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Objective:To explore the practice and preliminary effects of "integrated neurology curriculum" for medical students before internship.Methods:The following 3 aspects were integrated together: teaching content, teaching faculty and teaching methods. Teaching contents are comprised of basic medical theories and extension of clinical knowledge; teaching faculty includes teachers that teach basic theories and many other clinical disciplines; teaching methods were composed of classroom teaching, case discussion and clinical internship. It is a 56-hour curriculum, with 40 hours for studying theories and 16 for clinical internship. 82 students in total had attended the course. Independent sample t-test was used to compare the scores of students in the same grade but had different course structures, and chi-square test was performed with SPSS 22.0 to compare the results of the satisfaction degree from questionnaires.Results:The average score of students was (84.7±9.3) for the courses of 2017-2018 academic year, significantly higher than that of the students who were in the same grade in previous three years. The results of satisfaction degree by the questionnaires showed that 38.6% of the students considered the integrated course to be very helpful in general, 47.7% of the students thought the case analysis part during class was helpful, and 31.8% of the students thought clinical internship was of great help to their medical study.Conclusion:The neurology curriculum based on integrated textbooks has achieved preliminary achievements in preclinical teaching practice, and the teaching group of the curriculum will continue to track the performance of medical students after entering neurology clinical internship, while further improving the quality of integrated courses in terms of teaching and assessment.
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Objective@#To compare the diagnostic value of MRI plain scan and DWI for autoimmune pancreatitis(AIP).@*Methods@#From March 2016 to April 2017, 82 AIP patients in the Central Hospital of Taiyuan were selected in the research.And 42 healthy volunteers were selected as the control group.All patients received MRI plain scan and DWI examination.The imaging characteristics of AIP were observed and the diagnostic value of the two methods was compared.@*Results@#Among the 82 AIP patients, 42(51.22%) had diffuse pancreatic enlargement, 21(25.61%) in local pancreas, 72(87.80%) in pancreatic duct stricture, 68(82.93%) in common bile duct strictures, 67(81.71%) in false envelopes, and MRI plain scanning with low T1 signal, high T2 signal and delayed enhancement.The lesion was high in DWI, and the ADC was low.The average ADC value [(1.12±0.15)mm2/s] was significantly lower than that of the normal pancreas [(1.87±0.25)mm2/s], and the difference was statistically significant(t=22.295, P<0.05). The positive predictive value of MRI plain scan was 72.36%, the negative predictive value was 81.37%, and the sensitivity was 71.94%.The specificity was 70.52%.The positive predictive value of DWI for diagnosing AIP was 85.48%, the negative predictive value was 89.13%, and the sensitivity was 87.52%.The specificity was 88.49%.At ADC=0.001 13mm2/s, the sensitivity and specificity of DWI for the diagnosis of AIP were 86.9% and 89.2%, respectively, and the AUC was 0.826 (95% CI: 0.686-1.804).@*Conclusion@#MRI and DWI manifestations of AIP are characteristic, and the diagnostic efficiency of DWI for AIP is higher than MRI plain scan.
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Objective To compare the diagnostic value of MRI plain scan and DWI for autoimmune pancreatitis (ALP).Methods From March 2016 to April 2017,82 AIP patients in the Central Hospital of Taiyuan were selected in the research.And 42 healthy volunteers were selected as the control group.All patients received MRI plain scan and DWI examination.The imaging characteristics of AIP were observed and the diagnostic value of the two methods was compared.Results Among the 82 AIP patients,42 (51.22％) had diffuse pancreatic enlargement,21 (25.61％) in local pancreas,72 (87.80％) in pancreatic duct stricture,68 (82.93％) in common bile duct strictures,67 (81.71％) in false envelopes,and MRI plain scanning with low T1 signal,high T2 signal and delayed enhancement.The lesion was high in DWI,and the ADC was low.The average ADC value [(1.12 ± 0.15)mm2/s] was significantly lower than that of the normal pancreas [(1.87 ±0.25)mm2/s],and the difference was statistically significant(t =22.295,P ＜ 0.05).The positive predictive value of MRI plain scan was 72.36％,the negative predictive value was 81.37％,and the sensitivity was 71.94％.The specificity was 70.52％.The positive predictive value of DWI for diagnosing AIP was 85.48％,the negative predictive value was 89.13％,and the sensitivity was 87.52％.The specificity was 88.49％.At ADC =0.001 13mm2/s,the sensitivity and specificity of DWI for the diagnosis of AIP were 86.9％ and 89.2％,respectively,and the AUC was 0.826 (95％ CI:0.686-1.804).Conclusion MRI and DWI manifestations of AIP are characteristic,and the diagnostic efficiency of DWI for AIP is higher than MRI plain Scan.
