Foreign student education is an important task in medical colleges and universities.Clinical neurology teaching is very difficult because of its complex discipline.Neurologists in the First Affiliated Hospital of Chongqing Medical University summarized and analyzed the common problems including the training of teachers' ability to use language,teaching of basic subjects,clinical skills training,promotion of patients' compliance and implementation of regular tests so as to provide references for improving the quality of neurology teaching.

Objective To investigate the expression of peroxisome proliferator-activated rec eptor γ (PPARγ) and glucokinase (GK) induced by Wnt signaling pathway in mice NIT-1 β-cells,and to explore the interaction between PPARγ and Wnt signaling pathways.Methods Recombinant Wnt3a protein was applied to NIT-1 beta-cells to activate Wnt signaling pathway.The expression of PPARγ was determined by real-time PCR and Western blotting.The expression of GK was determined by real time PCR.Results Wnt3a rapidly activated Wnt/β-catenin/TCF signaling pathway,and increased PPARγ and GK mRNA expression by 41.2％ and 65.0％ in NIT-1cells,with PPARγ protein expression increasing by 97.8％ (P＜0.01).These effects were abrogated by Wnt and PIK3 inhibitors,dickkopf 1 and wortmannin treatment (P＜ 0.01).Conclusions PPARγ and GK can be upregulated by Wnt singnaling,and the effects might partially be PI3K-dependent.

Objective To quantitatively study right ventricular function in the normal second and third trimester fetuses by M-mode tricuspid annular displacement(TAD).Methods TAD was measured using conventional M-mode echocardiography on 161 normal second and third trimester fetuses with gestation age (GA) between 19-38 weeks,meanwhile multiple parameters for evaluating right ventricular function were obtained using pulsed Doppler echocardiography (PW) and myocardial Dopple tissue imaging (DTI).The correlation between TAD and other parameters were analyzed using SPSS 17.0.Results In normal second and third trimester fetuses,the TAD was (9.38 ± 1.71)mm with a range of 5.79-13.90 mm,and was increased with the growth of GA.TAD was correlated with GA,E,A,Em,Am and Sm significantly (r =0.759,0.547,0.320,0.497,0.483 and 0.598 respectively,all P ＜0.001).TAD was not correlated with HR(P ＞0.05).TAD showed differences between the second trimester fetuses and the third trimester fetuses (P ＜ 0.05).Conclusions In normal second and third trimester fetuses,the TAD is increased with the growth of GA,and has good correlation with GA,E,A,Em,Am and Sm respectively,and may become a new promising modality to evaluate function of RV simply and accurately.The technique will be propitious to use in hospitals (without DTI) because of simplicity of operator and lower requirement on the technology and equipment precision.

Objective To screen out specific microsatellite markers for use in Tupaia belangeri chinensis genetic testing. Methods Firstly to screen about 700 microsatellite loci from whole genome.Secondly to choose about 100 better loci without defect factors.Lastly 46 primers were designed by 33 tree shrew’ s microsatellite loci obtained from whole genome and other references.Agarose gel electrophoresis and polyacrylamide gel electrophoresis were used for PCR products, and better loci based on electrophoresis results were chosen.Then STR scan was used to select the microsatellite loci combination for genetic testing.Results Twenty-two microsatellite loci were selected with a significant Stutter peak on STR scanning.Comparing the alternative loci and ultimately selected loci, there were two loci available in the five alternative loci of T.glis.The coincidence rate between T.glis and T.b.chinensis was 40%.There were two loci available in the five alternative loci of T.minor, and the coincidence rate between T.minor and T.b.chinensis was 40%.There were two loci available in the three alternative loci of T.belangeri, and the coincidence rate between T.belangeri and T.b. chinensis was about 70%.Conclusions The 22 microsatellite loci screened in this study are well applied for genetic testing of Tupaia belangeri chinensis, therefore, provide a scientific basis for the genetic quality monitoring of tree shrews.

Objective To evaluate the clinical significance and cardiac function of fetuses with intracardiac hyperechogenic focus(ICEF) by fetal echocardiography. Methods Fetal echocardiograms were performed on 1291 fetuses for evaluation of fetal heart structures and rhythms. Echocardiographic characteristics of ICEF were investigated. Fetal systolic and diastolic functions of 399 fetuses with an isolated ICEF were compared with 128 normal fetuses using conventional two-dimensional, M-mode, pulsed Doppler echocardiography and myocardial Doppler tissue imaging(DTI). Results The prevalence of ICEF was 34. 7% (448/1291). Twenty-four(5.4%) cases were found with cardiovascular malformations. There was 1 (0.22%) case of ICEF fetus associated with chromosomal abnormality (trisomy 21 ). Comprehensive fetal echocardiographic data analysis showed no significant differences in heart dimensions, global cardiac functions,and myocardial performances in the two groups( P ＞0.05). Conclusions An isolated ICEF in the fetal heart is not associated with increased risk for chromosome abnormalities. Fetuses with ICEF do not indicate impaired left ventricular systolic or diastolic function, therefore having no hemodynamic significance.

