According to the course characteristics and teaching outline of medical psychology,problem-based learning (PBL) case about somatoform disorders was compiled based on a typical clinical real case.The PBL case covered a wide range of topics such as basic medicine,clinical medicine and medical psychology.Just as clinical treatment process,teachers gave information and put forward the corresponding questions in successive steps.By self-study and group discussion,students learned knowledge about anxiety,somatoform disorders,therapeutic relationship,sociocultural factors and individual personality.The course survey showed that PBL teaching was appreciated by medical students.The PBL model can improve learning interest and self-study ability,promote the connection of different subjects and combine theory and practice.The PBL model is useful for improving the quality of medical psychology teaching.

Objective:To explore the tracing effect of nano-carbon in the cervical lymph nodes of papillary thyroid carcinoma (PTC) and the guiding role of the dissection strategy of the contralateral lymph nodes.Methods:The medical records of 516 patients with PTC in Department of Endocrine and Breast Surgery, the First Affiliated Hospital of Chongqing Medical University from Jan. 2013 to Dec. 2017, including cN0 patients (436 cases) and cN1 patients (80 cases) , were retrospectively analyzed. There were 137 males and 379 females, the male to female ratio was 1.00:2.76. During the operation, nano-carbon was used to trace lymph nodes, and the number of lymph nodes in each lateral area (area II, III, IV) was collected, and the rate of black stained and non-black stained lymph node metastasis (LNM) was calculated based on the postoperative pathological results. SPSS 22.0 statistical software was used for analysis, t test was used for measurement data, and χ2 test was used for count data. Results:In 436 patients with cN0, the black-stained LNM rate in zone II ( P=0.002) , the black-stained LNM rate in zone III ( P=0.000) , and the black-stained LNM rate in zone IV ( P=0.002) were higher than those of non-black stained LNM. The rate of black-stained LNM in 80 cN1 patients (Ⅱ, Ⅲ, Ⅳ) was also higher than that of non-black-stained LNM (0.011, 0.019, 0.015) . The rate of black-stained LNM in cN0 patients affected the LNM in areas Ⅱ and Ⅳ ( P=0.000, P=0.000) . In patients with cN1, the black-stained LNM rate in zone Ⅲ had an effect on zone Ⅱ (0.030) ; it had no effect on the black-stained LNM rate in zone Ⅳ (0.315) . Conclusion:The black-stained LNM rate of the posterior zone (zone Ⅱ, Ⅲ, Ⅳ) with nano-carbon can represent the LNM rate of the lateral zone and help guide the lymph node dissection in the lateral zone. In addition, the black-stained LNM rate of zone Ⅲ can affect zone Ⅱ. The LNM rate in zone IV has the role of sentinel lymph nodes in the lateral zone.

AIM: To investigate the relationship between p21 WAF1gene polymorphisms and protein expression in breast carcinoma. METHODS: Polymerase chain reaction single-strand conformation polymorphisms technique (PCR-SSCP) and immunohistochemical assay of S-P immunostaining technique were used to study polymorphisms of p21 WAF1 and protein expression respectively on the specimen of paraffin-embedded tissues in 100 cases of breast carcinomas and 40 benign breast diseases as control. RESULTS: Two p21 WAF1 gene polymorphisms were found in 18% (18/100) of breast carcinomas and 5% (2/40) of control samples. The difference between the two groups was statistically significant (?2=3 94, P

Objective To investigate the effect of Glutamine (Gln) on heat stress-induced dysfunction of intestinal epithelial barrier. Methods Human intestinal epithelial Caco-2 cells were pre-incubated with Gln for 24h and then exposed to heat 43℃ for 1h. Cell counting kit-8 (CCK-8) was used to detect the cellular proliferation with various concentrations of Gln and choose an optimum concentration for subsequent experiments. The barrier integrity was measured by transepithelial electrical resistance (TEER) and horseradish peroxidase (HRP) permeability. Levels of tight junction protein occludin and ZO-1 were analyzed by Western blotting. Cytoskeleton using Coomassie blue staining was observed by microscopy. Results At 0.7mmol/L concentration, Gln showed the most effective cell proliferation compared with other concentration groups (P<0.05). Therefore, 0.7mmol/L Gln was used as effective concentration in following experiments. Gln attenuated the TEER decrease and impairment of intestinal permeability induced by heat exposure compared with 43℃ group (P<0.01). The expressions of occludin and ZO-1 were significantly elevated by pretreatment with Gln. The distortion of cytoskeleton was also effectively prevented. Conclusion 0.7mmol/L Gln is potentially beneficial for protecting against heat stress-induced permeability dysfunction and epithelial barrier damage.

Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms ; complications ; Female ; Humans ; Infusions, Intralesional ; Lung Neoplasms ; complications ; Lymphoma ; complications ; Male ; Middle Aged ; Pericardial Effusion ; etiology ; therapy ; Recombinant Proteins ; administration & dosage ; therapeutic use ; Remission Induction ; Tumor Necrosis Factors ; administration & dosage ; therapeutic use

OBJECTIVETo observe the effect of Shen warming Pi strengthening method on expressions of serum T cell subsets (C045+%, C03+%, and C04 +/COB+) in diarrhea-predominant irritable bowel syndrome (IBS-0) rats. Methods An IBS-0 rat model was established referring to AL-Chaer's modeling method combined with tail clamp and intragastric administration of sanna leaf. After modeling 30 SO rats were randomly divided into 6 groups according to random digit table, i.e., the model group, the high, middle, low dose Wenshen Jianpi Recipe (WJR) groups, and the Sishen Pill control group, 6 in each group. A normal control group consisting of 6 SO rats were also set up. Rats in high, middle, low dose WJ R groups were administered by gastrogavage with boil-free WJ R at the daily dose of 3. 100, 1. 550, 0. 775 g/kg, respectively. Rats in the Sis hen Pill control group were administered by gastrogavage with boil-free Sis hen Pill at the daily dose of 0. 736 g/kg. Equal volume of normal saline was given by gastrogavage to rats in the model group and the normal control group. All medication lasted for 2 successive weeks. Rats' general state, expressions of T cell subsets (CD45+%, CD3+%, and CD4+ /CDB+) changes were observed.

RESULTSCompared with the normal control group, expressions of CD45+% and CD3+% increased, but CD4+ /CDB+ decreased with statistical difference (P < 0. 05). Compared with the model group, expressions of CD45+% and CD3+% decreased, but CD4+ ICDB+ increased with statistical difference in high, middle, low dose WJR groups, and the Sis hen Pill control group (P <0. 05). Compared with the Sis hen Pill control group, there was statistical difference in all indices except CD45+ value in the low dose SWPSM group (P <0. 05). Compared with the low dose WJ R group, the expression of CD3+% decreased in high and middle dose WJR groups, and the Sis hen Pill control group; CD4+ /CD8+ increased in the Sishen Pill control group and the high dose SWPSM group (all P < 0. 05).

CONCLUSIONSWJR showed better treatment effect. The mechanism of Shen warming Pi strengthening method might be achieved by regulating expressions of CD45+% and CD3+%, and CD4+ /CD8+ ratios.

Animals ; Drugs, Chinese Herbal ; Female ; Irritable Bowel Syndrome ; therapy ; Leukocyte Common Antigens ; metabolism ; Medicine, Chinese Traditional ; Rats ; T-Lymphocyte Subsets ; metabolism

The combined application of statins that inhibit HMG-CoA reductase and fibrates that activate PPAR-α can produce a better lipid-lowering effect than the simple application, but with stronger adverse reactions at the same time. In the treatment of hyperlipidemia, the combined administration of TCMs and HMG-CoA reductase inhibitor in treating hyperlipidemia shows stable efficacy and less adverse reactions, and provides a new option for the combined application of drugs. In this article, the pharmacophore technology was used to search chemical components of TCMs, trace their source herbs, and determine the potential common TCMs that could activate PPAR-α. Because there is no hyperlipidemia-related medication reference in modern TCM classics, to ensure the high safety and efficacy of all selected TCMs, we selected TCMs that are proved to be combined with statins in the World Traditional/Natural Medicine Patent Database, analyzed corresponding drugs in pharmacophore results based on that, and finally obtained common TCMs that can be applied in PPAR-α and combined with statins. Specifically, the pharmacophore model was based on eight receptor-ligand complexes of PPAR-α. The Receptor-Ligand Pharmacophore Generation module in the DS program was used to build the model, optimize with the Screen Library module, and get the best sub-pharmacophore, which consisted of two hydrogen bond acceptor, three hydrophobic groups and 19 excluded volumes, with the identification effectiveness index value N of 2. 82 and the comprehensive evaluation index CAI value of 1. 84. The model was used to screen the TCMD database, hit 5,235 kinds of chemical components and 1 193 natural animals and plants, and finally determine 62 TCMs. Through patent retrieval, we found 38 TCMs; After comparing with the virtual screening results, we finally got seven TCMs.
Acyl Coenzyme A ; metabolism ; Animals ; Databases, Factual ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Hydrophobic and Hydrophilic Interactions ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; chemistry ; pharmacology ; Lipid Metabolism ; drug effects ; Lipids ; blood ; Medicine, Chinese Traditional ; Models, Molecular ; Quantitative Structure-Activity Relationship ; Technology

