The present advantage and disadvantage or problems of basic medical sciences elective courses in college and university are analyzed and indicated.Meanwhile,the experience of teaching optional course of the clinical applied anatomy of heart has been presented,including reforming teaching method,combining the anatomical theory with the clinical specialty,especially boosting the interesting in the course and medical research,encouraging students to do more dissection and culturing their competence in learning and following closely the trends of medical science and technology development.The new teaching style received a better teaching effect and improved the teaching quality. The significance that the teachers should pay more attention to practice training in their teaching students of optional courses has been positively emphasized.

OBJECTIVE:To determine the content of plumbm(Pb) and cadmium(Cd) in the roots of Arachniodes exilis.ME-THODS:The samples were treated with microwave digestion.Graphite furnace atomic absorption spectrometry was adopted for the content determination of Pb and Cd in samples.RESULTS:The contents of Pb and Cd were 2.209 mg?kg-1 and 0.215 mg?kg-1 in the roots of A.exilis.CONCLUSION:Harmful heavy metals have been detected in the roots of A.exilis,which is in line with the limitation stated in the Green Trade Standard for Medicinal Plant and Preparations.This method is simple,accurate and reliable for the content determination of practical samples.

AIM: To study the effect of calories restriction on endoplasmic reticulum(ER) chaperone protein 78-kD glucose regulated protein(GRP78) mRNA expression in the liver of high fat diet rats,in order to explore the mechanism of how calories restriction improves insulin resistance.METHODS: Wistar rats(n=24) were randomly divided into 3 groups: normal chow(NC) group,was fed free normal chow(18.94% of calories as fat) for 12 weeks;high fat group(HF) was fed high fat diet(50.55% of calories as fat) for 12 weeks;calories restriction group(CR) was fed high fat diet for 8 weeks at first,then given 50% of diet consumed by the same age NC group.Changes of body weight,height,and food intake were recorded.At the end of experiment,HOMAIR,the rate of visceral fat(including perirenal fat and epididymal fat) vs weight,plasma protein,blood lipid(including total cholesterol and triglyceride),hepatic GRP78 mRNA and hepatic histological changes(including light microscopic studies and electron microscopic studies) were detected.RESULTS:(1) Animals in HF group had an obviously elevation of fasting insulin(27.51?3.51) mU/L vs(15.46?2.25) mU/L,triglyceride(1.35?0.25) mmol/L vs(0.67?0.10) mmol/L,total cholesterol(2.59?0.34) mmol/L vs(1.41?0.28) mmol/L and insulin resistance index HOMAIR(5.85?0.23 vs 2.85?0.60) compared with NC group,and also had obviously lipid accumulations in the liver.(2) After calories restriction,all the abnormal elevated biochemical indicators were decreased to normal levels,the hepatic lipid accumulations were also improved.(3) The changes of liver ultrastructure in HF group showed rough endoplasmic reticulum enlargement,fragmentation,taking off grain,and with glycogen solution.The changes in CR group were nearly the same as those in NC group.(4) High fat diet induced the expression of GRP78 mRNA, calories restriction might reverse it.CONCLUSION: Reasonable food calories restriction is a good method to improve insulin resistance,partly due to improvement of endoplasmic reticulum stress in liver.

Objective:To observe and study the short-term efficacy of levocarnitine combined with trimetazidine in the treatment of elderly heart failure of ischemic cardiomyopathy. Methods:Totally 106 elderly patients with ischemic cardiomyopathy and heart failure were randomly divided into the observation group and the control group with 53 ones in each. All the patients were given anti-platelet, anti-myocardial ischemia and lipid-lowering therapy as well as the conventional therapy on myocardial ischemia. The control group was treated with trimetazidine,20mg,po,tid,while the observation group was additionally treated with 2g levocarnitine with 0. 9% sodium chloride injections,100ml,ivd,qd. The treatment course was 4 weeks. The improvement of heart function and the changes in cardiac function indices( including LVEDD,LVESD and LVEF)and cardiac ischemia markers( CKMB,TüI and BüP)before and after the treatment were compared between the two groups. The incidence of adverse drug reactions,the rate of re-hospitalization and mortality in the two groups were also compared. Results:The significant efficiency and total effective rate in the observation group were much higher than those in the control group(P<0. 05 or 0. 000 1). After the treatment,LVEDD and LVESD in the two groups were declined, LVEF was increased(P<0. 05),and the changes in the observation group were more notable than those in the control group(P<0. 05 or 0. 000 1). After the treatment,the contents of CKMB,TüI and BüP in the two groups were lower than those before the treat-ment(P<0. 05),and the decrease in the observation group was more notable than that in the control group(P<0. 05). There were no significant differences in the incidence of adverse reactions,re-admission rate and mortality between the two groups(P>0. 05). Conclusion:Levocarnitine combined with trimetazidine on the basis of the conditional therapy in the treatment of elderly patients with ischemic cardiomyopathy and heart failure can effectively improve heart function with better clinical efficacy,which is worthy of promo-tion in clinic.

