Objective To observe the validity and feasibility of PBL teaching method in occupational health and occupational medicine theory teaching.Methods Sixty-one five-year undergraduates majored in preventive medicine were selected and self-control was applied.Two teaching contents which had similar teaching requirements were selected,one applied PBL teaching method and the other applied traditional teaching method.Students' results and passing rate in examination were analyzed and compared.SPSS 16.0 software was used for statistical analysis and data were manifested as ((x-) ± s).T test was used to do comparison between average results and chi-square test was used to do comparison between rates.SAS 9.0 software was employed and Fisher's exact probability analysis was performed on percent of pass.P＜0.05 stands for statistically significant differences.Results Test scores of the students taught by PBL teaching method were significantly higher than those of students taught by traditional teaching method (P＜0.05).Both female and male students' test scores were improved (P＜0.05) and increase of female students' test scores were more obvious than male students'.Passing rate of female students taught by PBL teaching method was significantly higher than female students taught by traditional teaching method (P＜0.05).Conclusion PBL teaching method applied in occupational health and occupational medicine theory teaching can significandy improve the quality of teaching.

Background Greater variability in blood pressure and the disappearance of circadian rhythm are frequently found in the very elderly with hypertension.Blood pressure variability may be closely related to the target organ damages.Objective To assess the relationship between nocturnal blood pressure fall(NBPF)and 24 h blood pressure variability(BPV)by using BP weighted standard deviation as a new index for computing 24 h BPV,and to verify the clinical value of this new marker in the very elderly with hypertension.Methods We analysed retrospectively 1441 ambulatory blood pressure(BP)recordings,and computed:①the standard deviation(SD)of 24 h BP directly from all individual readings;②weighted mean value of daytime and night-time SD(wSD);③the magnitude of nocturnal BP fall(NBPF).Left ventricular mass(n=345)and carotid intima-media thickness(n=216)were determined by echocardiography.Results The 24 h SD of BP was significantly greater than the 24 h wSD(P

ABSTRACT:Objective To explore cardiac function and myocardial collagen type I in diet-induced insulin-resistant rats and the effect of telmisartan on cardiac diastolic function in diet-induced insulin-resistant rats. Methods We randomized 27 Wistar rats into control group (n = 9 ),high-fat group (n = 9 ),and telmisartan treatment group (n = 9 ).At the end of the study,left ventricular end diastolic pressure (LVEDP)and left ventricular systolic pressure (LVSP)of the rats and ± dp/dt were detected by carotid artery intubation.Masson cardiac staining was used to observe cardiac fibrosis,and collagen volume fraction (CVF)was measured.ELISA method was used to detect the concentration of plasma PICP and ICTP.Results Compared with the control group,in high-fat group LVEDP was significantly higher and -dP/dtmax decreased significantly (P < 0.01 );the plasma PICP level and the ratio of PICP/ICTP were significantly increased (P <0.01),cardiac collagen volume
fraction was significantly higher (P <0.01).After 22 weeks’telmisartan intervention,compared with the high-fat group,LVEDP and LVSP were significantly decreased (P < 0.01 ),but -dP/dtmax significantly increased (P <0.05).The level of the plasma PICP and PICP/ICTP were significantly decreased (P < 0.05 );left ventricular myocardial tissue collagen volume fraction content was decreased (P <0.01).The correlation analysis showed that cardiac collagen volume fraction in insulin-resistant group was positively correlated with insulin resistance index but negatively correlated with -dp/dtmax (P < 0.01 ).Conclusion Insulin resistance promoted the synthesis of myocardial type I collagen,leading to increased myocardial collagen deposition and decreased cardiac diastolic function.Telmisartan may improve diastolic function partly by improving insulin resistance and reducing the deposition of myocardial collagen type I.

