Objective To explore the effect and experience of problem-based (PBL) teaching in neurosurgical clinical training and improve the quality of the neurosurgical clinical training. Methods 600 clinical medical students of Grade 2011 in their probation in our department of neurosurgery were chosen as the subjects of study and were randomly divided into the experimental (PBL, 15 groups, 20 people/group, over 300 people) and control groups (CBL+ LBL, 15 groups, 20 people/group, over 300 people). In experimental group, PBL which is a problem-based, student-centered and teacher-directed pedagogy was adopted. In control group, CBL (case-based learning) + LBL (lecture-based learning) were adopted. After probation, two groups of students had the unified test and assessed their teaching methods by questionnaire survey and at the same time, the questionnaire survey about PBL' impact on the various aspects was done only to experimental group students. SPSS 15.0 software was used to do statistical analysis and data were processed by description analysis, t test, Mann-Whitney U test and correlation analysis. Results The scores of theoretical knowledge and general ability in PBL group [(40.57 ±3.24), (41.23 ±4.56) individually] were higher than these in control group [(37.21 ±4.05), (36.51±4.11) individually]. The differences demonstrated statistically meanings. Through the surveys, the students in experimental group showed the high satisfaction (97.0%, n=291) in PBL teaching. Most of the students considered that their abilities of team cooperation (96.7%, n=290), and self-directed learning (92.7%, n=278) were improved by PBL teaching. The students in experimental group illustrated their attitudes in satisfaction of teaching; interests of clinical training, participation of teaching and understanding of knowledge were superior to the control group. The differences demonstrated statisti-cally meanings. Conclusion PBL teaching got a good effect in neurosurgical clinical training. This method, which improved students' participation and motivation of study and contributed to the training of medical students' comprehensive abilities, is suitable for modern neurosurgical clinical training.

Objective To study effect of Tongbiling (TBL) on VEGF mRNA expression in RA synovlcytes cultured in vitro and explore its mechanism. Method Synovial cells from the knee joint in patient with RA were digested, divided and separately cultured after arthroscopy. Blank controls:DMEM culture containing 10% FBS in saline;Low-dose admission group of TBL:DMEM culture containing 10% FBS in 50 mg/L TBL;High-dose admission of TBL:DMEM culture containing 10% FBS in 200 mg/L TBL. RNA were distilled. Expression of VEGF mRNA were detected with RT-PCR. Result Compared with control group, expression of VEGF mRNA in low and high-dose admission groups of TBL both decreased (P

Objective:To investigate the expression of peripheral blood CD54,CD106,CD62p in patients with multi-infarct dementia.Methods:The levels of serum CD54,CD106,CD62P of 82 patients with multi-infarct dementia were measured with ELISA,and were compared with 23 normal controls.Results:The levels of serum CD54,CD106,CD62p in patients with multi-infarct dementia(CD54:469?76.33 ng/ml,CD106:1 103.3?98.96 ng/ml,CD62p:18.22?8.90 ng/ml) were higher than those in normal controls(CD54:196?45.91 ng/ml,CD106:601.0?76.30 ng/ml,CD62p:6.70?3.30 ng/ml). There were significant difference between the two groups.The levels of serum CD54,CD106,CD62p were positively correlated with the degree of dmentia.Conclusion:CD54,CD106,CD62p are closely related to the development of MID and play an important role in pathlogical procedure of cerebral damage after MID.The levels of CD54,CD106,CD62p in patients with MID implies the degree of their neurological function deficit scores and might be an important indicator to observe the changes of disease.

Objective To prepare the human bone sialoprotein (BSP) monoclonal antibodies (mAb)with high titer and specificity and identify its characterization,which is based on further studying BSP as clinical biomarker for breast cancer metastasizing to bone. Methods BALB/c mice were immunized with purified recombinant BSP protein.Cell fusion was performed between mouse splenic cells and myeloma cells (Sp2/0), and then the hybridoma cell lines secreting mAb against BSP antigen were screened and cloned. The ascites were prepared and purified with Protein G affinity chromatography.The titer and subtypes of mAb against BSP were identified and measured by ELISA and Western blotting analysis. ResultsNine hybridoma cell lines that stably secreted mAb against BSP were successfully obtained.Two of them,D001 and D002,were further identified, which belonged to the subtypes of IgG1 and κ light chain. The two antibodies titers in culture supernatant were 1∶5120 and 1∶10 240, respectively, and those in the ascites fluid were 1∶25 600 and 1∶51 200,respectively.Results of Western blotting analysis and immunohistochemistry showed that the two antibodies could specifically bind with BSP derived from human breast cancer cells.ConclusionNine mAb against BSP have been successfully prepared which can be used for further studying the biological properties of BSP and reveal its relationship with data from clinic patients.

Objective To explore the advantages and application of adjustable shunt valve in treatment of chil-dren with Communicating hydrocephalus. Methods Eighty six consecutive children undergoing surgery treatment for Communicating hydrocephalus from January 2006 to July 2011 were included in this retrospective study. Fifty cases re-ceived adjustable shunt valve whereas the rest received standard shunt valve. Results The success rate was 84.00% in the adjustable shunt valve group and 63.89%in the standard shunt valve group. Complication rate was 16.00%in the ad-justable shunt valve group and 36.11% in the standard shunt valve group. Inadequate and excessive shunt rate was 69.23% in the standard shunt valve group and zero% in adjustable shunt valve group. Compared with standard shunt valve group, adjustable shunt valve group had significantly higher success rate and lower complication rate (All P<0.05). Conclusions Adjustable shunt valve effectively reduce the complication rate and improve the success rate. In addition, adjustable shunt valve is superior to standard shunt valve in the treatment of children with communicating hydrocephalus because it fits for the development of children.

