Objective To investigate the application effect of Problem based learning (PBL) combined with role play teaching method in the training of emergency internal medicine.Methods Totally 60 medical students were randomly divided into two groups.The students in the observation groop were trained with PBL teaching method while those in control group were trained with traditional teaching method.The practical performances of the students in both groups were evaluated by virtual experience of dealing with patients in the emergency department through the role play teaching method.The grasp of basic knowledge was assessed by writing tests.Finally all the students in the observation group answered a survey about the teaching methods.Results There was uo difference in the scores of the basic knowledge test between the two groups ( P ＞ 0.05 ).The practical ability of the observation group was much better than that of the control group in the role play practice ( P ＜ 0.05 ).Almost all the students in the observation group accept the PBL teaching method.Conelusion PBL combined with role play teaching method is effective based on the characteristics of emergency medicine.

To investigate the immune regulatory effects of human bone marrow mesenchymal stem cells on alloantigen T lymphocyte in vitro, human MSCs were isolated and expanded from bone marrow cells, and identified with cell morphology, and the phenotypes were assessed by immunohistochemistry and flow cytometry. As the stimulation factor of T lymphocytes proliferation, either PHA or dendritic cells isolated from cord blood were cocultured with CD2(+) T lymphocytes from peripheral blood mononuclear cells by magnetic beads with or without MSC in 96-well plats for seven days. T cell proliferation was assessed by [(3)H]-thymidine incorporation using a liquid scintillation counter. T cell subsets, Th1, Th2, Tc1 and Tc2 were analyzed by flow cytometry after co-culture of CD2(+) T cells with MSCs for 10 days. The results showed that a significant decrease of CD2(+) T cell proliferation was evident when MSC were added back to T cells stimulated by DC or PHA, and an increase of Th2 and Tc2 subsets were observed after co-culture of MSC with T lymphocytes. It is suggested that allogeneic MSC can suppress T cell proliferation in vitro and the cause of that was partly depend on interaction of cells and the alteration of T cell subsets.
Bone Marrow Cells ; cytology ; immunology ; CD2 Antigens ; immunology ; Cell Communication ; immunology ; Cell Proliferation ; Cells, Cultured ; Coculture Techniques ; Flow Cytometry ; Humans ; Immunohistochemistry ; Mesenchymal Stromal Cells ; cytology ; immunology ; T-Lymphocyte Subsets ; cytology ; immunology ; T-Lymphocytes ; cytology ; immunology

OBJECTIVETo explore the effect of dexmedetomidine combined electrical stimulation on cognitive function of neurosurgical diseases patients treated by extracerebral intervention.

METHODSTotally 122 patients with neurosurgical diseases who underwent selective intervention were randomly assigned to the observation group and the control group, 61 cases in each group. Patients in the control group recieved anesthesia by dexmedetomidine. Those in the observation group received electrical stimulation at Baihui (DU20), Yintang ( EX-HN3), and Neiguan (PC6) before dexmedetomidine anesthesia. The cognitive function of patients at preoperative day 1 and postoperative day 1 was respectively evaluated by Mini-Mental State Examinations (MMSE). Serum NSE, S-100β, IL-1β, IL-6, and TNF-α levels were detected in the two groups before intervention and immediately after intervention using ELISA.

RESULTSMMSE scores of two groups were significantly reduced at post-intervention day 1, as compared with one day before intervention. MMSE score of the observation group at post-intervention day 1 was (23.15 ± 1.87) points, significantly higher than that of the control group [ (19.34 ± 1.64) points , (P < 0.05)]. The postoperative cognitive dysfunction (POCD) incidence rate of the observation group was 16.4% (10/61), significantly lower than that of the control group [39.3% (24/61); P < 0.05]. Compared with before intervention, NSE and S-100β protein levels, IL-1β, IL-6 and α-TNF levels of the two groups increased (P < 0.05). Post-intervention NSE and S-100β protein levels, IL-1β, IL-6 and α-TNF levels were significantly lower in the observation group than in the control group (P < 0.05).

CONCLUSIONDexmedetomidine combied electrical stimulation could effectively prevent the occurrence of postoperative cognition, and reduce levels of NSA, S-100β, IL-1β, IL-6 and TNF-α.

