Objective To evaluate the resultof applying computer simulated human for the diagnostics teaching.Methods The survey was conducted on medical simulation teaching and traditional teaching applied in 338 medical students through statistical evaluation of operative performance and questionnaire.Results The simulation teaching group performed better than the traditional teaching group on the operative assessment(P<0.05).79.2%students thought it was necessary to have simulation teaching.Conclusions Computer simulated human Can improve students'clinical practice ability.

Objective To investigate the effect of curcumin on chronic pancreatitis in rat.Methods Eighteen one-month old male SD rats were randomly divided into control group,ANP group and curcumin group with 6 rats in each group.After fed by 25％ alcohol for twelve weeks,the rats in ANP group were intraperitoneally injected with lipopolysaccharides ( LPS,2 mg/kg body weight) once a week for 4 weeks.The rats in curcumin group were fed with curcumin when they were intraperitoneally injected with lipopolysaccharides.Seventeen weeks later,the rats were sacrificed.Serum glucose was measured,pancreatic morphology was routinely examined,collagen deposition was determined by Masson stain,and the amylase and lipase in pancreatic tissue were evaluated,TGF-β1 mRNA was determined by using RT-PCR.Results The pathological score of control group,ANP group and curcumin group was 1.17 ±0.41,7.33 ±2.58 and 3.50 ± 1.05,and the score in curcumin group was lower than that of ANP group (P ＜ 0.01 ),but which was higher than that in control group (P ＜ 0.05 ).There was no difference in the serum glucose among the groups.The levels of amylase and lipase in pancreatic tissue were (7348 ± 102 ),( 14135 ± 1272) U/g,which were significantly higher than those in ANP group[( 5428 ± 547 ) and (9123 ± 1250 ) U/g,P ＜ 0.05].The expressions of TGF β1 mRNA in control group,ANP group and curcumin group were 0.618 ± 0.019,0.818 ±0.012,0.745 ±0.088,and the values in ANP group were significantly higher than those in control group and curcumin group (P ＜ 0.01 ).Conclusions On the basis of long term ethanol intake,repeatedly intraperitoneal injection of LPS can induce chronic pancreatitis,and curcumin has anti-fibrosis effect possibly by its inhibitory effect on the expression of TGF-β1.

ObjectiveTo evaluate the result of problem-based learning combined with Casebased learning teaching model in the clinical probation of digestive medicine.MethodsPBL combined CBL teaching method and traditional teaching method were used respectively among 120 medical students who were divided into two groups randomly. Educational effects were evaluated through examination and ques-tionnaire.Results The PBL combined CBL group test scores are significantly higher than traditional teaching group ( P＜0.05 ).96.4％ students thought it was necessary to have PBL combined CBL teaching.ConclusionsPBL combined CBL teaching method is an effective teaching method for medical students.

Objective To understand whether meloxicam combined with octreotide could enhance the inhibitory effect on proliferation of hepatic cell carcinoma (HCC). Methods The proliferation of HepG2 HCC cells was measured by 3H-thymidine incorporation into DNA. The synergic effect of meloxicam combined with octreotide on the growth of HepG2 cells was evaluated according to the median-response principle. We also observed the infiuence of combination therapy on the growth of HepG2 xenografts in nude mice. Results The combination of meloxicam and octreotide significantly inhibited 3H-TdR incorporation of HepG2 cells in a dose-dependent manner (r=-0.980, P

OBJECTIVE:To investigate the effect of rabeprazole on symptoms and psychological status of patients with non-erosive reflux disease (NERD).METHODS:GerdQ questionnaire survey was performed in 169 patients who accorded with diagnosis criteria to investigate relevant symptoms of gastroesophageal reflux disease in 1 week.Symptoms scores were carried out according to the occurrence frequency of heartburn,gastroesophageal reflux,nausea and epigastric pain,etc.RESULTS:159 NERD patients completed 4 weeks of treatment.GerdQ score was (10.44?1.62) and SAS score (47.11?10.92),SDS score (44.59?11.2) before treatment.After 1 week of treatment,relevant clinical symptoms relieved obviously,and SAS score and SDS score were lower than before treatment strikingly.The decrease of SAS score and SDS score were more significant after 4 weeks of treatment.There were statistical significance (P

[Objective]To study the clinical features and expressions of IL-17A,IFN-γ,and IL-10 in serum and intestinal mucosa of patients with post-infectious irritable bowel syndrome and non post-infectious irritable bowel syndrome.[Methods]44 diar?rhea-predominate IBS patients(21 with PI-IBS,23 with NPI-IBS)and 10 healthy controls were recruited in this study. Investigation questionnaires of GSRS,SAS,SDS were carried out to evaluate the gastrointestinal function,anxiety status and depression status of IBS patients. The expressions of IL-17A,IFN-γ,and IL-10 in intestinal mucosa and serum were measured by immunohistochemis?try(IHC)and enzyme-linked immunosorbent assay(ELISA).[Results]The SDS scores of NPI-IBS patients were higher than those of controls(P<0.05),and the SAS and SDS scores of PI-IBS patients were higher than those of controls(P<0.05). The GSRS, SAS and SDS scores of PI-IBS group were higher than those of NPI-IBS group(P<0.05). Compared with healthy controls,PI-IBS and NPI-IBS group showed significant rise of IL-17A,IFN-γlevels and decrease of IL-10 level in intestinal mucosa(P<0.05);In serum,the IL-17A levels were up-regulated and the IL-10 levels were decreased in PI-IBS group but not in NPI-IBS group when compared with controls(P<0.05). In intestinal mucosa and serum,IL-17A and IFN-γlevels in PI-IBS group were slightly higher than those in NPI-IBS group(P > 0.05).[Conclusion]PI-IBS and NPI-IBS patients existed various anxiety and depression. The levels of IL-17A and IFN-γ increased and level of IL-10 decreased in PI-IBS and NPI-IBS group. But the clinical symptoms and changes of cytokines of PI-IBS patients were more significant. There may exist other pathogenesis in PI-IBS but not in NPI-IBS.

