Problem-based learning(PBL) was applied in probation of 2002 grade with satisfactory results.It can inspire students' interest,improve their synthetic analyzing,self-thinking,self-study innovative ability,and make studerts graspe well theoretical and practical learning methods.It is important to cultivate their ability of synthetic analyzing and deepen the teaching reform.

Objective:We established nude mouse model of laryngocarcinoma and detect the disseminated tumor cell of peripheral blood and mutant p53 in tumour tissue,to research the correlation of DTC with variant p53 gene and their value of predicting cancer metastasis and prognosis in laryngocarcinoma.Methods:There are 40 nude mice in the experimental group which accepted hypodermic injection of laryngocarcinoma cell,10 in control.By the reverse transcription polymerase chain reaction and nested polymerase chain reaction(Nest-PCR),we tested CK19mRNA in nude mouse's peripheral blood,as a marker of disseminated cancer cell at the 10th weeks after tumor-planting.We also tested the expression of p53 gene in tumour tissue by RT-PCR and immunohistology.After the nude dead,we dissect lung,liver and lymph node and use continuous pathological dyeing confirmed whether the transfer.Results:The positive rate of DTC was 50.0%(20/40),but negative in the control group,the difference was significant(P

Objective To explore MR features of periventricular leukomalacia(PVL) in premature infants. Methods The clinical and MR data of 30 cases with premature infant PVL were analyzed retrospectively.Results In 30 cases with PVL,the gestational age was 28~31 weeks in 18 cases,32~35 weeks in 9 cases and 36~38 weeks in 3 cases.Clinical presentations included limbs palsy in 30 cases,cortex blind in 6 cases mental retard in 14 cases and epilepsy in 8 cases.At early and medial phase,the white matter lesions at periventricular appeared as long T1 and T2 signal with blured borderline,the boundary of white-gray was blured.According to the criterion,the mild,moderate and severe cases was 11,18 and 1 respectively.Conclusion PVL is a main factor of cerebral palsy, MRI has a characteristic manifestations of PVL.

Local recurrence and distant metastasis is the major factor of impacting long-term survival for patients with esophageal carcinoma after radical resection. Postoperative radiotherapy and chemotherapy is expected to reduce the rate of local recurrence and distant metastasis, but views for the value of postoperative radiochemotherapy were inconsistent in the past. In recent years, scholars have performed much more clinical studies on postoperative radiotherapy and chemotherapy and found that the combined postoperative radiotherapy and chemotherapy after surgery significantly reduces the recurrence rate and distant metastasis rate and can enhance the survival of the patients.

Objective To investigate the effect of perioperative fluid therapy on blood glucose in the neonates undergoing gastrointestinal operation. Methods Sixty-four ASA Ⅰ or Ⅱ neonates undergoing gastrointestinal operation were randomly divided into 4 groups ( n = 16 each). Group Ⅰ received water orally 2 h before operation and iv infusion of acetated Ringer's solution during operation. Group Ⅱ received water orally 2 h before operation and iv infusion of 2% glucose (in normal saline) during operation. Group Ⅲ received 10% glucose 5 ml/kg orally 2 h before operation and iv infusion of acetated Ringer's solution during operation. Group Ⅳ received 10% glucose 5 ml/kg orally 2 h before operation and iv infusion of 2 % glucose (in normal saline) during operation. Blood sam ples were collected from radial artery for determination of blood glucose concentrations at the beginning of fluid therapy (T0), immediately after induction of anesthesia (T1), at the beginning of operation (T2), and at 20,40and 60 min (T3-5) and 2 h after operation ( T6 ). MAP and HR were also recorded simultaneously. The blood lactic acid concentration was determined at T0 . Results There was no significant difference in MAP and HR among the 4 groups. Compared with group Ⅰ , blood glucose concentrations were significantly increased at T4-6 in group Ⅱand Ⅳ, but no significant change was found in blood glucose concentrations at each time point in group Ⅲ. There was no significant difference in blood glucose concentrations between group Ⅱ and Ⅳ. The blood lactic acid concentration was significantly higher in group Ⅲ than in group Ⅰ , and in group Ⅳ than in group Ⅱ . Conclusion Oral 10% glucose 5 ml/kg before operation and iv infusion of 2% glucose (in normal saline) during operation is beneficial for the stabilization of blood glucose levels in neonates undergoing gastrointestinal operation.

Objective To prepare the paliperidone long-acting suspension for injection and study the quality of it.Methods The optimum formula was measured by using orthogonal design method regarding the content of paliperidone, Na-CMC,mannitol and the ground time as variable factors. Orthogonal design table L9 ( 34 ) was used in the experiment. The paliperidone long-acting suspension for injection was prepared by grinding the dispersion,and its quality was evaluated. Results The optimum prescription was as follows: using paliperidone 40 g, Na-CMC 15 g, mannitol 60 g, purified water 1 000 mL, appropriate amount of NaH2 PO4 and NaOH, and grinding for 1 h. Paliperidone long-acting suspension for injection was characterized by an average pH of 7. 0,and ratio of average sedimentation volume of 90. 3%. The suspension released smoothly within 1 h in vitro and achieved sustained release. The suspension was stable in a freeze-dried powder. Conclusion The preparation for paliperidone long-acting suspension for injection is simple and stable,which may be a novel drug delivery system.

