The training of clinical skill is closely linked with medical personnel education.However,traditional paper-type training materials were unable to meet the training needs.As a new type of training materials,trial-and-error video-type clinical skill training materials (abbreviated as TEVT clinical skill training materials) have gradually attracted attention with its characteristics of lively and interesting,potentially informative,high acceptance among students,the advantages' of stimulating students' initiative exploration and consideration,fostering students' critical spirit and humanities.On the basis of analyzing the advantages' of TEVT training materials,we discussed the developing specialties of TEVT clinical skill training materials from four aspects as the material orientation and the application object,material sources,constructing the developing team and editing the teaching materials.Furthermore,we reflected the application prospect of TEVT clinical skill training materials in the future,in order to explore an available implementation path for the development of TEVT clinical skill training materials.

Objective To investigate the clinical characteristics of patients with polyarteritis nodosa (PAN),and to improve the understanding of the disease.Methods The data of 65 consecutive PAN patients admitted to Peking Union Medical College Hospital from October 2001 to March 2013 were analyzed.Patients were divided into two groups based on hapatitis B surface antigen (HBsAg) status.Chi-square test,Fisher exact probability,t test and Mann-Whitney test were used for statistical analysis.Results The male/female ratio of patients with PAN was 1.3/1,and the average age was (37.6±1.6) years old.Fever (in 40 cases,62％) was the most frequent manifestation.Skin was involved in 51 cases (79％),urologic involvement in 44 cases (68％),peripheral nervous system involvement in 22 cases (34％) and gastrointestinal involvement in 21 cases (32％).Forty-six (71％) patients had high-sensitivity C reactive protein (hs-CRP) elevation and 11 (17％) patients had eosinophil count elevation.The most common vascular involvements were limb arteries in 22 cases (34％),renal artery in 19 cases (29％),and gastrointestinal artery in 17 cases (26％).Patients with negative HBsAg had more frequent arthralgia or arthritis(41％ vs 9％,x2=4.00,P＜0.05),more indicators of poor prognosis (30％ vs 0,P＜0.05) and more glucocorticoid pulse therapy (30％ vs 0,P＜0.05) when compared with patients with positive HBsAg.Conclusion Clinical manifestations of PAN are complex.Young patients with fever of unknown origin,rash,weight loss,myalgias,accompanied by symptoms of multi-organ damage including urologic,peripheral nervous system,gastrointestinal involvement and negative autoantibodies should be highly suspected for the diagnosis of PAN.For the treatment of patients with positive HBsAg,special attention should be paid to maintain the delicate balance between controlling the organ damage caused by PAN and prevention of hepatitis B virus (HBV) infection reactivation.

Drugs, Chinese Herbal ; therapeutic use ; Humans ; Phytotherapy ; Precancerous Conditions ; drug therapy ; pathology ; Stomach Neoplasms ; drug therapy ; pathology

Objective To study the feasibility of using chitosan membrane to carry and transport melanocytes, in order to refine the technique for melanocyte transplantation with chitosan membrane. Methods Melanocytes were inoculated onto chitosan membrane and cultured for a period of time, then, electron microscopy,MTT assay and NaOH assay were carried out to estimate the adherence, growth and melanogenesis of the melanocytes. Skin wound surface was prepared in 12 nude mice, which were equally divided into 3 groups, test group inoculated with melanocytes on chitosan membrane, negative control group I treated with chitosan membrane without melanocytes, and negative control group II directly dressed immediately after the preparation of wound surface. On day 10 and 20 after the transplantation, confocal laser microscopy and immunohistochemistry were performed to observe the migration of melanocytes into the skin wound surface. Results Scanning electron microscopy and inverted microscopy showed that melanocytes were evenly distributed on and adhered well to the underlying chitosan membrane. As the growth curve of melanocytes demonstrated, chitosan membrane could support the normal growth of melanocytes, and no significant difference was observed in the synthesized melanin content between melanocytes cultured on the chitosan membrane and those in culture disks (0.087 ± 0.027 vs. 0.101 ± 0.036, t = 0.79, P > 0.05). Melanocytes were seen at the transplantation sites by confocal laser microscopy, and biopsy specimens from the transplantation sites stained positive for antimelan-A monoclonal antibody. Conclusions Melanocytes can adhere to and grow on the chitosan membrane,which can facilitate the migration of melanocytes to the transplantation sites in animals with the maintenance of biological activity of melanocytes.

