ObjectiveThis paper aims to probe into the effect of working and studying combined teaching reform of chnical medicine major.MethodsTwo classes containing 46 students respectively were selected at random as observation group and control group,from the six classes of Grade Two majoring in clinical medicine.The two groups of students were trained by adopting working and studying combined teaching model and traditional teaching model respectively,after which they were evaluated in terms of clinical theory,practical skills and operations,and exercitation achievement.ResultsThe observation group does better in practical skills and exercitation achievement than the control group,while they have no difference in clinical theory.ConclusionWorking and studying combined teaching model can improve students' clinical analytical ability,strengthen their awareness of medical morals,and help them achieve more in exercitation.

Chlorella pyrenoidosa No.2 was screened from five species of microalga Chlorella sp. for its higher lipid yield. Effects of medium components and culture conditions on cell growth as well as lipid ac-cumulation of C. pyrenoidosa No.2 were investigated and the results showed that the optimum medium rec-ipe was 20.0 g/L glucose,0.08 g/L glycine,1.0 g/L K2HPO4?3H2O,0.4 g/L MgSO4?7H2O and 0.004 g/L FeSO4?7H2O. The optimum culture temperature,initial pH,shaking rate and light intensity were 28℃,6.0,130 r/min and 650 Lux,respectively. Biomass and lipid content increased from 3.73 g/L and 40.15% to 6.56 g/L and 59.90% when Chlorella pyrenoidosa No.2 was cultivated under the above optimal conditions for 7 days,with lipid yield raised by 162%. Chlorella pyrenoidosa No.2 could produce lipid with xylose as carbon source,and so is potential for lipid production from renewable materials such as lignocellulose. GC analysis demonstrated that the fatty acid composition of the lipid was similar to that of vegetable oil and its unsaturated fatty acid content reached around 71%,thus it is a promising material for biodiesel production.

A complete aniline dioxygenase gene cluster cloned from an Acinetobacter sp. strain, which could utilize aniline as the sole carbon, nitrogen and energy, was sequenced. Sequence analysis showed that the gene cluster had six intact ORFs, and the whole sequence had high similarity with that of Acinetobacter sp. YAA at amino acid level. A recombinant strain was formed with the gene cluster ligated to vector pLAFR6 and transferred to E.coli. After optimizing the fermentation conditions of this strain for producing catechol, LB was confirmed as the final medium, pH7.0, aniline concentration 0.5mg/ml, E.coli DH5?as the host, incubation temperature 37℃, amount of inoculum 3%. Under above conditions, the yield of catechol could get to 0.546mg/ml, and the converting rate of substrate at molecule level could get to 92.4%.

Objective: To observe the alteration of type-　 Ⅰ collagen protein gene expression after arterial injury and investigate its effect on the development of restenosis. Methods: Firstly, thee xperimental carotid arterial injury rabbit model was constructed. Then, Norther n blot, in situ hybridization and histomorphometric analysis were used to de tect the expression of procollagen mRNA and the accumulation of collagen protein 1,2,4 weeks after injury. Results: Type-　Ⅰ collag en mRNA increased 1 week after injury, peaked 2 weeks later and decreased 4 week s later. The deposition of the collagen protein account for a high percentage o f space in neointima on histomorphometric analysis. Conclusion: Collagen protein may play an important role in the development of neointima and restenosis.

