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Objective To investigate the effect of the courses of image diagnostics on clinical pro-bation period via the combination of PBL and multimedia network teaching model. Methods 126 under-graduates from the department of medical image (Grade 2011 and 2012) were selected as teaching subjects, and PBL combined with multimedia network teaching was adopted in the teaching of the course of medical imaging diagnosis. After class we implemented a questionnaire survey, and let the students write learning experience. Statistical analysis was conducted by using SSPS 13.0 to reflect the teaching participation in the students' questionnaire and a. summary analysis of the learning experience of the students was also made. Results 123 valid questionnaires were collected. 94.31%(116 people) of students were active participants in these courses, 90.25%(111 people) of the students thought they could actively communicate in teaching, and 43% (110 people) of the students thought they got fully prepared before class. 123 articles in accor-dance with the requirements of experience were received; most students took positive attitude to the active influence the teaching methods had brought; some student pointed out that the teaching method had the disadvantages such as too much time to prepare, too much information, and so on. Conclusions The com-bination of PBL and multimedia network teaching has preliminary results. It is a novel model that is available for teaching image diagnostics on clinical probation period.
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Objective To observe the effects of mesenchymal stem cells (MSCs) surface CXC chemokine receptor 4 over-expression on the repair of kidney after ischemia reperfusion (I/R) injury.Methods The MSCs were co-cultured with I/R injured renal cell homogenate supernatant.The MSCs surface CXCR4 and stromal cells derived factor-1 (SDF-1α) protein levels were detected by Western blot, chemotactic ability of MSCs to SDF-1 was investigated by transwell test.The I/R injured renal model was made and pathological changes were observed in control group, I/R group, MSCs injection group and CXCR4 neutralize antibody group.Renal CXCR4 protein expression was measured by immunofluorescence histochemistry, SDF-1α、 CXCR4、 hepatocyte growth factor (HGF) and epidermal growth factor (EGF) mRNA were detected by Real-time quantitative polymerase chain reaction (RT-PCR).Comparisons among multiple groups were performed using One-way analysis of variance, and comparisons between groups were carried out using independent-sample t-test.Results In vitro, the SDF-1α protein expression markedly increased in I/R injured renal tissue homogenate, but the difference was not significant between I/R group and CXCR4 antibody group (t =0.862, P =0.403).MSCs surface CXCR4 protein expression increased significantly after co-cultured with I/R injured renal tissue homogenate (F =95.957, t =10.166, P ＜ 0.01), and the chemotactic ability of MSCs to SDF-1 increased at the same time (F =82.459, t =6.826, P ＜ 0.01), the CXCR4 protein expression (t =13.657, P ＜ 0.01) and the chemotactic ability (t =12.662, P ＜0.01) could be decreased by CXCR4 neutralize antibody.In vivo, renal tubular structure was destroyed in I/R group.After MSCs injection, the renal pathological injury improved rapidly, but the improvement could be inhibited by CXCR4 antibody.The expression of SDF-1α mRNA and level of SDF-1a protein increased in I/R group, but there was no significant difference among different groups (F =1.909,P =0.173).MSCs injection markedly up-regulated the CXCR4 protein and mRNA expression (F =6.663, P =0.006).Following the increase in CXCR4 expression, the expressions of HGF mRNA (F =11.898,P ＜ 0.01) and EGF mRNA (F =5.309, P ＜ 0.05) increased gradually which could be restrained by CXCR4 antibody (t =5.312, t =4.310, P ＜ 0.01).Conclusions I/R injured renal microenvironment markedly increased the mesenchymal stem cells surface CXCR4 expression, and increased CXCR4 expression can induce MSCs chemotaxis and stimulate the secretion of renal protective growth factors paracrine promoting the repair of the kidney.
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Objective To explore the therapeutic effect and nursing points of different linked modes in hemodialysis combined with hemoperfusion on renal osteopathy disease in maintenance hemodialysis (MHD) patients.Methods Sixty-four MHD patients with renal osteopathy disease were enrolled in the study.They were divided into two groups by random digits table method:the front connection group and the back connection group with 32 cases each.Their clinical data,serum parameters and complications were recorded.The therapeutic effect of two groups were compared.Results The serum level of intact parathyroid hormone(iPTH) was (191.36 ± 53.96) ng/L in the front connection group,while (133.02 ± 38.63) ng/L in the back connection group,and there was significant difference,t=3.517,P＜0.05.The incidence of lower blood pressure and blood coagulation were 8.85％(51/576),6.94％(40/576) in the back connection group,while 14.93％(86/576),15.97％(92/576) in the front connection group,and there were significant differences,x2=10.149,23.136,P＜0.01.Conclusion The back linked mode in hemodialysis combined with hemoperfusion can obviously decrease iP:TH of MHD patients combined with renal osteopathy disease and has less complications,worth clinical promotion.
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Objective To observe the changes of intedeukin (IL)-17 in patients with maintenance hemodialysis (MHD) and its relationship with anemia. Methods Twenty sera from normal people(normal group) and sixty-eight sera from patients with MHD were sampled. Patients with MHD were divided into 4 groups by haemoglobin (Hb) levels: severity anemia group (12 cases), midrange anemia group(18 cases),light anemia group(18 cases) and non-anemia group(20 cases). IL-6 and IL-17 levels were measured in all the sera with ELISA. Meantime, C-reactive protein (CRP),Hb, ferritin and iron saturation ratio was observed. Results CRP,IL-17 and IL-6 levels in MHD patients were much higher than those in normal group. IL-17 levels in severity and midrange anemia group were higher than those in light anemia group,and IL-17 was positively correlated to Hb. Conclusions IL-17,IL-6 and CRP in patients is higher than that in normal people,and the microinflammation status exists in MHD. IL-17 may play a role in pathogenesis of microinflammation in MHD patients with anemia.
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The clinical data and routine biochemical parameters of 64 maintenance hemodialysis (MHD)patients and 20 controls were analyzed in the study.Serum cystatin C levels were detected by latex particle enhalice inununo-turbidimetry:and the cardial structure and function were assessed by echocardiography.As MHD time extended,the levels of semm cystatin C increased gradually,accompanied with high incidence of left ventricular hypertrophy(LVH).The LVH-positive patients had higher systolic blood pressure and left veHtricular mass index,and had higher serum cystatin C than tllose in LVH-negative patients.The serum cystatin C levels were positively correlated with left yentricular mass index(r=0.633,P<0.01)and systolic blood pressure(r:0.397,P<0.01).The results suggest that serum cystatin levels may be an influencing factor for long-term cardiacvascular complication in MHD patients.
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An investigation of the current nurse-patient relationship is conducted in Guangzhou city,by analyzing the data it can be concluded that the attitude of nursing service and skills of communication,the degree of nurses' knowledge on their patients' cases have a significant influence on the nurse-patient relationship.Nurses should play a leading role in nurse-patient relationship.There is a lack of mutual consideration and understanding between nurses and patients,which lead to nurse-patient misunderstanding and conflicts.There is a strong desire to discuss the case together intensively between nurses and patients.Furthermore,the lack of effective communication and teamwork between medical staff will also hinder the relief of tension in current physician-patient relationship.