Correlations of serum total bilirubin level with infarct volume, severity and etiological typing in patients with acute ischemic stroke / 国际脑血管病杂志

Objective To investigate the correlations of serum total bilirubin level with infarct volume,severity and etiological typing in patients with acute ischemic stroke.Methods Patients with acute ischemic stroke admitted to hospital from January 2012 to January 2014 were used as subjects of study.Their clinical and imaging data were collected,and serum total bilirubin levels were detected.The correlations of the serum total bilirubin levels with the infarct volume,severity and etiological typing were analyzed.Results A total of 290 patients with acute ischemic stroke were enrolled in the study.The patients were divided into either a large infarction group (≥1.8 cm3,n =145) or a small infarction group (＜ 1.8 cm3;n =145)according to the median cerebral infarction volume.The total bilirubin level of the large infarction group was significantly higher than that of the small infarction group (16.896± 7.761 μmol/L vs.13.039±4.477 μmol/L;t =5.185,P ＜ 0.001).Multivariate logistic regression analysis showed that the bilirubin highest quantile group (＞ 17.893 μmol/L) was an independent risk factor for large infarction (odds ratio [OR] 2.754,95％ confidence interval [CI] 1.028-7.375;P =0.044).According to the National Institutes of Health Stroke Scale (NIHSS) score,the patients were divided into a mild stroke group (NIHSS score ＜8;n =210) and a moderate to severe stroke group (NIHSS score≥ 8,n =80).The total bilirubin level of the moderate to severe stroke group was significantly higher than that of the mild stroke group (16.861 ±7.689)μmol/L vs.14.246 ± 6.019 μmol/L;t =3.052,P =0.002).Multivariate logistic regression analysis showed that the total bilirubin level was not an independent risk factor for moderate to severe stroke.Small artery occlusive stroke,large artery atherosclerotic stroke,and other definite causes of stroke were combined into non-cardioembolic stroke group (n =244).The total bilirubin level in the cardioembolic stroke group (n=46) was significantly higher than that in the non-cardioembolic stroke group (19.639±8.409 μmol/L vs.14.087 ±5.831 μmol/L;t =5.479,P＜0.001).Multivariate logistic regression analysis showed that the bilirubin highest quartile group (＞ 17.893 μmol/L) was an independent risk factor for cardioembolic stroke (OR 8.405,95％ CI 1.719-41.106,P =0.009).Conclusions The increased serum total bilirubin level is an independent risk factor for larger infarction and cardioembolic stroke.As an oxidative stress index,serum total bilirubin in acute stage can provide help for early identification of infarct volume and etiological subtype in patients with ischemic stroke.

Relationship between inflammation and blood coagulation function for the prognosis in the patients with acute exacerbation of chronic cor pulmonale / 实用医学杂志

Objective To investigate the relationship between inflammation and blood coagulation function in the patients with acute exacerbation of chronic cor pulmonale (AECCP) and discuss the potential mechanism and influence on the patients. Methods The present study was based on 30 healthy controls and 141 cases of AECCP in our hospital from January 2011 to June 2014.Levels of white blood cell (WBC), neutrophil (NEUT), high-sensitivity C-reactive protein (hs-CRP, Complement 3 (C3), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB) and thrombin time (TT) in the patients were determined. Results Compared with the healthy controls, the patients had higher levels of WBC, NEUT, hs-CRP, PT, APTT, FIB, TT (all P < 0.001) and lower level of C3 (P < 0.001). Significant positive correlations were found between the levels of WBC, NEUT and FIB (r = 0.196 and r = 0.199, both P < 0.05); hs-CRP and APTT, FIB(r = 0.234, P < 0.01 and r = 0.466, P < 0.001); C3 and FIB(r = 0.466, P < 0.001), and significant negative correlations were observed between the levels of C3 and PT, APTT, TT (r=-0.258, P<0.01;r=-0.279, P < 0.01 and r = -0.168, P < 0.05, respectively). Compared with the survival patients, the cases of death had higher levels of WBC and NEUT (both P < 0.01). The area under receiver operating characteristic curve of WBC and NEUT, predicting the prognosis, was 0.666 (95% CI 0.552, 0.780; P < 0.01) and 0.695 (95% CI 0.558, 0.801; P = 0.001) respectively. Conclusions Inflammation and blood coagulation function disorder usually coexist in the patients with AECCP, and are closely associated with the severity. Levels of both WBC and NEUT can be used as prognosis predictors for the patients.

Relationship between Thyroid Hormones and the Nature of Thyroid Nodules / 天津医药

Objective To detect serum levels of thyroid hormones in patients with thyroid nodules (TN), and investi-gate their relationship with the nature of TN. Methods A total of 245 patients with TN were recruited in the study. Accord-ing to levels of thyroid antibodies and postoperative pathological results, all patients were divided into nodular goiter (NG) group, thyroid adenoma (TA) group and thyroid cancer (TC) group. TC group was further classified as the TC with increased level of thyroid antibodies (TC-AB+group) and the TC with normal level of thyroid antibodies (TC-AB-group). The serum levels of free T3 (FT3), free T4 (FT4) and thyroid stimulating hormone (TSH) were detected for all patients before operation, and differences of thyroid hormones were analyzed between different groups. Results The serum level of TSH was signifi-cantly higher in TC group than that of NG group and TA group (P<0.05). The serum level of FT3 was significantly lower in TC-AB+group than that of NG group and TC-AB-group. The serum level of FT4 was significantly lower in TC-AB+group than that of NG group, and the serum TSH level was significantly higher than that of other groups (P<0.05). Conclusion The increased serum levels of TSH were found in some patients with TC, which may partly attribute to their coexistence with autoimmune thyroiditis and subsequent hypothyroidism. The increased serum TSH level may not be the inherent characteris-tics of TC.

