To compare the advantages and the disadvantages of the teaching of problem-based learning(PBL) with lecture based learing(LBL) in Pathophysiology with the questionnaire.

In medical education,to cultivate the medical students with high comprehensive quality,we have carried out the teaching reform in Pathophysiology education.

OBJECTIVETo detect the expression level of interleukin 17 (IL-17) in the plasma and colonic mucosa of patients with ulcerative colitis (UC), and to explore the synergistic mechanism of qingchang huashi recipe (QHR) combined with Mesalazine.

METHODSRecruited were 24 mild or moderate UC patients of damp-heat inner accumulation syndrome (DHIAS). Their samples of intestinal tissues were histologically graded. They were assigned to the combination group and the Western medicine (WM) group, 12 in each group. Besides, another 12 healthy volunteers were recruited as the healthy control group. QHR combined Mesalazine were given to patients in the combination group, while those in the WM group took Mesalazine. The therapeutic course for all was 3 months. By the end of treatment the expression level of IL-17 in the plasma and colonic mucosa was detected using ELISA. The infiltration of IL-17 in the intestinal mucosal tissue was detected by immunohistochemical SP method.

RESULTSThe expression level of IL-17 in the plasma and colonic mucosa was significantly higher in UC patients than in healthy controls (P <0. 05). The higher the histological grading the higher the expression level. The expression level of IL-17 in plasma and colonic tissues decreased after treatment in the two treatment groups (P < 0.05). Besides, the expression level of IL-17 was lower in the combination group than in the WM group (P <0.05).

CONCLUSIONQHR combined Mesalazine could synergically enhance the effect and effectively inhibit intestinal inflammation through down-regulating the expression of IL-17.

Anti-Inflammatory Agents, Non-Steroidal ; therapeutic use ; Colitis, Ulcerative ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Immunologic Factors ; metabolism ; Inflammation ; metabolism ; Interleukin-17 ; metabolism ; Intestinal Mucosa ; drug effects ; Intestines ; metabolism ; Mesalamine ; therapeutic use

Objective To study the recombination type of B/C genotype in hepatitis B virus.Methods The PCR was applied to amplifed the whole genes of HBV through the serums of four chronic HBV carriers who come from Jinghong distict,Yunnan province.The whole HBV genomes were ligated with pMD18-T vector and trasformed to E.coli JM109.After the positive colones were picked up,the HBV genotypes and recombinated sites were discoved through sequenced the acquired positive colones.Results All the acquired sixteen HBV sequences from the four HBV carriers were genotype B which were combinated with genotype C in some region.There are two ways of the combinations.For the first one,a 496 bp fragment from genotype C taked place the genotype B at the place of nt1825 to nt2320 of precore C/C region.For the second way,a 695 bp fragment of genotype B taked place at the both sites of nt822 to nt1020 of P gene region and nt1825 to nt2320 of precore C/C region.Conclusion A new recombination type of B/C genotype in hepatitis B virus was reported for the first time.The new Bj subgenotype was combinated with genotype C not only at the region of precore C/C but also at the place of P gene region.

Objective:To design an intra-abdominal pressure measuring device applied to children on peritoneal dialysis (PD), and evaluate the feasibility and safety of the application of the device.Methods:The device consisted of a three-way stopcock with extension tubing, a three-way stopcock, a manometer tube, and a "Y" system peritoneal dialysis bag. The intraperitoneal pressure of different fill volumes was measured when a child was supine and relaxed in a horizontal position. The subjects of the study were children who received PD at the Pediatric Hospital of Fudan University from May 2019 to February 2020 and had PD dialysis age of>1 month. The children's demographic and clinical information were collected. During the measurement, the child’s complaints of pain, bloating, vital signs, and catheter-related contamination were recorded. Additionally, the occurrence of dialysis-related infections and complications during the hospitalization and outcomes of PD after three months of the measurement were tracked. A scatter plot and Pearson correlation test were used to explore the correlation between fill volumes and the intraperitoneal pressure.Results:Nine PD children were included in our study. The age of the children was (8.4±4.7) years old. The body surface area is (0.84±0.29) m 2. The intraperitoneal pressure was (12.6±1.9) cmH 2O at the fill volume of 1 000 ml/m 2 and (13.8±1.9) cmH 2O at the fill volume of 1 200 ml/m 2. The measurement was smoothly and safely taken without any case of contamination and dialysis-related infections during the hospitalization. After three months of the measurement, one child was transferred to temporary hemodialysis due to the aggravation of the umbilical hernia. Conclusions:The intraperitoneal pressure measuring device is feasible and safe to perform among children with PD. It can achieve non-invasive and continuous measurement of intra-abdominal pressure, and has guiding significance for the dialysis prescription of children with PD.

