Application of "hand-foot combination" method used in clinical teaching / 中华医学教育探索杂志

The concept of "hand-foot" teaching method was first formed and applied in orthopedic teaching. In the class of bone and joint anatomy and diseases, the students can understand them more thoroughly and memorize them more easily by gestures of hands and feet. In learning the classification of lumbar disc herniation, the body is compared to the dural sac and the arms are compared to the nerve roots, which perfectly explains the types of lumbar disc herniation. The clinical manifestations of nerve injury in limbs were explained by the anatomical similarity of upper and lower limbs. We also explain the position variation of appendix by different directions of the thumb. In the same way, the "hand-foot" teaching method are used to explain the female reproductive system and so on. The "hand-foot" method has been widely applied in clinical teaching of many disciplines and achieved good effect in teaching practice.

On the Effect of Peer-assisted learning in the teaching of pelvic fractures / 中华医学教育探索杂志

Objective To explore the feasibility and effectiveness of peer-assisted learning (PAL) in the clinical probation teaching of orthopaedics in excellent doctors classes. Methods Forty students in the 2014 excellent doctors class in Inner Mongolia Medical University were selected and randomly divided into the experimental group and the control group. The experimental group adopted the PAL teaching mode, and the control group received the ordinary teaching mode . At the end of the internship , theoretical knowledge and practical skills tests were conducted, and self-evaluation and course evaluation were completed in the form of questionnaires. Results The scores of the experimental group in theoretical knowledge and practical skills were higher than those of the control group, and the differences are statistically significant [theoretical scores (97.2±0.7) vs. (90.2±1.3); practical operation scores (98.5±2.4) vs. (89.2±1.5); case analysis (98.1 ±0.8) vs. (92.3 ±2.8), P<0.05]. Students in the experimental group were generally satisfied with their mastering of the basic theoretical knowledges and clinical practice skills of orthopaedics. Conclusion The application of the PAL model in clinical probation teaching not only stimulates students' enthusiasm for learning, but also enhances their eagerness in self-learning;it helps students master the basic theoretical knowledge and clinical skills better in clinical probation.

Establishment and practice of a point-of-care testing management system in hospitals / 中华医院管理杂志

With the market-oriented application of new technologies and the development of various subjects in hospitals, more and more point-of-care test(POCT) devices appear in medical institutions, as an important method for rapid clinical acquisition of test results. As introduced by the authors, the hospital since 2017, established based on the hospital′s total quality management system, the POCT management committee, and built the hospital′s POCT quality management system. Thanks to its efforts, the hospital has fully standardized the POCT management from equipment procurement, test, maintenance, personnel training and examination, thus further ensuring medical quality.

Application of"hand-foot combination"method in spinal surgery teaching / 中华医学教育探索杂志

There are many deficiencies in traditional clinical teaching of spinal surgery. With teach-ing introspections, we developed a teaching method of "hand-foot combination" on the basis of the teaching characteristics of spine surgery and the practical situation of clinical teaching, which can demonstrate the abstract spine anatomy, basic concepts and important signs with vivid body language, and expound complex theoretical and practical problems. Now, it has been widely used to improve clinical teaching effects. At the same time, this method has been improving in teaching and practice to achieve better clinical teaching effects and benefit both teachers and students.

Evaluation of transverse percutaneous fixation with iliosacral screws via the second sacral vertebra for longitudinal sacral fractures / 中华创伤骨科杂志

