Objective To compare the effect between problem-based learning and lecture-based learning for clinical teaching in the department of cardiovascular medicine. Methods Totally 110 five-year-program cardiovascular interns from June 2011 and June 2012 were selected. They were randomly divided into the PBL group(n=55) and LBL group(n=55). PBL and LBL teach-ing methods were applied in the two groups respectively. Teaching effects were evaluated by exam and questionnaire investigation. SPSS 15.0 was used to do data processing; t test was used to compare the average score of two groups;chi-square test was used to process the results of the questionnaire. P<0.05 signifies sta-tistically significant differences. Results There were statistical differences in examinational average score between PBL group and LBL group ((87.89 ±5.39) vs. (82.63 ±5.26), P<0.05). PBL group had significantly higher satisfaction rate in motivating study interests , deepening understanding of theoretical knowledge, cultivating self-learning ability, training verbal expression and developing clin-ical thinking, etc(P<0.05). Conclusions PBL teaching method demonstrates advantages in teaching of cardiovascular medicine and enhances the teaching effect. But the PBL teaching method should be improved in basic knowledge teaching, cultivation of teachers' ability and case selection.

OBJECTIVE: To optimize the formative excipients for cough remedy granules. METHODS: Effects of different excipients on the formation, moisture absorption and relative critical humidity of cough remedy granules were examined, and the optimal excipients as well as formula were selected by adoption of the comprehensive scoring method. RESULTS: The optimal excipient for preparation of cough remedy granules was lactose, and the best formula comprised of 4 doses of spraying powder and 6 doses of lactose mixture. CONCLUSIONS: The cough remedy granules thus prepared is ideal: good in granularity, easy to dissolve and not liable to moisture absorption.

Objective:To screen the differentially expressed miRNAs in umbilical cord tissue of children with nonsyndromic cleft lip and/or cleft palate( NSCL/P) using miRNA microarray and comprehensive bioinformatics analysis for the prediction of related the bio-logical process and signaling pathways. Methods:Umbilical cord tissues of 4 cases of healthy newborns' and 4 lip or palate tissues of 4 cases with NSCL/P without other disease aged younger than 2 years were collected. The differentially expressed miRNAs were screened by miRNA microarray. Targets of dysrugulated miRNAs were predicted by TARGETSCAN-VERT, MIRDB and RNA22-HSA. All the gene sets were analyzed by gene ontology and pathway enrichment. Results: MiRNA microarray demonstrated that 254 miRNAs were dysregulated(181 miRNAs were up-regulated and 73 downregulated,P <0. 05). The dysregulated miRNAs targets contained 5029 genes. The dysregulated miRNAs targets were enriched in anatomical structure development,cell adhesion,cell proliferation,cell motili-ty and other biological processes. The dysregulated miRNAs targets were enriched in Wnt, mTOR, cGMP-PKG, TGFβ, PI3K-Akt and other signaling pathways. Conclusion:The target genes set of miRNAs are enriched in multiple biological processes and signaling path-ways related to NSCL/P, which indicate that genetic and environmental factors may influence the development process of NSCL/P.

ObjectiveTo explore the effect of simvastatin on the level of serum adiponectin and asymmetric dimethylarginine (ADMA) in patients with acute stroke.MethodsNinety patients with acute stroke were selected and divided by random digits table method into common treatment group and intervention treatment group with 45 cases each.The volume of cerebral infarction and the evaluation score of clinical neurological impairment degree were calculated.The levels of serum adiponectin and ADMA before and after treatment were detected by erzyme-linked immunosorbent assay.The changes of serum adiponectin and ADMA before and after treatment in two groups were compared and their correlations with the volume of cerebral infarction and the evaluation score of clinical neurological impairment degree were analyzed.Results The level of serum adiponectin and ADMA in two groups before treatment had no statistical differences (P ＞ 0.05 ).The levels of serum adiponectin in two groups after treatment increased and ADMA decreased significantly,which had significant differences compared with those before treatment ( P ＜ 0.05 ).The level ofserum adiponectin in intervention treatment group was significantly higher than that in common treatment group and ADMA was obviously lower than that in common treatment group after treatment [(5.92 ± 0.15)mg/L vs.( 4.51 ± 0.13 ) mg/L,( 0.96 ± 0.13 ) μ mol/L vs.( 1.08 ± 0.15 ) μ mol/L ] ( P ＜ 0.05 ).Rank correlation analysis showed that the level of serum adiponectin before treatment was negatively correlated with the volume of cerebral infarction and the evaluation score of clinical neurological impairment degree ( r ＝ -0.75,-0.59,P ＜ 0.05).The level of ADMA before treatment was positively correlated with the volume of cerebral infarction and the evaluation score of clinical neurological impairment degree ( r =0.68,0.71,P ＜ 0.05 ).Conclusion Simvastatin can increase the level of serurm adiponectin and decrease the level of ADMA efficiently in patients with acute stroke,and improve the prognosis of the patients.

