Objective To write the school-based teaching material of pathology,and apply it to the students in higher vocational colleges to evaluate the application effect.Methods Two classes of clinical medical students of Grade 201 1were divided into two groups:the experimental group(Class1,58 students) and the control group(Class2,60 students).Both of the two groups take the integration of theory and practice teaching method.The traditional teaching material was applied in the control group while the school-based teaching materials were adopted in the experimental group.Statistical analysis software SPSS 13.0 and two samples t test were used to compare the preparing effect before the class,case study effect and the final examination of the two groups.After the end of the course,students' teaching satisfaction questionnaire was conducted,and the results of the survey for the rank sum test were analyzed.Results The scores of preparing effect before class were higher in experimental group(84.4 ±6.2) than those in the control group(78.2 ±5.8),t=5.61,P=0.001; the case study effect in experimental group(78.6 ± 6.6) was higher than that of the control group(72.8 ± 5.3),t=5.27,P=0.002; there was no significant differences in the final examination between the two class [experimental group (83.5 ± 6.8),control group (81.6 ± 6.9)],t=1.51,P=0.183.The questionnaire shows,in the aspect of the difficulty of teaching material,the degree of satisfaction in the experimental group(satisfied:28,general:30,unsatisfied:0) was higher than the control group(satisfied:18,general:37,unsatisfied:5),Z=-2.43,P=0.015; in the aspect of reading interest,the degree of satisfaction in the experimental group(satisfied:32,general:25,unsatisfied:1) was higher than the control group(satisfied:22,general:35,unsatisfied:3),Z=-2.09,P=0.036; in the aspect of emphasizing on the key point,the degree of satisfaction in the experimental group(satisfied:20,general:38,unsatisfied:0) was higher than the control group(satisfied:12,general:39,unsatisfied:9),Z=-2.72,P=0.007; in the aspect of self-study effect,the degree of satisfaction in the experimental group(satisfied:20,general:38,unsatisfied:0) was higher than the control group(satisfied:16,general:39,unsatisfied:5),Z=-3.13,P=0.002; but there was no significant differences in classroomlearning effect(experimental group:satisfied,38,general,20,unsatisfied,0; control group:satisfied,36,general,23,unsatisfied,1),Z=-0.68,P=0.497.Conclusions The school-based teaching material can contribute to the students' self-learning,enhancing the students' interest of learning and knowledge-application ability.

Objective To investigate the surgical treatment and early intravitreal injection of antibiotics to the curative effects of vitrectomy for exogenous endophthalmitis. Design Retrospective case-controlled study. Participants From Jan 2000 to Dec 2004, 94 patients(94 eyes), diagnosed as endophthalmitis were evaluated retrospectively. Methods All patients underwent pars plana vitrectomy. 46 patients (46 eyes) underwent the intravitreal injection of antibiotics early before undergoing vitrectomy from 3 to 14 days (mean 5.6 days) (group Ⅰ). The other 48 patients (48 eyes) underwent vitrectomy directly (group Ⅱ). Postoperative follow-up ranged from 3 to 12 months (mean 7.5 months). Main Outcome Measures Visual acuity. Results The visual acuities of these 94 patients improved significantly after vitrectomy (P=0.000). The rate of curative effects in group Ⅰ was significantly higher than that of the group Ⅱ (P=0.029). According to the further analysis, the rates of curative effects of the patients underwent vitrectomy in 7 days were similar between group Ⅰ and group Ⅱ(P=0.692), but the rates of curative effects of the patients underwent vitrectomy after 7 days were obviously different between two groups (P=0.008). Conclusions Undergoing vitrectomy as early as possible is a good available method for the treatment of exogenous endophthalmitis. If the vitrectomy can not be undergone early, intravitreal injection of antibiotics in time before vitrectomy may increase the therapeutic effect of exogenous endophthalmitis obviously.

Obej ctive To investigate the role of metastasis associated protein 1(MTA1)in estrogen reg-ulated expression of matrix metalloproteinase -9(MMP-9)and tissue inhibitor of metalprotease -1(TIMP-1) in estrogen receptor( ER ) positive breast cancer cells .Methods MTA1 knockdown cell model was generated based on MCF-7breast cancer cell line by transfected with MTA 1-shRNA.The mRNA and protein level of MMP-9 and TIMP-1 in wild type MCF-7(MCF-7WT)and MCF-7MTA1-shRNA before and after 17β-estradiol ( E2) treatment were examined by Real -time PCR and Western blot respectively .Results The MTA1-shRNA showed maximally 84.9%suppression of MTA1 expression in MCF-7,suggesting a satisfied MTA 1 knockdown cell model was established for subsequent experiments .After treated with E2 for 48 h,MCF-7WT showed an incre-ment of 46%(P<0.05)and 37%(P<0.05)of the mRNA and protein level of MMP -9 and a decrement of 32.3%( P<0.05)and 18.2%(P<0.05)of TIMP-1;MCF-7MTA1-shRNA showed a decrement of 32.3%(P<0.05)and 18.2%(P<0.05)of mRNA and protein expression of MMP -9 respectively but no significant differ-ence in TIMP-1 comparing with MCF-7WT before treated with Estradiol.After E2 treatment,MCF-7MTA1-shRNA didn′t show significant change of MMP -9 except decrements of 32.3%(P<0.05)and 18.2%(P<0.05)in the mRNA and protein levels of TIMP -1.Conclusion MTA1 may be involved in the pathway by which estrogen regulated the expression of MMP -9 but not TIMP-1 in ER positive breast cancer cells .