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Objective To investigate the influence of laparoscopic radical gastrectomy for gastric cancer or colon cancer on immune indices and micrometastasis.Methods According to the treatment method,80 cases of gastric cancer or colon cancer in the Second Hospital of Shanxi Medical University from May 2016 to May 2017 were divided into observation group and control group,with 40 cases in each group.The observation group was treated with laparoscopic radical gastrectomy for gastric cancer or colon cancer,and the control group was treated with open stomach cancer or colon cancer radical operation.The changes of immune indicators of peripheral blood and micrometastasis of peritoneal lavage fluid were compared between the two groups.Results Compared with the preoperative immune indicators in peripheral blood of the two groups of IgG [(8.1 ±2.6)g/L],IgA[(1.6 ±0.9)g/L],IgM[(0.8 ± 0.2)g/L],C3[(0.7 ±0.3)g/L]and C4[(0.2 ±0.1)g/L]levels were decreased at first and then increased,and at 7d after operation,the levels[(10.5 ±2.3)g/L,(2.4 ±0.5)g/L,(1.3 ±0.6)g/L,(1.2 ±0.4)g/L,(0.5 ± 0.2)g/L]were closed to the preoperative levels.The level of IL-10[(98.8 ±32.4)g/L]increased obviously first,and then gradually decreased.The differences of C3 and IL-10 in the two groups were statistically significant at different time points,between the two groups and between different points(F=3.6786,5.769,4.668,4.625,9.375,5.354,all P<0.05).The other indicators were only statistically different among different time points(F=3.578,4.137,3.966,all P <0.05).At the end of the surgery,the CEA and DDC of the two groups were significantly increased,and the CEA[(1165.2 ±386.5)ng/L vs.(1788.6 ±725.5)ng/L]and DDC[(102.5 ±36.5)ng/L vs.(150.5 ±57.2)ng/L] levels and added value in the observation group were significantly lower than those in the control group,the differences were statistically significant(t=6.543,5.669,5.712,4.935,all P<0.05).Conclusion Laparoscopic radical gastrectomy for gastric cancer or colon cancer can improve the immune indices of the patients and reduce the index of micrometastasis in the peritoneal lavage fluid.
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Objective To detect the plasma macrophage inflammatory protein (MIP) levels in patients with early Parkinson' s disease (PD) and to investigate whether plasma MIP was associated with motor and non-motor symptoms in early PD.Methods Fifty-nine patients with early idiopathic PD (Hoehn-Yahr Staging Scale from 1.0 to 2.5) treated in our hospital from January 28,2013 to September 30,2013 and 54 healthy controls were recruited.Plasma MIP-1α and MIP-1β levels were measured by enzyme-linked immunosorbent assay.Motor function was assessed by Unified Parkinson' s Disease Rating Scale Part Ⅲ and Hoehn-Yahr Staging Scale during “on” period.Total non-motor symptoms were assessed by Non-motor Symptoms Questionnaire.Cognitive dysfunction was assessed by Mini Mental State Examination.Autonotic dysfunction was assessed by Scales for Outcomes in Parkinson' s disease-Autonomic.Depression was assessed by Hamilton Depressive Scale (HAMD).Rapid eye movement (REM) sleep behavior disorder was assessed by REM sleep behavior disorder screening questionnaire (RBDSQ).Correlation between plasma MIP levels and scale scores was analyzed by Spearman rank correlation.Results Plasma MIP-1o and MIP-1β levels were not significantly different between early PD patients and healthy controls.However,plasma MIP-1 α level negatively correlated with depression (HAMD score,r =-0.520,P =0.027) and rapid eye movement sleep behavior disorder (RBDSQ score,r =-0.537,P =0.039).Conclusion MIP-1 α may be correlated with depression and RBD in early PD.
