To prove the clinical teaching of gynecology of medical foreign students,this paper concludes and analyses the problems of gynecological probation teaching of foreign student through the clinical teaching work,including difficulties in language communication,no unified textbook,particularity of gynecology,and cultural differences.

Vitamin D is a group of steroid hormones.Studies in recent years have shown that vitamin D is associated with the incidence of cerebral infarction,the severity of infarction,and functional outcome.In addition to the indirect effect of vascular risk factors,vitamin D may also play the direct protective effect by inhibiting inflammation and oxidative stress after cerebral infarction.

Objective To evaluate the role of angiotensin Ⅱ receptors in the development of neuropathic pain (NP) in rats.Methods Seventy-five male Sprague-Dawley rats,weighing 230-270 g,were randomly divided into 5 groups (n =15 each) using a random number table:sham operation group (group S),group NP,telmisartan (angiotensin Ⅱ receptor antagonist) 2 mg group (group T1),telmisartan 5 mg group (group T2),and telmisartan 10 mg group (group T3).NP was induced by chronic constrictive injury (CCI) in chloral hydrateanesthetized rats.The sciatic nerve was exposed and 4 loose ligatures were placed on the sciatic nerve at 1 mm intervals with 4-0 silk thread.In S group,the sciatic nerves were exposed but not ligated.Telmisartan 2,5 and 10 mg/kg were perfused via stomach once a day for 14 consecutive days in T1,T2 and T3 groups,respectively,while the equal volume of normal saline was given instead of telmisartan in S and NP groups.Mechanical and thermal pain thresholds were measured at 1 day before CCI and 3,7 and 14 days after CCI in each group.Results The mechanical and thermal pain thresholds were significantly decreased after CCI in NP,T1,T2 and T3 groups as compared with group S.The mechanical and thermal pain thresholds were significantly increased after CCI in T1,T2 and T3 groups as compared with group NP.The mechanical and thermal pain thresholds were significantly higher after CCI in T2 and T3 groups than in group T1.There was no significant difference in the mechanical and thermal pain thresholds between T2 and T3 groups.Conclusion Angiotensin Ⅱ receptors are involved in the development of NP in rats.

Objective To establish an HPLC-FLD method for simultaneous determination of homovanillic acid(HVA) and vanilmandelic acid(VMA) in human urine.Methods After being filtered with 0.45 ?m membrane,the samples of urine were injected directly into an ODS column(250 mm?4.6 mm,5.0 ?m) at the room temperature.The samples of urine were carried with the mobile phase comprised of methanol-0.1mol/L phosphate buffered solution(20:80,V/V).The flow rate was 1 ml/min,the injection volume was 10 ?l,the detection was taken at ?ex=277 nm,?em=320 nm.Results The determination was finished in 15 min,the retention time was 3.18 min for VMA and 6.72 min for HVA respectively.The detection limit of HVA was 0.15 ?g/ml,the linear range was 0-25 ?g/ml,the recovery rates were between 84.53%-106.1%,the relative standard deviation(RSD)

ObjectiveTo investigate the clinical eflicacy of magnesium sulfate combined with nifedipine in treatment of pregnancy-induced hypertension.MethodsOne hundred and fifty pregnancyinduced hypertension patients were divided into two groups by random digits table with 75 cases each.The observation group was treated with magnesium sulfate combined with nifedipine.The control group was treated with magnesium sulfate.Then the blood pressure before and after treatment and the pregnancy outcome were observed.ResultsThe systolic blood pressure,diastolic blood pressure after treatment in observation group were lower than those in control group [ (133.2 ± 7.9) mm Hg (1 mm Hg =0.133 kPa) vs.(142.5 ± 8.0)mm Hg,(80.6 ± 6.1 ) mm Hg vs. (86.6 ± 6.1 )mm Hg],and there were significant differences between two groups (P ＜ 0.05).The spontaneous labor rate in observation group was higher than that in control group [ 65.3％ (49/75) vs.41.3％ (31/75 )],and there was significant difference between two groups (P ＜ 0.05 ).The incidence of placental abruption,hypoproteinemia,postpartum hemorrhage,fetal growth retardation,fetal distress,premature delivery,asphyxia neonatorum,perinatal mortality in observation group were lower than those in control group [ 1.3％(1/75) vs.12.0％(9/75),13.3％(10/75) vs.33.3％(25/75),8.0％(6/75)vs.16.0％(12/75),2.7％(2/75) vs.9.3％(7/75),2.7％(2/75) vs.10.7％(8/75),2.7％(2/75) vs.17.3％(13/75),1.3％ (1/75) vs.5.3％ (4/75),0 vs.5.3％ (4/75)],and there were significant differences between two groups(P ＜0.05). Conclusion Magnesium sulfate combined with nifedipine in treatment of pregnancy-induced hypertension can effectively reduce the adverse pregnancy outcome,and reduce the asphyxia neonatorum rate and caesarean section rate.

ObjectiveTo observe the clinical effect of methotrexate combined with mifepristone in the treatment of unruptured ectopic pregnancy.Methods96 cases of unruptured ectopic pregnancy patients were randomly classified into two groups,observation group with 48 cases was treated with methotrexate combined with mifepristone and control group with 48 cases was only treated with methotrexate.The treatment effect and adverse reaction between two groups were compared.ResultsThe time of blood β-HCG recovery to normal and hospitalization time in observation group were significantly shorter than those in control group( P ＜ 0.05 ),and mass diameter was significantly smaller than that in control group( P ＜ 0.05 ).The adverse reaction incidence in observation group was 10.4％ ( 5/48 )while 6.3％ (3/48) in control group.ConclusionMethotrexate combined with mifepristone in the treatment of unruptured ectopic pregnancy could enhance clinical effect,shorten treatment time,decrease adverse reaction,which could be applied in clinic.

