The article discusses how to carry on case-based learning in the Marxist Philosophy Principle teaching.Case-based learning helps bring up students' ability in ponder,judgment,competition and innovation and is an important method that enhances students'ability to find,analyse and solve problems.It is also an important teaching method that strengthens the effect of Marxist philosophy Principle teaching.

History of abdominal surgery was the contradiction of reoperation with laparoscopy. With the development of laparoscopic technique, this contradiction now has been challenged and reoperative minimally invisave surgery is growing. The objective of this article is to state the applications of laparoscopic technique in gastrointestinal reoperative surgery.

The hemorrhage during laparoscopic cholecystectomy (LC) in operating field is a significant puzzle worries the surgeon. Besides disrupting the cystic artery hemorrhage originating from the gallbladder bed also plays a frequent role in the cause of bleeding in LC. The gallbladder bed bleeding which results from the disrupt of the branches of the middle hepatic vein is a ticklish problem in the operation. It will complicate the surgical operation, confuse the anatomic structttre, cause serious complications and is a main reason for conversion. Thus, we compose this review to expound the topographic anatomy of the branches of the middle hepatic vein as well as the prevention and treatment to the injure of the branches of the middle hepatic vein.

Cholesterol polyposis of the gallbladder is a metabolic disorder of cholesterol and characterized by the deposit of cholesterol esters and other lipids in the lamina propria of gallbladder.The pathogenesis is complicated which may involve various factors,and probably associated with the alteration of polygene expression,but at this moment the true nosogenesis is still unclear.

β-arrestins are involved in the insulin signaling pathway, affecting peripheral insulin resistance,also affecting insulin secretion and lipid metabolism. To clarify β-arrestins mediated signaling pathways is an approach to the pathogenesis and effective treatment of diabetes.

Objective To obtain optimum scheme on reaction system for randomly amplified polymorphic DNA(RAPD) of Pseudomonas aeruginosa. Methods The optimum reaction systems of RAPD were obtained by single factor design and response surface design(RSD). Results The multiple optimum reaction systems caused by effect of interaction on multifactor were observed in single factor design, and the concentrations of key components of the optimum reaction system with good stability obtained by response surface design were 2.0 mmol/L of Mg 2+ , 0.5 ?mol/L of primer and 0.5 ng/?l of template. Conclusion To optimize the reaction system of RAPD, RSD is simpler, more scientific, and more reasonable than single factor design.

Objective To analyze the changes of bone mineral density (BMD) and the incidence of osteoporosis in elderly people in Xuzhou area by measuring BMD, and provide reference to osteoporosis prevention and control. Methods From 2005 to 2008, BMD were measured in 1204 elderly people by dual energy X-ray absorptiometry (DEXA). The measurement included the neck of femur and L2-4 of lumbar. All subjects were divided into multiple sections with every 5 year interval. Osteoporosis was diagnosed according to the criteria of BMD peak minus 2. 5 SD. BMD values and the incidence of osteoporosis were analyzed among different age and gender groups. Results BMD of different sites decreased year by year in both male and female in Xuzhou area. After 55years of age BMD decreased more in female than in male ( P ＜ 0. 01 ). The incidence of osteoporosis in female was higher than that in male. Conclusions We should reinforce the health education on osteoporosis prevention. Intervention should be conducted in females older than 55 years and males older than 65 years to decrease the occurrence of osteoporosis.

AIM:To discover the effect of MCPH1 on the DNA damage induced by ionizing radiation in esoph-ageal cancer cells.METHODS:ECA109 cancer cells were radiated at dose of 8 Gy.The nuclear foci of relevant factors were detected 1 h after irradiation in the ECA109 cells after silence of MDC1 gene.A cell line was established that was sta-ble low expression of MCPH1.The nuclear foci induced by ionizing radiation after silence of MCPH1 were determined.RE-SULTS:The MCPH1 gene silenced ECA109 cell line was successfully constructed.A strong relationship between MDC1, MCPH1 andγ-H2AX was observed 1 h after 8 Gy irradiation.Silence of MDC1 did not affect the nuclear foci formation ofγ-H2AX and MCPH1.The nuclear foci of MDC1 but notγ-H2AX significantly reduced after silencing of MCPH1.CON-CLUSION:MCPH1 is located in the downstream of H2AX and upstream formation of MDC1, and regulates the nuclear fo-ci formation of MDC1 during DNA damage response.

Objective To compare the knee of patient controlled subcutaneous injection of morphine analge-sia after hip joint replacement ( PCSA ) and intravenous morphine patient-controlled analgesia ( PCIA ) effect and safety of postoperative analgesia.Methods 60 patients undergoing artificial total knee arthroplasty patients were selected and randomly divided into PCIA group of 30 cases,30 cases in group PCSA, two patients were completed under epidural anesthesia in the operation.Group PCIA and group PCSA single dose divided into 1mg/and 2.5mg/, lock time divided into 5min,20min,in the postoperative pain perception,from the patient's own pain medication.After 4h,8h,12h,24h record patient morphine dosage,frequency,pain score (VAPS),mean arterial blood pressure and re-spiratory rate,compose degree,analgesic effects were compared between the two groups.Results In group PCSA after 24h treatment for the total dose was (30.41 ±10.00) mg,significantly higher than that of group PCIA (18.03 ± 6.04)mg,there was significant difference between the two groups (t=3.98,P<0.05);but after each time point of the two groups of patients the average dosage had no statistically significant difference (P>0.05).PCIA group after 0-4h and >4-8h analgesia and sedation were better than those in PCSA group (t=3.4,3.2,3.5,3.7,all P<0.05), PCIA group,the incidence rate of nausea and vomiting was 30%,higher than 12%in the PCSA group,there was sig-nificant difference between the two groups (χ2 =5.76,P<0.05).Conclusion The two kinds of methods of analge-sia has a good analgesic effect,but PCSA analgesia is slower,less adverse reactions,should be given a loading dose at the beginning before PCSA,in order to improve the early analgesia effect.

Objective To observe the anti-inflammation effect of antidromic electronic stimulation of rat dorsal roots. Methods Cross-excitation between adjacent primary afferent fibers and subcutaneous injection of 2% FM were adopted here as two inflammatory models. The firing rate and mechanical threshold of single units after cross-excitation were collected. The phosphorylated cAMP response element binding protein (p-CREB) level in spinal cord induced by formalin was visualized with immunohistology. Results Antidromic electronic stimulation (ADES) of dorsal roots could significantly inhibit the p-CREB over expression to FM injected in the contralateral hindpaw, and the increase in firing rate and mechanical threshold induced by cross-excitation were also inhibited by the ADES. Conclusion Antidromic electronic stimulation of the dorsal root may produce a systemic anti-inflamma-tion capacity.