Problem-based and student-centered learning patten brings new challenges to the both sides of teaching and learning.Clinical probation is the first step of medical students.The problem-based learning patten is used to clinical probation and achieves good results.It helps to improve medical students' quality and should be applied in China medical education.

AIM: To investigate the changes of the renal L-arginine /nitric oxide pathway and the relationship of L-arginine transport between kidney and erythrocytes in spontaneously hypertensive rat (SHR). METHODS: Sixteen week old SHR, 16 week old SHR with captopril (CAP) treated for four weeks and 16 week old WKY rats were used in the experiment. L-arginine transport, NO synthase(NOS) activity, nitrite and cyclic GMP (cGMP) content were measured in renal tissue or erythrocytes. RESULTS: In the renal tissue, compared with that of WKY group, the Vmax of high-or low-affinity L-arginine transporter, NOS activity, NO - 2 and cGMP content of SHR group were significantly decreased ( P

0.05).No significant histological and ultrastructural changes were observed in the skin biopsies.Conclusion The long pulsewidth Diode Laser is a safe hair removal technique with good result and without adverse effect on the function of axillary sweat gland excretion.

The transfection efficiency of oligonucleotide and plasmid to the HL-60 cell line with lipofectaminePLUS was compared through observing the transfection rate and the expression duration of exogenous gene in the target cells. The results showed that the transfection rate of oligonucleotide to the HL-60 was about 90% - 95% and it had no obvious attenuation within 84 h. However, the plasmid transfection rate was only 5% -25% and it was decreased significantly within 60 h. It was suggested that the transfection of oligonucleotide with liposomes was better than that of plasmid.
Green Fluorescent Proteins/genetics ; HL-60 Cells ; Liposomes ; Oligonucleotides/*genetics ; Plasmids/*genetics ; Transfection

Objective To investigate the effects of the frozen embryo transplantation for patients with poor outcome of endometrial growth by using growth hormone (GH) intrauterine perfusion combined with replacement cycle in the treatment of thin endometrium.Methods This was a prospective study and study participants were consecutively recruited between Jun 2014 and September 2015.A total of 88 frozen thawed embryo transfer cycles was divided into two groups from the Reproductive Center of Hunan Provincial Maternal and Child Health Hospital.Group A were 63 hormone replacement therapy (HRT) cycles and Group B were 25 GH intrauterine perfusion combined HRT cycles.Results The endometrial thickness of 22 thin endometrium patients from Group B were increased above 7 mm on progesterone day.The endometrial thickness on transplant day of Group A was (9.28 ± 1.64) mm,which was significantly higher than Group B (7.9 ± 0.86) mm (P ＜ 0.05).The clinical pregnancy rate (50.79％ vs 52.0％),implantation rate 31.1％ vs 47.17％),miscarriage rate (9.38％ vs 15.38％) had no significant difference between Groups A and B.The endometrial thickness from 7 mm to 7.9 mm on transplant day,the clinical pregnancy rate (30.76％ vs 54.54％) had no significant difference in two groups (P ＞0.05),but the implantation rate of group A was significantly lower than that of group B (20％ vs 52.17％) (P ＜0.05).When the endometrial thickness was above 8 mm on transplant day,the clinical pregnancy rate (58.33％ vs 63.63％),implantation rate (36.36％ vs 50％) had no significant difference between groups A and B (P ＞ 0.05).Conclusions GH uterine cavity perfusion was a useful method for treatment of thin endometrium,and was helpful for improvement of endometrial thickness and receptivity,improved embryo implantation environment by assistance for HRT under the high estrogen levels.

Objective To explore the effects of seven-step complex decongestion therapy (CDT) on post-operative upper limb lymphede-ma of breast cancer. Methods From August, 2015 to September, 2016, 71 patients with upper limb lymphedema after breast cancer surgery accepted CDT for 20 days, including skin care, opening of lymphatic pathway, relief of scar tissue, manual lymphatic drainage, bandage compression, air pressure wave therapy and functional exercise. The circumference of eight sites of both limbs was measured and the differ-ences were calculated before treatment, and one, five, ten, fifteen and twenty days of the treatment. Results The differences of circumfer-ence increased one to 15 days of the treatment (Z>2.03, P<0.05), and decreased 20 days of the treatment (Z=3.01, P<0.01). Conclusion CDT is effective on lymphedema after breast cancer surgery for 20 days of a course, but may worsen in the first 15 days, which may be relat-ed to acute stress response or redistribution of lymph.