Objective To investigate and analyze the application of three steps therapy analgesics in good pain management(GPM)-ward,in order to provide rational analgesics drug application in clinical practice.Methods Through the hospital HIS system,the application data of analgesics in GPM-ward from Jan.2014 to Dec.2015 were collected and analyzed.Results The sum and proportion of the strong opioid drug was lined first.The total DDDs of the three -stage analgesics ranked from high to low was celecoxib >tramadol >oxycontin >morphine >fentanyl trans-dermal.The celecoxib was usually assisted the other;in addition,tramadol's DDDs and expense amount decreased, which was in the line with NCCN guidelines.Moreover,oxycontin's DDDs and expense amount increased.As well as, anesthesia prescription qualified rate was 93.5%,medical record standard rate was 80.5% in 2014,prescription qual-ified rate was rose to 97.5%,medical record standard rate was rose to 91.5% in 2015.Conclusion The application of cancer pain drug was basically rational in GPM-ward,which is in line with the principles of cancer pain relief by the mouth,by the clock,by the ladder and for the individual.

Objective: To study the effect of catch up growth after semistarvation on insulin resistance in rats. Methods: Wistar rats (n=40) were randomly divided into 5 groups: normal chow group (NC given diet with 18.94% of calories as fat for 12 w); high fat group (HF, given diet with 50.55% of calories as fat for 12 w); food restriction group (FR, 50% of their normal spontaneous food for 4 w); refeeding normal chow group (RN, after 4 w semistarvation, given normal diet for another 8 w ); refeeding high fat diet group (RH, after 4 w semistavation, given high fat diet for 8 w). Changes of body weight, height, and food intake were recorded. At the end of experiment, homeostasis model assessment of insulin resistance (HOMAIR), the rate of abdominal fat (including perirenal fat and epididymal fat) vs weight, plasm protein, blood lipid (including total cholesterol and triglyceride) were detected. Results: There were 82.5% rats getting catch-up growth in refeeding groups. Body weight of both refeeding groups could not catch that of NC group, but the rate of visceral fat vs weight was higher than that of NC group, and this rate of RH group was close to that of HF group. The changes of visceral fat vs body weight were consistent with that of TG levels. All nutritional status except high fat diet could not influence total cholesterol levels. RH and RN group’s HOMAIR were higher than those of NC group and HF group. All groups have similar fastingglucose levels. Conclusion: Catch-up growth can induce insulin resistance, but is not consistent with fat accumulation and hypertriglyceridemia in rats.

Objective To investigate the clinical effects of the treatment of cancer pain control by the partic-ipation of pharmacist,and the effect on cancer patients and families mental state and quality of life.Methods Clini-cal pharmacists took participate in the standardized treatment of pain,before and after different intervention,NRS scale was used to assess the patients'pain,self -rating anxiety scale(SAS)and self -rating depression scale(SDS)were used to assess the patients and families'psychological mental status.SF -36 scale was used to assess the quality of life.Results Compared with pre -intervention,two weeks later,the overall situation of patients with pain was signifi-cantly improved[NRS score (4.72 ±1.13)points vs.(3.57 ±0.97)points,t =7.722,P <0.01].Patients and their families,anxiety and depression significantly alleviated [patients:SAS (32.56 ±4.66 )points vs.(60.31 ± 4.27)points,t =38.180,P <0.01,SDS (45.89 ±5.46)points vs.(68.34 ±6.23)points,t =28.250,P <0.01;families:SAS(33.76 ±4.82)points vs.(50.31 ±6.47)points,t =15.593,P <0.01,SDS (32.89 ±3.54)points vs. (52.34 ±6.23)points,t =15.593,P <0.01 ].At the same time,the patients and families'quality of life were improved.Conclusion Clinical pharmaceutical care can relieve the body pain,meanwhile,those could effectively relieve the anxiety,depression and other negative psychology of cancer patients and families,improve the whole quality of life.

