Objective To explore the application effect of Sandwich teaching method in clinical teaching in the department of neurosurgery.Methods Totally 144 clinical medicine students were divided into 2 groups:Sandwich teaching group (n=72) and traditional teaching group (n=72).The analysis of test and the questionnaire of the students were conducted after the course.Comparison between the two groups was made using independent sample t test and measurement data were expressed as as ± s.P＜0.05 signifies statistically significant differences.Rank sum test was used to compare the distribution of the test scores.Results The test score was statistically higher in Sandwich teaching group than control group [(76.38 ± 10.84) vs.(69.67 ± 10.50)].And the main distribution of the test scores was 70～90 in Sandwich teaching group while 60～80 in control group.Questionnaire showed that the scores of Sandwich teaching group were statistically higher than those ofthe control group in five aspects such as enhancing self-learning ability,improving the ability to analyze and solve problems,and so on.Conclusions Sandwich teaching method achieves good teaching effect and it is worth recommending in clinical teachifig.

Objective:To study the effects of glutamine on the rehabilitation and the immune function in patients with acute stroke. Methods: The study included 57 patients with cerebral ischemia and 29 patients with brain hemorrhage.Nutritional and immune function parameters were evaluated at admission and after 2 weeks following stroke respectively.Neurological deficit was also evaluated by the Chinese Stroke Scale at admission and after 28 days following stroke.The infective complications were investigated. Results:At the same duration after acute stroke,the extent of neurological deficit recovery was significantly lower in the control group than the glutamine group.The rate of the infective complications was significantly higher and it's duration was significantly longer in the control group than the glutamine group.The degree of nutriture and immune function deteriorating was significantly severer in the control group than the glutamine peptide group. Conclusion:Parenteral glutamine supplements is helpful for the rehabilitation and in preventing deterioration of nutrition status and immune function following acute stroke.

Objective To explore the correlation between arterial iodine fraction ( AIF) obtained with energy spectrum CT and Child-Pugh staging of liver cirrhosis.Methods Retrospectively analyzed the Child-Turcotte-Pugh of hospitalized 80 patients diagnosed as liver cirrhosis (15 cases of Child -A,40 cases of Child -B,and 25 cases of Child-C) and CT examination results.HD750 spectral three-stage CT scanning was conducted in all patients.AIF was calculated with energy spectrum analysis software,and the correlation between AIF and Child-Pugh staging of liver cirrhosis was explored.Results There was no statistically significant difference in the iodine content of hepatic artery and portal vein among different groups(t=1.786,P>0.05).The hepatic artery iodine score pair-wise analysis among different groups showed that the differences were statistically significant(F=30.45,P<0.05). The hepatic artery iodine score was highest in Child-Pugh C group,secondary in Child-Pugh B group and lowest in Child-Pugh A group.AIF and Child-Pugh staging of liver cirrhosis was significantly correlated.Conclusion AIF of liver cirrhosis reveals the state of liver function and is correlated with Child-Pugh staging,thus can be adopted as a supplement in clinical Child-Pugh staging.

Objective To measure 95% effective doses (ED95) of propofol and etomidate by using up-down intravenous administration method, and compare the potency ratio and the anesthesia duration of them. Methods Twenty eight male SD rats were divided into two groups randomly: the propofol group and the etomidate group. Loss of righting reflex was regarded as the judgment index of unconsciousness. The dose-response curve was made according to the formula of Y=Ymin+(Ymax-Ymin)/ [1+10log(ED50-X)× m]. Values of ED95 of propofol and etomidate were calculated, and the anesthesia duration periods after administration of the two equivalent dose drugs were measured respectively. Results The values of ED95 were 9 mg/kg and 1.5 mg/kg for propofol and etomidate. The ED95 ratio for propofol and etomidate was 6. There was a significant difference in anesthesia duration between propofol group (465.6±18.5)s and etomidate group (233.7±9.3)s (P<0.05). Conclusion The anesthesia duration of propofol is longer than that of etomidate, taking the ED95 as equivalent dose.

Objective To investigate the relationship between sICAM-1 and colorectal carcinoma metastasis. Methods ELISA was used to detect sICAM-1 level in specimens from 50 cases colorectal cancer patients' serum and 30 cases controls. Results Serum sICAM-1 level in colorectal cancer was significantly higher than that in controls (P 0.05), that in patients with metastasis was significantly higher than that in control(P

Objective To investigate the changes and its clinical significance of serum brain-derived neurotrophic factor (BDNF) level and plasma tissue plasminogen activator( t-PA ) level in patients with amnestic mild cognitive impairment (aMCI). Methods 99 aMCI patients (aMCI group) and 99 matched normal controls (NC group) were recruited for the present study. Multi-dimension neuropsychologic tests were used to extensively assess cognitive function of subjects. An enzyme-linked immunosorbent assay was applied to measure serum BDNF level and plasma t-PA level. The correlation analysis between serum BDNF level and plasma t-PA level tested by ELISA and cognitive function were also made. Results (1) The results neuropsychologic tests in aMCI guoup were significantly lower than those in NC group (all P