Objective To evaluate the feasibility and accuracy of full volume three-dimensional echocardiography(FV3DE) for quantifying the left ventricular volume in healthy fetuses. Methods Two hundred and twenty-two normal fetuses with gestational ages between 20 and 40 weeks were investigated. Full volume three-dimensional, two-dimensional (2D) and M-mode images were acquired by Philips iE33 system and data was processed offline using QLAB analysis software. Left ventricular end-systolic volume(ESV) and end-diastolic volume ( EDV) were measured using semiautomated border detection echocardiographic techniques, and compared with 2D biplane Simpson's method and M-mode Teichholz formula. Results Thirty-six fetuses with poor three-dimensional images and 5 twin pregnancies were excluded,the study subjects consisted of 181 singleton fetuses. The highest concordance correlation ( r =0.987 for EDV, r =0.988 for ESV) P <0. 001) was noted between 2D biplane Simpson's and FV3DE-derived values with a small bias (0. 332 ml for EDV,0. 135 ml for ESV). The Bland-Altman analysis showed that FV3DE had the best reproducibility than M-mode Teichholz formula and 2D biplane Simpson's method. Intra- and interobserver error of EDV were 2.85% and 4.22% for FV3DE,8.37% and 8.98% for 2D biplane Simpson's rule,30. 63% and 54. 70% for M-mode Teichholz formula. Intra- and interobserver error of ESV were 2.34% and 6. 14% for FV3DE,6. 26% and 11.7% for 2D biplane Simpson's rule,43.06% and 66.03% for M-mode Teichholz formula. Conclusions FV3DE is a novel technique that can be more accurate than conventional methods in quantification of fetal left ventricular volumes, it may provide new insight into evolving fetal cardiac structure and function.

Objective To explore the correlation of left ventricular systolic function calculated by automated cardiac motion quantification (aCMQ) and three-dimensional quantitative analysis (3DQA). Methods According to LVEF by 3DQA,patients were divided into abnormal cardiac function group(LVEF<50%)and normal cardiac function group(LVEF≥50%).Dynamic images from two chamber view(AP2), four chamber view(AP4)and three chamber view(AP3)of left ventricular long axis were acquired from 32 patients with abnormal cardiac function and 119 normal subjects.AP2 longitudinal strain (AP2LS),AP4 longitudinal strain (AP4LS) and AP3 longitudinal strain (AP3LS) as well as the left ventricular global longitudinal strain (LVGLS) were measured by aCMQ. While left ventricular end diastolic volume (LVEDV),left ventricular end systolic volume (LVESV) and LVEF were derived through aCMQ automatically calculated region of interest (ROI) driven automation.The correlation of left ventricular systolic function indexes obtained by aCMQ and 3DQA were compared.Results No significant differences were found between the two groups in gender,body mass index(BMI) and age (P > 0.05).LVEF in abnormal group by 3QDA and aCMQ were much lower than those in normal group (P < 0.01).The absolute values of AP2LS,AP4LS,AP3LS and LVGLS in abnormal group were significantly lower than those in normal group (P < 0.01).LVEF by aCMQ in abnormal group was positively correlated with LVEF by 3QDA methods(r =0.91 ,P <0.01);LVEF by aCMQ in normal group was positively correlated with LVEF by 3QDA (r = 0.73,P < 0.01).The left ventricular global longitudinal strain (LVGLS) measured by aCMQ was negatively correlated with LVEF by 3QDA(r = -0.815,P < 0.01).LVEF measured by aCMQ and 3DQA showed high inter-observer and intra-observer agreements in Bland-Altman charts.Conclusions aCMQ has preferable repeatability.Comparing with the traditional measurement method,LVEF measured by aCMQ has higher correlation with that measured by 3QDA.aCMQ can be a new and relatively accurate method to evaluate the left ventricular systolic function.

