In higher education,adult English teaching is remarkably different from general English teaching.Years of teaching has made me understand some important means to motivate adult students,improve their study and English practice.Here I list three of these means:changing the learning attitude,teaching in accordance with aptitude and using the multimedia.

Objective To assess global systolic function of left ventricle (LV) using speckle tracking echocardiography in patients who are left volumetric overload and to establish the correlativity between strain and left ventricle end-diastolic volume index (LVEDVI). Methods Seventy-seven patients who were left volumetric overload and 30 normal volunteers were enrolled in this study. Respective 3 high frame rate (＞ 100 frames/s) 2D images were recorded from the left ventricular short axis views: the levels of mitral valve annulus, papillary muscle and apex. Three global peak systolic radical strain and strain rate were measured using 2D strain imagirg. LVEDV was obtained by two-plane Simpson method and LVEDVI was obtained by normalized LVEDV with surface body area. Patients were divided into 6 groups: transitionalgroup,group A (LVEDVI:90- 120 ml/m2),group B (LVEDVI: 121 - 150 ml/m2 ),group C (LVEDVI:151 -180 ml/m2),group D (LVEDVI: 181 - 210 ml/m2),and group E (LVEDVI＞210 ml/m2). Patients were divided into two groups by left ventricular ejection fraction (LVEF): group Ⅰ (LVEF≥ 50 % ), group Ⅱ (LVEF＜50％). Results①Compared with normal control group,GRS,GRSr in transitional group showed no change at three short axis levels (P ＞0.05). The above parameters in group A, B and C were significantly higher than those in normal control group( P ＜0. 01 ). In transitional group,group A,B and C,GRS, GRSr of three short axis gradually increased with LVEDVI augmentation. Compared with group A, B,C,D and normal control group,the above parameters of 3 short aixs in group E were decreased( P ＜0. 01 ),which gradually decreased in group C, D, E with LVEDVI augmentation. ②GRS,GRSr of 3 short axis views in group Ⅰ were more significantly high than those in group Ⅱ and normal control group. The parameters above were significantly low in group Ⅱ ( P ＜0.01). ③In group A,B,C,GRS of papillary muscle and apex levels were correlated positively to LVEDVI ( rpapillary muscle = 0.55,0.64,0.76 and rspex = 0. 74, 0. 79,0.71,P ＜0.05) ; In group D, there was no correlativity between GRS of papillary muscle and LVEDVI( r =- 0.35, P ＞ 0.05) while negative correlativity was established in apex level( r = - 0.73, P ＜ 0. 05). In group E,the negative correlativity was found between GRS of papillary muscle and LVEDVI( r = -0. 70,P ＜0.05) while no correlativity was established in apex level( r = - 0.39, P ＞0. 05). GRS of mitral valve annulus was correlated positively to LVEDVI in group A, B( r = 0.79, 0.77, P ＜ 0.05) and had no correlativity in group C,D. The negative correlativity between them was found in group E( r = - 0. 54, P ＜0.05). At LVEDVI: 180- 190 ml/m2 ,GRS of papillary muscle and apex level reach the peak point about 93% and 62% ;GRS of mitral valve annulus level reach the peak about 63% at LVEDVI 150 - 160 ml/m2.Conclusions Radial strain,strain rate change periodically with LV volume overload. Wall motion of left ventricle can be evaluated accurately by speckle tracking echocardiography, which provide useful modality for evaluation cardiac systolic function.

AIM To examined the effect of bFGF on the calcium influx in outer hair cells (OHCs) and its antagonistical effects with streptomycin. The aim of the study is to explore the mechanism of acute ototoxicity of streptomycin and antagonism of bFGF. METHODSE The OHCs of guinea pig were isolated using an enzyme machine methods and loaded with 10 ?mol?L -1 Fluo 3/AM for 30 min at 37℃,then cultured 60 min at room temperature. Individual Fluo 3 loaded OHCs were examined with a confocal microscope (ACAS Ultima, USA) using a 20? objective lens and linear scan mean. The fluorescent images, collected every 5 sec for 300 s, were stored in a computer. The fluorescent intensity of the images were analyzed by the software cooperated with the confocal microscope, and a function curve showing the change trend of fluorescent intensity with time was obtained. RESULTS The OHCs [Ca 2+ ] i hold steady within the process of normal extracellular liquid perfusion. OHCs [Ca 2+ ] i increased when perfused 100 mmol?L -1 high potassium media(10/11) and normal media containing 1 nmol?L -1 bFGF(9/9), but the OHCs [Ca 2+ ] i don't changes in high potassium free calcium media(7/7) and free calcium media containing 1 nmol?L -1 bFGF(8/8). After treated by 1 mmol?L -1 streptomycin, the OHCs [Ca 2+ ] i increased 0/12, 4/8 respectively when perfused high potassium media and bFGF media. And after treated by 1 nmol?L -1 bFGF, high potassium media make OHCs [Ca 2+ ] i increased more obviously and keeping longer time. After treated by 1 mmol?L -1 streptomycin, respectively, 0 1,1 and 10 nmol?L -1 bFGF make 4/11,6/9 and 12/12 OHCs [Ca 2+ ] i increasing when perfused high potassium media. CONCLUSION High potassium media and bFGF perfusion can result in increasing of OHCs [Ca 2+ ] i ,and OHCs [Ca 2+ ] i increase rooted in the calicum influx, there is synergic effects between high potassium and bFGF. The streptomycin can block the process of calcium influx induced by high potassium media and the block effects can be antagonized by bFGF, and the antagonistical effects have bFGF concentration dependence.

