Case-problem-based learning of pathophysiology based on inquiry-based learning and process management / 中华医学教育探索杂志

Based on the teaching concept of constructivism, this study aims to promote independent inquiry-based learning and clinical thinking among students and establish the guiding ideology of "full participation, process control, in-depth discussion, and expansion of thinking". A blending learning model was adopted with offline inquiry-based group learning and in-class defense and comment, as well as online teacher-student interaction and supervision to promote learning. Case-problem-based learning (CPBL) of pathophysiology was carried out among the medical students in the class of 2017, and process management was strengthened to effectively manage the two key links of data retrieval and group discussion. The analysis of 176 teaching evaluations collected at the end of the semester show that in terms of the overall evaluation of CPBL teaching, 162 students (92.05%) had high evaluation on teaching objectives, organization, cases, and personal gains and held a very or relatively favorable attitude. There were more negative feedbacks on "appropriate time allocation"; 21 students (11.93%) held a relatively or very disapproving attitude, and 149 students (84.66%) "felt very tired". In terms of teaching effect evaluation, 150 students (85.23%) strongly or relatively agreed that CPBL teaching may help to understand professional knowledge, stimulate learning enthusiasm and initiative, improve problem solving ability, emphasize clinical practice to cultivate clinical thinking, supervise and promote learning, and enhance team cooperation and teacher-student communication. In terms of the evaluation of teachers, 167 students (94.89%) thought that teachers were rigorous, responsible, and enthusiastic in teaching, attached importance to process management, and did well in effective guidance and thinking inspiration (strongly or relatively agree). The above results suggest that the CPBL teaching reform of pathophysiology based on process management can effectively promote in-depth inquiry-based independent learning and the cultivation of clinical thinking and improve teaching effectiveness, but further improvement is needed for teaching arrangement and time allocation.

The correlation between serum CXCL10 level and the severity of OSAS in male patients / 实用口腔医学杂志

Objective:To investigate the correlation between serum CXCL10 level and the severity of obstructive sleep apnea syndrome(OSAS) in male patients.Methods:52 male patients and 41 control volunteers were enrolled.Polysomnography was processed to monitor the AHI scores.Serum CXCL10 level was determined by ELISA.The correlation between serum CXCL10 level and AHI scores was analyzed statistically.Results:Serum CXCL10 level(ng/ml) in the OSAS groups was significantly higher than that in the control group [99.18 (70.46-158.01) vs 64.13 (53.5-73.6),P ＜ 0.001].Multivariate logistic regression analysis demonstrated that serum CXCL10 level was the only independent predictor of OSAS(OR:1.021;95％ CI:1.009-1.035;P ＜0.001).The serum CXCL10 level was positively correlated with the severity of OSAS [CXCL10 level in mild OSAS:82.7 (56.76-145.51);in moderate:OSAS 113.28 (87.15-162.67)].Serum CXCL10 level was independently correlated with AHI scores(r =0.476,P ＜ 0.001).Conclusion:Serum CXCL10 level was independently associated with the occurrence and the severity of OSAS.Serum CXCL10 level can be used as a biomarker to diagnose the OSAS and further to assess the severity of OSAS.

The changes of plasma neuropeptide Y and neurotensin levels in patients with heart failure / 中国医师进修杂志

Objective To observe the changes of plasma neuropeptide Y (NPY) and neurotensin (NT) levels in patients with heart failure and investigate their clinical significance. Methods The levels of plasma NPY, NT of 76 patients with heart failure and 28 normal controls were determined by radioimmunoassay (RIA). The color echocardiogram was used to evaluate the cardiac structure, function and left ventricular ejection fraction (LVEF). Results The level of plasma NPY in patients with heart failure [(159.7 ± 56.3) ng/L] was higher than that in normal controls [(120.8 ± 51.9) ng/L] (P < 0.05), the level of plasma NT [(69.5 ± 29.6) ng/L] was significantly lower than that in normal controls [(99.1 ± 19.3) ng/L] (P < 0.01). Following the severity of heart failure, the level of plasma NPY increased, and the level of plasma NT decreased. The level of LVEF had negative correlative relationship with the level of plasma NPY (γ = -0.31, P < 0.05) and positive correlative relationship with the level of plasma NT (γ = 0.28, P < 0.05). The level of plasma NPY and NT in patients with heart failure had negative correlative relationship (γ = -0.26, P < 0.05). Conclusions The levels of plasma NPY, NT in patients with heart failure are unbalanced. This unbalance may participate in the damage of cardiac function.

