Case discussion is an effective approach,which combines basic theory with clinical medicine.It can evoke students' interest and cultivate their creative thinking capacity.Moreover,it can improve teachers' general ability in teaching pathophysiolo- gy.In this article,we discuss the application of case discussion in pathophysiology teaching.

Acetamides ; metabolism ; toxicity

Objective To understand the main pathogenic bacteria distribution and drug susceptibility in the common bile duct calculi with infection ,so as to provide the basis for rational use of antimicrobial agents .Methods Data′s of 296 cases of bile specimens treated from January 2011 to December 2013 were retrospectively surveyed and drug resistance of bacteria culture results were analyzed .Results Among all the 296 cases ,there were 199 cases of pathogenic bacteria in bile specimens ,the positive rate was 67 .23% ;among them ,there were 21 cases of two kinds of bacteria ,a total of 220 strains of pathogenic bacteria were detected ,and among them there were 158 strains of gram negative bacteria ,accounting for 71 .82% ;there were 46 strains of gram positive bacte‐ria ,accounting for 20 .91% ;there were 16 strains of fungi ,accounting for 7 .27% ;the lowest resistance of gram negative bacilli lies in amikacin ,followed by tazobactam ,aztreonam ,three to four generations of cephalosporins and quinolone .Gram negative bacilli has the highest drug resistance to pseudomonas aeruginosa and e .coli ,and it has a drug resistant rate higher than 50 .00% to most anti‐microbial drugs .Gram positive cocci has 0 drug resistance rate to add ring element ,has a drug resistance rate lower than 30 .00% to vancomycin and rina thiazole amine ,and has highest drug resistance rate (70 .00% -100 .00% ) to erythromycin ,clindamycin and chlorine lincomycin .Conclusion Among all the 296 cases of common bile duct calculi bile with biliary tract infection ,the main path‐ogenic bacteria were e .coli ,klebsiella pneumoniae ,eosinophilic malt narrow and excrement enterococcus bacterium ;and the drug re‐sistance to penicillin is highest .

Background Medical refraction after cycloplegia is the preferable choice for precise measurement of degree of refractive error.Drugs used in China for cycloplegia include atropine and tropicamide,and the use of cyclopentolate is an alternative for ophthalmologist.However,the data for the evaluation and comparison of efficacy of the available drugs in cycloplegia is still lacking.Objective This system analysis was to evaluate the difference between atropine and cyclopentolate in cycloplegia in children.Methods A systematic literature retrieval was conducted in MEDLINE,EMbase,Google residual accommodation after cycloplegia by atropine and cyclopentolate were compared.Statistical analysis was performed using the RevMan 5.1.0 software.Results A total of 7 studies were included in this meta analysis,including 6 cohort study design and 1 randomized,doubleblinded clinical trial and 1232 eyes.For retinoscopic evaluation after cycloplegia,no significant differences were found between cyclopentolate and atropine in children with hyperopia and myopia (WMD =-0.21,95％ CI:-0.47-0.06,P=0.13 ; WMD =-0.10,95％ CI:-0.36-0.15,P =0.43).For residual accommodation after cycloplegia,no significant difference was seen between cyclopentolate and atropine in ammetropic children (WMD =0.30,95％ CI:-0.10-0.71,P =0.15).Conclusions Cyclopentolate shows the same effect on the cycloplegia as atropine in children,and it can take the place of atropine in cycloplegia in childhood.

Objective To investigate the influence of preterm premature rupture of membranes (PPROM) on neurological development of preterm infants.Methods The preterm infants were classified into 2 groups( PPROM group and control group).The neonatal behavioral neurological assessment (NBNA) and CDCC of infants in two groups were measured and compared after retrieved:gestational age 40 weeks,3 months and 6 months.Results Psycho-moter developmental index(PDI) of PPROM group after retrieved gestational age 3,6 months was significantly lower than that of control group(Pa

The records of 25 psychiatric patients ( clients ) who received case management from November 2009 to July 2010 were retrospectively analyzed.The factors related to the quality of professional relationship established between case managers and the clients were evaluated.The study revealed that timely supports, encourage and affirmation from case managers ( 40%) , the successful coordinate service (40%) , the active care for clients (24%) and helping to build up confidence and hope for clients (24%) were favourable factors for professional relationship establishment, while lack of desire to receive service and change from clients (24%) was adverse factor.

