This paper gives the statistical analysis on the examination of Computer-Based Case Simulation to test 350 undergraduate clinical medical students of 5th or 6th year students,and analyses the statistical items of examination,then gives some discussion and reasonable suggestions.Finally,the author makes a series of discussion and views in the application of the medical education evaluations in future.

Objective: To observe the changes of somatosensory evoked potential(SEP) and nitric oxide (NO) after subarachnoid hemorrhage(SAH), and the influence of Ginkgo biloba extract (EGb). Method: Rats in sham-operated group, SAH model group and EGb-treated group underwent measurement of dynamic changes of regional cerebral blood flow( rCBF),SEP and NO levels both in serum and in brain tissue within 24h after operation. Result: In SAH group, rCBF decreased immediately after operation, with no tendency to recover within 24h. The latency of SEP delayed progressively from 1h to 24h after SAH. NO levels in serum and in brain tissue decreased and increased respectively from 1h to 24h after SAH. EGb effectively antagonized the changes of above parameters. Conclusion: SEP is helpful in the judgement on brain ischemic damage after SAH. Decrease of NO in serum and increase of that in brain tissue may lead to cerebral vasospasm and ischemic brain damage respectively after SAH. EGb relieves SAH-induced brain ischemic damage by reversing the pathological alterations of NO.

Irreducible anteromedial radial head dislocation (IARHD) caused by transposed biceps tendon is rare. Delayed diagnosis and surgical failure often occur. A 46-year-old fisherman presented with 10 days history of painful swelling and restricted movement of his right elbow due to strangulation injury by a fishing boat cable. On examination, the images of the right elbow reveals in a "semi-extended and pronated" elastic fixation position. Radiography and 3-dimensional reconstruction CT reveals an isolated anteromedial radial head dislocation with extreme protonation of the radius and the bicipital tuberosity towards the posterior aspect of the elbow joint, and MRI shows biceps tendon wrapping around the radial neck, similar to umbilical cord wrapping seen in newborns. The Henry approach was applied for the first time to reduce the biceps tendon. The patient achieved a good functional recovery at 26 months, which represents the first reported case of IARHD without fracture caused by biceps tendon in an adult. In treatment of IARHD, attention should be paid to the phenomenon of biceps tendon transposition. Careful clinical examination, comprehensive imaging modalities, and appropriate surgical approach are the keys to successful management.

OBJECTIVETo culture and amplify the young rabbit's bone marrow stromal cells (BMSCs) in vitro, and to observe the effect of hypothermia on the cells' growing behavior and biological function.

METHODSBMSCs were acquired from the rabbit' tibia bone marrow and induced to mature osteoblasts in vitro. The cultured cells growing well in vitro were preserved in liquid nitrogen. The anabiotic cells having cryopreserved for 1 week were chosen as the experimental group, and the routine 7th generation as the control group. Their biological function in comparion by the examination of morphological changes, cells' proliferation ability, colone forming ratio, synthesis ability of ALP and protein, mineralized nodes forming ability were observed.

RESULTSAs contrast to the control groups, the anabiotic cells also grew and proliferated well in vitro except a little more slowly than before. They had the similar general shape in all the time segments, but a little differences in cells' ultrastructure. The experimental groups also had the typical characters of mature osteoblasts, and high abilities of the synthesis of ALP and proteins. The statistic data showed that these two groups had no significant difference (P > 0.05).

CONCLUSIONThe cryopreserved osteoblasts had the same biological functions and the similar growing behaviors as before. These results suggest that it is practical to use the cryopreserved osteoblasts for further study on bone tissue engineering.

Animals ; Bone Marrow Cells ; Bone and Bones ; Cell Differentiation ; Cell Proliferation ; Cells, Cultured ; In Vitro Techniques ; Osteoblasts ; Rabbits ; Tissue Engineering

OBJECTIVETo observe the clinical effect of the combined therapy using argon-helium cryosurgery (Ar-He knife) and Chinese herbal medicine in treating non-small cell lung cancer (NSCLC).