Objective To explore the effect of manual lymphatic drainage on prevention of postoperative axillary web syndrome of breast cancer. Methods From June to December, 2015, 400 breast cancer patients after modified radical mastectomy were randomly divided into control group (n=200) and intervention group (n=200). The control group accepted routine functional exercise on affected upper limbs, while the intervention group accepted manual lymphatic drainage in addition. The incidence of axillary web syndrome in both groups was compared one, two and three months after operation. Results The incidence of axillary web syndrome was less in the intervention group than in the control group in all the time points after operation (χ2>6.17, P<0.05). Conclusion Manual lymphatic drainage can effectively pre-vent axillary web syndrome in patients with breast cancer after modified radical mastectomy.

The transfection efficiency of oligonucleotide and plasmid to the HL-60 cell line with lipofectaminePLUS was compared through observing the transfection rate and the expression duration of exogenous gene in the target cells. The results showed that the transfection rate of oligonucleotide to the HL-60 was about 90 %-95 % and it had no obvious attenuation within 84 h. However,the plasmid transfection rate was only 5 %-25 % and it was decreased significantly within 60 h. It was suggested that the transfection of oligonucleotide with liposomes was better than that of plasmid.

Objective To apply Canadian Occupational Performance Measure (COPM) on the patients injured in Sichuan Earthquake. Methods COPM was applied to evaluate 51 patients in hospital before and 1 months after treatment. The first evaluation confirmed the problems on occupational activities for them. Then the plan was made to solve the problems. The second evaluation was to assess the effect of the treatment.Results The problem of self-care activity is more than that of productive activities and leisure activities(P<0.01). Total scores of performance of occupational activity and satisfaction improved(P<0.01, P<0.01)Conclusion COPM is helpful to confirm the problems of occupational activities and contribute to develope the primary goals for rehabilitation and treatment programs.

Objective To assess the effects of artificial cycle after long-acting gonadotropin-releasing hormone (GnRH) agonist down regulation scheme and artificial cycle only scheme in preparation of endometrium before frozen embryo transfer in polycystic ovary syndrome (PCOS) patients on pregnancy outcome.Methods A retrospective analysis was made on the frozen embryo transfer of 132 PCOS patients in the reproductive center of Hunan Maternal and Child Health Hospital from November 2016 to October 2017.The patients were divided into GnRH-a down regulation + artificial cycle group (n =66) and simple artificial cycle group (n =66) according to the different endometrial preparation schemes before frozen embryo transplantation.The transplantation cycle and pregnancy outcome of the two groups were compared.Results (1) There was no statistically significant difference in age,primary infertility rate,infertility years and body mass index (BMI) between the two groups (P ＞ 0.05).(2) In the artificial cycle group,4 cases in which the transplantation was cancelled,including 2 cases who were cancelled due to breakthrough bleeding and 2 cases due to endometrial thickness that were less than 7 mm.There was a statistically significant difference in the cancellation rate between the two groups (x2 =4.13,P =0.04).There were no statistically significant difference in embryo frozen storage time,retrieved oocytes in fresh embryo cycle,frozen thawed embryos in the survival rate,graftage embryonic number,high-quality embryonic rate,endometrium thickness in conversion day (P ＞ 0.05).Estrogen level,luteinizing hormone (LH) levels on endometrium conversion day in GnRH-a down regulation plus artificial cycle group and artificial cycle group were respectively as [(1 439.38 ± 357.43) nmoL/ml vs (1 580.54 ± 479.69) nmol/ml and (2.32 ± 0.94) mIU/ml vs (9.46 ±1.52) mIU/ml],with statistically significant difference (x2 =53.64,P ＜ 0.001;x2 =14.32,P ＜ 0.001).(3) The biochemical pregnancy rates of the patients in the GnRH-a down regulation plus artificial cycle group and artificial cycle group were 72.73％ and 53.23％ respectively,with statistically significant difference (x2 =5.23,P =0.036).The clinical pregnancy rate (65.15％) in GnRH-a down regulation plus artificial cycle group was higher than that of the artificial cycle group (46.77％),with statistically significant difference (x2 =4.39,P =0.022).There was no statistically significant difference in early abortion rate and ectopic pregnancy rate between the two groups.Conclusions In frozen embryo transplantation cycle,long-term GnRH-a down regulation after artificial cycle scheme is superior to simple artificial cycle scheme with significantly reduced cycle cancellation rate,low estrogen and LH levels in endometrium transformation day and higher biochemical pregnancy rate and clinical pregnancy rate.