Objective To assess the different protein expressions of epithelial mesenchymal transition (EM T ) markers Vimentin and E‐cadherin in craniopharyngioma ,especially at the tumour invasive front ,and correlate the findings with clinicopathological fea‐tures and patient outcomes .Methods Forty‐two craniopharyngiomas were subjected to the detection of Vimentin and E‐cadherin by immunohistochemistry and double immunofluorescence staining .The relationships between expression of these markers and various clinico pathological indicators and clinical outcomes of these tumors were analyzed .Results There was statistically significant difference in the expression of Vimentin and E‐cadherin between adamantinomatous and papillary variants in whole tumor and at the tumor invasive front .The expression of Vimentin and E‐cadherin in whole tumor sections were associated with tumor recurrence , postoperative weight and hypothalamic disturbances ,and the expression of vimentin and E‐cadherin at the tumor invasive front were colligated with tumor recurrence ,postoperative weight and hypothalamic disturbances .Conclusion Our study exemplifies the po‐tential prognostic implications of Vimentin and E‐cadherin expression in craniopharyngioma .EM T may represent a crucial mecha‐nism in the progression of adamantinomatous craniopharyngioma .

Objective:With the development of digital technology, network technology and mobile technology, new media aided-teaching has become a hot topic in medical teaching. However, the studies about the application of new media aided-teaching in training for professional postgraduates of neurosurgery are still less studied.Methods:In this study, 24 Batch 2015-2016 professional postgraduates of neurosurgery from Neurosurgery Department of Affiliated Hospital of Southwest Medical University were divided into the test group and control group, with 12 students in each group. From September 2016 to August 2018, students in the test group were taught with conventional teaching and various new media such as WeChat official accounts, professional video sharing websites and so on. The control group adopted conventional teaching methods. Students' theoretical knowledge, operation ability and clinical research ability were assessed between the two groups. SPSS 22.0 software was used for t test and descriptive statistics on the data.Results:The results of t test analysis showed that the scores of theoretical knowledge and general ability in test group were higher than those in control group, with significant differences ( P < 0.05). Meanwhile, the scores of teaching satisfaction, professional interest, teaching participation, knowledge mastery and scientific research ability in the test group were higher than those in the control group, with significant differences ( P<0.05). Conclusion:Conventional teaching combined with new media aided-teaching is a good new training model for professional postgraduates of neurosurgery, which has improved students' participation and motivation of study and contributed to the training of medical students' comprehensive abilities.

Objective To prospectively investigate the characteristics and correlative influential factors of pulmonary hypertension (PHT) in patients on long-term maintenance hemodialysis (MHD). Methods Pulmonary artery systolic pressure (PASP) was assessed by echocardiography according to the guideline from the American Society of Echocardiography in 2010 and PASP more than 35 mm Hg was diagnosed as PHT.Echocardiography and pulse wall velocity (baPWV) was performed in the next day after hemodialysis.Arteriovenous fistula (AVF) flow was evaluated by the ultrasound dilution method.Hemodialysis-related informations and laboratorial parameters were detected in the same period. Results One hundred and eleven MHD patients [male 45,female 66,mean age (57.32±12.49) years old] in our hemodialysis center were included in the study.All of the patients received MHD treatment for more than 6 months with AVF as the vascular access.The patients with any possible diseases causing PHT were excluded.The mean MHD period was (70.51±44.98) months.Twenty-eight patients (25.32％) were diagnosed as PHT with mean PASP (45.68±10.83) mm Hg.Left ventricular diastolic dysfunction was severer in patients with PHT than that in patients without PHT.The prevalence of moderate to severe diastolic dysfunction was statistically higher in PHT group compared to non-PHT group (53.60％ vs 6.02％,P＜0.01).Ejection fraction (EF),fractional shortening of left ventricular diameter in PHT group were also significantly lower than those in non-PHT patients (62.06％±14.90％ vs 69.72％±8.60％,36.46％±10.04％ vs 40.20％±7.86％,P＜0.01).The patients with EF less than 50％ were 21.43％and 3.61％ in PHT and non-PHT group respectively.However,there were no significant differences in age,sex,MHD periods,body mass index (BMI),interval dialysis weight growth,blood pressure before dialysis,hemoglobin,albumin,pre-albumin,serum calcium and phosphorus,iPTH,nPCR,Kt/V,baPWV and AVF flow between the two groups. Conclusions PHT is a common complication of patients on long-term MHD.There is close relationship between PHT and left ventricular insufficiency.PHT is not significantly relevant to mineral metabolic disturbance,AVF flow,hemoglobin,dialysis adequacy and nutrition status.

Objective:To evaluate the advantages of function-preserving parotidectomy for benign tumors involving deep parotid lobe. Methods:17 patients with benign tumor involving deep parotid lobe were treated by limited partial parotidectomy.All of the tumors were not more than 3 cm of diameter,12 of them were in the deep lobe and 5 involving both superficial and deep lobes.In the operation fascia glandular flap was made,the tumor with the surrounding gland tissue was thoroughly dissected and the glandular parenchyma was preserved.Results:All the operations were successful and the wounds healed well with symmetrical facial contours.No patient experi-enced salivary fistula.Temporary facial palsy was observed in 2 cases(11.76%).No tumor recurrence was observed.Facial nerve function of all patients completely recovered after a median follow-up of 11 months.Conclusion:Function-preserving parotidectomy for benign tumor involving the parotid deep lobe may improve functional outcomes without compromising local tumor control.