Diversified teaching methods including traditional teaching,problem based learning,interactive teaching and team cooperation teaching were adopted in the process of teaching.Problem based learning can stimulate students' learning interests; interactive teaching can improve the students' hands-on ability and team cooperation teaching can cultivate students' cooperation spirits.Diversified teaching mode made different teaching methods integrated and complemented each other,forming a special teaching mode for the course of functional experiment.

BACKGROUND: Sepsis is a common complication of infections, burns, traumas, surgeries, poisonings, and post-cardiopulmonary resuscitation. The present study aimed to investigate prognostic value of CD4+CD25+ regulatory T cells (Treg) in peripheral blood of patients with sepsis. METHODS: Periphery blood from 28 patients diagnosed with sepsis was collected on day 1 and 7 after hospitalization in the ICU of Shanghai Changzheng Hospital between December 2013 to April 2014. The blood was used for analyses of Treg ratio using flow cytometry and for analyses of blood routine test, C-reactive protein (CRP), bilirubin, procalcitonin (PCT), and coagulation. APACHE II and sequential organ failure assessment (SOFA) scores were also investigated. The results were compared between two outcome groups of survival or death to evaluate prognostic value for sepsis. RESULTS: The patients had an average age of 60.36±15.03 years, APACHE II score 16.68±7.00, and SOFA score 7.18±3.78. Among the 28 patients, 12 had severe trauma (42.9％), 10 had septic shock (35.7％), and 9 (32.2％) died. The median ratio of Tregs was 2.10％ (0.80％, 3.10％) in the survival group vs. 1.80％ (1.15％, 3.65％) in the death group (Z=–0.148, P=0.883) on day 1; however it was significantly changed to 0.90％ (0.30％, 2.80％) vs. 5.70％ (2.60％, 8.30％) (Z=–2.905, P=0.004). CONCLUSION: With better prospects for clinical application, dynamic monitoring of Tregs ratio in peripheral blood has potential value in predicting prognosis of sepsis.

OBJECTIVETo study the genetic association of apolipoprotein (apo) E and apoCI gene polymorphisms with coronary heart disease (CHD) in China.

METHODSapoE genotypes were identified by multiplex amplification refractory mutation system (multi-ARMS) and the apoCI promoter polymorphisms were detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) in 186 cases with CHD (age: 65.0 +/- 10.5 years) and 350 controls (age: 63.6 +/- 8.3 years). The haplotype frequencies were estimated.

RESULTSThe frequencies of apoE E4/3 genotype (26.9%) and epsilon4 (14.5%) in CHD group were significantly higher than that in the control group (12.6%, 7.0%), P <0.05. The significant difference was also found for the apoCI locus and the CHD group showed higher rate of both for the H2 allele and genotypes, carrying this allele. Estimation of the haplotype frequencies indicated that the association between the apoE-CI haplotype and CHD was significantly strong. The apoE-epsilon4/apoCI-H2 was estimated to be responsible for 9.86% of CHD.

CONCLUSIONWhen the subjects carrying both epsilon4 and H2 alleles, they would have higher risk of suffering from CHD than controls.

Adult ; Aged ; Aged, 80 and over ; Alleles ; Apolipoproteins C ; genetics ; Apolipoproteins E ; genetics ; China ; epidemiology ; Coronary Disease ; blood ; epidemiology ; genetics ; Female ; Genotype ; Haplotypes ; Humans ; Male ; Middle Aged ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Risk Factors

OBJECTIVETo compare the efficacy of Chinese herbal medicine (therapy A) or Chinese herbal medicine plus indomethacin (therapy B) with that of indomethacin alone (therapy C) in treating polyhydramnios.

METHODSLiteratures published up to April 2012 were retrieved from PubMed, Embase and Cochrane library, Chinese National Knowledge Infrastructure (CNKI), Chinese Scientific and Technological Periodical Database (VIP), Wangfang, and Traditional Chinese Medicine online. Two researchers collected data independently. The assessment of methodological quality was based on Cochrane handbook and the materials were analyzed with software RevMan 5.1.2. The outcome measure index was relative risk or difference of mean value (95% confidence interval). The following outcomes were evaluated (1) general clinical improvement rate; (2) maximum vertical pocket depth; (3) amniotic fluid index (AFI) value; (4) rate of fetal ductus arteriosus constriction; (5) incidence of adverse events.

RESULTSBased on the search strategy, 5 trails involving 1017 patients were finally included. Compared with therapy C, therapy A decreased the rate of fetal ductus arteriosus constriction (P<0.01). Therapy B was more effective than therapy C in general clinical improvement and decrease of AFI for polyhydramnios (P<0.01). No serious adverse events were reported in therapy A and therapy B.

CONCLUSIONSCompared with therapy C, therapy A and therapy B may appear to be more effective for polyhydramnios. However, the exact effect needs to be confirmed with well-designed large-scale clinical trials.

