Establishment and practice of the blended teaching model in human embryology / 中华医学教育探索杂志

Based on the virtual simulation of "digital embryo" in the digital teaching platform for medical morphology, this study constructs the course resources of human embryology by integrating the contents of the course, recording micro-videos, formulating course guides, and analyzing clinical cases, then implements the blended teaching model of pre-class preview, in-class discussion, and after-class expansion, and establishes a course evaluation system combining formative assessment and end-of-course assessment. Comparison of assessment scores and satisfaction questionnaire between traditional off-line teaching and blended teaching showed a significant improvement in total score, and more than 5% of the students reported a significant reduction in the difficulty of the course, while the degree of satisfaction with the course was increased by 11%. This suggests that the establishment of the blended teaching model of human embryology meets the requirements for personalized and diversified learning among students, realizes the diversity of teaching methods and teaching evaluation, and improves the quality of teaching.

Secondary therapy-related acute megakaryocytic leukemia in childhood acute lymphocytic leukemia: report of one case and review of literature / 白血病·淋巴瘤

Objective:To explore the laboratory characteristics and diagnostic methods for therapy-related acute megakaryocytic leukemia (t-AMKL).Methods:The data of one child with acute lymphoblastic leukemia (ALL) in the Blood Disease Hospital of Chinese Academy of Medical Sciences & Peking Union Medical College in September 2014 was retrospectively analyzed. After inducing remission for more than 43 months, the child was diagnosed as t-AMKL.Results:After the diagnosis of ALL, the child was given chemotherapy with standard childhood ALL regimen. After 43 months, t-AMKL was diagnosed by comprehensive morphology, cytogenetics, and molecular biology. Bone marrow morphology showed that the proportion of primitive cells was 0.44; flow cytometry showed the phenotype was abnormal myeloid primitive cells; the pathology result showed that the abnormal cells weakly expressed CD42b and CD61; the electron microscopy showed platelet peroxidase (PPO)-positive and myeloperoxidase (MPO)-negative; the bone marrow immunohistochemistry showed the positive rate of CD41 was 34%; the child had a complex karyotype. After reviewing his medical history, he was diagnosed as t-AMKL.Conclusion:The t-AMKL is relatively rare, and it is helpful to improve the prognosis of patients by completing the relevant examinations for early diagnosis.

Cost-minimization Analysis of Interferonα1b and Interferonα2b in the Treatment of Chronic Hepatitis C / 中国药房

OBJECTIVE:To compare the economics of interferon α1b and α2b in the treatment of chronic hepatitis C. METH-ODS:By retrospective study,114 patients with chronic hepatitis C who received interferon were selected,60 patients received interfer-on α1b were divided into group A and 54 patients received interferon α2b were divided into group B. Negative conversion rate of HCV-RNA,normalization rate of ALT and the incidence of ADR in 2 groups were compared,and pharmacoeconomic analysis was conducted. RESULTS:Negative conversion rates of HCV-RNA in group A in 4,12,24,36,48 weeks were 55.00%,71.67%, 63.33%,61.67% and 65.00%,group B were 64.81%,66.67%,62.96%,55.56% and 61.11%,respectively,there were no signifi-cant differences between 2 groups (P>0.05);after treatment,normalization rate of ALT in group A was 95.23%,group B was 96.10%,there was no significant difference between 2 groups(P>0.05);and there were no significant differences in the incidence of ADR between 2 groups (P>0.05),so cost-minimization analysis was used to evaluate pharmacoeconomics. Therapy cost in group A was 13 216.56 yuan,group B was 7 929.60 yuan,group B was lower to group A;sensitivity analysis received the same results. CON-CLUSIONS:Interferonα2b is more economical thanα1b in the treatment of chronic hepatitis C.

Construction and application of the micro-course of human body shape and structure in higher vo-cational nursing specialty / 中华医学教育探索杂志

To explore micro-course suitable for human morphology in high vocational nursing pro-fession and meanwhile attempt to make a combination between micro-course and flipped-classroom in some chapter, accompanied by taking advantage of the digital equipments such as computer, tablet and smart phone to carry out teaching. Based on digitization, we aim to lead the fragmented time and energy of students to this beloved teaching method, realizing “self-inquiry learning before class, interactive learning between teacher and students in class, effect assessment after class to reinforce the independent participation and inspire the interest of students in human morphology learning.

Effect analysis of dynamic blood glucose monitoring and clinical intervention in the middle and late pregnant women with diabetes mellitus / 中国医师进修杂志

Objective To investigate the clinical value of dynamic glucose monitoring in the middle and late pregnant women with diabetes mellitus,and the related clinical and nursing measures.Methods One hundred admitting cases of the middle and late pregnant women with diabetes mellitus were grouped according to the random number table,50 cases of the control group were treated with finger tip blood glucose monitoring and conventional treatment,50 cases of dynamic blood glucose monitoring and comprehensive clinical and nursing intervention for the observation group.The blood glucose control situation with different time,the incidence of hypoglycemia,the actual control range of the glycosylated hemoglobinblood and the length of hospital stay and so on were evaluated in two groups.Results The incidence of hypoglycemia in the observation group was 6.0％ (3/50),the control group was 24.0％ (12/50),the difference was statistically significant (P ＜ 0.05).In the early morning,after breakfast 2 h,before and after lunch 2 h,before and after dinner 2 h and before bed and other different time,the blood glucose level with the observation group was lower than that in the control group (P ＜ 0.05).At the same time,in the blood glucose effective controlling time,hospitalization time,the observation group was better than the control group (P ＜ 0.05).The blood glucose level and the detection range of the glycosylated hemoglobin were also detected in the safe state for outpatient follow-up after hospital discharge.Conclusions The intervention of dynamic blood glucose monitoring and comprehensive clinical and nursing measures in middle and late pregnant women with diabetes mellitus is conducive to control blood glucose level timely and accurately and to improve their prognosis.It is the key to the success of the future obstetric prevention and diagnosis and treatment of the disease,and is recommended clinical popularization.

Identification and characterization of clinical features and gene mutation in a patient with iron refractory iron deficiency anemia (IRIDA) / 中华血液学杂志

<p><b>OBJECTIVE</b>To report the clinical data of a case of iron-refractory iron deficiency anemia (IRIDA), so as to improve the understanding of IRIDA.</p><p><b>METHODS</b>The IRIDA patient's hematological characteristics were summarized and analyzed. The hepcidin levels were tested by ELISA kit. The TMPRSS6 gene was amplified by PCR reaction and its mutation was analyzed by sequencing. The effect of TMPRSS6 gene mutation on TMPRSS6 protein tertiary structure was predicted by Swiss-Model.</p><p><b>RESULTS</b>The patient was characterized by typical microcytic hypochromic anemia, low transferrin saturation, more reduction of intracellular iron than exocellular iron. The plasma hepcidin level was 213.77 μg/L which was significantly higher than that of IDA patients [5.19(3.31-12.02) μg/L]. The patient also carried a homozygous missense mutation of K253E in exon 7 of TMPRSS6.</p><p><b>CONCLUSION</b>In children and younger IDA patients with no reason for iron deficiency but unresponsiveness to routine iron treatment, the diagnosis of IRIDA needs to be considered. Serum hepcidin level and TMPRSS6 gene mutation should be detected.</p>