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MOOCs (massive open online courses) is a new curriculum model and teaching form emerging in recent years in the field of education. The characteristics and advantages of MOOCs can make up for the deficiencies in the traditional teaching of pediatric otolaryngology & head and neck surgery, and improve the quality of the course of Otolaryngology-Head and neck surgery in children. In the implementa-tion, the course teaching is divided into four modules, "theoretical teaching module" "case discussion and interaction module" "after-school question answering and feedback module" and "clinical practice module"respectively. These modules are closely linked and connected, which can help enhance interacting with students, feedback teaching effect timely, and then improve the teaching quality and students' self-learning ability, thus make it possible to better cultivate pediatric clinical specialists.
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Objective To evaluate the efficacy and safety of autologous peripheral blood stem cell transplantation (APBSCT) in treatment of patients with decompensated hepatitis B cirrhosis.Methods Sixty two patients with decompensated hepatitis B cirrhosis admitted in Ningbo Second Hospital during January 2010 and December 2013 were enrolled in the study.Patients were randomly assigned in two groups: 50 patients in control group received comprehensive medical treatment only, and 12 patients in combination group received APBSCT on the basis of medical treatment.The levels of serum total bilirubin (TBil), albumin (Alb), alanine aminotransferase (ALT) and prothrombin time (PT) in two groups were mearsured at the 4th,12th,24th week.Overall survival (OS),progression-free survival (PFS) and complications were compared between two groups after 3 years follow-up.SPSS17.0 software was used to analyze the data.Results After APBSCT treatment, the level of Alb and PT at week 4,12 and 24 in combination group improved significantly(tAlb=-4.437,-5.210 and-6.915,tPT=12.083,11.251 and 10.640,all P<0.01),there were also significant differences between combination group and control group (tAlb=4.985, 5.565 and 6.260,tPT =-3.013、-3.727 and-3.983,all P<0.01).The 3-year OS and 3-year PFS of patients in combination group were higher than those of control group [(90.9±8.7)%vs.(60.7±7.4)%, (75.8±12.5)% vs.(47.9±7.3)%](χ2=6.887 and 5.565,P<0.05).Besides,APBSCT had more advantages than control group in reducing ascitic fluid and hepatic encephalopathy(χ2=7.992 and 4.681,P<0.05 or <0.01).Conclusion APBSCT combined with medical treatment can improve liver function and 3-year survival rate with mild adverse reaction in patients with decompensated hepatitis B cirrhosis.
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Objective To observe the therapeutic effects of end-to-side and side-to-side portal vein-hepatic artery shunts (P-H shunt) in pigs with liver cirrhosis and portal hypertension.Methods There were 15 pigs in each group (control and experimental),and the P-H shunt was made in each animal to observe the process of blood flow into the liver and the reduction of portal vein blood pressure.Results The portal vein pressures before the P-H shunt of pigs in the control and experimental group were (20.51±0.74) cm H2O (1 cm H2O=0.098 kPa) and (30.82±2.53) cm H2O respectively (P＜0.05).Portal vein pressures 30 days after the P-H shunt were(19.75±0.84) cm H2O and (20.84± 1.36) cm H2 O respectively (P＞0.05).The portal vein pressure differences of pigs in the control and experimental group before P-H shunt were (7.20±0.34) cm H2O and (17.34±0.62) cm H2O respectively (P＜0.05).Pressures differences 30 days after the P-H shunt were (6.40±0.21) cm H2O and (7.84 ± 1.32) cm H2O respectively (P＜0.05).Splenic vein injection of methylene blue after the P-H shunt operation stained the liver well.No necrosis and hepatic encephalopathy occurred for 30 days after the P-H shunt,and the splenomegaly gradually returned to normal.Liver function was most affected after the operation and other biochemical markers were least affected.Conclusions The P-H shunt changed the channel of blood flow into the liver,the portal hemodynamic was not affected,and a new balanced mechanism was established to maintain the portal hemodynamic stability.However,further treatment was needed for liver function recovery.
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Objective To evaluate recurrent laryngeal nerves exposure during thyroid resection. Methods Nineteen case-control clinical trials were collected from relevant studies published in different Chinese databases, and 9269 cases were collected for analysis OR (odds ratios). 95% confidence intervals using the Mantel-Haenszel method for a fixed-effects model, and the Mantel-Haenszel method for a random-effects model were summarized. Both fixed effect model and random effect model were applied to analyze the results and heterogeneity. Results The injury rate of the recurrent laryngeal nerves was significantly lower in exposure group ( OR 0.29, 95% CI 0.16～0.54, P
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Objective To investigate the expression of vascular endothelial growth factor-C(VEGF-C) and matrix metalloproteinase-7(MMP-7) in gastric carcinoma and their correlation with tumor invasion and(metastasis).Methods Streptavidin peroxidase immunohistochemistry technique(SP)was used to detect the(expression) of VEGF-C and MMP-7 in 60 gastric carcinoma specimens,60 specimens of gastric mucosa(adjacent) to carcinoma,and 30 regional lymph node specimens.Results The positive expression rate of VEGF-C,MMP-7 in gastric carcinoma was markedly higher than that in normal gastric mucosa and gastric mucosa adjacent to carcinoma.The positive expression rates of VEGF-C and MMP-7 in metastatic regional lymph nodes were significantly higher than that in non-metastatic regional lymph nodes(P