To meet with the need for culivating high-quality medical talents,the new teaching mode of problem-based learning (PBL) is attracting a lot of attention. Pathophysiology, which bridges basic medicine courses and clinical medicine courses,is more suitable for implementing PBL teaching mode. The teaching mode of incorporating case analysis is used into pathophysiology teaching by many ways is studied and an ideal result has been achieved.

AIM: To investigate the feasibility of establishment for chronic graft-versus-host disease (cGVHD) model in rats after allo-bone marrow transplantation (allo-BMT), in order to provide premise conditions for further studying the immuno-regulation role of mesenchymal stem cell (MSC) on GVHD after allo-BMT. METHODS: This experiment was finished in Laboratory of Pathology and Pathophysiology in Sun Yat-sen University from April to September 2006.①Six-week-old male Fischer344 rats (RT1Al) were used as donors while six-week-old female Waster (RT1Au) rats were used as recipients.②Recipient rats were given water supplemented with gentamycin (320 mg/L) and erythromycin (250 mg/L) three days before BMT. On the day of transplantation, recipient rats received 8.0 Gy (60Co ?, 0.7 Gy/min) total body irradiation. Within 6 hours following the irradiation, recipient rats in BMT group were transplanted with 0.8?108 cells via tail vein injection, while rats in control group only received the same volume injection of phosphate buffer. Each group included 10 animals. Evaluation of common living status was monitored including daily diet, activity, stool and urine, fur and body mass. Shaved skin, liver and intestine tissues were also analyzed histologically. RESULTS: ①All rats in the control group died within 17 days following the irradiation and most of them died on day 11 or 12 post-transplantation, while BMT group had higher survival rate, in addition to three rats died on days 12, 16, 18 respectively, whereas others were all alive through 60 days expectation period.②Rats in the BMT group had no clear symptoms of acute GVHD, such as rapid weight loss and severe diarrhea, however, the weight growth in rats of the BMT group was quite slow. Furthermore, 1 month following BMT, depilation phenomenon was evident in the head and back of recipients, and then extended to abdominal part and extremity with the increase of time. Two months following BMT, skin follicular dropout and slight dermal mononuclear infiltration were found. Hepatic disease was characterized by portal tract lymphocyte infiltration, fibrous thickening and sclerosis of the bile duct wall. Small bowel specimens showed clear inflammatory cell infiltration (neutrophils, acidophils, macrophages) within lamina propria. CONCLUSION: ①The cGVHD model can be established through allo-BMT from F344 to Wistar rats.②The typical histological signs of cGVHD are evident in skin, liver and intestine tissues, among which hepatic sign is the most dominant including portal tract and bile duct mononuclear infiltration followed by fibrous thickening and sclerosis of the bile duct wall.

Objective To understand the relationship between the requirement and the consumption of the health management, and provide the theoretical basis for the developing of China health management. Methods It took the survey to understand the relationship among 152 medical staffs from the six counties surrounding with Shi Jiazhuang downtown. Results 85.5%of medical staffs always and almost accept health advisory and provide health guidance. There are not the direct relationship between the requirement and the consumption(x2 = 9.39,P＞0.05 ). Health advice and guidance are not translated into the concepts of investment on the health management and disease prevention (x2 = 1.69, P＞0.05 ). The medical staffs don't realize it is important to invest on the health. Conclusions Related industries should strengthen the training on the health management, publicize this profession, promote the development of health management services and improve the national health quality.[ Key words] Health promotion ; Needs assessment; Economics

Objective To explore the key points of diagnosis and treatment of Behcet's disease with venous sinus thrombosis.Methods The diagnosis and treatment of a 25 year-old female patient with recurrent headaches was analyzed and discussed.Results Her headache was due to Behcet's disease with venous sinus thrombosis and her symptoms were gradually relieved.Conclusion Physician should be asked about the history in patients with persistent headache and the correct diagnosis can be made by MRI.

Objective To modify a classic two-vessel occlusion (2VO) modeling method in order to decrease the systematic errors in the behavioral experiments such as Morris water maze.Methods Thirty-two adult male Wistar rats were randomly allocated into classic 2VO model,modified model,sham operation and sham ligation groups (n =8 in each group).Only the bilateral common carotid arteries were ligated in the classic 2VO model group; the common carotid arteries were clipped intermittently,and the origins of pterygopalatine arteries of the internal carotid arteries were high selectively ligated in the modified model group; the common carotid arteries were only ligated intermittently in the sham ligation group; and only the common carotid arteries and the upper segment of pterygopalatine artery branches were separated in the sham operation group.The rat behavior was evaluated using the pupillary light reflex,Morris water maze and eight-arm radial maze.HE staining was used to observe the histological changes.Results The Morris water maze escape latency (F =72.169 - 163.102,all P ＜ 0.001) and the number of reference memory errors of eight-arm radial maze (F =33.515-74.726,all P ＜0.001) in the modified model and the classic 2VO model groups were longer and higher than those in the sham operation group.The pupillary light reflex of the rats was lost in the classic 2VO model group and the pupillary light reflex of the rats was normal in other groups.The reaching platform time in the classic 2VO model group was significantly longer than that in the modified model and sham operation groups (P ＜0.001).The percentage of target quadrant dwell time was also decreased significantly (at day 7 after procedure:F =13.770,P ＜0.001 ; at day 90 after procedure:F =14.780,P ＜0.001).HE staining showed pathological changes such as the cells decrease in hippocampal CA1 region and leukoaraiosis in the modified model and the classic 2VO model groups.In addition,there were more vacuole-like changes in the rat optic nerve region in the classic 2VO model group,while there were no such changes in the modified model group.Conclusions Establishing vascular dementia model with permanent occlusion of bilateral internal carotid arteries after intermittent occlusion of bilateral carotid arteries could avoid severe visual impairment in rats.In the Morris water maze and eight-arm maze test,the modified model rats showed significant decrease in learning and memory abilities and had hippocampal damage.

