ObjectiveThis paper discusses the instructional design of ＂General survey of medical culture＂,to provide the basis for the implementation of the teaching.MethodsThe first round of our teaching situation was concluded,to improve the teaching objectives,content,methods and the content and methods of teaching evaluation.Results The course is a new medical humanities curriculum to improve medical knowledge of the human spirit of nursing students,training the cultural literacy,but the teaching content should be combined with professional features,and teaching evaluation methods should be improved.ConclusionsRigorous designed curriculum,flexible and diverse teaching methods and forms of assessment and suggestions from the students are conducive to the improvement of the course.

Objective Alzheimer's disease (AD) is the most common neurodegenerative disorder of aging.Identifying novel AD genetic risk factors is important for understanding its pathogenesis.Presenilin- 2 (PSEN2) is one of the causative genes for familial AD.Polymorphism of the promoter region of PSEN2 has recently been reported to be associated with sporadic AD in a Russian population.The purpose of this study was to determine whether AD is associated with the PSEN2 gene polymorphism in a case-control study.Methods We examined PSEN2 and ApoE genotypes of 160 patients with AD and an equal number of age- and sex-matched controls from the same community by using PCR-RFLP method.Statistical analyses included a Chi-square test for homogeneity and a Logistic regression analysis.Results Examination of PSEN2 genotypes revealed no statistically significant differences in the frequency of the+A/-A polymorphism when compared with the total sample of AD patients and control individuals (P=0.11). However,subgroup of ApoE 84 non-carriers suggested significant differences of the three genotypes of PSEN2 promoter between AD and controls (P=0.038).Logistic analyses indicated ApoE genotypes were related with AD,and after stratification by e4 allele,PSEN2 genotypes were related with AD of e4 non-carriers.In addition,there was no interaction between ApoE and PSEN2 gene.Conclusion The+A/-A polymorphism of PSEN2 promoter may be a minor genetic risk factor for sporadic AD,especially in the group of AD without ApoE ?4 allele.

Abnormalities, Multiple ; diagnosis ; Colon ; abnormalities ; Humans ; Infant, Newborn ; Male ; Peristalsis ; Syndrome ; Urinary Bladder ; abnormalities

Objective To investigate the effect of microbubbles mediated ultrasound insonation on proliferation and apoptosis of vascular smooth muscle cells (VSMCs) in different phase of cell cycle. Methods Rat thoracic aortic VSMCs were cultured in vitro by the method of tissue adherence. The cells were synchronized by the methods of serum starvation and double thymidine block. The synchronization results were detected by flow eytometer. VSMCs in different phases of cell cycle were exposed to 1 MHz continuous waves ultrasound for 120 s at intensity 0.3 W/cm2 in the presence of lipid-coated microbubbles (1 ml/L). Apoptosis of VSMCs was analyzed by AnnexinV/PI staining using flow eytometry. The proliferation and the proliferating cell nuclear antigen(PCNA) protein expression of VSMCs were detected by MTT assay and immunoeytochemistry, respectively. Results The synchronized G0/G1 and S phase VSMCs were achieved, with synchronized rates to 89.53 % and 66.87 %, respectively. Ultrasound sonication for 120 s with microbubbles could significantly inhibit the proliferation and downregulate the PCNA expression of S phase VSMCs,but the proliferation and PCNA expression of G0/G1 phase VSMCs were not affected. After treatment of ultrasound with microbubbles, the apoptotic ratio were found to reach (7.05 ± 2.04)% in G0/G1 phase VSMCs and (27.01 ±3.87)% in S phase VSMCs. Conclusions Microbubbles mediated ultrasound insonation can significantly inhabit the proliferation and induce apoptosis in VSMCs at proliferation stage.

Objective To investigate the effect of ultrasound irradiation combined with liposome membrane microbubbles on the reorgnization of cytoskeleton in vascular smooth muscle cells (VSMCs). Methods Rat thoracic aortic VSMCs were cultured in vitro. VSMCs were exposed to 1 MHz continuous waves ultrasound radiation for 120 s at intensity 0.3 W/cm2in the presence of liposome membrane microbubbles (1 μl/ml) after treated with platelet derived growth factor-BB (PDGF-BB). The reorganizations of microfilaments, microtubules and intermediate filaments were examined by using immunofluorescence and fluorocytochemistry techniques. Results There was a substantial increase in the expression of F-actin and assembly of long bundles of stress fibers in the transversed cell body when treated with PDGF-BB. Neither alterations of β-tubulin nor of vimentin cytoskeletal protein organization were observed in PDGF-BB treated cells as compared to those of the contol group. After ultrasound irradiation combined with liposome membrane microbubbles, the expression of F-actin, β-tubulin and vimentin were reduced along with the simultaneous changes in microfilaments, microtubles and intermediate filaments array. Conclusions Ultrasound irradiation combined with liposome membrane microbubbles can induce significant changes in cytoskeleton structure of VSMCs cultured in vitro.

