Observing and understanding of clinical medical education in the department of cardiology of Yale New Haven Hospital in the United States / 基础医学与临床

Clinical teaching plays a vital role in medical education ,it improves the medical students 'comprehensive capacity in analyzing and solving problems with their knowledge independently , and serves as a close link between the past and the future .It is a difficult and key point on how do students grasp the knowledge of cardiovascular dis -eases well in clinical teaching .This article shows the cardiologists 'methods of training the medical students in Yale New Haven Hospital from the auther 's point of view , and compares with the auther 's related experience in China in order to exchange opinions with other doctors and explore the cardiovascular diseases 'training methods .

Serum 25(OH)D Level and Parathyroid Hormone in Chinese Adult Population: A Cross-Sectional Study in Guiyang Urban Community from Southeast of China.

Objective. To evaluate vitamin D status and serum parathyroid hormone (IPTH) of healthy adults living in Guiyang. Design and Participants. We conducted a cross-sectional evaluation in the General Community in Guiyang by cluster sampling method. The data was a part of 1510 participants (634 men, 876 women) aged 20-79 years median 45.2 years from November 2009 to February 2010 in Guiyang Health Measures Survey. Measurements. Aradioimmunoassay was used to measure the level of 25-hydroxyvitamin D [25(OH)D] and intact parathyroid hormone (iPTH). Results.The mean serum 25(OH)D level was (20.4 ± 9.0) ng/mL and the highest level among participants aged 40-59 years (22.8 ng/mL). The mean serum PTH level was (32.1 ± 13.7) pg/mL and the lowest level among participants aged 40-50 years (30.8 ng/mL). Serum 25(OH)D was below 50 nmol/liter in 52.3%, below 75 nmol/liter in 84.6%, and above 75 nmol/liter in 15.4% of the respondents. Secondary hyperparathyroidism was 5.4% (5.4% among men and 4.6% among women). The prevalence of secondary hyperparathyroidism increased (5.8%, 6.5%, and 7.1%, resp.) with decreasing serum 25(OH)D levels among subjects who were 30 to 20, 19.9 to 10, and <10 ng/mL, respectively. Serum 25(OH)D was inversely associated with serum PTH. Conclusions. Vitamin D insufficiency and its complication of secondary hyperparathyroidism are common.

Web-based curriculum model of “write to learn” : a case report / 中华医学教育探索杂志

Transitional relationship between input and output in the writing course was researched from multidimensional perspectives under the web-based writing course example of “ write to learn” and guided by input and output hypothesis.The improving methods for teaching of college English writing course were discussed in order to provide references.

[The correlation between panicle angle and rice quality and genetic analysis on rice quality in japonica rice (Oryza sativa L.)].

Linear correlation between panicle angle and 10 quality traits were studied by using P1, P2 and 349 lines of the RIL population in a cross of Bing 8979(erect panicle)/C bao (curve panicle) in japonica rice. We found that, there were no linear correlation between panicle angle and brown rice rate , head rice rate, chalky grain rate, chalkiness area, gelatinization temperature, gel consistency and apparent amylose content. The correlation coefficients between panicle angle and milled rice rate, between panicle angle and grain length, and between panicle angle and grain length/width ratio were 0.124*, 0.470** and 0.241** , respectively. By using major gene-polygene mixed inheritance models, genetic analyses showed that brown rice rate, milled rice rate and apparent amylose content were controlled by two major genes plus polygenes. The two major genes expressed additive effect and additive x additive effects. Head rice rate, grain length, grain length/width ratio and gel consistency were controlled by two major genes with additive-epistatic effects plus polygenes. Chalky grain rate, chalkiness area and gelatinization temperature were controlled by three major genes with additive-epistatic effects plus polygenes. Brown rice rate, milled rice rate, head rice rate, chalky grain rate, chalkiness area and gelatinization temperature traits were mainly governed by major genes. Grain length, grain length/width ratio, gel consistency and apparent amylose content traits were mainly governed by polygenes.

[Correlation between serum levels of IL-18 and acute graft versus host disease in patients after allogeneic hematopoietic stem cell transplantation].

