ObjectiveThis paper aims to probe into the effect of working and studying combined teaching reform of chnical medicine major.MethodsTwo classes containing 46 students respectively were selected at random as observation group and control group,from the six classes of Grade Two majoring in clinical medicine.The two groups of students were trained by adopting working and studying combined teaching model and traditional teaching model respectively,after which they were evaluated in terms of clinical theory,practical skills and operations,and exercitation achievement.ResultsThe observation group does better in practical skills and exercitation achievement than the control group,while they have no difference in clinical theory.ConclusionWorking and studying combined teaching model can improve students' clinical analytical ability,strengthen their awareness of medical morals,and help them achieve more in exercitation.

OBJECTIVETo investigate the risk factors of pinhole infection in the fractured lower limbs after external fixation.

METHODSThe case-control study was designed. From May 2009 to May 2014, the clinical data of 272 patients with lower limb fracture treated by external fixation device were collected. All the patients were divided into two groups according to post-operative pinhole infection. There were 29 cases in the case group including 23 males and 6 females. The age of patients in case group ranged from 25 to 77 years old,with the average age of (53.41 ± 12.77) years old. There were 243 cases in control group including 217 males and 26 females. The age of patients in the control group ranged from 27 to 78 years old, with the average age of (48.71 ± 11.87) years old. There were nine risk factors observed in our study including age, gender, fixed time by external fixation device, diabetes, time in bed, smoking, operation condition of other parts in the body, infection condition of other parts in the body.

RESULTSThe results of univariate analysis showed that there were statistically significant differences among age (χ² = 15.708, P < 0.001), fixed time by external fixation device (χ² = 11.940, P < 0.001), severity of the lower limb fracture (χ² =15.438, P < 0.001), diabetes (χ² = 8.519, P = 0.004) and time in bed (χ² = 7.165, P = 0.007) between case group and control group. The results of Logistic regression analysis showed that the risk factors of pinhole infection after fixed by external fixation device in the lower limb fracture were the advanced age (OR = 8.327, P < 0.001), fixed time by external fixation device (OR = 6.795, P < 0.001), diabetes (OR = 4.965, P = 0.001) and time in bed (OR = 4.864, P = 0.008).

CONCLUSIONThe advanced age, long fixed time, diabetes and long time in bed could increase the risk of pinhole infection after external fixation in the lower limbs with fracture.

Adult ; Aged ; Case-Control Studies ; External Fixators ; adverse effects ; Female ; Humans ; Lower Extremity ; injuries ; Male ; Middle Aged ; Postoperative Complications ; etiology ; Risk Factors

OBJECTIVETo explore the correlation between the expressions of galectin-3 and E-cadherin and lymph node metastasis of colon cancer.

METHODSImmunohistochemistry was employed to examine the expressions of E-cadherin and galectin-3 in 37 colon cancer samples, among which 21 samples underwent RT-PCR for E-cadherin and galectin-3 mRNA expressions. The correlation of E-cadherin and galectin-3 expressions with lymph node metastasis of the tumor was analyzed.

RESULTSThe positivity rate of galectin-3 expression was 83.8% (31/37) in these samples. Of the tumor cases with lymph node metastasis, 94.7% (18/19) of the tumors were positive for galectin-3 expression, a rate significantly higher than that in non-metastatic cases. The positivity rate of E-cadherin expression was 59.5% (22/37) in the total cases, and 47.4% (9/19) in the metastatic cases, significantly lower than that in the non-metastatic cases.

CONCLUSIONGalectin-3 and E-cadherin expressions are associated with lymph node metastasis of colon cancer and may serve as potential prognostic indicators for colon cancer patients.

Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor ; analysis ; genetics ; Cadherins ; genetics ; Colonic Neoplasms ; genetics ; pathology ; Female ; Galectin 3 ; genetics ; Humans ; Immunohistochemistry ; Lymphatic Metastasis ; Male ; Middle Aged ; Prognosis ; Reverse Transcriptase Polymerase Chain Reaction ; Young Adult

Adolescent ; Adult ; Environmental Exposure ; Female ; Humans ; Inhalation Exposure ; Male ; Middle Aged ; Nasopharynx ; pathology ; Sulfuric Acid Esters ; poisoning ; Young Adult

