With self-designed experiment as its basis,Basic Medical College of Shanghai Jiao Tong University has made teaching reform that is design-oriented and integrative with intent to cultivate students' innovation consciousness and practice ability.As a result,a teaching model of"research-based learning",which aims at bringing forth innovative talents,has been constructed and produced desired effects.

Objective To determine quantity of type Ⅰ collagen and mRNA expression of decorin and transforming growth factor (TGF)- β_1 in the upper portion of the anterior vagina in women with pelvic organ prolapse (POP). Methods Transvaginat biopsies were obtained from the anterior vaginal wall in 27 POP(POP group) and 21 non-poP(control group). The concentration of type Ⅰ collagen was determined by ELISA technique. RT-qPCR was used to verify the mRNA level of decorin and TGF- β_1. Results The mean concentration of type Ⅰ collagen in the premenopausal women in POP group [(47.94 ± 6.82) mg/g total protein (TP)]was significantly lower than that in control group [(62.33±6.57) mg/g TP],in the postmenopausal women in POP group, it was (41.82±5.96) mg/g TP, significantly lower than that in control group[(61.21 ± 4.84)mg/g TP](P< 0.01). The mRNA expression of decorin was 1.61 ± 0.10 in POP group, significantly lower than that in control group 2.77±0.60 ,while that of TGF-β_1 was higher in POP greup10.86 ± 0.23 than that in control group 9.87 ± 0.92 (P < 0.05). In the postmenopausal women in two groups, there were no significant difference in the mRNA expression of decorin and TGF-β_1 (P > 0.05). Conclusions A decrease in quantity of type Ⅰ coUagen in the connective tissue of anterior vagina may compromise the tensile strength and an increase susceptibihty to prolapse. Deeorin might be involved in the pathogenesis in premenopausal women with POP. The pathogenesis of POP is muhifactorial.

Objective To investigate the effect of bilateral uterine artery embolization in the prevention of postpartum hemorrhage.Methods Twenty-seven patients with risk factors of postpartum hemorrhage (prevention group) and 36 patients with postpartum hemorrhage refractory tendency(treatment group) were underwent bilateral uterine artery embolization.The clinical efficacy and side effects were observed.Results The patients in prevention group were given bilateral uterine artery embolization and conventional induction by ethacridine.All of them finished vaginal delivery,postpartum hemorrhage was 200-480 ml,average 385 ml,no case of postpartum hemorrhage.The patients in treatment group occurred intractable postpartum hemorrhage before bilateral uterine artery embolization,the amount of hemorrhage was 1 000-4 200 ml,average 2 050 ml.Among them,9 patients were given carbasus to stuff cavitary uteri,2 patients were given striped-back saturation.Effective in 35 patients,the successful rate was 97.2％ (35/36).One patient was performed with hysterectomy because of inefficient treatment.None occurred maternal deaths,inefficient and necrosis of lower limbs.All of patients had entire involution of uterus.Reviewed at clinic service after delivery,none occurred postpartum hemorrhage,puerperal infection,Sheehan's syndrome.The menstrual recovery time was 3-13 months for 53 patients who were followed up.Conclusions Bilateral uterine artery embolization have advantage such as safe,effective,less side effects,and is an effective method for the treatment of various causes of intractable postpartum hemorrhage.It is worthy of clinical application on the prevention of postpartum hemorrhage.

Legg-Calvé-Perthes disease is one of the most concerned hip diseases in the pediatric orthopaedic field.Although there are many treatments for Legg-Calvé-Perthes disease,new ideas for the therapy of Legg-Calvé-Perthes disease still exist.Moreover,the prognosis of the disease mostly focuses on the studies of the degree of involvement of the epiphyseal plate,age of onset and lateral pillar classification.This contribution summarizes the treatments and prognosis of Legg-Calvé-Perthes disease.

Objective:To observe the clinical effect of warm needling moxibustion at Zhongji (CV 3) and Zusanli (ST 36) in treatment of urinary retention after gynecological surgery. ＜br> Methods: Forty patients with urinary retention after gynecological surgery were randomly divided into two groups by the randomized method, 20 cases in each group. Patients in the treatment group were treated by warm needling moxibustion at Zhongji (CV 3) and Zusanli (ST 36). Patients in the control group were treated by inductive urination. The therapeutic effects of the two groups were observed after one course of treatment. ＜br> Results:The total effective rate was 95.0%in the treatment group and 70.0% in the control group. The difference in the total effective rate between the two groups was statistically significant (P＜0.05). ＜br> Conclusion: Warm needling moxibustion at Zhongji (CV 3) and Zusanli (ST 36) is more effective than inductive urination in treating urinary retention after gynecological surgery.