Objective To compare the diagnostic efficacy of the V/Q scan and CT pulmonary angiography (CTPA) for the detection of acute pulmonary embolism (PE) in elderly patients.Methods Fortyfour patients (age ≥60 years old) with suspected acute PE underwent V/Q scan and CTPA.The diagnosis of PE by V/Q scan was based on the criteria of prospective investigation of PE diagnosis (PIOPED) Ⅱ and the prospective investigative study of acute PE diagnosis (PISA-PED).The final diagnosis was made clinically.The sensitivities,specificities and accuracies of PIOPED Ⅱ,PISA-PED,CTPA and Wills score were calculated and compared using x2 and Fisher's exact tests.Kappa analysis was used to analyze the diagnostic accordance rate of PIOPED Ⅱ and PISA-PED.Results The sensitivities of PIOPED Ⅱ,PISA-PED and CTPA in the diagnosis of PE were 70.00％ (14/20),84.62％ (22/26) and 65.22％ (15/23),respectively (x2 =0.069-1.545,all P＞0.05).The sensitivity of Wills score was significantly lower (23.08％,3/13).The specificity of CTPA (93.75％,15/16) was significantly higher than those of PIOPED lⅡ and PISAPED (80.00％,12/15 and 61.11％,11/18,both P＜0.05).The accuracies of PIOPED Ⅱ,PISA-PED and CTPA were 74.29％ (26/35),75.00％ (33/44) and 76.92％ (30/39),respectively (x2 =0.005-0.070,all P＞0.05).The accuracy of Wills score was significantly lower (52.17％,12/23).The diagnostic accordance rate of PIOPED Ⅱ and PISA-PED criteria was 77.14％(27/35),Kappa=0.547,P＜0.05.Conclusion V/Q scan and CTPA have no significant difference for the diagnosis of PE in the elderly patients.

Objective To evaluate the effectiveness of using low-frequency repetitive transcranial magnetic stimulation (rTMS) along with donepezil in the rehabilitation of aphasia after cerebral infarction. Methods Fortythree aphasic patients with acute cerebral infarction were assigned into a treatment group or a control group.Both groups received standard basic treatment for acute cerebral infarction.From day 7 on,both groups received oral donepezil hydrochloride (5 mg/d) for 12 consecutive weeks.The treatment group received in addition 2 sessions of low frequency rTMS on the language center of the right hemisphere.The first session started at day 7 after onset,and each session consisted of rTMS on 10 consecutive days (once per day).There was a resting interval of 3 d between the two sessions.The rehabilitation of the aphasia was assessed prior to and after each session,and at the end of the entire 12 weeks of treatment using the western aphasia battery ( WAB ) scoring system and the aphasia quotient (AQ). Results There was no significant difference between the two groups after the first session in terms of the WAB or AQ results.However,the difference in improvement became statistically significant after the second session,as well as at the end of the entire 12 weeks.The average change in AQ was significantly greater in the treatment group. Conclusion Donepezil combined with rTMS early in the acute phase of cerebral infarction is helpful for the rehabilitation of aphasia.

Objective To investigate the therapeutic effects of repeated transcranial magnetic stimulation (rTMS) at high and low frequency for the rigidity and tremors of Parkinson's disease (PD).Methods Sixty-nine patients with PD received rTMS at 5 Hz or 0.5 Hz.The efficacy was assessed using the unified Parkinson's disease rating scale (UPDRS),motor function tests and motor evoked potentials (MEPs).Results Thirty-two patients with rigidity from PD received 5 Hz rTMS therapy,and their UPDRS total scores decreased significantly.Their motor function test results improved significantly and their MEP relaxed motor thresholds were significantly elevated.Thirtyseven patients with tremors from PD received 0.5 Hz rTMS therapy,and their UPDRS total scores were significantly decreased.Their motor function test results improved significantly and their MEP relaxed motor thresholds were significantly elevated.Conclusion High frequency rTMS may improve the symptoms of patients with PD rigidity and low frequency rTMS may improve the symptoms of patients with PD tremors.

