This paper was to explore the application of case based learning method in medical psychology course for medical undergraduates.According to curriculum standard,nine cases were compiled which matched six articles,forming the complete instructional design.We followed the five steps of scientific teaching stage.The preliminary results showed that the case teaching was helpful to improving the medical students' knowledge acquisition,and their ability to master and solve practical problems.

Bronchial asthma is the most common chronic disease in children.In recent years,the inci-dence of bronchial asthma is rising and seriously harmed to the public health,has been gained comprehensive attention in community and scholars.With the in-depth study of the pathogenesis of asthma,the immunologi-cal dysfunction caused by disordered Th1 /Th2 cell play a major role in the pathogenesis of asthma,and im-munotherapy for its pathogenesis has also made great progress,which is expected to become the safer,more effective and more specific treatment.Currently immunomodulator for the treatment of asthma can be divided into four categories according to the source:microbial agents,biological agents,herbal or plant origin and syn-thetic agents.Microbial agents which include BCG,Pan Fu Shu,biologics including Th2 receptor antagonist, Th1 cytokines,anti-IgE antibody,immunoglobulin,thymosin,synthetic agents include pidotimod,transfer fac-tor,traditional Chinese medicine or plant.The main source of Gin kgo biloba extract,Huaiqihuang etc.We make a summary on the research progress and immunomodulator in the treatment of asthma in this review.

? AlM: To study the application value of phacoemulsification in clinical treatment of angle-closure glaucoma.?METHODS:A total of 60 cases ( 82 eyes ) , the best corrected visual acuity, anterior chamber depth, intraocular pressure, width of chamber angle and adverse reaction of patients were researched and analysed before and after treatment.?RESULTS:ln this group, 60 cases (82 eyes) compared with that before treatment, the best corrected visual acuity in patients after treatment significantly improved, with significant difference between the two groups ( P<0. 05 ); anterior chamber depth of patients before treatment were 2. 0±0. 3mm, anterior chamber depth after treatment was 4. 4 ± 1. 0mm, treatment of patients with anterior chamber depth comparison significantly improved after treatment, with statistically significant difference between the two groups ( P<0. 05 ); lOP in patients with postoperative effective control over an extended period, the difference before treatment was statistically significant ( P<0. 05 ); the width of chamber angle after treatment compared with before treatment significantly increased, with statistically significant difference between the two groups ( P < 0. 05 ); after treatment by the emergence of 5 corneal edema, 3 mydriasis, an iris atrophy, no one cases of retinal detachment.?CONCLUSlON: Phacoemulsificationin the treatment of angle - closure glaucoma has a high value, can be effectively corrected visual acuity, improve patient anterior chamber angle width and depth, a small incidence of adverse reactions.

Objective: To observe the initial effectiveness of retrograde urethrotomy with a cold knife combined with the lucency via antegrade flexible cystoscopy in treatment of patients with obliterative urethral stricture. Methods: From September 2007 to April 2010, 8 patients with obliterative urethral stricture (0.8-2.0 cm in length) underwent antegrade-retrograde via flexible cystoscopy endoscopic urethrotomy with a cold knife: the initial effectiveness was observed. Results: All the 8 patients were successfully treated with antegrade-retrograde via flexible cystoscopy endoscopic urethrotomy with a cold knife. The operation time ranged 15-30 min, with a mean of 21 min. Urethral catheter (20-22F) was maintained for 4-6 weeks, and all the patients had passable urinary tract, with no urinary incompetence. The 8 patients were followed for 6-24 months (with a mean of 18 months). Three patients had no stricture recurrence and needed no further treatment. Four patients needed further intermittent urethral dilations(6-16 procedures, mean 12 procedures) to keep normal urination. One patient received a second endoscopic urethrotomy due to recurrent stricture 3 months after first treatment. Conclusion: The antegrade-retrograde urethrotomy via flexible cystoscopy with a cold knife can improve the successful rate of endoscopic surgery, with shorter operation time and satisfactory short-term outcome, but the long-term outcome needs to be further observed.

