?AIM:To improve the efficiency and quality of teaching, and to cultivate students’ ability to analyze and solve clinical problems, the case - based learning ( CBL ) combined with problem-based learning ( PBL ) teaching mode is introduced into the clinical teaching of ophthalmology.?METHODS:Two classes ( total 131 students ) of 2013 grade major in clinical medicine, Kunming Medical University, were randomly selected as experimental group using CBL combined with PBL teaching mode, and control group using traditional teaching mode. The part of acute angle-closure glaucoma was taught. The scores of the experimental group were compared with that of control group at the end of term.?RESULTS:The mean scores of CBL combined with PBL teaching group were significantly higher than that of traditional teaching group.?CONCLUSION: The application of CBL combined with PBL in the clinical teaching of ophthalmology has obvious advantages in improving the learning interests and promoting students’ self-learning ability. It is helpful in improving the students’ ability of independent-thinking, analyzing and solving problem.

Humans ; Infant ; Male ; Mycoses ; pathology ; Penicillium ; isolation & purification

Objective To study the CT perfusion features of various lymph nodes in the neck.Methods Dynamic perfusion CT scanning was performed in 83 neck lymph nodes proved by pathology,including tuberculosis lymph nodes, lymphoma and metastatic lymph nodes. The shapes, blood flow modes,and perfusion parameters of these lymph nodes were compared among 3 groups. Statistical analysis of L/T and CT perfusion parameters was performed by one-way ANOVA and LSD test. Results The values of MTT of tuberculosis lymph nodes, lymphoma and metastatic lymph nodes were (28. 13 ±5.08), (31.08 ±5.82),and ( 11.24 ±5.31 ) s,respectively. The MTT of metastatic lymph nodes was statistically lower than that of tuberculosis lymph nodes and lymphoma (P ＜ 0. 05). Their frequencies of marginal blood flow were 5/9,4/19, and 39/55 (70. 9% ), respectively. The frequency of marginal blood flow in the tuberculosis lymph nodes and metastatic lymph nodes was statistically higher than that of lymphoma ( P ＜ 0. 05 ). Their frequencies of central blood flow were 2/9, 11/19, and 9/55 (16.4%), respectively. The frequency of central blood flow in the lymphoma was statistically higher than that of tuberculosis lymph nodes and metastatic lymph nodes ( P ＜ 0. 05 ). Their values of L/T were 1.82 ± 0. 32, 1. 80 ± 0. 39, and 1.84 ± 0. 36,(40. 98 ±6. 62) s,respectively. There were no significant differences in L/T, BF, BV and TTP among tuberculosis lymph nodes, lymphoma and metastatic lymph nodes( P ＞ 0. 05 ). Conclusion CT perfusion,especially combination functional imaging with perfusion images may be helpful in judging the nature of neck lymph nodes.

Objective To study the significance and expression relationship among STAT1,STAT2 and hMLH1 ,hMSH2 proteins in hepatocellur carcinoma(HCC). Methods SABC immunohistochemistry method was used to detect the expression of STAT1,STAT2,hMLH1 and hMSH2 proteins in cancer tissues and paracancer tissue from 37 patients of HCC. Results The positive rates and expressive levels of STAT1,STAT2,and hMLH1, hMSH2 in HCC was significantly lower than those in paracancer liver tissues(P

The composition, nutritional evaluation and clinical trials of a nutritionally complete enteral preparation were presented. It was composed of glucose oligosaccharides, emulsified fat, solubilized proteins, twelve vitamins, certain minerals and trace elements. Rats were forced to negative nitrogen balance by means of protein-free diet. Body weight and serum total protein declined accordingly. When the feed was changed to this preparation in one group, and a routine one with equal nitrogen content in another, nitrogen balance was turned to positive, body weight increased, serum total protein returned to normal in both groups. The increments of nitrogen balance and body weight were, however, higher significantly in the group fed with the preparation than that with routine diet. The biological value, net protein utilization and protein efficiency ratio of the solubilized proteins in the preparation were higher than casein in the routine feed. Twenty surgical patients having the preparation as the sole source of nutrients could take around 8.37MJ(2000 kcal)a day. Nitrogen balance turned from negative to positive in an average time of 3.6 days. Body weight, serum total protein, serum albumin were all increased. Fourty patients took this as dietary supplement and the similar results were observed too. Clinical effects were excellent in all cases, especially for healing of surgical wounds and fistula. Incidence of diarrhea was 3.3%.