Objective:This study aims to evaluate the effect of an elevated preoperative neutrophil to lymphocyte ratio (NLR) on outcome after comprehensive staging laparotomy or optimal tumor debulking surgery for epithelial ovarian cancer (EOC) and determine the value of the NLR as an independent prognostic prediction marker. Methods:A total of 80 women with primary EOC and with complete clinical and pathological information documented at the time of surgery were selected for this study. The optimum cut-off value of the preoperative NLR was identified through receiver operator characteristic (ROC) curve, and the patients were then classified into two groups: low and high NLR group. Univariate and multivariate analyses were performed to assess the prognostic effect of the preoperative NLR patients who underwent comprehensive staging laparotomy or optimal tumor debulking surgery. The levels of expression of CD68 were measured through immunohistochemistry. Results:The optimal cut-off value of the NLR was 3.8. The preoperative NLR differed significantly in the FIGO stage between the low NLR group (NLR ≤3.8) and the high NLR group (NLR>3.8), but no discrimination was observed in other parameters. The mean follow-up time was 45 months, and the post-operative 1-and 3-year survival rates were 93.7%and 60.0%, respectively. The preoperative NLR>3.8 and stageⅢ/Ⅳwere all risk factors for poor overall and disease-free survival. Multivariate analysis revealed the patients with high NLR (P<0.05) and stage Ⅲ/Ⅳ (P<0.05) had prognostic significance for poor overall survival. The number of CD68-positive tumor-associated macrophages was significantly higher in the high NLR group than in the low NLR group (54.65 ± 8.78 and 41.78 ± 9.10, respectively; P<0.001). Conclusion: An elevated blood preoperative NLR indicates poor prognosis in patients with EOC. Preoperative NLR may function as an important independent prognostic factor for patients with EOC.

DNaseⅠhypersensitive sites (DHSs) are regions of extreme chromatin which is highly sensitive to DNaseⅠ.Ge-nome-wide mapping DHSs is a powerful method for identifying many different types of regulatory elements within nuclear chromatin .It can help systematically resolve gene and genomic information , and the dynamic molecular mechanism of transcriptional regulation .This paper reviews the distribution of DHSs , the technology of DNase-seq and the research progress in transcriptional regulation functions of DHSs.

Objective To investigate the correlation between urine protein and VEGF in of IgA nephropathy patients .Methods Selected data of 67 patients of IgA nephropathy patients in Xinxiang Medical University ,VEGF expression was tested by immuno-histochemistry in renal tissue ,enzyme linked immunosorbent assay were used to detect the serum and urine levels of VEGF and ana-lyze the distribution of different pathological parameters .Analyzed correlation between urine protein and VEGF by regression analy-sis ,and analyzed the therapeutic effect and biochemical index in different combination of urinary protein and VEGF .Results (1)u-rine and serum VEGF levels in patients with IgA nephropathy were higher than healthy controls and patients with lupus nephritis group ,expression of VEGF in renal tissue was higher than that of lupus nephritis group (P<0 .01) ,and the difference of VEGF lev-el of IgA nephropathy group in Lee's classification ,renal tubular interstitial lesions and Katafuchi total score had statistically signifi-cant(P<0 .05) ,and increased with the severity of the pathological ;(2)Renal tissue VEGF urine and blood VEGF level were statis-tically significant in different levels of urinary protein of IgA nephropathy ,and increased according to urine protein was less than 1 .0 g ,1 .0 to 3 .0 g and more than 3 .0 g(P<0 .05) .Levels of urinary protein and VEGF expression in the kidney ,urinary VEGF and serum VEGF levels were positively correlated (r=0 .59 ,P<0 .01 ;r=0 .46 ,P<0 .01;r=0 .37 ,P<0 .05);(3) IgA nephropathy with urinary protein level between different levels of VEGF sAlb ,blood IgA ,Cr ,eGFR ,β2-MG ,urine osmotic pressure ,BUN and the effect rate of treatment differences were statistically significant (P<0 .05) .Conclusion Renal tissue VEGF expression in pa-tients with IgA nephropathy enhance ,while levels of VEGF in blood and urine were increased and associated with urinary protein . Pathological factors and treatment effect have statistically significant difference between different urinary protein and VEGF combi-nation .

Objective To explore the presence of biliverdin reductase (BR) activity in adult worms of Schistosoma japonicum in vitro. Methods The soluble fraction was isolated from homogenates of adult worms of S. japonicum, and incubated with biliverdin under different pH conditions and buffers. The time dependency of this enzymatic reaction was also detected. ResultsThe soluble fraction of the homogenates of adult worms could degrade biliverdin in vitro, the BR activity was 43.30 nmol/(mg?min), with its optimal condition at pH 8.7. The rate of reaction peaked at 15 min of incubation for the BR activity. Conclusion The presence of BR activity in adult worms of S. japonicum was firstly demonstrated.