Objective: To establish and identify androgen-independent human prostate cancer cell line LNCap by culturing LNCaP cells with gradual deprivation of hormone. Methods: LNCaP cells were cultured in the medium with gradual deprivation of hormone (treated by active carbon to simulate androgen deprivation) for 10 days; and then the cells were cultured with complete deprivation of androgen for 3 months till the cell entered the rapid proliferation phase again. The cell growth and expression of PSA and androgen were examined by CCK-8, immunfluorescence and RT-PCR methods. Results: LNCaP cells grew slowly after deprivation of hormone and took on a neuroendocrine phenotype and cluster growth pattern. After 3 months' non-androgen culture,the cells regained original morphology and growth. CCK-8 indicated that LNCaP cells could grow in non-androgen condition; immunofluorescence assay indicated that LNCaP-AI cells could regain PSA-secreting activity in non-androgen condition; and RT-PCR suggested that androgen was highly expressed in LNCaP-AI cells. Conclusion: Androgen-independent LNCaP cell line can be established by culturing with gradual deprivation of hormone for 3 months.

Objective To observe the effect of short-term treatment with metfbrmin on psychological distress and metabolic feature in patients with polycystic ovary syndrome(PCOS).Methods Ninety women were diagnosed as cases of PCOS based on the 2003 Rotterdam criteria.These patients were divided into three groups:group A,consisted of 26 subjects treated with mefformin only; group B,36 cases treated with metformin plus Dane-35 ; and group C,28 cases treated with placebo and Dane-35.The treatment was carried out for 3 months.Clinical and metabolic parameters were observed.The psychological distress was evaluated by the hospital anxiety and depression scale(HAD scale).Results Compared with group C,patients in group A and B showed significantly lower body mass index(BMI),waist circumference (WC),waist-hip ratio (WHR),serum fasting insulin,homeostasis model assessment for insulin resistance (HOMA-IR),total cholesterol (TC),triglyceride (TG),low density lipoproteincholesterol(LDL-C) levels as well as anxiety and depression scores,but higher high density lipoprotein-cholesterol (HDL-C) levels (all P＜0.05).Compared with group A,patients in Group B had significantly higher WC,WHR,and LDL-C levels(all P＜O.05).No significant differences in BMI,TG,HDL-C,anxiety and depression scores were found between group A and B (all P＞0.05).In group A,a positive correlation was found between the changes of metabolic feature (BMI,WHR,and HOMA-IR) and the changes of anxiety and depression scores (all P ＜0.05).Conclusion Short-term treatment with metformin will benefit patients with polycystic ovary syndrome,regarding psychological distress and metabolic features.

Objective To observe the effects of intravenous injection of fentanyl and tramadol on postoperative analgesia in laparoscopic cholecystectomy of clinical efficacy.Methods 80 cases treated with laparoscopic cholecystectomy were randomly divided into the fentanyl group (group F) and tramadol group (group Q).VAS score,adverse reaction incidence and patient satisfaction,were observed after the administration of 0.5,1,2,4,8,12h.Results In group F after administration of 0.5,1,2h,VAS score was better than that of group Q; group F after administration of the drug 4,8 h VAS score was inferior to group Q;two groups of patients in postoperative 12h VAS scores showed no significant difference in group F;the overall incidence of adverse reactions was higher than that of group Q,patients' satisfaction was higher than that of group Q.Conclusion Intravenous fentanyl in laparoscopic cholecystectomy operation postoperative overall are superior to the analgesic effect of tramadol,with high patient's satisfaction.

