Objective To observe effect of personalized health education on drug compliance and efficacy in patients with multidrug-resistant pulmonary tuberculosis. Methods From October 2015 to May 2016, 100 cases with multidrug-resistant tuberculosis were selected. The patients were randomly divided into two groups, 50 cases in each group. The contorl group was given a routine clinical health education, the observation group were received personalized health education . Awareness of disease and medication, medication compliance and satisfaction after education in the two groups were compared. Results The total awareness rate in the observation group was 96.00% (48/50), the total medication compliance rate was 94.00% (47/50), the satisfaction degree was (87.62±6.95) points. The above three indicators in the observation group were better than those in the control group (P<0.05). Conclusion It is possible to improve the patient's awareness and adherence to disease and medication after taking the personalized health education program in patients with multidrug-resistant tuberculosis disease clinically. It can get a better satisfaction test result.

Neurobiology is a cross subject,in which"Language and Attention"is an impor-tant chapter as a hotspot involved with physiology,psychology,anatomy and biology.Inorder to im-prove the teaching efficiency,it is necessary to apply the techniques such as arranging the content logically,giving prominence to the emphases and breaking through the difficulty,using interactive teaching method and collocating the assistant method rationally. Through this way,it is easier for the students to get interested in this chapter and grasped the content.

Objective To study the clinical features, diagnosis,and treatment of hepatolithiasis complicated with cholangiocaminoma. MethodsClinical and pathological data were analysed retrospectively on 46 cases of hepatolithiasis complicated with cholangiocarcinoma. Results The results showed that the incidence of cholangiocarcinoma in hepatolithiasis was 4%, and 33% of patients were diagnosed as cholangiocarcinoma preoperatively. Tumor occurring in left intrahepatic ducts, right intrahepatic ducts, and hilar bile duct was 72%, 9% and 20%, respectively. Only 15(33%) cases underwent radical resection with 1-, 2-, and 3 year survival rate of 100%, 67% and 25% for the 12 cases that were closely followed-up. None of 15 cases receiving palliative bile duct drainage had survived for 1 year. KG2Conclusions Patients with a history of hepatolithiasis more than 10 years are under the risk of cholangiocarcinoma.During a surgery for hepatolithiasis a thorough exploration for the possible coexistance of cholangiocarcinoma is strongly recommended.

Objective To investigate the modulation of affective pictures on experimental tonic cold and heat pain in a behavioral study. Methods Fifteen healthy female subjects went through the tonic cold and tonic heat stimulation when watching the affective pictures in a counter-balanced order after the pictures were grouped into the pleasant, the unpleasant and the neutral picture sets. The pain tolerance time ( PTT ) was recorded.Results The tolerance time was prolonged when watching the pleasant and unpleasant pictures contrast to thatwhen watching the neutral ( Unpleasant ( 146.20 ± 13.68 ) s, Neutral ( 86. 73 ± 12.93 ) s, Pleasant ( 145.27 ±15.99 ) s, F(2,42) = 5.718, P ＜ 0.01 ) ). However, no significant difference was observed in the heat pain test under the different experimental conditions ( Unpleasant ( 74.73 ± 15.78 ) s, Neutral ( 68.80 ± 15.85 ) s, Pleasant ( 78.80± 14.81 )s, F(2.42) =0. 109, P＞0.05) ). A correlation between the residual difference of arousal in pleasant and neutral picture sets and the residual difference of heat PTT in pleasant and neutral picture sets was investigated (r = 0.546, P = 0.035 ). Conclusion Besides the emotional valence,the arousal may be one of the key elements that modulate the tonic pain.

