Through the excellent experiment of cardiovascular system in pathology, the prac-tice of the teaching reform was carried out such as combining flow model with real specimens, digital sections with light microscope slides, inserting the use of special staining experiments in combination with digital medical image analysis and the simulation of cardiovascular clinical pathological case dis-cussions. Linking theory with experiment teaching and experiment teaching with clinical practice was focused on, which not only stimulated students' interest in learning and their exploring thinking and hands-on ability, but also promoted them to obtain good learning effect, thus improving the teaching quality.

Objective To detect steroidogenic acute regulatory protein (StAR) expression in apolipoprotein E-deficient mice at different ages and serum lipid levels. Methods Nighty-six C57BL/6J and apoE-/- mice were enrolled, which were divided into 16 groups with 6 mice per group according to age (1 day, 1, 3, 5 months), sex and genotype (C57BL/6J and apoE-/-). The serum lipid levels in C57BL/6J and apoE-/- mice were detected by commercial kits. StAR mRNA and protein expressions in liver were detected by Real-time PCR and Western blot respectively. Results ApoE-/- mice had higher LDL-cholesterol and lower HDL-cholesterol compared with C57BL/6J mice of the same age and sex. StAR mRNA and protein expressions were decreased following with aging in C57BL/6J mice. However, in apoE-/- mice with higher lipid levels, StAR mRNA and protein expressions were changed with the lipid levels other than ages. StAR mRNA and protein increased in the early stage, and then decreased with the increasement of lipids levels. Conclusions StAR could affect lipids levels and may be an effective regulator for atherosclerosis and other cardiovascular diseases.

BACKGROUND:Cervical decompression and fusion internal fixation wil accelerate adjacent segment disc degeneration, and it is not clear whether single segment instaibility can increase the adjacent segment disc degeneration. OBJECTIVE:To study the changes of morphology, proteoglycan and col agen type Ⅱ in the adjacent intervertebral disc of the cervical instability models. METHODS:Sixteen New Zealand white rabbits were divided into two groups randomly, with eight rabbits in the control group and eight rabbits in the model group. The animal cervical instability models were made by destroyed partly annulus fibrosus and absorbed C 5/6 nucleus pulposus through anterior cervical puncture. After 12 weeks, the animal models were tested by X-ray film. Al rabbits were sacrificed and 10 mg nucleus pulposus of the intervertebral discs of C 4/5 cut from sagittal plane were harvested and stored under 0 ℃. The content of proteoglycan in nucleus pulposus was tested with phloroglucinol method. Then, the paraffin sections of intervertebral disc tissues were taken for hematoxylin-eosin staining and SABC immunohistochemical staining. RESULTS AND CONCLUSION:The notochord cells of C4/5 intervertebral discs in the experimental group was decreased, and being replaced by fibroblast-like cells. Round chondrocytes could be seen occasional y and intervertebral discs annulus fibrosus became rough and arranged disorderly, the hyaline degeneration and pigmentation were observed as wel as the fibrochondrocytes, and there was a gap between inner and outer annulus fibrosus. The content of proteoglycan was decreased in the nucleus pulposus, and there was significant difference between two groups. The col agen type Ⅱ in the degenerative disc nucleus pulposus and annulus fibrosus of the experimental group was lower than that of the control group. Cervical instability can lead to adjacent intervertebral disc degeneration with the morphological changes and decreased content of proteoglycan and col agen type Ⅱ.

To compare the effects of laparoscopic total or subtotal hysterectomy and myomectomy on ovarian reserve by measuring the serum level of anti-Mullerian hormone (AMH).A total of 96 patients with uterine fibroids underwent total laparoscopic hysterectomy (TLH group,n =32),laparoscopic subtotal hysterectomy (LSH group,n =31) and laparoscopic myomectomy (LM group,n =33).Changes in ovarian reserve were examined by measuring the level of AMH pre-operation and at 1 and 4 months post-operation.No significant differences existed in AMH in LM group[(1.42 ±0.65),(1.31 ±0.53) & (1.33 ±0.61) μg/L,P ＞ 0.05].The levels of AMH in both groups were significantly lower than those at pre-operation [(1.17 ± 0.11),(1.01 ±0.10),(0.48±0.54) & (1.18±0.93),(0.45 ±0.39),(0.14±0.0) μg/L,P＜0.001].The mean percentage decrease in AMH was lower in TLH group than that in LSH group at 4-month follow-up [(-37.4 ± 37.6) ％ vs.(-27.0 ± 23.0) ％,P =0.017].The results showed that LM had no effect on ovarian reserve.Both LSH and TLH had adverse effects on ovarian reserve and TLH was more marked.

