Aged ; Coronary Artery Disease ; Female ; Heart Ventricles ; Humans ; Vascular Fistula

Problem-Based Learning(PBL)is a new teaching mode.Application of PBL in Laboratory Diagnostics is a practical teaching reform.Students'learning mainly by themselves is PBL’s main feature.The status and role of teachers have a qualitative change.They are not teaching but guiding.Therefore teachers must realize the change of their roles in PBL.

Objective To explore the clinical significance of mycoplasma pneumoniae(MP) antibody IgM positive with high titers.Methods Two hundred and sixty-seven cases of respiratory tract infections of MP with MP-IgM positive were confirmed in our hospital during Jun.2005 to Aug.2008,of which 63 cases with significantly increased titers of MP-IgM antibodies(MP-IgM≥1:1 280).A prospective observation and later analysis of the clinical manifestations of the 63 cases were carried out.Results 1.Among 63 cases,6 cases were diagnosed as upper respiratory tract infection,12 cases as acute bronchitis and 45 cases as pneumonia,respectively.2.The 63 cases pre-sented mainly with fever and cough,of them 59 cases had fever and 45 cases with paroxysmal cough,39 cases could be found crackles on physical examination.3.Extrapulmonary manifestations could be found in many cases,including heart complications in 21 cases,abnormal liver functions in 35 cases,gastrointestinal manifestations in 22 cases,neurological manifestations in 1 case,dermatological disorders in 7 cases and renal manifestations in 3 cases.4.Patterns of chest X-ray findings of the 63 cases with MP infections were varied,of which 45 cases showed pulmonary abnormality.Chest X-ray findings of the 45 children included 12 cases with interstitial infiltration,6 cases with lobar condensation,15 cases with patch shadows,4 cases with enlarged porta pulmonis and 8 cases with reticulonodular infiltrates.Three cases were complicated with pleural effusion and 2 children with segmental atelectasis.5.The cases were given azithromycin,10 mg/(kg?d),a daily dose for 5 days and intermitted for 4 days.All cases repeated the treatment courses for 1 to 4 times.The mean duration of fever was 6.6 days,cough could last 11.7 days and the crackles on physical examination could not be found 7.5 days later after treatment.The abnormality of chest X-ray findings dissolved in 38 cases 2-3 weeks later after treatment.Conclusions Cases of MP infections with high titers of MP-IgM positive had severe symptoms,of which more than 90% patients presenting with lower respiratory tract infections,mainly with pneumonia.Recovery of chest radiological finding was posterior to clinical improvement,so timely and regular chest X-ray examinations were essential after treatment and could avoid the false ceasing of treatment of the cases.Patients of MP infections with high titers of IgM antibodies positive have good prognosis.

Objective To analyze the trend of disease constitution of hospitalized neonates in China-Japan Friendship Hospital and provide a scientific basis for the focus adjustment of perinatal health.Methods Six hundred and ninety-eight neonates were admitted during Jan.2004 to Dec.2008.Relevant data of all cases were retrospectively collected.The discharge diagnosis of the neonates was counted accor-ding to the year,and the trends of the neonatal disease constitution of the 5 years were analyzed.Results 1.The first 10 diseases of hospita-lized neonates were centralized,and the first 3 diseases including premature infants,neonatal hypoxic-ischemic encephalopathy(HIE) and neonatal hyperbilirubinemia accounted for 42.84% of the neonate diseases.2.The characteristics of neonatal disease constitution were as fo-llows:the disease constitution of premature infants always located within the first 3 diseases;the location of neonatal HIE went ahead from number 8 to number 1 or 2,and its constitution proportion increased from 4.93% to more than 15.00%(P

OBJECTIVE:To observe therapeutic efficacy and liver toxicity of chemotherapy combined with bevacizumab in the treatment of colorectal cancer liver metastases (CLMs). METHODS:126 CLMs patients were selected and randomly divided into chemotherapy group(54 cases)and combination group(72 cases). Chemotherapy group received FOLFOXIRI regimen:irinotecan 165 mg/m2+oxaliplatin 85 mg/m2+calcium folinate 200 mg/m2+fluorouracil 2 g. Combination group was additionally given bevaci-zumab 5 mg/kg one day before chemotherapy on the basis of FOLFOXIRI regimen. A treatment course of 2 groups lasted for 2 weeks,and both received 12 courses of treatment. The pathological response,survival rate and toxic reactions caused by chemother-apy were compared between 2 groups. RESULTS:Pathological complete response proportion,tumor remission rating(TRG),the proportion of patients with tumor necrosis rate ≥50% in combination group were significantly higher than chemotherapy group, with statistical significance (P<0.01). The proportion of TRG4-5,TRG 1-3 progression-free survival in combination group were significantly higher than chemotherapy group,with statistical significance (P<0.05). The incidence of liver parenchymal necrosis in combination group was significantlg higher than chemotherapy group,there was statistical significance (P>0.05). CONCLU-SIONS:Chemotherapy combined with bevacizumab can improve pathological response and the incidence of CLMs necrosis and doesn't increase liver toxicity.