ObjectiveTo investigate the efficacy of combined therapy of mild hypothermia and hibernation to treat severe brain injury. Methods24 patients with severe brain injury were randomly divided into combined therapy group and normothermia group. Glasgow Coma Scale scores of all the patients were in the range of 3 to 8. No later than 10 hours after their injury, hypothermia patients were given half dosage of No.1 hibernation cocktail and had been cooled by cooling blankets to 32℃-34℃ (rectal temperature) for 5 days, then to 35℃ for 24 hours, and slowly increased to their normal level. 3 days and 7 days after their admission, intracranial pressure,creatine phosphate kinase,partial pressure of arterial O2 and CO2, platelet and Na+,K+ were measured.7 days after their admission, Glasgow Outcome Scale scores of each patient and mortality of each group were measured. ResultsThe mortality of combined therapy group(25.0%) was significantly lower than that of normothermia group (66.6%,P<0.05). The decreased values of intracranial pressure, creatine phosphate kinase and platelet number of combined therapy group were all significantly higher than that of normothermia group respectively (P<0.05). There were no significant difference in mean artery pressure, blood electrolyte, and partial pressure of arterial O2 and CO2 between these two groups(P>0.05). ConclusionThe combined therapy of mild hypothermia and hibernation can effectively reduce the mortality of patients with severe brain injury as it is much easier, less invasive and with less complications.

The high expression of tissue factor (TF) is related to the coagulation disorder in acute leukemia. TF in blood circulation is mainly expressed in cells, microparticles (MP) and alternatively spliced human tissue factor (asHTF). To elucidate the role of TF in the coagulation disorder of acute myeloid leukemia (AML), RT-PCR was performed on 6 common AML cell lines NB4, HL-60, Kasumi-1, U937, K562 and THP-1. The results showed that only NB4 and U937 cells expressed baseline full-length TF and asHTF which were proved by sequencing. The flow cytometric detection, TF activity and TF antigen tests in NB4 and U937 cells revealed that the asHTF was expressed in trace amount and almost had no activity, while the TF antigen and activity in microparticles were significantly higher than that in asHTF. It is concluded that asHTF may play an unimportant role in the coagulation disorder of AML. Microparticle associated tissue factor (MP-TF) is the predominant source of TF activity released from AML cells.
Alternative Splicing ; HL-60 Cells ; Humans ; Leukemia, Promyelocytic, Acute ; genetics ; metabolism ; Thromboplastin ; genetics ; metabolism ; Tumor Cells, Cultured ; U937 Cells

Acupuncture Therapy ; Adult ; Aged ; Chronic Disease ; therapy ; Female ; Humans ; Male ; Middle Aged ; Pharyngitis ; therapy ; Young Adult

