Objective This article made an exploration on the feasibility of combined applica-tion of TBL with LBL in immunology experiment teaching, and analyzed teaching effectiveness of such combined model in order to find a new way of teaching reformation. Methods 2012 grade biophar-maceutical technology students were chosen in this research, one class as the experimental group(n=42), the other one as control group(n=42). In the experimental group, students were taught on a TBL+LBL combination model, while in the control group, students were taught only on LBL model. After the course was finished, effects of teaching were evaluated by questionnaire survey and compre-hensive ability evaluation. SPSS 18.0 software was used to do statistical analysis. Quantitative data and qualitative data were analyzed by t test and chi-square test respectively. P<0.05 means that difference is statistically significant. Results Above 90.0% of students in experiment group approved that TBL+LBL can improve the interest in learning , can enhance sense of teamwork , can help acquiring of knowledge and improving of individual comprehensive ability. Average score of comprehensive ability evaluation and percentage of students achieving good score in experimental group were higher than those in control group, the differences were statistically significant(t=2.020, P=0.049; χ2=6.372, P=0.012). Conclusion The TBL+LBL combination model can improve immunology experiment teach-ing quality, and is worth publicizing.

Objective To evaluate the efficacy and safety of Xuebijing combined with corticosteroid injection treating paraquat poisoning with regression analysis. Methods 146 patients of paraquat poisoning in 3 years were divided into two groups: control group and therapeutic group. 50 patients in the control group were treated with Methylprednisolone, while 96 patients in the therapeutic group were treated with Xuebijing injection (300～400 ml/d, intravenous drip) and Methylprednisolone. The patients' clinical symptoms, signs and the levels of white blood cell (WBC), Neutrophils (N), C-reactive protein (CRP), glutamic-pyruvic transaminase (ALT), aspartate aminotransferase (AST), serum creatinine (Scr) and arterial partial pressure of oxygen were collected. And patients did chest CT examinations every three days. All the data were compared between the two groups. Results ① The biochemical indicators of the control group in the 14th day [WBC,N,CRP, and PaO2 is (16.49±4.30), (84.22±21.07), (24.58±7.06), and (83.20±22.95) respectively]were better than those in the third day[WBC, N, CRP, and PaO2 is (19.21 ±5.34), (85.04± 12.33), (27.98±6.51), and (73.42±11.43)respectively], but there was not significant difference between them(P>0.05). While the biochemical indicators of the therapeutic group in the 14th day [WBC,N, CRP, and PaO2 is (9.16 ± 3.23 ), (70.48 ± 10.79), ( 17.48 ± 4.7), and (95.04± 11.93) respectively] were much better than those in the third day [WBC,N,CRP, and PaO2 is (16.96±9.95),(84.82±9.34), (27.34± 10.03), and (89.12±9.47) respectively], and there was significant difference between them( P< 0.05 ). ② The survival rate in the control group was 32% comparing to 67.71% in the therapeutic group, showing significant difference between the two group (x2=9.588, P<0.05) . ③ The patients' chest CT examinations in the therapeutic group were better than those in the control group. Conclusion Xuebijing injection combined with methylprednisolone had good effects m treating paraquat poisoning.

Objective To evaluate invitro antibacterial activity of Gymnema sylvestre extractant.Methods The antibacterial activity of Gymnema sylvestre extractant against staphyloccus aureus,bacillus coli,bacillus proteus,bacillus aeruginosus was detected by agar dilution method.Results The minimum inhibitory concentration were 0.65,1.25,1.25,2.5 mg/mL respectively.Conclusion Gymnema sylvestre extractant had strong antibacterial activity against various bacteria.