Objective:To investigate the changes of T lymphocyte subsets and cytokines in children with he-patitis B virus(HBV)-associated glomerulonephritis (HBV-GN), and their relationship with HBV-DNA load.Methods:Forty-one children who was the first diagnosed with HBV-GN in Department of Pediatrics, the People′s Hospital of Gansu Province and Institute of Infectious Diseases, the First Hospital of Lanzhou University from September 2012 to September 2016 were collected as the objects(HBV-GN group). At the same time, the 40 patients with HBV infection (chronic HBV infection, normal liver and kidney function, normal 24-hour proteinuria quantitation, no hematuria under the microscope, no recent symptoms of cold and fever, etc.) were enrolled as the control group.The levels of T lymphocyte subset, tumor necrosis factor α(TNF-α), interferon-γ (IFN-γ), interleukin (IL)-2, IL-4, IL-6, IL-8 and IL-10 in the HBV-GN group and the control group were compared, and the relationship between HBV-DNA and cell factors was farther analyzed.Results:Compared with the control group, the proportions of CD3 + T, CD4 + T lymphocyte and CD4 + /CD8 + ratio decreased in the HBV-GN group(0.632±0.052 vs.0.692±0.047, 0.204±0.050 vs.0.466±0.038, 0.006±0.002 vs.0.017±0.003, t=1.025, 3.342, 5.234, all P<0.05), and the proportions of CD8 + T lymphocyte was significantly higher than that in the control group (0.411±0.023 vs.0.220±0.043, t=4.452, P<0.01). Besides, IL-2 and IFN-γ levels in the HBV-GN group were significantly lower than those in the control group[(23.36±2.55) ng/L vs.(36.33±1.24) ng/L, (19.20±2.18) ng/L vs.(61.25±2.08) ng/L, all P<0.05], and the serum levels of TNF-α, IL-4, IL-6, IL-8, and IL-10 were significantly higher than those in the control group[(19.60±1.46) ng/L vs.( 6.68±2.32) ng/L, (13.65±3.34) ng/L vs.(1.35±1.52) ng/L, (5.57±1.02) ng/L vs.(1.43±0.57) ng/L, (26.32±3.45) ng/L vs.(9.68±2.55) ng/L, (19.82±2.78) ng/L vs.(1.02±0.56) ng/L, all P<0.01]. Moreover, in HBV-GN patients, there was negative correlation between HBV-DNA load and IFN-γ, IL-2( r=-0.985, -0.943, all P<0.05), and positive relationship in HBV-DNA load with TNF-α, IL-4, IL-6, IL-8 and IL -10 levels( r=0.942, 0.966, 0.953, 0.944, 0.963, all P<0.05). Conclusions:There is an CD4 + /CD8 + imbalance and an abnormal level of cell factors in HBV-GN progression.In further HBV-GN treatment, HBV-DNA and the cell factors should be detected simultaneously to dynamically eva-luate the illness change and the clinical curative effect.

OBJECTIVETo analyze the clinical features of clonal evolution of acquired aplastic anemia (AA) into myelodysplastic syndrome/acute myeloid leukemia (AML) and review of literatures.

METHODSAA developing MDS/AML patients between December 1994 and December 2011 enrolled into this study to analyze their clinical characteristics.

RESULTSDuring the median follow-up of 49(15-97) months, 19 patients evolved to MDS/AML, of whom 10, 8 and 1 were from VSAA, SAA and NSAA subgroups, respectively. The median G-CSF therapy was 270(29-510) days. There were monosomy 7 in 11(57.9%) of 19 patients with AA evolved to MDS/AML. The median AA evolved to MDS/AML was 33(11-88) months. The median MDS/AML transformation in responders (54.2 months) was significantly longer than of non-responders (25.7 months, P<0.01).

CONCLUSIONAA patients could evolved into MDS/AML concomitant with abnormal karotype and worse prognosis.

Anemia, Aplastic ; Chromosome Deletion ; Chromosomes, Human, Pair 7 ; Granulocyte Colony-Stimulating Factor ; Humans ; Leukemia, Myeloid, Acute ; Myelodysplastic Syndromes