The flip classroom,as a new teaching form,has innovated the traditional teaching model.Although the flip classroom has its superiority,it will encounterchallenges in practice.This paper firstly analyzed the feasibility and necessity of medical ethics education based on the flip classroom.Then,it introduced the teaching model of medical ethics flip classroom based on three aspects:the basic pattern design,learning resources design and teaching process design.Finally,it discussed the application and effects of the flip classroom on the teaching of medical ethics.

Objective To explore the expression change of Toll Like Receptor 4 (TLR4) in lung ischemia-reperfusion injury in rabbits and the influence of clemastine fumarate on it. Methods Fifty rabbits were divided into five groups randomly (n=10): Sham (N+S), reperfusion for 2 hours (N+I1/R2), reperfusion for 4 hours (N+I1/R4), clemastine fumarate + reperfusion for 2 hours (F+I1/R2) and clemastine fumarate+reperfusion for 4 hours (F+I1/R4). The ischemia time in each group was 1 hour and normal saline was given respectively in groups of N+S , N+I1/R2 and N+I1/R4. Western blotting , RT-PCR and immunofluorescence were used to detect the expression of TLR4 in lung tissue , and the changes of ultrastructure in ischemia-reperfusion lung tissue were observed by electron microscope. Result The expression of TLR4 was elevated obviously in ischemia-reperfusion lung tissue (P<0.05), and there was positive correlation between the increased TLR4 level and reperfusion time (P<0.05), the swelled and thick-ridge mitochondria were observed in type II alveolar epithelial cells after LIRI (P<0.05); but clemastine fumarate inhibited the expression of TLR4 in lung tissue significantly caused by LIRI (P<0.05). And the mitochondria injury was reduced in the groups of clemastine fumarate. Conclusion TLR4 expression is elevated in lung tissue after LIRI; clemastine fumarate inhibits the expression of TLR4 caused by LIRI and protects the lung tissue from LIRI in rabbits.

Objective To investigate the effect of clemastine fumarate on lung ischemia-reperfusion (I/R) injury in rabbits.Methods Fifty New Zealand white rabbits of both sexes,weighing 2.0-3.0 kg,were divided into 3 groups using a random number table:sham operation group (Sham group,n =10),I/R group (n =20) and clemastine fumarate group (Cle group,n =20).The model of lung I/R was established by clamping the left hilum of lung and decreasing the tidal volume followed by restoration of perfusion and ventilation 1 h later in I/R and Cle groups.At 3 h of ventilation in group Sham and 2 and 4 h of reperfusion in I/R and Cle groups,blood samples were collected for determination of serum tumor necrosis factoralpha (TNF-α) and interleukin-8 (IL-8) concentrations by enzyme-linked immunosorbent assay.The left lung was lavaged,and the broncho-alveolar lavage fluid (BALF) was colleted for determination of white blood cell count.Lung specimens were obtained for microscopic examination of the ultrastructure of lung tissues and for determination of wet/dry weight ratio (W/D ratio),expression of IL-1β and IL-6 mRNA (by real-time polymerase chain reaction) and cell apoptosis (by TUNEL).The apoptosis rate was calculated.Results Compared with Sham group,the W/D ratio,white blood cell count in BALF,serum concentrations of TNF-α and IL-8 and apoptosis rate were significantly increased,and the expression of IL-1β and IL-6 mRNA was up-regulated in I/R and Cle groups (P＜0.05 or 0.01).Compared with I/R group,the W/D ratio,white blood cell count in BALF,serum concentrations of TNF-α and IL-8 and apoptosis rate were significantly decreased,and the expression of IL-1β and IL-6 mRNA was down-regulated in Cle group (P＜0.05 or 0.01).The pathological changes of lung tissues were significantly attenuated in Cle group than in I/R group.Conclusion Clemastine fumarate can attenuate lung I/R injury in rabbits.

Objectiv e To investigate the correlation between ( CAG) n repeat polymorphism of androgen receptor(AR)geneandmalebreastcancer.Methods 40casesofmalebreastcancerand40controlswerecol-lected.DNA was extracted from peripheral blood and the AR gene CAG coding exon sequences for PCR amplifica -tion,sequencing and calculated the number of CAG repeats frquency .χ2 test and Logistic regression analysis were used assess the AR gene CAG repeat length frequency affect the number of male breast cancer risk .Results There was statistically significant difference in male breast cancer cases and controls the number of CAG repeat length frequency.Man for whom the(CAG)n≥22 repeat sequence had 3.52 times risk of male breast compared (CAG)n≤22(OR=3.52,P=0.036).Conclusion AR gene CAG repeat length is a predictor of the frequency of male breast cancer risk .Longer CAG repeats can increase the risk of male breast cancer .