Animals ; Bridged-Ring Compounds ; poisoning ; Disease Models, Animal ; Female ; Male ; Mice ; Sodium Oxybate ; therapeutic use ; Unithiol ; therapeutic use

Objective To observe the expression of protein kinase C(PKC)isoforms in pulmonary artery of chronic inflammatory pulmonary hypertension(PHT)rats.Methods Chronic inflammatory PHT model rats were established induced by monocrotaline(MCT).Western blotting analysis was used to detect the expression of four PKC isoforms(PKC?,PKC?Ⅱ,PKC? and PKC?)in pulmonary arteries of rats during the development of PHT.Results The values of mean pulmonary artery pressure and right ventricular hypertrophy index increased significantly after the injection of MCT,which suggested successful formation of PHT.Western blotting analysis showed that PKC?,PKC?Ⅱ and PKC? isoforms were presented in pulmonary arteries of normal and PHT rats,while PKC? isoform was not detected.The expressions of PKC? in both cytosolic and membranous fractions increased within 14 days,and decreased a little during the development of PHT.But the increase of PKC? in cytosolic fraction was much more obvious than that in membranous fraction.The highest expression of both PKC?Ⅱ and PKC? in cytosolic fractions appeared at the eighth day,while the expression of both isoforms in membranous fraction went up continuously.Conclusions PKC?,PKC?Ⅱ and PKC? isoforms were involved in the development of chronic inflammatory PHT.The changes of their expression might be the results of PKC isoforms translocation which is related to the proliferation regulation of pulmonary artery smooth muscle cells.

Health Education ; Humans ; Occupational Health Services ; Rural Population

Objective To establish an accurate, rapid and practical method for determination of lead in whole blood by graphite furnace atomic absorption spectrometry. Methods It can improve the accuracy and precision of the method by digesting blood sample in nitric acid at constant 135℃, adding matrix to standard series, using matrix modifier and changing ashing temperature of the graphite furnace. Results The linear range, detection limit, mean recovery rate and combination coefficient of variation of the method were 0-50 ?g/L, 1.96 ?g/L, 92.2% and 6.5% respectively. Conclusion This method shows some advantages such as low background, little interference, simple, rapid, sensitive, repeatable and accurate.

[Objective]To summarize clinical experience of Pemberton's ilium osteotomy in developing hip dislocation and emphasize the combined and individual principles in the clinical practice. [Methods]From February 1996 to April 2007,26 patients(aged 3 to 10 years) with 28 hips were operated on together with soft tissue solution,a pericapsular osteotomy of the ilium (Pemberton) and an optional femoral rotational,shortening or varus osteotomy of the proximal femur. Pre-and post-operative indexes including those of AI angle,CE angle and deep of acetabulum were compared. According to Severin's classification and McKay clinical curative effect evaluation critera,these indexes were evaluated.[Results]According to the Severin's classification,the results were rated as 64.3% excellent,28.6% good and 7.1% fair.On the McKay's critera ,the functional results were graded as 50.0% excellent,35.8% good,7.1% fair and 7.1% poor. On the whole,the radiographic evaluation was superior to that of the functional results.[Conclusion]The Pemberton's osteotomy is safe and effective.The combined surgical treatment can improve the success rate and decrease complications.

Epidermal growth factor receptor (EGFR) inhibitors are currently widely used for targeted lung cancer therapy. Target-ed therapy evaluation principally relies on genetic testing or rough clinical estimation. PET receptor imaging is highly sensitive and spe-cific. According to domestic and foreign literature, PET imaging using radiolabeled EGFR-targeting agents can be used to predict and monitor therapy response. This paper presents new evaluating methods for targeted lung cancer therapy.