Objective To discuss the practical application effect of the work process oriented teaching model that based on flipped classroom in the teaching of higher vocational Chinese medicines.Method We chose 97 students from Grade 2012 higher vocational Chinese traditional medicine,set them into experimental group (47 students) and comparison group (50 students).The experimental group was applied with the flipped classroom teaching,combined with the teaching mode of working process and the comparison group was applied with the traditional teaching mode from September 2014 to July 2015.At the end of the experiment,through the questionnaire survey,the differences of the experimental group students' autonomous learning ability and problem solving ability were compared between before the experiment teaching and after the teaching.The difference of post adaptation ability of the experimental group and the control group was also compared,and besides,the students' satisfaction degree to flipped classroom combined with working process teaching mode was investigated and analyzed.SPSS 16.0 software was used for statistical analysis,and t test was used to compare two groups' measurement information and count data with chi-square test.Result The score of independent learning ability after teaching in the experimental group was significantly higher than before [(77.50 ± 7.10) vs.(88.51 ± 9.30);t=6.451,P=0.000].However,there was no statistically significant difference in problem-solving capability before and after the teaching[(83.70 ± 2.32) vs.(84.30 ± 2.11);t=1.312,P=0.193].The score of five aspects of the adaptability to work in the experimental group and total score were higher than the comparison group and the difference was statistically significant [work attitude (18.72 ± 2.01) vs.(16.78 ± 3.33),t=3.447,P=0.001;service ability (17.99 ± 1.98) vs.(16.05 ± 2.15),t=4.614,P=0.000;professional ability (18.19 ± 2.46) vs.(15.37 ± 2.79),t=5.267,P=0.000;completion of work (19.01 ± 1.75) vs.(16.88 ± 1.83),t=5.851,P=0.000;strain capacity:(18.33 ± 2.09) vs.(17.01 ± 2.46),t=2.839,P=0.006;the total score of job adaptability (92.24 ± 3.89) vs.(82.09 ± 4.05),t=12.574,P=0.000].Experimental group's satisfaction showed that 91.48％ of students liked the teaching model,87.23％ thought that it improved their learning interest,82.98％ believed that it was beneficial to improving their communication skills.Conclusion Teaching mode of flipped classroom combined with working process helps to improve teaching quality.

Objective To determine whether the fixation method of electrode of the improved pediatric video electroencephalogram (VEEG) is better than the traditional fixation method. Methods A total of 746 children patients who needed VEEG monitoring were divided into the experimental group and the control group with random digit table with 373 patients in each group. Improved fixation method and traditional fixation method of electrode were adopted during VEEG monitoring in the experimental group and the control group. The advantage and disadvantage of the two fixation method were compared through evaluation of skin injury of scalp and deltoideus triangularis, electrode loss and electrode breakage. Results The incidence of skin injury of scalp and deltoideus triangularis, electrode loss and electrode breakage in the experimental group were 7, 0, 29, and 12, which were less than 29, 6, 71, and 37 of the control group, the differences were of statistical significance (χ2=14.126, 20.371, 13.652, P<0.01 or 0.05). Conclusions Improved electrode fixation method during pediatric VEEG can avoid skin injury of scalp and deltoideus triangularis, reduce electrode loss and electrode breakage, besides, it also can reduce medical cost and discomfort of children. The modified electrode fixation method proved to be superior to the traditional method and it is worth popularization and application.

Objective To analyze the DCE-MRI features and ADC value in triple-negative breast cancer and HER-2 overexpres-sion breast cancer,and to improve the j udgment of both characteristic in MRI.Methods To analyse the DCE-MRI imaging of TNBC and HER-2 overexpression breast cancer,measured the ADC value and compared the statistics.Results Compared with the shape, margin,the way of enhancement and ADC value of the TNBC and HER-2 overexpression breast cancer,the distinction has statisti-cally significant(P<0.05);there were no statistically significant difference among age,mass or nomass,categories of lesions and TIC,(P>0.05).Conclusion DCE-MRI features of the shape,margin,the way of enhancement and ADC values were useful for the diagnosis of TNBC and HER-2 overexpression breast cancer.

Objective:to investigate the psychological status of the patients suffering from hemoptysis caused by bronchiectasis and influence to hemostasia therapy.Methods:patients were randomly divided into two groups (study group and control group) after their psychological status was collected with SCL-90. The study group received supportive psychotherapy. Both groups were evaluated by parameters such as change of the blood pressure, dosage of pituitrin and duration of hemoptysis.Results:Among all 62 patients, 83.87% were in anxiety, 66.13% had fear. 32.26% of the patients had hypertension relevant to psychological factors, in some of them (20.97%) the use of pituitrin was limited. The time of the mean duration of the hemoptysis decreased to 5 days in the study group, while it was 7 days in the control group.Conclusion:Patients suffering from hemoptysis caused by bronchiectasis usually have mood disturbance, which leads to hypertension. The psychological factors affect not only the hemoptysis but also the use of pituitrin. Supportive psychotherapy is effective in shortening the duration of hemoptysis.

[Objective] To investigate the construction and inhibitory effects of artificial microRNA targeted on hepatitis B virus.[Methods] Four artificial microRNA sequences for HBV gene were designed with Invitrogen online design software (BLOCK-iTTM RNAi Designer),amiRNA eukaryotic expression plasmid were constructed and transfected into human hepatocellular carcinoma cell line HepG2.2.15.Hepatitis B virus DNA in supernatant was detected by quantitative fluorescence PCR.HBsAg and HBeAg detected by ELISA.[Results] All of the four artificial microRNA sequences could down regulate the level of HBV-DNA,HBsAg and HBeAg.miR3 had the most significant effect on inhibiting HBV-DNA replication.[Conclusion] Artificial microRNA sequences can effectively inhibit the replication of HBV in vitro.