This study was aimed to investigate the correlation between the serum levels of IL-18 and acute graft versus host disease (aGVHD) in patients received allogeneic hematopoietic stem cell transplantation (allo-HSCT), and to explore the role of serum IL-18 levels in the pathogenesis of aGVHD so as to provide a reliable and early indicator for the diagnosis of aGVHD. 62 patients received allo-HSCT were enrolled in this study. Before and after transplantation, as well as at onset of aGVHD. The serum levels of IL-18 were analyzed by ELISA. 62 patients were divided into 5 groups: group A without aGVHD (28 cases) referred to the patients who had no aGVHD after transplantation and whose specimen were collected before transplantation; group B with aGVHD before transplantation (34 cases) referred to the patients who had aGVHD after transplantation and whose specimen were collected before transplantation; group C before the onset of aGVHD (34 cases) referred to patients with I - II grade a GVHD whose specimen were collected before 3 - 4 days, and according to whether the I - II grade aGVHD patients developed III - IV grade or not after treatment, these patients were divided into two subgroups retrospectively, one subgroup had good curative effect (18 cases) and the other subgroup had not (16 cases); group D with I - II grade aGVHD; group E with III - IV grade aGVHD (16 cases). The results showed that 34 patients developed I - II grade aGVHD, then out of them 16 patients (16/34) developed III - IV grade aGVHD. The serum levels of IL-18 in these patients with aGVHD were higher than that in patients without aGVHD. About 3 days before onset of aGVHD, the serum levels of IL-18 started to increase. The serum levels of IL-18 were correlated with the severity of aGVHD, but no correlation was found with infection, conditioning regimens and disparity of HLA-typing. The serum levels of IL-18 in the early stage of aGVHD were correlated with prognosis. The aGVHD of patients with higher serum levels of IL-18 easy developed to III - IV grade aGVHD. It is concluded that the serum level of IL-18 in the patients received allo-HSCT is related to the occurrence of aGVHD. Detections of serum IL-18 are helpful for the early diagnosis of aGVHD, and the serum levels of IL-18 may be considered as a reliable indicator to evaluate the prognosis and severity of aGVHD.

Correlation between serum levels of IL-18 and acute graft versus host disease in patients after allogeneic hematopoietic stem cell transplantation / 中国实验血液学杂志

This study was aimed to investigate the correlation between the serum levels of IL-18 and acute graft versus host disease (aGVHD) in patients received allogeneic hematopoietic stem cell transplantation (allo-HSCT), and to explore the role of serum IL-18 levels in the pathogenesis of aGVHD so as to provide a reliable and early indicator for the diagnosis of aGVHD. 62 patients received allo-HSCT were enrolled in this study. Before and after transplantation, as well as at onset of aGVHD. The serum levels of IL-18 were analyzed by ELISA. 62 patients were divided into 5 groups: group A without aGVHD (28 cases) referred to the patients who had no aGVHD after transplantation and whose specimen were collected before transplantation; group B with aGVHD before transplantation (34 cases) referred to the patients who had aGVHD after transplantation and whose specimen were collected before transplantation; group C before the onset of aGVHD (34 cases) referred to patients with I - II grade a GVHD whose specimen were collected before 3 - 4 days, and according to whether the I - II grade aGVHD patients developed III - IV grade or not after treatment, these patients were divided into two subgroups retrospectively, one subgroup had good curative effect (18 cases) and the other subgroup had not (16 cases); group D with I - II grade aGVHD; group E with III - IV grade aGVHD (16 cases). The results showed that 34 patients developed I - II grade aGVHD, then out of them 16 patients (16/34) developed III - IV grade aGVHD. The serum levels of IL-18 in these patients with aGVHD were higher than that in patients without aGVHD. About 3 days before onset of aGVHD, the serum levels of IL-18 started to increase. The serum levels of IL-18 were correlated with the severity of aGVHD, but no correlation was found with infection, conditioning regimens and disparity of HLA-typing. The serum levels of IL-18 in the early stage of aGVHD were correlated with prognosis. The aGVHD of patients with higher serum levels of IL-18 easy developed to III - IV grade aGVHD. It is concluded that the serum level of IL-18 in the patients received allo-HSCT is related to the occurrence of aGVHD. Detections of serum IL-18 are helpful for the early diagnosis of aGVHD, and the serum levels of IL-18 may be considered as a reliable indicator to evaluate the prognosis and severity of aGVHD.

HLA-DRB1 allele polymorphisms in genetic susceptibility to esophageal carcinoma.

