To introduce the application of CBL teaching method on neuroanatomy teaching in undergraduate of con -tinue education school .Cases selection and reconstruction , designing problems , organization , implementation and standardized teaching were analyzed .Finally, we discussed the advantages and disadvantages of CBL teaching method.

Objective To provide a scientific basis for the creation and promotion of the rapid propagation of excellent Bupleurum chinense and study on botanical characters of test-tube plantlets and seed plantlets in B.chinense.Methods B.chinense with high effective medicinal ingredients and great stability of genetic characters was selected for rapid propagation,and some of botaninal characters between test-tube plantlets and seed plantlets were compared.Results The tiller number,the branch stem number,and the inflorescence number of the test-tube plantlets were significantly greater than those in seed plantlets.Conclusion Through the rapid propagation and the large-scale cultivation of test-tube plantlets of B.chinense,much more roots and seeds are obtained comparing with those of seed plantlets,while maintaining the excellent traits of B.chinense.

Objective To investigate the effects of CYP3A5~* 3 genetic polymorphism on analgesia with fentanyl. Methods One hundred and eighty ASA Ⅰ or Ⅱ patients, aged 20-50 yr, Hart nationality, Henan province, scheduled for elective abdominal total hysterectomy or myomectomy under general anesthesia, were enrolled in this study. The polymorphic sites of the CYP3A5~* 3 allele were analyzed by polymerase chain reaction-restriction fragment length polymorphism. The patients were assigned to one of 3 groups according to their genotypes: wild homozygote group, mutation heterozygote group and mutation homozygote group. Midazolam, remifentanyl, propofol and succinylcholine were used for induction of anesthesia. The patients were mechanically ventilated after tracheal intubation. Remifentanyl, propofol and atracurium were given iv for maintenance of anesthesia. The pain was assessed with visual analog scale (VAS) after consciousness was regained. When VAS score > 3, the patients were given fentanyl 20 μg every 5 min until VAS score was decreased to ≤3 and then patient-controlled intravenous analgesia (PCIA) with fentanyl was started. The background infusion rate of fentanyl 1.0 mg and droperidol 5 mg (in 100 ml normal saline) was 0.5 ml/h. The PCIA pump was programmed to give a 2 ml bolus of fentanyl solution with a 5 min lockout interval, 7 time successful delivery per hour and maximum dosage 145 μg/h, and VAS score was maintained less than 3. The amount of fentanyl used within 24 h after surgery was recorded. Results No significant difference was detected in the fentanyl consumption in the 24 h during PCIA among the 3 groups (P> 0.05). Conclusion The genetic polymorphism CYP3 A5~* 3 is not the factor contributing to the individual variation in the patient's response to analgesia with fentanyl.

Objective To systematically evaluate the clinical efficacy of Lanqin Oral Liquid(LOL)and ribavirin on infantile hand-foot-mouth disease(HFMD).Methods The randomized controlled trials(RCT)of LOL and ribavirincombined for treating HFMD were retrieved from EMbase, PubMed, CNKI, CBM and VIP(from establish to Oct 2014), the methodological quality of included literature was evaluated, and data analyses were performed with RevMan 5.2 software.Results Fifteen studies involving 2 016 patients were ultimately identified.The meta-analysis results showed that the effective rate of LOL group was superior to that of the control,OR(95%CI)was 5.80 (3.94, 8.52), and there were significant differences in the antifebrile time, erythra regression time, herpes regression time and oral ulcer regression time between the groups,MD (95%CI): -1.29 (-1.45,-1.13), -1.88 (-2.44,-1.33), -1.57 (-2.36,-0.78), -1.57 (-2.07,-1.08), respectively. Conclusion Based on the present clinical evidence, the meta-analysis results indicate that LOL and ribavirin treating HFMD is effective and safe. However, due to the uneven quality of these included studies, this conclusion need more large sample size and high-quality clinical RCTs to be confirmed.