Female ; Herbal Medicine ; Humans ; Medicine, Chinese Traditional ; Polyhydramnios ; drug therapy ; Pregnancy

To detect the in vitro probe microdialysis recoveries based on an HPLC-DAD method for simultaneous quantification of nine active ingredients (ephedrine, pseudoephedrine, methylephedrine, amygdalin, liquiritin, cinnamyl alcohol, cinnamic acid, cinnamaldehyde and glycyrrhizic acid) in Mahuang decoction, which provides reference for in vivo pharmacokinetic study. The concentrations of nine active ingredients in dialysate were detected by HPLC-DAD, to investigate the effect of flow rates (incremental method and subtraction method) and intraday stability of the probe recoveries and medium concentrations on the recoveries. Nine active ingredients could be well separated in 52 min. At the perfusion rate of 1.0 μL x min(-1), the relative recoveries of ephedrine, pseudoephedrine, methylephedrine, amygdalin, liquiritin, cinnamyl alcohol, cinnamic acid, cinnamaldehyde and glycyrrhizic acid were (50.95 ± 0.82)%, (52.74 ± 1.13)%, (51.29 ± 0.51)%, (32.56 ± 0.84)%, (45.36 ± 0.83)%, (70.94 ± 0.99)%, (69.98 ± 2.30)%, (71.68 ± 0.63)%, and (22.14 ± 0.48)%, respectively. And the probe kept steady in 7 hours. At the same medium concentration, the probe recoveries decreased exponentially with the increase in flow rates. The recoveries of seven ingredients detected by these two methods were similar at certain flow rates, except for amygdalin and cinnamaldehyde. At the same flow rate, the relative recoveries of cinnamyl alcohol, cinnamic acid and cinnamaldehyde changed greatly (9.55%-16.2%) and the others six ingredients had less change (3.27%-5.71%) with the changes in medium concentrations. Microdialysis method could be used to detect the in vitro recoveries of nine ingredients in Mahuang decoction. Reverse dialysis method could be used for the in vivo probe recovery calibration of ephedrine, pseudoephedrine, methylephedrine, liquiritin, cinnamyl alcohol and cinnamic acid at the flow rate of 2.0 μL x min(-1).
Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Ephedra sinica ; chemistry ; Microdialysis ; methods ; Molecular Structure

OBJECTIVETo explore the differences of electroacupuncture (EA) on onset time and symptom improvement for treatment of different types of functional constipation.

METHODSThirty-eight cases of constipation were selected, including 9 cases of constipation-predominant irritable bowel syndrome (IBS-C), 10 cases of slow transit constipation (STC), 10 cases of pelvic floor dyssynergia (PFD) and 9 cases of inadequate defecatory propulsion (IDP). The electroacupuncture was applied at Tianshu (ST 25), Fujie (SP 14), Shenshu (BL 23), Dachangshu (BL 25) and so on in abdominal and lumbosacral area, 5 times per week, 10 times as a treatment course. The onset time, score of clinical symptoms of constipation and improvement of every symptom in each group were compared.

RESULTS(1) The onset time was (1.78 +/- 0.83) days in IBS-C type, (3.11 +/- 1.90) days in IDP type, (4.10 +/- 1.85) days in STC type and (4.30 +/- 2.00) days in PFD type, indicating statistical differences between IBS-C type and STC type, IBS-C type and PFD type (both P < 0.05). (2) Compared before the treatment, the total scores of symptoms on the onset day in each group were all improved (P < 0.05, P < 0.01), and score of IBS-C type was superior to the rest 3 types (P < 0.05, P < 0.01). (3) EA improved desire to defecate or frequency of defecation in each type (P < 0.05, P < 0.01), in which both were improved in STC type and PFD type, and the improvement of defecation frequency was more significant in STC type (P < 0.01). EA relieved unsmooth defecation or pendant-expansion feeling in each type (all P < 0.05), in which both were improved in IBS-C type (both P < 0.05). EA relieved abdominal distension and pain in IBS-C type, STC type and PFD type (all P < 0.05), while its effects were not obvious on defecation difficulty, defecation time and defecation texture (all P > 0.05).

CONCLUSIONThe electroacupuncture for treatment of 4 types of constipation is characterized by rapid onset; the improved symptoms are not identical in the electroacupuncture treatment plan for each type of defecation; the main improvement of symptoms are lied on desire to defecate and frequency of defecation, unsmooth defecation or pendant-expansion feeling and abdominal distension and pain. Meanwhile the improvements of defecation texture, defecation difficulty and defecation time were not signi-ficant.

Adult ; Aged ; Constipation ; etiology ; physiopathology ; therapy ; Defecation ; Electroacupuncture ; Female ; Humans ; Irritable Bowel Syndrome ; complications ; Male ; Middle Aged ; Pelvic Floor Disorders ; complications ; Treatment Outcome ; Young Adult

Objective To investigate the relationship between sleep duration and metabolic syndrome in obese children.Methods Sleep time was recorded and metabolic syndrome (MS) diagnostic criteria as blood pressure,body mass index (BMI) were measured among 311 obese children.The children were divided into 4 groups by sleep time while normal-weight children served as the control group.A disorderly multi-classification logistic regression method was used.Results Statistically,significant differences were found in the levels of BMI,blood pressure,fasting blood glucose and postprandial 2 h glucose and the incidence rates of abnormality on MS,blood pressure,fasting insulin,and BMI≥30 kg/m2 between the group with daily sleep time less than 8 h and the group with daily sleep time no less than 10 h (P＜0.05).Date from logistic regression analysis revealed that the reduction of sleep time was the risk factor of MS in obese children.Conclusion Insufficient sleep could greatly contribute to the occurrence of MS in obese children.