Objective To study the dependablity of clinical characteristics and prognosis in patients with endometrial cancer,so as to apply the basis for the treatment. Methods The clinical and pathological data of 92 patients with endometrial cancer were analyzed retrospectively, 5-year survival rate was followed and observed. Using Cox proportional hazard regression analysis to evaluate the factors related to overall survival. Results The overall 5-year survival rate was 72.41%. Using univariate analysis, the survival time was correlated with histologic type, pathological staging, histologic grade, myometrium invasion,cervical invasion and lymph node metastasis (P＜0.05).Using multivariate analysis, the survival time was correlated with histologic type,histologic grade and myometrium invasion. Conclusions Histologic type, histologic grade and myometrium invasion are independent prognostic factors for survival time of patients. In order to improve the prognosis of the patients, they should be treated by individual therapies.

BACKGROUND:Chronic hepatitis B virus infection can impact the biological characteristics of bone marrow mesenchymal stem cel s. Adipose-derived mesenchymal stem cel s have gained more and more attention due to their high safety, little invasiveness, easy purification and rapid proliferation. OBJECTIVE:To establish the isolation and culture method of adipose-derived mesenchymal stem cel s from patients with hepatitis B virus infection in vitro, and to observe the biological characteristics of cel s. METHODS:Adipose-derived mesenchymal stem cel s were isolated from the subcutaneous fat of hepatitis B virus infection patients by col agenase digestion and adherent method. Growth curve of adipose-derived mesenchymal stem cel s were detected by MTT method and cel phenotypes were detected by flow cytometry. The adipogenic and osteogenic differentiation potential of adipose-derived mesenchymal stem cel s were detected in vitro. RESULTS AND CONCLUSION:(1) Adipose-derived mesenchymal stem cel s from 10 patients with hepatitis B virus infection were al isolated and cultured successful y. The primary passage time of adipose-derived mesenchymal stem cel s was (8.3±1.2) days. The growth curve of cel s was“S”shaped. Cel s came into a logarithmic phase at days 3-4, and came into platform at day 7. (3) Passage 3 adipose-derived mesenchymal stem cel s highly expressed CD29, CD166, HLA-ABC and CD44, but did not express or lowly expressed CD34 and HLA-DR. (3) Adipose-derived mesenchymal stem cel s differentiated into adipocytes after adipogenic induction, and differentiated cel s were positive for oil red O staining;after osteogenic induction, adipose-derived mesenchymal stem cel s differentiated into osteoblasts that were positive for alkaline phosphatase staining. These findings indicate that the col agenase digestion and adherent method can be used to effectively isolate adipose-derived mesenchymal stem cel s from patients with hepatitis B virus infection, and the cel proliferation is rapid so that a large number of cel s can be obtained in the short term.

Objective To explore the effect of progressive active respiratory exercise on the pulmonary function and quality of life of middle-aged and elderly patients after surgery for carcinoma of the esophagus.Methods Forty post-operative middle-aged and elderly patients with carcinoma of esophagus were randomized into 2 groups.The patients in the control group were given conventional thoracic nursing,while those in the experimental group were given 3-step thoracic or abdominal breathing training,breath holding training and respiratory gymnastics training in addition.A lung function test,the 6-min walk test and a 36-item short form health survey (SF-36)were used to evaluate the subjects' pulmonary function,motor ability and quality of life after 3,6 and 12 months of treatment.Results Vital capacity (VC) increased 23％ after training.Forced vital capacity (FVC) increased 16％.Maximal ventilation volume (MVV) increased 15％ and 50％ of forced expiratory flow (FEFS0) and the diffusing capacity for carbon monoxide of the lungs (DLCO) increased 30％.Average distance in the 6-minute walk test (6MWD) lengthened from 320 m to 449 m,and the quality of life of the patients in the experimental group improved much more than that of the control group.The average pulmonary function and 6MWD of the control group did not improve significantly with only nursing care.Their average SF-36 scores for physical function,mental health,physical pain,mental role and comprehensive health did,however,improve significantly after treatment.The changes in their role limitation,social function and energy scores were not significant.Conclusion Early and progressive active respiratory exercise can ameliorate lung dysfunction after a thoracic operation,and improve motor ability and quality of life.

Objective To explore the current situation and influencing factors of moral distress among nurses.Methods 252 clinical registered nurses from 3 Grade-3 Level-A hospitals in Jinan were investigated by the Chinese version of Moral Distress Scale-Revised and Job Diagnostic Survey.Results The mean score of MDF was (1.06±0.46) points and the mean score of MDI was (1.05±0.63) points.The total score of MDS-R was (38.86+26.26) points.Futile care was the main source for the high frequency and high intensity of moral distress among nurses.There were significant differences in the level of moral distress among different groups of age,years of nursing experience,first education degree,professional title,position,department,staffing of government affiliated institutions and income.The result of multiple linear regression analysis showed that age,first education degree,department,professional title,and the importance of assignment,autonomy,collaboration of work were the influencing factors for moral distress of nurses.Contusions It suggested that nurses should strengthen the study of knowledge about ethics to improve their capacity of ethical decision-making,and nurse managers should pay attention to department management,strengthen the medical cooperation,and improve nurses' job autonomy to improve nurses' capacity of coping and decision-making and reduce the level of moral dilemmas.