Objective To investigate the effects of clinical pathway-based teaching methods in clinical teaching of hematology. Methods Interns, which studied in department of hematology, were classified non-randomized into two groups. The interns in experimental group received idiopathic thrombocytopenic purpura (ITP) clinical pathway-based teaching. And the interns in the control group received the seventh edition textbook of medicine-based traditional teaching. All interns were oral tested when they finished two weeks period clinical studied of hematology. Meanwhile, a questionnaire designed for clinical pathway-based teaching was included in this test only for the experimental group. Results There were 32 interns recruited in the group of clinical pathway-based teaching and 38 interns in the control group of traditional teaching. There were statistically significant differences between the two groups in the fields of the key points about history of diseases ( = 0.0017), assessment of diagnostic criteria and differential diagnosis ( =0.0074), selection of laboratory examination items ( <0.0001) for ITP. The group of clinical pathway-based teaching achieved higher scores than the control group. However, there was no statistically significant difference between the two groups in the field of selection of first-line treatment measure of ITP ( = 0.1155) . Moreover, the control group achieved higher scores than the group of clinical pathway-based teaching in the field of how to treat ITP patients with first-line treatment failure ( =0.0003) . In addition,there were 93.8%interns in the experimental group accepted the new clinical pathway-based teaching tool in the survey. The open-ended question survey showed the clinical pathway teaching method was more simple, intuitive and standardizing than the traditional one. Conclusion The ITP clinical pathway, as an interns teaching tool of hematology, is helpful for understanding more clearly the diagnosis and treatment of ITP. However, an in-depth explanation is necessary combination with textbook of medicine study in the clinical teaching of ITP.

Objective To construct mouse model of acute myeloid leukemia and detect the expression of ANGPT 1 ,ANGPT2 and VEGF gene on the cells its as well as the clinical significance .Methods The HL‐60 cells were transfected to NOD/SCID mouse through abdominal injection to construct mouse model of acute myeloid leukemia .Then identify mouse model by histopathology and Flow Cytometry .The expression of ANGPT2 ,ANGPT1 and VEGF mRNA in the tumor tissues of mouse model was detected by real‐time fluorescence quantitative PCR .The expression of ANGPT2 will be analyzed on the survival time of mouse model by Spearman′s correlation method .Results Mouse model has been successfully identified by histopathology and Flow Cytometry .The expression of ANGPT2 and VEGF in mouse mode was significantly detected ,which was that of higher than normal group (P<0 .05) .The expression of ANGPT1 was lower than that of ANGPT2 and VEGF ,there was no significant difference between AN‐GPT1 and normal groups (P>0 .05) .The higher expression of ANGPT2 in mouse model had a short survival time in mouse with acute myeloid leukemia .Conclusion This study showed that ANGPT2 mRNA was over‐expressed in acute myeloid leukemia .The increasing expression of ANGPT2 mRNA may lead to poor prognosis in mouse with acute myeloid leukemia .

Objective: To determine the relation dynamic contrast-enhanced magnetic resonance imaging (MRI) and histologic features and angiogenesis of breast disease. Methods: Forty patients with breast disease, diagnosed by histopathology were reviewed, including imaging and pathological data. Dynamic MRI was performed by a fat-suppressed 3D-FSPGR sequence ,Time-Signal curve was acquired by Functool 2 software, then early-phase enhancement rate and E max , T max were acquired. The mean MVD and VEGF expression of the lesions were measured with immunohistology. Evaluation of inflammatory changes was assessed by histology. Results: The MVD , VEGF expression and inflammatory scores of malignant tumor were significantly higher than that of benign tumor(P0.05), The Time-SI curve between malignant and benign was significant different(P

