Clinical education for undergraduates in China can be divided into three phases:preclinical phase,clinical clerkship phase,clinical practice phase,and each phase has its own features and different teaching tasks.Currently there are four teaching methods mostly applied in clinical education:lecture-based Learning (LBL),team-based learning (TBL),case-based learning (CBL) and problem-based learning (PBL).LBL is a teacher-centered.teaching method,which focuses on making knowledge accurate,systematic and comprehensive;TBL,CBL and PBL are student-centered teaching methods,which can improve students' enthusiasm and subject initiative.Each teaching method has advantages and dis-advantages.According to the different characteristics of three stages of medical education,this paper analyzes the reasonable application of different medical teaching methods in three stages of undergraduate medical education:in preclinical stage,combining LBL with TBL teaching methods;in clinical clerkship phase,combining the teaching methods of LBL,TBL and CBL;in clinical practice stage,combining CBL with PBL teaching methods.

Para-neoplastic neurological syndrome (PNS) is a series of rare illnesses affecting the nervous system and associated with several malignant tumors. PNS is manifested by various clinical symptoms, which conventionally precede the diagnosis of tumors in months or even years. Although anti-neuronal antibodies can indicate the presence of cancer, numerous false positive and false nega-tive cases are detected. Therefore, the clinical diagnosis of PNS has become a challenge. Position emission tomography/computed to-mography (PET/CT) is an image-fusion method containing anatomical and functional information and can be used to obtain whole-body images by a single scan. Fluoro-deoxy-glucose (FDG) PET/CT imaging can reveal potential malignant lesions in the whole body and diagnose specific types of cancer. This technology can also be applied to assess functional abnormality in the brain and moni-tor its response to treatment. Furthermore, the mechanism, clinical manifestation, and diagnosis of PNS are introduced in this study. Re-cent applications of FDG PET/CT in the diagnosis of PNS are reviewed to improve diagnostic accuracy.

Chemical investigation of fruits of Mours alba L. lead to the isolation of fifteen compounds by various chromatographies such as silica gel, Sephadex LH-20, RP-C18 column chromatography. Their structures were determined to be: 1-[5-(2-formlfuryl) methyl] dihydrogen 2-hydroxypropane-1, 2, 3-tricarboxylate 2, 3-diethyl ester (1), 1-[2-(furan-2-yl)-2-oxoethyl] pyrrolidin-2-one (2), divaricataester A (3), methyl 1-[2-(furan-2-yl)-2-oxoethyl]-5-oxopyrrolidine-2-carboxylate (4), 1-[2-(furan-2-yl)-2-oxoethyl]-5-oxopyrrolidine-2-carboxylic acid (5), L-pyroglutamic acid (6), L-pyroglutamic acid ethyl ester (7), 3-O-caffeoylquinic acid methyl ester (8), 3-O-caffeoylquinic acid ethyl ester (9), 5-O-caffeoylquinic acid methyl ester (10), 5-O-caffeoylquinic acid ethyl ester (11), 4-O-caffeoylquinic acid methyl ester (12), 4-O-caffeoylquinic acid methyl ester (13), 4-O-caffeoylquinic acid (14), 3-O-caffeoylquinic acid (15), respectively, based on the spectral analysis such as NMR, MS etc. Compounds 1-14 were isolated from this genus for the first time, among which 1 was a new compound.

Objective To evaluate the bedside index for severity in acute pancreatitis (BISAP) and harmless acute pancreatitis (HAP) scoring system in predicting prognosis of acute pancreatitis (AP).Methods A total of 442 AP patients,who were admitted to The First Affiliated Hospital of Sun Yat-sen University from January 2003 to December 2010,were retrospectively studied.BISAP and HAP scores were evaluated respectively.The value of BISAP and HAP scores in predicting severity,local complications,organ failure and mortality were measured by the area under the curve (AUC) of receiver operator characteristic curve (ROC),and it was compared with that of traditional Ranson's score.Results Among 442 patients,73 patients (16.5％) were diagnosed to have severe acute pancreatitis (SAP).AUC for BISAP score in predicting SAP,local complications,organ failure and mortality were 0.90 (95％ CI:0.86 ～ 0.93),0.82(95％ CI:0.76 ～ 0.89),0.93 (95％ CI:0.89 ～ 0.96),0.93 (95％ CI:0.87 ～ 0.98).There were no statistically significant differences in AUCs of the four prognostic parameters between BISAP and Ranson's score.The specificity,positive predictive value (PPV),and AUC of HAP score in predicting mild AP were 85％,95％ and 0.73 (95％ CI:0.67 ～ 0.79).The risk of dismal prognosis increased when both BISAP and HAP score were abnormal.Conclusions BISAP and Ranson's score have comparable ability in predicting prognosis of patients with AP.However,BISAP score is simpler.HAP score is a simple and accurate method for predicting prognosis of patients with mild AP.Combination of BISAP score with HAP score can better help predict the prognosis of AP patients.

This article made a summarization and analysis on acupuncture related empirical and clinical research literature in Science Citation Index (SCI) periodicals in 2009.Authors used acupuncture respectively as the key word to retrieve in SCI periodicals in 2009 through Web of Science and got 630 articles.The articles were summarized and analyzed on experimental design, experimental research content, disease category, acupuncture accident and systematic review of clinical effect from native and abroad.