AIM:To detect the changes of active status of bypass signaling pathways in EML4-ALK positive lung cancer cell line H3122 treated with alectinib, hepatocyte growth factor (HGF), epidermal growth factor (EGF) and transforming growth factor-α (TGF-α), and to explore the potential mechanisms.METHODS:EML4-ALK positive cell line H3122 was treated with increasing concentrations of alectinib or/and induced by HGF, EGF and TGF-α.The cell viability was measured by CCK-8 assay.The cell apoptosis was analyzed by flow cytometry.The protein levels and phosphorylation status of ALK, c-Met and EGFR, and the downstream molecules AKT, ERK, p-AKT and p-ERK were examined by Western blot.RESULTS:The viability of the H3122 cells was inhibited by alectinib in a dose-dependent manner after administrated for 72 h, and the IC50 value was 0.042 μmol/L.The concentration-growth curves of the H3122 cells shifted to the right after induced by HGF, EGF and TGF-α.After treatment with alectinib at 0.05 μmol/L for 48 h, the apoptotic rate of H3122 cells was (20.12±1.36)%, while the apoptotic rates of the cells in the groups of alectinib combined with HGF, EGF or TGF-α were (7.85±1.03)%, (5.60±0.79)% and (4.58±1.00)%, respectively.Those values were remarkably lower than those in alectinib single treatment group (P<0.05).Alectinib inhibited the protein levels of p-ALK and its downstream signaling pathway molecules, while HGF significantly up-regulated the protein levels of p-Met and its downstream p-AKT and p-ERK.Besides, EGF and TGF-α remarkablely up-regulated the protein levels of p-EGFR and its downstream p-AKT and p-ERK.Combined treatment with crizotinib and 17-DMAG successfully inhibited the viability of the H3122 cells even in the presence of the HGF and EGFR ligands, respectively.CONCLUSION:Bypass signaling pathways are activated by HGF, EGF and TGF-α in EML4-ALK positive lung cancer cell line H3122, which may be linked to alectinib resistance.

AIM: To investigate the role of HGF/c-Met signaling pathway in crizotinib-induced apoptosis of different lung carcinoma cell lines and to analyze its potential regulatory mechanisms .METHODS: EML4-ALK positive cell line H2228, c-Met proliferation cell line H1993 and control cell line A549 were treated with crizotinib at different doses for different time periods .The viability of the cell lines was measured by MTT assay .The apoptosis was analyzed by flow cytometry with PI staining.The protein levels of MET and phosphorylated MET (p-MET) of HGF/c-Met signaling pathway as well as its down-stream key proteins AKT , ERK, p-AKT and p-ERK in the cell lines before and after crizotinib treatment were examined by Western blot .RESULTS:The growth of H1993, H2228 and A549 cell lines was inhibited after crizoti-nib treatment for 72 h in a dose-dependent manner .Apoptotic rates of H1993 cells and H2228 cells were increased with the crizotinib concentration and exposure time .Down-regulation of p-MET, p-AKT and p-ERK at protein levels in H1993 cells and H2228 cells after exposure to crizotinib for 72 h was confirmed by Western blot .No obvious change of the related-pro-teins of HGF/c-Met signaling pathway was found in A 549 cell line.CONCLUSION: HGF/c-Met signaling pathway may contribute to crizotinib-induced apoptosis of H1993 cells and H2228 cells, which provides the experimental basis for MET-targeting treatment of lung cancer .

Objective To investigate the detection of early cervical cancer patient's peripheral blood CK19 mRNA and its clinical significance. Methods 30 early (ⅠA2~ⅡA) cervical cancer patients from the department of gynecological tumors in the third affiliated hospital of Kunming Medical University were selected as experimental group, 15 patients with uterine myoma and 15 healthy volunteers as negative control group,15 advanced (ⅡB~ⅢB) cervical cancer patients as positive control group. Peripheral blood samples before receiving radical resection of experimental group,and the same samples before treatment of control groups were collected. The change of relative expression level and positive rate of peripheral blood CK19 was analyzed using qRT-PCR technique, and its correlation with clinicopathological parameters and prognosis was further analyzed. Results There was significant difference in relative expression level of CK19 mRNA in the peripheral blood between experimental group and control groups ( <0.001) . And the positive rate of CK19 in the peripheral blood from 30 patients with early cervical cancer before operation in the experimental group was 30% (9/30) . Furthermore, CK19 mRNA positive rate before surgery was correlated with lymph node metastasis, muscularis invasion and pathologic risk factors for postoperative ( <0.05) . There were no significant correlation between CK19 mRNA positive rate and other clinical and pathological features such as age,clinical stage (FIGO),tumor cell differentiation,tumor size,pathological type and etc ( > 0.05) . Conclusions CK-19 mRNA is a specific and suitable molecular marker for the detection of circulating tumor cells in early cervical cancer. Detection of peripheral blood CK19 mRNA expression before receiving radical hysterectomy in patients with early cervical cancer can also make up for the disadvantage of other methods such as the imaging, tumor marker detection. Most important of all, it can provide the basis for choosing a proper adjuvant therapy post-operation and estimating the relapse and prognosis.