Acute Disease ; Adult ; Aged ; Cyanides ; poisoning ; Emergency Nursing ; Emergency Treatment ; Female ; Humans ; Male ; Middle Aged ; Young Adult

Objective To compare and evaluate the effect of PBL in clinical teaching of Pediatrics.Methods Among students of Grade 2002 in our university,two types of PBL,pre-learning and case-discussion,were used in their clinical learning of Pediatrics. And then,their effects were evaluated and compared with those of traditional learning method.Results More than 60% of the students agreed with PBL methods,and they considered PBL favorable to practice scientific logical thinking of clinical affairs,to increase their capabilities of learning,oral expression,communication and cooperation.The teachers agreed with PBL methods too for the better learning effect resulting from PBL.Conclusion PBL fits the needs of medical learning reformation.To train new type of doctors in century 21st,it is necessary to use kinds of new learning methods,including PBL methods and standardized patient (SP)in clinical teaching.

Humans ; Infant ; Neuroaxonal Dystrophies ; diagnosis

To establish a UFLC-MS/MS method for the determination of valproate acid in human plasma. Methods:The sample was precipitated by methanol. The analysis of valproate acid and diclofenac sodium ( internal standard) was carried out on a Shim-pack XR-ODS II C18 column (2. 0 × 75 mm,2. 2 μm). Gradient elution was adopted with acetonitrile and water (containing 5 mmol·L-1 ammonium acetate) at a flow rate of 0. 3 ml·min-1. The detection was performed with multiple reactions monitoring (MRM) using nega-tive electrospray ionization (ESI) at m/z 142. 8→142. 8 for valproate acid and m/z 294. 0→249. 8 for diclofenac sodium. Results: The calibration curve of valproate acid was linear over the range of 8.4-168.0 μg·ml-1(r=0.997 5). Inter- and intra-day RSDs were less than 15%, and the analysis was proven to be stable. Totally 30 samples determined by EMIT were assayed by the method. And the results of the two methods analyzed by independent t-test showed no statistical significance. Conclusion:The method is rapid,sensitive and spe-cific,which can be applied in the determination of valproate acid in human plasma.

Objective To discuss the correlation between cervical intraepithelial neoplasia(CIN) and uterine cervix cancer and the combination of TCT and colposcope for the investigation of cervical lesion.Methods 5545 patients were preliminarily screened by cervical fluid basement cell folium smear,in which 307 patients are masculine and 219 are negative,the 526 patients are suspected cervical lesions in clinical symptoms and they further underwent colposcopy and biopsy,the results were analyzed by pathohistology which is golden standard.Results CIN coherent dangerous factors analyzed by single factor Logistic regression analysis are:cervical HPV pollution,age of sexual activity,sexual partners numbers,protection of sexual life, STD history,age and frequency of miscarriage ( P < 0.05 ).The coincidence between TCT,colposeopy and pathologic diagnosis are 49.4%, 83.8% ;the omission diagnostic rate of LSIL,HSIL and CC from TCT are 63.63% ,74.44% ,100% ;the omission diagnostic rate of LSIL,HSIL and CC from colposcopy are 33.37%, 12.22% ,0;the sensitivity of TCT,colposcopy and TCT combine colposcopy for CIN are 61.2% ,84.6% ,94.5% and specificity are 85.4% ,88.2.% ,90.8%.Conclusions (1)The generation of CIN and cervical cancer are correlated with cervical HPV pollution,sexual behavior and various kinds of lower genital tract infection.(2) Fluid basement cell folium smear can promote the property of diagnosis,meet the demands of early stage uterus neck cancer and precancer lesion investigation,are suitable to be routine cheek methods in primary hospital.

PBL(Problem-Based Learning, PBL) is a problem-oriented and effective supplementary teaching method. PBL is giving a great help to improve self-learning, communication and cooperation, thinking and problems solving abilities for the students. In the process of PBL teaching, attention should be paid to two important items. One item is the role transfer for the teacher. Teacher is only a guider in PBL teaching, teacher should avoid excessive interfere of the process for keeping the passion and enthusiasm of the students. Meanwhile, students should always be realized that they are the main part in PBL teaching, they should not depend on their teacher too much. Another important item is how to find and solve the frequently encountered problems, in order to avoid students wandering from the subject, and lead them toward the main goal to get effective teaching and learning.

