Through the Introduction of the visualization technology based on VREL and its application in ultrasound teaching,the teaching means has been changed,the teaching content enriched and the contact between basic and clinic knowledge enhanced,which indicates that the visualization technology exerts an important role in ultrasound teaching.

Objective To evaluate the application of video-assisted thoracoscopic surgery (VATS) in the treatment of traumatic hemothorax. Methods We performed VATS in 60 cases of traumatic hemothorax with medium amount of bleeding or above from March 2000 to March 2004, including 12 cases accompanying the prodrome of shock and 6 cases associated with injuries of liver or spleen. Unilateral VATS was carried out in 48 cases, all of which were completed under thoracoscope except 3 cases of heart injuries were supplemented with mini-incision repair. Bilateral VATS was conducted in 6 cases and the combination of thoracoscopy with laparoscopy was required in 6 cases. Results The operation time was 45～175 min (mean, 105 min) and the postoperative hospital stay was 7～13 days (mean, 11 days). No complication occurred. Conclusions VATS in the management of traumatic hemothorax is safe, effective and minimally invasive, with a relatively short operation time and quick recovery.

Objective To discuss the value of percutaneous dilatational tracheotomy(PDT) for cardiosurgery in intensive care unit by comparing its outcomes with that of open tracheotomy(OT).MethodsA prospective study was conducted on 40 severe patients undergoing cardiosurgery.The patients were divided into PDT(treated from January 2002 to July 2003) and OT groups(treated from August 2003 to February 2008) with 20 cases in each.The operation time,length and heal time of the incision,blood loss,vital signs,and postoperative complications were compared between the two groups.ResultsThe operation time,length and heal time of the incision in the PDT group were significantly different from that in the OT group [(8.8?2.2) min vs(21.5?5.3) min,t=-9.897;(1.3?0.2) cm vs(3.4?0.5) cm,t=-17.440;and(3.9?0.9) d vs(5.9?1.2) d,t=-5.963;P=0.000].One patient in the PDT group(5%) had Ⅱ degree blood loss during the operation that was significantly less than those in the OT group(13 patients,65%,?2=15.824,P=0.000).The level of the vital signs change in the PDT group was significantly milder than those in the OT group [MAP: 1-5 mm Hg(median 2) vs 1-20 mm Hg(median 3.5),Z=-2.959,P=0.003;heart rate: 3-12 beats/min(median 5.5) vs 7-70 beats/min(median 10),Z=-3.956,P=0.000;SpO2: 0-4%(median 2%) vs 0-31%(median 3.5%),Z=-3.548,P=0.000].Furthermore,the rate of incisional leakage of sputum and overall rate of complications in the PDT group were significantly lower than those in the OT group.[1(5%) vs 8(40%),?2=5.161,P=0.023;and 1(5%) vs 12(60%),?2=13.789,P=0.000].ConclusionsPDT is a safe and minimally invasive technique with a high rate of success and low rate of complications.The method is easy to operate,and thus could be a good choice for severe patients after cardiovascular surgeries.

This article introduces the way of making and using ultrasound multimedia courseware,which can improve teaching means,enrich teaching contents,activate classroom atmosphere and enhance the connection of basic and clinical knowledge.Meanwhile,the environment request of the demonstration courseware and interaction courseware as well as the necessity and significance of multimedia in ultrasound teaching are discussed.It is suggested that computer assisted instruction(CAI) plays an important role in ultrasound teaching.

AIM: To investigate the alteration of the vascular response to contracting material and the endothelium dependent vascular relaxation (EDVR) at different stages of type Ⅱ diabetes rats. METHODS: Type Ⅱ diabetes rat model was established by high-energy diet and lower dose of STZ. At 12th and 20th weekends after injecting STZ, the vascular reactivities to phenylephrine (PHE) and KCl and the EDVR induced by Ach were measured respectively in the isolated aorta rings. RESULTS: At 12th weekend after injecting STZ, the response to PHE increased, the reactivity to KCl kept unchanged, and the EDVR was damaged lightly. But at the 20 th weekend after injecting STZ, the response to PHE increased further and the reactivity to KCl markedly reinforced, and the EDVR was obviously damaged. CONCLUSION: The response of great vessels to contracting material increased, but the EDVR attenuated at different stages of type Ⅱ diabetes rats. These changes are further reinforced along with the developing of disease duration.

AIM: To study the expression of type Ⅰtransforming growth factor ?(T?R-Ⅰ)in renal cortex in streptozotocin-induced type Ⅱ diabetic mellitus and the regulation of valsartan. METHODS: The rat models of type Ⅱ diabetic rats were made. At the end of the 20th weeks,the kidneys were taken out to measure the expression of T?R-ⅠmRNA by RT-PCR. RESULTS: The expression of T?R-ⅠmRNA in diabetic rats without any therapy ( 0.72? 0.14) was higher than that in control ( 0.26? 0.12) (P

Aim To investigate the alteration of the nitric oxide (NO), the expression of nitric oxide synthase (NOS) mRNA at different stages of the cardiomyopathy in type 2 diabetes rats, and the protective effects of valsartan. Methods Type 2 diabetes model was established by high-energy diet, lower dose of STZ treated SD rat. The treatment period of valsartan was 8 weeks. At 12th and 20th weekend after injection of STZ, cardiac function, heart weight index, concentrations of NO in myocardium and plasma, expressions of iNOSmRNA and eNOSmRNA were measured respectively.Results From 12th week to 20th weekend, the left ventricular systolic and diastolic function was decreased and the heart weight index was increased in diabetes control group (DC group) compared with normal control group (NC group). The levels of the cardic tissue and plasma NO were higher at 12th weekend and lower at 20th weekend in DC group than that in NC group. The expression of iNOSmRNA in cardiac tissue was obviously up-regulated at 12th or 20th weekend while the expression of eNOSmRNA was down-regulated at 20th weekend in diabetes rats. All these abnormalities were partially attenuated by valsartan. Conclusion The abnormal change of the NO and expression of NOSmRNA might be related to the cardiomyopathy in type 2 diabetes. Valsartan might play a protective role in the myocardial disease.