Objective To analyze and evaluate the joint teaching of subspeciahy teachers in the application of diagnostics probation.Methods 293 clinical medical undergraduates of Grade 2009 were randomly divided into experimental group(the joint subspeciahies teaching group,n=153) and control group(traditional teaching group,n=140).The two groups of students were divided into the 14-16 study group.The diagnostics probation teaching content(all general physical examination and ECG examination)was decomposed in the experiment group and students were taught by different subspecialties teachers while the students of the control group were taught by a teacher of internal medicine.The final examination grades and operative performance of the two groups were compared,evaluated and U tested.At the same time the questionnaire smvey was conducted to the students in the experimental group.Results The experimental group's theory examination score was (75.2 ± 8.9) and the operative assessment score was (88.5 ± 6.2),higher than that in the control group(70.9 ± 10.7 and 84.6 ± 5.5),the difference was statistically significant(P=0.001).The questionnaire results showed 92.8％(142/153)medical students improved their clinical skill,86.9％(133/153) medical students were satisfied with the joint teaching of subspecialty teachers.Conclusions The subspecialty teachers' joint teaching can improve students' clinical practice ability.It is a valuable teaching method in diagnostics teaching.

Objective:To investigate the phenotype and function of the intestinal γδT lymphocytes in post-infectious irritable bowel syndrome mouse model. Methods:The mouse model for post-infectious irritable bowel syndrome was established by the infection with trichinella spiralis. The intestinal inflammation,abdominal withdrawal reflex( AWR) and colon transportation test were observed. 2 and 8 weeks later,the animals were sacrificed and the lymphocytes in the intestinal lymph nodes and spleen were collected,from which the γδT lymphocytes were isolated and purified by monoclonal antibody-immuno-microbeads method. The functions of the purified γδT lymphocytes were evaluated,including proliferation by 3 HTdR;CD69,CD62L molecule staining by flow cytometry. Furthermore,the con-centration of cytokine IL-17 and IFN-γ in the supernatant of the cultured γδT lymphocytes were detected by ELISA. Results: At 2nd weeks after infection,significant intestinal inflammation was observed,with increasingγδT lymphocytes,proliferating and activating with increasing production of IL-17. At 8th weeks after infection, the intestinal inflammation disappeared, whereas the number of γδT lymphocytes remained increasing,also with proliferating and activating with increasing production of IL-17. Meanwhile,the mice show higher AWR score and Bristol score. Conclusion: γδT lymphocytes could participate in the pathogenesis of PI-IBS via their proliferation,activation and production of IL-17.

Objective:To deeply understand the views of nurses on nursing robots, so as to provide reference for standardizing the application of nursing robots and promoting innovation in smart nursing service models.Methods:From March to June 2023, purposive sampling was used to select 15 registered nurses from two ClassⅢ general hospitals in Shanghai as research subjects for semi-structured interviews. Colaizzi 7-step analysis method was used to analyze interview data.Results:Three themes were extracted, including the perceived multiple benefits of nursing robots (obtaining work assistants, facilitating nursing safety, and promoting professional value recognition), the perceived multiple risks of nursing robots affecting patients (concerns about affecting patient safety, concerns about triggering negative emotions in patients, and concerns about functional limitations), and the perceived multiple dilemmas in the application of nursing robots (concerns about academic burden, concerns about changes in work patterns, concerns about unclear responsibilities, and concerns about affecting nursing positions) .Conclusions:Although nurses hold a positive attitude towards nursing robots and expect them to reduce their workload, nurses are also concerned that they may not be able to fully adapt to the clinical environment, pose potential risks to the physical and mental health of patients, and pose new challenges to nursing staff and work models. In the face of intelligent nursing, efforts should be made to strengthen professional training for nurses in information technology, improve nursing work models and processes, and perfect the rules and regulations for the application of intelligent products. Multiple parties should cooperate to create a smart nursing application ecosystem.

Objective To investigate the expression change of cytokines in peripheral blood and intestinal mucosa in the patients with diarrhea post-infectious irritable bowel syndrome(PI-IBS) and its relation with clinical symptoms scores.Methods Thirty outpatients and inpatients with diarrhea PI-IBS(observation group) and contemporaneous 30 individuals undergoing physical examination(control group) in the Hainan Provincial People's Hospital from January to December 2013 were selected.The peripheral blood mononuclear cells(PBMC) were separated and cultured.Then the levels of IFN-y and IL-10 in peripheral blood and cell culture supernatant fluid were detected by ELISA.The colonic mucosal tissue was taken by coloscopy.Then colonic mucosal IFN-γ and IL-10 protein expression was detected by immunohistochemistry staining.Furthermore,the correlationship between the level change of IFN-γ and IL-10 with clinical symptom score was analyzed by using the Spearman correlation method.Results Peripheral blod IL-10 and IFN-γ levels had no statistical difference between the two groups(P＞0.05).Compared with the control group,in PBMC seperation and cuture,the IFN-γ level in the observation group was increased and IL-10 level was decreased,the difference was statistically signifieant(P＜0.01).The intestinal main symptom score in the observation group had the positive correlation with IFN-γ expression level of PBMC culture supernatant fluid and colonic mucosal IFN-γ expression level(r=0.45,0.94,P＜0.01),and had the negative correlation with IL-10 expression level(r=-0.52,-0.79,P＜0.01).Conclusion The unbalance of IFN-γ and IL-10 level could be involved in the pathogenesis of diarrhea PI-IBS,which can serve as the observation indicators of disease activity.