Case based learning/problem-based learning ( CBL/PBL ) is a new teaching method based on traditional medical education methods.In order to conquer the deficiency of traditional education methods in autonomous study motivation and ability of knowledge integration, CBL/PBL has been introduced into vascular surgery teaching procedure since 2006.The quality and effort of CBL/PBL compared with lecture-based learning ( LBL ) were evaluated and scored. The outcome of this teaching innovation shows CBL can arouse students' desire in autonomous study and enhance their ability in clinical analysis.But, its superiority is difficult to develop in the current medical education system.

Objective To investigate the feasibility and safety of percutaneous interstitial implantation of ~(125)I seeds into the pancreas of pig under CT-guidance. Methods Twelve healthy pigs were equally divided into 6 groups.~(125)I seed implantation into the pancreatic tail under CT-guidance was performed in pigs of study groups (group A-E), while ghost seeds that contained no radioactive materials were used in the control group (group F). Imaging examination and laboratory tests, including serum amylase, hepatic and renal functions, were conducted before and 1, 7, 15, 21, 30, 60 days after the procedure. Every two pigs (group A-E) were sacrificed each time at 15, 30, 45, 60, and 75 days after treatment, and specimens of pancreas, duodenum, liver, kidney, etc. were collected and sent for pathologic examination. Results The ~(125)I seeds were successfully implanted in all pigs. During the follow-up period, no severe complications occurred. Imaging and pathologic studies demonstrated that in study groups necrosis of pancreatic tissue appeared around the implanted ~(125)I seeds in 15 days, the necrosis area increased significantly in 45 and 60 days, and in 75 days the necrosis size remained quite the same as seen in 60 days. No necrosis was found in the control group (group F) 60 days after treatment. No serious complications, such as effusions, hemorrhage or necrosis of the adjacent duodenum, stomach, liver or kidney, occurred 75 days after the treatment. Conclusion Percutaneous interstitial implantation of ~(125)I seeds into the pig's pancreas under CT-guidance is safe and feasible.

Objective To compare the therapeutic effects of CT-guided ~(125)I seed implantation with simple Gemcitabine chemotherapy for the treatment of unresectable pancreatic carcinoma. Methods Forty-six untreated patients with unresectable advanced pancreatic carcinoma were randomly divided into two groups: group A (n = 22), treated with ~(125)I seed implantation and group B (n = 24), treated with intravenous chemotherapy using Gemcitabine only. The clinical benefit response (CBR), objective tumor response (OTR), safety and the improvement of living quality were evaluated and analyzed. Results Three months after the treatment, the OTR rate of group A and group B was 45.5% and 8.33% respectively (P < 0.05). The CBR rate of group A and group B was 47.1% and 25% respectively (P < 0.05). No significant difference in PFS between group A and group B (P > 0.05). And also, the incidence of hematological toxicity and complication between two groups were of no significant difference. Conclusion For the treatment of advanced unresectable pancreatic carcinoma, both simple Gemcitabine chemotherapy and ~(125)I seed implantation are able to obtain a moderate objective response, although ~(125)I seed implantation seems to be more effective than Gemcitabine in improving the living quality and survival rate.

OBJECTIVE:To investigate the effect of liposome-encapsulated demethoxycurcumin on the proliferation of human lung adenocarcinoma cell line A549.METHODS:The in vitro cultured human lung adenocarcinoma cell line A549 was treated with liposome-encapsulated Bisdemethoxycurcumin.The bionomics including morphology and cell cycle of cell line A549 were observed by morphological analysis,MTT assay and flow cytometry assay.RESULTS:Marked morphological changes were noted in cell line A549 under microscope.Liposome-encapsulated Bisdemethoxycurcumin showed inhibitory action on the growth of A549 cell lines,with IC50 at 12.108?g/mL.The progression of cell cycle was arrested in S phase.CONCLUSION:Liposome-encapsulated Bisdemethoxycurcumin can inhibit the growth of human lung adenocarcinoma cell line A549,which has a promising future in the treatment of adenocarcinoma of lung.

BACKGROUND:Related medical researches have shown that the incidence of simple diastolic heart failure is higher than that of systolic heart failure. OBJECTIVE:To investigate the application value of echocardiography in the monitoring of rabbit models of simple diastolic heart failure. METHODS: Sixty healthy male New Zealand rabbits were included in this study. The pressure overload hypertrophy rabbit model was established by the method of abdominal aortic coarctation. Rabbits were randomly divided into surgical group and sham group. Al rabbits were subjected to the echocardiography and left heart catheterization, the left ventricular end-diastolic pressure and relaxation time constants were measured to judge the presence of simple diastolic heart failure. RESULTS AND CONCLUSION:Compared with the sham group, the aortic annular diameter was significantly reduced before surgery and at 1, 4, 8 weeks after surgery in the model group (P < 0.05); the peak of retrograde velocity at atrial contraction was decreased in the model rabbits at 8 weeks after surgery (P< 0.05); the left ventricle dry weight, ratio of left ventricle dry weight/body weight, left ventricular posterior wal thickness, systolic pressure, interventricular septum, left ventricle systolic pressure, and left ventricular end-diastolic pressure were obviously increased at 8 weeks after surgery (P < 0.05). Experimental findings indicate that rabbit models of simple diastolic heart failure are successfuly established, and echocardiography can effectively monitor the left ventricular systolic and diastolic functions in cardiac hypertrophy.