Objective To collect the data of present basic constructive situation of intensive care units (ICUs) in second and tertiary grade hospitals in Xinjiang Uygur Autonomous Region and to provide a data base beneficial to the construction of ICUs in the whole region.Methods The information including basic situation of ICUs in a total of 49 second and tertiary grade hospitals as samples in Xinjiang Uygur Autonomous Region were investigated by questionnaire survey from December 2012 to April 2013. The contents of questionnaire chiefly included the basic situations of hospitals, ICU constructions, ICU human resources and allocation of equipments.Results Forty-nine questionnaires were sent out, and all of them gave answers, the recovery rate being 100%. In the whole region of Xinjiang, there were 49 second and tertiary grade hospitals with establishment of 66 various types of ICUs. ① Medical unit basic situation: the second grade A hospitals accounted for 59.2%, and the tertiary grade A hospitals, 34.7%. There was a larger proportion of local hospitals (67.3%); most of the hospitals had beds over 500 (57.14%), the designed hospital bed number was 41 403, and 35 442 beds were open up for service (85.60%). ② The ICU basic construction situation: the construction of ICUs concentrated mainly after the year 2000, from 2000 to 2010, a total of 37 units, and from 2010 to 2012, 12 units were constructed; when they opened to the public, the beds were relatively few, and the ICUs containing less than 10 beds occupied 79.00%. In the 66 ICUs surveyed, there were 43 general ICUs, accounting the largest proportion, followed by 7 emergency ICUs, and the least were 1 neurosurgery and 1 cardiac surgery ICU. In the 66 ICUs, all together 765 beds were prepared, but actually 808 beds were opening up to public; most of ICUs had 5 - 20 beds, accounting for 71% in all the ICUs. At present, in the whole Xinjiang region, the rate of beds in ICUs in various grades of hospitals opening to the outside for use accounted for more than 80% of which 56% ICUs were almost turning round fully. ③ ICU human resources situation: totally, there were 484 doctors in ICUs in the whole region, the ratio of full-time doctor to nurses was 1:3.50, the ratio for bed to physician 1:0.55 and the ratio for bed to nurse 1:0.92. The title of doctor was primarily resident, and the various title gradient levels were good. Most doctors graduated from a regular medical college, and the doctors having obtained a master degree were few. The physician professional backgrounds were mainly critical disease medicine, emergency medicine and respiratory medicine, the professional relevance being good; the chief way of ICU physicians to engage in advanced study of their professional training was in China, and generally they joined professional continuing education programs poorly, mostly joining once a year or non at all. The physicians who obtained the identification of Chinese critical care medicine specialist accounted only for 23.56%. ④ ICU equipment allocation situation: according to the requirements of ICU construction guidelines, the equipments must be allocated including bedside monitors (703 units), ventilators (516 units) and infusion pumps (702 units), occupying the highest proportion. In the optional equipments, there were enteral nutritional pump (89 stations), blood glucose monitoring device (57 units) and anti-decubitus mattresses (54 units), the proportion being the largest, bispectral index monitor (2 units), extracorporeal membrane oxygenation (ECMO, 1 table) and gastric mucosal carbon dioxide tension pHi meter (0 unit), the proportion being the least or non at all.Conclusions In the whole Xinjiang region, the construction of ICUs is still at the developing stage, and needs to further strengthen the standardized construction. The human resources, equipments, etc. are not distributed in balance, and it is necessary to move forward the adjustment to benefit the development of ICUs in the whole region.

Objective To master current operating situation of water-defluoridation-project and the level of fluoride in drinking water of Zhangjiakou city and provide a scientific basis for prevention and control of the disease.Methods Itemized survey of current operating situation of water defluoridation projects built in 2010 and before,and the source of fund situation in Zhangjiakou city was carried out.One source water and 2 terminal water samples of the projects in use were collected,respectively.Water fluoride were determined by Sanitary Standard for Drinking Water Testing Method (GB/T 5750.5-2006).Results A total of 386 water improvement projects to reduce fluoride were investigated,310 in good operation,accounting for 80.31％; 6 in intermittent use,accounting for 1.55％; 70 out of use,accounting for 18.14％.Water fluoride was surveyed in 316 water improvement projects to reduce fluoride,175 of the projects provided water with normal fluoride,accounting for 55.38％; 141 of the projects provided water with fluoride exceeded the standard,accounting for 44.62％.The total investment of 386 water defluoridation projects was 21.8682 million yuan,the investment of the state,the collective and the individual were 10.0780 million yuan,6.2104 million yuan and 5.5798 million yuan,accounted for 46.09％,28.40％,25.51％,respectively.Conclusions The current situation of the projects is very worrying in Zhangjiakou city.Further instensify the water improvement project in diseased areas,insist on sustainable water defluoridation strategy.