The computerized imitating system constructed by the Second Affiliated Hospital of Guangzhou Medical University contains four blocks:administration of student infomation,administration of question bank,on-line tests and administration of score inquiry.It's designed to imitate typical pediatric cases,so that the medical students may put themselves into the practical clinical scenario and solve the challenges step by step in one-direction procedure.Teaching with computerized clinical scenario imitating patients can improve students' test resuhs and activate students' learning enthusiasm significantly.It not only helps to solve the contradiction between increasing number of medical students and clinical typical teaching case shortage but also improves the clinical thinking ability of the medical students.This system can also be used as a test bank for pediatric technical skills examination.

OBJECTIVE To investigate the characteristics and risk factors of nosocomial infection(NI) in patients with hematological malignancies(HM),and provide the bases for making the controlling measures of NI.METHODS Using the targeted monitoring to study NI in patients with HM,and recording 14 factors such as the time of hospitalization,chemotherapy,count of leukocyte and absolute neutrophil count(ANC) and so on.The data were analyzed with unifactorial ?2 test and multifactorial Logistic-regression analysis.RESULTS Among 242 patients with HM the prevalence of NI was 35.5%(86/242) and the prevalence of NI time-cases was 52.9%(128/242).Among 86 patients of NI there were 27 patients occurred multiple sites NI(31.4%).The main infection sites were upper respiratory tract,gastrointestinal tract,lower respiratory tract,oral cavity and blood.66.7% Of NI happened in the period of chemotherapy and 7 days after chemotherapy.The time of hospitalization and ANC were independent risk factors of NI in patients with HM.CONCLUSIONS The patients with HM are susceptible population of NI,and NI often occurs in the period of chemotherapy and 7 days after chemotherapy.So medical staff should strengthen monitoring,and shorten the time of patient hospitalization and of recovery of ANC to reduce the prevalence of NI efficiently.

OBJECTIVE By investigating the incidence of nosocomial infection with objective monitoring method and prospective overall monitoring method, to analyze the advantage and significance between two methods. METHODS Using the objective monitoring method to study the incidence of nosocomial infection of patients after neurosurgical operation from May to December in 2003 and using the prospective overall monitoring method to study the incidence of nosocomial infection of patients after neurosurgical operation from May to December in 2002. All data were analyzed with Stata 7.0 soft. RESULTS There were 100 cases occurring nosocomial infection in 267 neurosurgical operation patients. The patient incidence of nosocomial infection was 37.5% and the rate of nosocomial infection cases was 50.9% with objective monitoring method, that was significant higher than those data coming from May to December in 2002 with 248 cases under prospective overall monitoring method, with which the patient incidence of nosocomial infection and the rate of nosocomial infection cases were 20.2%(50 cases ) and 21.4%(53 cases), respectively . Statistically significant difference was found (P

Objective To study the effects of caesarean section on breastfeeding.Methods Divides into 2 groups stochastically 120 example c-section parturient woman,each group of 60 examples,the control group gives obstetrics conventional nursing;The observation group carries on the target-oriented behavior intervention and psychological unblocking by professional nurse to the parturient woman:Uses the pre-natal health education seepage,instructs the parturient woman to feed correctly nurses the skill,promotes the wet-nurse nutrition,dredges intervention measures promptly and so on mammary gland tube.Results The observation group parturient women compare the control group to secrete young timing advance,secrete the young quantity to increase,the early nursing success ratio is high,the difference has the significance (P<0.01).Conclusion Early interventions to parturient after caesarean section is propitious to their health recover and elevate the success rate of early breast feeding.

Objective To explore the interventional effect of two different methods in the prevention of chemotherapy phlebitis caused by 5-fluorouracil.Methods Eighty cases of patients treated with cisplatin+5-fluorouracil (PF) chemotherapy in the First Affiliated Hospital of Guangxi Medical University from May 2015 to July 2016 were selected and divided into the observation group and control group according to admission time,40 cases in each group.The observation group was smeared with 2% anisodamine along the direction of vein puncture after peripheral venous puncture success,while the control group was smeared with mucopolysaccharide polysulphate emulsion paste.The occurrence of phlebitis and degree of local pain after intervention were compared between the two groups.The blood biochemical indexes and inflammatory factors levels before and after intervention were compared too.Results After the intervention,the distribution of phlebitis level and local pain degree had statistical difference between the two groups (Z=2.57,2.53;P=0.01);the observation group was superior to the control group in the aspects of phlebitis lesion degree and local pain alleviation;WBC,MPV and PDW in the observation group had statistical difference between before and after intervention;WBC,PLT and PCT in the control group had statistical difference between before and after intervention (P<0.05);PLT count was positively correlated with PCT in the two groups (r=0.952,P<0.05);the CRP level and WBC count after intervention had no statistical difference between the two groups(P>0.05).Conclusion 2% anisodamine can effectively prevent and alleviate the occurrence of 5-FU caused chemotherapy phlebitis and local pain.At the same time,PLT can provide a basis for preventing chemotherapy phlebitis.

