To meet the challenges of the current evaluation system for the residents , the department of internal medicine of Peking Union Medical College Hospital (PUMCH) developed a new on-line system.This new system, not only solved the problems of the current system , but also had several advantages as manpower saving , real-time update , back-to-back evaluation , convenience in comparison .This promising system is a possible solution to simi-lar problems in other institutions .

Objective The aim of this study is to explore the application of virtual patient system in medical educa-tion in China .Methods Forty-one medical students were recruited to take part in a 5-week pilot use of PUMC-DxR Clinician system , and to finish ten virtual cases totally .At the end of the pilot use , all students were required to complete a survey about PUMC-DxR Clinician system.Results General assessment scored 3.71 ±0.72,novel-ty scored 4.66 ±0.62 ,usability scored 3.51 ±0.87 ,practicality scored 4.00 ±0.87 ,and all of them were over 3 points.According to the survey, 95.1% students agreed that this kind of virtual patient system was suitable for clerkship, intern, or junior resident, and 80.5%students agreed that it was suitable to teaching.Conclusions PUMC DxR Clinician system shows good practicality and usability in this pilot use , whose value is mainly based on the training of clinical reasoning .

Objective In order to summarize the common characters of medical education , this research Compared curricula and educational reformation of different counties .The common characters of international medical educa-tion are useful to China's current medical education reformation .Methods This research used method of compara-tive education study to compare the medical education of the U .S, the U.K and Japan.Results Although the medical education program length is different in the 3 countries, they all recognize medical education as professional education .So they all adopt muti-method to test candidates .The curriculum frameworks of medical education pro-gram of 3 countries are different , but the curriculum organization , teaching methodologies , assessment methods are similar.They all have complete quality control system .As the medical education reformation , about half of medical schools in the U .K and Japan have implemented graduate entered medical education program .Conclusions Al-though medical education program length is different in the U .S, the U.K and Japan, they do share some charac-ters.These common characters are useful to medical education reformation and quality control in China .

The rates of chronic obstructive pulmonary disease ( COPD) and lung cancer morbidity in Xuanwei city of Yunnan province are among the highest nationwide , and COPD is an major risk factor for lung cancer .The concur-rence of COPD and lung cancer is a common disease .There are common causative environmental risk factors and pathogenic processes between the two diseases , which provides new ideas for the research , prevention and treatment of both diseases .Additionally the discussion of the relationship between COPD and lung cancer can provide refer -ences for further studies of both diseases .

SWI/SNF is an ATP-dependent chromatin remodeling complex .ARID1 A gene is an important subunit of SWI/SNF complex and its dysfunction can cause abnormal chromatin remodeling , resulting in tumorigenesis .AR-ID1A occurs frequently low expression or deletion mutation in a variety of malignant tumors , such as ovarian canc-er, liver cancer, breast cancer, stomach cancer, lung cancer and so on, which indicates that ARID1A is an impor-tant tumor suppressor gene .

Objective To explore the expression of thrombospondin-1 ( TSP-1 ) and bone morphogenetic protein-7 ( BMP-7 ) in mucus membrcane of chronic rhinosinusitis ( CRS ) and its potential significance in pathogenesis . Methods TSP-1 ,BMP-7 and TGF-β1 were detected by ELISA .Results The expression level of TSP-1 and TGF-β1 increased gradually with the advanced stage of CRSsNP ( P<0.05 ) .The expression of BMP-7 decreased gradu-ally with the advanced stage of CRSsNP ( P<0.05 ) .The expression of TSP-1 and TGF-β1 decreased gradually with the advanced stage of CRSwNP ( P<0.05 ) .The expression level of BMP-7 increased gradually with the ad-vanced stage of CRSwNP ( P<0.05 ) .Conclusions The expressions of TSP-1 and BMP-7 were abnormal in nasal mucosa of CRS , which might be involved in the pathogenesis of CRS .