Objective To explore lipoxinA4 (LXA4) expression in maternal serum of pregnant women and the protective effect and mechanism of LXA4 on trophoblastic cells from oxidative injury. Methods Trophoblastic cells were randomized into six groups: Control group; Lipopolysaccharides (LPS) group, cells were stimulated by 10 μg/ml LPS for 24 h; Intervention group, cells stimulated by LPS were treated with 100 nmol/L LXA4 for 24 h; LXA4 group, cells were treated with 100 nmol/L LXA4 for 24 h; Antagonistic group, cells stimulated by LPS were treated with 100 nmol/L LXA4 plus 100 μmol/L N-tert-butoxycarbonyl-2-pyrrolidine (BOC-2) for 24 h; BOC-2 group, trophoblastic cells stimulated by LPS were treated with 100 μmol/L BOC-2 for 24 h. The serum concentration of LXA4 in normal group and preeclampsia group was detected by ELISA. The intracellular formation of reactive oxygen species (ROS) was detected by 2,7-dichlorofluorescein diacetate (DCFH-DA) as a fluorescent probe. SOD mRNA was analyzed by RT-PCR. SOD and Nrf2 protein expressions were analyzed by Western blot. The levels of SOD in trophoblastic cells were detected by using detection kit. Results (1) The serum concentration of LXA4 was significantly lower in preeclampsia group (165.53±18.89) pg/L than in the control [(545.67±30.91) pg/L, P<0.01]. (2) Compared with control group, the levels of ROS in LPS group were significantly higher, DCF density of trophoblastic cells increased from 53.00±3.08 to 77.00±5.83 (P<0.01). The expression of nuclear Nrf2 protein, SOD mRNA and protein in LPS group were obviously decreased (P<0.01). The levels of SOD in LPS group were also significantly lower (P<0.01). (3) Compared with LPS group, the levels of ROS in intervention group were significantly lower, DCF density of trophoblastic cells decreased from 77.00±5.83 to 62.00±3.39 (P<0.01). The expression of nuclear Nrf2 protein, SOD mRNA in intervention group were obviously increased (P<0.01), so did the SOD protein expression (P<0.05). The levels of SOD were significantly increased from (4.77±0.34) U/ml to (8.93±0.53) U/ml (P<0.01). (4) The levels of SOD in antagonistic group were lower than in intervention group, but still higher than LPS group. [(6.23±0.41) U/ml vs (8.93±0.53) U/ml (P<0.01) or (4.77±0.34) U/ml (P<0.01)]. No significant difference was found in the levels of SOD between BOC-2 and LPS group (P>0.05). Conclusions LXA4 can significantly reduce the oxidative stress of placental trophoblastic cells stimulated by LPS. LXA4 can bind to lipoxin receptors and activate Nrf2-ARE signaling pathway playing a protective effect. So LXA4 in pregnant women can affect the oxidative stress of placenta.

ObjectiveTo investigate the effects of 5(S),6(R),7-trihydroxyheptanoic acid methyl ester (BML-111) on pregnant mice with fetal growth restriction(FGR) induced by antenatal dexamethasone and its probable mechanism. MethodsThe mice were mated overnight,with day 1 of pregnancy designated as the day on which spermatozoa were presented in a vaginal smear.The pregnant mice were then randomly divided into control group,dexamethasone group and BML-111 group.From 9 to 14 days of pregnancy,pregnant ICR mice of control,dexamethasone and BML-111 group were treated separately with saline,dexamethasone(5 mg/kg) and dexamethasone at 8:00 am,and two hours later they were treated separately again with 1 mg/kg saline,saline and BML-111.On the day 18 of gestation,they were sacrificed after blood were collected from their eyeballs.The serum lipoxin A4 was measured with enzyme-linked immunosorbent assay. Fetuses were delivered by cesarean section; the placenta and uterus were immediately removed and frozen.Gene expressions of 11β-hydroxysteroid dehydrogenase 2 ( 11β-HSD2 ),interleukin-1β (IL-1β) in placenta and lipoxin A4 receptor-formyl peptide receptor 3 (FPR3)in uterine were detected by reverse transcriptionpolymerase chain reaction and compared with analysis of variance.The 11β-HSD2 protein in mice placenta was detected by immunohistochemistry. ResultsThe mean fetal weight of dexamethasone group was (0.823±0.054) g,lower than that of the control group and BML-111 group [(1.103±0.218) g and (0.992 ± 0.207) g] (t =- 4.108 and - 2.890,P ＜ 0.05 respectively).Protein expression of 11β-HSD2 in dexamethasone group (0.030±0.019) was weaker than that in control group (0.058±0.015,t=-3.107,P＜0.05) or in BML-111 group (0.049±0.026,t=-2.211,P＜0.05).The expression of 11β-HSD2 mRNA in dexamethasone group (0.457±0.062) was lower than that in control group (0.943±0.057,t=-9.418,P＜0.05) or in BML-111 group (0.698±0.071,t=-4.617,P＜0.05).Expression of IL-1β mRNA in dexamethasone group (0.543±0.103)was less than that in control group (0.710± 0.085,t=-3.736,P＜0.05) but more than that in BML-111 group (0.229 ±0.031,t=7.025,P＜0.05). The expression of FPR3 mRNA in dexamethasone group (0.323 ± 0.019) was less than that in control group (0.857 ± 0.057,t =-14.630,P＜0.05) or in BML-111 group (0.499 ±0.050,t=-4.822,P＜0.05).The serum concentration of lipoxin A4 in dexamethasone group was lower than that in control group [(64.463±22.144) pg/ml vs (101.610±24.916) pg/ml,t=3.152,P＜0.05].ConclusionsBML-111 regulate the expression of 11β-HSD2 and then protect against FGR resulted from too much prenatal application of dexamethasone.