Expression of vascular endothelial growth factor in serum of umbilical blood from the newborns of women with severe pre-eclampsia / 国际儿科学杂志

Objective To study the expression and significance of vascular endothelial growth factor(VEGF) in serum of umbilical blood from the newborns of women with severe pre-eclampsia.Methods Radioimmunoassay was used to measure the serum VEGF of umbilical blood from 26 newborns of women with severe pre-eclampsia (severe pre-eclmpsia group) and 30 newborns of normal pregnancy women (control group). According to birth weight-gestational age relation,severe pre-eclampsia group included 15 newborns small for gestational age (SGA group) and 11 newborns appropriate for gestational age (AGA group).Results (1)The VEGF level of umbilical vein blood and umbilical artery blood in severe pre-eclmpsia group was significantly higher than that in control group respectively(t = 2.16, P < 0.05;t = 4.82, P < 0.01). (2) In control group and severe pre-eclampsia group, the VEGF level in umbilical artery blood was significantly higher than that in umbilical vein blood (control group: t = 2.24, P < 0.05;severe pre-eclampsia group: t = 3.00, P < 0.01). (3)In both control group and severe pre-eclampsia group, there was no significant correlation respectively between VEGF levels in umbilical vein blood or umbilical artery blood and newborns' gestational age or birth weight. (4)VEGF level of umbilical artery blood in SGA group was significantly higher than that in AGA group as well as in control group(t = 3.22, P < 0.01 ;t = 6.80, P < 0.01). Conclusions The serum VEGF level of umbilical vein blood and umbilical artery blood from the newborns of women with severe pre-eclampsia was significantly higher than that of normal pregnancy women respectively. The VEGF level of umbilical artery blood can reflect the severity degree of the damage of hypertensive disorder complicating pregnancy to their newborns to some degree.

Radical surgery of kidney cancer by post-pyelic retrograde free control of renal pedicle / 中国医师进修杂志

Objective To explore the effect on radical surgery of kidney cancer by post-pyelic retrograde free control of renal pedicle. Methods The patients with pre-T3a stage kidney cancer were divided into two groups, 50 patients in traditional surgical group (traditional group) and 52 patients in post-pyelic retrograde free control of renal pedicle group(research group). The surgical duration, hemarrhage volume, local tumor recurrence in one year after operation, and distal metastasis rate had been compared between the two groups. Results One hundred and two patients underwent successful operations and had one year of follow-up as scheduled after being discharged from hospital. The traditional group took (130± 37) min for surgical duration, and had (400 ± 306) ml of hemarrhage volume; and the research group took (99 ± 28) min for surgical duration, and had (280 ± 225) ml of hemarrhage volume,there were significant difference between the two groups (P < 0.05). After one year of follow-up, 2% (1/50) of local recurrence rate and 6%(3/50) of distal metastasis rate occurred in the traditional group,and only 2% (1/52) of local recurrence rate and 4% (2/52) of distal metastasis rate happened in the research group. There were no obvious difference between the two groups. Conclusion The radical surgery of kidney cancer by post-pyelic retrograde free control of renal pedicle has such features as easy performance, short surgical duration, less hemarrhage, and can lower the surgical risk, achieve satisfactory efficacy and deserve popularization.

Diagnosis and treatment of female duplicated kidney with urinary incontinence / 中华泌尿外科杂志

Objective To discuss the experiences of management of female duplicated kidney with urinary incontinence. Methods The clinical data of 25 cases with duplicated kidney with urinary incontinence were retrospectively analyzed. They were all female, age ranged from 2 to 12 years old, averaging 7. Fifteen cases were with right side lesions, 10 with left side. The main complaint was urinary incontinence and itching of pudendum. The diagnosis was set up by physical examinations and imaging methods. Results Twenty-five cases reported continent after operation. For the patients taken ureteral replant, the upper kidney function kept or recovered during follow-up. Conclusions Sonography, IVU, and MRU play an important part in the diagnosis of duplicated kidney with urinary incontinence. Operation is the key treatment for this disease.