BACKGROUND: Monkeys, dogs, pigs, rabbits and other large animals have bean applied previously to prepare animal models of midpelatel suture expansion, but there are high cost, small sample size, difficult to obtain antibodies and other disadvantages, Wistar rats have wide heads to facilitate cavity operation, with low cost and high reproduction rata, as the midpalatal suture model, it is possible to overcome the above deficiencies. OBJECTIVE: To establish a rat model of midpalatal suture expansion, and to supply basement for further relative researches of animal models. METHODS: Twenty Wistar male rats of 5 weeks old, average weight of 65 g, were randomly divided into 2 groups, a experiment and a control, with 10 rats in each group. Rats in experimental group were placed on the expansion appliance, inserting into the diastema between the first and second molars, then stick to molar lingual using light-cured resin for retention. The rats in control group were sham operated, followed by one weak of active expansion. After expansion, the midpalatal sections were observed by X-ray and light microscopy. RESULTS AND CONCLUSION: Maxillary X-ray film showed that midpalatal suture in experimental group was significantly widened, molar lead to cheek. Observed by light microscopy, partial oral side of midpalatal suture in the experimental group was obviously enlarged, mesenchymst ceils were spindle, in the same direction to tension force, Below it, traumatic inflammatory response appeared, with a clear bleeding area. The midpalatal suture expansion model in rats is available, simple and reprodudble.

Electrolyte disturbance was prominent in patients with severe acute mountain sickness. In these patients hypoxia caused water and salt retension together with vasoactive substances and excessive free radicals might play important roles in the development of multiple organ dysfunction syndrome (MODS). More attention should be given to electrolyte monitoring in dealing with these severe mountain sickness in field.

Objective To investigate the bacterial resistance profile of clinical isolates collected in Tongling area . Methods Antimicrobial susceptibility test was conducted by Kirby‐Bauer method . All the data were analyzed with WHONET 5 .6 software .Results A total of 3 419 clinical isolates were collected during 2013 ,of which gram negative organisms and gram positive organisms accounted for 75 .9% and 24 .1% .MRSA accounted for 41 .3% of S .aureus and MRCNS accounted for 73 .5% of coagulase negative Staphylococcus ,respectively .MRSA showed higher resistance to gentamicin ,ciprofloxacin , erythromycin and rifampicin . No vancomycin‐ or teicoplanin‐resistant strains of Staphylococcus spp . were found . No vancomycin‐or teicoplanin‐resistant strains of E . f aecalis and E . f aecium were found .About 51 .6% of E .coli isolates and 42 .8% of K . pneumoniae isolates produced extended‐spectrum β‐lactamases (ESBLs ) . The prevalence of imipenem‐ or meropenem‐resistant strains of K . pneumoniae increased significantly .The percentage of P . aeruginosa strains resistant to amikacin ,piperacillin‐tazobactam ,ciprofloxacin ,cefepime and cefoperazone‐sulbactam was lower than 20 .0% .The percentage of A .baumannii strains resistant to cefoperazone‐sulbactam , minocycline and amikacin w as 34 .7% ,57 .0% and 58 .3% , respectively . More than 68 .0 % of A . baumannii strains were resistant to any of the other antibiotics tested . Conclusions The antibiotic resistance is growing in clinical bacterial isolates .The spread of carbapenem‐resistant strains of K . pneumoniae in some departments poses a serious threat to clinical practice .We should pay more attention to resistance surveillance and rational use of antibiotics .

Objective To investigate the bacterial resistance of clinical isolates collected in Tongling area during 2011.Methods Antimicrobial susceptibility testing was conducted by Kirby-Bauer method.All the data were analyzed by WHONET 5.5 soft-ware.Results A total of 2 690 clinical isolates were collected during 2011,of which gram negative organisms and gram positive organisms accounted for 74.2% and 25.8%,respectively.MRSA and MRCNS accounted for 45.1% of S.aureus and 71.6%of coagulase negative Staphylococcus,respectively.MRSA and MRCNS showed higher resistance to gentamicin,ciprofloxacin and erythromycin than the corresponding methicillin-susceptible strains.No vancomycin- or teicoplanin-resistant strain of Staphylococcus spp.was identified.The resistance rate to penicillin,nitrofurantoin and fosfomycin was low in E.faecalis.No ampicillin-,vancomycin-or teicoplanin-resistant strains were found.For E.faecium,some strains were resistant to vancomy-cin and teicoplanin.About 46.6% of E.coli isolates and 27.7% of Klebsiella isolates produced extended-spectrumβ-lactamas-es (ESBLs).No imipenem-or meropenem-resistant isolate was found.The percentage of P .aeruginosa strains resistant to imipenem,meropenem and amikacin were 29.5%,36.9%and 2.3%, respectively. More than 60.0% of the Acinetobacter strains were resistant to all the antibiotics test-ed except minocycline and cefoperazone-sulbactam,to which 26.4% and 12.5% of the strains were resistant.Conclusions No glycopeptides-resistant isolate was found in gram positive organisms except E.faecium.The resistance rate of Enter-obacteriaceae isolates was lower to imipenem,meropenem, cefoperazone-sulbactam,piperacillin-tazobactam and amika-cin.The prevalence of resistant strains is still increasing,es-pecially carbapenem-resistant P .aeruginosa and carbapenem-resistant A.baumannii.It is mandatory to take effective antibiot-ic policy and infection control measures.