Objective To investigate the effects of UDP glucuronosyltransferase (UGT) 1A9 I399 C ＞ T single nucleotide polymorphism on postoperative sedation with propofol in patients undergoing breast surgery.Methods One hundred and fifty-two ASA Ⅰ or Ⅱ female patients,aged 20-50 yr,weighing 50-70 kg,scheduled for elective benign breast tumor excision under general anesthesia,were enrolled in this study.The polymorphic sites of the UGT1A9 I399 C ＞ T allele were analyzed by polymerase chain reaction-restriction fragment length polymorphism.The patients were assigned to one of 3 groups according to their genotypes:wild homozygote (C/C) group,mutation heterozygote (C/T) group and mutation homozygote (T/T) group.During induction and maintenance of anesthesia,propofol was given by target-controlled infusion with the plasma concentration (Cp) of 3μg/ml.Blood samples were taken at 60 min after target-controlled infusion of propofol was started for determination of the Cp of propofol using high-performance liquid chromatography.The time when OAAS was 4 after stopping the infusion of propofol was recorded and the BIS value and effect-site concentration of propofol were also recorded at this time.The time when BIS value was 80 was recorded and the effect-site concentration of propofol was also recorded at this time.Results Genotyping analysis revealed that genotype distribution of UGT1A9 I399 C ＞ T polymorphism was C/C 24 cases,C/T 96 cases and T/T 32 cases.The T allele frequency was 53％.The C allele frequency was 47.4％.There was no significant difference in the Cp of propofol,time when OAAS was 4,BIS value and effectsite concentration of propofol when OAAS was 4,time when BIS value was 80 and effect-site concentration of propofol when BIS value was 80 among the three groups (P ＞ 0.05).Conclusion UGT1 A9 I399C ＞ T single nucleotide polymorphism is not the genetic factor contributing to the individual variation in the patient' s response to postoperative analgesia with propofol in patients undergoing breast surgery.

Objective To study the inhibitory effects of TPP,a desmosdumotin-C B ring para-fluoro modified derivative,on human breast cancer MCF-7 cell proliferation,and investigate the possible mechanisms.Methods MTT assay was used to measure the proliferation suppression of MCF-7 cells after treated with 1.0,2.5,5.0,10.0,and 20.0 μg/mL TPP for 48 h,and then the cell apoptosis rate and expression rate of NF-κB P65 positive cells were tested by flow cytometry after 20.0 μg/mL TPP treatment for 0,24,and 48 h.Results MTT assay showed that,after treatment for 48 h,1.0,2.5,5.0,10.0,and 20.0 μg/mL TPP all exhibited the inhibitory effects and showed a dose-dependent relationship.Flow cytometry results showed that 20.0 μg/mL TPP induced cell apoptosis after treatment for 24 and 48 h.TPP (20.0 μg/mL) significantly reduced the rate ofNF-κB P65-positive cells in MCF-7 cells after treatment for 48 h.Conclusion TPP could inhibit the proliferation of MCF-7 cells,which may be induced by cell apoptosis.Down-regulation of NF-κB is possible to be related with apoptosis.

One hundred and thirteen newly-diagnosed type 2 diabetic patients were treated with rosiglitazone for 16 weeks. Glucose tolerance was restored in 46 cases ( group A), but not restored in 67 cases (group B). Compared with group B,the patients of group A were younger and had shorter course of diabetes and lower body mass index (BMI,P＜0.05); Homeostasis model assessment for β-cell function (HOMA-β) and earlyphase insulin secretion in group A were better than those of group B before and after treatment respectively (P＜0. 05 ) ,while homeostasis model assessment for insulin resistance ( HOMA-IR )in group A was lower than that of group B before treatment (P＜0. 05 ). In conclusions, rosiglitazone improved insulin resistance of type 2 diabetes patients, thus facilitated restoration of β-cells function and glucose tolerance. The related factors of glucose tolerance restoration included age ,diabetes duration, BMI, HbA1 c, β-cells function, and insulin resistance.

Objective To investigate the effects of CYP3A4* 1G genetic polymorphism on fentanyl pharmadynamics after intravenous injection in healthy female velunteers,Methods Twenty-eight healthy female volunteers aged 18-25 yr weighing 45-70 kg were enrolled in this study.The CYP3A4 * 1G genetic polymorphic sites were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).The volunteers were assigned into 3 groups according to their genotypes:group Ⅰ wild homozygote ; group Ⅱ mutation heterozygote and group Ⅲ mutation homozygote.Fentanyl 5 μg/kg was injected iv over 1 min.Pain threshold was measured using electrical stimulation before and at 45,150 and 240 min after fentanyl injection.Results Pain threshold was significantly higher at 45 and 150 min after iv fentanyl injection in mutation homozygote group than in mutation heterozygote group and wild homozygote group.There was no significant difference in pain threshold between mutation heterozygote group and wild homozygote group.Conclusion CYP3A4* 1G genetic mutation can enhance the analgesic efficacy of fentanyl after intravenous injection in healthy female volunteers.

