Instructional design is the process of creating and conducting teaching protocol as well as assessing the feasibility of the protocol through analyzing teaching problems and goals.The theory of instructional design was applied in the teaching practice of different conrses.Under the direction of instructional design theory,the preliminary experience was obtained and summarized in the teaching practice of Fundamental Toxicology for medical undergraduate,which centered on the curriculum standard,specific situation of teaching objects,normalization of teaching content and different levels of teaching targets.

Objective To explore the changes of osteopontin (OPN) gene expression induced by tumor promoter of 12-O-tetradecanoylphorbol13-acetate(TPA),okadaic acid(OA) or cadmium chloride(CdCl_(2)).Methods The two-stage transformation test of BALB/c 3T3 cells was established with MNNG as initiator,TPA,OA or CdCl_(2) as promoter respectively.Mouse toxicology gene chip was used to detect the gene expression of BALB/c 3T3 cells transformed with TPA,OA or CdCl_(2) respectively,and the expression of OPN gene was validated by real-time RT-PCR assay.Results TPA,OA or CdCl_(2) could increase the transcriptional expression of OPN gene in BALB/c 3T3 cells.The expression of OPN gene was up-regulated in the eight transformed cell colonies induced by TPA,OA or CdCl_(2) respectively.Moreover,the up-regulation of OPN gene expression was confirmed by real-time RTPCR assay.Conclusion The up-regulation of OPN gene expression is closely related to cell transformation of BALB/c 3T3 cells induced by TPA,OA or CdCl_(2).

BACKGROUND:Currently a big controversy erupts in the repair of abdominal wal defects with composite patch. OBJECTIVE:To compare the composite patch and biological patch in the repair of abdominal wal defects in dogs. METHODS:Ten dogs were selected to prepare abdominal wal defect models, and then randomized into experimental group subjected to composite patch repair and control group subjected to biological patch repair. Incision adhesion was assessed at postoperative 30, 60, 90 days; patches and defect tissues were taken and detected histologicaly at postoperative 14 days. RESULTS AND CONCLUSION:The incision adhesion in the experimental group was milder than that in the control group at different time post operation (P < 0.05). At 14 days post operation, the material structure was clear with no signs of absorption in the experimental group, and there were a large amount of infiltrated inflammatory cels around the patch material, such as neutrophils and lymphocytes, and non-phagocytic patch was found; in the control group, the material structure was fuzzy with the presence of inflammatory cel infiltration and slight signs of absorption. Moreover, inflammation and fibrosis were severer in the control group than the experimental group. These findings indicate that compared with the biological patch, the composite patch is better to effectively reduce inflammatory reactions.

Objective To study the clinical implementation strategy analysis about fast track surgery ( FTS) used in right co-lon cancer radical.Methods 72 patients with right colon cancer laparoscopic treatment in our hospital from June , 2013 to Decem-ber, 2014 were randomly selected and divided into observation group ( n=36 ) and control group ( n =36 ) by numeric randomized method.Observation group adopted treatments based on FTS while control group treated with conventional laparoscopic radical prosta-tectomy.Stress reaction, operation time, intraoperative blood loss, exhaust time, defecation time, stop the infusion time, drainage a-mount and postoperative drainage tube root out time, postoperative hospital stay and postoperative complications of two groups were sta-tistically analyzed.Results Preoperative blood cortisol, fasting blood glucose, serum IL-6 and plasma CRP level of two groups, op-eration time and compare differences of 2 groups had no statistical significance (p>0.05).Postoperative 24 h blood cortisol, fasting blood glucose, serum IL-6 and plasma CRP level of two groups were higher than that of preoperative.Postoperative 24 h blood corti-sol, fasting blood glucose, serum IL-6 and plasma CRP level of observation group were lower than that of the control group, and the difference was statistically significant (p<0.05).In observation group, the exhaust time, defecation time, drainage tube root out time, stop infusion time and postoperative hospital stay of observation group were (43.62 ±8.21) h, (50.42 ±6.85) h, (5.51 ± 1.08), (4.12 ±0.85)d and (5.42 ±1.13)d respectively, which were shorter than the (56.65 ±8.26)h , (64.78 ±8.26) h, (9.53 ±4.13)d, (7.78 ±1.43) d and (10.62 ±2.14)d of the control group, and the difference was statistically significant (p <0.05).Rainage amount of observation group[(602.54 ±165.78) ml] was less than that of the control group[(1265.28 ±572.94) ml];And the total complications incidence of observation group (8.33%) was lower than that of the control group (25.00%), and the difference was statistically significant (p<0.05).Conclusion Implementation of laparoscopic treatment based on FTS used in right colon cancer radical can effectively promote patients recovery and reduce complications.thus it is worthy of clinical promotion use.

Objective:To establish an HPLC method for the determination of Cinnamic acid、Cinnamaldehyde in Guzhi Decoction. Methods:Defferent decoction were preparded and analyzed by L16(215)orthogonal design,the contents of the Cinnamic acid and Cinnamaldehyde in each decoction was determined by HPLC.Results:Different compatibilities have significantly on content of Cinnamic acid and Cinnamald.Conclusions The method is simple,effective,sensitive and feasible.