Objective To investigate the incidence of recurrence and occurrence rate of recurrence of hand-foot-and-mouth disease (HFMD)in Jiangbei District of Ningbo City between 2012 and 2014,analyze the influencing fac-tors,and provide a scientific basis for the prevention and control of HFMD.Methods Data of HFMD in Jiangbei in 2012-2014 were collected from China Disease Surveillance Information System,immunization data were from Im-munization Programme Information System of Ningbo City,the recurrent infectious cases were selected and analyzed by descriptive epidemiological methods.Results The occurrence rate of recurrent HFMD in Jiangbei in 2012-2014 was 5.40% ,the median month of patients with single occurrence and recurrence of HFMD were 33.77(20.03, 47.83)and 38.26(22.05,54.75)months respectively,median month of patients with the initial occurrence were 23.93(15.87,36.87)months,median of time interval of recurrent HFMD was 10.27(5.23,16.06)months. The oc-currence rate of recurrence was the highest in 3- years old group(χ2= 37.51,P<0.001). Most were scattered chil-dren and children in child-care center. Female was a protective factor of recurrence of HFMD (OR,0.73[95% CI, 0.57-0.92]),while children in child-care center was a risk factor (OR,1 .46[95% CI,1 .16-1 .84]). The median attack rate of recurrence in HFMD group and control group in blocks within 7 days were 10.36(9.29,11.44)/100000 and 8.95(8.16,9.74)/100000 respectively,there was significant difference(Z= -2.68,P<0.001). In-oculation frequency between recurrent HFMD group and control group was not significantly different (Z= -1.38,P= 0.17).Conclusion The epidemic of recurrence of HFMD was serious in Jiangbei District of Ningbo City between 2012 and 2014,boys and children in child-care center should be paid attention,contacts with patients should be re-duced,and targeted prevention and control measures should be carried out.

Objective To explore the safety and clinical effect of combined laparoscopic-colonoscopy resection of colorectal tumor.Methods A total of 26 patients with early colorectal tumor was treated by combined laparoscopic-colonoscopy resection.To observe the postoperative complications,the mean operative time,mean intraoperative blood loss,mean time of gastrointestinal function recovery,and mean postoperative hospital stay were analyzed.Results All the 26 cases were operated successfully.The mean operative time was 60 ～ 162 (93.7 ± 22.5)min.The mean intraoperative blood loss was 15 ～ 120 (35.9 ± 24.2) ml.The mean time of gastrointestinal function recovery was 48 ～ 120(73.2 ± 14.5)h.The mean postoperative hospital stay was 5 ～ 13 (7.4 ± 1.8) d.No postoperative complications occurred,such as stomach leak,enterobrosis and intestinal obstruction.Follow up 6 ～ 12 months,there were no tumor residue and recurrence.Conclusions The combined laparoscopic-colonoscopy resection was located exactly,reasonable excision scope,minimally invasive,quick recovery and other advantages.It was worth of clinical application.

This paper is to study the clinical characteristics of Brugada syndrome (BrS) in Chinese by analyzing clinical and ECG data of BrS patients. Data were included by computerized and manual research, and was analyzed by 2 doctors alone. The data of repetition and of non-Chinese were rejected. Forty-nine BrS patients were included (45 males and 4 females). Main manifestations included sudden death in 29 and syncope in 27 patients. Malignant ventricular arrhythmia (MVA) occurred in 14 of 17 patients with family history of sudden death or syncope and in 15 out of 32 ones without family history. Occurrence of MVA in 11 of 14 patients was within the period from 7pm to 7am. ECG revealed that sloped ST segment elevation appeared mainly in V1, V2 leads and coved ST segment elevation appeared mainly in V3 lead. BrS is not rare in Chinese people,and its clinical characteristics is similar to that overseas data.