Objective To investigate the distribution of the mini mental status examination in the elderly Methods Totally 3 776 residents aged 55 years or over serving as samples in the urban and rural areas of Lhasa city, from August to December in 2001 were studied A residential area and a door to door general sampling procedures were used in this study, respectively Mini mental status examination (MMSE) and a activity of daily living scale (ADL) were used as screening methods for dementia Results The distribution of lower scores in such examination in middle elderly people, in Lhasa city was 7 2%, in which, males were 9 3% and femals, 6 3% Conclusion The results of lower scores in the mini mental status examination were similar to those reporting from inland cities, but there appear some what differences in distributions of ages, educational levels and sexes from Tibetan, which may be due to their special location and living habits

[Objective]To study the neurologic criterion and curative effect facts of cervical spondylotic myelopathy.[Method]A prospective study was carried out and 21 cases of cervical spondylotic myelopathy were involved in this investigation to be classified by Nurick grade,JOA score and 40 cent classification.The possibility curative effect facts were analysed.[Result]The patients were followed up for average 11 months.Spinal cord function score were improved by 2~3 grades according to Nurick grade;1～6 cent to JOA score and 7~12 cent to 40 cent postoperation.Height of vertebral,cervical lordosis,centrum posterior decompression being unenough,excess height of centrum were curative effect facts of cervical spondylotic myelopathy.[Conclusion]Nurick classify allow even more contrast,but unsuit to some Cervical spondylotic myelopathy,JOA is simple and convenit,efficienf and across-the-aboard;40 cent assess measure is impersonality but cockamamie.Height of vertebral and centrum posterior decompression being unenough are most important facts about surgery.

Objective To explore the relationship between the polymorphism of angiotensin converting enzyme (ACE) gene and essential hypertension complicated with left ventricular hypertrophy (LVH). Methods ACE gene I/D polymorphism in 150 healthy subjects, 80 essential hypertensive(ET)patients with LVH and 152 ET patients without LVH was detected by PCR. Left ventricular mass (LVM) was measured by echocardiography, and then left ventricular mass index (LVMI) was calculated. Results The frequencies of the ACE D allele in the ET patients with or without LVH were 0.493 and 0.514, respectively, and significantly higher than those in the healthy subjects (P

BACKGROUND: Metal-on-metal hip surface arthroplasty has improved the abradability for hip joint prosthesis and has the characteristics of normal biological stress transfer.OBJECTIVE: To observe the long-term state of hip-joint function of patients who underwent metal-on-metal hip surface arthroplasty.DESIGN: Follow-up study for cases.SETTING: Department of Orthopaedics, Jiangsu Provincial Corps Hospital of the Chinese People's Armed Police Force; Department of Orthopaedics, Affiliated Hospital of Nantong University.PARTICIPANTS: Eighteen cases (23 hips) who underwent a metal-on-metal hip surface arthroplastyprocedure in the Department of Orthopaedics, Jiangsu Provincial Corps Hospital of the Chinese People's Armed Police Force, and Department of Orthopaedics, Affiliated Hospital of Nantong University between September 2004 and July 2005 were recruited in this study. All cases, aged 28 to 54 years, include 11 males and 7 females. According to the classification of etiology, there were 13 cases of osteonecrosis(16 hips),3 cases of osteoarthritis( 4 hips ),1 case of congenital hip dysplasia (2 hips) and 1 case of posterior trauma arthritis(1 hip ). All cases applied the Conserve Plus resurfacing prosthesis (manufactured by Wright Medical Technology, USA), of which the pattern number of acetabular cup (press-fit depth: 1-2 mm) ranged from 38 mm to 56 mm in the inner diameter and from 44 mm to 62 mm in the outer diameter and that of femoral head cup ranged from 38 mm to 56 mm in the outer diameter. Preoperatively all patients signed the informed consent for the surgery, and the application of this technique also gave the approval of the Ethics Committee of the hospital.METHODS: ①After the epidural and lumbar combination anesthesia was satisfactory, the coxacava was exposed at first and the suitable size acetabular cup coated by hydroxyapatite ceramic was selected to be implanted, to be tightened and to be fixed by press-fit referring to the anatomical position. Subsequently to install the femoral head prosthesis, femoral cup was laid on the ready caput femoris and impacted by the presser to make the metal cup paste close-up with sclerotin when the concocted bone cement was overlaid on the prefabricated caput femoris surface and internal surface of prosthesis. Further, short-term of femoral cup should be kept the conformity with axial ray of the femoral neck. ②Patients were allowed to make the function exercise such as initiative stretch and contract of quadriceps muscle of thigh, passive motion of the knee joint and initiative motion of the knee joint under the non-weight loading on bed. Then they were encouraged to walk with two walking sticks two weeks after operation, progressing to get out of the two walking sticks six weeks postoperatively. All affected extremities were fixated with T-shaped tabula shoes in the abduction position after operation. ③All patients were reviewed with taking the anteroposterior radiographs of pelvis, evaluation of the clinically curative effect on the procedure of metal-on-metal hip surface arthroplasty and biocompatibility between the prosthesis and the host one year and two years after operation. Moreover, Harris score was assessed for all affected hips preoperatively, one year and two years postoperatively.MAIN OUTCOME MEASURES: ①The clinically curative effect on metal on metal hip surface arthroplasty; ②Biocompatibility;③The Harris score for the affected hips; ④The pain status of hip after operation.RESULTS: Eighteen cases were all brought into the outcome analysis at last.①The curative effect on the metal-on-metal hip surface arthroplasty: The femoral component of one case had a varus deformation of 10°six weeks after operation, but such complications as component loosening and femoral neck fractures, etc. Did not occur during the coming follow-up. The locations of rest prosthesis were satisfactory. Substantial radiolucencies were found at the rim of acetabular component (1 and 2 zone) in two hips, respectively one and two years after operation. But there was no evidence of radiolucencies around the short-stem of femoral component.②Biocompatibility: No patients were found to have obvious reactions including renal toxicity, pyretogen and rejection. No radiograph showed signs of loosening, dislocation, heterotopic bone formation, femoral neck narrowing, femoral head necrosis and prosthesis fixation failure, etc.③Harris score for the affected hips: The Harris score of all disease hips was improved from the mean 46 preoperatively to 85 one year after operation to 93 two years postoperatively. Of these,15 hips were excellent(> 90),6 hips good (80-89), and 2 hips fair(70–79).④The pain status of hip after operation: Two patients complained of slight pain, one patient of moderate pain, and no cases of severe pain happened.CONCLUSION: The long-term outcome for hip disease patients who undergo metal-on-metal hip surface arthroplasty is satisfactory.

