Case-problem-based learning of pathophysiology based on inquiry-based learning and process management / 中华医学教育探索杂志

Based on the teaching concept of constructivism, this study aims to promote independent inquiry-based learning and clinical thinking among students and establish the guiding ideology of "full participation, process control, in-depth discussion, and expansion of thinking". A blending learning model was adopted with offline inquiry-based group learning and in-class defense and comment, as well as online teacher-student interaction and supervision to promote learning. Case-problem-based learning (CPBL) of pathophysiology was carried out among the medical students in the class of 2017, and process management was strengthened to effectively manage the two key links of data retrieval and group discussion. The analysis of 176 teaching evaluations collected at the end of the semester show that in terms of the overall evaluation of CPBL teaching, 162 students (92.05%) had high evaluation on teaching objectives, organization, cases, and personal gains and held a very or relatively favorable attitude. There were more negative feedbacks on "appropriate time allocation"; 21 students (11.93%) held a relatively or very disapproving attitude, and 149 students (84.66%) "felt very tired". In terms of teaching effect evaluation, 150 students (85.23%) strongly or relatively agreed that CPBL teaching may help to understand professional knowledge, stimulate learning enthusiasm and initiative, improve problem solving ability, emphasize clinical practice to cultivate clinical thinking, supervise and promote learning, and enhance team cooperation and teacher-student communication. In terms of the evaluation of teachers, 167 students (94.89%) thought that teachers were rigorous, responsible, and enthusiastic in teaching, attached importance to process management, and did well in effective guidance and thinking inspiration (strongly or relatively agree). The above results suggest that the CPBL teaching reform of pathophysiology based on process management can effectively promote in-depth inquiry-based independent learning and the cultivation of clinical thinking and improve teaching effectiveness, but further improvement is needed for teaching arrangement and time allocation.

Anti-Caspr2 antibody-associated encephalitis in a child: a case report and literature review / 临床儿科杂志

Objective To explore the clinical features of anti-Caspr2 antibody-associated encephalitis. Method The clinical data of anti-Caspr2 antibody-associated encephalitis in a child were retrospectively reviewed. Results A 5-year-old girl manifested as recent memory loss, irritability, cognitive impairment, hallucination, sleep disorders, and so on. The child had positive serum Caspr2 antibody, and was diagnosed with Caspr2 antibody encephalitis after exclusion of other diseases. The literature search retrieved 50 cases of Caspr2 antibody encephalitis with complete data, including 43 male cases and 7 female cases. The minimum onset age of the disease was 5 years in this case. In addition, 1 patient developed the disease at the age of 8, while the rest developed in adulthood. There were 32 cases (62.75％) of marginal encephalitis and 19 cases (37.25％) of morvan's syndrome. The most common clinical symptoms were impaired memory, epileptic seizures, and psychiatric symptoms such as anxiety, apathy, irritability, hallucinations or delusions, peripheral nerve hyperexcitability (PNH) , cerebellar ataxia and autonomic nervous disorders. Forty-four cases (86.27％) recovered or improved, 8 cases (15.69％) were complicated with tumors and 8 cases (15.69％) relapsed. Conclusion Caspr2 antibody encephalitis is relatively rare, especially in children. If the patient has marginal encephalitis symptoms, combining with PNH, ataxia and autonomic nerve symptoms, the possibility of Caspr2 antibody encephalitis should be considered.

Analysis of neurofibromatosis 1 gene mutation in a family with neurofibromatosis and its clinical significance / 中华神经科杂志

To screen the pathogenic mutation location in a genetic family with the neurofibromatosis (NF1) by the next generation sequencing and analyze the clinical phenotype,Illumina Miseq sequencing was applied to capture and analyze the target regions of NF1 family's probands,and furtherly find out the suspicious mutations,as well as to verify the family members by Sanger sequencing.Two rare variants were identified in proband,including the heterozygous missense mutation c.C3649T (p.P1217S) in KIF1B gene and the missense mutation c.T6311C (p.L2104P) on exon 41 of NF1 gene (NM_000267.3).The amino acid at position 2104 was found to be changed from leucine to proline in NF1.The protein prediction SIFT and Polyphen-2 values were 0,0.997,which predicted a conformational change in the encoded protein and eventually affected its function.The mutation c.T6311C in NF1 gene was detected in all patients in this family,which showed genetic co-segregation.The clinical phenotype was neurofibroma in the spinal canal.There were no café au lait spots,iris Lisch nodules,scoliosis,tinnitus,heating loss,or elevated intracranial pressure.The missense mutation c.T6311C (p.L2104P) in NF1 gene might be the genetic cause of this hereditary disease of neurofibromatosis.

Relationship between polymorphism of peroxisome proliferator activated receptor gamma gene and osteoporosis in elderly male / 中华老年医学杂志

Objective To investigate the relationship between the single nucleotide polymorphisms of exon 6 C161→T of peroxisome proliferators activated receptor γ(PPART)gene and osteoporosis in elderly male. Methods Polymerase chain reaction restriction-fragment length polymorphism(PCR-RFLP)was used to analyze the gene frequency distribution in the groups of nonosteoporosis and osteoporosis in elderly male.Bone mineral density of lumbar and hip(neck of femur,greater trochanter,Ward's triangle)were measured by dual energy X-ray absorptiometry.Serum osteocalcin level was measured by enzyme-labeled immunosorbent assay(ELISA). Results The exon 6 of PPARγ had 3 genotypes(CC,CT and TT).The frequency of T allele in osteoporosis was higher than that in non-osteoporosis.Compared with the control group,serum bone glaprotein level and bone mineral density was lower in osteoporosis group.The bone mineral density in the genotype of CT and TT groups were lower than that in the genotype of CC group. Conclusions The study shows that the single nucleotide polymorphisms of 6th exons of PPARγ may relate to osteoporosis in elderly male.T allele of PPARγ may be a predisposing factor of osteoporosis in elderly male.PPARγmay be a candidate gene of osteoporosis in elderly males.

Hyperbaric oxygenation on infantile cerebral palsy / 中国康复理论与实践

@# ObjectiveTo evaluate effects of hyperbaric oxygenation on motor function in children with cerebral palsy. Methods49 infants with cerebral palsy were classified into two groups, hyperbaric oxygenation group(29cases) and control group (20 cases). Two groups were treated with cerebrolysin and received family rehabilitation drill. In additional, the hyperbaric oxygenation group was treated with hyperbaric oxygenation therapy. The children's motor function of two groups was evaluated before and after the treatment.ResultsThe effect in the hyperbaric oxygenation group was better than that in the control group(P<0.01). Conclusions Hyperbaric oxygenation is an effective therapy on infantile cerebral palsy.