Objective To investigate in vitro combined effect of ceftriaxone and azithromycin against clinical isolates of Neisseria gonorrhoeae(NG). Methods A total of 25 NG clinical isolates were collected from the STD clinic of Dalian Dermatosis Hospital in 2012. Epsilometer test(Etest)method was used to determine the minimum inhibitory concentrations(MICs)of ceftriaxone and azithromycin against NG isolates. Fractional inhibitory concentration index (FICI) was calculated to evaluate the in vitro combined effect of ceftriaxone and azithromycin against NG isolates. Results The mean MICs of ceftriaxone and azithromycin were 0.032 mg/L (range, 0.008- 0.064 mg/L) and 0.834 mg/L (range, 0.064-4.000 mg/L), respectively. The FICI ranged from 0.724 to 2.696, and ceftriaxone and azithromycin showed an additive effect against the above NG isolates. Conclusion Ceftriaxone and azithromycin show an additive effect against NG in vitro, but further studies with large sample size are needed to confirm their effects.

Objective To emphasize the importance of embolization of nonbronchial systemic arteries in treatment of acute and life-threatening massive hemoptysis.Methods In a series of 146 patients with hemoptysis who underwent bronchial artery embolization,we found 12 cases whose blood supply were from 17 nonbronchial systemic arteries and hemoptysis was more than 300 ml blood within 24 hours.Embolic materials included absorbable gelatin sponge(GS),kelp micro gelatin(KMG),polyvinyl alcohol(PVA) particles and metal coils. Results In the 12 cases with 17 nonbronchial systemic arteries (4 were intercostal,3 internal mammary,3 thyrocervical trunk,3 inferior phrenic,1 left gastric,2 originated from the inferior aortic arch,and 1 originated from anterior abdominal aortic wall).Five cases were embolized by GS alone,2 cases by KMG,3 cases by GS+PVA,and 2 cases by GS+PVA+metal coils.Eight cases were performed embolization once,3 cases were performed twice and 1 case was performed three times.No significant complications developed related to embolization,except that 1 patient had transient eyesight decrease after embolization of thyrocervical trunk and 2 patients had chest pain after embolization of intercostal artery which resovled without any treatment.Conclusions During bronchial artery embolization for hemoptysis patients,all supplying artery should be searched and found.Even after successful embolization of bronchial arterys for hemoptysis patients,nonbronchial systemic arterial supply should still be taken into account.

Objective To compare the effects of pulse high-volume hemofiltration (PHVHF) and continuous veno-venous hemofiltration (CVVH) on severe acute panceatitis (SAP). Method From January 2005 to December 2009, a total of 38 patients with SAP were randomly(random number) divided into PHVHF group ( n = 18)and CVVH group ( n = 20). After hemofiltration for 72 hours, clinical symptoms, APACHE Ⅱ score, biochemical changes and mortality were observed. The levels of TNF-α, IL-6, and IL-10 in plasma were assayed by using ELISA before and after treatment. The doses of dopamine used in shock patients were also observed. Measurement data were expressed in(-x) ± s, and t-test was used for comparison between two groups. Results In both groups ,symptoms were markedly improved after treatment. The APACHE Ⅱ score, serum amylase, creatinine, and white blood cell count were decreased ( P ＜ 0.05). Besides, hypoxemia and acidosis were corrected, and the PHVHF group was superior to the CVVH group especially in heart rate, breathing and APACHE Ⅱ score ( P ＜ 0. 05).The levels of TNF-α, IL-6 and IL-10 decreased in both groups ( P ＜ 0.05), and the PHVHF group was superior to the CVVH group ( P ＜ 0. 01 ). The doses of dopamine used in shock patients also decreased in both groups ( P ＜0. 01 ), and they decreased more in PHVHF group than in CVVH group ( P ＜ 0.05). The mortality was 11.1%in PHVHF group and 25 % in CVVH group. Conclusions PHVHF is obviously superior to CVVH in the treatment of SAP, and can serve as an important adjuvant therapy for SAP, stabilizing the hemodynamics and reducing the levels of pro-inflammatory factors and mortality.

Objective To explore the applicable conditions for using urine uranium monitoring data to assess personal internal doses with a view to providing references for the occupational health management and the urine uranium monitoring in nuclear industry sector.Methods The urine uranium levels were calculated, through simulation calculation set at 1 mSv effective dose arising from either acute or chronic ingestion of uranium compounds.The results were compared with the monitoring values of workers without occupational exposure history.The feasibility of urine uranium monitoring for dose assessment of internal radiation exposure was discussed.Results For special monitoring of acute ingestion, liquid fluorimetry can meet monitoring requirements of Type F uranium compound, Type M low enriched uranium and Type S naturally occurring uranium.For routine monitoring, only Type F low enriched uranium and Type M naturally occurring uranium can be detected at shorter monitoring intervals, But it was not suitable for Type S uranium compounds.Conclusions Background levels and detection limits should be considered when urine uranium is measured for the purpose of assessment or control of exposure to uranium and the interpretation of the results.