Adenosine Triphosphate ; metabolism ; Animals ; Animals, Newborn ; Cantharidin ; pharmacokinetics ; Cell Hypoxia ; drug effects ; Enzyme Inhibitors ; pharmacology ; Epithelial Cells ; drug effects ; metabolism ; pathology ; Flow Cytometry ; Kidney Tubules ; drug effects ; metabolism ; pathology ; Swine

Objective To analysis the MRI features of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), to improve the understanding of MRI manifestations of this disease. Meth?ods The clinical manifestations, neuroimaging analysis and genetic analysis were performed in the CADASIL pedigree proband and his families. Results Five of six cases were confirmed with C2182T mutation on exon 14 of the NOTCH3, of which three cases were diagnosed by MRI. Brain MRI findings included bilateral symmetric distributed confluent lesions in the subcortical and periventricular white matter in the frontal lobe, hypointensity on T1WI and hyperintensity on both T2WI and T2 FLAIR imaging in four cases. The external capsule was involved in three cases, with hyperintensity on T2WI. Subcortical lacunar lesions (SLLs) were shown in three cases. Lacunar infarction in the basal ganglia and thalamus were presented in four cases. T2WI hyperintensity at the brain stem was found in two cases. Cerebral microbleeds were re?vealed in three cases. There was no O’Sullivan sign in all the six cases. Conclusions There is characteristic change of MRI in CADASIL patients, which may play a very important role in screening these cases.

Objective To explore the changes of pathogens and antibiotic susceptibility in a respiratory ward.Methods All pathogens isolated from patients in a respiratory ward from 2001 to 2005 and the drug susceptibility results were retrospectively analyzed.For patients with more than 1 isolates of the same species, only the first strain of pathogen was included for analysis. The isolation and identification procedure was based on guidelines for national clinical laboratories.The susceptibility test was performed by disk diffusion method.WHONET 5.3 software was used for statistical analysis.Results A total of 876 strains were analyzed.The majority was gram negative bacteria.MRSA prevalence was 72.4% and showed a trend of increase.No vancomycin resistant Staphylococcus aureus or Enterococcus was detected.Streptococcus pneumoniae was highly resistant to macrolides.The non-sensitivity rate to penicillin was 25.5%-66.7% over years.The resistance rate to levofloxacin was 22.2%-27.3%.Enterobacter and Acinetobacter baumannii showed stable susceptibility to imipenem.ESBLs-producing Esche- richia coli and Klebsiella pneumoniae accounted for 33.3%-38.9% and 14.3%-19.2% respectively.P.aeruginosa strains were relatively susceptible to ceftazidime, amikaein, cefoperazone-sulbactam, imipenem, piperacillin-tazobactam and cefepime. The sensitivity rate was 87%, 82.6%, 78.3%, 73.9%, 73.9% and 71.4% respectively in 2005.Conclusions The changes of pathogens and antibiotic resistance in the respiratory ward were consistent with the surveillance data in this country, which were influenced by underlying diseases, severity of illness and antibiotic use.Our data are useful for the guidance of rational use of antibiotics.

Objective To study the pathological characteristics of skeletal muscle in patients with polymyalgia rheumatica(PMR).Methods Thirteen patients were diagnosed PMR according to the diagnostic criteria described by Bird in 1979.The onset of disease was between 49-78 years of age (median 60.3 years).All of them showed continuous symmetric myalgia with markedly elevated erythrocyte sedimentation rate(ESR).Five patients had mild fever and 8 patients had elevated C-reactive protein(CRP).Electromyogram(EMG)showed myogenic pattern in 2 patients.Only 1 patient showed anemia and 2 patients had mild elevated creatinine phosphokinase.None of them showed evidence of temporal arteritis.Biceps brachii muscle biopsies were performed in all patients before corticosteroid therapy.Results The typeⅡmuscle fiber atrophy was observed in all patients.Moth-eaten changes appeared in 8 cases,increased intramuscular lipid drops in 8 cases and ragged red fibers(RRF)in 3 cases of them.After steroid therapy,all patients showed improvement of myalgia and normal ESR as well as CRP.Conclusions The main symptoms of the patients are myalgia and abnormal ESR.Some patients have high level of CRP and abnormal EMG.Anemia and temporal arteritis are less frequent.The main myopathological changes were typeⅡmuscle fiber atrophy.Some patients have moth-eaten changes.More lipid drops and RRF indicate abnormal metabolism of skeletal muscle.

Objective To explore the relationship between the expression of syndecan-1 and the prognosis in pancreatic cancer. Methods The data of 30 patients with pancreatic cancer who received radical operations were retrospectively analysed.Immunohistochemical staining was performed,and the expression of syndecan-1 in tumor epithelial cells and stroma was observed by light microscopy.The relationship between immunohistochemical findings and survival was analysed.Results For those with negative,weak positive,moderate positive and strong positive expression of synecan-1 in tumor epithelial cells and stroma,there were significant differences in the case numbers between those survived for 1 to 2 years and those survived for 2 to 4 years(P