Construction of experience-based individual development interpretation (EBIDI) and its application in the course of growth and development for children / 中华医学教育探索杂志

Objective:To explore the hierarchical learning path and its internal logic of experiential learning at three levels of "knowledge, emotion and action" based on Kolb's experiential learning theory, and to design the learning method of "experience-based individual development interpretation (EBIDI)", apply it in the course of "growth and development for children" and evaluate its implementation effectiveness.Methods:EBIDI learning method was implemented among undergraduate students of health education major in 2016-2019. The "ladder of abstraction" analysis on case data was conducted to analyze the learner's reflection report of development and group case study report and find the significant learning outcomes. According to the results, this paper explained the "three levels and six steps" experiential learning model.Results:Experiential learning included two types of introspective experience and observational experience, and its learning results were shown in two levels of identification/comprehension and evaluation/application. EBIDI mainly achieved learning effects through four paths: getting value identity in introspective learning; promoting learning transfer in contextual reappearance; trying innovation and criticism in case study, and rousing emotion and motivation based on lively interests.Conclusion:EBIDI and its experiential learning model can provide a theoretical framework for the path design and effect evaluation of experiential learning and can provide a perspective for the curriculum design for adolescent health education activities.

CT features in diagnosis of traumatic diaphragmatic rupture / 中国医学影像技术

Objective To explore value of CT features in diagnosis of traumatic diaphragmatic rupture.Methods A retrospective analysis was performed on totally 256 patients with suspected traumatic diaphragmatic rupture,among them 128 were confirmed after surgery.All patients underwent CT scan before surgery.The prevalence of CT findings were recorded,including diaphragm discontinuity or segmental non-recognition of diaphragm," collar" sign," intrathoracic herniation of abdominal contents" sign," dependent viscera" sign," dangling diaphragm" sign and " thickness of the diaphragm" sign.The sensitivity and specificity of each sign were calculated.Results The sensitivity of diaphragm discontinuity or segmental non-recognition of diaphragm,"collar" sign,"intrathoracic herniation of abdominal contents" sign,"dependent viscera" sign,"dangling diaphragm" sign and "thickness of the diaphragm" sign of diaphragmatic rupture was 75.00％ (96/128),84.37％ (108/128),78.13％ (100/128),76.56％ (98/128),54.68％ (70/128) and 46.87％ (60/128),respectively.The specificity was 93.75％ (120/128),98.43％ (126/128),98.43％ (126/128),99.21％ (127/128),93.75％ (120/128) and 84.38％ (108/128),respectively.The sensitivity and specificity of overall MSCT signs was 92.18％ and 100％,respectively.Conclusion CT features have high value in diagnosis of traumatic diaphragmatic rupture.

Analysis of CT imaging findings and pathological features of the thymic cyst / 实用放射学杂志

Objective To analyze CT imaging findings and pathological features of the thymic cyst.Methods The CT findings of 20 cases with thymic cyst confirmed by pathology were analyzed retrospectively.The analysis included the location,shape ,size ,density ,contour, unilocular or multilocular,with or without walls,enhancement and lesion periphery.The pathology results were compared to CT findings.Results All lesions were located in the anterior mediastinum,in which the location of left side in 12 cases,right side in 6 cases,median mediastinum in 2 cases.All lesions had clear border and unilocular,including round shape in 4 cases,oval shape in 8 cases,and irregular shape in 8 cases with triangular shape in 1 case,the size range was 2-6 cm.4 cases had obvious cyst wall.The CT value of the cyst had range of 4-53 HU,with 10 cases less than 10 HU and 10 cases greater than 10 HU.There was no enhancement within the cysts of 20 cases and the cyst wall had enhancement in 4 cases.All cases of pathological findings were confirmed as thymus cyst.Gross sample showed gray red or isabeling.The lesion was cystic in 18 cases,soft stereocyst in 2 cases,bright yellow liquid within the capsule in 10 cases,butter fat in 5 cases,chylomicrons in 3 cases,unilocular in 19 cases and multilocular in 1 case (butter fat).Microscope showed the fibrous capsule wall in all cases,lined with squamous epithelium,ciliated columnar epithelium,monolayer columnar epithelium,in which could be seen normal thymus tissue.The thickness of the wall was no more than 0.5 cm,and multilocular wall smooth,no obvious inflammatory response in the surrounding.Conclusion CT image findings can clearly show the thymic cyst site,shape,size,density and boundaries,unilocular or multilocular,with or without walls.The CT image can reflect pathological features of the thymic cyst,and can provide accurate and reliable information for the clinic.

