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Objective Evaluation the effect to improve the eight-year program medical students` comprehensive ability between standard of PBL mode and complex scenarios PBL mode.Methods To comparative improved teaching quality between complex scenarios PBL teaching mode and standard of the PBL teaching mode by final exam scores and DREEM scale.Results The complex scenarios PBL teaching mode improve the ability of problem solving score significantly higher than the standard scores of PBL teaching mode at the start of analyzing questions and help students to stimulate interest, increase self-confidence, (P<0.05).Comparative analysis shows the comprehensive thinking ability of medical students has improved significantly.ConclusionsComplex scenarios PBL teaching mode can improve the ability of handling the students` study enthusiasm, comprehensive ability and strain capacity more effectively than that of standard PBL teaching mode.The obvious effect is worth promoting.
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Objective To investigate the value of early trophic feeding on maintenance of the integrity of intestinal mucosa barrier in severe traumatic patients.Methods The seriously traumatic patients were eligible for enrollment to this study from January 1st,2014 to March 31st,2015 in the intensive care unit of Xiangcheng People's Hospital.All patients were randomly divided into early enteral nutrition (EEN)group and the control group.Within 12 to 24 hours after ICU admission,all patients were fed on enteral nutrition.In the EEN group,the nutrient was reached to 25％ of target nutrient amount [104.6 kJ/ (kg · d)],and in the control group,the nutrition was reached to 60％ of the target nutrient amount.Comparisons of feeding intolerance,incidence of newly developed lung infection,the total length of hospital stay,ICU medical costs,and the markers of mucosa barrier function including lactulose/mannitol ratios (L/M),serum lactic acid level,and diamine oxidase (the first day,the third day and the seventh day) between two groups were carried out.Results Of them,56 patients were treated with early enteral nutrition.Early enteral feeding intolerance and ICU associated infection complications were significantly lower in EEN group than those in control group (P =0.012,P =0.046).There were no significant differences in ICU associated infection complications,the length of ICU stay,the length of hospital stay,ICU medical costs,L/M ratios,D-lactic acid level and diamine oxidase concentration between the two groups (P=0.135,P=0.126,P =0.223,P =0.235).Conclusions Under the seriously traumatic stress,the significantly increased intestinal mucosal permeability will be occurred early.In patients with early trophic feeding,the intestinal mucous membrane barrier function can be improved,thus decreasing ICU associated infection complications and incidence of feeding intolerance.
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Objective To investigate the value of early trophic feeding on maintenance of the integrity of intestinal mucosa barrier in severe traumatic patients.Methods The seriously traumatic patients were eligible for enrollment to this study from January 1st,2014 to March 31st,2015 in the intensive care unit of Xiangcheng People's Hospital.All patients were randomly divided into early enteral nutrition (EEN)group and the control group.Within 12 to 24 hours after ICU admission,all patients were fed on enteral nutrition.In the EEN group,the nutrient was reached to 25％ of target nutrient amount [104.6 kJ/ (kg · d)],and in the control group,the nutrition was reached to 60％ of the target nutrient amount.Comparisons of feeding intolerance,incidence of newly developed lung infection,the total length of hospital stay,ICU medical costs,and the markers of mucosa barrier function including lactulose/mannitol ratios (L/M),serum lactic acid level,and diamine oxidase (the first day,the third day and the seventh day) between two groups were carried out.Results Of them,56 patients were treated with early enteral nutrition.Early enteral feeding intolerance and ICU associated infection complications were significantly lower in EEN group than those in control group (P =0.012,P =0.046).There were no significant differences in ICU associated infection complications,the length of ICU stay,the length of hospital stay,ICU medical costs,L/M ratios,D-lactic acid level and diamine oxidase concentration between the two groups (P=0.135,P=0.126,P =0.223,P =0.235).Conclusions Under the seriously traumatic stress,the significantly increased intestinal mucosal permeability will be occurred early.In patients with early trophic feeding,the intestinal mucous membrane barrier function can be improved,thus decreasing ICU associated infection complications and incidence of feeding intolerance.