It is imperative to apply information technology in the area of management of clinical research so as to ensure the quality of clinical trials and to improve management efficiency.In this study,the based analysis method was the quality function deployment (QFD).This methodology is used to analysis the clinical trials management information system on a hospital directly under the Ministry of Health.It ensured user participation,lay a solid foundation for software engineers on system design.

Objective To investigate the pathogens distribution and their drug resistance of blood culture-positive neonates with sepsis in neonatal intensive care unit(NICU) and to provide evidence for clinically reasonable use of antibiotics.Methods One thousand four hundred and fifty neonates admitted to our NICU of Affiliated Hospital of Guangdong Medical College from Jan 2009 to Jul 2011 were enrolled.The blood samples from 1 450 neonates were cultured and isolated,and all of the isolates and their resistances were analyzed retrospectively.Results A total of 9 species and 233 pathogenic strains were isolated from 1 450 specimens,and the positive rate was 16.1％.Among the 233 strains,93 strains were gram-positive cocci,103 strains were gram-negative bacilli,and 37 strains were fungus.Among gram-positive cocci,the most dominant organism was coagulase negative staphylococcus,the next was Staphylococcus aureus;while among gram-negative bacilli,Ktebsiella pneumoniae were the most frequently isolated,the next were Escherichia coli and Acinetobacter baumannii,and among the fungus,monilia were the most isolated.The resistance rates of gram-positive cocci to vancomycin,linezolid and teicoplanin were high.Moreover,the antibiotic resistance rates to penicillin,oxazocilline and the β-lactamase were more than 95％.Gram-negative bacilli were sensitive to levofloxacin,imipenem and meropenem.A majority of fungus was Monilia,which was sensitive to antifungal.Conclusion Coagulase negative staphylococcus,Klebsiella pneumoniae and Escherichia coli are the the most common pathogens of neonatal sepsis in NICU,and have high drug resistance.Clinicians should select sensitive drug treatment according to bacterial identification and susceptibility testing.Besides,mycotic infection cannot be ignored and merit our attention.

Objective To investigate whether 5 different chemotherapeutic drugs and their combination of either two drugs could further promote the inhibition on the cell growth of HCC cell line (HepG2) in vitro in the hypoxic and hyponutritional culture medium (HHCM) mimicking the different scenarios of transcatheter arterial chemoembolization (TACE).Methods The cells were treated by 5 drugs for 2 h, 4 h,6 h and 24 h, which include epirubicin (EPI), cisplatin (DDP), mitomycin-C (MMC), oxaliplatin (OXA) and 5-fluorouracil (5-FU) in four concentrations of HHCM (5％, 10％, 25％ and 50％) mimicking the scenarios during TACE and the cell viability was assessed using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay.The combinations of dual drugs treated for 24 h were also tested.Results The sensitive drugs with inhibition rates more than 30％ were EPI, MMC and OXA in 4 different concentrations of HHCM.The sensitivity of the drugs treated for 24 h was significantly increased compared with that for 2 h in 5％, 10％ and 25％ HHCM.The dual combinations did not increase the chemosensitivity of HepG2 cells.Conclusions EPI, MMC and OXA exhibited cytotoxic activity against HepG2 cells in various hypoxia and hyponutrition states.Prolonging the exposure time could increase the sensitivity of drug in HHCM, and the combination of dual drugs cannot enhance the cytotoxic effect.

Purpose Bronchial arterial embolization is the preferred hemostasis method for hemoptysis when medical treatment is invalid. This paper aims to discuss the safety and efficacy of inferior phrenic artery (IPA) embolization in the treatment of hemoptysis of tuberculosis when IPA is involved. Materials and Methods Twenty-eight patients who were confirmed that IPA got involved in the hemoptysis due to pulmonary tuberculosis by IPA angiography underwent embolization. CT scan was performed before the procedure and IPAs arteriography were performed during the interventional procedure. Once the blood supply was identified, catheterization and embolization was carried out with gelatin sponge particle, sodium polymannuronate microsphere or microcoil according to the patients' conditions. After the procedure, the IPA angiographic manifestations, clinical efficacy and complications were evaluated. Results Thirty-three IPAs were identified as getting involved in the blood supply in the 28 patients. Among those patients, 12 had left IPA involved, 11 had right IPA involved and the rest 5 had IPAs involved in both sides. The selective IPA angiography showed IPAs had enlargement, with numberous and disordered branches and hypervascularity. IPA-pulmonary artery shunt was found in 22 cases. None of the cases was found extravasation of contrast medium. The hemoptysis reoccurred in 4 patients on the second day, sixth day and 6 months after the first embolization, thus the procedures were performed three times in 1 patient and twice in the other 3 patients. Nine patients had fever as complication, 19 patients had chest pain and 5 suffered from mild dyspnea. These complications usually disappeared in 3-7 days after symptomatic treatment. Conclusion IPA embolization is technically feasible and safe, whose complications are likely to be few and self-restrictive.

Objective To explore the roles of [Ca 2+ ]i in the apoptosis of Jurkat cells induced by Tripterygium Hypoglaucum (Levl) Hutch alkaloids. Methods After Jurkat cells were stained with Indo 1 AM and PI, changes of [Ca 2+ ]i were assessed by flow cytometry at the single cell level. Results THH alkaloids could induce no changes of [Ca 2+ ] inside cytoplasm. Conclusion THH alkaloids induce the apoptosis of Jurkat cells via other pathways rather than via the [Ca 2+ ] pathway.