Traditional teaching plays a major role in pre-clinical genetics teaching,but the PBL teaching mode greatly mobilizes the enthusiasm of students in clinical genetics teaching. However reasonably and scientific combination between traditional teaching and PBL teaching contributes to more positive effect in medical genetics teaching.

OBJECTIVE:To optimize the water extracting technology of Rubingxiao tablet.METHODS: The extracting technology of Rubingxiao tablet was optimized by orthogonal experiment with the yield of extractum and ferulic acid content as indices. RESULTS: The optimum extracting condition was A3B1C3D2,i.e. adding 12 times water and extracting 0.5 h/time for 3 times with 60% alcohol. CONCLUSION: The extracting technology for Rubingxiao tablet is simple and rapid with stable result, and it provided theoretical basis for the production of Rubingxiao Tablets.

OBJECTIVE:To observe the effects of sitagliptin phosphate combine with acarbose on blood glucose,blood lipid and the serum glucose transporter 4(GLUT4)in elderly patients with type 2 diabetes. METHODS:86 elderly patients with type 2 diabetes were randomly divided into control group and observation group,43 cases in each group. All patients received guidance about diet,exercise and living habits,etc.,as well as the care about psychology and medication. Based on it,control group was given Acarbose tablet 50 mg/times,tid,chewing when a meal;observation group was given Acarbose tablet(the same dosage and usage)+ Sitagliptin phosphate tablet 100 mg/times,qd,orally. They were treated for 3 months. Fasting blood glucose(FBG),2 h postprandial blood glucose(2 hPG),glycosylated hemoglobin(HbAlc),body mass index(BMI),fasting insulin(FINs),insulin resistance index(HOMA-IR),islet B-cell function index(HOMA-B),total cholesterol(TC),triglyceride(TG),low-density lipo-protein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C)before and after treatment in 2 groups were compared, the incidence of adverse reactions was recorded. Other 43 healthy people were selected as healthy control group,the differences of serum GLUT4 levels before and after treatment between the 2 groups and healthy control group were respectively compared. RE-SULTS:After treatment,the BMI,FBG,2 hPG,HbAlc,HOMA-IR,FINs,TC,TG and LDL-C level were significantly lower than before,observation group was lower than control group;HOMA-B and HDL-C level were significantly higher than before,ob-servation group was higher than control group,with statistical significance(P<0.05). Before treatment,the serum GLUT4 level in 2 groups were significant lower than healthy control group with satistical significance(P<0.05);after treatment,the serum GLUT4 level in control group there was no significant different than before(P>0.05),while the serum GLUT4 level in observation group was significant higher than before and control group;and the serum GLUT4 level in 2 groups were still significant lower than healthy control group(P<0.05). And there was no significant difference in the incidence of adverse reactions(P>0.05). CON-CLUSIONS:Sitagliptin phosphate combine with acarbose can effectively control patients'blood glucose and lipid levels in the treatment of elderly patients with type 2 diabetes,improve HOMA-B and serum GLUT4 level,and does not increase the incidence of adverse reactions,with good safety.

Objective To investigate the Survivin and Cyclooxygenase-2 (COX-2) expression and their relationship in cervical carcinoma tissues and to investigate the relationship with the genesis and devclopment of cervical carcinoma.Methods The expression of Survivin and COX-2 was assayed by immunohistochemical technique in 60 cervical carcinoma and 30 normal cervical tissue specimens.The relation with its clinical pathology characters were analysed.Results Survivin and COX-2 expression in the tissues of cervical carcinoma [76.7 ％ (46/60),63.3 ％ (38/60)] were higher than that in normal cervical tissues evidently [6.7 ％ (2/30),10.0 ％ (3/30)] (P ＜ 0.05).The COX-2 expression in cervical carcinoma was positively associated with lymph node metastasis (P ＜ 0.05),but no correlation was found between COX-2 expression and age,clinical stages,grades and invasive depth (P ＞ 0.05).Any correlation between Survivin expression and classical prognostic factors of cervical carcinoma was found.Moreover,these two proteins were positively correlated.Conclusion The Survivin and COX-2 might play important roles in the development of cervical carcinoma.

Objective To explore the clinical significance of prenatal ultrasound examination in diagnosing twin reversed arterial perfusion sequence (TRAP). Methods This was a retrospective study on 5 cases of TRAP sequence conifrmed by prenatal ultrasound and clinical method. The clinical data and ultrasound images were analyzed. Cases were collected at Hubei Maternal and Child Health Hospital from 2001 January to 2013 February. Results Four-iffths of TRAP were not corrected diagnosed and another one was misdiagnosised as asymmetrical conjoined twins in early pregnancy. Five cases of TRAP were correctly diagnosed during the second trimester. Sonographic ifndings of ifve acardia without blood lfow were as follows:(1) All acardias had no blood perfusion in body and umbilical cord, were absence of the fetal head (acephalous) and heart (acaidia), without skin edema, and a linear object resemble as umbilical cord extend from umbilical region of acardia to plcenta could be seen. Four (case 2-5) had lower limbs or dysplasia of lower limbs (two had spine), and one (case 1) had an irregular mass with bone. (2) Four pump twins had no obvious abnormity, while one had two clubfeet (case 2). Three died in uterus, one underwent induced labor due to oligohydramnios and heart dysfunction, and another one survived. Prenatal ultrasound images were consistent with MRI, X-ray examination, autopsy and postnatal neonatal examination results. Conclusions Acardia without blood lfow which was generally misdiagnosed as single gestation in utero can be diagnosed according to the special disformity of acardia and the linear umbilical cord extend from umbilical region to placenta, besides, it still need to strengthen monitoring the pump twin even if there was no blood perfusion to acardia.

