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This paper focuses on the practical necessity of discipline-integrated PBL curriculum in cultivating clinical thinking ability of college students majoring in clinical medicine. Through the teaching process of group discussion of some real and complete cases, this paper explains in detail how to cultivate medical students' clinical thinking ability by discipline-integrated PBL curriculum, discusses the implementation of ideological and political education associated with clinical medicine by heuristic teaching from close touching with clinical case and implicitly infiltration of the socialist core values such as dedication and integrity, and elaborates the humanistic quality and psychological comfort levels of medical students by being close to clinical patients. After five years of teaching practice, the teaching effect of discipline-integrated PBL curriculum has been approved by the national clinical medicine professional certification experts and praised by students. We believes that the development of discipline integrated PBL curriculum in medical college can strengthen students' problem-based autonomous learning ability, significantly improve the two-way integration ability between basic medical courses and basic medicine, and significantly build students' clinical thinking and clinical decision-making ability.
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The thalamostriatal pathway is implicated in Parkinson's disease (PD); however, PD-related changes in the relationship between oscillatory activity in the centromedian-parafascicular complex (CM/Pf, or the Pf in rodents) and the dorsal striatum (DS) remain unclear. Therefore, we simultaneously recorded local field potentials (LFPs) in both the Pf and DS of hemiparkinsonian and control rats during epochs of rest or treadmill walking. The dopamine-lesioned rats showed increased LFP power in the beta band (12 Hz-35 Hz) in the Pf and DS during both epochs, but decreased LFP power in the delta (0.5 Hz-3 Hz) band in the Pf during rest epochs and in the DS during both epochs, compared to control rats. In addition, exaggerated low gamma (35 Hz-70 Hz) oscillations after dopamine loss were restricted to the Pf regardless of the behavioral state. Furthermore, enhanced synchronization of LFP oscillations was found between the Pf and DS after the dopamine lesion. Significant increases occurred in the mean coherence in both theta (3 Hz-7 Hz) and beta bands, and a significant increase was also noted in the phase coherence in the beta band between the Pf and DS during rest epochs. During the treadmill walking epochs, significant increases were found in both the alpha (7 Hz-12 Hz) and beta bands for two coherence measures. Collectively, dramatic changes in the relative LFP power and coherence in the thalamostriatal pathway may underlie the dysfunction of the basal ganglia-thalamocortical network circuits in PD, contributing to some of the motor and non-motor symptoms of the disease.
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Animais , Masculino , Ondas Encefálicas , Fisiologia , Corpo Estriado , Sincronização Cortical , Fisiologia , Neurônios Dopaminérgicos , Fisiologia , Eletrocorticografia , Vias Neurais , Oxidopamina , Transtornos Parkinsonianos , Ratos Wistar , Núcleos Talâmicos , Caminhada , FisiologiaRESUMO
BACKGROUND:Recovery of motor and sensory function from peripheral nerve injury is relatively slow and incomplete. It is a difficult problem for orthopedic surgeons that mainly leads to the decline in the quality of life in patients. OBJECTIVE: To conclude the methods and corresponding outcomes in peripheral nerve regeneration by analyzing the new treatment means for peripheral nerve injury. METHODS:PubMed, Wanfang, CNKI databases were retrieved for relevant articles using key words of “nerve injury, regeneration”, and then retrieval data were sorted and analyzed. RESULTS AND CONCLUSION:In recent years, in-depth studies on peripheral nerve repair have been made in the folowing aspects: surgical mode, drug, cytokine, gene transfer and biomaterials as wel as traditional Chinese medicine. If the detect size is four times longer than the diameter of nerves, the nerve regeneration chamber can achieve good outcomes. The methods of restoring nerve continuity folowing nerve injury are developed from surgical anastomosis to photochemohistological method, thermal laser welding, plastic repair and other emerging technologies. Studies have found that plasminogen activator, nerve growth factor, neurotrophic factor, recombinant erythropoietin, human tissue kalikrein, B vitamins and their derivatives, herbal preparations, immunosuppressive agents al can promote nerve regeneration.
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BACKGROUND:Studies have shown that craniocerebral injury can promote the repair of sciatic nerve injury in rats, but its precise mechanism remains unclear. OBJECTIVE:To further explore the action mechanism of craniocerebral injury on the repair of sciatic nerve injury using morphology and histology. METHODS:Sixty specific-pathogen-free healthy male Sprague-Dawley rats were randomly divided into two groups. Rats with craniocerebral injury and sciatic nerve injury were considered as the experimental group. Rats with simple sciatic nerve injury were considered as the control group. Classical Feeney method was used in models of craniocerebral injury and SunderlandV sciatic nerve injury. At 8 and 12 weeks after modeling, sciatic nerve index was detected. Masson staining and NF200 immunofluorescence staining were used to observethe nerve regeneration atthe anstomotic site. Transmission electron microscope was used to observe the number of regenerative axons. RESULTS AND CONCLUSION:At 8 and 12 weeks after modeling, compared with the control group, gait and sciatic nerve index recovered better in the experimental group. In the experimental group, Masson staining showed fewer nerve membrane colagen fibers, and the axon arranged neatly.NF200 immunohistochemistry showed that in the experimental group, the density of regenerated nerves was high, and nerveswere regularly distributed. Transmission electron microscopy showed that in the experimental group, regenerative axons were regularly arranged, colagen scar was less, and myelin layer arranged regularly. Results suggested that the craniocerebral injury in rats may promote the repair of peripheral nerve injury by reducing scar colagen in nerve endings.