BACKGROUND:Exchange nailing has been reported to be a very good method for metaphyseal nonunion after femoral shaft fracture treated with intramedul ary nail. However, the effect of intramedul ary nail exchanging is not ideal for the treatment of nonisthmal femoral shaft nonunions.
OBJECTIVE: To compare the clinical and imaging outcomes between intramedul ary nail exchanging and intramedul ary nail retention plus augmentation plating for the treatment of nonisthmal femoral shaft nonunions.
METHODS:The clinical data of 39 patients with nonisthmal nonunions of femoral shaft fractures after failure of intramedul ary nail were retrospectively analyzed, and 21 patients were treated with intramedul ary nail exchanging and 18 patients were treated with intramedul ary nail retention plus augmentation plating. Clinical therapeutic effect was evaluated by Tohner-Wrnch standard.
RESULTS AND CONCLUSION:Al cases were fol owed-up for more than 15 months. In the intramedul ary nail exchanging group, postoperative internal fixator loosening occurred in three cases who obtained bony union by intramedul ary nail retention plus augmentation plating combined with autogenous iliac bone graft. The fixation time, blood loss, volume for suspended red blood cel s transfusion, hospitalization costs and re-operation rate in the intramedul ary nail retention plus augmentation plating group were lower than that in the intramedullary nail exchanging group (P<0.05). Al the patients in two groups obtained bony union, and the clinical and radiographic healing time in the intramedul ary nail exchanging group were longer than those in the intramedul ary nail retention plus augmentation plating group (P<0.05);according to Tohner-Wrnch standard at final fol ow-up, excel ent in 10 cases, good in six cases and poor in five cases in the intramedul ary nail exchanging group, and the excel ent and good rate was 76%;in the intramedul ary nail retention plus augmentation plating group, there were 11 cases of excel ent and seven cases of good, and the excel ent and good rate was 100%;there was significant difference between two groups (P<0.05). Due to relatively simpler manipulation, shorter fixation time, less intraoperative blood loss, slighter trauma, less hospitalization cost, lower re-operation rate and more satisfactory therapeutic effect, intramedul ary nail retention plus augmentation plating combined with autogenous iliac bone graft has been a better method for the treatment of nonisthmal nonunions of femoral shaft fractures after failure of intramedul ary nailing when compared with intramedul ary nail exchanging.

