To evaluate the effect of problem-based learning (PBL) in internal medicine teaching for residency training of general medicine.Fifty two residents of general medicine were divided randomly into PBL teaching and traditional teaching groups with 26 in each.The evaluation was conducted in combination of examination scores and questionnaire survey in both groups.In questionnaire survey the residents of PBL group responded positively about the use of PBL in teaching, and rated themselves as having much better competencies in problem solving and self-directed learning.The scores of case analysis examination in PBL group were higher than those in traditional teaching group ( 73.7 ± 4.1 vs.71.1 ± 4.8, P ＜ 0.05 ).The results suggest that the application of PBL has better effect than traditional teaching in residency training of general medicine.

Objective To identify the targeted-regulating relationship between human MicroRNA335 (hsa-miR-335 )and CCL1 1,CCL26 and SOX4.Methods The potential fragments of hsa-miR-335 target genes CCL1 1,CCL26 and SOX4 were predicted by the bioinformatics analyzing tools online.The 3′untranslated regions(3′UTR)of the CCL1 1,CCL26 and SOX4 were connected to the eukaryotic expression vectors pMIR REPORT.The constructs of pMIR-REPORT-CCL1 13′UTR,pMIR-REPORT-CCL26 3′UTR,pMIR-REPORT-SOX4 3′UTR and positive control were co-transfected with Pre-miRTM miRNA335 Precursor or negative control into 293 T7/1 7 cell line by lipofectamine 2000,respectively.Both Firefly and Renilla luciferase activity were detected by dual luciferase reporter assay system.Results Compared with the negative control group,luciferase assay revealed that has-miR-335 could significantly diminish luciferase activity from SOX4 reporter vector (P <0.01 ),while the suppression of luciferase activity was not found in CCL1 1 or CCL26 reporter vector (P >0.05).Conclusion The results suggested that hsa-miR-335 targeted regu-lated SOX4,but not targeted CCL1 1 and CCL26.

?Objective: To study the effects of endogenous bone morphogenic protein 2(BMP 2) and 6(BMP 6) in rat facial nerve after injury. Methods: Facial nerve trunk was cut and then anastomosed in 30 adult male Sprague Dawley rats,another 6 rats without operation were used as the controls. Every 6 rats were killed 6 ,72 h,1, 2 and 4 weeks respectively after operation and nerve specimens were immunohistochemically examined for BMP 2 and BMP 6 expression. Result:In the control nerve the gray level of BMP 2 and BMP 6 were 210.89?8.21 and 232.03?9.25 respectively. 6, 72 h,1, 2 and 4 weeks after operation the gray level of BMP 2 were 242.83?11.01,240.67?7.91,234.46?5.28,232.12?7.27 and 220.71 ?10.19;that of BMP 6 210.75?5.19,204.08?10.85,198,91?8.58,186.37?4.11 and 184.62? 8.45 ,respectively. Conclusion: BMP 2 may play a role in the early irritable actions when facial nerve was injured. However, BMP 6 might have functions in the regeneration of facial nerve during later period after injury.

Objective To investigate the effect of different investing materials on the complete denture flasking deformation.Methods The denture wax casts were invested by plaster,dental stone,and dental stone together with silicone,respectively.8 trial dentures were randomly chosen from above each group,and 4 reference points were selected in the cast.The conventional water bath polymerization system was used for the process.The distance between reference points were measured before and after thermally processing the Acrylic base.F test and Kruskal-Wallis H test were applied for statistical analysis.Results The distance between A and B (F =3.768,P =0.040) and the mean of total distance among O,A,B and C(F =4.830,P =0.019) had statistically significant differences among the three groups.The deformation variance of Group 1 (a conventional plaster) between 175μm and 267μm was maximum.The deformation values of Group2 (a dental stone) was appropriate with Group3 (a dental stone + a silicone).Smoothness (x2 =17.575,P ＜ 0.01) was statistically different among the three groups.Conclusion The flaskingprocess with the plaster had the maximum movement.The process with dental stone showed the minimal toothmovement,the process with the dental stone along with with thesilicone caused a similar movement as from the single dental stone but resulted in a smoother denture surface.

Objective:To investigate the characters of ERP in undergraduates with different trait anxiety during exam stress. Methods: By the State Trait Anxiety Inventory, one group of 15 undergraduates with high trait anxiety and another group with low trait anxiety were chosen from 200 participants in Band 4 College English Test. Their change of P3 were observed through NeuroScan 32 Channel ERP System during pre- exam and post- exam. Results: The amplitude of P3 of the group with low trait anxiety was enhanced while another group with high trait anxiety had no significant difference after exam; The latency of P3 of the group with low trait anxiety were decreased while another group with high trait anxiety had no significant difference after exam; There weren’t significant differences in amplitude and latency of P3 between high trait anxiety group and low trait anxiety group before exam; There were significant enhance of amplitude of P3 and decrease of latency of P3 in low trait anxiety group after exam as compared with high trait anxiety group. Conclusion: The result suggests different trait anxiety groups have different cognitive functions. When confronting with the same stress.