METHODSFifty-seven patients of NSCLC were treated with the combined therapy and observed.

RESULTSThe treatment was successfully completed in all patients with mild adverse reactions. The effective rate was 83.8% 3 months after the operation, 79.6% 6 months after the operation, and 77.3% 12 months after the operation, with median survival of 9 months. The survival rate after 12 months was 46.67% (21/45), 34.62% (9/26) after 18 months, and 36.36% (4/11) after 24 months.

CONCLUSIONArgon-helium cryosurgery therapy is superior in its assured orientation, quick tumor load deprivation and less postoperational reaction. Combined with Chinese herbal medication, Argon-helium cryosurgery therapy can prolong survival time, relieve clinical symptoms, and elevate the quality of life in NSCLC patients, and is thus worthy of promotion.

Adult ; Aged ; Argon ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; mortality ; surgery ; Combined Modality Therapy ; Cryosurgery ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Female ; Helium ; Humans ; Karnofsky Performance Status ; Lung Neoplasms ; drug therapy ; mortality ; surgery ; Male ; Middle Aged ; Postoperative Period ; Survival Rate ; Treatment Outcome

OBJECTIVETo study the validity of criteria currently used in China for the classification of symmetric small for gestational age infants (SGA) as compared with its definition.

METHODSThis study included 417 inpatients diagnosed as SGA in authors' hospital from January 1998 to June 2002. Symmetric SGA was diagnosed by the following three criteria: (1) the Ponderal Index (PI), (2) the crown-heel length-to-head circumference ratio (BL/HC) issued in Chin J Pediatr (1988;26:164 - 165), as well as (3) the SGA definition. The definition criterion was considered as the "gold standard". The sensitivity, specificity, false positive and negative values, positive and negative predictive values, exact agreement ratio, diagnosis index, and Cohen's Kappa value were used to evaluate the validity and agreement of the methods of PI and BL/HC. Receiver Operating Characteristic (ROC) analysis was used to evaluate the validity of the diagnosis.

RESULTSOf 417 SGA infants, 376 (90.17%), 376 (90.17%) and 187 (44.84%) subjects were diagnosed as symmetric type with PI, BL/HC and the definition criteria, respectively. (2) The agreement rate and Kappa value between PI and BL/HC was 80.82% and -0.093 (SEM 0.026), respectively. And the agreement rates between PI or BL/HC and the definition criterion were 49.88% and 50.84%, respectively. As compared with the definition criterion, the PI and BL/HC methods had sensitivities of 91.8% - 96.4%, specificities of 9.3% - 25.9%, positive predictive values of 45.8% - 51.1%, negative predictive values of 72.7% - 82.8%, diagnosis indices of 4.9% - 17.7% and Kappa values of 0.070 - 0.167. (3) The areas under the ROC curves in full-term and preterm infants by PI method were 0.635 (95% CI, 0.573 - 0.697) and 0.698 (95% CI, 0.622 - 0.725), respectively. PI cutoffs at 2.47 in full-term SGA, at 2.43 in preterm SGA, and BL/HC cutoff at 1.43 produced the maximum diagnosis indices that were 24.7%, 39.6% and 33.7%, respectively. When the PI at 2.50 (full-term), PI at 2.31 (preterm) and BL/HC values at 1.46, the sensitivity closed mostly to the specificity. The sensitivities and specificities in full-term and preterm infants were 59.4% and 59.3%, 65.3% and 65.5%, and 66.3% and 65.5%, respectively.

CONCLUSIONIn the classification of SGA, the results showed a poor agreement between PI or BL/HC and the definition criterion. The results suggested that the current cutoffs of PI and BL/HC might not be appropriate for the diagnosis of symmetric SGA. Low AUC suggested that PI and BL/HC could not give a valid diagnosis at any cutoffs.

