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In recent years, progress has been made in general practice education research with the integration of narrative medicine and general practice. The narrative medicine is conducive to upgrading the abilities of general practice residents in doctor-patient communication, disease management and clinical decision makings; it also conducive to improvement of their humanistic quality and doctor-patient relationship. This article reviews the application of narrative medicine in the general practice residency training, and discusses relevant problems and countermeasures.
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Objective To evaluate clinical application of VCS technology in diagnosis for acute leukemia and its subtypes by LH750 automated hematology analyzer. Methods A total of 178 leukemia patients (105 acute granilocytic leukemia, 42 acute lymphocytic leukemia, 31 acute monecytic leukemia)and 151 non-leukemia patients (86 granulocytic abnormal cases, 35 lymphocytic abnormal cases,30 monocytic abnormal cases) were enrolled into this study. Peripheral blood samples were analyzed by both Coulter LH750 automated hematology analyzer and manual microscopic examination. Microscopic examination was used as reference to evaluate the diagnosis value of VCS technology in blast detecting. VCS parameters were compared for AGL subsets. The clinical value of VCS technology in diagnosis for different acute leukemia was also evaluated by combining VCS scattergram and suspect flags provided by LH750. Results Compared with manual examination, a sensitivity of 95.5% (170/178) and specificity of 95.4% (144/151) were achieved by VCS technology in detecting blasts in acute leukemia and nonleukemia patients. In patients with AGL, the MNV, MNV-SD, MNC and MNC-SD (224.40 ± 23.37,37.40 ±12. 31,145. 80 ±7. 93,24. 79 ±5. 18) were higher than granulocytic abnormal patients( 169.96 ±11.50,29.21 ± 5.27,133.30 ± 5.50, 10.62 ± 4.09) and the differences were statistically significant ( t values were 16. 832, 5. 148, 5. 735, 19. 953 respectively, P < 0. 01 ). On the contrary, MNS ( 122. 90 ±6. 35) in AGL patients was significantly lower than granulocytic abnormal patients( 131.00 ± 5. 69, t =-7.64, P<0.01). In patients with ALL, the MLV, MLV-SD, MLC, MLS, MLS-SD (97.60 ± 13.40,22. 35 ± 7.94,110. 00 ± 4. 60,77. 60 ± 19.00,20. 61 ± 3.30 ) were higher than lymphocytic abnormal patients(82. 10 ± 3.00, 14.41 ±2.35, 100.60 ±2.70, 48. 10 ±3.50, 17.60 ± 1.60). The data also showed a statistical significance (t values were 7.576, 6. 118, 4. 041, 9. 353, 2. 988 respectively, P <0.05). In patients with AMOL, the MMV, MMV-SD, MMC, MMC-SD, MMS(197. 30 ±20.50,30.47 ±6.58,123.20 ± 10. 10,6.57 ± 1.57,98.00 ± 5.60) were significantly higher than monocytic abnormal patients( 167.80 ± 15.77,21.90 ± 9. 64,113.60 ± 6. 73,5.20 ± 3. 21,84. 20 ± 14. 35 ) and the differences were statistically significant (t values were 6. 332, 4. 033, 4. 650, 2. 993, 6. 273 respectively , P <0. 01 ).The differences of MNV, MNV-SD, MNC, MNC-SD, MNS-SD for different AGL subtypes were statistically significant ( F values were 21.2, 169. 5, 13.6, 3. 6 and 98.6 respectively, P <0. 01 ). For AGL, ALL and AMOL, the ratios of normal blast distribution in scattergram were 81% (85/105), 74% (31/42) ,and 74% (23/31). Conclusions The VCS parameters can reflect the changes of peripheral white blood cell morphology sensitively. VCS technology can diagnose acute leukemia and its subtypes efficieutly.