Objective:To explore the relationship between atrial fibrillation stroke risk score (CHA2DS2-VASc score) and short-term prognosis of aged patients with nonvalvular atrial fibrillation (NVAF)complicated ischemic cerebral stroke (ICS).Methods:A total of 206 aged NVAF+ ICS patients who hospitalized in our hosipital from Jun 2011 to Aug 2013 were selected.CHA2DS2-VASc score was used to perform stroke risk stratification,and patients were di- vided into low risk group (n=24,0 score),medium risk group (n=78,1 score)and high risk group (n=104,2~9 scores).Modified Rankin scale (mRS)was used to assess patients'prognosis on three months after onset.According to mRS score,patients were divided into good prognosis group (n=89,0~2 scores)and poor prognosis group (n=117,3~6 scores).Independent predictors for poor prognosis in three months were analyzed.Results:Compared with low risk group,there were significant rise in age,percentages of hypertension,diabetes mellitus (DM),heart failure,stroke and vascular disease history,scores of United States national institutes of health stroke score (NIHSS) in medium and high risk groups (P<0.05 or <0.01).Compared with good prognosis group,there were significant rise in age [(72.81±7.68)years vs.(81.56±8.03)years],percentages of hypertension (58.4% vs.71.8%)and stroke history (9.0% vs.29.9%),scores of NIHSS [(2.97±1.42)scores vs.(7.67±3.92)scores]and CHA2DS2- VASc [(1.70±1.63)scores vs.(4.03±2.53)scores]in poor prognosis group,P<0.05 or <0.01. Multi-factor Logistic regression analysis indicated NIHSS score (high risk:OR=1.78,95%CI:1.27~2.56,P=0.001 ), CHA2DS2-VASc scores (high risk:OR=3.24,95%CI:1.32~6.98,P=0.001)and age (high risk:OR=1.23, 95%CI:1.07~1.54,P=0.01)were independent predictors for poor prognosis on three months in aged NVAF +ICS patients.Conclusion:CHA2DS2-VASc score is related to early improvement of patients with NVAF + ICS;age,scores of NIHSS and CHA2DS2-VASc are independent predictors for poor short-term prognosis.

Objective To establish a three- dimensional hindlimb gait data toolkit (THGT) for healthy and spinal cord injured (SCI) non-human primate (rhesus monkey) based on Matlab to realize upload of original data, automatic gait division, calculation and drawing of multiple gait parameters, etc. Methods Vicon system was used to collect three-dimensional hindlimb gait data of healthy and SCI (after 6 weeks) rhesus monkey to obtain the kinematics data of both hindlimbs in continuous strides. It was analyzed with THGT to process the gait division, calculation and drawing of multiple gait parameters. Results THGT read the data, distinguished cycles of gait, calculated 140 kinds of gait parameters and drew graphs of the results. Conclusion THGT extends the universality of the Vicon data, realizes automatically gait division and friendly interactive interface, and puts out the visible results.

OBJECTIVE: To determine the sensitivity of cetuximab induced apoptosis in laryngeal squamous carcinoma cells Hep-2, and to evaluate the synergistic killing effects and regulation mechanism of cetuximab alone or cetuximab in combination with chemotherapeutic agents (cisplatin) or radiation means on Hep-2 cells. METHOD: To investigate the cytotoxicities of cetuximab, cisplatin and radiation, cell counting kit-8 (CCK-8) assay was used for the detection of cell growth inhibition ratio, and fluorescence activated cell sorter FACS for the apoptotic rate and cell cycle distribution. RESULT: Cetuximab had inhibitive effect on Hep-2 cells within a certain range of concentration in a time- and dose-dependence manner. The inhibition concentration 50% (IC50) of cetuximab on Hep-2 cells for 24 h was 1 036.84 microg/ml. For application of cisplatin and radiation, the apoptotic rate of Hep-2 cell was higher by combining with cetuximab than their single or combined administration. Moreover, the cell cycle arrested at G0/G1 phase. CONCLUSION Laryngeal cancer Hep-2 cells was sensitive to the cetuximab induced apoptosis. Cetuximab combined with cisplatin and/or radiation can increase the antiproliferative effects on Hep-2 cells. These findings suggest the synergistic combination of cetuximab and cytotoxic agents was sequence depended.
Antibodies, Monoclonal, Humanized ; pharmacology ; Apoptosis ; drug effects ; radiation effects ; Cell Line, Tumor ; Cetuximab ; Cisplatin ; pharmacology ; Combined Modality Therapy ; Humans