Acupuncture Points ; Anesthesia ; methods ; Cognition ; Cognition Disorders ; prevention & control ; Dexmedetomidine ; therapeutic use ; Electric Stimulation Therapy ; Humans ; Interleukin-1beta ; blood ; Interleukin-6 ; blood ; Neuropsychological Tests ; Neurosurgical Procedures ; Phosphopyruvate Hydratase ; blood ; Postoperative Complications ; Postoperative Period ; S100 Calcium Binding Protein beta Subunit ; blood ; Tumor Necrosis Factor-alpha ; blood

Magnetic anchoring and traction technique is one of the core technologies of magnetic surgery. With the "non-contact" traction force of the outer magnet on the inner magnet, we can drive the inner magnet and the gripper to multiple directions, and pull tissue or organ to required position in operations, so as to get a clearer surgical field of view. On the basis of the previous animal experiments, we applied magnetic anchoring and traction device in 3 human (males aged 63-71 years) thoracoscopic esophagectomies. Using the magnetic anchoring device, we could pull the esophagus dorsally or ventrally to assist in exposing the anatomical plane without special equipment or pleural puncture for retraction of the esophagus. The interference between operating instruments reduced. The mean blood loss in operation was 83 mL, the mean total operation time was 253 min and the mean length of hospital stay was 10 d. Postoperative follow-up showed that all 3 patients had good short-term prognosis. There was no swellling or pain in magnetic anchoring zone of chest wall.

OBJECTIVETo analyze the infection of human parvovirus B19, human bocavirus (HBoV) and human parvovirus 4 (PARV4) in blood samples among patients with liver disease in Nanjing by molecular detection.

METHODSNested PCR assays were designed and validated to detect B19, HBoV and PARV4, respectively. The assays were used to screen three parvoviruses in blood samples from 95 patients with different liver disease in Nanjing. The parvovirus infection was analyzed statistically.

RESULTSThe detection limits were 10 copies of genomic DNA equivalents per reaction for each assays and the good specificity were observed. The frequency of B19 and HBoV were 2/95 (2.1%) and 9/95 (9.5%) in blood samples respectively. No PARV4 was detected. HBoV was detected in 3/5 patients with drug-induced hepatitis.

CONCLUSIONBoth B19 and HBoV infection were detected in blood from patients with liver disease.

Adolescent ; Adult ; Aged ; Child ; Coinfection ; virology ; Female ; Human bocavirus ; isolation & purification ; Humans ; Liver Diseases ; virology ; Male ; Middle Aged ; Parvovirus ; isolation & purification ; Parvovirus B19, Human ; isolation & purification ; Polymerase Chain Reaction ; Viremia ; virology

OBJECTIVESTo explore a sensitive and specific method for detection of bcl-2/IgH gene rearrangement in diffuse large B cell lymphoma (DLBCL), and verify the credibility of the established method.

METHODSbcl-2/IgH hemi-nested PCR primers were designed using the professional primer design software. Fifty-two samples of pathologically diagnosed DLBCL and 10 fresh tonsil tissues were amplified using hemi-nested touch down-PCR to detect bcl-2/IgH gene rearrangement. The PCR products were cloned and sequenced.

RESULTSbcl-2/IgH gene rearrangement was detected in 6 of 52 DLBCL samples and 2 of 10 fresh tonsil tissues using one-way method. By using the hemi-nested PCR for the second round amplification, 5 of DLBCL were positive, but all of the fresh tonsil tissues were negative. The positive PCR products were sequenced and analyzed on the Internet, 3 of 8 cases obtained by one-way method were false positive, 5 positive cases amplified using hemi-nested PCR were all bcl-2/IgH gene rearrangement. PCR products of 3 false positive cases were homologous to BAC331191 and LLNLR-245D11 in human chromosome 19 and RP11-498P10 in chromosome 1.

CONCLUSIONThere are false positive results using common primers for detecting bcl-2/IgH gene rearrangement. The mechanism may be that highly homologous sequences to human genome exist in commonly used primers. The specificity of the diagnosis could be improved by hemi-nested PCR using the combination of primers we designed and the traditional ones.

