Case teaching is one of the important means to improve teaching effect in the process of pharmacology teaching. According to the teaching object, teaching objectives and requirements to build one useful teaching case library about pharmacology, which can be used and shared for a long time, is the premise of case teaching in pharmacology. According to the actual situation of case teach-ing in our university, this study researched and explored the background of case library building, the basic principles of case compilation, the establishment of team, the teacher-led and the student-oriented processes of case building, and the process of sorting and summarizing cases in the case library build-ing, which promotes the reform in the pharmacology case teaching, improves teaching quality, and also provides a reference for other universities or schools and disciplines on teaching case library building.

Objective To study the effect of danshao shugan granule combined with metformin in treatment of nonalcoholic fatty liver and its effects on lipid and uric acid metabolism.Methods 80 patients of nonalcoholic fatty liver who received therapy from February 2014 to February 2015 in our hospital were selected as research objects.According to random number table,those patients were divided into the observation group (n=40) cases in each group and the control group (n=40).The control group was treated with metformin, while the observation group was treated with danshao shugan granule combined with metformin.Then blood lipid level, FBG, FINS, IR, SUA level, SOD, MDA level, therapeutic effect of two groups after treatment were compared.Results After treatment, TG,TC in observation group was significantly less than the control group (P<0.05); FBG, FINS, IR, SUA levels in the observation group were significantly lower than the control group ( P<0.05 ); SOD level higher than the control group, MDA level significantly less than the control group (P<0.05); The total effective rate of observation group was statistically higher than that in the control group (P<0.05).Conclusion Danshao shugan granule combined with metformin is well for nonalcoholic fatty liver,which can improve the glucose, lipid, uric acid metabolism and insulin resistance, and can protect the liver function.

Objective To evaluate the clinical value of three-dimensional contrast-enhanced MR angiography (3D CE-MRA) in the diagnosis and treatment of aortic coarctation. Methods Twenty-one patients with aortic coarctation underwent 3D CE-MRA with a 3D FLASH sequence after injection of 0.2 mmol Gd-DTPA per kg b. w. The source images were subtracted and transferred to computer workstation subsequently post-procession. In six patients, cardioangiography was performed simultaneously. The diagnoses of all patients of them were proven by surgery. Results There were 6 cases (28.6%) of simple type of aortic coarctation and 15 (71.4%) accompanied other cardiovascular abnormalities. 3D CE-MRA could directly demonstrate the stenotic location, degree, extent and extracardiac vascular abnormalities, which accorded with surgical findings. The depiction of the entirety and collateral vessel formation was very helpful for surgery. It can be easier for pre- and post- operative evaluation. Conclusion 3D CE-MRA is a noninvasive and accurate technique in the diagnosis of aortic coarctation. It could replace the cardioangiography for extracardiac vascular abnormalities, and may be one of the first choice examinations.

Objective To evaluate clinical and procedural characteristics and outcomes of patients with ST-elevation myocardial infarction(STEMI) caused by drug-eluting stent(DES) thrombosis undergoing primary percutaneous coronary intervention(PCI).Methods From October 2004 to June 2007,31 patients with STEMI due to definite DES thrombosis who received primary PCI were retrospectively studied(ST group).Baseline clinical,angiographic,PCI procedural features and 1-year outcomes were recorded.Another consecutive 93 patients with STEMI due to de novo coronary thrombosis were served as control group.The primary endpoint was cumulative rate of major adverse cardiac events(MACE),including death,reoccurrence of myocardial infarction and target vessel revascularization(TVR),during hospitalization and at 1-year follow-up.Results Compared with the control group,patients in ST group were older(69.9?11.4 y and 63.7?13.6 y,P=0.01) and higher comorbidity rates of diabetes(41.9% and 22.6%,P=0.04)and previous history of myocardial infarction(29.0% and 11.8%,P=0.02).The occurrence of TIMI 3 flow immediately after primary PCI was reduced(45.2% and 92.5%,P

Objective To investigate the association between mycoplasma infection and pathogenesis of renal cell carcinoma(RCC). Methods There were 95 samples of archived embedded tissues of RCC and 60 samples of archived embedded normal renal tissues around the tumor for comparison.We detected mycoplasma hyorhinis P40 expression in archived embedded renal tissues by immunohistochemistry(IHC) with mycoplasma hyorhinis monoclonal antibody(MAb) PD4. Results Mycoplasma hyorhinis P40 was present in 64.2%(61/95 cases) of RCC and in 21.7%(13/60 cases) of the paratumor normal renal tissues in controls.The mycoplasma hyorhinis P40 expression ratio in RCC was significantly higher than that in the normal renal tissue,around the tumor(P