Objective To compare the efficacy of oral rehydration salts(ORS),health education and autonomic nervous activity training with health education and autonomic nervous activity training on children with postural orthostatic tachycardia syndrome (POTS).Methods Fifty-two children with POTS based on head-up test or head-up tilt test were divided into ORS treatment group and conventional treatment group.ORS treatment group included 33 children,and they received ORS and health education and autonomic nervous activity training therapy.Conventional treatment group included 19 children who received health education and autonomic nervous activity training therapy only.Telephone follow-ups were made after the therapy for 1-3 months.The contents of follow-up were the compliance of ORS treatment,the implementation of health education and POTS related symptom frequency.Results 1.The compliance of doctor's advice in ORS treatment group was better than that in the conventional treatment group.2.There was no significant difference in the symptom scores before therapy between ORS treatment group and conventional treatment group [(6 ± 3) scores in ORS treatment group vs (5 ± 3) scores in conventional treatment group,t =0.799,P ＞ 0.05].After 1 to 3 months therapy,the symptom scores were significantly lowered in both groups.The symptom scores in ORS treatment group was lower than those of the conventional treatment group[(2 ± 1) scores in ORS treatment group vs(3 ± 1)scores in conventional treatment,t =-2.189,P ＜ 0.05].3.If the therapy was determined to be effective when the symptom scores decreased by at least 2 scores,the effective rate in ORS treatment group was significantly higher than that of the conventional treatment group(78.8％ in ORS treatment group vs 42.1％ in conventional treatment group,x2 =7.169,P ＜ 0.01).Conclusions The efficacy of ORS,health education and autonomic nervous activity training therapy is better than that of the health education and autonomic nervous activity training therapy only in POTS children.

Objective To explore the practical value of intracardiac echocardiography (ICE) on transcatheter closure of patent foramen ovale (PFO). Methods Eight-six patients with PFO were occluded using CardioSEAL under guidance of ICE. A diagnostic ICE was performed for imaging PFO anatomy and monitoring the closure procedure. Measurements of PFO tunnel diameter and length were made by ICE. The device deployment was evaluated by 2-D and color Doppler ICE after release, and then any residual shunt was detected by ICE agitated saline contrast study. Results ICE showed detailed anatomy of PFO and variations in morphology such as redundant secundum septum, convex secundum septum, tissue extension of primum into the fossa ovalis and hypertrophic limbus. Of 86 cases, 85 cases had successful implantation of the CardioSEAL, 1 case failed.Conclusions Transcatheter closure of PFO guided by ICE is a safe, effective, simple and less invasive solution.

Objective To assess the diagnostic value of ChromID for Clostridium Clostridium infection (CDI) on the premise of large sample size,with Meta-analysis.Methods The literature inclusion and exclusion standards were made,and the databases were searched,including PubMed,Cochrane Library,China Biology Medicine disc (CBM),China National Knowledge Infrastructure (CNKI) and so on,using the keywords (ChromID,Clostridium difficile,and chromomgenic agar) along with each of the following words (detection,diagnosis,and infection).Quality assessment of diagnostic accuracy studies (QUADAS) was used to evaluate the quality of the literature.The Meta-disc 1.4 software was used to analyze the data.Results Five studies on 1 851 patients were included in this meta-analysis.The pooled sensitivity was 0.793 (95 ％ CI:0.750 ～ 0.832) for the diagnosis of CDI on 48 h,the pooled specificity was 0.942 (95 ％ CI:0.972 ～0.955),the pooled positive likelihood ratio was 16.817 (95％ CI:7.042 ～ 40.157),with negative hkelihood ratio was 0.124 (95％ CI:0.040 ～0.386) and diagnostic odds ratio for 244.64 (95％ CI:17.711 ～3 379.3).The area under the working curve (AUCSROC) of the subjects was 0.981 4 and the Q* index was 0.939 9.Conclusions Meta-analysis on ChromID for diagnosis of clostridium difficile infection revealedChromID had higher sensitivity,specificity,positive likelihood ratio,and negative likelihood ratio,which can be recommended for clinical use.

Objective To investigate the effect and safety of urinary kallidinogenase on acute cerebral infarction.Methods One hundred and sixty-four patients with acute cerebral infarction were randomly divided into two groups:treatment group with urinary kallidinogenase(86 cases)and control group (78 cases).According to Chinese guidelines for prevention and management cerebrovascular disease,two groups were treated with basic therapy,such as antiplatelet,neurologic protection,blood pressure control,and so on.On basis of control group,treatment group Was administrated intravenous injection of urinary kallidinogenase 0.15 PNA U per day for 10 days.The primary efficacy Was evaluated by the National Institutes of Health Stroke Scale(NIHSS)score and Barthel index.Results The score of NIHSS and Barthel index at 15 days after treatment in the treatment group were higher than those in the control group[(6.67±3.02)scores vs(7.42±3.02)scores;75.36±23.56 vs 68.36±22.36,P＜0.05].Urinary kallidinogenase could significantly reduce neurological deficits in big artherosclerosis type by TOAST typing.Conclusion Urinary kallidinogenase may be effective and safe in the treatment of acute cerebral infarction.

OBJECTIVE To establish a rapid method of detecting class D carbapenemase gene in Acinetobacter baumannii by multiplex PCR.METHODS Design primers according to the conservative region of blaOXA-51 and blaOXA-23,the class D carbapenemase gene were detected by Multiplex PCR.RESULTS 24 of 30 A.baumannii isolates produced two bands of blaOXA-51 and blaOXA-23;other 6 isolates showed a band of blaOXA-23.CONCLUSIONS The multiplex PCR could detect rapidly the class D carbapenemase gene.