Changes of plasma neuropeptide Y and neurotensin levels and damages of cardiac function in patients with essential hypertension / 中国医师进修杂志

Objective To observe the changes of plasma neuropeptide Y(NPY) and neurotensin(NT) levels in patients with essential hypertension and the relationship between those changes and damage of cardiac function. Methods Eighty patients of essential hypertension and 28 normal controls were chosen. The cardiac function was divided into 3 classes on the standard of New York Heart Association(NYHA). The plasma NPY,NT concentration was determined by radioimmunoassay. Results The level of NPY in hypertension patients was higher than that of the normal controls(P

Management of bladder cancer near ureteral orifice / 中华泌尿外科杂志

Objective To evaluate the surgical treatment of bladder cancer near ureteral orifice. Methods 42 cases of bladder cancer requiring ureteral reimplantation were divided into two groups at random:20 cases in group A:tongue-shaped incision of bladder wall around ureteral orifice was performed to modify Huctch-Ⅱ ureter implantation and 22 cases in group B:severing the ureter just outside the bladder,the ureter was then implanted into the bladder after partial cystectomy.Duration of the procedure,blood loss,amount of post-operation drainage,early complication,bladder ureter reflux,ureter obstruction,and cancer recurrence rate were studied and compared. Results In group A,the surgery took 60.5?18.5 min,blood loss amounted to 50.6?12.8 ml and the post-operative drainage 50.6?17.8 ml.In group B,the operation needed 150.9?22.4 min,the blood loss amounted to 220.5?28.2ml and post-operative drainage 280.6?58.9 ml.All the above three indexes showed siginificant difference between the 2 groups (P0.05). Conclusions Tongue-shaped incision of bladder wall around the ureteral orifice better with less complication,technically easier and worth recommendation.

A self-designed double J tube for ureteral stenting / 中华泌尿外科杂志

Objective To devise an improved double J tube for ureteral stenting so as to simplify its postoperative removal. Methods One end of the double J tube was made blind and got through the urinary tract via the ureteral wall or via a weak point of the renal cortex.The blind end was then embeded in the subcutaneous tissue and the ureteral stent was left behind for 4～12 weeks.A small incision (0.5 cm) was made in order to withdraw the stent and cystoscopy could be avoided.The self devised tube has been clinically employed for 60 cases. Results The stent has been satisfactory in all the 60 cases and its postoperative removal has been easy with no need of cystoscopy. Conclusions The subcutaneous embedding of a blind end of double J tube is simple and effective and its postoperative withdrawal is easy with no need of cystoscopy.

THE EFFECT OF PROPOFOL ON THE CONTENT OF ENDOTHELIN AND CALCITONIN GENE-RELATED PEPTIDE IN THE MONKEYS WITH HEMORRHAGIC SHOCK AND RESUSCITATION / 解放军医学杂志

To investigate the effect of propofol on the plasma contents of endothelin(ET) and calcitonin gene related peptide(CGRP).Twelve monkeys with hemorrhagic shock were divided randomly into two groups.The monkeys in propofol group(PG) were administered propofol to 8mg/L plasma concentration by target control infusion with computer,while monkeys in control group(CG) were not .Venous blood were collected to determine plasma ET and CGRP contents by radioimmunoassay before bleeding, 2 hours after hemorrhagic shock and 2h after resuscitation. Compared with control group,the CGRP level and CGRP/ET of PG were significantly increased at 2h after hemorrhagic shock and 2h after resuscitation,while ET level of PG at 2h after resuscitation was significantly lower than that of CG. These findings indicate that propofol can increase the plasma content of CGRP and decrease the plasma content of ET in monkeys after hemorrhagic shock and resuscitation, and ET may play an important role in the development of hemorrhagic shock.

Changes in plasma neurotension level of patients with coronary heart disease and its clinical significance / 中国病理生理杂志

AIM: To investigate the plasma neurotensin(NT) concentration in patients with coronary heart disease: acute myocardial infarction(AMI),unstable angina(UA),stable angina pectoris(SAP), old myocardial infarction (OMI), and to study the relationship between the plasma NT level and the myocardial ischemia . METHODS: The plasma NT concentration of 30 patients with AMI,32 patients with UA,35 patients with SAP, 31 patients with OMI and 32 normal controls were determined by radioimmunoassay(RIA). RESULTS: The plasma NT level in patients with AMI(24 h),in patients with UA when angina attacked is significantly higher than that of healthy controls. The plasma NT level in patients with SAP, in patients with OMI is not significantly different from that of healthy controls. The NT level of patients with UA when angina attacked is significantly higher than that after 2 weeks treatment (P