Objective To explore the screenplay dialogue pattern in the interrogation of the second classroom training effect, so as to improve the quality of the inquiring teaching.Methods 69 five-year students of clinical medicine specialty of Grade 2014 in our university were randomly divided into the control group (34 persons) and the experimental group (35 persons), The students in the control group, during the second class-room training, received the consent of the patient, and informed the patient,to answer the illness according to the truthdo not disclose the diagnosis and treatment after hospitalization and other matters needing attention. Besides, we also arranged for students to conduct repeated bedside inquiry training. While the experimental group carried out the script dialogue model training on the campus. The teacher provided a script for interroga-tion. Students answered in accordance with the principle ofdon't ask don't answer, don't say anything other than the question, don't miss the question, don't answer the question wrongly. SPSS 19.0 was used for statistical analysis, and the comparison of measurement data between groups was performed by t test.Results There was no significant difference between the experimental group and the control group in the inquiry and assessment. The results showed that the training effect of the two groups was basically the same. Through the analysis of various aspects of inquiry, the chief complaint and communication ability of students in the experimental group were better than those in the control group, and the difference was statistically significant, which showed that the script dialogue model promoted students' ability of inducing complaints and their language ability when they did medical history collection.ConclusionTaking screenplay dialogue mode in the second classroom practice is good, which improves the students' enthusiasm, trains their clinical thinking and improves the teaching quality.

Objective In order to find early latent faults and prevent catastrophic failures, diagnosis of insulation condition by measuring technique of partial discharge(PD) in gas insulated switchgear (GIS) is applied in this paper, which is one of the most basic ways for diagnosis of insulation condition. Methods Ultra high frequency(UHF) PD detection method by using internal sensors has been proved efficient, because it may avoid the disturbance of corona, but the sensor installation of this method will be limited by the structure and operation condition of GIS.There are some of electromagnetic (E-M) waves leak from the place of insulation spacer, therefore, the external sensors UHF measuring PD technique is applied, which isn't limited by the operation condition of GIS. Results This paper analyzes propagated electromagnetic (E-M) waves of partial discharge pulse excited by using the finite-difference time-domain (FDTD) method. The signal collected at the outer point is more complex than that of the inner point, and the signals' amplitude of outer is about half of the inner, because it propagates through spacer and insulation slot. Set up UHF PD measuring system. The typical PD in 252kV GIS bus bar was measured using PD detection UHF technique with external sensors. Finally, compare the results of UHF measuring technique using external sensors with the results of FDTD method simulation and the traditional IEC60270 method detection. Conclusion The results of experiment shows that the UHF technique can realize the diagnosis of insulation condition, the results of FDTD method simulation and the result UHF method detection can demonstrate each other, which gives references to further researches and application for UHF PD measuring technique.

Objective:The immunogenicity of DNA vaccine immunogenicity can be improved by fusing antigenic genes to IgG Fc fragment.It is critical for enhancing immunogenicity of DNA vaccine to construct the secreting eukaryotic expressing vector.The purpose of this study is to construct a secreting eukaryotic expressing vector ligated with IgG Fc gene by amplifying human IgG Fc fragment and fusing the fragment with human CD5 signal peptide sequence for highly efficient expression.Methods:Human lymphocytes were isolated from the tonsil obtained by removal surgery.The total RNA of lymphocytes was extracted using Trizol reagent.Human IgG Fc cDNA was amplified by RT-PCR from lymphocytes and then inserted into pMD-18T vector.The Fc encoding sequence fused with CD5 signal peptide(sp) sequence was constructed by cross PCR using Fc fragment and CD5sp sequence and cloned in pcDNA-CD5 plasmid as the template.CD5sp-Fc fragment was inserted into pcDNA3.1 expressing vector to construct the pcDNA-CD5sp-Fc plasmid.The plasmids were transfected into HEK293T cells mediated by calcium phosphate.Western blot was used to detect expressed Fc protein in cultural supermatant of the cells.Results:The amplified sequence of human IgG Fc was consistent with that previously published.The secretory expression of Fc in HEK293T cells was achieved and the expressing level reached 50 ?g/106 cells at 48 h culture after transfection.Conclusion:The human IgG Fc gene is amplified by RT-PCR methods and the secretory expression of Fc gene mediated by CD5 signal peptide in 293T cells is achieved.The results provide a experimental basis for further construction of antigen genes fused to IgG Fc fragment and investigation on DNA vaccines and Fc as a biological adjuvant.