Objective To evaluate clinical use of tigecycline in hospital patients. Methods Basic diseases, pathologic examinations, concurrent medication, therapeutic efficacy and side effects of 40 patients in Lishui Central Hospital of Zhejiang Province from January 2012 to December 2014 were analyzed retrospectively. Results The effective rate of patients using tigecycline for anti-infection treatment in hospital was 42. 5%. The rates of rational use, basically rational use and irrational use were 17. 5%, 77. 5% and 5. 0%, respectively. Adverse drug reactions occurred in 6 cases of tigecycline use (15. 0%). Conclusion Clinical use of tigecycline in inpatients was basically reasonable in this hospital. The clinical curative effect of tigecycline was good in a variety of infections caused by sensitive bacteria. However, the incidence of adverse drug reactions was high. Attentions should be paid in clinical application.

Objective To explore the effect of different pH values on calcification of rat vascular smooth muscle cells (VSMCs) through bone morphogenetic protein (BMP)-2 signaling pathway. Methods Healthy male SD rats aged 5-8 weeks were selected in the study. VSMCs from rat thoracic aorta were cultured in vitro, and then identified by immunocytochemistry. The VSMCs were randomly divided into 4 groups by random sampling method:normal group (pH 7.4), pH7.4+high phosphorus group, pH 7.1+high phosphorus group, and pH 7.7+high phosphorus group. Calcium deposition and alkaline phosphatase (AKP) activity were measured by alizarin red staining and enzyme linked immunosorbent assay. The expressions of BMP-2, Smad1 and Runx2 mRNA were detected by RT-PCR. Results Compared with the control group, the calcification staining was increased in pH 7.4+high phosphorus group, calcium content was increased and expressions of BMP-2, Smad1, Runx2 mRNA and AKP activity were also increased (P<0.05). While compared with the pH 7.4+high phosphorus group, calcification staining, calcium content, expressions of BMP-2, Smad1, Runx2 mRNA and AKP activity were decreased in pH 7.1+high phosphorus group (P<0.05). The calcification staining, calcium content, expressions of BMP-2, Smad1, Runx2 mRNA and AKP activity were increased in pH 7.7+high phosphorus group (P<0.05). Conclusion The extracellular acidic environment (pH 7.1) can inhibit high-phosphotus-induced VSMCs calcification, whereas extracellular alkaline environment (pH 7.7) induce high-phosphotus-induced VSMCs calcification. The mechanism is presumably that VSMCs calcification is induced by influencing BMP-2 pathway, which may be mediated by VSMCs phenotype transdifferentiation of BMP-2 signaling pathway.

Objective To analyze risk factors for metabolic syndrome in Mongolia versus Han nationalities in Xilinhaote city. Methods Using the epidemiology investigation data of health examination,we calculated the prevalence of metabolic syndrome of Mongolia and Han nationalities, then used logistic regression model to explore risk factors of two nationalities. Results The crude prevalence of MS in Mongolia and Han nationality was 34.3%and 24.6% respectively. The multivariate logistic regression showed that male, the meat-rich diets and aging(OR:2.18, 1.92, 1.04 respectively)were the risk factors for Mongolia nationality, and smoking, family history of hypertension, drinking, the meat-rich diets, aging(OR:1.89, 1.84, 1.72, 1.61 and 1.04 respectively)were the risk factors for Han nationality. Conclusions Xinlinhaote population has higher MS prevalence, and different nationalities have different risk factors. We should take preventive actions to control it.

Objective To find out a treatment with high remission rate,long living period,and a good quality of life for elderly patients with multiple myeloma.Methods All patients were recruited into a treatment group(treated with traditional Chinese medicine,routine chemotherapy,and thalidomide)and a comparison group(treated with traditional Chinese medicine and routine chemotherapy).Results The total effective rate of the treatment group was 71.4%,higher than the comparison group(38.5%),but showing 110 statistical difference(P=0.128＞0.05).Median survive time of two groups were 21.8 months and 12 months respectively,(P=0.001＜0.01).The survival rate of 3 years and 5 years were 28.6%,15.4%and 7.1%,0 in the two groups respectively,without significant difference(0.317,1.000,both P＞0.05).Conclusion The treatment group showed higher results in both complete remission rate(CR)and very good partial remission rate(VGPR)than the comparison group,demonstrating a better results in improving the patient's quality of life.The treatment group also had a higher value of the median survive time and the median progression-free surial time than the comparison group.The combined therapy of traditional Chinese medicine,routine chemotherapy and thalidomide is an ideal choice for both aged Patients or young MM patients who had no transplant conditions.

Objective To investigate the relationship of the1675A/G polymorphism of AT2 gene with the therapeutic effect of indapamide sustained release tablets in female patients with primary hypertension.Methods Two hundred and twenty female patients with primary hypertension were treated with Indapamide Sustained Release Tablets ( 1.5 mg · qd) for 8 weeks.The blood samples from the patients were collect to determine AT2 gene polymorphism by PCR combined with HRM and sequencing.Results Two hundred and five patients completed the test.In female patients,the therapeutic efficacy of indapamide sustained telease tablets among different AT2R genotypes( AA:70.6％,AG:71.6％,GG:71.4％ ) showed no significant difference ( x2=2.53,P=0.49 ),neither do the decline of BP after therapy ( F=0.39 and 0.19 respecrively,P ＞ 0.05).Conclusion The AT2 genotype was assumed to be not correlated to the blood pressure lowering response to Indapamide Sustained Release Tablets in female primary hypertension patients.