Objective To investigate the linearity on testing creatinine in various assay instntments,in order to evaluate creatinine testing ability of clinical laboratories. Methods Statistically standard linearity and nonlinearity were judged via polynomial regression analysis recommended by EP6-A guideline. The imprecision of analytical data were analyzed and the average deviation of best fitting curve from linearity were determined by Dr. Kroll's EP6-A extended methods. In accordance with the instruments used, the testing data were divided into four groups: Beckman LX (28 Labs), Beckman CX ( 14 Labs), Hitachi (62 Labs)and Olympus (72 Labs) groups. Results This research found that in samples analyzed by Beckman LX,Beckman CX, Hitachi and Olympus instruments, the imprecision ranged from 0. 30%-3.01%, 0.09%-3.46%, 0. 14%-4. 91% and 0. 17% -16. 44%, respectively. The imprecision in one laboratory in Olympus group exceeded the acceptable limit, while the imprecision in the remaining laboratories were precision for linear survey. The average deviations of best fitting curve from linearity ranged from 0%-2. 38%, 0%-2. 51%, 0% -5.46% and 0% -4. 66%, respectively. The linearity with statistical significance were 21.4% (6/28), 35.7% (5/14), 11.3% (7/62) and 18. 1% (13/72), respectively. The linearity with clinical significance were 78.6% (22/28), 64. 3% (9/14), 88. 7% (55/62) and 80. 6% (58/72), respectively.The percentages of laboratories whose creatinine testing met the linearity criteria were 100% (28/28),100% ( 14/14 ), 100% ( 62/62 ) and 98. 6% ( 71/72 ), respectively. Conclusion Majority of the laboratories involved in the linearity survey present good capability for creatinine testing.

The concept of modern medicine in treating chronic heart failure (CHF) has changed markedly in recent years. To improve the quality of life and prolong life, the treatment goal is no longer just temporary improvement of symptoms, more importantly, is to prevent and delay the occurrence and development of ventricular remodeling. Long-term chronic over-activation of sympathetic system, renin-angiotensin-aldosterone system and other neuroendocrine factors promotes myocardial remodeling, increases myocardial injury and deteriorates cardiac function. Despite short-term use can significantly improve the blood flow dynamics, long-term use of beta-adrenergic receptor stimulators and phosphodiesterase inhibitors does not prolong life, but increases the rate of sudden death caused by cardiac arrhythmia. Angiotensin converting enzyme inhibitors and beta-blockers have become the preferred drugs in treating chronic heart failure. In fact, after long-term use, beta-blockers can significantly improve ventricular remodeling, enhance ventricular function and reduce the incidence of sudden death of patients with CHF. In traditional Chinese medicine practice, short-term use of drugs for warming yang and reinforcing qi can improve symptoms of CHF, but long-term use may have adverse effects, for these medicines can stimulate sympathetic system. Early treatment with medicines of cold and cool property may be more favorable to patients with CHF, except the advanced patients who need special intervention. Eliminating heat and nourishing yin may play more active role in controlling the occurrence and development of CHF. Drugs with good efficacy and value in treating CHF may be developed from the Chinese herbal medicines with eliminating heat and nourishing yin property.

Objective To study CT and MR imaging features of pulmonary carcinoma of mediastinal type.Methods CT and MRI data (including anatomic site,size,shape,margin of the tumors and the relationship between tumors and mediastinum) of 15 patients with pulmonary carcinoma of mediastinal type confirmed by surgery and pathology were analyzed retrospectively.All patients underwent plain CT scans,and 11 of them also underwent contrast-enhanced CT scans,and 3 of them underwent plain MR scans and Gd-DTPA enhanced MR scans.Results On CT and MRI,the single mass was located subpleural of mediastinum with wide base.There were 5 cases of small cell lung carcinoma,8 squamous carcinoma,1 adenocarcinoma and 1 adenosquamous carcinoma.The majority of tumors manifested as ellipse.The tumors were lobulated in 12 and spicular margins in nine.8 tumors located in superior mediastinum,5 in medium mediastinum,2 in infra mediastinum and 12 in the borderline between the anterior mediastinum and medinum mediastinum.The tumors and enlarged lymph nodes of hilar and mediastinum connected closely in 7 cases.The bronchus were stenosed or obstructed by the tumors in 9 cases,and metastatic bone destruction of thoracic cage in 4 cases.Conclusion The pulmonary carcinoma of mediastinal type is easy misdiagnosed,CT and MRI findings in combination with clinical data can improve its diagnostic rate.

ObjectiveTo evaluate creatinine proficiency testing data by robust Z-score analysis.MethodsThe data were collected from three proficiency surveys of routine biochemical test in 2009,to which 1 179,1 169 and 1 168 laboratories participated respectively.Creatinine data were divided into Jaffe group and enzymatic group based on the analytical method used.The results tested by both methods were compared using Mann-Whitney test.The outliers were deleted using the TUKEY fence established by quartile values.The normality of raw data and trimmed data was tested using one-sample Kolmogorov-Smirnov test.The performance of the laboratories was assessed using robust Z-score,whose values were considered satisfactory when ｜ Z-score｜ ≤2,questionable when 2 ＜ ｜ Z-score ｜ ＜ 3 and unsatisfactory when ｜ Z-score ｜ ≥3.Results86.7％ results tested using Jaffe and enzymatic methods were not comparable.The raw data in all research groups were not normally distributed.After deletion of outliers,73.3％ trimmed data in most research groups were normally distributed.For the three proficiency tests in 2009,in Jaffe group,the satisfactory rates were 89.8％( 495/551 ),87.2％( 468/537 ) and 89.5％( 476/532 ) respectively,unsatisfactory rates were 3.3％ ( 18/551 ),6.5％ (35/537) and 4.5％ (24/532) respectively; while in enzymatic group,the satisfactory rates were 88.8％ (558/628),89.3％ (564/632) and 88.1％ (560/636) respectively,unsatisfactory rates were 5.6％( 35/628 ),5.2％ (33/632) and 6.6％(42/636) respectively.Conclusion It is reasonable to choose robust Z-score as a proficiency testing assessment index,because it avoids the influence of the outliers on evaluation results.