Objective To investigate the protective effect of Ulinastatin on liver function after precise hepatectomy.Methods Fifty-six patients of hepatocellular carcinoma undergoing hepatectomy were divided into Ulinastatin group (U group,28 cases) and control group (group C,28 cases).Results There were no significant differences in liver function and inflammatory factors between the two groups on the 1 st day before the surgry (P＞ 0.05).Serum ALT levels of (231 ±29;140 ±21;56 ± 13;42 ±6) U/L,were lower than group C (267 ± 29;158 ± 23;69 ± 18;53 ± 8) U/L,all P ＜ 0.05;serum AST levels were (175 ±23;94 ±25;47 ± 16;36 ± 8) U/L,lower than group C (191 ± 17;139 ± 16;64 ± 15;46 ±11) U/L,all P＜0.05;Serum TBIL levels were (30 ±6;39 ±9;31 ±9;21 ±6) μmol/L,lower than group C (34 ± 6;46 ± 7;35 ± 8;26 ± 7) μmol/L,all P ＜ 0.05;Serum hs-CRP levels were (52 ± 22;112 ±23;71 ± 16;42 ± 13) rg/L,lower than group C (69 ±23;129 ±25;72 ± 15;49 ± 15) mg/L,all P ＜ 0.05;serum IL-1 β levels were (7.8 ± 0.9;11.1 ± 1.5;8.9 ± 1.6;5.6 ± 0.9) pg/ml,lower than group C (9.2±1.3;13.0 ±2.1;11.1 ±1.4;7.3 ±0.8) pg/rml,all P ＜0.05;Serum IL-6 levels were (187 ±30;76 ±25;46 ± 15;26 ±8) pg/ml;lower than group C(260 ±36;92 ± 16;53 ± 11;30 ±8) pg/ml,all P ＜ 0.05;Serum TNF-α levels were (17 ± 4;12.0 ± 2.4;8.6 ± 2.4;6.7 ± 2.0) pg/ml,lower than group C (25 ± 4;18.7 ± 3.3;15.0 ± 3.1;9.6 ± 1.7) pg/ml,all P ＜ 0.05.Conclusion Ulinastatin protects liver function in perioperative patients undergoing precise hepatectomy.

Objective:To evaluate the changes in glucose metabolism in the prefrontal cortex during long-term cognitive dysfunction induced by neuropathic pain in developing rats.Methods:SPF healthy male Sprague-Dawley rats, aged 4 weeks, weighing 80-100 g, were used in this study.The model of neuropathic pain was established by using spared nerve injury in anesthetized rats.The mechanical paw withdrawal threshold (MWT) was measured at 1 day before establishing the model (T 0) and 1, 3, 7, 14, 28, 42 and 56 days after establishing the model (T 1-7). According to the results of MWT compared between T 5 and T 0, the rats were divided into neuropathic pain group (group NP) and non-neuropathic pain group (group NNP). Open field test and novel object recognition test were performed at T 7 to assess anxiety-like behavior and cognitive function.Positron emission tomography/computed tomography imaging was performed to determine the standard uptake value of 18F-fluorodeoxyglucose in the prefrontal cortex.Then the rats were sacrificed, and prefrontal cortex was removed for determination of the expression of glucose transporter 3 using Western blot and immunofluorescence. Results:Compared with the baseline at T 0, the MWT at T 1-2 in group NNP and at T 1-7 in group NP were significantly decreased ( P<0.05). Compared with group NNP, the MWT at T 1-7 were significantly decreased, the time of staying at the central region at T 7 was shortened, the percentage of time for exploring the novel object was decreased, the percentage of novel object exploration was decreased, the standard uptake value of 18F-fluorodeoxyglucose in prefrontal cortex was decreased, and the expression of glucose transporter 3 in prefrontal cortex was down-regulated in group NP ( P<0.05). Conclusion:Long-term cognitive dysfunction induced by neuropathic pain may be related to decreased glucose metabolism in the prefrontal cortex of the developing rats.