To explore the clinical value of the color Doppler flow imaging (CDFI))in diagnosis of vascular disease in the lower extremities of patients with type 2 diabetic mellitus(2DM), 102 patients with 2DM and 20 normal controls were included in this study. The values of vessel intimal-media thickness(IMT), the size of plaque, vessel diameter, percentage of diameter stenosis, percentage of the peak systolic velocity acceleration at stenosis orifice, and velocity wave pattern were obtained with CDFI. The study indicated that the incidence of vasculer disease in the lower extremities as shown by CDFI was higher than that as assessed by clinical manifestations only. By CDFI,the severity of the stenosis or the obstructive lesions of blood wessels in lower extremities was better evaluated,moreover quantitative indexes for clinical diagnosis were provided.

Objective To evaluate the MR manifestation to provide guidance for the clinical diagnosis of adenomyosis.Methods The MR images of 43 cases of adenomyosis which were proved by operation and pathology were reviewed.Results Among the 43 cases of adenomyosis,26 cases were of diffuse adenomyosis and 17 of focal adenomyosis.Leiomyoma(21 cases),intra-pelvic cavity chocolate cyst (17 cases)and ovarian cyst(15 cases)were concurrently found in this group of patients.The MRI of diffuse adenomyosis demonstrated an enlarged uterus and widened uterine junction zone with ill-defined margin between junction zone and myometrium.The adenomyosis lesions showed iso-signal intensity on T_1 weighted images and iso-signal or slight low signal intensity on T_2 weighted images with scattered hyper- intense foci.The uterine cavities were irregularly narrowed due to compression of thickening junction zone.The lesions showed mild con- trast enhancement on contrast-enhanced MR images.The MRI of focal adenomyosis displayed localized myometrial masses with ill-defined margin with widening of junction zone.The lesions were round or oval in shape with iso-signal intensity on T_1 weighted images and inho- mogeneous slightly low signal on T_2 weighted images.Multiple scattered hyperintense foci could be found in the mass on the T_2 weighted images.The lesions had mild contrast enhancement on contrast-enhanced MR images.The concurrent leiomyoma,intra-pelvic cavity choc- olate cyst and ovarian cyst were also displayed by MR imaging.Conclusion The widened junction zone is the characteristic change of ade- nomyosis.MRI can demonstrate the types,size and concurrent changes in adenomyosis,and is a useful noninvasive imaging method for the diagnosis of adenomyosis.

Objective To investigate the hemostasis effect of alginate dressing for puncture point bleeding after peripherally inserted central catheter (PICC) by ultrasound-guided modified Seldinger technique (MST).Methods Between November 2013 and May 2016, 538 cases of cancer in our department underwent PICC, including 270 cases from November 2013 to February 2015 selected as control group (after PICC was successfully placed, sterile gauze and 3M transparent film were used to fix the puncture point) and 268 cases from March 2015 to May 2016 selected as observation group (after PICC was successfully placed, alginate dressing, sterile gauze and 3M transparent film were used to fix the puncture point).The patients in both groups were given 20 minutes of pressure for puncture point and elastic bandage compression fixation for 24 h.The degree of puncture point bleeding and times of dressing change in 24 h and 24-72 h between the two groups were compared.Results In the observation group, mild, moderate, and severe bleeding was seen in 232 cases, 34 cases, and 2 cases within 24 h, and in 242 cases, 25 cases, and 1 case between 24-72 h, respectively.In the control group, mild, moderate, and severe bleeding was seen in 12 cases, 196 cases, and 62 cases within 24 h, and in 21 cases, 212 cases, and 37 cases between 24-72 h, respectively, with significant differences (Z=-18.647, P=0.000;Z=-18.768, P=0.000).In the observation group, there were zero, once, twice, and ≥3 times of puncture point dressing change in 232 cases, 33 cases, 3 cases, and 0 case within 24 h and in 242 cases, 25 cases, 1 case, and 0 case between 24-72 h, respectively.In the control group, there were zero, once, twice, and ≥3 times of puncture point dressing change in 12 cases, 196 cases, 51 cases, and 11 cases within 24 h and in 21 cases, 209 cases, 37 cases, and 3 cases between 24-72 h, respectively, with significant differences (Z=-18.560, P=0.000;Z=-18.755, P=0.000).Conclusion The hemostasis effect of alginate dressing for puncture point bleeding after ultrasound-guided PICC by MST is satisfactory.

An overall improvement of teaching quality is the core task of the reform and the development of higher education. Based on the analysis of the main factors of affecting the teaching quality in universities and combined with the implementation of “views on improving the overall qual-ity of higher education”by the Education Ministry, countermeasures for improving the teaching quality of undergraduates have been proposed such as increasing higher education funds investment to im-prove the condition of running a school, paying attention to the construction of teaching management staff to improve the level of teaching management, establishing Teacher Development Research Center to consolidate the fundamental position of undergraduate teaching , utilizing the high-quality social resources to implement the collaborative education innovation, and improving the personnel training system to strengthen the teaching quality standard .