OBJECTIVE: To determine an approach enriching cancer stem cells from laryngeal cancer cell line. To investigate whether laryngeal cancer stem cells in chemoradiotherapy have the characteristic of resistance. METHOD: CD133+ cells and CD133- cells was detected and isolated from Hep-2 cell line by fluorescence activated cell sorting technology. The cytotoxicities of cisplatin and radiation were investigated by cell counting kit-8(CCK-8) assay. The apoptosis and cell cycle was analyzed with flow cytometry. RESULT: CD133+ cells accounted for a fraction of (2.43 +/- 0.77)% in Hep-2 cell line. CD133+ cells have a more obvious characteristics of cancer stem cells. Different cisplatin and radiation concentrations of for two cell have inhibition, in a certain concentration range and the dosage dependence. Cisplatin and radiation had synergistic inhibitory effects with CD133- cells on the growth of two cell. Moreover, cell cycle arrest at G0/G1 phase and more apoptosis was induced by synergistic combination. Different concentrations of cetuximab for Hep-2 cells have inhibition, in a certain concentration range and time and the dosage dependence. The half maxial inhibitory concentration (IC50) of cetuximab to Hep-2 cells on 24 h was 1 036.84 microg/L. Cisplatin and radiation had synergistic inhibitory effects with cetuximab on the growth of Hep-2 cell line. Moreover, cell cycle arrest at G0/G1 phase and more apoptosis was induced by synergistic combination. CONCLUSION Compared with CD133- cells, CD133+ cells subpopulation exhibited extraordinary cancer stem.
AC133 Antigen ; Antibodies, Monoclonal, Humanized ; pharmacology ; Antigens, CD ; analysis ; Antineoplastic Agents ; pharmacology ; Apoptosis ; Cell Cycle ; Cell Line, Tumor ; Cetuximab ; Chemoradiotherapy ; Cisplatin ; pharmacology ; Drug Resistance, Neoplasm ; Flow Cytometry ; Glycoproteins ; analysis ; Humans ; Laryngeal Neoplasms ; therapy ; Neoplastic Stem Cells ; drug effects ; radiation effects ; Peptides ; analysis ; Radiation Tolerance

OBJECTIVE: To investigate the expression of Bax and PHF20 in laryngeal squamous cell carcinoma (LSCC)and to discuss their relevance and the roles in carcinogenesis and development in LSCC. METHOD: The expressions of Bax and PHF20 in the LSCC tissues and normal mucosa tissues adjacent to carcinoma were detected by SP immunohistochemistry assay. The relationship between the expressions of Bax and PHF20 and the clinicopathological characteristics including clinical stage, pathological type, histological grade and lymph node metastasis in LSCC were analyzed according to the clinical data. RESULT: (1) The expressions of Bax and PHF20 were both significantly lower in the LSCC tissue than that in the normal laryngeal tissue (P < 0.01). (2) In clinical stage grouping, there were no statistical differences of the quantity and positive rate of Bax and PHF20 expressions among supraglottic, glottic and subglottic LSCC (P > 0.05). In histological differentiation grouping, the quantity and positive rate of Bax and PHF20 expressions decreased significantly in poorly differentiated LSCC compared with the well and moderately differentiated LSCCs (P < 0.01, P < 0.05, respectively). In T stage grouping, the quantity and positive rate of Bax and PHF20 expressions were both significantly higher in T1 + T2 compared with T3 +T4 (both P < 0.01). In addition, the quantity and positive rate of Bax and PHF20 expressions were both significantly higher in LSCC with lymph node metastasis compared to that without lymph node metastasis (both P < 0.01). CONCLUSION The lack of Bax and PHF20 might contribute to the carcinogenesis and development in LSCC. The positive expression of Bax and PHF20 maybe relative to T term degree, differentiation degree and lymphamatic metastasis of LSCC.
Antigens, Neoplasm ; metabolism ; Biomarkers, Tumor ; metabolism ; Carcinoma, Squamous Cell ; metabolism ; Head and Neck Neoplasms ; metabolism ; Humans ; Immunohistochemistry ; Laryngeal Neoplasms ; metabolism ; Lymphatic Metastasis ; Prognosis ; Squamous Cell Carcinoma of Head and Neck ; bcl-2-Associated X Protein ; metabolism

Hepatocyte transplantation may be a viable alternative treatment to liver transplantation for acute/chronic liver failure and metabolic liver disorders. Hepatocyte transplantation is an effective treatment to support liver function around liver transplantation due to its relatively easy manipulation and mild wound. In recent two decades, hepatocyte transplantation have been applied in clinical treatment and showed some effect in acute/chronic liver failure and metabolic liver disorders. Here, we sum up the status of clinical hepatocyte transplantation, discuss its value in clinical application and some challenges need to resolve.