Anthropometry ; methods ; Birth Weight ; Body Height ; China ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature ; Male ; Reproducibility of Results ; Sex Factors

Objective To explore and integrate the key techniques used in the surveillance and forecast of schistosomiasis in the water regions along the Yangtze River,so as to provide technical support for identifying rapidly the risk of schistosomiasis transmission and implementing control measures targeting the risk. Methods According to the distribution of water systems and water regions along the Yangtze River in Jiangsu Province,the demonstration sites for surveillance and forecast of schistoso? miasis were set across the province,where the integration and demonstration of the techniques regarding monitoring of Schistoso?ma japonicum infection in sentinel mice,human and animal activities,release of forecast information,and emergency treat?ment of water regions at risk of infection were performed. The pattern of human and animal activities was compared with the S. ja?ponicum infection in sentinel mice in the demonstration sites,and the operability of the release of information and emergency treatment of the risk of S. japonicum infection was evaluated. Results A total of 50 demonstration sites for surveillance and forecast of schistosomiasis were set in fixed anchor points,opening of the navigation lock to the Yangtze River,freight terminal, agritainment places,ferry,large construction places,and places for guaranteeing the Youth Olympic Games in 23 counties(dis?tricts)of 5 cities,Jiangsu Province. During the period between May and September,2014,the infectivity of water body was monitored by using 5 batches of sentinel mice,with a 99.06%(4 954/5 001)gross recovery rate of mice. S. japonicum infection was detected in a demonstration site,and an infected mouse was found,with a 0.02%(1/4 933)gross positive rate of sentinel mice. The field survey showed 2 088 person?times contacting water,including 91.95%(1 920/2 088)contacting water due to the production such as capturing fish,harvesting and cultivating crops,and repairing and building boats,and 8.05%(168/2 088)contacting water due to the life activity,such as fishing,washing vegetables and playing with water. The people contacted water predominantly in August and September(49.57%). A total of 859 boats containing 1 877 boatmen were observed,68.22%(586/859)of which were fishing boats containing 1 306 fishermen(69.58%). There were 32 sheep found in 4 demonstration sites,and 3 sheep were seen in the demonstration site with infected sentinel mouse. Four blue forecasts(emergence of water con?tact)and one orange forecast(S. japonicum?infected sentinel mouse detected)were released across the province,with one fore?cast map released which showed 5 sites with fishing and one site with sheep grazing,one emergency response system initiated, mollusciciding implemented in 10 hm2 high?risk regions,120 sheep grazed in fence,and 35 fishermen given health?education materials,schistosomiasis examination and preventive therapy. In addition,no acute schistosomiasis occurred in the demonstra?tion site with S. japonicum?infected sentinel mice. Conclusions The integration and demonstration of the techniques regarding monitoring of S. japonicum infection in sentinel mice,human and animal activities,release of forecast information,and emer?gency treatment of water regions at risk of infection provides an effective approach for the large?scale surveillance and forecast of schistosomiasis.

