The article analyzed the problems of the improper orientation of the teaching objective, the imperfect coursesystem, the excessive shifting of the teaching approaches and the reverse effect of the test system. It also put forward thesolutions such as working out the syllabus fit for all the colleges and universities, giving free rein to the extracurricularactivities, and strengthening teachers' training and improving the test system ect.[

Objective To evaluatethe clinical value of procalcitonin(PCT)in the diagnosis and assessment of community-acquired pneumonia(CAP).Methods Ninety-six patients with CAP(CAP group)who hospitahzed during the period of November 2005 to August 2006 were admitted.Meanwhile,30 people were taken as control group.The levels of PCT,CRP and WBC were detected on the next day and the 8th day of hospitalization.Results(1)The receiver operating characteristic(ROC)curve was made through setting the threshold value of PCT,CRP and WBC as 1.5 μg/L,10 md/L and 10×109/L respectively in AP group and control group.The RFea undering ROC curve was 0.979.0.831 and 0.736 respectively.(2) The mean value of PCT in the patients of bacterial pneumonia.atypical pathogen pneumonia and viral pneumonia was(9.74±6.20),(7.81±5.70)and(12.20±6.50)μg/L respectively.There were no statistical differences in those patients.(3)There was correlation between PCT and CURB-65 score(r=0.258.P=0.011).The value of serum PCT showed significant differences in the patients with mild pneumonia.moderate pneumonia and severe pneumonia. Conclusions Serum PCT has higher sensitivity and specificity than CRP and WBC in the diagnosis of CAP.There is correlation between PCT and the severity of CAP,so it indicates that PCT has a certain practical value in the iudgement of the condition of CAP.

Colitis, Ulcerative ; classification ; diagnosis ; pathology ; Humans ; Inflammation ; Medicine, Chinese Traditional

Objective To explore clinical effect of dinoprostone in premature rupture of the membranes at term cervical ripening.Methods 42 cases with premature rupture of the membranes at term cervical ripening were selected.All patients were randomly divided into two groups.The dinoprostone group had 21 cases,which applied the treatment of dinoprostone belt the posterior fornix of vagina medicine induced abortion.The oxytocin group had 21 cases,which applied the treatment of intravenous drip oxytocin.The time of induction labor,6h,12h cervical Bishop score after using the medication,drugs acting time,labor conditions and perinatal situation,pregnancy outcome and some other index were observed.Results It taken (6.18 ± 4.48 ) h until parturient and ( 12.62 ± 8.03 ) h until the cervical mouth full open in the dinoprostone group,which were shorter than the oxytocin group,that taken( 10.21 ±5.42) h,( 18.87 ± 9.14) h.( t =2.62,2.35,all P ＜ 0.05 ).There was no significant difference about cervical Bishop score before using the medication.It's(7.52 ± 2.44 ) point 6h after using the medication and( 9.03 ± 1.96 ) point 12h after in the dinoprostone group.They were better than the oxytocin group,which were(5.97 ± 1.95 )point,(7.13 ±2.12 )point.It was significantly different( t =2.27,3.02,all P ＜0.05 ).The average incubation period of dinoprostone group wss (9.91 ± 1.73 )h.It's longger than the oxytocin group,which was( 8.72 ± 1.34)h.The active period of dinoprostone group was(4.36 ± 0.66 ) h.It's shortter than the oxytocin group,which was( 5.84 ± 1.02 ) h.The difference was significant( t =2.49,5.58,all P ＜ 0.05 ).There was no significant difference in the second and third stage of laber between the two groups( t =0.56,0.33,all P ＞ 0.05 ).There was also no significant difference about intrauterine distress,amniotic fluid contamination,cesarean section,intestinal bleeding,the Apgar score of newborns and some other index in the two groups ( x2 =0.00,0.00,0.52,t =0.84,1.04,all P ＞ 0.05 ).Conclusion Dinoprostone had good promoting effect on cervical ripening for preterm premature rupture of membranes pregnant woman.Its effect was better than oxytocin and it was safe to use.

Objective To analyze the clinical,molecular and genetic features of a Chinese family with WalkerWarburg syndrome(WWS).Methods The clinical data of the proband and his family members were collected.Genomic DNAs from the patient and his parents were extracted with standard procedures from the peripheral blood leukocytes.Polymerase chain reaction and DNA direct sequencing were employed to analyze all of the 20 exons of the POMT1 gene to determine the mutation,and the relationship between genotype and phenotype was analyzed.Results The proband presented with delayed psychomotor development,muscle hypotonia and early joint contractures,his serum creatine kinase was elevated moderately and the brain magnetic resonance imaging (MRI) displayed brain structural malformations,cerebellar cyst,bilateral dilatation of the lateral ventricle,cerebellum and brainstem dysplasia.Further genetic testing detected a compound heterozygous mutation of c.313C ＞ T,p.Arg105Cys inherited from his father,a frameshift mutation c.2208delG,p.Trp736X inherited from his mother,both of which were known as pathogenic mutations.Conclusions According to the study,the proband carried compound heterozygous mutation of POMT1 gene,and his parents were heterozygous carriers,which is consistent with autosomal recessive inheritance.The child is definitely diagnosed as WWS.Genetic counseling and prenatal diagnosis are available for this family.