AIM:To observe the changes of heart function and the expression of serum cardiac troponin I ( cT-nI) in early type 2 diabetic rats, and to explore the role of cTnI in the development of type 2 diabetes and early diabetic cardiomyopathy .METHODS:The type 2 diabetes rat model was established by an injection of streptozotocin after high fat diet (5 weeks).The rats were randomly divided into control group , model group of 2 weeks, and model group of 4 weeks. M-mode echocardiography was performed for echocardiographic measurements .Fasting blood glucose ( FBG) , total choles-terol ( TC) , triglyceride ( TG) , high density lipoprotein-cholesterol ( HDL-C) , low density lipoprotein-cholesterol ( LDL-C) , fasting insulin ( FINS) and cTnI levels were tested .HE staining was used to observe the pathological changes of myo-cardial structures .The alteration of cTnI in myocardium was determined by Western blot .RESULTS:Compared with nor-mal group , the levels of TC , TG and LDL-C in type 2 diabetic rats were significantly increased , HDL-C levels were signifi-cantly reduced .Cardiac histological analysis revealed that type 2 diabetes induced cardiomyocytes degeneration and necro-sis.The expression of cTnI increased significantly in diabetic groups compared to control group , and that in model group of 4 weeks increased far more than that in model group of 2 weeks (P<0.05).CONCLUSION:The increased level of cTnI and the change of the heart function may be associated with the development diabetic cardiomyopathy .These changes are valuable for the early clinical diagnosis of myocardial injury in diabetic cardiomyopathy .

Objective To investigate the effect of mental processing speeds of judging traffic lights varying in location and color meaning. Methods 20 healthy adult male (age: 18 ～30 years) were enrolled in this study. By simulation of traffic lights as picture stimuli, all subjects performed a Go/NoGo task separately under normal condition, location-reversed condition, color meaning-reversed condition and both location and color meaning-reversed condition randomly. The accuracy rate and reaction time of the behavior task were quantified. Results The average accuracy rate of the four conditions was 99. 13% , no differences were found in different traffic light colors and different conditions. In the normal condition,the subjects' reaction time(ms) of traffic lights were as fallowings: red light 491.59 ±71.74; green light 487.55 ±58. 11, no difference was found between the two traffic light colors (P=0.522). In the location-reversed condition, subjects' average reaction time(ms) was respectively for red light 606.29 ± 107.59, and green light 593.13 ± 102.45. In the color meaning-reversed condition, it was respectively for red light 572.08 ±78.75, and green light 592.43 ±87.58. Compared with the normal condition, subjects' reaction time was prolonged in the location-reversed condition (F(1,19)=59.77, P<0.01), and also in the color meaning-reversed condition (F(1,19) =52.55, P<0.01). When in the both location and color meaning-reversed condition, the subjects' reaction time (ms) of traffic lights was respectively 502.92 ± 65.27 for red light, and 508.97 ±63.40 for green light,the result came close to statistical significance(P= 0.065)compared with the normal condition. Conclusion A likely "conceptual constancy" is demonstrated on the basis of prolonging the brains' information processing when location and color information changes.

Aim To investigate the alteration of Wnt/β-catenin signaling pathway in early diabetic rat myo-cardium and clarify its role in development of diabetic cardiomyopathy. Methods The diabetes mellitus ( DM) model was prepared by intraperitoneal injection of streptozotocin ( STZ, 60 μg · g-1 ) . The alteration of Wnt/β-catenin signaling pathway was determined by Western blot and immunohistochemistry. HE staining was used to analyze the change of myocardial pathologi-cal structure. Results Cardiac histological analyses revealed that DM induced cardiomyocyte degeneration and necrosis. Myocardial Wnt2, β-catenin and c-Myc were enhanced in 2 wk DM compared with control group while DKK1 showed no significant alteration. Conclusion Wnt/β-catenin signaling pathway is acti-vated in early diabetic myocardial injury. Further re-searches on its role in DM myocardium may find a new therapeutic target for diabetic cardiomyopathy.

