoped that BMP-7 can be used to control and reverse the intervertebral disc degeneration. However, because of the short half-life of recombinant protein and low biological activity, it is difficult to maintain BMP-7 high concentrations on degenerative disc. Gene therapy can prevent these defects effectively.OBJECTIVE: To study the effect of hBMP-7 gene transfeotion on biological activity of primary cultured rabbit nucleus pulposus cells in vitro, to determine the feasibility of hBMP-7 gene which will on gene therapy research of intervertebral disc degeneration,and to provide basis for further study.DESIGN, TIME AND SETTING: A randomized and controlled observation was performed at the Institute of Cardiothoracic Surgery of Changhai Hospital from December 2005 to September 2006.MATERIALS: Six healthy New Zealand white rabbits of either gender, averaging 4 weeks old and weighing 500 g, were used in this study, and Ad-hBMP7 was constructed by the Cardiothoracic Surgery Institute of Changhai Hospital.METHODS: After rabbits sacrifice under aseptic condition, the nucleus pulposus was got. After digested with Pronase, type Ⅱcollagenase and type Ⅱ DNAase (4 hours, 37 "(2), the cells were seeded in the Petri dishes and were kept in the incubator. After 7 days and then twice a week, the media were refreshed. The nucleus pulposus cells were infected by adenovirus integrated with hBMP7 gene. The cells which were transfected by adenovirus vector for Lac-Z gene and which were not transfected were adopted as control.MAIN OUTCOME MEASURES: The expression of hBMP-7 was determined by RTopCR and Western blot. The effect of hBMP-7 on cell proliferation was surveyed by MTT. Furthermore, the effect of hBMP-7 gene on synthesis of proteoglycan and type Ⅱcollagen was detected by modified dimethylmethylene blue method and ELISA, respectively.RESULTS: Gene sequencing and PCR showed that hBMP-7 gene was inserted correctly and no mutation happened. The pdmary cultured rabbit nucleus pulposus cells were identical with those reported in literature. After Ad-hBMP7 transduct into the nucleus pulposus cells, high level of hBMP-7 expression was observed and lasted over 3 weeks. Also hBMP-7 gene can promote cell proliferation and synthesis of proteoglycan and type II collagen with significant difference compared with control groups (P < 0.05).CONCLUSION: hBMP-7 gene mediated by adenovirus can be the target gene for the further study on gene therapy of intervertebral disc degeneration.

Objective To explore the classification of intracranial arachroid cysts(IAC) in CT cisternography(CTC) and its clinicalapplication.Methods 22 cases of IAC diagnosed by plain CT underwent CTC exminaton. IACs were classified into noncommnicatingintracranial arachnoid cyst (NCIAC) and commnicating intracranial arachnoid cyst (CIAC) by wheather or not filled with contrast media in cysts on CTC. NCIAC cases were selected and treated with neuroendoscopic fenestration.Results 15 cases of NCIAC were found by CTC examination. All the NCIAC patients had definite neurologic findings. Postoperatively, all the patients were improved or cured. Follow-upplain CT scan of 9 NCIAC cases showed the cysts were decreased markedly in size, most of the space around the cysts were replaced bynormal cerebral tissue.Conclusion (1)CTC is simple ,safe and specific for making a final diagnosis of IAC. IACs can be classified into CIAC and NCIAC by CTC findings.(2)Neurosurgical indication for IAC is NCIAC patients with symptoms.

Objective To understand the diagnostic value of blink reflex (BR) in central neuropathy by observing the variations of blink reflex in diabetic patients. Methods Electrical pulse was used to stimulate the supraorbital nerve at the supraorbital notch. The responses of bilateral orbicular muscles of the eye were recorded, the variations of the latency and amplitude of R 1 and R 2 recorded on the side of stimulation and of R′ 2 recorded on the contralateral side were measured. Results There was significant prolongation in the latency and lowering of the amplitude of R 1, R 2 and R′ 2 in the diabetic patients compared with the control group. The abnormality rate of BR increased gradually with the prolongation of diabetic duration. Conclusion BR examination might provide an objective index for nervous damage in diabetic patients and it is helpful in early diagnosis of diabetic neuropathy.

Objective: To compare the dissolution quantities in vitro of ferulic acid and the analgesic effect of Rhizoma Chuanxiong by supper-micronized powder, fine powder, water extraction, alcohol extraction and double extraction. Methods: Their dissolution rates in vitro were determined by paddle stirring method, the dissolution quantities of ferulic acid in 60 min were determined by TLC-scaning, the analgesic effects were determined by torsion and hot-plate methods. Results: The dissolution quantities of ferulic acid were respectively: supper-micronized powder (0.645?0.008)mg, fine powder (0.359?0.005)mg, water extraction (0.220?0.004)mg, alcohol extraction (0.526?0.007)mg, double extraction (0.061?0.003)mg. The analgesic effect of supper-micronized powder of Rhizoma Chuanxiong was the best. Conclusion: The supper-micronized powder of Chuanxiong improved the dissolution quantity of active components and improved the potency.