Objective To explore the changes of intereferon-?(IFN-?)and interleukin-4(IL-4)in peripheral blood of children with mycoplasma pneumoniae(MP) encephalitis at the acute phase.Methods The peripheral blood concentrations of IFN-? and IL-4 were measured by enzyme-linked immunosorbent assay(ELISA) in 24 cases of children with MP encephalitis at the acute stage.The samples from 24 cases of healthy children were control group.Twenty-four children with MP encephalitis were intravenous drip with azithromycin,at the same time,10 cases received hexadecadrol and 15 cases received gamma globulin.Results The serum concentrations of IFN-? and IL-4 in the mycoplasmal encephalitis group were(98.56?12.93) and(45.55?17.58) ng/L,respectively,which were significantly higher than those in control group [(85.35?6.91) and(26.78?9.89) ng/L] respectively(Pa

As a key of military medical stodents education,clinical practice teaching continues to progress with the changing needs of society and the army advances.Transforming teaching philosophy,reforming curriculum,strengthening the hardware construction,improving the faculty building,exploring new models of teaching,practicing learner-centered teaching are important teaching experiences,according to the actual situation in our hospital for many years.In this paper,we illustrate the main contradiction,the current response measures taken and achievement achieved

Objective:To investigate the effect of long-term alcohol intake on sensory information synaptic transmission of mossy fiber-granular cells in the cerebellar cortex of mice.Methods:Twenty healthy male ICR mice aged 6 to 8 weeks were divided into normal saline group(control group) and alcohol intake group(alcohol group) according to random number table, with 10 mice in each group. The mice in alcohol group were injected intraperitoneally with 20% alcohol and the mice in control group were injected with the same amount of saline for 28 days.After the injection, the scalp, muscle tissue and skull were removed in turn, and the dura mater was removed to fully expose the crus II area of cerebellum. The mice were stimulated by air blowing at 30 mm of the ipsilateral tentacle pad with a gas jet device.When the the maximal response site was determined, the NMDA receptor antagonist (D-APV), metabolic glutamate receptor 1 antagonist (JNJ16259685) and N-methyl-D-aspartic acid (NMDA) were perfused on the brain surface of mice. Each drug was perfused for 20 minutes and ACSF was used between the two drugs until the waveform was recovered. Patch clamp amplifier was used to record the changes of potential waveform in mouse cerebellar granule layer. The data were analyzed by the softwares of Clampfit 10.3 and SPSS 22.0.Results:After exposure to wind stimulation, the latency of field potential response in granular layer of mice in alcohol group (11.8±0.7)ms was significantly longer than that in the control group (10.1±0.2)ms ( t=-8.041, P<0.05), and the amplitude of N1 (1.2±0.1) MV was significantly lower than that in the control group (0.6±0.1) MV ( t=-12.728, P<0.05). Compared with the control group, the rise time of P1 waveform((4.4±0.2)ms, (3.2±0.2)ms), duration ((12.1±0.5)ms, (10.3±0.2)ms), extinction time((7.8±0.2)ms, (6.9± 0.2)ms), volume under waveform ((7.3±0.2)ms, (4.3±0.2)ms) were significantly increased in the alcohol group ( t=16.100, - 11.840, -11.673, -35.576, all P<0.05). There were no significant differences in the amplitude, half width, rise time and decay time of Roff wave between the two groups ( t=-1.909, -0.910, -0.789, 1.462, all P>0.05). When JNJ16259685 was perfused on the brain surface of mice in alcohol group, the amplitude of field potential evoked by five blowing stimuli had no significant difference compared with that before administration (all P>0.05). When D-APV was perfused into the brain surface of mice in the alcohol group, the amplitude of P1 ((42.3±1.5) Mv)was significantly lower than that before administration ((101.1±0.9)mV) and after elution ((100.1±2.2) mV) ( t=106.762, - 69.605, both P<0.05), and the area under waveform of P1 ((42.6±1.3)%) was also significantly lower than that before administration ((100.6±1.6)%) and after elution ((97.6±2.2)%) ( t=88.862, -67.791, both P<0.05).The ratio of N2 / N1 (0.3±0.1) was significantly lower than that before administration (0.4±0.1) and after elution (0.3±0.1) ( t=2.242, 2.121, both P<0.05). When NMDA was perfused on the brain surface of mice in the control group, compared with before administration and after elution, the amplitude of P1 ((110.7±3.2) mV, (100.1±0.9) mV, (102.0±1.7) mV, t=-10.173, 7.669, both P<0.05), the area under the waveform of P1 ((127.9±3.5)%, (100.0±3.1)%, (115.0±5.3)%, t=-18.698, 6.447, both P<0.05), the ratio of N2 / N1 ((0.5±0.1), (0.3±0.1), (0.3±0.1), t=-5.669, 5.669, both P<0.05) were all significantly increased. When D-APV was perfused on the brain surface of mice in control group, the field potential evoked by blowing stimuli had no significant difference compared with that before administration and after elution (all P>0.05). Conclusion:Long-term alcohol intake significantly suppresses the synaptic transmission of excitatory glutamate in MF-GC, and enhances the inhibitory response mediated by GABAA receptor in cerebellar cortex. The inhibitory component is enhanced by NMDA receptor, but not by type 1 metabolic glutamate receptor.