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Objective To discover the best physical training way including frequency and intensity each day ,and to guide pa‐tients to get the best cure .Methods Totally 60 chicken ,which were randomly divided into 3 groups ,20 for each ,the deep flexor tendon of the third left toes were found ,repairing after cut them off .Flexor tendon proximal were found by making knees incision then indwelling long silk line .External fixation bandage were used .Their left toes were accepted physical training ,Training stand‐ards :6 pulling backs each time ,toe flexion 1/4 arc ,but less than 2 N .For group A ,exercised once a day ,twice a day for group B , three times a day for group C .Right ones were consider as control group weren′t processed after operation .28 days later ,tendon distance was recorded by using 2 N pulling forces at tendon proximal with aspiring balance .Gross specimen was observed and histo‐logical specimens using Tang Jinen classification method to classify adhesions ,and the dates were analyzed by statistics SPSS 19 .0 . Results Group A remaining of 18 ,rate of 5 .56% ,grade Ⅰ of 1 ,Ⅱ of 2 ,Ⅲ of 4 ;Ⅳ of 10 .Group B remaining of 17 ,rate of 5 .88% , grade Ⅰ of 12 ,Ⅱ of 2 ,Ⅲ of 1 ,Ⅳ of 1 .group C remaining of 16 ,15 toes broke again ,fracture rate was 93 .75 % ,grade Ⅰ of 1 ,con‐trol group were grade Ⅳ .Between group A and B there were no significant differences in degree of adhesion(P> 0 .05) .Group A and Cs′ differences were statistically tested (P α′) .Conclusion Physical training can reduce chicken′s tendon adhesion effectively .
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BACKGROUND:The adhesion between muscle tendon and surrounding tissue after tendon restoration is one hot topic in clinic. OBJECTIVE:To construct a deep flexor tendon transection model in the third toe of female Leghorn chicken and to explore the effect of peritenon transplantation on the prevention of tendon adhesions. METHODS:After the transection models were successful y established, the third toe of left claw was taken as experimental group A. The transected tendon was sutured, the tendon anastomosis end was wrapped with the peritenon of the deep flexor tendon from the ipsilateral fourth toe (experimental group B). The third toe of right claw served as control group A, the transfected tendon was sutured and restored with the peritenon. The fourth toe of right claw was taken as control group B. Gross observation and histological observation of the tendon were performed. RESULTS AND CONCLUSION:At 28 days postoperatively, gross observation and histological observation of Leghorn chicken were performed and compared using the Kruskal-Wal isH and Nemenyi test, respectively. The results showed that, the therapeutic effect was better in experimental group A than in control group A (P0.05). The flexor function was evaluated and compared with the least significant difference t-test. The results showed that the postoperative effect was better in experimental group A than in control group A (P0.05). Peritenon transplantation can effectively prevent tendon adhesions and has little impact on normal tendon sliding.
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Objective To investigate the prognostic value of plasma brain natriuretic peptide (BNP) in patients with acute cerebral infarction. Methods Sixty-five patients with first-ever acute cerebral infarction and 32 healthy controls were recruited. The neurological deficits in patients with cerebral infarction were evaluated by using Chinese Stroke Scale (CSS).Plasma BNP levels were detected by immunofluorescence technique. Death and recurrent stroke events were followed up. Plasma BNP levels were compared between an event group and a non-event group, and the relationship between plasma BNP levels and poor prognosis was analyzed.Results Plasma BNP levels in patients with acute cerebral infarction was significantly higher than those in healthy controls (238.7 ± 131.6 pg/ml vs 38.7±23.8 pg/ml, P <0.01). Nine patients (13.8%) died, and 8 (12.3%) had nonfatal recurrent stroke during the follow-up period. Compared to the non-event group, the baseline plasma BNP levels in the death/recurrent stroke event group were significantly higher (304.0 ± 134.9 pg/ml vs 214.4 ± 120.9 pg/ml,P < 0.01). There was significant correlation between plasma BNP levels and CSS scores (r = -0.359, P <0.05). After performing multivariate analysis of various risk factors, it found that BNP levels (OR = 3.5, 95 % CI 2.1 to 5.8, P < 0.01), advanced age (OR = 4.1,95% CI 1.7 to 9.2, P <0.01) and CSS scores (OR =2.6, 95% CI 1.6 to 4.3, P <0.01)were the independent predictors of poor outcome. Conclusions The increased BNP levels are the recent death and recurrent independent predictors in patients with acute cerebral infarction.
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0.05), while the differences between hepatocarcinoma and cirrhosis as well as hepatocarcinoma and hepatitis B were significant (P