With self-designed experiment as its basis,Basic Medical College of Shanghai Jiao Tong University has made teaching reform that is design-oriented and integrative with intent to cultivate students' innovation consciousness and practice ability.As a result,a teaching model of"research-based learning",which aims at bringing forth innovative talents,has been constructed and produced desired effects.

Objective:To observe the clinical effect of warm needling moxibustion at Zhongji (CV 3) and Zusanli (ST 36) in treatment of urinary retention after gynecological surgery. ＜br> Methods: Forty patients with urinary retention after gynecological surgery were randomly divided into two groups by the randomized method, 20 cases in each group. Patients in the treatment group were treated by warm needling moxibustion at Zhongji (CV 3) and Zusanli (ST 36). Patients in the control group were treated by inductive urination. The therapeutic effects of the two groups were observed after one course of treatment. ＜br> Results:The total effective rate was 95.0%in the treatment group and 70.0% in the control group. The difference in the total effective rate between the two groups was statistically significant (P＜0.05). ＜br> Conclusion: Warm needling moxibustion at Zhongji (CV 3) and Zusanli (ST 36) is more effective than inductive urination in treating urinary retention after gynecological surgery.

Objective To select a matrix modifier,which can effectively eliminate the matrix interference in the determination of chromium in cosmetics by graphite furnace atomic absorption spectrometry(GFAAS).Methods The orthogonal experiment design was used to define the best operation parameter of graphite furnace.Vitamin C,(NH4)H2PO4,(NH4)2HPO4,NH4Cl and Mg(NO3)2 were added respectively as the matrix modifiers.The effect of five matrix modifiers was compared by precision test.Results When(NH4)H2PO4 was taken as the chemical modifier,the determination result was satisfied.The characteristic mass was 5.68?10-12 g,relative standard deviation were from 2.11% to 4.46%.The rate of recovery of two cosmetics samples were 95.2% and 102.01%.Conclusion(NH4)H2PO4 can increase the ashing temperature,decrease the atomization temperature,eliminate the matrix interference and the result has good precision and accuracy.

Objective:To explore the relationship between periodontitis and coronary heart disease (CHD)by meas-uring changes of serum inflammatory cytokine levels.Methods:A total of 197 patients from our hospital were en-rolled,including CHD + periodontitis group (123 cases),pure CHD group (CHD group,39 cases)and pure peri-odontitis group (periodontitis group,35 cases).Another 45 healthy subjects were enrolled as healthy control group. Concentrations of tumor necrosis factor-α(TNF-α),interleukin-6 (IL-6),serum amyloid-a (SAA),high sensitive C reactive protein (hsCRP)and plasma fibrinogen (Fg)were measured in all groups,and levels of above inflammatory cytokines were compared among four groups.Results:Compared with healthy control group,there were significant rise in levels of above inflammatory cytokines in CHD + periodontitis group (P<0.01 all),Com-pared with CHD group or periodontitis group,there were significant rise in levels of hsCRP [(6.52±2.03)mg/L, (4.34±1.76)mg/L vs.(9.21±2.65)mg/L],IL-6 [(65.32±21.01)ng/L,(65.12±12.34)ng/L vs.(85.76± 25.96)ng/L]and TNF-α[(9.75±3.74)ng/L,(9.34±4.55)ng/L vs.(13.46±8.12)ng/L],SAA [(2.25±1.2) pg/ml,(2.22 ±1.02)pg/ml vs. (2.85±1.45)pg/ml],P<0.05 all in CHD + periodontitis group;there were no significant difference in all serum inflammatory cytokine levels between CHD group and periodontitis group (P>0.05 all).Conclusion:Serum inflammatory cytokine levels significant rise in palients with periodontitis,it is related with coronary heart disease.

OBJECTIVE:To observe the efficacy and safety of vitamin A acid combined with vitamin A,vitamin E,celecoxib in the treatment of oral leukoplakia. METHODS:104 patients with oral leukoplakia were randomly divided into control group(52 cases) and observation group (52 cases). Control group received 1 Vitamin A soft capsule,3 times a day+1 Vitamin E soft cap-sule,3 times a day+1 Celecoxib capsule,twice a day. Observation group additionally received 1 Vitamin A acid tablet,twice a day. 4-week was regarded as 1 treatment course,it lasted for 3 courses. Clinical efficacy,and leukoplakia number,maximum diam-eter of leukoplakia,immunoglobulin A(IgA),IgM,IgG before and after treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in observation group was significantly higher than control group,the dif-ference was statistically significant(P<0.05). Before treatment,there were no significant differences in leukoplakia number,maxi-mum diameter of leukoplakia,immunoglobulin levels in 2 groups(P>0.05). After treatment,leukoplakia number,maximum diam-eter of leukoplakia,IgA and IgM in 2 groups were significantly lower than before,and observation group was lower than control group,IgG was significantly higher than before,and observation group was higher than control group,the differences were statisti-cally significant (P<0.05). And there was no significant difference in the incidence of adverse reactions in 2 groups (P>0.05). CONCLUSIONS:Vitamin A acid combined with vitamin A,vitamin E,celecoxib shows obvious efficacy in the treatment of oral leukoplakia,it can effectively reduce clinical symptoms,improve immune function,with good safety.