AIM: To probe into the genetic susceptibility of HLA-DRB1 alleles to esophageal carcinoma in Han Chinese in Hubei Province. METHODS: HLA-DRB1 allele polymorphisms were typed by polymerase chain reaction with sequence-specific primers(PCR-SSP) in 42 unrelated patients with esophageal cancer and 136 unrelated normal control subjects and the associated HLA-DRB1 allele was measured by nucleotide sequence analysis with PCR.SAS software was used in statistics. RESULTS: Allele frequency (AF) of HLA-DRB1*0901 was significantly higher in esophageal carcinoma patients than that in the normal controls (0.2500 vs 0.1397, P=0.028, the odds ratio 2.053, etiologic fraction 0.1282). After analyzed the allele nucleotide sequence of HLA-DRB1*0901 which approachs to the corresponded exon 2 sequence of the allele in genebank. There was no association between patients and controls in the rested HLA-DRB1 alleles. CONCLUSION: HLA-DRB1*0901 allele is more common in the patients with esophageal carcinoma than in the healthy controls, which is positively associated with the patients of Hubei Han Chinese. Individuals carrying HLA-DRB1*0901 may be susceptible to esophageal carcinoma.

The value of 64-slice spiral CT angiography based on pre-contrasted raw data in diagnosing pulmonary arteriovenous fistula / 中华放射学杂志

Objective To evaluate the value of 64-slice spiral CT angiography based on pre- contrasted raw data in diagnosing pulmonary arteriovenous fistula.Methods 64-slice spiral CT plain scan and enhanced scan was performed in 16 patients with pulmonary arteriovenous fistula,pulmonary angiography based on pre-contrast and post-contrast raw data was performed respectively,including maximum intensity projection(MIP),shaded-surface display(SSD),and volume rendering(VR).According to the results of angiocardiography and surgical findings,comparson of the three methods was made in the display of PAVF in pre-contrast and post-contrast phase images.Results 8 of the 16 PAVF cases were single lesion,8 cases were multi-lesions.30 PAVF lesions were found in all the patients.MIP,SSD and VR based on pre-contrast raw data displayed PAVF lesions in 20,14,and 22,respectively.The combination of the 3 methods based on pre-contrast raw data could show 26 PAVF lesions.MIP,SSD,and VR based on post-contrast raw data displayed PAVF lesions in 24,18,and 30,respectively.The combination of the 3 methods based on post- contrast raw data could show 30 PAVF lesions.Conclusion 64-slice spiral CT angiography based on pre- contrasted raw data can clearly show the position,number,and shape of PAVF lesions,which is of great value in diagnosing PAVF.

Hypoplasia of cochlear nerve foramen:CT findings / 中华放射学杂志

Objective To observe the CT findings of hypoplasia of cochlear nerve foramen. Methods CT findings of cochlear nerve foramen were observed in 50 volunteers (100 ears)and in 9 cases with hypoplasia of cochlear nerve foramen.The width of the bony canal for the cochlear nerve were measured in both groups.Results The fissure in the cribriform area were seen in every volunteers.The width of the bony canal for the cochlear nerve was (2.32?0.25)mm in normal group.The stenosis of cochlear nerve foramen were shown in 9 cases (10 ears),the lacking of fissure in the cribriform area were seen in 8 ears, while the fissure were shown in 2 cases.The stenosis of internal auditory canal was shown in 4 cases. Abnormality of vestibule and horizontal semicircular canal was shown in one case.The maximum value of the width of the bony canal for the cochlear nerve was 1.5mm,the minimum value was 0.9 mm.Conclusions The typical CT findings of hypoplasia of cochlear nerve foramen were stenosis of cochlear nerve foramen,the lacking of fissure in the cribriform area and cochlear nerve foramen without helix shape.The hypoplasia of cochlear nerve foramen may be a subtype of cochlear dysplasia.

Treatment of bochdalek′s hernia and defect of diaphragm in children / 实用儿科临床杂志

Objective To study the diagnosis and treatment of bochdalek′s hernia in children, especially to introduce the methods of repairing the defect of diaphragm using rib-flap and terylene fabric.Methods The diagnosis, misdiagnosis and methods of repairing of diaphragm in 10 cases of bochdalek′s hernia were retrospectively reviewed, and the findings of reconstruction of diaphragm in 2 cases of defect of diaphragm were analyzed.Results All of the 12 cases were misdiagnosed for the first time. Ten cases were cured through abdominal surgery and 2 cases were cured through reconstruction of diaphragm.Conclusions Bochdalek′s hernias in children are lack of specific clinical manifestation and often misdiagnosed before operation. Early surgical treatment is necessary once the diagnosis is established, and the defect of diaphragm should be reconstructed. The repairment of diaphragm using rib-flap and terylene fabric is a practical methods.