ABSTRACT
There are some problems in the teaching of medical physics course,such as low learning initiative,deficient grasp of concept,and obstacles to realize the internalization and practical application of knowledge.The PAD (presentation-assimilation-discussion) class is applied in the course,in order to improve the students' learning state.PAD class is a teaching mode proposed from a psychological point,which advocates that teaching is the first before students start to learn and has an equal treatment on students' discussions and teachers' instruction,supporting independent learning.The teaching measures include:selecting course content to reach the balance between simplification and detailed interpretation;assigning open homework based on the course;dividing the class discussion into four steps;assessing students based on the performances of homework and final examinations.The research has shown that the PAD class facilitates improving the students' initiative of study and promoting the absorption and application of knowledge.
ABSTRACT
Objective To explore the changes of the peripheral blood soluble Fas (sFas) and soluble FasL (sFasL) in patients of diabetes complicated with tuberculosis,in order to provide the basis for condition judgment and intervention.Methods The patients of diabetes complicated with tuberculosis (diabetes comphcated with tuberculosis group,25 cases),simple diabetes (diabetes group,25 cases),simple tuberculosis (tuberculosis group,25 cases) and healthy person (control group,25 cases) were selected.The peripheral blood sFas,sFasL and T-lymphocyte subsets were examined by enzyme-linked immunosorbent test.Results The peripheral blood sFas,sFasL in diabetes complicated with tuberculosis group,diabetes group,tuberculosis group was higher than that in control group[(7.91 ± 1.93),(8.74 ± 2.12),(7.86 ± 1.61)mg/L vs.(2.10 ±0.88) mg/L and (562.37 ± 196.38),(1512.32 ±303.48),(607.48 ± 102.53) ng/L vs.(263.18 ±46.32) ng/L](P＜ 0.05).The peripheral blood sFas,sFasL in diabetes group was higher than that in diabetes complicated with tuberculosis group and tuberculosis group (P ＜ 0.05).With sFasL 1000 ng/L as boundary value,the diagnostic coincidence rate of diabetes complicated with tuberculosis group and diabetes group was 90.00％ (45/50).CD3 +,CD4+ T-lymphocyte subsets in diabetes complicated with tuberculosis group,diabetes group,tuberculosis group was lower than that in control group (0.3376 ± 0.0712,0.2368 ± 0.0803,0.4801 ± 0.0896 vs.0.5849 ± 0.0487 and 0.1798 ± 0.0401,0.2100 ± 0.0679,0.2312 ± 0.0487 vs.0.2811 ± 0.0348) (P ＜ 0.05).CD3 + T-lymphocyte subsets in diabetes complicated with tuberculosis group was higher than that in diabetes group and lower than that in tuberculosis group (P ＜ 0.05).CD4+ T-lymphocyte subsets in diabetes complicated with tuberculosis group was lower than that in diabetes group,tuberculosis group(P ＜ 0.05).CD8+ T-lymphocyte subsets in diabetes complicated with tuberculosis group,diabetes group was higher than that in control group (0.3209 ± 0.0707,0.2831 ± 0.0794 vs.0.2086 ± 0.0589)(P ＜ 0.05).CD8+ T-lymphocyte subsets in diabetes complicated with tuberculosis group was higher than that in diabetes group and tuberculosis group (0.2287 ± 0.0690)(P ＜ 0.05).C D3 +,CD4+,CD8+ T-lymphocyte apoptotic rate in diabetes complicated with tuberculosis group,diabetes group,tuberculosis group was higher than that in control group [(4.34 ± 2.08)％,(3.22 ± 2.12)％,(2.59 ± 1.41)％ vs.(1.01 ± 0.38)％,(5.12 ± 1.58)％,(4.82 ± 1.98)％,(3.21 ± 1.19)％ vs.(1.78 ±0.53)％ and (1.45 ±0.52)％,(2.31 ±2.01)％,(1.62 ± 1.33)％ vs.(1.07 ± 0.38)％] (P ＜ 0.05).CD3 +,CD4+ T-lymphocyte apoptotic rate in diabetes complicated with tuberculosis group,diabetes group was higher than that in tuberculosis group (P ＜0.05).CD8+ Tlymphocyte apoptotic rate in diabetes group was higher than that in tuberculosis group (P ＜ 0.05).Conclusions The peripheral blood sFas and sFasL exists abnormal increase in patients of diabetes complicated with tuberculosis.CD3+,CD4+ T-lymphocyte decreasing shows that the patients exist immune function disorder.sFas and sFasL may be involved development process of disease,and the peripheral blood sFasL content can also be used as auxiliary indicators for identifying diabetes patients with tuberculosis.
ABSTRACT
BACKGROUND: The main clinical manifestation of the nerve entrapment syndrome in the inguinal region is chronic and spontaneous pain of the scrotal region and proximal ventro-medial thigh region. Few reports have discussed the anatomic background of this kind of pain with special reference to skin innervation.OBJECTIVE: To study the features of clinical anatomy in entrapment of nerve for providing anatomic basis for preventing and treating entrapment of nerves in the inguinal region.DESIGN: Observational study based on cadavers.SETTING: Anatomical department in a university.MATERIALS: Fifty halves of twenty-five adult male cadavers that were routinely embalmed and fixed by the Anatomical Department of Dali University from January 1998 to December 2000.METHODS: Cutaneous nerves in the inguinal region in 50 halves of 25adult male cadavers were observed, measured and drawn.tionship of the genital branch of the genitofemoral nerve to the inguinal canal.RESULTS: In addition to cutaneous branches originating from the iliohypogastric nerve in 3 of 50 cases(6% ), cutaneous branches from the ilioinguinal nerve were found in the inguinal region in 45 of 50 halves(90% ),cutaneous nerves from the genital branch of genitofemoral nerve were in 21 of 50 halves(42% ), the unions of the ilioinguinal nerve and genital branch of the genitofemoral nerve were in 6 of 50 sides(12% ), and branches from the femoral branch of the genitofemoral nerve were in 4 of 50 sides(8% ) . The genital branch of genitofemoral nerve and the ilioinguinal nerve united at three the canal(1 case). The cutaneous branches of the genital branch were found to perforating the transversus abdominis and the obliquus internus abdominis via the border between the ligament and the aponeurosis of obliquus externus abring after being united with the ilioinguinal nerve.CONCLUSION: The courses of cutaneous nerves in the inguinal region vary considerably, and the anatomic variations of these nerves may be a principal cause for nerve entrapment.