Objective To explore the safe bone channels for transverse placement of sacroiliac screws via the second sacral vertebra in the fixation of longitudinal fracture of the sacrum by digital analysis and clinical observation.Methods Firstly,abdomen CT scanning was performed in 50 healthy adult volunteers.They were 30 males and 20 females,aged from 18 to 56 years (mean,34.6 years).After their CT images were transformed by software Materialise Mimics Innovation Suite 15.0,three-dimensional (3D) models of the pelvis were generated,stored in stereolithography format,and transferred into software Imageware 12.0.In the standard antero-posterior position,the sacrum was segmented and the points of 2D image coordinate geometric boundary were extracted to generate an optimal channel for transverse placement of sacroiliac screws via the second sacral vertebra.Secondly,we admitted 10 patients with longitudinal fracture of the sacrum.They were 7 men and 3 women,aged from 20 to 51 years (average,38.3 years).By Tile classification,4 cases were type B2 and 6 type C1.All the fractures were Denis region Ⅱ ones.Pubic ramus fracture was complicated in 3 cases.After traction reduction of the tibial tubercle was conducted for patients with obvious displacement,the optimal channel was calculated on the basis of the CT data.On the lateral images of the sacrum acquired before operation by C-arm fluoroscopy,the optimal channel for transverse placement of sacroiliac screws via the second sacral vertebra was located.After the skin was marked,2.5 mm Kirschner wire was drilled and the 6.0 mm hollow screws were fixated along the Kirschner wire.Postoperative CT scanning images and 3D reconstructed models were analyzed to validate the accuracy of screw placement.Results The projection of safety bone channel on the sagittal fluoroscopy of S2 vertebral body displayed an irregular water drop shape;the projection area in males (213.9 ± 52.4 mm2) was significantly larger than that in the females (171.6 ±49.6 mm2) (P ＜ 0.05).The average length of the channel in men (135.2 ± 12.9 mm) was significantly longer than that in women (121.1 ± 10.1 mm);the average diameter of the screw in men (10.2 ± 0.9 mm) was also significantly larger than that in women (9.1 ±0.8 mm) (P ＜ 0.05).The postoperative X-ray and CT scanning images showed satisfactory positions and lengths of the screws.The screw lengths averaged 98.2 mm;the operation time averaged 25.6 min.No nerve or vascular injury,loosening or breakage of the sacroiliac screws occurred in the patients.Follow-ups for 12 to 24 months revealed no other complications.Conclusion The safety channel for transverse placement of sacroiliac screws via the second sacral vertebra can be determined using the lateral 3D reconstruction images of the sacrum in preoperative planning,which facilitates the percutaneous transverse fixation of longitudinal fracture of the sacrum.

Microporous polysaccharide hemostatic powder to stop bleeding in posterior spinal surgery:An experimen-tal study / 医学研究生学报

Objective Microporous polysaccharide hemostatic powder ( MPPHP) is a most commonly used hemostatic mate-rial, but reports are rarely seen on its application in posterior spinal orthopedic surgery.The present paper aimed to investigate the val-ue of MPPHP in stopping bleeding in posterior spinal surgery. Methods Twenty-four 5-month-old New Zealand rabbits were equally randomized to an experimental and a control group.An 8 cm-long wound was made in the back muscle of animals to establish the model of spinal posterior surgery.MPPHP was applied to the wound of the experimental rabbits but none to that of the controls.Comparisons were made between the two groups of animals in the bleeding time, in vitro coagulation time, intra-operative blood loss, and results of pre-and post-operative blood routine and histopathological examinations. Results Statistically significant differences were observed between the experimental and control groups in the mean bleeding time ([15.36 ±1.42]s vs [347.58 ±32.43]s, P0.05).Pathological examination revealed mild bleeding and a small number of red blood cells in the muscle interstitium and blood vessel lumen of the experimental rabbits as compared with the controls. Conclusion Intraoperative topical ap-plication of MPPHP can reduce blood loss and achieve rapid and efficient hemostasis in posterior spinal surgery without affecting wound healing.

MRI and clinical manifestations of delayed encephalopathy after carbon monoxide poisoning

To explore the relationship between the clinical manifestations and functional magnetic resonance images [MRI] of delayed encephalopathy after carbon monoxide intoxication. Six patients received the MRI were diagnosed with delayed encephalopathy after carbon monoxide [CO] poisoning. Clinical manifestations were observed in each patient. MRI revealed multiple lesions. The majority of the lesions were located in the globus pallidus, sub cortical white matter, and basal ganglia. The cognitive injury, akinetic mutism, fecal and uroclepsia, forced crying, forced laughing and extra pyramidal syndromes such as chorea and parkinsonism were manifested in clinic. Cognitive impairment improved greatly while involuntary movements only improved slightly after several months. Meanwhile brain MRI suggested remarkable improvement. Neuroimaging directly correlated with the clinical manifestations