Objective To investigate the expression and clinical significance of MUC1,MUC2,MUC4 and MUC5AC in pancreatic ductal adenocarcinoma(PDA).Methods To analyze the expression profiles of MUC1,MUC2,MUC4 and MUC5AC in PDA(n=26),chronic pancreatitis(CP,n=4),normal pancreas(n=16)and intraductal papillary-mucinous neoplasm(IPMN)(n=2),solid-pseudo-papillary tumor of pancreas(SPT)(n=4),serous cystic neoplasm(SCN)(n=1)using immunohistochemistry.Results Positive staining with MUC1 Was exclusively found in normal pancreas and CP tissues(100%);the expression of MUC1,MUC4 and MUCSAC in PDA was 100%,88.5%(23/26)and 76.9%(20/26)in PDA tissue;MUC2 and MUC5AC were expressed in 2 samples of IPMN;none of the four mucins were expressed in Sfrr and SCN.There was no association between the expression of MUC4,MUC5AC and the clinicopathologic parameters in PDA(P＞0.05).Conclusions Multiple mucins were expressed in PDA.Measurement of the mucin profile including all 4 mueins(MUC1,MUC2,MUC4,and MUC5AC)may be helpful in the diagnosis and differential diagnosis of PDA.

Objective To observe CT features of ovarian thecofibroma and the clinical significance.Methods CT manifestations, clinical data and pathological diagnosis of 12 cases of ovarian thecofibroma proved by pathology were retrospectively analysed.Results The CT manifestation of ovarian thecofibroma was typical,which was showed as following:on one side of the attachment area tumor,single,ovoid or class circular shape,most boundary clear,equal or slightly low density solid masses,internal or boundary ar-ea accompanied by a small amount low density area,mild delay enhancement in solid ingredients or no obvious enhancement.Conclu-sion CT examination is important for qualitative diagnosis of ovarian thecofibroma and finding complications.

ObjectiveTo detect the expressions of β-catenin protein in different pancreatic tissues ( NP,PanINs,IPMNs and PDAC) and evaluate its significance during the carcinogenesis of PDAC.Methods The expression of β-catenin protein in 12 samples of normal pancreatic tissues,52 samples of IPMN (IPMA 20 foci,IPMB 13 foci,IPMC 19 foci),PanINs 118 foci (PanIN-1 73 foci,PanIN-2 29 foci,PanIN-3 16 foci),50 cases of PDAC was determined by using immunohistochemistry. The correlation between β-catenin expression and clinicopathologic characteristics of PDAC was analyzed. Results β-catenin was mainly expressed in cell membrane of NP,the quantity was 4.38 ± 2.11 ; in PanINs,PDAC and IPMN,β-catenin membrane expression was significantly decreased or absent,the β-catenin membrane expressions of PanIN-1,PanIN-2,PanIN-3,PDAC,IPMA,IPMB,IPMC were 5.22 ±2.21,2.24 ±2.31,1.44 ±1.37,2.71 ±2.08,4.85 ±2.28,4.15 ±2.51,2.68 ±2.75.The cytoplasm expression of PanIN-1 was 12.3％ (9/73),while the nuclear expression was 0 ; and the corresponding values were 34.5％ (10/29) and 3.4％ ( 1/29 ) in PanIN-2; 43.8％ (7/16) and 12.5％ (2/16) in PanIN-3; 44.0％ (22/50) and 10.0％ (5/50) in PDAC.The IHCS of β-catenin membrane expression decreased with the severe tissue atypia along the progressive multistage.The β-catenin membrane expression was significantly associated with tumor size,neural infiltration and lymphatic metastasis ( P ＜ 0.05 ).Ectopic cytoplasm expression was significantly associated with tumor size (P＜0.05 ). Ectopicnuclear expression was significantly associated with tumor differentiation (P＜0.01).The membrane or ectopic cytoplasm expression of β-catenin was significantly associated with postoperative survival.ConclusionsAbnormal Wnt/β-catenin signal activation induces decreased β-catenin membrane expression and increased ectopic expression,which is an important mechanism of pathogenesis and development of PDAC,and promotes the growth and metastasis of PDAC.The expression of β-catenin was associated with postoperative survival.