Histone deacetylase inhibitors induce human renal cell carcinoma cell apoptosis through p-JNK activation / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the effect of histone deacetylase inhibitors trichostatin A (TSA) and LBH589 on the growth of human renal cell carcinoma OS-RC-2 cells in vitro and explore the underlying molecular mechanism.</p><p><b>METHODS</b>OS-RC-2 cells were treated with LBH589 or TSA with or without SP600125 pretreatment, and the cell viability was measured by MTT assay. The changes of cell cycle distribution and apoptosis of OS-RC-2 cells were examined by flow cytometry, and the expressions of c-Jun, p-c-Jun, Bcl-2, and Bax were quantified by Western blotting.</p><p><b>RESULTS</b>TSA and LBH589 both inhibited the growth of OS-RC-2 cells in a dose- and time-dependent manner. TSA at 1 µnmol/L and LBH589 at 50 nmol/L caused obvious cell cycle arrest in G2/M phase and cell apoptosis, and significantly increased the protein levels of phosphorylated c-Jun. TSA treatment obviously increased Bax expression but decreased Bcl2 expression in the cells. The growth inhibitory effect of TSA was attenuated by the JNK inhibitor SP600125 in OS-RC-2 cells. TSA-induced phosphorylation of c-Jun and Bax upregulation was partially counteracted by SP600125.</p><p><b>CONCLUSION</b>TSA and LBH589 can cause cell cycle arrest and induce apoptosis in OS-RC-2 cells, in which process P-JNK pathway plays an important role.</p>

Exploration on the promotion of clinical bilingual teaching by objective structured clinical examination / 中华医学教育探索杂志

This paper concluded and analyzed the application of objectivc structured clinical examination (OSCE) in clinical bilingual education.It explored the promotion and inhibition effects of OSCE on bilingual teaching by discussing its implementation process,introduction pattern,advantages,disadvantages and feedback from teachers and students.

The review and reflection of the reform about science teaching in clinical practice / 中华医学教育探索杂志

The department of Internal Medicine at our hospital has enhanced students' clinical skills training,strengthened the system of clinical teaching rounds,established an effective clinical practice teaching supervision mechanism,and established a scientific and effective clinical evaluation system for basic skills. These clinical teaching practice reforms have achieved satisfactory teaching results.

Discussion on the training of clinical puncture skills of medical students / 中华医学教育探索杂志

The clinical puncture skills are the elementary technical skills for every medical student.In recent years,reforms have been carried out on teaching method of the training of clinical puncture skills in our hospital and we have achieved satisfactory teaching effect.These reform measures include reforming of operating flow,repeated training from simulative training to clinical practice,educating the medics'consiousness of medical safety and cultivating their competence of communication with patients.

Bilingual Teaching in Clinical Medicine: Exploration and Experience / 中华医学教育探索杂志

Based on the understanding of the present situations of bilingual teaching in clinical medical courses together with the analysis of the students' characteristics,the different methods in improving bilingual teaching were explored and the experience was discussed.The problems encountered in bilingual teaching were also discussed.

The Application of the Student-centered Teaching Mode in the Teaching of Clinic Medicine / 中华医学教育探索杂志

The article has studied the application and the student-centered teaching mode in clinic medicine teaching and discussed how to cultivate students' self-learning ability and life-time learning skills by means of internet teaching,problem-base learning,case-studying and question-discussion.It has also pointed out that compared with the traditional teaching mode this teaching mode has advantages in cultivating innovative,pioneering and practical medical talents.

Training of Evidence Based Medicine Thinking for Medical Students in Clinical Teaching / 中华医学教育探索杂志

Methods:188 students majorting in clinical medicine were randomly divided into two groups:the experimental group with evidence based medicine(EBM)teaching method and the control group with traditional teaching method.Results:The experimental group was better than the control group in results of theory examination and skill test,writing medical record,analyzing condition of patients and the level of student's satisfaction.Conclusions:EBM thinking training is practicable in clinical teaching.

Discussion on the present status and reforms of clinical staff room administration models in hospitals affiliated to colleges and universities / 中华医学教育探索杂志

Based on the present status of administration models in clinical staff rooms of affiliated hospitals in colleges and universities,reform on the administration model is required for adaptation to the modern medical teaching situation.Through the development of the standard staff room,establishment of the teaching performance appraisal system to standardize teachers' teaching responsibility,increasing clinical teachers’enthusiasm to participate in teaching activity, reforming the management model and process in teaching,the creation of teaching teams,im-prove the quality control of teaching,we have further improved the scientific management of our clinical staff room.

Analysis of the Standardized Training Model for Medicine Residents / 中华医学教育探索杂志

Based on the present standardized training model for medicine residents,we analyzed the problems we met in the performance and discussed how to innovate the standardized management.

Taking the assessment of undergraduate teaching as a turning point, enhancing the clinical teaching quality / 中华医学教育探索杂志

Taking the assessment of undergraduate teaching as a turning point,this article discussed how to enhance the clinical teaching quality in all directions and put forward some measures such as improving the quality of classroom teaching,standardizing the teaching rounds,stressing the practice skills,consolidating the theoretical knowledge,strengthening the managements and constructions of the teaching documents,creating the excellent course of internal medicine,and expanding the network teaching resources.

Establishment of Teaching Files in Medicine Curriculum Construction / 中华医学教育探索杂志

The standard administration and the management of the teaching files have been built firstly in the teaching and research apartment of medicine.A variety of databases to achieve files informatics and a series of teaching resources have been reinforced for recent years.Informatics technology,curriculum construction and teaching methods have been conformed to take full advantage of the teaching files.