AIM:To investigate the effect of case-based learning ( CBL) teaching combination with paper review method in the teaching of ophthalmology residents. ·METHODS:The study was conducted from 2015 to 2016. The residents in Department of Ophthalmology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital were included in the research. During the year of 2015, the traditional lecture-based learning ( LBL) method was applied (as a control group). During the year of 2016, the CBL teaching combination with paper review teaching method was applied (as an experimental group). At the end of the course, exams and questionnaires were conducted to evaluate the teaching effect of two different methods. The exams consisted of theoretical and operational assessment. The teaching satisfactions, learning interests, scientific research interests and clinical abilities were included in the questionnaires. The data was analyzed by SPSS 16. 0. ·RESULTS:The results of final exams indicated that the scores of the experimental group (88. 2±6. 5) were higher than the control group ( 75. 6 ± 6. 0 ). The difference showed statistically significant (t=6. 68, P<0. 05). The results of questionnaires indicated that students showed much more satisfied with CBL teaching combination with paper review teaching method ( 91%) than traditional teaching method (50%, x2 =8. 84, P<0. 05). Students in the experimental group improved learning interest ( x2 =6. 29, P<0. 05), increased research interest (x2=4. 54, P<0.05) and approved clinical ability (x2 =4. 25, P<0. 05). The comparison of two groups showed the statistically difference (P<0. 05). ·CONCLUSION: CBL teaching combination with paper review teaching method is beneficial to improve the teaching effect, and it is also beneficial to train residents'clinical skills and research abilities.

Objective To study the damage effect of oxidized low density lipoprotein (OX-LDL)on the endothelial cells and its influence in the expressions of Toll like receptor 4 (TLR-4)and epithelial cell adhesion molecule (EpCAM).Methods The human endothelial cells ECV-304 were cultured in vitro and treated by different concentrations of OX-LDL for 24 h,and the cell vitality was measured by Taipan blue rejection test.The reactive oxygen species (ROS)level,mitochondrial membrane potential (MMP),cell cycle and apoptosis were detected by flow cytometry (FCM).The expression of TLR-4 and EpCAM were also analyzed by FCM.Results Compared with control group,the ROS levels in ECV-304 cells in 25,50,100,and 200 mg·L-1 OX-LDL were increased, but the cell vitalities and MMP were decreased (P < 0.05).Compared with control group,the percentages of S phase cells in 25 and 50 mg·L-1 OX-LDL groups were increased,the G0 G1 phase cells were slightly reduced,and the SubG1 phase cells (apoptotic cells)were increased with the increasing of OX-LDL concentration.Compared with control group,the TLR-4 and EpCAM expression levels in ECV-304 cells in 50 mg·L-1 OX-LDL group at 24 h were significantly increased (P < 0.05 ). Conclusion OX-LDL could increase the ROS level and induce the apoptosis in vascular endothelial cells,while increase the cell vitality and MMP.During the damage process,the expresion levels of TLR-4 and EpCAM are up-regulated.

Objective To observe the effects of electro-acupuncture on Jiaji acupoints combine with treadmill training on tibia bone mass of rabbits with sciatic nerve injury,so as to provide the theoretical support for better project to maintain normal metabolism of bone after peripheral nerve injury.Methods A total of 24 New Zealand rabbits were randomly divided into four groups (n =6),namely a model group,a sham group,a treadmill group and an electro-acupuncture + treadmill group according to a random number table.The sciatic nerve of rabbits in the model,treadmill and electro-acupuncture + treadmill group was clamped using hemostatic forceps to establish the model of sciatic nerve injury,while that of the sham group was not clamped,just cut soft tissue around the sciatic nerve.Three days after modeling,the rabbits in treadmill group and the electro-acupuncture + treadmill group were given treadmill training and electro-acupuncture combine with treadmill training respectively,lasting 4 months,whereas those in the sham and the model groups were not given any intervention.Right after modeling,the behavior of rabbits in four groups was observed.Four weeks after treatment or feeding,their bone mineral density and bone strength of tibia were measured.Results Four weeks after treatment,there was significant reduction in bone density and bone strength of tibia in the model,the treadmill and the electro-acupuncture + treadmill groups compared with those in the sham group(P ＜ 0.05) ; the bone mineral density and bone strength of tibia in the electro-acupuncture + treadmill group were 0.17 ± 0.01 g/cm2 and 161.92 ± 43.27 N respectively,significantly higher than those in both the model and the treadmill groups (P ＜ 0.05).Conclusion Electro-acupuncture combined with treadmill training can improve tibia bone mineral density and bone strength after sciatic nerve injury and facilitate the normal metabolism of the bone and to maintain its normal function.