Clinical study of minimally invasive percutaneous crossover K-wire fixation of scaphoid fractures under C-arm / 国际外科学杂志

Objective To observe the clinical efficacy of minimally invasive percutaneous K-wire crossover fixation treating scaphoid fractures under C-arm.Methods From March 2011 to May 2014,20 patients with fresh scaphoid fractures had postoperative regular outpatient follow-up.Evaluation indicators included Cooney wrist scoring system,X-ray assessment of fracture healing,questionnaire survey of patient's subjective satisfaction at the final follow-up.Results All patients were followed up for 4 to 18 months,the mean follow-up time being 10 months.Postoperative X-ray showed all cases achieved bony union within 8 to 12 weeks,an average of 9.2 weeks.The questionaire resuits of patient's subjective satisfaction showed that general feeling of treatment in 2 cases,relatively satisfied in 2 cases,greatly satisfied in remaining 16 patients at the final follow-up.According to the postoperative Cooney wrist score,excellent in 8 cases,good in 10 cases,fair in 2 cases,the overall satisfactory rate was 90.2％.There were not pin tract infection,nonunion,malunion,avascular necrosis of scaphoid and other complications.2 cases showed that wrist pain during weight-bearing activities and weather getting cold,minor limitations of wrist function and degree of activity,grip strength slightly worse than the contralateral.Conclusions Minimally invasive percutaneous K-wire crossover fixation under C-arm combined with postoperative plaster external fixation properly can attain good clinical results in the treating of scaphoid fractures and worthy of further promotion.

Comparative experimental study of different administration methods for steroid-induced femoral head nec-rosis in rabbits / 医学研究生学报

Objective The method of administration is one of the important factors influencing steroid-induced femoral head necrosis ( FHN) .From the perspective of administration compliance, time and persons needed, and pharmacodynamics, this study compared different administration methods for steroid-induced FHN in rabbits aiming to provide some experimental evidence for selec-ting correct methods of administration. Methods The steroid-induced femoral head necrosis rabbits ( New Zealand, male) were ran-domly divided into five groups according to the different administration methods of intervention:deep oral administration group (n=10), in-tragastric gavage administration group ( n =10 ) , free-drinking drug group (n=10) and model control group (n=5), blank control group (n=5), the administration compliance, administration time, mortal-ity, pharmacodynamic index of lipid content and empty lacunae rate were compared among deep oral administration group, intragastric ga-vage administration group, free-drinking drug group. Results Compliance effect size of deep oral administration group ( 1.78 ± 0.64) lower than intragastric gavage administration group (4.04 ±0.87) and free-drinking drug group (8.94 ±1.05) (P<0.01). Administration time among deep oral administration group ([0.94 ±0.02]min), intragastric gavage administration group ([9.47 ± 0.31]min) and free-drinking drug group ([889.50 ±235.38]min) overall comparison gradually increased (P=0.000), the differ-ence between the two groups was statistically significant (P<0.05).At the 2 and 4 weeks, cholesterol, triglycerides and low-density lipoprotein of deep oral administration group, intragastric gavage administration group, free-drinking drug group compared with model control group and blank control group the difference was statistically significant ( P<0.05) , and deep oral administration group com-pared with free-drinking drug group, the difference was also statistically significant ( P<0.05) .At the 2 weeks, empty lacunae rate of deep oral administration group ([15.44 ±2.68]%), intragastric gavage administration group ([15.02 ±3.34])%), free-drinking drug group ([16.72 ±4.06]%) compared with model control group ([18.59 ±3.12]%) and blank control group ([10.82 ± 2.76]%, the difference was statistically significant (P<0.05).At the 4 weeks, empty lacunae rate of deep oral administration group ([18.53 ±3.26]%), intragastric gavage administration group ([18.85 ±3.17]%), free-drinking drug group ([20.41 ±4.18]%) compared with model control group ([24.66 ±3.74]%) and blank control group ([11.37 ±2.23]%), the difference was also sta-tistically significant ( P<0.05 ) . Conclusion Compared with traditional methods of administration, deep oral administration has better compliance, shorter administration time, and similar to intragastric gavage administration in pharmacodynamics, but more effec-tive than free-drinking drug administration, and it is a new and effective method of administration.