Fu's subcutaneous needling (FSN) is a modern approach developed from traditional Chinese acupuncture. It could give some stimulation in the subcutaneous region that has a quick and long-lasting effect on soft tissue injuries and some of the internal medicine diseases. It is a safe approach without adverse reaction. Through analysis of the features and possible mechanism of FSN, it is believed that research on mechanism of FSN is beneficial to the development of modern medicine, especially to pain management.
Acupuncture Analgesia ; instrumentation ; methods ; Acupuncture Points ; Humans ; Pain Management ; instrumentation ; methods

Birth Weight ; Fetal Growth Retardation ; genetics ; Humans ; Molecular Biology

Objective To compare the effects,stress reaction and concentration of ropivacaine in umbilical cord blood of patients who accepted combined spinal epidural analgesia or patient controlled epidural labor analgesia in latent and active phase.Methods After approved by the ethics committee and informed consents from 80 nulliparous parturients who were admitted to Beijing Friendship Hospital,Capital University of Medical Sciences between January to June 2009,and who were term,single,cephalic presentation delivery and ASA Ⅰ-Ⅱ,were divided into two groups randomly:latent phase group (Group L,cervical dilation 0.5-2.5 cm,n=40) and active phase group (Group A,cervical dilation ≥3.0 cm,n =40).Ropivacaine 2 mg and fentanyl 10 μg was administered in subarachnoid space of all patients.Then,patient controlled epidural infusion of 0.1 ％ ropivacaine plus fentanyl 2 μg/ml were administered.Pain scores (visual analogue score,VAS),lower extremity muscle strength,duration of labor,delivery mode,total dosage used,maternal satisfaction,Apgar score (1 min and 5 min) were evaluated; concentration of ropivacaine (high performance liquid chromategraphy) in cord blood,and concentration of cortisol (radioimmunoassay) in maternal venous blood and cord blood were detected.Forty nulliparous parturients without labor analgesia were taken as control group (Group C).Chi-square test and one way analysis of variance was applied for statistical analysis.Results (1) VAS in Group L and Group A were lower than that of Group C when cervix dilated at 7.0-8.0 cm (2.9± 1.4,2.6± 1.5 vs 9.2±0.7,F=201.50,P＜0.01) and fully dilated (4.7±2.2,3.6±2.0 vs 9.1±0.7,F =-62.07,P＜0.01,respectively).(2) Tbe concentration of cortisol in maternal venous blood right after delivery was higher than that before analgesia in all groups,and the change in group C was significantly greater than that in group L and group A [(902±172) μg/L vs (761±125) μg/L and (731±184) μg/L,t =-3.491 and-3.483,all P＜0.01],moreover there was no significant difference between group L and group A (P＞0.05).There were no difference in cortisol concentration of umbilical blood among the three groups [(168±46) μg/L,(159±49) μg/L and (170±86) μg/L,F=0.23,P＞0.05].(3) There was no difference between ropivacaine concentration in umbilical blood of group L and group A [(0.21±0.10) mg/L vs (0.20±0.03) mg/L,t=0.557,P＞0.05].(4) No significant differences was shown among the three groups in the duration of first and second stage of labor,rate of augmentation,neonatal birth weight,Apgar score at 1 min and 5 min (all P＞0.05).Compared with group C,group L and group A had higher rate of vaginal delivery (52.5％ vs 75.0％ and 85.0％,P＜0.05) and lower rate of cesarean section (45.0％ vs 20.0％ and 15.0％,P＜0.05).The duration of analgesia in group L was longer than that in group A [(215±143) min vs (118±50) min,t =3.722,P＜0.01] and the dosage of fentanyl was also higher [(28± 11) μg vs (17±6) μg,t =5.084,P＜0.01].Conclusions Labor analgesia with combined spinal epidural could decrease cesarean section rate and maternal stress reaction without prolonging the duration of labor and inhibiting neonatal stress reaction.Labor analgesia start from latent phase would not increase the concentration of ropivacaine in cord blood.