Objective To investigate the clinical and pathological features of anorectal malignant melanoma ( AMM) .Methods The clinical pathological and follow-up data of 7 cases of anorectal malignant melanoma were collected.The clinical and histopathological features and immunophenotype were analyzed .Results Among the 7 cases, 5 cases were female, 2 cases were male, aged 50-68 years, the average was 61 years.The tumors located in the lower rectum in 1 cases, 2 cases of teeth near the line , 4 cases of anal anus .The structure and morphology of the cancer cells were diverse .The organizational structures were mainly diffuse , focal and acinar .The cellular morphologies were mainly epithelioid , spindle and lymphocyte like .And the results of IHC showed the expression of the following three markers, vimentin, S-100 and HMB45, were strongly positive in cancer cells.However, the expression of CK , EMA and LCA were negative .And 2 cases of CEA expression were positive , LI Ki-67 was 20%-50%.Conclusions Anorectal malignant melanoma is one kind of rare malignant tumor and its characteristic morphology , immunophenotype could be helpful for diagnosis and differential diagnosis .

Objective To analyze the expression of hsa-miR-10b in three cervical cancer cell lines , and to find the target genes of hsa-miR-10b.Methods PCR was applied to measure expression levels of hsa-miR-10b in C-33A, HeLa and CaSki .The relative studies on hsa-miR-10b were retrieved from PubMed .The sequence and genome char-acteristics of hsa-miR-10b were analyzed on line by miRbase and NCBI .The target genes of hsa-miR-10b were searched by TargetScan , PicTar and miRanda , and then demonstrated by Gene Ontology and Pathway Enrichment analysis.Results Compared with C-33A, the expression of hsa-miR-10b significantly reduced in HeLa and Caski (P<0.01).Current studies showed that hsa-miR-10b was related with multiple tumorigenesis .hsa-miR-10b was lo-cated in human chromosome 2q31.1 and highly conserved among different species .The target genes were enriched in the biological processes of transcription , gene expression regulation , cell proliferation and etc .(P<0.05).Pathway analysis showed that these target genes were responsible for biochemical erents mediated by to the signaling pathways of cancer, cell cycle, ARF and etc.(P<0.05).Conclusions hsa-miR-10b may have extensive functions , and closely related with the occurrence and development in cervical cancer .Prediction of target genes provides a theoreti-cal basis for the further study .

Objective To identify the relationship between impaired glucose regulation of neuronal apoptosis in hip-pocampus and the ability of learning/memory in rats.Methods The model rats were made by high fat and sugar diet;The morris water maze was used to detect the learning and memory function;The TUNEL method was used to detect neuronal apoptosis in hippocampus .Expression of Bcl-2/Bax and Bcl-2 mRNA/Bax mRNA factor in hippo-campus neurons was detected with immunohistochemistry and in situ hybridization .Results Compared with NGT group, in IGR group the learning and memory ability were meaningfully decreased (P<0.05);the number of neuro-nal apoptosis in hippocampus was increased significantly ( P<0.05 ); the expression of Bcl-2 and Bcl-2 mRNA in hippocampus decreased significantly ( P<0.05);the expression of Bax and Bax mRNA in hippocampus increased sig-nificantly ( P<0.05 );The ability of learning and memory was positively correlated with expression of Bcl -2 ( P<0.05) and negatively correlated to the expression of Bax (P<0.05).Conclusions There is a relationship between impaired glucose regulation and the ability of learning and memory in rats , its mechanism may be potentially related to hippocampal neuronal apoptosis .

Objective To explore the 5,10-methylenetetrahydrofolate reductase (MTHFR) and 5-methyltetrahydro-folate-homocysteine methyltransferase reductase ( MTRR ) gene polymorphisms among the Han women in Zhangjiagang city .Methods A total of 4008 Han women were recruited .Their oral epithelial cells were collected to extract genome DNA in order to detect gene polymorphisms of MTHFR and MTRR using fluorescence quantitative PCR.Then the results were compared with those in other cities in China .Results The genotype frequencies of MTHFR C677T CC, CT and TT among Zhangjiagang women are 32.2%, 49.5%and 18.3%, respectively.The C allele frequency is 64.3%, T allele frequency is 35.7%.The genotype frequencies of MTHFR A1298 C AA, AC and CC are 68.7%,28.7% and 2.5%, respectively .The A allele frequency is 80.8%, C allele frequency is 19.2%.The genotype frequencies of MTRR A66 G AA, AG and GG are 54.4%, 38.5%and 7.1%, respectively . The A allele frequency is 76.3%, G allele frequency is 26.4%.Conclusions The MTHFR, MTRR polymorphism distribution of Han women in Zhangjiagang city is region specific.