Observation of the effect of ilaprazole in treatment of peptic ulcer / 中国基层医药

Objective To observe the clinical effect of ilaprazole in the treatment of peptic ulcer.Methods 100 patients with peptic ulcer were randomly divided into omeprazole group and ilaprazole group,50 cases in each group.The patients were given omeprazole or ilaprazole combined with amoxicillin and clarithromycin.The treatment effects and clinical symptom relief satisfaction rate were compared between the two groups.Results After treatment,the results under gastroscopy:in ilaprazole group,20 cases cured,16 cases healed,9 cases were effective and 5 cases were invalid.Those in omeprazole group were 14 cases,12 cases,12 cases,12 cases respectively.The differences between the two groups were statistically significant(U =3.78,P ＜ 0.05).The removal rate of Helicobacter pylori and clinical symptom relief satisfaction rate of ilaprazole group were significantly higher than those of the omeprazole group(x2 =3.84,4.57,P ＜ 0.05).Conclusion Ilaprazole can obtain good clinical effect in treatment of peptic ulcer,with high symptom relief satisfaction rate and clearance of Helicobacter pylori.

Effects of IL-8 on the tight junction of vascular endothelial cells / 国际生物医学工程杂志

Objective To investigate the influence of IL-8 on the tight junction of vascular endothelial cells.Methods Immunofluorescence was used to observe the modality and the distribution of three tight junction proteins (occludin,claudin-5 and ZO-1) of the EA.hy926 cells treated with IL-8 under different concentrations and different times.RT-PCR was used to measure the mRNA expression of these three proteins.Results The results demonstrated that IL-8 could change the distribution of occludin,claudin-5 and ZO-1 in EA.hy926 cells,and the mRNA expression of occludin,claudin-5 and ZO-1 decreased with the increase of IL-8 concentration and treated time.Conclusion The effects of IL-8 on the distribution and the expression of occludin,claudin-5 and ZO-1 are dose and time-dependent.

Sequence polymorphisms of the mitochondrial DNA HVR I and HVR II regions in the Deng populations from Tibet in China / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To analyze the sequence polymorphisms of the mitochondrial DNA hypervariable regions I (HVR I) and HVR II in the Deng population in Linzhi area of Tibet.</p><p><b>METHODS</b>mtDNAs obtained from 119 unrelated individuals were amplified and directly sequenced.</p><p><b>RESULTS</b>One hundred and ten variable sites were identified, including nucleotide transitions, transversions, and insertions. In the HVR I region (nt16024-nt16365), 68 polymorphic sites and 119 haplotypes were observed, the genetic diversity was 0.9916. In the HVR II (nt73-nt340) region, 42 polymorphic sites and 113 haplotypes were observed, and the genetic diversity was 0.9907. The random match probability of the HVR I and HVR II regions were 0.0084 and 0.0093, respectively. When combining the HVR I and HVR II regions, 119 different haplotypes were found. The combined match probability of two unrelated persons having the same sequence was 0.0084.</p><p><b>CONCLUSION</b>There are some unique polymorphic loci in the Deng population. There are different genetic structures between Chinese and other Asian populations in the mitochondrial DNA D-loop region. Sequence polymorphism of mitochondrial DNA HVR I and HVR II can be used as a genetic marker for forensic individual identification and genetic analysis.</p>

Polymorphisms of mitochondrial DNA hypervariable regions HVR I and HVR II in Changdu Tibetan in China / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To analyze the sequence polymorphisms of mitochondrial DNA HVR I and HVR II in Tibetan population in Changdu area of Tibet.</p><p><b>METHODS</b>mtDNAs obtained from 97 unrelated individuals were amplified and directly sequenced.</p><p><b>RESULTS</b>One hundred and eleven variable sites were identified, including nucleotide transitions, transversions, insertions and deletions. In HVR I region (nt16024-nt16365), sixty-eight polymorphic sites and 92 haplotypes were observed, and the genetic diversity was 0.9985. In HVR II region (nt73-nt340), forty-three polymorphic sites and 91 haplotypes were detected, and the genetic diversity was 0.9882. The random match probability of HVR I and HVR II regions were 0.0120 and 0.0118, respectively. When the sequence analysis of HVR I and HVR II regions were combined, ninety-seven different haplotypes were found. The combined match probability of two unrelated persons having the same sequence was 0.0103.</p><p><b>CONCLUSION</b>There are some unique polymorphic loci in the Changdu Tibetan population. The results suggest that there are significant difference in the genetic structure in the mitochondrial DNA D-loop region between Changdu Tibetans and other Asian populations and Caucasians. Sequence polymorphism in mitochondrial DNA HVR I and HVR II can be used as a genetic marker for forensic individual identification and genetic analysis.</p>