ObjectiveTo explore the clinical manifestations of infant cytomegalovirus infection in different age. MethodThe clinical data of 237 infants who suffered from cytomegalovirus infection was analyzed retrospectively and divided into three groups: 0-3 months old (77 cases,group A) ,4-6 months old ( 65 cases , group B ) , 7-12 months old ( 95 cases , group C ). ResultsThe incidence of respiratory infection was the highest among all infectious organs in three groups, the numbers of patients who had wheeze in group A was less than that in the other two groups[24.7％(19/77) vs. 61.5％ (40/65), 61.1％( 58/95 )](P ＜ 0.01 ).The incidence of jaundice decreased gradually as the babies grew up[23.4％( 18/77 )→7.7％(5/65 )→1.1％( 1/95 )](P ＜ 0.05). There was no significant difference in diarrhoea and bleeding among three groups (P＞0.05 ). The proportion of alanine aminotransferase], aspartate amino transferase increasing was similar among three groups, but gamma-glutamyl transferase (GGT) was different, the proportion of GGT increasing was 77.9％ (60/77) in group A which was higher than that in the other two groups[10.8％ ( 7/65 ), 2.1％ ( 2/95 )].Granulocytopenia in group B was obviously decreased compared with the other two groups (P ＜ 0.05 ), anemia was easily occurred in group C (P ＜ 0.05 ). ConclusionThe injury of cytomegalovirus infection may be related to month old.

Objective To study the role of early intravenous nutrition given aggressively combined with early minimal feeding on very low birth weight infants (VLBWI),and to evaluate the clinical value of intestinal barrier protein and MicroRNA.Methods All of 62 cases of VLBWI admitted in NICU,the Maternal and Child Health Hospital of Nantong Affiliated to Nantong University from January 2006 to June 2014 were recruited.Sixty-two VLBWI were randomly divided into group A and group B.Thirty infants in group A were exposed to conventional intravenous nutrition.Thirty-two infants in group B were treated with early intravenous nutrition aggressively combined with early minimal feeding.The time of birth weight recovery,days with intravenous nutrition,hospital stay and complications were recorded.The liver and kidney functions,electrolytes,blood gas analysis were monitored.Enzyme-linked immunosorbent method was used to detect intestinal fatty acid binding protein (Ⅰ-FABP),an intestinal barrier protein in plasma.Infection related MicroRNA155 was detected with fluorescent quantitative polymerase chain reaction (RT-PCR).Results Group B was superior to group A in weight loss after birth [(13.70 ± 3.10) ％ vs (5.46 ± 2.64) ％,P ＜ 0.05],shorter recovery time of body weight [(12.20 ± 3.38) d vs (6.82 ± 3.20) d,P ＜ 0.05],fewer days with intravenous nutrition [(29.62 ± 4.16) d vs (20.80 ± 3.20) d,P ＜ 0.05] and shorter hospital stays [(44.60 ± 6.32) d vs (28.91 ± 4.36) d,P ＜ 0.05].Compared with group A,the infants in group B had less complications,including hyperbilirubinemia (31.2％ vs 56.7％),extrauterine growth retardation (34.3％ vs 73.3％),cholestasis (6.2％ vs 23.3％),feeding intolerance (15.6％ vs 53.3％) and necrotizing enterocolitis (0 vs 16.7％) (all P ＜ 0.05).Although Ⅰ-FABP had a higher plasma concentration in group A than that of group B [(9.083 ± 1.059) μg/L vs (7.563 ± 0.739) μg/L],the difference was not significant (t =1.190,P =0.076 4).However,the plasma levels of Ⅰ-FABP in infants with necrotizing enterocolitis were significantly higher than those of group B [(19.500 ± 3.510) μg/L vs (7.563 ±0.739) μg/L,t =5.231,P =0.035 0].The expression of MicroRNA155 in group A was markedly higher than that of group B (2-△△ct were 0.81 ± 0.12 and 0.24 ± 0.08,respectively,P ＜ 0.05).Conclusions Giving aggressive intravenous nutrition early combined with early minimal feeding was safety and effective to VLBWI,which was of benefit to their growth and development,reducing complications and shorting hospital stays.The detection of intestinal barrier protein Ⅰ-FABP and MicroRNA155 is useful for monitoring feeding complications of VLBWI.