0.05).The average rate of three times NI prevalence surveys was 5.23% and that of NI prospective overall(monitoring) method in the same months was 6.60%,the statistical difference between them was found(P

Objective To study the feasibility and safety of measles vaccination in women of childbearing age and to understand the influence of measles vaccination on the fetal transmission measles antibody level of the infants.Methods From January 1,2012 to December 31,2012,600 women of childbearing age were included in this study.The measles IgG antibody was detected,then all participants were randomized according to the IgG level.The measles IgG antibody of participants in non-vaccinated group was detected predelivery in hospital by enzyme linked-immunosorbent assay (ELISA).That of participants in vaccinated group was detected 3 months after vaccination with measles mumps rubella combined vaccine and predelivery by ELISA.And measles nuclear protein fragment gene (measles virus nucleoprotein,MVN) in the blood was detected by reverse transcription polymerase chain reaction (RT PCR).A total of 368 participants gave birth within 2 years after vaccination,and 357 infants 8 months after birth were healthy.In non-vaccinated group,8 infants were diagnosed with measles within 8 months after birth.Finally,349 8-month infants were enrolled in the study,including 52 whose mothers in high antibody without vaccination group,65 whose mothers in high antibody with vaccination group,110 whose mothers in low antibody without vaccination group and 122 whose mothers in low antibody with vaccination group.The measles IgG antibody levels in the blood of all the 8-month infants were detected.Data were analyzed using t test,one-way ANOVA (Newman-Keuls was used for comparison between groups) and Pearson analysis.Results The measles IgG antibody level of expectant women in high antibody without vaccination group was significantly lower compared to that in high antibody with vaccination group ([268.5±74.9] IU/mL vs [578.3t208.1] IU/mL,Q=15.57,P＜0.01).That in low antibody without vaccination group was also significantly lower than low antibody with vaccination group ([169.4+42.3] IU/mL vs [584.7+195.8] IU/mL,Q=29.54,P＜0.01).The results of MVN RT-PCR after 3 months of vaccination showed no positive bands in all blood samples.Two of the expectant women in high antibody without vaccination group and one in low antibody without vaccination group were positive for MVN bands.Among 8-month infants,the levels of antibody in high antibody without vaccination group and high antibody with vaccination group were (106.3 ± 36.8) IU/mL and (291.8±86.5) IU/mL,respectively,which was statistically different (t=23.33,P＜0.01).Those in low antibody without vaccination group and low antibody with vaccination group were (87.1 ± 26.4) IU/mL and (274.0±72.5) IU/mL,respectively,which was statistically different (t =33.27,P＜0.01).The measles antibody level of expectant women was positively correlated with their 8-month infants (r=0.652,P＜0.01).All 8 infants who were diagnosed with measles were delivered by women without vaccination,and the measles infection rate of infants was significantly different between women with and without vaccination (P=0.002).Condusion It is feasible for women of childbearing age to receive measles vaccination,which can increase the measles IgG antibody level of both expectant women and their infants.