Objective: To evaluate recent prognosis of patients with acute ST elevation myocardial infarction (STEMI) treated by primary percutaneous coronary intervention (PCI), and explore related risk factors.Methods: Clinical data of 168 STEMI patients undergoing primary PCI were retrospectively analyzed.According to occurrence of major adverse cardiovascular events (MACE) within 30d or not, they were divided into poor prognosis group (n=40) and good prognosis group (n=128).Clinical data were compared between two groups.Logistic regression analysis was used to analyze independent risk factors for MACE.Results: Incidence rate of MACE was 23.81% among the 168 STEMI patients.Logistic regression analysis indicated that age (OR=1.326, 95%CI 1.168~1.505), family history of coronary heart disease (OR=1.852, 95%CI 1.369~2.505), number of diseased vessels ≥2 (OR=1.682, 95%CI 1.382~2.047), Killip′s class Ⅲ~Ⅳ (OR=1.693, 95%CI 1.428~2.007) and onset-to-PCI time (OR=1.785, 95%CI 1.425~2.236) were the independent risk factors, P<0.01 all;TIMI grade 3 (OR=0.623, 95%CI 0.518~0.749) and tirofiban application (OR=0.452, 95%CI 0.367~0.557) were independent protective factors for MACE, P<0.01 both.Conclusion: Advanced aged, family history of coronary heart disease, number of diseased vessels ≥2, poor cardiac function and long onset-to-PCI time are independent risk factors, while TIMI grade 3 and tirofiban application are independent protective factors for MACE.

Objective To observe the clinical efficacy of shenqifuzheng injection combined with sulfasalazine (SASP) in the treatment of ulcerative colitis (UC) ,and to evaluate the effect of CX3CR1 on colonic mucosa of UC in treatment with shenqifuzheng injection .Methods Fifty‐one patients with active mild to moderate UC were collected during the period from January 2012 to June 2014 in the second people′s hospital of Lianyungang ,which randomly divided into experimental group and control group ,and setting up health group of 15 cases .Experimental group were treated with shenqifuzheng injection combined with SASP ,control group were only with SASP ,health group were no‐treatment control .The modified Mayo scoring results and the expression of CX3CR1 on co‐lonic mucosa of the same lesion site were observed before and two weeks after treatment separately .Results The total positive rate of CX3CR1 on colonic mucosa in patients with ulcerative colitis was 88 .37% before treatment ,The total positive rate of CX3CR1 on colonic mucosa in health group was 20 .00% ,There was significant difference between two groups (Z= -2 .689 ,P<0 .01) .Two weeks after treatment ,the expression of CX3CR1 on colonic mucosa and the modified Mayo scoring results in the experimental group were significantly lower than those in the control group (P<0 .05) .The clinical comprehensive efficacy of the experimental group was significantly better than the control group (Z= -2 .085 ,P<0 .05) .Conclusion Combination of shenqifuzheng injection and SASP is more effective than using SASP alone in the treatment of UC .Shenqifuzheng injection may play important role in the treatment of UC by inhibiting the expression of CX3CR1 on colonic mucosa .

A global quality control method based on high performance liquid chromatography (HPLC) coupled with diode array detection (DAD), single quadrupole mass spectrometry (MS) and time-of-flight mass spectrometry (TOFMS) was developed for simultaneous determination of seven major components (mangiferin, neomangiferin, timosaponin E1, timosaponin E, timosaponin BⅡ, timosaponin BⅢ, and timosaponin AⅢ) and identification of most components in extracts of Rhizoma Anemarrhenae (RA). HPLC analysis was performed on an Agilent SB-C18 column (4.6 mm×150 mm, 5 μm) by gradient elution using acetonitrile and water-acetic acid(100∶0.05, v/v) as the mobile phase. Seven major components in RA were successfully separated. This quantitative method was fully validated in respect of the following performance criteria: linearity, precision, repeatability, stability, accuracy, limits of detection (LOD) and quantification (LOQ). A formula database of known compounds in RA was established, against which, most of the reported components in this herbal extract were identified effectively based on the extract masses acquired by TOFMS. This qualitative and quantitative method was successfully used to analyze the components in 10 batches of RA samples collected from different regions in China. This global quality control method, which consisted of HPLC-DAD-MS assay of seven major components and unambiguous identification of nineteen components, is suitable for routine quantification and comprehensive quality control of RA.