ECG is a highly practical discipline,not only requires students to have a solid theoretical foundation,but also requires them to have a wealth of clinical practice (graph reading) capacity.This study aims to improve the students' ability of reading ECG,and introduces the game logic and mechanism,to design and implement the educational games APP.The structure of this APP includes learning module,test module,and evaluation and feedback module,which can realize the three functions of independent inquiry,cooperation plus communication,and test challenge.By the development and application of this kind of inquiry medical education game on the mobile terminal,we can provide learners with adaptive,fragmented,and game-based mobile learning environment.

BACKGROUND:Raloxifene is the third generation of selective estrogen receptor modulators, which can decrease bone loss, increase bone mineral content, and reduce fracture risk. OBJECTIVE: To study the effects of raloxifene combined with self-setting calcium phosphate cement on the repair of rabbit mandibular defects. METHODS:Totaly 36 New Zealand white rabbits were selected to prepare 8 mm×4 mm×3 mm mandibular defect models, and then randomized equaly into experimental group (raloxifene, 7.5 mg/kg per day, combined with self-setting calcium phosphate cement), drug group (raloxifene, 7.5 mg/kg per day), artificial bone group (self-setting calcium phosphate cement). Rabbits were sacrificed 4, 8 and 12 weeks later, respectively, for measurement of bone morphogenetic protein 2 using immunohistochemistry method and transforming growth factor β using a laser scanning confocal microscope. RESULTS AND CONCLUSION:After 4 and 8 weeks, the expression of bone morphogenetic protein 2 was obviously higher in the experimental group than the drug and artificial bone groups; after 12 weeks, bone remodeling was basicaly complete in the experimental group, and the expression of bone morphogenetic protein 2 became lower than that in the other two groups. The expression of transforming growth factor β in the experimental group was gradualy increased and reached the peak at 8 weeks, while in the drug and artificial bone groups, the expression of transforming growth factor β exhibited an increasing trend within 4-12 weeks, which was close to the peak. These findings suggest that raloxifene can promote early expression of bone morphogenetic proteins and early calus formation as wel as accelerate the repair of bone defects with calcium phosphate cement.

Objective To study the survivin expression in mononuclear cells of both bone marrow and peripheral blood in childhood acute leukemia(AL).Methods Twenty-one children with AL were divided into newly diagnosed group(n=12) and complete remission(CR) group(n=9).The control group was consisted of 15 children without tumor.Mononuclear cells were separated from bone marrow and peripheral blood (PBL) by gradient density centrifugation and RNA was extracted,and RT-PCR was performed to detect survivin mRNA.Results In newly diagnosed AL group,6 out of 12 patients had positive survivin expression in bone marrow(50%) and 4 out of 11 patients in the PBL(36.37%),both of which were higher than the control group(P0.05).In 9 CR patients,all the patients had the negative expression in the PBL,but 1 positive expression in bone marrow(11.11%).The positive expression in CR group was significantly lower than the newly diagnosed AL group.The only one patient with positive survivin expression in CR group had relapse 7 weeks later.In newly diagnosed patients,the average immature leukocytes were(76.43?43.28)?10~(9)/L in the patients with positive survivin expression and(13.85?5.86)?10~(9)/L in those with negative survivin expression(P