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Objective To discuss the metabolic characteristics and significance of peripheral blood cell and T lymphocyte subgroup in patients with air condition disease.Methods Thirty-six patients diagnosed as air condition diseases with fever and 30 patients diagnosed as non-fever patients enrolled this study as observation group(fever group and non-fever group respectively),and 30 health population were used as control.The changes of peripheral blood cell and T lymphocyte was measured using regular blood examination and flow cytometry.Results(1)No significant diffence on white blood cell was found between the three groups(F =1.89,P =0.134);(2)The percentage of neutrophils was(68.13 ±5.67)％,(53.24 ±8.36)％ and(61.25 ±6.31)％ respectively in the fever,non-fever and control group,respectively.Compared to the non-fever and control group,the percentage of neutrophils were significantly higher(t =6.64,9.13; P =0.018,0.027 respectively).No signiciant difference in the percentage of neutrophils was found between the non-fever group and control group(P =0.356,0.125).The percentage of lymphocyte percentage was(31.66 ±7.11)％,in the fever group,which was significantly higher than those of(43.67 ±8.17)％ and(30.98 ± 8.76)％ in the nonfever and control group(t =5.59,4.98 ; P =0.022,0.021 respectively).(3)The percentage of CD4 + was (36.351 ± 6.531)％,(42.676 ± 5.169)％ and(39.253 ± 5.461)％ in the fever,non-fever and control group,respectively.The percentage of CD4 + in the fever group was significantly lower than that in the non-fever group(t =1.28,P =0.039),whereas the percentage of CD4 + in the non-fever group was significantly higher than that in the control group(t =3.80,P =0.048).The percentage of CD8 + was(28.084 ± 7.344)％,(21.186 ± 6.331)％ and(24.607 ± 7.108)％,respectively.Compared to nonfever group,the percentage of CD8+ was significantly higher(t =3.17,P =0.016).(4)The ratio of CD4 +/CD8 + was(1.629 ±0.554)％、(2.380 ± 0.391)％,and(2.079 ± 0.659)％.Compared to the non-fever and control group,the ration in the fever group was siginificantly lower(t =19.21,P ＜ 0.001 ; t =6.98 ; P =0.006),whereas compared to the control group,the ratio in the non-fever group was significantly higher(t =8.68,P =0.031).Conclusion The changes of T subgroup show the unbalance immunity function network in patients with air condition disease.
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Objective: To observe the characteristic changes of specific immunological function of serum endo toxin level,spleen lymphocyte human leukocyte antigen(locus) DR(HLA-DR),limphopolesis and positive expression of caspase-3 in rats with sepsis and the effect of Xuebijing injection(血必净注射液) on their immunological function.Methods: Sepsis model was produced by cecal ligation and puncture(CLP).Seventytwo male SD rats were randomly divided into four groups: sham operation,model,levofloxacin and Xuebijing injection.Blood samples were taken from the vein in the abdominal cavity at 3,24 and 72 hours after the models were established, afterwards the rats were sacrificed and their spleens were taken out.Matrix development process was employed to examine the level of serum endotoxin,FACS flow cytometer was used to examine the expression level of HLA-DR,immunohistochemistry method was applied to examine the positive expression of caspase-3 in spleen,and the method of methyl thiazolyl tetrazolium(MTT) was employed to examine the lymphopoiesis.Results: The levels of serum endotoxin,lymphopoiesis and caspase-3 positive expression index in model group were obviously elevated than those of sham operation group,and percentage of HLA-DR was markedly lowered(all P
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OBJECTIVE To study the characteristic change of the expression of caspase 3 of spleen in different sepsis rats.METHODS We designed sepsis model by cecal ligation puncture,divided into five groups,sampled tissue in 3,24 and 72 h after model built,and compared the change between groups.We employed the immuno-histochemistry to examine the positive expression of caspase 3 in spleen,and examined the index of apoptosis in different groups.RESULTS The result showed that three traditional Chinese medicine compounds could significantly cut down the expression of caspase 3 in spleen lymphocyte.CONCLUSIONS The three traditional Chinese medicine compounds could decrease the apoptosis of lymphocyte,and adjust the immunity.