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Objective To develop a real-time fluorescence quantitative PCR method for detection of Legionella pneumophila as a tool for environmental and clinical examination. Methods A pair of degen-erated primers and one TaqMan-MGB probe were designed to test the conserved region at the macrophage in-fective potentiation (mip) gene of Legionella pneumophila. TaqMan MGB real-time quantitative PCR assay was developed with pMD-19T plasmid including mip gene of Legionella pneumophila as standard sample. The sensitivity and specificity of the real-time quantitative PCR was evaluated using the standard sample and dif-ferent strains. Results The detection limit of 0.71 copy/μl was obtained for the standard sample in a reac-tion system of 0.6μl of sense and antisense primers (20μmol/L), respectively, 0.4μl of probe (20μmol/L) and 6.0μl of DNA temple. Conditions for the PCR reactions were as follows. After an initial de-naturation at 95℃ for 20s, 40 amplification cycles were performed. Each cycle consisted of denaturation at 95℃ for 10 s, primer annealing at 50℃ for45s. The PCR Ct value of a standard strain and 12 isolates was in a scale of 13.23 and 16.04. However, the Ct values of the strains of Staphylococcus aureus, Salmonella typhimurium, Vibrio parahaemolyticus, Escherichia coli, Pseudomonas aeruginosa and Shigella sonnei were greater than 30. Conclusion The real-time quantitative PCR method has good sensitivity and specificity and the result has potentiality of applying for detecting Legionella pneumophila.
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Aim To observe the protective effect of valsartan,benazepril and combination valsartan withbenazepril on cardiac damage in rats with chronic renal failure and explore the mechanism.Methods Forty Sprague Dawley male rats were selected,and were performed five-sixths nephrectomy to produce chronic renal failure model.Two weeks after the surgery,the rats were divided randomly into model group,valsartan group,benazepril group and both valsartan and benazepril group,and a sham group was established as control group.Systolic blood pressure,BUN and serum creatinine was measured at 10 week after operation,then all rats were killed to take the hearts for pathological histological observation.The transcription of endothelin-1(ET-1 )mRNA and nitricoxide synthase (eNOS-3) mRNA in myocardium was examined by hybridization in situ.Results Systolic pressure,heart weight,heart weight index,left ventricular weight mass(LVWM) and left ventricular weight mass index(LVWMI) in model group increased significantly at 10 week after operation. Systolic pressure,heart weight,heart weight index,LVWM and LVWMI decreased markedly in rats with five-sixths nephrectomy by valsartan and/or benazepril (P
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AIM: To observe the therapeutic effect of valsartan on cardiac hypertrophy and expression of endothelin-1(ET-1) in myocardium of rats with chronic renal failure and explore the mechanism.METHODS: 24 Sprague Dawley male rats were selected,and performed five-sixths nephrectomy to produce chronic renal failure model.Two weeks after the surgery,the rats were randomly divided into model group,valsartan group,and a sham group was established serving as control group.Systolic blood pressure,BUN and serum creatinine were measured at ten weeks after operation,then the rats were sacrificed to take the hearts for pathological histological examination.Hybridization in situ was used to examine the transcription of ET-1 mRNA in myocardium.RESULTS: Systolic pressure,heart weight,heart weight index,left ventricular weight mass(LVM) and left ventricular weight mass index(LVMI) in model group increased significantly tenth week after operation.Systolic pressure,heart weight,heart weight index,LVM and LVMI were decreased markedly in rats with five-sixths nephrectomy by valsartan(P
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AIM:To investigate the effects of angiotensin Ⅱ(AngⅡ)blockers on TNF-? and the relationship between TNF-? and proteinuria in patients with chronic glomerulonephritis(CGN).METHODS:32 patients examined by biopsy as primary CGN with proteinuria were treated by benazepril,valsartan or combination with benazepril and valsartan for 8 to 12 weeks respectively.The TNF-? levels in serum and urine,24 hours proteinuria quantity,and serum creatinine level were assayed and recorded respectively before and after 8 to 12 weeks therapy.RESULTS:The TNF-? levels in serum and urine and 24 hours proteinuria quantity were reduced significantly after therapy [(7.8?3.9)vs(5.0?1.6)fmol/mL,(11.9?6.8)vs(8.3?3.5)fmol/mL,(2.6?2.0)vs(1.0?0.5)g,respectively;P
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AIM: To evaluate the effects of Beiling Capsule(cordycepic mycelium) on chronic renal failure(CRF). METHODS: 82 cases of CRF were divided into two groups randomly. 42 cases were treated with Beiling Capsule and the usual treatment, while 40 cases were only treated with the usual treatment as the control group, 2 months coustituing a single therapeutic course. RESULTS: In respect to BUN, the total efficiency of the group with Beiling Capsule was 57.1%, while the control group was 30.0%. In respect to Cr, the total efficiency of the group with Beiling Capsule was 59.5%, while the control group was 32.5%. CONCLUSION: Beiling Capsule provides protection against the progression of CRF.