ObjectiveTo evaluate whether AN69 ST membrane would prolong filter lifetime in continuous renal replacement therapy (CRRT) without anticoagulation in patients with high risk of bleeding.Methods A single-center, prospective, randomized, double-blind control trial with crossover design was conducted. From March 1st to December 31st in 2013, patients who were admitted to Department of Critical Care Medicine of the Fourth Hospital of Hebei Medical University meeting CRRT treatment indications, but could not receive systemic anticoagulation because of high risk of bleeding were studied. The selected patients were randomly divided into two groups according to a random number table, and four filters consisting of two AN69 ST100 membrane filters (A) and two traditional AN69 M100 membrane filters (B) were used for them. GroupⅠ with the filter order of A-B-A-B, and groupⅡ with the order of B-A-B-A. The clinical data of patients was recorded in detail, and conventional AN69 ST and AN69 membrane filter lifetime, their influence on coagulability, and the incidence of bleeding complications were compared.Results Seventeen patients were enrolled, with 10 in groupⅠ, and 7 in groupⅡ. The basic medical characteristics including gender, age, acute physiology and chronic health evaluationⅡ (APAECHⅡ) score, sequential organ failure score (SOFA), Acute Renal Injury Network (AKIN) stage, activated partial thromboplastin time (APTT), prothrombin time (PT), international normalized ratio (INR), platelet count (PLT), and use of mechanical ventilation were not significantly different between two groups. But the use of vasoactive drug was more frequent in groupⅡcompared with that of groupⅠ[100.0% (7/7) vs. 30.0% (3/10),χ2 = 8.330,P = 0.010]. AN69 ST filter lifetime (n =34) was (15.92±2.10) hours, there was no statistically significant difference compared with that of AN69 membrane (t = 0.088,P = 0.942), filter lifetime of which (n = 34) was (16.12±1.38) hours. It was also found by Kaplan-Meier survival analysis that there was no significant difference between the two membrane filter lifetime (χ2=1.589,P =0.208). Logistic regression analysis showed that the life of the first filter was not correlated with coagulation indicators, including APTT, PT, INR, and PLT [APTT: odds ratio (OR) = 0.977, 95% confidence interval (95%CI) = 0.892-1.071, P = 0.623; PT:OR = 1.001, 95%CI = 0.901-1.109,P = 0.988; INR:OR = 1.078, 95%CI = 0.348-3.340,P = 0.896;PLT:OR = 0.996, 95%CI = 0.974-1.019,P = 0.735]. The application rate of vasoactive drugs, which was different between two groups for basic medical indications showed no effect on filter life time (OR = 2.541, 95%CI = 0.239-26.955,P = 0.439). Reasons of clotting in filters were also analyzed, and it was found that blood coagulation in the filter ranked the top (88.2%), and the other reasons were catheter-related problems, death, and unscheduled transport. No difference in blood coagulation function was found in both groups after treatment for 12 hours, and there was no bleeding complication.ConclusionDuring the CRRT without systemic anticoagulant, both surface-treatment with polyethyleneimine AN69 and AN69 ST membrane cannot prolong filter lifetime.

Objective To investigate the effects of endotracheal suctioning,turning over,oral caring and swallowingon cuff pressure,so as to provide evidence for the management of the endotracheal cuff.Methods During continuous monitoring of cuff pressure with pressure sensor,the changes of cuff pressure were recorded in the process of endotracheal suctioning,turning over,and oral caring.The data of cuff pressure were recorded including before activity,during activity,after activity for 5 min,15 min and 30 min.In addition,the data of cuff pressure were recorded including before swallowing,during swallowing,after swallowing for 1 min,5 min and 10 min.Results The cuff pressure during endotracheal suctioning and after endotracheal suctioning for 5 min was higher than that before endotracheal suctioning,the difference was statistically significant (P＜0.05);the cuff pressure during turning over and after turning over for 5 min was higher than that before turning over,the difference was statistically significant (P＜0.05);the cuff pressure during the oral caring was higher than that before oral caring,the difference was statistically significant(P＜0.05);the cuff pressure during swallowing was higher than that before swallowing,the difference was statistically significant(P＜0.05).Conclusion These clinical factors would lead to transient increase of cuff pressure including suctioning,turning over,oral caring,and swallowing.The instantaneous cuff pressure will mislead the staff to judge the safey of endotracheal cuff.The cuff pressure should not be blindly adjusted,so as to avoid the risks of leakage and aspiration.

Extracurricular activities are necessary to curricular study and significant in quality and practical ability education for medical students.Research and practice on how to improve the interest in extracurricular activities for medical students were carried out,and good results were achieved in the aspect of the development of teaching efficiency.