Objective To study the functional mechanism of Yougui Pill(Right Restoring Pill)through its effect on cerebral gene of mice models with kidney-yang asthenia caused by excessive physical and sexual activity.Methods There were 10,15,10 male mice in the control,model and treatment groups respectively.The control and model groups were treated with 0.5ml permouse perday distilled water by gavage while the treatment group was given 0.5ml permouse perday suspension of Yougui Pill.In the model and treatment groups,the ratio of male and female was 1∶6,feeding in the same cage,and the males were swimming everyday for 30~40 minutes,4 weeks in succession,to induce the kidney-yang asthenia.The 36K mouse cerebral gene chips were used to measure the brain genes of mice of 3 groups.The intensity ratio of fluorescence signals ≥2 and ≤0.5 were used as the scale to screen out the remarkably different genes.Results In the model and control groups,totally 186 gene with different expressions were screened out,including the 150 up-regulated genes and 36 down-regulated genes.In the treatment and model groups,155 gene with different expressions were screened out,including the up-regulated 64 genes and 91 down-regulated genes.There were 32 genes up-regulated in the model and control groups but down-regulated in the treatment and model groups,mainly involving the inflammation perimmunity and neurotransmissions persignal transduction genes.There were 12 genes down-regulated in the model and control groups but up-regulated in the treatment and model group,mainly involving the hormone related genes of melanin and orphan nuclear receptor.Conclusion Yougui Pill may make the notably down-regulated genes of melanin markedly up-regulated in mice models of kidney-yang asthenia,improving the effect of hormone related orphan nuclear receptor and promoting the cellular proliferation.

Conspecific organ transplantation provides the survival for the diseased patients at the later stage. The transplantation-induced emotional disorder, rejection, social and psychological burdens all affect the donor, recipients and their relatives, together with the involved medical staff regarding the physical and mental health. The differences of gender, age, cultural background, economic status, social and family roles, and religion beliefs may result in the varying psychological reactions. Therefore, it is recommended to conduct the psychological intervention for the population at each stage of the organ transplantation, as the transplantation technique increases.

Objective To evaluate the effects of desamethasone in pregnancy on fetal pituitary-adrenal functions.Methods From May 2003 to November 2003 24 cases of intrahepatic cholestasis of pregancy(ICP) in the third trimester were treated with dexamethasone.The levels of ACTH and cortisone in the umbilical blood were detected after delivery.The pregnant Wistar rats were intramuscularly injected of dexamethasone(1 mg?kg-1?d-1) from the pregnancy day 15 for 5 days as group B,while the rats in group A received no dexamethasone as control group.The levels of ACTH and cortisone of the rat fetus as well as the ACTH in fetal pituitary gland by immunohistochemistry were examined.Results The ACTH level in the umbilical blood of the fetus increased and the cortisone level decreased as compared to that of the control group.Treatment with desamethasone to pregnant rats resulted in enhanced expression of ACTH,increased serum ACTH concentration,and decreased concentration of cortisol in the rat fetal pituitary gland.Conclusion Treatment with dexamethasone in pregnancy causes some impact on the adrenal gland of the newborn rats in the near future.

[Objective]To evaluate the clinical result of surgical treatment of coronal shear fracture of the capitellum humeri of adults.[Method]From January 2001 to July 2005,6 cases of 2 males and 4 females with coronal fractures capitulum humeri were chosen open reduction and internal fixation utilizing screws.The fractures were terated under direct vision and were fixed with screws.The left arms in 4,right in 2,the age of the group were from 27 to 48 years old,with the average of 38 years.The operative time was from 3 days to 9 days after injury.All cases were fresh and close fractures.[Result]All operations were successful,no nerves and blood vessels injury was found,the incisions were all healed by first intention.The X-ray films showed that the fractures were anatomic reduction.The healing time was 7 weeks in average with 6 to 9 weeks range.All cases were followed up from 12 to 52 months with an average of 32 months,no postoperative complications such as myositis ossificans or avascular necrosis of capitulum humeri was found.According to BrobergMorrey Scale,there were 5 caese of excellent,1case of good.[Conclusion]The coronal shear fracture of the capitellum humeri of adults are suitable for opening reduced direct vision and fixing with screws,prompt treatment with anatomic reduction and internal fixation and early rehabilitation could lead to excellent or good outcomes.