Objective To evaluate the short and long term efficacy of self-expandable metallic stent implantation through bronchoscope in the management of the patients with malignant airway stenosis.Methods Seventy-four hospitalized patients with malignant airway stenosis during a 10-year period were selected as our subjects from Dec.2002 to Nov.2012 in the Respiratory Department of the Central Hospital of Wuhan.All these patients underwent bronchoscope for nitinol self-expandable metallic stent implantation.Clinical improvement,6min walking distance (6MWT),mMRC index,arterial blood gas,as well as early and late postoperative complications were investigated.Results A total of 77 stents were implanted,including 34 covered metallic stents and 43 uncovered metallic stents.All patients showed the obvious relief of dyspnea after the operation.6MWT at pre-operation was (172 ± 45)m and (288 ± 36)m at 28 week post-operation.Arterial blood gas was (61.34 ±6.44)mmHg at pre-opemtion and (72.12 ±6.87) mmHg at 28 week post-operation.mMRC was 3.56 ± 0.44 at pre-operation and 1.96 ± 0.37 at 28 week post-operation.All these differences were significant(P ＜ 0.01).The operation succeeded in releasing bucking of patients with esophago-tracheal fistula.Symptoms such as fever,cough,pharyngodynia,foreign body sensation and hemoptysis were observed,and all the above side effect could be solved while no serious complications arose.Conclusion Bronchoscopic insertion of metallic airway stents for malignant airway stenosis is a safe and effective procedure that could obviously relieve respiratory distress and improve the quality of life.

Objective To investigate the effect of brain-derived neurotrophic factor (BDNF) gene modified neural stem cells (NSCs)transplantation on cerebral ischemic injury in rats.Methods NSCs from newborn rat hippocampus were isolated,cultured in a medium containing fibroblast factor (FGF) in vitro. Their proliferation and differentiation were detected by immunohistochemistry.Virus vectors pLXSN-BDNF were built and BDNF were transfected into NSCs.Biological activity were detected to obtained engineering stem cells of BDNF protein with secretary activity.Middle cerebral artery occlusion (MCAO) models were made and transplanted with NSCs-BDNF by stereotaxic technique.The effect of transplantation on MCAO models was evaluated histologically and behaviorally.Results Statistical analysis showed that the behavioral performance of the animals improved after transplantation (Longa mark being 1.343?0.293 four weeks after stem cell transplantation).The number of hippocampal dentate gyrus neurons increased to 87.5%?6.6% , four weeks after stem cell transplantation on Nissle stained hippocampal sections,which was significantly different from that of controls.Positively BrdU stained neural stem cells revealed by immunohistochemistry in the cultured cells and in the transplanted brain sections,indicated that the engineering cells transplanted had survived in the host brain and began to proliferate.Conclusion Transplantation of BDNF genetically modified NSCs can effectively promote the recovery from cerebral ischemic injury.

Objective To study the expression of intermediate-conductance-Ca~(2+)-activated K~+ (IKCa1)channels in endometrial cancer and its role in regulating proliferation of endometrial cancer cells. Methods Western blot and RT-PCR were used to examine the expression of IKCa1 channels in 13 normal endometrial specimens and 25 endometrial cancer specimens;and RNA interference(RNAi),[ ~3H ] thymidine incorporation,and inhibitor of IKCa1 channel were used to explore the role of IKCa1 channels in regulation of proliferation of endometrial cancer cells HEC-1A.Results The expression rate and level of IKCa1 mRNA in endometrial carcinoma(84%,0.89?0.52)were higher than in normal endometria(8%, 0.14?0.12;P