Abstract: Objective To analyze the changes of coagulation indicators in patients with hepatitis B complicated with Clonorchis sinensis (C. Sinensis), and provide reference value for diagnosis, drug using and prognosis monitoring. Methods　The patient samples were collected from the Third Affiliated Hospital of Sun Yat-sen University from June 2018 to February 2022 and divided into six groups. They were 40 healthy patients, 47 patients with simple chronic hepatitis B, 47 patients with post-hepatitis B liver cirrhosis, 40 patients with C. Sinensis mono-infection, 30 patients with chronic hepatitis B patients co-infected with C. Sinensis and 27 patients with post-hepatitis B liver cirrhosis patients coinfected with C. Sinensis. Four coagulation indexes, prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT) and fibrinogen (FIB), were detected and compared among the groups. Results Compared with the healthy group, C. Sinensis mono-infection group had higher level of FIB and delayed PT, APTT; chronic hepatitis B group and chronic hepatitis B patients co-infected with C. Sinensis group had delayed PT, APTT, TT and significant lower FIB, these differences were statistically significant (all P<0.05). Compared with simple chronic hepatitis B group, post-hepatitis B liver cirrhosis and chronic hepatitis B patients co-infected with C. Sinensis had significant delayed PT, APTT, TT and lower FIB (all P<0.05). Compared with the post-hepatitis B liver cirrhosis and chronic hepatitis B patients co-infected with C. Sinensis, post-hepatitis B liver cirrhosis patients coinfected with C. Sinensis group had significant delayed PT, APTT, TT and lower FIB (all P<0.05). Conclusions The coinfection of C. Sinensis will further aggravate the coagulation dysfunction of HBV patients, leading to poor treatment and prognosis. HBV patients will have worse coagulation function in the process to post-hepatitis B liver cirrhosis; Therefore, it is important to pay attention to C. Sinensis co-infection when treating HBV patients, so that further guidance on clinical use and monitoring of prognosis can be provided.

Objective To design a wireless monitoring system for locating oxygen supply terminals and measuring oxygen intake value of patient.Methods The locating and measuring system was built by using Mesh network of Zigbee technology and AODV algorithms based on hardware featuring MC9S08 microprocessor and MC13192.Results The oxygen supply terminals sent the location and oxygen flux information to monitoring nodes,while the monitoring server read data from all nodes in turn and save to the database.Conclusion The wireless network based on Zigbee technology can effectively monitor the utilization information about oxygen supply terminals and the value of patient oxygen intake.

Objective To explore the influencing factors and timing of acute cholecystitis laparoscopic surgery.Methods One hundred and sixty acute cholecystitis patients treated with laparoscopic surgery were divided into group A (56 cases,performed treatment within 24 h),group B (42 cases,performed treatment at 24 -48 h),group C ( 40 cases,performed treatment at 49 -72 h),group D (22 cases,performed treatment after 72 h).The operation time,rate of conversion to laparotomy,length of stay and average costs were compared among four groups and analyzed the impact of laparoscopic surgery conversion to laparotomy.Results The rate of conversion to laparotomy of group D [ 59.09％(13/22) ] was significantly higher than that in group A [ 19.64％(11/56) ] (P ＜ 0.01 ).The operation time of group A was the shortest and group D was the longest.The length of stay of group D was significantly longer than other groups (P ＜ 0.05 ).The costs of the four groups had no significant difference(P ＞ 0.05 ).Single factor analysis showed that white blood cell (WBC) count,body temperature,timing of surgery,gallbladder neck calculi incarceration were correlated with conversion to laparotomy(P ＜ 0.05 ).Multifactor analysis showed that WBC count,timing of surgery were independent risk factors of conversion to laparotomy (P ＜ 0.05 ).Conclusions WBC count,body temperature,timing of surgery,gallbladder neck calculi incarceration are correlated with acute cholecystitis laparoscopic surgery conversion to laparotomy.While WBC count and timing of surgery are independent risk factors.The best time of laparoscopic surgery is within 72 h and WBC count ＜ 15 x 109/L.

The subject nature of nursing science was defined as that of humanity and social science.Qualitative and quantitative methods should be combined in studies of nursing science .Only the research methods of nursing science are used , can the nursing science turn out an independent subject .

Objective To investigate the clinical features and treatment of mycoplasma pneumoniae infection complicated with allergic purpura.Methods 40 children with mycoplasma pneumoniae infection complicated with allergic purpura were selected.Clinical symptoms,disease treatment and outcome were analyzed retrospectively.Results 25 cases were abdominal type allergic purpura,9 cases were articulated joints allergic purpura,6 cases were kidney patients with allergic purpura.In addition,some patients showed upper or lower respiratory tract infections.All the patients received blood circulation improvement,anti-allergy and other conventional treatment,and on the basis of this,azithromycin,low-dose dexamethasone or gamma globulin was given.All 40 patients were cured,the average length of hospital stay was (18.6 ± 3.1) d.Conclusion Mycoplasma pneumoniae infection may trigger allergic purpura purpura-like rash,the clinical symptoms,some accompanied by lower respiratory infections,should give the conventional anti-mycoplasma pneumoniae infection treatment,and the treatment time should be sufficient to cure allergic purpura,shortening hospitalization time,has an important role in the prevention of recurrent disease.