Objective To investigate the bacterial resistance of clinical isolates collected in Tongling area. Methods Antimicrobial susceptibility test was conducted by Kirby-Bauer method.All the data were analyzed with WHONET 5.5 software.Results A total of 3 092 clinical isolates were collected during 2012,of which gram negative organisms and gram positive organisms accounted for 76.3% (2 359/3 092)and 23.7% (773/3 092),respectively.MRSA and MRCNS accounted for 50.9% of S.aureus and 73.0% of coagulase negative Staphylococcus,respectively.MRSA and MRCNS showed higher resistance to gentamicin,ciprofloxacin and erythromycin.No vancomycin-or teicoplanin-resistant strains of Staphylococcus spp.were found.No vancomycin-or teicoplanin-resistant strains of E.faecalis were found.Some E.faecium strains were resistant to vancomycin and teicoplanin.About 52.1% of E.coli isolates and 42.1% of Klebsiella isolates produced extended-spectrumβ-lactamases (ESBLs).Imipenem-or meropenem-resistant strains of K. pneumoniae were found. The percentage of P.aeruginosa strains resistant to amikacin, cefoperazone-sulbactam and cefepime was 3.4%,14.0% and 17.7%,respectively.More than 70% of Acinetobacter spp. strains were resistant to all the antibiotics tested except minocycline and cefoperazone-sulbactam,to which 42.1%and 4.4% of the strains were resistant.Conclusions The antibiotic resistance of clinical bacterial isolates is growing. The spread of multi-drug or pan-drug resistant strains in a specific region poses a serious threat to clinical practice.We should pay more attention to resistance surveillance and the rational use of antibiotics.

The postoperative pathological staging system (pTNM) has become an important reference for the selection of various tumor treatment strategies and prognosis evaluation at a global scale, and is a powerful predictor of the prognosis of a variety of solid tumors, but the prognosis is still different in patients with the same pTNM staging. In recent years, studies have confirmed that the negative lymph nodes count (NLNC) is related to the prognosis of a variety of solid tumors. Higher NLNC can improve the prognosis of cancer patients, and NLNC can reduce staging migration, which is expected to be a supplement to the pTNM staging system. This article reviews the value of NLNC in the prognosis of solid tumors.

Objective To explore the influence of negative lymph node count (NLNC) on the prognosis of patients with gastric signet ring cell carcinoma (GSRC) and develop a prognostic nomogram based on NLNC. Methods On the basis of the SEER database, 2 101 patients diagnosed with GSRC were collected and randomly divided into the modeling group and validation group to test the relationship between clinicopathological characteristics and the prognosis of GSRC. The multivariate Cox proportional hazard regression model was used to analyze the independent risk factors affecting overall survival and establish a prognostic prediction model. The consistency index (C-index), calibration curve, net reclassification index (NRI), integrated discrimination improvement (IDI), and decision curve analysis (DCA) were used to evaluate the accuracy and clinical applicability of the nomogram. Results All patients were divided according to the ratio of 7:3, with 1 473 in the modeling group and 628 in the validation group. NLNC > 10 (HR=0.578, 95%CI: 0.504-0.662, P < 0.001) was a protective factor for the prognosis of patients with GSRC, and the nomogram model was established based on multivariate Cox proportional hazards model. The C-index values of the nomogram were 0.737 (95%CI: 0.720-0.753) and 0.724 (95%CI: 0.699-0.749) in the modeling and validation groups, respectively, showing good discrimination. The calibration curves showed high consistency of the model. NRI=17.77%, continuous NRI=36.34%, and IDI=4.2% indicated that the model had positive returns compared with the traditional model. The DCA was far from the baseline, indicating that the model had good clinical applicability. Conclusion The increase in NLNC is a favorable factor for the prognosis of patients with GSRC, and a relatively accurate nomogram was established to predict the prognosis of patients with GSRC and help clinicians conduct individualized prognostic evaluations.