Objective To evaluate the effect of metformin treatment on the thyroid hormone profile in patients with polycystic ovary syndrome (PCOS).Methods A total of 148 patients with PCOS was specifically selected for either being diagnosed of hypothyroidism or subclinically hypothyroid or euthyroid without levothyroxine treatment before the starting of metformin.The serum levels of thyroid stimulating hormone (TSH) and free thyroxine (FT4) were measured before and after a 6-month period of metformin therapy.Results Thyroid function parameters did not change after starting metformin therapy in euthyroid patients with PCOS.In the 9 hypothyroid patients and 38 subclinical hypothyroid patients with PCOS,the basal median serum levels of TSH (P ＜ 0.05) decreased after a 6-month course of mefformin treatment [(2.77 ±1.47) μIU/ml vs (6.77 ± 2.46) μIU/ml;(2.90 ± 1.08) μIU/ml vs (4.05 ± 0.94) μIU/ml,P ＜ 0.05].No significant change in the serum levels of FT4 was observed in these patients (P ＞ 0.05).Conclusions Mefformin treatment has no effect on thyroid hormone,but has a TSH-lowering effect in hypothyroid and subclinically hypothyroid patients with PCOS.

Objective To determine the ability of biofilm formation of Staphylococcus ephtermidis isolates and analyze the correlation between the icaA gene and its expression and biofilm formation. Methods Collecting 205 Staphylococcus epidermidis isolates identified with normal laboratory tests (coagulase-negative, biochemical identification, polymyxin-resistant and novobiocin-sensitive ), the suspected isolates were con-formed with API-Staph. Biofilm production was assessed by incubating the strains on Congo Red Agar (CRA) plates and quantitative biofilm production determined by a 96-well tissue culture plate and biofilm morphous were detected by scanning electron microscope ( SEM ) ; Amplifying partial fragments of icaA genes with PCR; Analyzing the expression levels of icaA gene with RT-PCR through Bio-Rad system and Quantity One software. Results 24 isolates showed positive in CRA tests, 22 isolates were positive in semiquantita- tive adhesion assays and 28 isolates existed icaA gene among 205 isolates of Staphylococcus epidermidis. The icaA-positive strains demonstrated biofilm formation (microcolonies on silica films ) while icaA-negative strains only adhered as individual cells under scanning electron microscope. All 22 strains which showed positive in semiquantitative adhesion assays harbored the icaA gene. The expression levels of icaA gene with RT-PCR in 6 Staphylococcus epidermidis isolates showed a higher tendency in 4 strains which demonstrated positive in semiquantitative adhesion assays than 2 negative strains in semiquantitative adhesion assays. Conclusion The isolations of Staphylococcus epidermidis have the abilities of forming biofilm, and the icaA gene and its normal expression is the important molecular biology foundation of biofilm formation. Other fac-tors maybe involve in the expression of icaA gene in Staphylococcus epidermidis isolates.

Legg-Calvé-Perthes disease is one of the most concerned hip diseases in the pediatric orthopaedic field.Although there are many treatments for Legg-Calvé-Perthes disease,new ideas for the therapy of Legg-Calvé-Perthes disease still exist.Moreover,the prognosis of the disease mostly focuses on the studies of the degree of involvement of the epiphyseal plate,age of onset and lateral pillar classification.This contribution summarizes the treatments and prognosis of Legg-Calvé-Perthes disease.

Objective To investigate the effect of bilateral uterine artery embolization in the prevention of postpartum hemorrhage.Methods Twenty-seven patients with risk factors of postpartum hemorrhage (prevention group) and 36 patients with postpartum hemorrhage refractory tendency(treatment group) were underwent bilateral uterine artery embolization.The clinical efficacy and side effects were observed.Results The patients in prevention group were given bilateral uterine artery embolization and conventional induction by ethacridine.All of them finished vaginal delivery,postpartum hemorrhage was 200-480 ml,average 385 ml,no case of postpartum hemorrhage.The patients in treatment group occurred intractable postpartum hemorrhage before bilateral uterine artery embolization,the amount of hemorrhage was 1 000-4 200 ml,average 2 050 ml.Among them,9 patients were given carbasus to stuff cavitary uteri,2 patients were given striped-back saturation.Effective in 35 patients,the successful rate was 97.2％ (35/36).One patient was performed with hysterectomy because of inefficient treatment.None occurred maternal deaths,inefficient and necrosis of lower limbs.All of patients had entire involution of uterus.Reviewed at clinic service after delivery,none occurred postpartum hemorrhage,puerperal infection,Sheehan's syndrome.The menstrual recovery time was 3-13 months for 53 patients who were followed up.Conclusions Bilateral uterine artery embolization have advantage such as safe,effective,less side effects,and is an effective method for the treatment of various causes of intractable postpartum hemorrhage.It is worthy of clinical application on the prevention of postpartum hemorrhage.

[Summary] Chronic suppurative otitis media affects patients ’ quality of life, and is life-threatening in patients with cholesteatoma which causes intracranial or extracranial complications .The purpose of surgery is to clear up all the lesions and to reconstruct hearing function .Tympanoplasty is the main surgical method , which includes basically canal wall down ( CWD) and canal wall up (CWU) styles.CWD provides lager surgical field but impairs normal auditory canal structure ; CWU preserves the posterior wall of external auditory canal and provides better quality of life although it has higher possibility of recurrence of cholesteatoma .We reviewed the surgical methods , surgical effects , recurrence rates , and surgical indications of canal wall up mastoid-tympanoplasty , hoping to provide meaningful reference for clinical application .