Difference in upper airway between OSAS patients and normal population with dynamic radiography / 实用放射学杂志

Objective To analyze the difference in changes of upper airway between obstructive sleep apnea syndrome (OSAS) patients and normal population using dynamic radiography under sleeping and awake conditions.Methods 20 normal subjects and 20 OSAS patients underwent the dynamic digital radiography of the upper airway under sleeping and awake conditions.And the dynamic diameter changes of the upper airway at velopharyngeal,oropharynx and hypopharynx levels were measured and recorded.Results The velo-pharyngeal upper airway collapse in normal subjects under sleeping condition was significantly larger than that under awake condition (P <0.014).However no significant differences in the collapse of upper airway at oropharynx and hypopharynx level were observed between sleeping and awake conditions.For the OSAS patients,the upper airway collapses at velopharyngeal,oropharynx and hypopharynx levels under sleeping condition were significantly larger than those under awake condition respectively (P <0.000,P =0.001,P <0.013). During awake state,there were no significant differences in upper airway collapse at velopharyngeal,oropharynx and hypopharynx levels between normal subjects and OSAS patients under awake condition.During sleeping state,the upper airway collapses of OSAS patients were significantly larger than that of normal subjects at velopharyngeal and oropharyngeal levels (P =0.000,P =0.003). However,no significant difference was observed at hypopharynx level.Conclusion The normal upper airway represents obvious col-lapse at velopharyngeal level under sleeping condition.However,the upper airway in OSAS patients at velopharyngeal,oropharynx and hypopharynx level showed significant collapse under sleeping condition compared with that under awake condition.The upper airway of the OSAS patients represents obvious collapse at velopharyngeal and oropharyngeal level under sleeping condition,however no abnormal changes can be observed under awake condition.

A research about nursing student's attitude and caring intent toward death / 中国实用护理杂志

Objective To explore the attitude and caring intent toward death among nursing students,so as to provide information for nursing school to make a point of taking death education. Methods 225 samples of nursing students from three grades of Shanghai Jiaotong University were conducted questionnaire research. The Questionnaire included personal background, personal thanatopsis, students' attitude and caring intention to death. Results Students with high grade, practical experience in clinical settings, or with experience in death care showed a positive thanatopsis and high awareness while negative caring intention on death events. Against the backdrop of pre-school in rural areas showed more positive care intention. The death attitude of nursing students was also affected by their health status and other factors. Conclusions The death education should focus on the building of caring intention and caring behavior for nursing students.

Detection of TNF-related apoptosis inducing ligand gene expression by real-time fluorescent quantitative method / 中华检验医学杂志

Objective To establish a real time fluorescent quantitative revers transcripatase PCR(FQ-RT-PCR) method to detect the expression level of TNF-related apoptosis inducing ligand (TRAIL) mRNA in peripheral blood mononuclear ceils (PBMC) and determine its expression level in healthy donors, HBV-caused cirrhosis patients and PBC ones. Methods Specific primers and Taqman-MGB probe were designed and β-actin was used as endogenous control. The amplified fragment was obtained by RT-PCR. The quantitative template was constructed and then the fluorescent intensity was documented on the ABI Prism7000 analyzer. The standard curve was established, according to which, the TRAIl. mRNA levels in 30 healthy individuals, 30 patients with primary biliary cirrhosis (PBC) and 25 ones with HBV-caused cirrhosis were calculated automatically by software after the values of cycle threshold (Ct) were detected continuously during amplification. Results The linear detection range of the assay for TRAIL gene was 103 - 109 copies/ ug RNA ( r=-0.997). The coefficients of variation of both intra-and inter-assay reproducibility for high concentration samples were 5.6% and 6. 3% , respectively, and those for low concentration samples were12.5% and 14. 6%. The TRAIL mRNA expression level in PBC patients was [ (3.3±2.5)×105copies/ugRNA] significantly higher than that of healthy control [ (0.5±0.2)×105 copies/ug RNA ] (t=5.994,P <0.01). TRAIl. mRNA level of HBV-caused cirrhosis patients[ (2.1±0.9)×105 copies/ug RNA] wasalso significantly elevated (t=8.536, P<0.01). However, the difference between these two diseased groups had no significance. Conclusion We have successfully set up a FQ-RT-PCR method for detecting TRAIL gene expression and found that its expression levels of peripheral blood mononuelear cells in PBC and HBV caused cirrhosis patients are elevated, which provides a new insight into mechanism study of liver injury caused by cirrhosis.