Carbapenems ; pharmacology ; Drug Resistance, Bacterial ; Humans ; Klebsiella Infections ; drug therapy ; microbiology ; Klebsiella pneumoniae ; drug effects

OBJECTIVE:To observe the efficacy and safety of vitamin A acid combined with vitamin A,vitamin E,celecoxib in the treatment of oral leukoplakia. METHODS:104 patients with oral leukoplakia were randomly divided into control group(52 cases) and observation group (52 cases). Control group received 1 Vitamin A soft capsule,3 times a day+1 Vitamin E soft cap-sule,3 times a day+1 Celecoxib capsule,twice a day. Observation group additionally received 1 Vitamin A acid tablet,twice a day. 4-week was regarded as 1 treatment course,it lasted for 3 courses. Clinical efficacy,and leukoplakia number,maximum diam-eter of leukoplakia,immunoglobulin A(IgA),IgM,IgG before and after treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in observation group was significantly higher than control group,the dif-ference was statistically significant(P<0.05). Before treatment,there were no significant differences in leukoplakia number,maxi-mum diameter of leukoplakia,immunoglobulin levels in 2 groups(P>0.05). After treatment,leukoplakia number,maximum diam-eter of leukoplakia,IgA and IgM in 2 groups were significantly lower than before,and observation group was lower than control group,IgG was significantly higher than before,and observation group was higher than control group,the differences were statisti-cally significant (P<0.05). And there was no significant difference in the incidence of adverse reactions in 2 groups (P>0.05). CONCLUSIONS:Vitamin A acid combined with vitamin A,vitamin E,celecoxib shows obvious efficacy in the treatment of oral leukoplakia,it can effectively reduce clinical symptoms,improve immune function,with good safety.

Objective To explore the synchronous cosmetic surgical procedures for the beauty-seekers who have both single eyelid and commonly horizontal cockeye in order to acheive either time saving or beautifying. Methods Firstly, the distance of moving backwards and shortening length of the eye muscle were calculated and designed according to the degree of cockeye; secondly, the height of the double eyelids line and positioning were re-designed; then the moving backwards and shortening of the horizontal macula were put up to rectify the cockeye; finally, the incisal double eyelid operation was performed. Results All 25 patients with inner cockeyes were corrected at the right position; 4 of 11 patients with outer cockeyes were corrected 5～10 degrees over the right position, and others were at the right position. The single eyelid with thin-eyelid and middle-thick-eyelid restored within 3 months; but the patient with thick-eyelid restored slowly, about half a year in average. 2 patients with redundant skin at inner corner of eye were also corrected at the right position. Conclusions Although there is somewhat difficulty in the plastic surgery for patients with cockeye and single eyelids, synchronous operation can save time and outlay, and also acheive the aim of beautifying. Therefore, it is a good approach to deal with cockeye.

Objective To select a matrix modifier,which can effectively eliminate the matrix interference in the determination of chromium in cosmetics by graphite furnace atomic absorption spectrometry(GFAAS).Methods The orthogonal experiment design was used to define the best operation parameter of graphite furnace.Vitamin C,(NH4)H2PO4,(NH4)2HPO4,NH4Cl and Mg(NO3)2 were added respectively as the matrix modifiers.The effect of five matrix modifiers was compared by precision test.Results When(NH4)H2PO4 was taken as the chemical modifier,the determination result was satisfied.The characteristic mass was 5.68?10-12 g,relative standard deviation were from 2.11% to 4.46%.The rate of recovery of two cosmetics samples were 95.2% and 102.01%.Conclusion(NH4)H2PO4 can increase the ashing temperature,decrease the atomization temperature,eliminate the matrix interference and the result has good precision and accuracy.

Objective To determine the ability of biofilm formation of Staphylococcus ephtermidis isolates and analyze the correlation between the icaA gene and its expression and biofilm formation. Methods Collecting 205 Staphylococcus epidermidis isolates identified with normal laboratory tests (coagulase-negative, biochemical identification, polymyxin-resistant and novobiocin-sensitive ), the suspected isolates were con-formed with API-Staph. Biofilm production was assessed by incubating the strains on Congo Red Agar (CRA) plates and quantitative biofilm production determined by a 96-well tissue culture plate and biofilm morphous were detected by scanning electron microscope ( SEM ) ; Amplifying partial fragments of icaA genes with PCR; Analyzing the expression levels of icaA gene with RT-PCR through Bio-Rad system and Quantity One software. Results 24 isolates showed positive in CRA tests, 22 isolates were positive in semiquantita- tive adhesion assays and 28 isolates existed icaA gene among 205 isolates of Staphylococcus epidermidis. The icaA-positive strains demonstrated biofilm formation (microcolonies on silica films ) while icaA-negative strains only adhered as individual cells under scanning electron microscope. All 22 strains which showed positive in semiquantitative adhesion assays harbored the icaA gene. The expression levels of icaA gene with RT-PCR in 6 Staphylococcus epidermidis isolates showed a higher tendency in 4 strains which demonstrated positive in semiquantitative adhesion assays than 2 negative strains in semiquantitative adhesion assays. Conclusion The isolations of Staphylococcus epidermidis have the abilities of forming biofilm, and the icaA gene and its normal expression is the important molecular biology foundation of biofilm formation. Other fac-tors maybe involve in the expression of icaA gene in Staphylococcus epidermidis isolates.