Objective To explore the mechanism 、diagnosis of pancreatic encephalopathy(PE);To evaluate the therapy of PE.Methods To analyze the treatment and diagnosis of 23 PE patients.Results 12 PE patients were cured.11patients were dead,the mortality is 47.8%,5patients in operation group died,the mortality is 62.5%.6 patients in non-operation group were dead,the mortality is 40%,among them,5patients died for multiple organ system falure.one died for septic shock.Conclusions PE is relating to serum amylase inflammatory mediators and infection etc.The diagnosis of PE is based on AP and neurological and mental abnormality.The relative auxiliary diagnosis standard is uncertain.the conventional therapy of PE 、the remedy of MOSF and disorder in water and electroltes were basic therapy.the nerve preserving is necessary for PE's therapy.

Objective:To explore expression of plasma omentin -1 in patients with central obesity (CO) complicated essential hypertension (EH) and its clinical significance .Methods : Serum level of omentin - 1 was measured by enzyme linked immunosorbent assay in 57 CO patients without EH (pure CO group) and 67 CO complicated EH patients (CO + EH group) ,and 56 healthy subjects (normal control group) .Blood glucose ,blood lipid and biochemical indexes were compared and analyzed among three groups ,and Logistic multi - factor gradual regression analysis was used to perform risk factor analysis .Results : Serum omentin - 1 level in CO + EH group was significantly lower than those of pure CO group and normal control group [ (25.15 ± 3.95) ng/ml vs .(45.63 ± 9.66) ng/ml ,(53.12 ± 7.97) ng/ml , P < 0.05 or < 0.01] ,but there was no significant difference between pure CO and normal control group , P > 0.05 ;Logistic multi - factor gradual regression analysis indicated that age and homeostasis model - insulin resistance index (HOMA - IR ) were independent risk factors affecting EH occurrence in obese people (OR = 1.124 ,95% CI : 1.000 - 1.248 ,P = 0.049 ;OR = 3.446 ,95% CI : 1.087 - 5.607 ,P = 0.001) ,while serum omentin - 1 level was an independent protective factor (OR = 0.423 ,95% CI : 0.210 - 0.636 , P = 0.001) .Conclusion : Serum omentin - 1 level may possess certain guiding significance in early diagnosis ,prevention and treatment for patients with central obesity complicated essential hypertension .

Objective To evaluate the efficacy of transversus abdominis plane (TAP) block for postoperative analgesia in the pediatric patients undergoing operation on the inguinal region.Methods Sixty-four pediatric patients of both sexes, aged 1-3 yr, weighing 8.5-23.6 kg, of American Society of Anesthesiologists physical status Ⅰ , undergoing elective unilateral high ligation of the hernia sac or high ligation of the processus vaginalis, were equally randomized into either intravenous analgesia group (group VA) or TAP block group (group TAP).In group TAP, after induction of anesthesia, the pediatric patients received ultrasound-guided TAP block with 0.2％ ropivacaine 1 ml/kg injected locally.After the laryngeal mask airway was inserted, the pediatric patients were mechanically ventilated, and then inhaled 2％-3％ sevoflurane for maintenance of anesthesia.In group VA, postoperative analgesia was performed with fentanyl 0.35 μg · kg-1 · h-1 until 24 h after operation.The level of pain was rated using the FLACC pain scale.When FLACC score＞5, fentanyl 0.25 μg/kg was injected intravenously as rescue analgesic.The occurrence of TAP block-related adverse events, time for removal of laryngeal mask airway, and occurrence of fentanyl-related nausea and vomiting, respiratory depression, and emergence agitation were recorded.Results No TAP block-related adverse events were observed in group TAP, and no respiratory depression was found in the two groups.Compared with group VA, the time for removal of laryngeal mask airway was significantly shortened, and the requirement for rescue analgesics and incidence of vomiting and emergence agitation were decreased in group TAP (P＜ 0.05).Conclusion TAP block with 0.2％ ropivacaine 1 ml/kg provides good efficacy for postoperative analgesia with good safety in the pediatric patients undergoing operation on the inguinal region.