Objective To analyze the value of dual-source computed tomography (DSCT)in the diagnosis of complex congenital heart disease(CCHD).Methods DSCT angiography and transthoracic echocardiography (TTE)were retrospectively assessed in 46 patients who were confirmed by surgery with 107 deformities.Results There were 49 intracardiac deformities and 58 extracardiac deformities.The diagnostic accuracies in detection of intracardiac malformation were 81.63%(40/49)on DSCT and 93.88%(46/49) on TTE,those in detection of extracardiac malformation were 94.83%(55/58)on DSCT and 58.62%(34/58)on TTE,and the overall accuracies of cardiovascular malformations were 88.79%(95/107)on DSCT and 74.77%(80/107)on TTE,respectively,exhibting statistical differences.The diagnostic accuracy of DSCT in combination with TTE in detection of intracardiac and extracardiac malformation was 94.39%(101/107),which was higher than DSCT or TTE with statistical differences.Conclusion The combination of TTE and DSCT is helpful to improve the diagnostic accuracy of CCHD.

Objective To evaluate early and mid-term results in infants,weighing less than 2 500 g,who underwent early cardiac surgery on cardiopulmonary bypass (CPB).Method Since November 2003 to December 2007,28 consecutive infants of less than 2 500 g underwent early cardiac surgery on CPB in Children's Hospital Affiliated to Fudan University.Sixteen infants were male,and 12 infants were female.The mean pregnancy period was 34 weeks (30 to 41 weeks) ,and 14 patients were premature,and the mean birth weight was 2 010 g(1 370-2 500 g).Mean age at operation was 27.46 d (range 1～61 d),and mean weight was 2 391 g (range 1 500～2 500 g).Deep hypothermia circulatory arrest was used in 9.Indications for surgery were:ventricular septal defect (10 infants),transposition of great arteries (6 iofants),totally anomalous pulmonary venom return (5 infants),pulmonary atresia with intact ventricular septum(2 infants),coarctation of aorta (1 infants) ,interrupted aortic arch (1 infants),cortriatriatum(1 infants),abnormal original of fight pulmonary artery (1 infants).Resuits Two (7.14%) infants died after operation at early phase.Mean duration of mechanical ventilation and intensive care unit stay were 113.9 h and 14.4 d,respectively.During follow-up (mean 16.87 months),one died.Two patients needed reintervention.About 84.4% infants didn' t need reintervention at the end of 12-month followup.Conclusions If medicine is aseless,infants woth low birth weight and congenital heart defect can obtain satisfactory outcome after CPB.Perioperative proration for virtual organs should be payed attention to.

ObjectiveTo investigate the expression and activity of Rho-associated kinase 1 (ROCK1) in renal tissues of uninephrectomized diabetic rats,and to explore the possible mechanism of renal protection of spironolactone.Methods The model rats were established by a single intraperitoneal injection of streptozotocin(STZ) after uninephrectomy and randomly divided into sham operation group(N),uninephrectomized control group?,uninephrectomized diabetic group (D),and spironolactone treated group (S).Four and 8 weeks later,biochemical indexes and renal morphology were detected.Expressions of ROCK1 and connect tissue growth factor (CTGF) were examined by immunohistochemistry and real-time PCR.Protein expression of p-MYPT1 was examined by Westem blotting.Results After 4 and 8 weeks,compared with group N and C,blood glucose,systolic blood pressure,24-h urinary protein,kidney weight/body weight (KWI) were significantly increased (P＜0.01),and extracellular matrix proliferation and basement membrane thickening were found in group D.After 8 weeks in group D,Alb significantly decreased and Scr significantly increased (P＜0.05).In group D,protein and mRNA expression of ROCK1 and CTGF increased significantly and protein expression of p-MYPT1 increased significantly as well with time.Treatment with spironolactone could partially reverse those changes. ConclusionsExpression and activity of ROCK1increase in renal tissues of uninephrectomized diabetic rats and are positively correlated with the expression of CTGF.Spironolactone can protect the kidney of diabetic rats in early stage probably through decreasing the expression of ROCK1,CTGF and inhibiting the activation of ROCK1.