High resolution melting (HRM), based on melting curve analysis, requires not only saturating dyes that fluoresce in the presence of double-stranded DNA, but also higher resolution detection equipment. The melting curve is a novel method for sequence matching, genotyping and mutation scanning. The technology is simple, accurate, rapid, closed-tube, low-cost, and high-throughput, which make it gain more and more applications. This review article presents the basic principles, key factors and both the advantage and limitations of HRM. The potential application is discussed in the study of molecular identity of traditional Chinese medicine.
DNA Mutational Analysis ; methods ; Drugs, Chinese Herbal ; classification ; Genotyping Techniques ; methods ; Medicine, Chinese Traditional ; Nucleic Acid Denaturation

A new terpenoid, lucidone D (1), has been isolated from Ganoderma lucidum. Its structure was determined to be 7beta, 15alpha-dihydroxy-4, 4, 14alpha-trimethyl-3, 11, 20-trioxo-5alpha-pregn-8-en on the basis of 1D and 2D-NMR spectral analysis.

High resolution melting (HRM), based on melting curve analysis, requires not only saturating dyes that fluoresce in the presence of double-stranded DNA, but also higher resolution detection equipment. The melting curve is a novel method for sequence matching, genotyping and mutation scanning. The technology is simple, accurate, rapid, closed-tube, low-cost, and high-throughput, which make it gain more and more applications. This review article presents the basic principles, key factors and both the advantage and limitations of HRM. The potential application is discussed in the study of molecular identity of traditional Chinese medicine.

Objective To study the mechanism of miR-548a-3p targeting MMP-2 inhibits the metastasis and invasion of gastric cancer cells.Methods Bioinformatics were used to search those miRNAs targeting MMP-2.The level of miR-548a-3p in gastric cancer tissues were detected by qRT-PCR and the expression of MMP-2 were detected by Western blot.The level of miR-548a-3p in three reconstructed gastric cancer cell lines were detected by qRT-PCR and the expression of MMP-2 were detected by Western blot.miR-548a-3p targeting the 3'-UTR of MMP-2 were detected by Luciferase reporter assay detected.And the changes of ability of metastasis and invasion were examined by Transwell experiment before and after transfection.Results There were high expression of miR217 and low expression of MMP-2 in human poorly differentiated gastric cancer cell line BGC-823.There were low expression of miR-548a-3p and high expression of MMP-2 in human middle and high differentiated gastric cancer cell line MKN-28 and SGC-7901 (P ＜ 0.05).The result of Luciferase reporter assay showed that miR-548a-3p can targeting the 3’-UTR of MMP-2.There were high expression of miR-548a-3p and low expression of MMP-2 in MKN28-miR-548a-3p mimics.There were low expression of miR-548a-3p and high expression of MMP-2 in others reconstructed three cell lines.There were smaller invaded cells in SGC-7901-miR-217 mimics than in others three cell lines (P ＜ 0.05).Conclusions miR-548a-3p can target the 3'-UTR of MMP-2 and down regulate its expression and inhibit the ability of invasion of gastric cancer cells.

Objective To explore whether albumin corrected anion gap (ACAG) is associated with long-term mortality of sepsis patients.Methods Adult patients with a diagnosis of sepsis within the first 24 hours (from December 2013 to December 2014) admitted to the intensive care unit (ICU) were included via the Sepsis database of West China Hospital Sichuan University. To record their long-term survival, patients were followed up by telephone interview one year after enrollment. ACAG was calculated according to the anion gap (AG) level within the first 24 hours admitted to ICU, and patients were divided into normal ACAG group (ACAG 12-20 mmol/L) and high ACAG group (ACAG > 20 mmol/L), and clinical characteristics and 1-year mortality were compared between groups. Patients were also divided into survivors and non-survivors according to the 1-year survival outcome, and multivariate logistic regression analysis was conducted to find independent risk factors for long-term mortality of sepsis patients.Results A total of 296 sepsis patients were enrolled in the study, with 191 (64.5%) in the high ACAG group and 105 (35.5%) in the normal ACAG group. There were no significant differences in age, gender, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), sequential organ failure assessment (SOFA), Charlson cormobidity index (CCI) and other background variables between groups. Compared with the normal ACAG group, patients who suffered from multiple organ dysfunction syndrome (MODS) in the high ACAG group were more prone to develop renal and gastrointestinal injury (43.5% vs. 25.7%, 52.9% vs. 33.3%, respectively), had significantly higher serum creatinine [SCr (μmol/L): 89.0 (61.0, 148.0) vs. 67.1 (48.0, 86.0)], greater need for continuous renal replacement therapy (CRRT, 16.8% vs. 6.7%), and significantly shorter length of ICU stay and hospital stay [days: 11 (5, 22) vs. 16 (18, 31), 21 (14, 39) vs. 28 (20, 47)], with statistically significant differences (allP < 0.05). It was shown by Kaplan-Meier survival analysis that 1-year cumulative survival for the high ACAG group was significantly lower than that of the normal ACAG group (55.0% vs. 67.7%,P = 0.046). It was shown by multivariate logistic regression that ACAG [odds ratio (OR) = 1.201, 95% confidence interval (95%CI) = 1.115-1.293,P = 0.000], APACHE Ⅱ (OR = 1.053, 95%CI = 1.011-1.098, P = 0.014), the incidence of septic shock (OR = 2.203, 95%CI = 1.245-3.898,P = 0.007), fungus infection (OR = 3.107, 95%CI = 1.702-5.674,P = 0.000), acute renal failure (OR = 2.729, 95%CI = 1.134-6.567,P = 0.025) and complicated with malignancy (OR = 2.929, 95%CI = 1.395-6.148,P = 0.005) were independent risk factors contributing to increased 1-year mortality among sepsis patients.Conclusion ACAG was an independent risk factor for 1-year mortality of sepsis patients.