Objective To explore the clinical curative effect of cerebral angio spasm after aneurysm rupture subarachmoid hemorrhage by Fasudil, Methods The clinical data of cerebral angio spasm after aneurysm rupture subarachnoid hemorrhage were retrospectively analyzed, which was divided into detection group and control group.Results The GCS score of detection group was better than control group;the average blood flow rate of arteria cerebri media after curing in detection group the difference had statistical significance( all P ＜0. 05 ). The mutilation rate、rate of death of detection group were lower than control goup, the difference had statistical significance ( P ＜ 0. 05 ).Conclusion The clinical curative effect was good of cerebral angio spasm after aneurysm rupture subarachnoid hemorrhage by Fasudil, and prognosis was good.

ObjectiveTo comprehend the similarities and differences of postoperative quality of life between mastectomie avec dissection axillaire and modified radical mastectomy among patients with breast cancer,and in order to supply references for establishing corresponding nursing measures. Methods160patients with early breast cancer were selected,40 patients accepted the mastectomie avec dissection axillaire (the conservative group)and 120 patients accepted modified radical mastectomy (the radical group).The quality of life of patients was surveyed with questionnaires. ResultsThe EORTC QLQ-C30 score of the conservative group was not significant than the radical group.The EORTC QLQ-BR 23 score showed that the conservative group had a better self-evaluation of their configuration. ConclusionsThe patients who accepted the mastectomie avec dissection axillaire will live a better life than those who accepted modified radical mastectomy.

Objective To explore the role of process management in preventing peripheral central venous catheter (PICC)-related bloodstream infections (CRBSI). Methods A standard process management policy was established for the uniform management of PICC in our hospital. The incidences of CRBSI before and after the implementation of this policy were compared. Results The incidences of CRBSI was 6.0‰ (48/79 793 ) every 1000 catheter-days before process management and 2.9‰ (29/99643) after process management (P =0.000).Conclusion Standard process management can effectively prevent and control CRBSI caused by PICC.

AIM:To explore the application effect of pranoprofen combined with tobramycin and dexamethasone ophthalmic suspension in cataract extraction after IOL implantation.METHODS:Retrospective analysis of the clinical data of cataract patients treated from May 2015 to June 2016 in our hospital.According to the treatment methods, patients were divided into tobramycin and dexamethasone ophthalmic suspension with pranoprofen group (combined treatment group) and pranoprofen treatment group.The difference of visual acuity, intraocular pressure, anterior chamber flash change, satisfaction rate and symptom score before and after treatment in two groups were observed.RESULTS:The vision of the two groups before treatment had no difference(P>0.05).At 1wk and 1mo after treatment, the visual acuity of the two groups all improved compared with before treatment, there was no significant difference between the two groups (P>0.05).Before treatment, the anterior chamber flare of the two groups had no difference(P>0.05).At 1wk and 1mo after treatment, the anterior chamber flare of combined treatment group was lower, the difference was statistically different (t=2.435, 1.864;P<0.05).The symptom score of the two groups before treatment had no difference(P>0.05).After treatment, the symptoms and signs of combined treatment group was significantly lower than that of pranoprofen group (t=2.586, 7.820;P<0.05).The satisfaction rate of the combined treatment group patients was 100%, significantly higher than pranoprofen group.CONCLUSION:Pranoprofen and tobradex in the treatment of cataract extraction and intraocular lens implantation has good application effect, can significantly improve the patient's symptoms and signs.