OBJECTIVETo investigate clinical effects of arthroscopy in the treatment of medial meniscal cyst.

METHODSFrom June 2011 to January 2013, 7 patients with medial meniscal cyst were treated with arthroscopy. There were 3 males and 4 females,ranging in age from 27 to 63 years old,with a mean age of (43.93±2.10) years old. The cysts have been discovered for 3 to 30 months,with a mean time of (10.6±1.3) months. All the patients complained of knee pain,especially in the medial joint gap. The Pisani sign, Caklin sign and medial McMurray sign were all positive. Preoperative MRI examination confirmed the diagnosis. Lysholm score changes and clinical efficacy were observed through a six-month follow-up.

RESULTSThe postoperative Lysholm scores were all significantly higher than the preoperative scores. According to Sarimo standard, 6 patients got an excellent result, and 1 good.

CONCLUSIONArthroscopic treatment of medial meniscal cyst has replaced the traditional method, which could retain the normal meniscus as much as possible and repair the meniscus injury simultaneously, as well as get a good curative effect and a good recovery of knee function. This method is worthy of clinical application.

Adult ; Arthroscopy ; methods ; Cysts ; physiopathology ; surgery ; Female ; Humans ; Male ; Menisci, Tibial ; physiopathology ; surgery ; Middle Aged

Humans ; Male ; Osteosarcoma ; complications ; diagnostic imaging ; surgery ; Ultrasonography ; Wounds and Injuries ; complications ; Young Adult

Objective To investigate the role of telomerase in the pathogenesis of the keloid. Meth-ods Expression of telomerase in 17 specimens from keloidal lesions, 10 specimens from normal skin adjacent to keloids and 9 skin specimens from normal controls were detected by immunohistochemistry tech-niques. Results It was shown that 50.5% of fibroblasts were positive (with telomerase activity) in keloids, 21.1% of fibroblasts positive in the normal skin adjacent to keloids, and only 7.9% of fibroblasts positive in the skin of normal controls, and expressing less degree o?staining in the positive fibroblasts than that in keloids and its adjacent normal skins. Consequently, the expression of telomerase was significantly higher in both keloid and its adjacent normal skins than that in normal controls. Conclusion High level of telomerase expression may be related to the pathogenesis of the keloid.

Objective:To study the effect of compound Biejiaruangan tablets on the expression of liver AngiotensionII and its receptor in rats with hepatic fibrosis,and to explore the mechanism of its anti-hepatic fibrosis.Methods: Thirty male SD rats were randomly divided into three groups as followings: the normal group,the model group and the compound Biejiaruangan tablets group,all rats in the two latter groups were given subcutaneous injection of 40%carbon tetrachloride(twice every week for 6 weeks),the rats in the compound Biejiaruangan tablets group were given 1g?kg-1?d-1 of the compound Biejiaruangan tablets by daily gavage,the rats in normal control group and the model group were given distilled water according to the same volume,the histopathological changes in liver were observed through HE and Massion staining.The serum ALT,AST and ALP were evaluated by antomatic biochemistry analysator,the serum levels of hyaluronic acid (HA),Laminin(LN) and plasm AngiotensionII(Ang-Ⅱ) were determined by radio immunoassay.The expressions of AngⅡ,AT1R mRNA were examined by RT-PCR.Results:The severity of inflammation scoring,hepatic fibrosis scoring,the amounts of serum ALT,AST,ALP,HA,LN and plasma AngⅡ in the liver tissues of hepatic fibrosis model group were higher than those in the normal group(P