CT Features of Brain Lesions in AIDS / 实用放射学杂志

Objective To discuss the CT characteristics of AIDS's brain common disease,so that to improve the diagnostic level.Methods CT features of brain lesions in 25 patients with AIDS were retrospectively analyzed.Results Acute HIV encephalitis(n=6),CT features included low density at the basis festival area and the ventriculi laterals,no enhancement on contrast-enhanced scan in 1 case.Subacute HIV brain illness(n=5),CT images showed different degree of atrophy.Toxoplasmosis(n=4),CT images showed iso-dense tubercles with edema in the deep part of brain white matter or iso-dense circle at the edema area.Cytomegalovirus encephalitis(n=3),CT images showed symmetrical low density at bilateral cerebral occipital lobe,internal capsule and thalamus.Progressive multifocal leukoencepathy(n=3),CT showed multiple low density at the inferior surface of brain cortex,the gyri close of focus was clearer,and far of tapetum room system.Mixed infectious(n=4),mixed CT characteristics.Conclusion CT is beneficial in the differential diagnosis of brain disease in AIDS.

Imaging Manifestations of Pneumocystis Carinii Pneumonia in AIDS(A Report of 18 Cases) / 实用放射学杂志

Objective To study the X-ray and CT findings of pneumocystis carinii pneumonia(PCP)in AIDS.Methods 18 cases with PCP in AIDS proved by clinic and pathologically were collected.HIV antibody was positive in all cases.Chest radigraphy and CT scan were taken in all cases.The imaging findings were analysed.Results The typical features of PCP on radiography and CT included unsymmetric diffuse mesh or reticulo-nodular changes,symmetric ground-glass opacification and many more even lobar consolidations which distributed in bilateral hilar regions and middle-lower lung fields.The atypical manifestations included cystic lesions,lobar consolidation,hilar and/or mediastinal adenopathy,pleural effusion,pneumothorax,atelectasis,mass and cavity-mass.Conclusion Plain chest film and CT scan are of important value in diagnosis of PCP.It is possible to diagnose PCP in patients with typical imaging manifestations positive HIV and in combination with clinical data.

Study of polymorphism on 15 STR loci of Luoba ethnic group from Tibet / 西安交通大学学报(医学版)

Objective To select 15 short tandem repeat(STR) loci that are highly and steadily polymorphic,and study the genetic relationships between Luoba ethnic group,Tibetan living in Lassa and Changdu area,and other Asian populations by using 15 STR polymorphism.Methods The blood samples of unrelated individuals from Luoba ethnic group,Lassa Tibetan and Changdu Tibetan were collected.DNA templates were screened using AmpF/ STR Identifiler kit and ABI3100Avant DNA analyzer with Genescan and Genotype software.The STR data of Luoba,Lassa Tibetan,Changdu Tibetan,other 21 Chinese ethnic groups and six Asian populations were compared;phylogenesis tree was constructed;the genetic relationships among ethnic groups living in Tibet and other Asian populations were analysed.Results Eight Hans clustered,and five ethnic groups of Guangxi clustered firstly;then the two clustered with Luoba,and two groups of Tibetan secondly;and then clustered with other Chinese populations,and then the Chinese groups clustered with other six Asian populations and Chinese Uygur lastly.Conclusion The results of this study are basically consistent with geographic distribution,and histories of these ethnic groups.They can provide the genetic proofs for the origin,migration,formation and development of ethnic groups living in Tibet.