Objective To quantitatively study the distance between the left atrial posterior wall and the descending aorta(DLD)in the normal fetal four-chamber view using fetal echocardiography.Methods The distances between the left atrial posterior wall and the descending aorta in end-systole (DLDs) and in end-diastole(DLDd) were measured in a standard apical four-chamber view using fetal echocardiography in 300 normal fetuses.The gestation ages ranged from 20 to 40 weeks.Fetal non-cardiac biometric parameters included femoral length(FL),biparietal diameter(BPD) and gestation age (GA) based on menstrual age. The correlation between DLDs,DLDd and non-cardiac biometric parameters were analyzed.Results In normal fetuses,the DLDs was (0.32±0.08)cm with a range of 0.19 -0.48 cm,the DLDd was (0.43 ± 0.10)cm with a range of 0.25-0.62 cm.The DLDs and DLDd increased with the growth of GA,and were correlated with GA and BPD and FL significantly (r = 0.545,0.556,0.574,0.530,0.563 and 0.576, respectively,all P <0.001).The linear regression equations between DLDs,DLDd and GA,BPD,FL were:Y =0.009GA+0.041 ,Y =0.038BPD+0.028,Y =0.044 FL+0.073,Y =0.01 1 GA+0.083,Y =0.048 BPD+0.063,Y = 0.054 FL + 0.124,respectively.Conclusions In normal fetuses,the DLDs and DLDd increase with the growth of GA,and have good correlation with GA,BPD,and FL respectively.Normal reference ranges of DLDs and DLDd have been provided.These normative data may be a new tool for assessment of fetal heart,especially has potential applications in screening of total anomalous pulmonary venous connection(TPVAC),absent pulmonary valve syndrome(APVS)or other complex congenital heart defects.

Objective To investigate the feasibility of spatiotemporal image correlation(STIC)to assess left ventricular volume in normal fetuses.Methods The volume data acquisition of 162 normal fetuses ranging between 22 and 38 weeks of gestation was achieved by automatic sweep scan.The virtual organ computer-aided analysis(VOCAL Ⅱ)was then used to evaluate end-systolic and end-diastolic volumes of left ventricle and compared with that obtained by M-mode Teichholz formula and 2D biplane Simpson's method.Results Twenty-six fetuses with poor STIC image and 2 twin pregnancies were excluded,the study subjects consisted of 134 singleton fetuses.The highest concordance correlation(r =0.968,for EDV,r =0.956 for ESV;P =0.000)was noted between 2D biplane Simpson' s and STIC VOCAL Ⅱ values with a small bias(0.282 ml for EDV,0.117 ml for ESV).The Bland-Altman analysis showed that STIC VOCAL Ⅱ had the best agreement than M-mode Teichholz formula and 2D biplane Simpson's method.The result showed that there were significant difference between Mmode Teichholz formula and Simpson's method in EDV and ESV(P＜0.05).There were significant differences between M-mode Teichholz formula and STIC VOCAL Ⅱ(P＜0.05).There were no significant differences between STIC VOCAL Ⅱ and Simpson' s method in EDV and ESV.Conclusions There is a good agreement between left ventricular volumes measured either by STIC VOCAL Ⅱ or by 2D biplane Simpson's method.STIC is a novel technique that can be more accurate than conventional Methods in quantification of fetal left ventricular volumes.All the volume data acquisition is achieved by postprocessing facilities.STIC promises to become a new method for left ventricular volume quantification.

Objective To evaluate cardiac function in fetuses with intracardiac hyperechogenic focus (ICEF) by tissue Doppler imaging(TDI).Methods Fetal echocardiography was performed in 335 fetuses for evaluation of fetal cardiac function with ICEF by TDI,two-dimensional,M-mode and pulsed Doppler echocardiography.The ratio between early ventricular filling(E-wave)and active atrial filling(A-wave)peak velocities at the level of the atrioventricularvalves as an index of ventricular diastolic function.TDI mode was used to measure the mitral and tricuspid valve annulus including Em,Am and Sm.The characteristics of fetal echocardiography of 119 fetuses with ICEF were compared with 137 normal fetuses.Results E/A and Em/Am were significantly lower in fetuses with ICEF than in control fetuses.Positive correlation was found between the velocity of orifice and annulus in controls.No systematic differences were found in cardiac dimensions,ventricular shortening fraction,Doppler and TDI systolic indices between groups.Conclusions TDI is feasible and reproducible to evaluate fetal ventricular function,and it can avoid the influence of fetal heart rates and preloading.Fetuses with ICEF show lower Em/Am values in the second to third trimester echocardiography,it might indicate cardiac diastolic dysfunction.