Objective To evaluate the characteristics of 99Tcm-ciprofloxacin and explore its feasibility in early detection of secondary infectious foci of severe acute pancreatitis (SAP).Methods Ciprofloxacin was labeled with 99Tcm.The labeling efficiency and radiochemical purity of 99Tcm-ciprofloxacin were calculated and its biodistribution in normal pigs was measured.The recruited baby pigs were divided into three groups:normal control group (6), non-infected group (6) and infected group (16).370-400 MBq of 99Tcm-ciprofloxacin was injected into each pig intravenously.SPECT scanning was performed at 0.5, 1,2, 3, 4 and 6 h after administration.The differences of 99Tcm-ciprofloxacin uptake among groups were calculated and the tracer activity ratio of lesion-to-background was recorded at each time point.The diagnostic value of 99Tcm-ciprofloxacin SPECT imaging for the dectection of secondary infection of SAP was assessed using histopathological results as the gold standard.Variance analysis and least significant difference test were used to analyze the data.Results Both the labehing efficiency and radiochemical purity of 99Tcm-ciprofloxacin were over 90% within 6 h.Organs with rich blood supply, such as kidney, liver and spleen were the target organs for the accumulation of 99Tcm-ciprofloxacin; while no significant uptake was found in gastrointestinal tract or normal pancreas tissue of SAP.Rapid plasma clearance and renal excretion were observed.In the infected group, the lesion was visualized at 1 h after administration.The highest radioactivity ratio of lesion-to-background (3.36 ± 0.33) was at 3 h after administration, which was significantly higher than that of the other time point ( F =99.570, P ＜0.001 ).The sensitivity, specificity, positive and negative predictive values, Youden's index (YI) and Kappa value of 99Tc%ciprofloxacin imaging were 88.2% (15/17), 83.3% (5/6), 93.8% ( 15/16), 71.4% (5/7), 0.715 and 0.667 respectively.Conclusions The biodistribution of99Tcm-ciprofloxacin is suitable for imaging infectious focus of SAP.The optimal imaging time for the detection of secondary infection of SAP is 3 h after administration, with high sensitivity and specificity.

To investigate the changes in bcl-2, bax expression and neuron apoptosis in the hippocampus after the blockade of cervical lymphatics, the model of lymphostatic encephalopathy was established by occluding and removing both the superficial and deep cervical lymph nodes in rats. The animals were sacrificed at 1, 2, 3, 5, 7 and 14 d after operation. H and E staining was used to observe the structure of brain tissues and TUNEL staining was used to detect in situ cell apoptosis in the hippocampus. The expression of bcl-2 and bax in the hippocampus were examined by RT-PCR. The results showed that cerebroedema appeared at day 2 and was most serious at day 5 after the blockade of cervical lymphatics. The number of TUNEL positive cells began to increase at day 2 and reached the maximum at day 5. The expression of bax began to increase at day 1 and reached the maximum at day 2. The expression of bcl-2 began to decrease at day 1 and dropped to the minimum at day 5. The items mentioned above recovered to control level at day 14. These results suggest that lymphostatic encephalopathy following the blockade of cervical lymphatics result in changes in bcl-2 and bax expression in the hippocampus and that apoptosis is the main form of neuron death.
Animals ; Apoptosis ; physiology ; Female ; Hippocampus ; metabolism ; pathology ; Lymph Node Excision ; Lymphatic System ; physiology ; Male ; Neck ; Neurons ; cytology ; Proto-Oncogene Proteins c-bcl-2 ; genetics ; metabolism ; Random Allocation ; Rats ; Rats, Wistar ; bcl-2-Associated X Protein ; genetics ; metabolism

Objective To study the pharmacokinetics of omeprazole tablets in Chinese Hui and Han healthy volunteers.Methods Twenty volunteers were involved in the study,including ten Chinese Hui volunteers and ten Han volunteers.Each healthy volunlteers were given asingle oral dose(40 mg)of omeprazole tablet.The concentration of omeprazole in plasma was determined by RP-HPLC and the pharameters were calculated by DAS 2.0 software.Results The main pharmacokinetic parameters of Chinese Hui and Han were as follows:C_(max) were (941.94±446.08) and (760.49±581.23) μg·L~(-1);t_(max) were(2.7±0.68)and(2.70±0.82)h;t_(1/2) were(2.43±2.83)and(1.60±1.28)h;AUC_(0-12) were (2.29±1.12)and(1.44±7.98)mg·h·L~(-1);AUC_(0-∞) were (2.33±1.11)and(1.47±7.69)mg·h·L~(-1),respectively.Conclusion Individual difference is significant in C_(max),AUC_(0-12),AUC_(0-∞) after an oral omeprazole,but the pharmacokinetic parameters obtained from the results of ststistical analysis show no significant difference in the main pharmacokinetic of omeprazole between Chinese Hui and Han.