CT findings and complete clinical data of 185 cases with closed chest injuries were retrospectively analyzed.The diagnosis of 185 cases were pulmonary contusion ( n = 185 ),pulmonary laceration ( n = 35 ),Macklin effect ( n = 5 ) and lung herniation ( n = 1 ).CT findings of lung contusion appeared as thick and vagur lung marking (n =9),small points shadows (n = 12 ),blotchy shadows (n =48),small pieces shadows (n=10),ground-glass shadows (n=16),large pieces shadows (n =5),diffuse patchy clouding shadows (n = 17) or mixed lesions (n = 68).CT appearance of lung laceration included pulmonary hematomas (n = 12),cavitary lesions with air ( n = 19),cavitary lesions with air-fluid levels ( n = 53 ).Macklin effect appeared as bronchus-,pulmonary vessel-adjacent air collection and mediastinal air collection (n=5).Traumatic pulmonary hernia appeared as lung herniation through an intercostal space.Initial CT scan missed one case of pulmonary contusion and 2 cases of pulmonary laceration.

Objective To observe changes of venous blood gas when applying tourniquets to arterial bleeding dog models and compare the injury of the bundled tissues caused by three different tourniquets. Methods A total of 18 dogs were randomly divided to three groups and made into femoral artery bleeding model of the hind limbs. Then, rubber tubing, half-hitch tourniquet and multi-function pressure-control bandage (hemostatic bandage group) were employed respectively for femoral artery hemostasis in three groups. The pressure produced by the bandage and femoral vein blood gas indices were measured at 0.5, 1, 3 and 6 hours respectively after tourniquet application. Results The pressure produced by the hemostatic bandage group was 0.74 kg, which was obviously lower than 1.46 kg in the rubber tubing group and 2.09 kg in the half-hitch tourniquet group ( P ＜ 0.05 ). At one hour after hemostasis, PvO2 was (36.45 ± 10.45 )mm Hg in the hemostatic bandage group and (28.73 ± 9.07 )mm Hg in the rubber tubing group, which was significantly higher than (21.87 ±4.30) mm Hg in the half-hitch tourniquet group ( P ＜ 0.05 ). At 3 and 6 hours after hemostasis, PvCO2 was (50.67 ± 9.31 ) mm Hg and (60.02 ± 10.85)mm Hg respectively in the hemostatic bandage group, while (16.85 ± 16.51 )mm Hg and ( 60.02 ± 10.85) mm Hg respectively in the rubber tubing group, which were lower than that in the half-hitch tourniquet group ( P ＜ 0.05 or 0.01 ) . Conclusion Compared with rubber tubing and Halfhitch tourniquet, the hemostatic bandage can efficiently stop bleeding under slight pressure, with the least injury to the bundled tissues.

Objective:To compare the mRNA expression of IRG1in PBMCs from patients with TB, individual with latent infection and healthy controls, and investigate its diagnostic value for Mycobacterium tuberculosis infection.Methods: The mRNA expression of IRG1 from PBMCs stimulated with Mtb-specific antigens was quantitatively detected by quantitative real-time PCR ( qPCR).Receiver-operating-characteristic ( ROC) curves were used to determine the cutoff points yielding the highest specificity and sensitivity,and discriminative ability was evaluated by the area under the ROC curve.Results: The mRNA expression of IRG1 in healthy controls was significantly lower than that in patients with tuberculosis and LTBI ( P<0.05 ).The AUC for using IRG1 mRNA levels (>0.01536 ) to identify Mycobacterium tuberculosis infection was 0.91, with 76.47% sensitivity, 96.30% specificity, LR 20.65,and 85.2% of cases correctly classified.Conclusion: IRG1 may be used as a biomarker for diagnosing Mycobacterium tuberculosis infection.

Objective To report 1 case with renal immunoglobulin light and heavy chain deposited disease (IgG-κ light chain and γ1 heavy chain).Methods The clinical manifestations,serum immunofixation electrophoresis,light and heavy chain abnormalities of blood and urine,bone marrow biopsy and renal biopsy data laboratory data were recorded and analyzed.Results A 63-year-old woman presented with massive proteinuria,microscopic hematuria,hypertension,anemia and serum IgG-κ light chain.Bone marrow aspirate revealed 4％ plasma cells.Renal biopsy revealed nodular glomerulopathy with congo red staining-negative.Immunofluorescence showed that κ light chain and IgG1 (γ1 heavy chain) were deposited along the glomerular basement membranes (GBM) and tubular basement membranes (TBM).Electron-microscopy revealed electrondense deposits that delineate the outer aspect of TBM and endothelial aspect of GBM.Conclusion The diagnosis of renal immunoglobulin light and heavy chain deposited disease (IgG-κ light chain and γ1 heavy chain) should be addressed combine with clinical and is pathology,especially with immune pathological examination.

Purpose To study the cytopathologic features of CT-guided percutaneous lung biopsy samples and to evaluate the role of cytopathology in the diagnosis and staging of lung carcinomas, as compared to histopathology. Methods Four-hundred twenty-five specimens were collected by CT-guided percutaneous lung biopsy which were also confirmed by histological diagnosis. Direct smears were performed for each case. Cytological and histological examination was carried out. Results The sensitivity, specificity, false positive rate, false negative rate and accuracy of cytopathology in diagnosing lung carcinomas by CT-guided percutaneous lung biopsy was 86. 6% (264/305), 100% (120/120), 0 (0/120), 13. 4% (41/305), 90. 4% (384/425), respectively. Overall 51. 1%(135/264) of the cases were precisely typed, including 77. 6% (83/107) of adenocarcinoma, 76. 9% (40/52) of squamous cell car-cinoma and 75. 0% (9/12) of small cell carcinoma. Conclusions Cytopathology of CT-guided percutaneous lung biopsy specimens is sensitive and accurate for diagnosing pulmonary carcinomas. In some cases, the lung carcinoma can be precisely typed. Therefore, it is useful for diagnosing and staging lung carcinomas.