AIM: To evaluate the relationship between damages of visual field and retinal nerve fiber layer (RNFL) thickness in primary open angle glaucoma (POAG)with highly myopia. POAG with highly myopia group (21 eyes of 17 cases), POAG with non-highly myopia group (17 eyes of 16 cases), highly myopia without POAG group (25 eyes of 20 cases) and normal control group (19 eyes of 17 cases).automated perimeter and thickness of RNFL was measured by optical coherent tomography(OCT). Main outcome mean deviation (MD), pattern standard deviation (PSD) and mean sensitivity at superior, inferior, nasal and temporal sectors in total deviation probability plots. Thickness of RNFL at superior, inferior, nasal and temporal sector.total deviation probability plots of the early POAG with highly myopia than that of POAG without highly myopia,and the early visual field defects of glaucoma in pattern deviation probability plots of this group. MD of POAG with highly myopia was more than those of others (P＜0.05).The differences of MD, PSD and mean sensitivity between POAG with highly myopia and others were significant(P＜0.05).Mean sensitivities in each sector of POAG without highly myopia were similar to those of highly myopia(P＞0.05). The thickness of RNFL of POAG with highly myopia was thinner than that of others and the thickness of RNFL of normality was thicker than that of others. The relationship between mean sensitivity and the thickness of RNFL in each quadrant was significant(P＜0.05).judgment of the visual field changes in POAG with highly myopia. The relationship between RNFL thickness by OCT and visual field damage may provide clinically relevant information in diagnosis of POAG with highly myopia. Field; optical coherent tomography

ObjectiveTo observe the efficacy and side effects of paroxetine and amitriptyline in the treatment of post-stroke depression (PSD).Methods82 PSD patients were randomly divided into the paroxetine group (n=42) and amitriptyline group (n=40). Before the treatment and at the ends of 2nd, 4th and 8th week after the treatment, all patients in two groups were assessed with Hamilton Depression Scale (HAMD) and TESS.ResultsAfter treatment, HAMD scores of patients of two groups were decreased significantly (P<0.01), but no difference was found between two groups. The side effects of the paroxetine group were obviously fewer and milder than that of amitriptyline group (P<0.01).ConclusionParoxetine is an effective and safe drug in the treatment of PSD.

Adenocarcinoma, Mucinous ; drug therapy ; metabolism ; pathology ; surgery ; Adult ; Aged ; Breast Neoplasms ; drug therapy ; metabolism ; pathology ; surgery ; Carcinoma, Ductal, Breast ; drug therapy ; metabolism ; pathology ; surgery ; Carcinoma, Lobular ; drug therapy ; metabolism ; pathology ; surgery ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Lymphatic Metastasis ; MCF-7 Cells ; metabolism ; Mastectomy, Modified Radical ; Membrane Proteins ; metabolism ; Middle Aged ; Receptor, ErbB-2 ; metabolism ; Sphingosine N-Acyltransferase ; metabolism ; Survival Rate ; Tumor Suppressor Proteins ; metabolism

Objective To observe the effects of comprehensive measures of changing grain,selenium supplementation,off-site education and resettlement on prevention of children's Kashin-Beck disease in Aba state.Methods Fifty eight villages in Aba Kashin-Beck disease areas were chosen as intervention points in Aba state Sichuan province from 2007 to 2011.Based on the implementation of prevention and control measures,the villages were divided into off-site education + changing grain + selenium supplementation group and resettlement + off-site education + changing grain + selenium supplementation group,Geletuo town of Seda county,Ganzi state was selected as a control point,and right-hand anteroposterior X-ray examination(including the wrist) was carried out on children aged 6-13 from 2007 to 2011 annually.Clinical and X-ray diagnosis of Kashin-Beck disease was made in accordance with the Diagnostic Criteria of Kaschin-Beck Disease(GB 16003-1995).The effects of prevention and control measures were evaluated by comparing the child X-ray detection rate before and after the implementation of the measures.Results The average X-ray positive detectable rate of children in the intervention points was 2.07％(66/3181),2.72％ (69/2540),1.16％ (35/3017),0.56％ (19/3397) and 0.56％ (24/4273),respectively from 2007 to 2011,with a downward trend (x2trend =66.74,P ＜ 0.01).There was a downward trend in the average X-ray positive detectable rate of children in off-site education + changing grain + selenium supplementation group [1.60％(29/1809),2.63％ (39/1484),1.29％ (25/1941),0.64％ (15/2332),0.42％ (10/2379)] and resettlement + off-site education + changing grain + selenium supplementation group [2.70％ (37/1372),2.84％ (30/1056),0.93％(10/1076),0.38％ (4/1065),0.74％(14/1894)] (x2trend=30.97,35.19,all P ＜ 0.01).The average X-ray positive detectable rate of children in the intervention group was 0 from 2007 to 2010,and was 1.61％ (1/62) in 2011.The difference of X-ray positive detectable rate was not statistically significant in the control group in the 5 years from 2007 to 2011.The difference of children's X-ray positive detectable rate was not statistically significant between control group and intervention group.Conclusions The effect of taking changing grain,selenium supplementation,off-site education and resettlement comprehensive measures to prevent children's Kashin-Beck disease is not significant in those places where the state of Kaschin-Beck disease is not active.