Objective To explore the relationship between the cardiac function of pregnant women with cardiac disease and the level of N -terminal pro -B -type natriuretic peptide (NT -pro -BNP).Methods A total of 74 pregnant women with cardiac disease and 80 healthy pregnant women were enrolled in the study and the NT -pro -BNP was detected and compared.The concentrations of NT -pro -BNP in different trimester were compared among the healthy pregnant women, and the correlation between the cardiac function of pregnant women with cardiac disease and the level of NT -pro -BNP were analyzed.Results The median of concentrations of plasma NT -pro -BNP in pregnant women with cardiac disease was 352.50 pg/mL,which was significantly higher than that in healthy pregnant women 58.00 pg/mL(P <0.01 ).The cardiac function was positively correlated with the level of NT -pro -BNP (P <0.01 ).The concentration of plasma NT -pro -BNP during the late trimester(49.00 pg/mL)was significantly higher than that of the early trimester(49.00 pg/mL) among the healthy pregnant women (P <0.01 ).Conclusion It is of great clinical value for the concentration of plasma NT-pro -BNP in evaluating the cardiac function of pregnant women with cardiac disease,and the pregnancy may influence the cardiac function.

OBJECTIVETo evaluate the efficacy and safety of adefovir dipivoxil in treatment of decompensated liver cirrhosis patients with YMDD motif mutation during lamivudine therapy.

METHODSThe disease relapsed in 14 hepatitis B patients with decompensated liver cirrhosis during lamivudine treatment due to the YMDD motif mutation. All 14 patients had positive HVBDNA and active hepatitis, and were evaluated as Child-Pugh Score C (CPS-C). The patients were treated with lamivudine 50 mg/d and adefovir dipivoxil 10 mg/d for 6 months.

RESULTSOne patient signed off due to non-hypoxemic hyperlactacidemia; other 13 patients showed decreased serum HBVDNA. All patients had serum HBVDNA < or =10(5) copies/ml and 7 patients had HBVDNA < or =10(4) copies/ml. Six patients regained normal serum ALT level and Child-Pugh scores decreased in all patients.

CONCLUSIONAdefovir dipivoxil has satisfied efficacy and safety in treatment of decompensated liver cirrhosis patients with YMDD motif mutation during lamivudine treatment.

Adenine ; adverse effects ; analogs & derivatives ; therapeutic use ; Adult ; Aged ; Amino Acid Motifs ; genetics ; Antiviral Agents ; therapeutic use ; DNA-Directed DNA Polymerase ; genetics ; Female ; Hepatic Encephalopathy ; drug therapy ; genetics ; virology ; Hepatitis B virus ; genetics ; Hepatitis B, Chronic ; complications ; drug therapy ; Humans ; Lamivudine ; therapeutic use ; Liver Cirrhosis ; drug therapy ; genetics ; virology ; Male ; Middle Aged ; Mutation ; Organophosphonates ; adverse effects ; therapeutic use ; Protein Structure, Tertiary ; genetics ; Recurrence ; Reverse Transcription ; genetics

OBJECTIVETo investigate the risk factors of female breast cancer and its potential alteration in Wuhan area.

METHODSA case-control study was conducted on 213 cases with histopathological diagnosis and 430 matched controls, using conditional logistic regression analysis.

RESULTS28 factors such as educational level, history of benign breast disease, age at menarche, age at menopausal, meat and well-done meat intake, soy bean food, fruit, lactation time, body mass index (BMI), juvenile chest X-ray, psychological factor, were associated with breast cancer risk in one-way variance model. Multivariate conditional logistic regression analysis in total significant factors and subgroups showed that the risk factors of breast cancer would include high level education, psychological trauma, history of benign breast disease later age at menopause, more years of menstrual and more years of menstrual before giving first birth, high BMI, well-done meat intake and smoked food. Factors as later menarche, lactate longer, soybean food, fruit, drink tea habit were protective factors for breast cancer. Further breakdown of data showed some difference between premenopausal and postmenopausal women. Risks in premenopausal women were associated with history of benign breast disease, age of menarche, soybean food intake, whereas risks in postmenopausal women were related to age of menopausal, BMI, waist-hip ratio and fruit intake. Both psychological traumatic and duration of lactation were common pre-and postmenopausal risk and protective factors.

CONCLUSIONSDietary habit and endogenous estrogen exposure related factors played important roles on women breast cancer in Wuhan area.

Adult ; Breast Neoplasms ; etiology ; metabolism ; Case-Control Studies ; China ; Estradiol Congeners ; metabolism ; Feeding Behavior ; Female ; Humans ; Logistic Models ; Middle Aged ; Multivariate Analysis ; Risk Factors