Objective To investigate the operative outcomes of anatomic and functional reconstruction of the spinal posterior column after resection of intraspinal neoplasms.Methods From January 2010 through October 2014,we treated 32 patients with intraspinal neoplasm in the spine.They were 18 men and 14 women,13 to 62 years of age (average,38 years).The neoplasm was detected in the cervical spine in 10 cases,in the thoracic spine in 14 and in the lumbar spine in 8.All cases received expansive open door laminoplasty via the posterior approach for resection of the intraspinal neoplasm,followed by replantation and titanium plate fixation for anatomic and functional reconstruction of the spinal posterior column.The neural functional recovery,spinal motion and sagittal diameter of the spinal canal before and after operation,spinal stability and graft fusion were observed.Results The patients were followed up for 3 to 23 months (average,13 months).All the intraspinal neoplasms were completely resected.The Frankel grading of neural functional recovery was improved differently in all the cases.By the final follow-ups,the spinal motion was normal in all the cases,without any significant limitation.Graft fusion and rigid internal fixation were achieved in all the cases.Short-term follow-ups revealed no signs of spondylolisthesis or spinal instability.At the final follow-ups,the 3-D CT reconstruction showed no significant shortening in the sagittal diameter of the same spinal canal before and after operation (P ＞0.05).Conclusions For intraspinal neoplasm in the spine,the whole vertebral lamina is opened or removed via the posterior approach to resect the neoplasm,followed by reduction of the vertebral lamina and mini titanium plate fixation to reconstruct the anatomy and function of the original spine.This is an ideal way to treat intraspinal neoplasms in the spine.

Crohn's disease is a transmural and chronic granulomatous inflammation and it can easily complicated with enterostasis,intestinal obstruction,intestinal perforation,fistula,abscess and massive hemorrhage of gastrointestinal tract.Therefore,patients with Crohn's disease often need surgery,but the surgical indications and postoperative management is still full of challenge.Preventing postoperative recurrence and reducing the complications is essential.

Objective To establish the PDGF-BB-induced proliferation of rat pulmonary artery smooth muscle cells(PASMCs), and investigate the effects of the AMPK agonist AICAR on the cell cycle of PASMCs, in order to search new drugs for prevention of pulmo-nary vascular remodeling. Methods 20ng/ml PDGF-BB was used to induced the proliferation of PASMCs, and the effect of 0. 5mmol/L AICAR on the proliferation of PASMCs was observed. Western blot was used to detect the total and phosphorylated AMPK. The prolifer-ation of PASMCs was determined by CCK-8. The mRNA expression of cyclinD1, cyclinE and CDK2/4/6 were detected by flow cytometry analysis cell cycle,quantitative real-time PCR. Results Western blot Results indicated AICAR could promote the activation of AMPK. CCK-8 test Results showed that AICAR blocked the proliferation of PASMCs induced by PDGF-BB. Flow cytometry analysis indicated that AICAR arrested the cell cycle in G0/G1 to S phase. RT-PCR Results demonstrated that AICAR inhibited the mRNA expression of cy-clinD1, cyclinE and CDK2/4/6. Conclusion The AMPK agonist AICAR can block the proliferation of PASMCs induced through arrest cell cycle in G0/G1-S phase by regulation the mRNA expression of cyclin D1, cyclinE, CDK2/4/6, and AICAR has a potential applica-tion in preventing pulmonary vascular remodeling.

Adult ; Glottis ; pathology ; Humans ; Laryngeal Neoplasms ; pathology ; Lymphoma, Non-Hodgkin ; pathology ; Male ; Tracheal Neoplasms ; pathology

Objective To study the status quo of the caring character of baccalaureate nursing students and its related factors.Methods A total of baccalaureate nursing students were recruited from two and three levels of baccalaureate in Nantong district by convenience sampling method and cluster sampling method.The students were investigated with a nurse caring character questionnaire which was developed in the previous study and then an analysis was conducted.Results The caring characters of the nursing baccalaureate students were at the medium level.The caring characters of baccalaureate nursing students were affected by various factors.The linear regression revealed that choosing nursing willingly or not,relationship with familyand sex,among other things had the greatest influence on their caring characters.Conclusions Therefore,importance should be attached to the caring character of baccalaureate students and corresponding guidance and education directed at the various grades should be offered so as to increase their caring characters.