The self-designed experimental teaching method is introduced in detail in this paper,including the preparative work before class,discussion of experimental designing proposal,and accomplishment of specific experiment and so on.The teaching method innovations on pathophysiology experiment are very helpful to cultivate the students' ability to solve practical problem and lay the foundation to cultivate talented medical science personal.

Objective To transplant the umbilical cord mesenchymal stem cells(UCMSCs) derived from human umbilical cord into cisterna magna of hypoxic-ischemic encephalopathy(HIE) rat model,and to observe their survival,proliferation and differentiation in the rat brain.Methods UCMSCs were isolated from human umbilical cord of babies delivered after full-term normal cesarean section,and labeled by bromodeoxyuridine(BrdU).Pregnant rats were randomly divided into experimental group(n=6) and control group(n=1).HIE models were built by ligating both sides of the uterine arteries of full-pregnant rats(21 days) in experimental group rats for 15 minutes.The neonatal rats in experimental group were divided into stem cells group(n=24) and PBS group(n=19) at random.The labeled UCMSCs were injected into cisterna magna of the rats in stem cells group,while PBS was injected into the rats of PBS group.In 1,2,3 and 4 weeks after transplantation,the brain tissue section slides were immunohistochemically stained with antibodies against BrdU,Nestin,neuron specific enolase(NSE) and glial fibrillary acidic protein(GFAP),and thionin.Control group with normal delivery was tested as concurrent control.Results At 1 week after transplantation,BrdU,Nestin,NSE and GFAP positive cells were found in the hippocampal dentate gyrus of the rats in stem cells group rats.The number of BrdU-positive and Nestin-positive cells increased(Pa0.05).The NSE-positive and GFAP-positive cells gradually increased from 1-4 weeks post transplantation and comparisons between groups had statistical significance(Pa

Silk fibroin is a natural polymer with certain water solubility, structural modification, good biocompatibility and biodegradability, which can be used as a drug delivery carrier material. As a promising drug delivery system, drug-loaded silk fibroin nanoparticles can control drug release, reduce toxicity and improve therapeutic effects. In this paper, the basic characteristics of silk fibroin, the preparation methods of drug-loaded silk fibroin nanoparticles and the application of silk fibroin in nanoparticulate drug delivery systems are reviewed, and on this basis, the further development of drug-loaded silk fibroin nanoparticles is prospected.

Objective To investigate nursing workload and related factors of Coronary Care Unit (CCU),and to provide evidence for rationally arranging nursing human resources and improving nursing efficiency.Methods 77 inpatients of a third-grade class-A hospital were surveyed by means of Intensive Care Nursing Scoring System (ICNSS) to investigate workload of CCU nurses.Results Total score of CCU nursing workload was (25.5714 ± 6.48) points.ICNSS scores of the four seasons were (27.24 ± 4.438 ),( 25.62 ±4.535),(22.33 ±9.403),(27.24 ±6.953 ),respectively,the difference was statistically significant (F =11.867,P ＜0.01 ).The LSD multiple comparison showed that there were significant differences of ICNSS scores between the first quarter and the second quarter,the first quarter and the third quarter,the second quarter and the third quarter,the third quarter and the fourth quarter,the difference was statistically significant (P ＜0.05 ).The workload of the nurses who took care of the patients admitted by means of wheel chair and stretcher was (20.74 ± 4.663 ) and (25.89 ± 6.508 ) points,and the difference was statistically significant ( t =0.319,P ＜0.05 ).There was significant difference of nursing workload regarding length of stay and percutaneous coronary intervention (P ＜ 0.05 ).Among same type of disease,workload of CCU nurses was the highest on admission and on the day of percutaneous coronary intervention.Nursing workload was found negatively correlated with length of stay of the patients ( P ＜ 0.05 ).Of the 36 patients undergone percutaneous coronary intervention,the workload of CCU nurses was (26.35 ± 4.057 ) scores on the day of intervention,(23.58 ±3.525) scores on day 1,( 22.16 ± 4.537 ) scores on day 2 and ( 19.17 ± 3.637 ) points after day3,the difference was statistically significant ( F =21.024,P ＜ 0.05 ).Conclusions A flexible staff arrangement should be adopted according to the characters of the disease,patients' conditions and the nursing workload.