Objective To investigate the incidence of healthcare-associated infection (HAI)in patients in a respiratory in-tensive care unit (RICU)of a teaching hospital,and provide reference for HAI prevention and control.Methods All pa-tients admitted to this RICU from January to December 2014 were surveyed with prospective targeted monitoring method, surveyed data were analyzed statistically.Results A total of 561 patients were surveyed,43 patients developed 44 times HAI,HAI rate and HAI case rate were 7.66% and 7.84% respectively,incidence of HAI and adjusted incidence of HAI per 1 000 patient-days were 6.26‰ and 1.79‰ respectively.The main infection site was urinary tract (45.46%,n=20). Incidence of ventilator-associated pneumonia (VAP ),catheter-related bloodstream infection (CRBSI),and catheter-associat-ed urinary tract infection (CAUTI)per 1 000 catheter-days were 2.73‰(n=13),1.57‰(n=2),and 3.78‰(n=18)re-spectively.Incidence of HAI per 1 000 patient-days between the first and second half year of 2014 was significantly differ-ent(4.59‰ vs 7.89‰;u=-1.75,P =0.04).A total of 47 pathogenic strains were isolated,the main pathogens were gram-negative bacteria(n=26,55.32%).Conclusion The major HAI in RICU is device-associated infection,it is necessary to strengthen the management of invasive procedures;targeted monitoring can find the weak links of infection control prac-tice and helpful for taking effective prevention and control measures to reduce the incidence of HAI in ICU.

OBJECTIVETo investigate the inhibitory effect of danshensu on c-Jun N-terminal kinase (JNK) and nuclear factor-kappa B (NF-kappaB) signaling in activated rat hepatic stellate cells (HSCs) and explore the mechanisms of danshensu for inhibiting hepatic fibrosis.

METHODSMTT colorimetric assay was used to detect the proliferation of rat HSCs treated with danshensu, and the apoptosis of the cells was analyzed with Annexin- V-FITC/PI and AO/EB staining. The expressions of P-IkappaB-alpha, NF-kappaBP65 and JNK in HSCs stimulated by IL-1beta with subsequent danshensu treatment were observed by Western blotting. Type III collagen in the medium of HSCs was detected by ELISA and immunocytochemistry.

RESULTS AND CONCLUSIONSDanshensu inhibited the activation and proliferation of HSCs, and increased the apoptotic rate of HSCs and reduced the synthesis and secretion of type III collagen. Danshensu showed obvious inhibitory effect on JNK and P-IkappaB-alpha phosphorylation and NF-kappaBP65 expression in HSCs stimulated by IL-1beta. The mechanism of the actions of dansgensu may be mediated by inhibition of JNK and NF-kappaB signal transduction.

Animals ; Down-Regulation ; Hepatic Stellate Cells ; cytology ; metabolism ; Interleukin-1beta ; pharmacology ; Lactates ; pharmacology ; MAP Kinase Kinase 4 ; metabolism ; Male ; Rats ; Rats, Wistar ; Signal Transduction ; drug effects ; Transcription Factor RelA ; metabolism

Adult ; Disease Outbreaks ; Humans ; Metapneumovirus ; Paramyxoviridae Infections ; epidemiology ; Respiratory Tract Infections ; epidemiology ; virology ; Students

Objective To isolate and identify the adult neural stem cells from the parenchyma of spinal cord in adult mouse.Methods The parenchymal spinal cord from adult mouse was dissected and dissociated by mechanical trituration.The tissue suspension was cultured in serum-free DMEM/F12 medium supplemented with EGF and B27.The cell colonies generated from a single cell were screened by limited dilution and incubated with BrdU.The cell colonies were transferred into medium with serum to induce differentiation.The cells were identified with antibodies to Nestin,BrdU,MAP2 and GFAP by immunofluorescence staining.Results The cells were cultured for seven days to generate proliferative neurospheres.The majority of cells in these neurospheres expressed Nestin and were differentiated into MAP2-positive cells and GFAP-positive cells in medium containing with fetal bovine serum.Conclusion A significant number of neural stem cells are present in the parenchymal adult mouse spinal cord and can proliferate and also give rise to neurons and glia in vitro.