Objective To investigate clinical value of levels of CA125 and LPA as a panel for early diagnosis of ovarian cancer.Methods The levels of two tumor markers(CA125 and LPA)in serum were determined in 76 patients with ovarian cancer,35 patients with benign tumor and 29 healthy control.Results The results showed that the levels of two tumor markera in ovarian cancer patients were significantly higher than those in benign tumor patients and controls(P＜0.05).Butuo siguificant difforences was loud betwcen benigutumor patient and coatrols.Conclusion Combined detection of the two markers represent a potential biomarker for diagnosis of epithelial ovarian cancer because of its diagnostic accuracy in ovarian cancer case.

AIM:To investigate the effect of Sonic Hedgehog ( Shh) signaling blockade on the growth of hema-tocarcinoma cells and underlying mechanisms.METHODS: The expression of Shh signaling molecules in hematocarci-noma cell lines BEL-7402, Huh7 and HepG2 was detected by RT-PCR.The cell viability was detected by MTT assay.The cell cycle and apoptosis were analyzed by flow cytometry.The expression of apoptosis-related proteins was determined by Western blot.RESULTS:Shh signaling molecules were all expressed in BEL-7402, Huh7 and HepG2 cells.The mRNA expression of Patched ( Ptch) , Gli1 and Gli2 was down-regulated by anti-Shh antibody.Blockade of Shh signaling pathway inhibited the proliferation of hepatocarcinoma cells with increasing cells in G0/G1 phase and induced the apoptosis of hepa-tocarcinoma cells.Treatment with anti-Shh antibody down-regulated the protein expression of pro-caspase-3, pro-caspase-8 and pro-caspase-9, while up-regulated the protein levels of cleaved caspase-3, cleaved caspase-8 and cleaved caspase-9 in BEL-7402 cells.CONCLUSION:Blockade of Shh signaling pathway inhibits the growth of hepatocarcinoma at different levels by cell cycle arrest and inducing apoptosis of hematocarcinoma cells.

AIM: To isolate and identify triterpenes from inflorescence of Cremanthodium potaninii C.Winkl,collected from Qinghai province.METHODS: The triterpenes were isolated by column chromatography and their structures were elucidated through NMR.RESULTS: Seven triterpenes were isolated and identified as ?-amyrin(I),Taraxast-20(30)-ene-3?,16?-diol-3-O-palmitate(II),olean-12-en-3?,16?-diol-3-O-palmitate(III),Olean-12-en-3?,11?,16?-triol-3-palmitate(IV),lup-3?,16?-diol-3-O-palmitate(V),lup-3?,16?,28-triol-3-O-palmitate(VI),16?-hydroxypseudo tarsxasterol-3-O-palmitate(VII).CONCLUSION: All these compounds are obtained from Cremanthodium potaninii C.Winkl for the first time.

Objective To investigate the curative effect of noninvasive mechanical ventilation (NMV) and its influence on plasma brain natriuretic peptide (BNP) and endothelin-1 (ET-1) in senile patients with cot pulmonale complicated with respiratory failure. Methods Eighty senile patients with cot pulmonale complicated with respiratory failure were randomly divided into treatment group (40 cases) and control group (40 cases). The treatment group was treated by NMV combined with routine therapy, and the control group was treated by only routine therapy including respiratory stimulant,lowering pulmonary artery pressure, cardiotonic agents, diuretics and nasal catheter oxygen inhalation. Blood pressure, heart rate (HR), respiratory rate (RR), blood gas analysis (pH, PaO2, PaCO2 ,SaO2) and clinical symptoms and signs were observed before and 72 hours after treatment. The plasma levels of BNP and ET-1 were also measured before and after treatment. Results Compared with the control group, the clinical symptoms and signs were significantly improved, SaO2 and PaO2 were significantly elevated, and PaCO2, HR and RR were significantly reduced in NMV group (t=2.23 ～ 3.92, P< 0.05 or P< 0.01). The plasma levels of BNP and ET-1 were significantly decreased after treatment in both groups,especially in the treatment group (t=2. 93,3. 56, P<0.01). The plasma levels of BNP and ET-1 had significantly negative correlation with PaO2 (r=-0.69,-0.61 ,P<0. 01) ,and positive correlation with PaCO2 (r= 0.51,0.42, P<0. 05). Conclusions NMV can improve hypoxemia and CO2 retention in senile patients with cot pulmonale complicated with respiratory failure,and may have some influences on neuroendocrine functions.

Objective To investigate the association of HLA-DRB1 alleles in Han population of Shanxi childrcn with nephrotic syndrome of non-IgA mesangial proliferative glomerulonephritis (MsPGN). Methods HLA-DRB1 was performed by polymerase chain reaction-sequence specific primers technique, and twenty patients with nephrotic syndrome of non-IgA MsPGN were detected. Results Analysis of the fre- quencies of specific at the HLA-DRB1 loci revealed significantly higher frequencies of HLA-DRB1 * 11 al- leles among the nephrotic syndrome patients of non-IgA MsPGN comparing with controls (22. 50% vs 8.33%, x2= 9. 544, P = 0.002, CI = 1. 674-9.995, RR = 4.09). Nine patients with HLA-DRB1 * 11 all accompanied hematuria, hypertension or short renal insufficiency. Conclusion The results suggested that HLA-DRB1 * 11 alleles contribute to genetic susceptibility to nephritic syndrome of non-IgA MsPGN. The pa- tients with HLA-DRB1 *11 easy accompanied hematuria, hypertension or short renal insufficiency.