BACKGROUND: Magnetic therapy has a long history and is used in the treatment of various diseases. To study the protective function of constant magnetic field for ischemic cerebrovascular diseases may provide new clinical foundation for non-medicinal and non-traumatic treatment and develop a novel way for treatment with physical factor.OBJECTIVE: To observe the influence of constant magnetic field treatment on hemodynamics at macroscopic level, RBC membrane fluidity at subcellular level and antioxidase activity at molecular level, as well as NO and NO synthetase activity in rats with ischemic-reperfusion (IR) injury.DESIGN: A completely randomized design.SETTING: Biophysical Teaching and Research Department of Harbin Medical University.MATERIALS: This experiment was carried out at Biophysical Laboratory,Harbin Medical University, between May and November 2002. Forty healthy Wistar rats were adaptively raised for 1 week before randomized into 3 groups, namely, sham-operation group (n=10), model group (n=15)and magnetic therapy group (n=15).METHODS: ① IR model of middle cerebral artery (MCA) was established in rats in model group and magnetic therapy group, but MCA was only tied up without occlusion in sham-operation group. ② In magnetic therapy group, rat necks were exposed to 40 mT constant magnetic field instantly after ischemic injury for 30 minutes, once a day, while rats in sham-operation group and model group were not exposed to magnetic field.Three groups of rats were anaesthetized at postoperative 7 days for obtaining blood from eyeball, and cut off head for obtaining brain.MAIN OUTCOME MEASURES: ① Hemodynamic changes in three groups of rats. ② Changes of RBC membrane fluidity-related parameters.③ Changes of serum glutathione peroxidase and ceruloplasmin content.④ Changes of brain malonedialdehyde (MDA), NO, and NO synthetase activity indexes.RESULTS: Thirty rats were included and all entered the result analysis.① Hemodynamic parameters: Blood high-shearing, blood low-shearing viscosity, fibrinogen and HCT were remarkably higher in model group than in sham- operation group (P ＜ 0.01), but obviously lower in magnetic therapy group than in model group (P ＜ 0.01). ② RBC membrane fluidity: The fluorescence polarization, average microviscosity and aeolotropy were remarkably higher in model group than in sham-operation group (P ＜ 0.01), and the above indexes were lower in magnetic therapy group than in model group (P ＜ 0.05). ③ Serum glutathione peroxidase and ceruloplasmin contents in model group were remarkably lower than those in sham-operation group (P ＜ 0.05), but were higher in magnetic therapy group than in model group (P ＜ 0.01), and slightly higher than sham-operation group. ④ The brain Cu/Zn-SOD, MDA, NO, NO synthetase activities in model group were remarkably higher than in sham-operation group (P ＜ 0.05 or 0.01),but antioxidase activity was remarkably lower than that in sham-operation group (P ＜ 0.01); all parameters were proved to get better in magnetic therapy group after magnetic field treatment, and better than those in model group (P ＜ 0.05, 0.01).CONCLUSION: Constant magnetic field exposure can remarkably improve rat hemodynamic property, increase RBC membrane fluidity and antioxidase activity, and reduce the content of MDA, NO, NO synthetase,thereby improving organic anti-oxidation capability and effectively preventing free radicals and NO-induced neural damage. It possesses certain function of protecting brain IR injury through holding up the pathophysiological development of brain ischemia injury.

Objective:To assess whether intrathecal orphanin FQ can develop the antinociceptive effect tolerance,and whether there is a cross tolerance between the antinociceptive effect of intrathecal orphanin FQ and the ? opioid receptor agonist morphine.Methods: Tail flick test was used to observe the change of antinociceptive effect after orphanin FQ/morphine intrathecal microinjection into the rats tolerant to acute or chronic morphine/orphanin FQ.Results:Like morphine,large dosage of continuous intrathecal orphanin FQ microinjection produced tolerance to the antinociceptive effect,but there was no apparent cross tolerance between the orphanin FQ and morphine; Hyperalgesic response was found in morphine tolerant rats,but not in orphanin FQ tolerant rats.Conclusion:Lack of cross tolerance between the antinociceptive effect of intrathecal orphanin FQ and morphine indicates that the mechanism of tolerance to orphanin FQ may differ from that to morphine; The antinociceptive effect of intrathecal orphanin FQ may be largely related with its specific receptor in the spinal cord.