BACKGROUND:Percutaneous kyphoplasty with bone cement injection for repair of multi-segmental thoracolumbar vertebral osteoporotic fractures can restore the compressed vertebral height, correct deformity and reduce complications. OBJECTIVE: To explore the therapeutic effects of percutaneous kyphoplasty with bone cement in patients with multi-segmental thoracolumbar vertebral osteoporotic fractures. METHODS:Eighty patients with multi-segmental thoracolumbar vertebral osteoporotic fractures were enroled, 29 males and 51 females, aged 61-78 year, including 52 case of two-segmental vertebral fractures, 22 cases of three-segmental vertebral fractures, 6 cases of four-segmental vertebral fractures. Al the patients were divided into experimental group and control group randomly. Patients in the control group were given active basic treatment and anti-osteoporosis treatment and stayed in bed. Patients in the experimental group were given percutaneous kyphoplasty with bone cement injection on the above basis. Al the patients were folowed-up 12 months after treatment. Then the Oswesty dysfunction index, Barthel index, visual analog scale score, and theanterior vertebral height and midline height, Cobb angle were compared between the two groups. RESULTS AND CONCLUSION: In the experimental group, the Oswesty dysfunction index, Barthel index, visual analog scale score, and the anterior vertebral height and midline height, Cobb angle were al significantly improved at 3 days, 3 months and 12 months after treatment than before (P < 0.05). In the control group, the Oswesty dysfunction index, Barthel index and visual analog scale score were improved significantly at 3 and 12 months after treatment (P < 0.05), while the anterior vertebral height and midline height were improve dramaticaly at 12 months after treatment (P < 0.05). Compared with the control group, the experimental group showed better the Oswesty dysfunction index and Cobb angle than the control group at 12 months after treatment (P < 0.05), but there were no difference in the other indicators between the two groups. No adverse reactions associated with bone cement material occurred in the experimental group. Taken together, the percutaneous kyphoplasty with bone cement injection can rapidly relieve pain in patients with multi-segmental thoracolumbar vertebral osteoporotic fractures, which can correct kyphosis and improve patient's quality of life.

Objective To study the esthetic indexes of soft tissue profile in lateral face in Anhui youths with normal occlusion. Methods The study was carried out by taking the cephalometric photographs in the 102 Anhui youths with normal occlusion. The data of measurement were got from the photographs by image database and analysis system (IDAS) software, and statistically evaluated by SPSS software. Some specially selected items were analysed again by Fisher's discriminant method. Results Seven items, i.e. Li Ns Pos, Ls Ns Pos, Ls B, Li B, Sn H, Bs Li FH and Z angle, were chosen as esthetic indexes of facial profile, and the discriminant functional formula was established. Conclusion Combination of all the above 7 items contribute to the beauty of facial profile.

Objective To explore the secretion of chemokine regulated upon activation normal T cell expressed and secreted(RANTES)influenced by the complex microenvironment in the peritoneal cavity of women with endometriosis and investigate chemotaxis of RANTES on the peritoneal monocytes.Methods The contact and non-contact co-culture systems including three target cells of ectopic tissue were established.The three target cells were endometrial stromal cells(ESC),human peritoneal mesothelial cells(HPMC)and monocytes.After collection of the supernatant of co-culture systems,the levels of RANTES were detected by enzyme linked immunosorbent assay(EUSA).Migration of U937 cell,a monocyte line,was detected by chemotaxis assay.Results ESC,HPMC,and U937 cultured alone secreted slight RANTES,(5.0±0.5),(4.0±0.3),and (254±40)ng/L. Compared with the culture of the target cell alone,the levels of RANTES in each co-culture system increased significantly,with the highest level in the contact culture system of E-H-U(2250±96)ng/L. RANTES secretion of non-contact co-culture of three cells were higher than contact co-culture of two cells(P＜0.01):U/E-H(912±93) vs E-H(50±40)ng/L,H/E-U(1201±93) vs E-U(243±192)ng/L,and E/H-U(1519±96) vs H-U(1251±73)ng/L. ESC,HPMC,and ESC-HPMC co-culture improved significantly migration of U937 cells [ number of cell migration respectively(6.0±0.3),(6.2±0.3),(10.0±0.3)×103,P＜0.01],which could be inhibited efficiently by anti-RANTES neutralizing antibody.Condusion The target cells in the peritoneal cavity of patients with endometriosis promote the secretion of RANTES in autocrine and paracrine manners and migration of monocytes.

With the transformation of medical model,technical improvement,and the development of various medical laws and regulations,requirement for medical ethics is being increased in clinical medical education gradually.Under this circumstance,medical simulation education come into being and evolves prosperously.However,present application of medical simulation education is imperfect and far from satisfaction in China.This article summarizes the relation of medical ethics and medical simulation education.