Objective To investigate the clinical efficacy of adefovir dipivoxil in antiviral treatment of chronic hepatitis B and its effect on peripheral blood T lymphocyte subsets.Methods 40 cases of patients with chronic hepatitis B were selected from The Fourth People’s Hospital of Qinghai in October 2009 to June 2012,the patients were given the antiviral treatment of adefovir dipivoxil.Before treatment,3 months,6 months and 12 months after treatment,the changes of liver function indicators of alanine transaminase(ALT),aspartate transaminase(AST)and total bilirubin(TBiL),and hepatitis B virus-DNA(HBV-DNA)were recorded;the total effective rate was observed;the peripheral blood T lymphocyte subsets changes was tested and analyzed by flow cytometry.Results The ALT,AST and TBiL of the patients all improved good,and the indicators of ALT,AST and TBiL after 12 months decreased significantly than before treatment,the HBV-DNA testing of the patients recovered negative,the difference was statistically significant (P<0.05 );the total effective rate of hepatitis B patients is 92.5%;the peripheral blood T lymphocyte subsets has no significant improvement in patients after antiviral treatment for 3 months.After the treatment for 6 months and 12 months,the CD4 +T and CD4 +/CD8 +T were significantly higher than those before treatment,there was no significant changes in CD3 +T and CD8 +T before and after treatment.Conclusion Adefovir dipivoxil has a good clinical efficacy in antiviral treatment of chronic hepatitis B,and can significantly improve the patients’liver function,improve peripheral blood T lymphocyte subsets imbalance.

Objective:To develop HMGA1-silencing SMMC-7721 cell and investigate its impacts on apoptosis and cell cycle in tumor cells.Methods:Constructing HMGA1-silencing SMMC-7721 cell through G418 selection of RNAi plasmid transfected cells;surveying the apoptosis,prliferation and cell cycle of the tumor cells by FACS and MTT.Results:Stable HMGA1-silencing cells were obtained successfully.The apoptosis percentage in RNAi group(29.46?3.04%) was significantly higher than that in the negative control (1.96?0.76%) or control (2.04?0.70%)within each P

Objective:To establish a mouse fibroblastic cell line stably transfected with HMGA1 gene,and to use the cell line to investigate the role of HMGA1 in tumor development and progression.Methods:Eukaryotic expression vector pcDNA3.0-HMGA1 was transfected into NIH3T3 by lipofectamine-mediation.Stable transfectants were selected by G418.The expression of extraneous HMGA1 gene was analyzed by RT-PCR and DNA sequencing.Cell growth was measured through MTT and the cell cycle by FCM.Soft agar colony formation was employed to analyze the ability of anchorage-independent growth.The expression of the immune inhibition factors of VEGF and FasL mRNA was detected by RT-PCR.Results:NIH3T3 cell lines stably expressing HMGA1 gene were successfully established.Comparing with controls,the HMGA1 gene-transfected cells grew faster,acquired the ability of anchorage-independent growth and expressed the immune inhibition factors of VEGF and FasL mRNA.Conclusion:Extraneous expression of HMGA1 gene can induce malignant transformation of NIH3T3 and modulate mRNA expression of immune inhibition factors.HMGA1 gene plays a key role in tumor development,progression and immune escape.

Objective To observe and evaluate the application of case-based learning in occupational health teaching of clinical medicine students.Methods Seven-year undergraduates majored in clinical medicine were selected as study subjects,divided into two groups,and received case-based learning(55 persons,story case for theory course,field case for experiment course)and traditional teaching(56 persons,theoretical instruction for theory course,instructional video for experiment course),respectively.T test and x2 test were used to analyze and compare students' after-school evaluation results and the questionnaire survey results of both groups respectively.Results The total score of the after-school evaluation[(11.84 ± 2.86) vs.(9.80 ± 3.39),t=-3.419],basic cognitive ability score[(4.80 ± 1.08) vs.(4.05 ± 1.43),t=-3.097] and analyzing ability score[(7.04 ±2.21) vs.(5.75 ± 2.59),t=-2.813] of students in the case-based learning group were significantly higher than those of the students in the traditional teaching group(P＜0.05).Questionnaire survey showed that the number and proportion of case teaching group of students held a positive attitude towards the teaching methods used in improving students' ability to analyze problems(x2=4.757),increasing study interest (x2=4.371),promoting knowledge mastery (x2=4.276) is higher than traditional teaching group (P＜0.05).Conclusion Case-based learning can inspire students' learning initiative,improve their creative ability to use knowledge,analyze and solve practical problems,so as to promote the course scores.