[ABSTRACT]OBJECTIVE To summarize the clinical related factors and prognostic influence factors of perioperative pulmonary embolism of head and neck malignant tumor.METHODSFrom 2010-2014, our hospital carried out a total of 2736 cases of head and neck malignant tumor surgical operations, of which, 10 cases were clinically diagnosed as postoperative pulmonary embolism, retrospectively analyzed the process of clinical treatment of the patients of pulmonary embolism with head and neck malignant tumors, and summarized their etiological factors, clinical manifestations, diagnosis and treatment. RESULTS The preoperative period incidence of pulmonary embolism in patients with head and neck malignant tumor was 0.37%(10/2736). Their clinical manifestations were mainly of asthma and breathing difficulty, and 3 cases of asymptomatic hypoxemia. 8 cases of patients showed pulmonary artery and branch filling defects after pulmonary artery angiography (CTA), 7 cases of patients got cured and were discharged from the hospital after comprehensive treatment such as anticoagulation etc; 3 cases of patients died after emergency treatment. 2 cases of patients suffered cavity bleeding, and there was no anticoagulant drug adjustment.CONCLUSIONThe mortality of head and neck cancer patients with perioperative pulmonary embolism is high, and therefore, preventive measures and timely treatments are important to reduce the incidence of pulmonary embolism.

Objective To investigate the serum calcium absorption level ,distribution level and nutritional status of 25‐hydroxy vitamin D and parathyroid hormone (PT H ) in pregnant and puerperal women .Methods A total of 740 healthy pregnant women and puerperal women in the perinatal clinic of our hospital from September 2014 to August 2015 were recruited as the observation group and divided into second trimester group ,third trimester group and puerperal group .Contemporaneous 100 healthy non‐preg‐nant women were chosen as the control group .The levels of serum 25‐hydroxy vitamin D and PTH in all research subjects were de‐tected by using the electrochemiluminescence method .Then the differences of detection results were compared among various groups .Results The serum 25‐hydroxy vitamin D level was (57 .9 ± 18 .2)nmol/L in the second trimester group ,(39 .4 ± 15 .0) nmol/L in the third trimester group ,(65 .1 ± 19 .6)nmol/L in the puerperal group and (78 .6 ± 16 .2)nmol/L in the control group , the differences among groups were statistically significant (P<0 .05) .The serum PTH level in the third trimester group was higher than that in the second trimester group ,the difference between the two groups was statistically significant (P<0 .05) .Serum calci‐um ,magnesium and alkaline phosphatase levels in the observation group were lower than those in the control group with statistical‐ly significant (P<0 .05) .Conclusion Pregnant and puerperal women usually have low levels of calcium and magnesium ,and 25‐hy‐droxy vitamin D deficiency .It is necessary to supply vitamin D and other mineral elements when taking calcium supplement .

Objective To observe the pulmonary X-ray changes of malignant malaria.Methods The chest routine X-ray examination in 86 cases with malaria in company with respiratory tract symptoms such as fever was performed,the pulmonary changes were obsenved.Results Of 86 cases, 58 cases were abnormal on chest filmes,including lung framework marked in 33 cases,miliary,small or large patchy shadow in 24 cases and multiple round opaque mass lesion in one case.Conclusion The pulmonary X-ray changes of malignant malaria are varied,the common characteristic is that most of them are situated at middle and lower portion of the lungs.This may attribute to blood dynamic abnormality resulting from malaria protozoan and the pathological changes of involved tissues.

Objective To study the action of enantone in chocolate cyst after laparoscopic surgery. Methods To devide the 76 patients into two groups, study group(50 patients, additional enantone after laparoscopic surgery) and the control group (26 patients, only laparoscopic surgery), to analyse their recurrence rate and pregnancy rate. Results The recurrence rate of study group was obviously lower than control group. In the 48 patients with infertility, the pregnancy rate of study group was higher than control group. Conclusions In chocolate cyst after laparoscopic surgery, enantone can decrease the recurrence rate and increase pregnancy rate.

OBJECTIVE To investigate changes in Beijing dentists′ infection control(IC) practices in 2000 vs 2005.METHODS Data from questionaires of 647 dentists in 2000 and 592 dentists in 2005 were compared by using descriptive statistics and Person′s ?2.RESULTS Their response rates were 95.00%(2000) and 93.00%(2005).There were improvements in 2005 vs 2000 in reports of routine use of gloves(94.59% vs 73.31%);masks(56.78% vs 13.94%);and protective gown(38.87% vs 14.51%);change of gloves after each patient(93.47% vs 63.25%);vaccination for hepatitis B virus(HBV)(73.60% vs 32.66%);autoclave sterilization of dental handpieces after each patient(95.07% vs 41.24%);flushing waterlines after each use(70.78% vs 42.01%);and high-volume suction(44.92% vs 11.19%).CONCLUSIONS The compliance with recommended infection control procedures among Beijing dentists is improving in 2005 vs 2000.More education and inspection is needed to develop the infection control practices in dental health care settings.