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 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 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 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.

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 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 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.

?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 clinical value of the combined detection of Golgi protein 73 (GP73),alpha-fetoprotein variant-L3 (AFP-L3)and transforming growth factorβ1(TGFβ1)in the early diagnosis of hepatocellular carcinoma (HCC).Meth-ods 48 cases of healthy control,42 cases of hepatitis B,50 cases of posthepatitic cirrhosis and 58 cases of HCC were selected and detected GP73,AFP-L3 and TGFβ1.The detection results were compared among 4 groups.Results (1)The levels of GP73,AFP-L3 and TGFβ1 had statistical differences among 4 groups(P <0.05 );(2 )The positive rate of the 3-marker combined detection reached 96.55%,which was higher than that of the 2-marker combined detection and the single marker detection.Conclusion (1) GP73,AFP-L3 and TGFβ1 may be used as the serum indicators for the early diagnosis of HCC;(2)Compared with the traditional HCC marker AFP,AFP-L3 has relatively high sensitivity and specificity and has the important role in the differential diagnosis of benign and malignant diseases of the liver,which is considered as a better serum marker in the HCC diagnosis;(3)The 3-indicator combined detection can significantly improve the positive detection rate of HCC and has better application value.

Objective To evaluate the relationship between serum magnesium and coronary artery calcification (CAC) and their associated factors.Methods 131 patients with chronic kidney disease on regular hemodialysis (HD) were recruited into this study from December 2014 to December 2015 in our center.Demographic and clinical data of selected patients were collected.Serum fibroblast growth factor 23 (FGF-23) level was quantified by enzyme linked immunosorbent assay(ELISA).Quantification of coronary artery calcification score (CACs) was determined by multi-slice spiral computed tomography (MSCT).The relationships between serum magnesium and FGF-23 level,CACs,demographic and clinical data were investigated.Results Patients were divided into low serum magnesium group,normal serum magnesium group and high serum magnesium group according to their serum magnesium levels.There were significant differences in the distribution of diabetes history,serum phosphorus,serum albumin,serum pre albumin,serum uric acid among these three groups(P ＜ 0.05).A significant positive correlation was confirmed between serum magnesium level and serum albumin,serum pre albumin,serun phosphorus and serum uric acid by Pearson correlation analysis and Spearman correlation analysis (r=0.389,0.234,0.200,0.234,P=0.000,0.007,0.022,0.007,respectively).According to the degree of CAC,all maintenance hemodialysis (MHD) patients were divided into non-calcification group,low calcification group,moderate calcification group and high calcification group,and there were significant differences in the distribution of the age,serum phosphorus,serum magnesium,FGF-23 levels among these groups (P ＜ 0.05).Spearman correlation analysis showed that CACs was positively correlated with age,FGF-23,serum phosphorus (r=0.309,0.277,0.180,P=0.000,0.001,0.040,respectively),while negatively correlated with serum magnesium level (r=-0.238,P=0.006) in patients with MHD.The independent risk factors of CACs were aging,high level of FGF-23 in MHD patients by using ordinal logistic regression.However,Hypermagnesemia was a protective factor.Conclusions The history of diabetes,low serum albumin,phosphorus metabolism disorder and CAC are associated with hypomagnesemia in MHD patients.In MHD patients,aging as well as high level of FGF-23 are the risk factors of CAC,and hypermagnesemia is a protective factor of CAC.