Objective:To discussed the diagnostic value of magnetic resonance cholangiopancreatography (MRCP), and the use of laparoscopic surgery in management of patients with choledochal cyst with extrahepatic bile duct anomaly.Methods:Of 330 consecutive patients who underwent laparoscopic choledochectomy at Guangzhou Women and Children's Medical Center from January 2010 to September 2018, there were 23 patients with extrahepatic bile duct anomaly. The data of these patients were retrospectively analyzed. There were 4 males and 19 females, with an average age of 3.2 (range 0.3~9.0) years. According to whether the extrahepatic bile duct anomaly was diagnosed by preoperative MRCP, these patients were divided into the preoperative MRCP diagnosis group and the preoperative MRCP undiagnosed group. The impact of MRCP in diagnosing bile duct anomaly to prevent bile duct injury, on operation time, hospital stay and the types of extrahepatic bile duct anomaly on outcomes of laparoscopic treatment were analyzed.Results:All the 23 patients with choledochal cysts complicated by extrahepatic bile duct anomaly were confirmed at surgery. The incidence of extrahepatic bile duct anomaly was 6.97% (23/330). There were 47.8% of type II AHD (11/23); 36.8% of type III AHD (7/23); 4.3% of type IV AHD (1/23); 17.4% (4/23) of the type with communication with accessory bile duct (CABD). The preoperative MRCP diagnosis group consisted of 14 patients, while the preoperative MRCP non-diagnosis group consisted of 9 patients, including 2 patients without MRCP. The diagnostic rate of MRCP in preoperative diagnosis of extrahepatic bile duct anomaly was 66.7%(14/21). The preoperative MRCP undiagnosed group, when compared with the preoperatives MRCP undiagnosed group, had a significantly higher bile duct injury rate [preoperative MRCP diagnosis group 7.1%(1/14), preoperative MRCP non-diagnosis group 55.6%(5/9)], and a significantly longer operation time [preoperative MRCP diagnosis group(232.6±10.0) min, preoperative MRCP undiagnosed group (278.9±22.45)min], (all P<0.05). Laparoscopic surgery was completed in 22 of 23 patients. One patient was converted to open surgery. AHD reconstruction was needed in 11 patients with type II AHD and 1 patient with type IV AHD. Seven patients with type III AHD did not require any surgical intervention for the anomaly. The 4 patients with CABD underwent simple ligation. Postoperative chyloperitoneum developed in 1 patient, who successfully responded to conservative treatment. Postoperative recovery was uneventful in the remaining patients. At a median follow-up of 2 years (range 1 to 5 years), no further complications, including intrahepatic bile duct dilatation and hepatic atrophy were detected. Conclusions:MRCP was effective in preoperative diagnosis of choledochal cysts with extrahepatic bile duct anomaly. It helped to decrease intraoperation injuries to bile duct anomalies. MRCP was also useful in classifying patients with extrahepatic bile duct anomaly to better preoperatively planning of surgical treatment strategies. Laparoscopic surgery could be completed in the majority of these patients with good postoperative results.

This investigation was aimed to detect the carotid elasticity in normal adults by use of echo-tracking (ET) technique. The stiffness parameter (beta), pressure-strain elasticity modulus (Ep), arterial compliance (AC), argumentation index (AI) and one-point pulse wave velocity (PWV beta) of carotid in 145 normal adults with the average age of 47.0 were calculated. The population were divided into five groups according to age: 20-29 y, 30-39 y,40-49 y, 50-59 y and > or = 60 y. The elasticity parameters between left and right side, between male female and between different age groups were compared using SAS 6.12 statistic software. There was no difference in carotid elasticity regarding the side and gender. The carotid beta, Ep, AI and PWV beta were noted to increase with age while AC was noted to decrease with age. The carotid elasticity was found to correlate with age significantly, but not with side and gender. This change can be detected by ET technique.
Adult ; Age Factors ; Biomechanical Phenomena ; Blood Flow Velocity ; Carotid Arteries ; diagnostic imaging ; physiology ; Compliance ; Echocardiography, Doppler, Color ; methods ; Elasticity ; physiology ; Female ; Humans ; Male ; Middle Aged ; Young Adult

PLZ-NPs (PNS-lipid-zein nanoparticles) prepared by co-assembly of Panax notoginseng saponins, lecithin, β-sitosterol and zein were applied for in vitro cell experiment and oral gavage to study the protective effect of cerebral ischemia-reperfusion rats.PLZ-NPs were characterized by Malvin-particle size analyzer and transmission electron microscope (TEM), respectively. The toxicity of PLZ-NPs and free carrier were evaluated by MTT, and the uptake of nanoparticles in Caco-2 cells was analyzed by laser confocal and flow cytometry. The cerebral ischemia reperfusion rat model was established by MCAO method and then be given samples by gavage for 3 days. The brain tissues were taken to stain by 2, 3, 5-triphenyltetrazole chloride (TTC) and the biochemical indicators of MDA, inflammatory cytokines IL-1β and TNF-α, apoptosis-related proteins Bax and Bcl-2 from the harvested brain tissues were detected to evaluate the protective effect of PNS in PLZ-NPs on cerebral ischemia reperfusion. The particle size, PDI, and zeta potential of formed PLZ-NPs were (116.4 ± 0.81) nm, 0.048 and -(31.5 ± 0.31) mV, respectively. The results of MTT showed that the zein lipoprotein carrier was non-toxic to Caco-2 cells. The results of laser confocal and flow cytometry showed that FITC uptake of nanoparticles could be significantly improved in Caco-2 cells.The uptake from the nanoparticles at 4h was 1.76 times of that of the free FITC group.Compared with the model group, the TTC staining images of free drug PNS group and PLZ-NPs group showed certain reduction in the white infarct area.The contents of MDA, IL-1β, TNF-α and Bax were significantly decreased, while the content of Bcl-2 was significantly increased. Furthermore, all parameters of PLZ-NPs group showed better results than those of PNS group, and there was a significant difference (P < 0.05). All results indicated that the prepared PLZ-NPs had good stability and biological safety, and could significantly increase the uptake in intestinal epithelial cells, and effectively protect against the damage caused by cerebral ischemia reperfusion in rats.