Gene Rearrangement, B-Lymphocyte, Heavy Chain ; Genes, bcl-2 ; genetics ; Humans ; Lymphoma, Large B-Cell, Diffuse ; genetics ; Polymerase Chain Reaction ; methods

To analyze and discuss placebo-related information in clinical research literatures in the past 30 years, including placebo's dosage form, ingredients, preparation process and quality control. Effort were made to research the CNKI. full-text database to preliminary find 700 placebo-related clinical research literature, screen out 301 eligible articles by hand, read the literatures to extract placebo-related information and make statistics and discussions. According to the results, Chinese randomized placebo-controlled clinical studies were characterized by diverse dosage forms of placebo with lack of reports for components, as evidenced by the only 17 literatures describing placebo's preparation or specific composition among the 301 literatures. Placebo-controlled clinical trials covered a wide range of disease spectra, but with a specific tropism of diseases in terms of system classification. Although placebo plays a key role in blinded clinical studies, researchers made less records of placebo, perhaps because they paid less attention to placebo or more attention to the research process or restricted by other objective conditions. Moreover, placebo production, quality control and quality evaluation also need to be further standardized.
Biomedical Research ; history ; standards ; China ; History, 20th Century ; History, 21st Century ; Humans ; Placebo Effect ; Quality Control ; Randomized Controlled Trials as Topic ; history ; standards

OBJECTIVETo investigate surgical methods and therapeutic effects of giant cell tumor of tendon sheath in finger.

METHODSFrom July 2002 to December 2010,70 patients with giant cell tumor of tendon sheath in finger which confirmed by operation and pathology,were retrospectively analyzed. There were 29 males,41 females with an average of 42 years (ranged, 16 to 61), and the course of disease ranged form 4 months to 6 years (mean 11 months). The method of surgery and anesthesia were observed.

RESULTSAll wounds were got stage I healing,no necrosis occurred. Vascular crisis occurred in 6 cases (8.6%), inconformity of diagnosis in 18 cases (25.7%), changing of anesthesia due to situation of tumor in operation in 17 cases (24.3%). The patients were followed up from 2.2 to 10.5 years. Among them, 8 cases (11.4%) recurred, and diagnosied by the second operation without malignant change.

CONCLUSIONThe best anesthesia for giant cell tumor in finger should choose brachial plexus to fully expose,complete resection and less harmful damage; while the operation should complete resection at the stage I, and followed up actively, the second operation can be carried out for recorrenced.

Adolescent ; Adult ; Female ; Fingers ; surgery ; Giant Cell Tumors ; diagnosis ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Tendons ; pathology ; surgery ; Young Adult

Disease Management ; Hospitals ; standards ; Humans

OBJECTIVETo evaluate the role of lung lobectomy in the patients of tumor with lung metastases.

METHODSA total of 45 cases of trophoblastic tumor with pulmonary metastases treated by lung lobectomy from 1985-2002 at PUMC hospital was retrospectively analyzed. Seven cases were diagnosed as invasive mole and thirty-eight as choriocarcinoma.

RESULTSLung lobectomy was performed in all of these patients after several courses of chemotherapy. Seven cases of invasive mole reached complete remission. Eleven cases of choriocarcinoma with stage IIIa had received average 13 courses of chemotherapy, 10 of them reached complete remission. Seventeen cases of choriocarcinoma with stage IIIb had received average 14.3 courses of chemotherapy, 11 of them reached complete remission. Ten cases of choriocarcinoma with stage IV had received average 15 courses of chemotherapy, six of them reached complete remission. In the 45 patients, histologic examination disclosed haemorrhagic necrotic tissue in 27 patients, 17 of them reached complete remission (63%). Histologic examination also revealed fibrosis around the focus in 16 patients, 14 of them reached complete remission (88%). Tuberculosis was found in 2 patients.

CONCLUSIONSAlthough the development of effective chemotherapy has resulted in improved survival of patients with gestational trophoblastic tumor, lung lobectomy remains an important adjunct treatment in a selected subset of patients. Pathological examinations can help to estimate the prognosis.

Adolescent ; Adult ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; therapeutic use ; Choriocarcinoma ; secondary ; surgery ; Combined Modality Therapy ; Cyclophosphamide ; administration & dosage ; Dactinomycin ; administration & dosage ; Etoposide ; administration & dosage ; Female ; Humans ; Hydatidiform Mole, Invasive ; pathology ; secondary ; surgery ; Lung Neoplasms ; secondary ; surgery ; Male ; Methotrexate ; administration & dosage ; Middle Aged ; Pneumonectomy ; methods ; Pregnancy ; Prognosis ; Retrospective Studies ; Trophoblastic Neoplasms ; secondary ; surgery ; Uterine Neoplasms ; pathology ; surgery ; Vincristine ; administration & dosage