The Arabidopsis thaliana glutathione S-transferases zeta class (AtGSTZ) is a multi-functional enzyme, which plays important role in cellular metabolism and environmental purification. Error-prone PCR and cycles of DNA shuffling were used to construct a mutagenesis library of AtGSTZ. The screening of the resultant libraries was carried out by a pH indicator dye-based colorimetric assay. Nine mutants which enhanced the dichloroacetic acid dechlorination activity were obtained. Among them, NN23 contained 25 amino acid substitutions with the activity improving 120%, whereas NN20 contained 24 amino acid substitutions with the activity improving 102%. EC1 contained 2 amino acid substitutions with the activity improving 47%. The rest 6 mutants contained one amino acid substitution with their activity increasing from 9% to 60%. The enzymatic characterization showed that all the evolved enzymes increased their catalytic efficiencies towards dichloroacetic acid and binding affinity towards glutathione whereas some of them increased the renaturability. However there is no obvious change in their thermostability. Based on these data, functional residues related to catalysis and refolding of AtGSTZ were discussed.

A quantitative method using ultrahigh-performance liquid chromatography was established to simultaneously determine ten ginsenoside active ingredients including ginsenoside Rg6, F4, Rk3, Rh4, 20(S) -Rg3, 20(R) -Rg3, Rk1, Rg5, 20(S)-Rh2 and 20(R)-Rh2 in steamed notoginseng. The ten ginsenosides of steamed notoginseng with different head numbers, parts, and steaming time were determined by this method. An Acquity BEH C18 chromatographic column (2.1 mm x 100 mm, 1.7 microm) was used to perform the determination, which was maintained at 35 degrees C throughout the analysis. Mobile phase was composed of water and acetonitrile with flow rate at 0.3 mL x min(-1) under gradient elution, and detection wavelength was set to 203 nm for monitoring the separation. The results demonstrate ginsenoside Rg6, F4, Rk3, Rh4, 20 (S)-Rg3, 20 (R) -Rg3, Rk1, Rg5, 20 (S)-Rh2 and 20(R) -Rh2 have shown good linearity (R2 > or = 0.999 8) within 0.46-115, 2.06-515, 1.632408, 3.216-804, 1.392-348, 1.4-350, 0.496-248, 3.012-1 506, 0.82-205 and 0.832-208 mg x L(-1), and their average recoveries were 97.00%, 97.96%, 98.86%, 95.27%, 98.67%, 98.02%, 95.53%, 96.63%, 99.57% and 103.6%, respectively. The proposed approach was quick and accurate and portrayed excellent repeatability and determination efficiency. The quality of steamed notoginseng was effectively controlled, which served as a foundation for establishing a normalized processing technique and quality standard for ensuring the reliability and consistency of its clinical efficacy.
Chromatography, High Pressure Liquid ; methods ; Ginsenosides ; analysis ; Panax notoginseng ; chemistry ; Reproducibility of Results ; Steam

Objective To investigate the diagnostic value of CT virtual endoscopy on the small intestine (CTVE)technology for intestinal diseases. Methods Forty-nine cases with suspected small bowel disease were tested by CTVE from December 2010 to February 2014. They also were performed. Results Of 49 patients, operation or electronic endoscopy showed that 9 cases were benign tumors,29 cases with malignant tumors,3 cases with intestinal polyps,4 cases with intestinal inflammation,2 cases with bowel dysfunction and 2 cases with normal intestinal. CTVE test showed that 11 cases were with benign tumors,29 cases with malignant tumors,2 cases with intestinal inflammation,1 case with intestinal polyps,4 cases with intestinal dysfunction and 2 cases with normal small intestine. Better consistency between the two diagnosis was seen(Kappa = 0. 70). The accurate rate of diagnosis was 85. 71%(42 / 49). The correct rate of CTVE diagnosis of space occupying lesions was 90. 24%(37 / 41). The correct rate of non occupied lesions was 50. 00%(3 / 6). Conclusion CTVE technology has the advantages of simple operation,safe,painless,and clinical diagnosis of small bowel disease rate is higher especially for small bowel accounted disease. It is worthy of clinical application.