Objective To explore the effect of mild hypothermia on serum ?-endorphin(?-EP),neuron-specific enolase(NSE) and its protection to encephalon in children with severe viral encephalitis.Methods Fifty-six cases with severe viral encephalitis were divided into mild hypothermia group(30 cases) and regular treatment group(26 cases).Regular treatment group was given combined therapy such as decreasing intracranial pressure,antiviral therapy,supportive and symptomatic treatment.While mild hypothermia group was given mild hypothermia treatment besides regular treatment,and the change of serum ?-EP,NSE before treatment and the first day,5~th and 10~th day after treatment in the two groups were determined.Results There were no significant difference of serum ?-EP,NSE before treatment and in the first day after treatment,while it decreased in 5~th and 10~th day after treatment.Serum ?-EP,NSE in mild hypothermia group were significantly lower than those of regular treatment group(P

Objective: To investigate the expression of platelet-derived growth factor receptor (PDGF-R) in periapical granuloma.Methods:Immunohistochemical staining was conducted on prepared specimens of 15 cases of human periapical granuloma. Results:The expression of PDGF receptor ? was detected in fibroblasts,capillary endothelial cells,plasmacytes and macrophage cells in all the 15 cases of human periapical granuloma.Conclusion:These results suggested that these cells are the target cells of PDGF, and PDGF may play an important role in the lesion.

Objective To investigate the clinical efficiency,safety,adverse reactions and healthrelated life quality of transdermal fentanyl patches for pain management in terminal cancer patients with hepatic and renal dysfunction and ascites.Methods 98 terminal cancer patients with moderate to serve pain combined with abnormal hepatic and renal dysfunction were randomly divided into two groups.Group Ⅰ (n=56)received transdermal fentany patches.Group Ⅱ,the control group (n=42),received morphine controlledrelease tablets.Terms of pain intensity,function of renal and liver,adverse reactions and heath-related quality of life were assessed before and after treatment.Results Patients were satisfied with their pain management in both groups,and no significant difference in pain release was observed between the groups (x2 =0.01,0.07,0.01,0.04,P ＞ 0.05).The incidences of constipation and dysuresia were significantly less in the group Ⅰ compared with that of the group Ⅱ (x2 =7.32,3.96,P ＜ 0.05).The incidences of hypersomnia,dizzy,nausea and vomiting were similar betwecn the two groups (x2 =0.12,0.54,0.54,0.02,P ＞ 0.05).Most of the adverse reactions would relieve or disappear after symptomatic treatment.Values of BUN,CR,ALT,AST were similar before and after treatment in group Ⅰ (t =1.43,1.67,0.91,0.11,P＞ 0.05).However,in group Ⅱ,these values were significantly increased after treatment (t =17.59,49.17,42.12,36.23,P ＜ 0.05).The heathrelated life quality (appetite,spirit,somnus,fatigue,daily life and countenance) were significantly improved after treatment in both groups (the group Ⅰ t =3.37,4.40,2.07,5.66,4.48,P ＜ 0.05; the group Ⅱ t =2.03,2.27,3.59,4.16,2.79,P ＜ 0.05),the spirit group Ⅰ improved more obviously compared with group Ⅱ (t =2.93,P ＜ 0.05).Conclusion Transdermal fentanyl patches provides equal pain relief compared with Morphine controlled-release tablets in the terminal cancer patients with abnormal hepatic and renal function and ascites.Transdermal fentanyl patches significantly improve health-related quality with less hepatic and renal function influence and low incidence of adverse reaction.It should be recommended in the treatment terminal cancer patients with moderate to serve pain combined with abnormal hepatic and renal function and ascites.