Objective: To analyze the current situation of gross motor development of infants in nine cities of China and their relationship with physical growth. Methods: Healthy full-term infants aged 1-24 months were investigated by cross-sectional survey, which was carried out in nine cities (Beijing, Harbin, Xi'an in northern, Shanghai, Nanjing, Wuhan in central, and Guangzhou, Fuzhou, Kunming in southern regions of China) from June to October in 2015. Subjects were grouped into 12 age groups (1-<2, 2-<3, 3-<4, 4-<5, 5-<6, 6-<8, 8-<10, 10-<12, 12-<15, 15-<18, 18-<21, 21-<24 months). Gross motor development of infants was examined by fieldworkers and the information on parental education, family income and birth status were obtained by questionnaire. Weight, length and head circumference was measured by fieldworkers according to standard methods in the fields and their Z scores were calculated by using WHO growth standard. Z scores of weight (WZ), length (LZ) and head circumference (HCZ) <-2 s was considered as lower group, -2 s-<-1 s as medium-lower group, -1 s-1 s as medium group, 1 s-<2 s as medium-higher group and ≥2 s as higher group. The age of gross motor development was calculated by Probit regression analysis and χ² test was used for comparison of categorical data. Results: (1) The number of infants whose gross motor development was examined were 88 968 in the nine cities. The proportion of achievement of motor development became larger with the chronological age, i.e. it was 11.1% (800/7 236) at 5-<6 months, 65.2% (4 921/7 545) at 6-<8 months and 98.5% (7 417/7 531) at 8-<10 months for sitting alone without support. There was no gender difference in the proportion of achievement of sitting alone without support, hand-knee crawl, stand alone and walk alone (χ²=2.873, 0.275, 0.250, 0.576, all P>0.05). (2) The median age of achievement of sitting alone without support, hand-knee crawl, stand alone, walk alone was respectively 5.9, 7.8, 10.8, 13.0 months, and their ranges from 1^st to 99^th percentile were respectively 4.2-8.3 months, 4.9-12.6 months, 7.6-15.4 months, 9.8-17.4 months. The gender difference of median age of gross motor development was 0.0-0.1 months and their regional difference was 0.0-0.7 months. (3) In the lower weight group, their median age of sitting alone without support and walk alone were 0.2-0.6 months later than the medium weight group, while their median age of hand-knee crawl and stand alone were similar to those of the medium weight group. In higher weight group, the median age of sitting alone without support and stand alone were similar to that of the medium weight group, while their median age of hand-knee crawl was 0.3 later months and their median age of walk alone was 0.3 months earlier than that of the medium weight group. There was no significant relationship between length and the age of sitting alone or standing alone (the difference was 0.0-0.2 months in each group). The median age of hand-knee crawl and walk alone was 0.4-0.7 months later in lower length group than in other length groups. The median age of gross motor development was similar among different head circumference groups (0.0-0.2 months). The relationship between weight/length and motor development was similar to that between weight and motor development. Conclusions There were no gender difference and slightly regional difference in the age of achievement of gross motor skills. The percentile age of gross motor skills helps to understand the population variation in healthy infants. The gross motor development is related with weight, length and body proportion.

Objective: To investigate the status of the development of primary teeth and to identify the development patterns among infants and toddlers in nine cities of China in 2015. Methods: Healthy children aged 1-<36 months were investigated by across-sectional survey and retrospective studies, which was carried out in 9 cities (Beijing, Harbin and Xi′an in northern China; Shanghai, Nanjing and Wuhan in central China; and Guangzhou, Fuzhou and Kunming in southern China) from June to October in 2015. Subjects (n=103 995) were divided into 14 age groups (1-<2, 2-<3, 3-<4, 4-<5, 5-<6, 6-<8, 8-<10, 10-<12, 12-<15, 15-<18, 18-<21, 21-<24, 24-<30, 30-<36 months). There were 150-200 boys and girls respectively in each group of urban and suburb areas in each city. The eruption status and the number of primary teeth were examined by the trained child health care physician or pediatrician on the spot. The timing of primary teeth eruption of children was retrospectively surveyed using a questionnaire. The prevalence of primary teeth was calculated and χ² test was used for comparison of categorical data. Probit regression analysis was used to determine the median and percentile age of eruption of primary teeth. Results: Totally 103 995 children aged 1-<36 months were investigated. There were 52 346 children in urban areas (boys 26 228, girls 26 118) and 51 649 children in suburb areas (boys 25 912, girls 25 737). The eruption rate of primary teeth in children under 2 years became higher with age and the difference among each age group was statistically significant (χ²=85 913.868, P<0.01), which was 0.3% (22/7 450) in 3-<4 months group, 43.0% (3 227/7 503) in 6-<8 months group and 99.9% (7 441/7 446) in 15-<18 months group. The eruption age of primary teeth was 6.6 months (95%CI: 6.5-6.7 months), and the range of the 3rd to 97th percentile was 4.1-10.6 months. The eruption ages of primary teeth in urban and suburb areas children were 6.6 months (95%CI: 6.5-6.7 months) and 6.6 months (95%CI: 6.5-6.7 months) respectively. The eruption age of primary teeth was earlier in boys (6.4 months, 95%CI: 6.3-6.5 months) than that in girls (6.7 months, 95%CI: 6.6-6.8 months). The median eruption age of primary teeth was earlier in northern China (6.2 months) than that in central (6.7 months) and southern China (6.9 months). The eruption rate of primary teeth became higher with age, showing that the median number of primary teeth was 2 in 8-<10 months group, 8 in 12-<15 months group and 20 in 30-<36 months group. Conclusions The timing of eruption of primary teeth was similar between urban and suburb areas children and that of the boys was slightly earlier than that of the girls. There were slight differences among different regions in the eruption timing of primary teeth. The range of the 3rd to 97th percentile in the eruption age of primary teeth was 4.1-10.6 months and the number of primary teeth followed the regular development pattern with age.