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From the four aspects of residency training plan,the actual clinical teaching arrangement,clinical operation skill training and examination system,we compared the pros and cons of neurological resident training systems in two famous hospitals in Australia and China,aiming to provide useful suggestions to improve the current neurological resident training system.
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Objective To summarize the echocardiographic characteristics and clinical signiifcance of prenatal diagnosis of coronary artery ifstula (CAF). Methods Images and follow-up results of ifve fetuses with CAF diagnosed by fetal echocardiography between January, 2011 and December, 2012 in our department were reviewed. Results Echocardiographic characteristics of CAF were a dilated coronary artery in the four chamber view and the left ventricular outlfow tract view. Track the course of the dilated coronary artery can conifrm the oriifce of the ifstula. Among the ifve cases, the oriifce of the ifstula included the aortic root of left ventricular outlfow tract, right atrium side of interatrial septum, the entrance of superior vena cava to right atrium, right ventricular apex and right ventricle cone. The colour Doppler lfow imaging showed turbulence in the dilated coronary artery. The spectral Doppler with the sampling gate in coronary artery showed the characteristic bidirectional lfow pattern. One case was associated with other complex intracardiac abnormalities and one case with persistent left superior vena cava. Among the ifve cases of CAF diagnosed by fetal echocardiography, one case was missed and four cases were conifrmed by postnatal echocardiography. Conclusion Coronary artery ifstula has special fetal echocardiographic characteristics. The fetal echocardiography plays an important role in early detection, diagnosis and treatment of CAF.
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Objective To investigate the echocardiographic features and clinical significance of prenatal diagnosis of fetal double aortic arch (DAA). Methods Totally 21 596 fetuses underwent fetal echocardiography in Nanjing Medical University Afifliated Suzhou Hospital and ifve cases were diagnosed as DAA by echocardiography. Echocardiographic characteristics, types and outcomes of these ifve cases were summarized retrospectively. Results Five fetal cases were diagnosed as DAA by fetal echocardiography. 1. Prenatal echocardiographic features:In three-vessel and trachea view, the normal“V”-shaped conlfuence formed by the aortic arch and ductal arch was absent. However, the ascending aorta bifurcated into the left and right aortic arch and these two arches encircled the trachea. Annular lfow signal around trachea was seen on color Doppler imaging. 2. Types:Among these ifve fetuses, three cases were called right arch predominant type, whose diameters of right arches were larger than those of left arches. The other two were balanced type, whose diameters of right arches were almost equal to those of left arches. 3. Accompanied malformations:Case 2 was accompanied with membranous ventricular septal defect and permanent left superior vena cava. Case 4 was associated by hemivertebrae. The other three cases had no other abnormalities. 4. Follow-up:These five cases were all arranged for MRI subsequently and all were confirmed by follow-up till to the induction of labor or three months after birth. Conclusions Double aortic arch is a kind of severe congenital heart disease. Echocardiography is the ifrst choice to diagnose DAA prenatally and three-vessel and trachea view are the effective cross sections in the diagnosis of double aortic arch.
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Objective To investigate the correlation of serum levels of HDL-C,LDL-C with clinical stage and lynlphatic metastasis in gastric malignant tumors. Methods Preoperative serum levels of HDL-C and LDL-C were retrospectively analyzed in 114 gastric cancer patients who were diagnosed by pathology.Results Serum, levels of HDL-C showed a remarkable correlation with tumor differentiation,lymphatic metastasis and the diameter of tumor in gastric cancer (P＜0.05).The lower serum levels of HDL-C were significantly observed in gastric cancer patients with TNM Ⅲ and IV stage,compared with those with TNM Ⅰ and Ⅱ stage (P＜0.05). Conclusion Preoperative serum levels of HDL-C might be a useful biomarker of lymphatic metastasis and advanced stage of gastric cancer.