Objective To investigate the clinical effects of gastrointestinal decompression with enteral feeding tube in elderly patients with gastric cancer.Methods 78 cases of gastric cancer patients undergoing postoperative gastric decompression with enteral feeding tube were selected as the treatment group,and 66 patients with gastric cancer undergoing postoperative intravenous nutrition and gastric decompression with routine nasogastric tube as the control group in our hospital from January 2015 to December 2015.The incidence rate of gastric tube patency,faster postoperative recovery,nutritional immune improvement,adverse reaction and complication were compared between the two groups.Results The incidence rate of adverse reactions and complications in treatment group were significant lower than in control group (3.0 ％ vs.12.8 ％,x2 =4.4857,P =0.0342;1.5 ％ vs.10.2％,x2 =4.6620,P =0.0308,respectively).Following parameters were significant better in treatment group versus in control group:the time of evacuating [(3.1 ± 0.3) d vs.(4.0 ± 0.1) d,t =24.9227,P =0.0000],defecation[(4.3 ± 0.6) d vs.(5.5 ± 1.1) d,t =7.9189,P =0.0000],extubation [(5.3±1.3)d vs.(10.1±2.2)d,t=15.5690,P=0.0000],hospitalization[(12.3±2.5)d vs.(18.6± 3.2)d,t=12.9864,P=0.0000],postoperative body weight[(57.2±4.9)kg vs(49.0±7.2)kg,t=-7.8408,P=0.0000],plasma protein[(133.2± 11.2)g/L vs(104.5± 10.3)g/L,t=-16.0055,P=0.0000],hemoglobin[(4.7 ± 1.0) g/L vs (3.2 ± 0.6) g/L,t =-11.0991,P =0.0000] and peripheral blood lymphocyte count[(3.5 ± 0.7) × 109/L vs (2.1 ± 0.4) × 109/L,t =-15.0088,P =0.0000].Conclusions Effects of postoperative gastrointestinal decompression in elderly patients with gastric cancer are similar between with routine gastric tube and with enteral feeding tube.However,the enteral feeding tube-induced enteral nutrition shows fewer side effects and complications,better nutritional and immune effects,and faster postoperative recovery,which is worthy of a generalization and application.

Objective To evaluate the significance of myocardial bridge and find a reasonable diagnosis and treatment strategy.Methods Sixty-three myocardial bridge patients and sixty-three patients with negative results of coronary artery angiography were reviewed.The clinical data of symptoms,electrocardiogram,exercise tests,coronary artery angiography,therapeutics and the serum levels of C-reactive protein(CRP)were analyzed.Results The symptoms of chest distress and chest pain were found in myocardial bridge patients.Myocardial consumption of oxygen augmentation causes the symptoms of aggravation.Positive results of electrocardiogram and exercise tests in many of myocardial bridge patients were examined.There were no relationship with severity of myocardial bridge artery stenosis.Most of myocardial bridge were discovered in anterior descending branch.At present,the main treatment of myocardial bridge was drug therapeutics.After treatment,the serum levels of CRP was significantly decreased.Conclusion Myocardial bridge was anatomy abnormality with important clinical significance.The serum levels of CRP can be used to evalue the therapeutic efficacy of myocardial bridge.

[Objective] To explore the techniques of hand-assisted laparoscopic splenectomy plus portozygos disconnection procedure. [Methods] 18 patients with portal hypertension were operated by hand-assisted laparoscopic splenectomy plus portozygos disconnection. [Results] The operations were completed successfully. The mean operative time was 180(150～260) minutes, the mean blood loss estimated was 540(200～2 000) mL, the mean weight of spleen was 910 (500～2000) g and the mean length of hospital stay was 9.7 (8～18) days after operation. All patients had recovered rapidly and suffered less pain and only 5 patients needed analgesic. The mean recovery time of the bowel function was 52(24～74) hours. The hand incisions healed well, and only one occurred complications and another suffered death. [ Conclusions ] Hand-assisted laparoscopic splenectomy plus portozygos disconnection procedure is to be feasible and safe, and has the merits of minimally invasive surgery.

Objective To study the feasibility and curative effect of laparoscopic radical resection of rectal carcinoma. Methods Sixty-two cases were enrolled in this study between Feb 2003 and Mar 2005, including 32 cases undergoing laparoscopic radical resection (19 Dixon and 13 Miles) , and 30 cases undergoing open radical resection (22 Dixons and 8 Miles). Results The mean operation time of laparoscopic group was 195 min, and open group was 156 min (P 0. 05 ). The GI and urination function of laparoscopic group recovered faster than open group ( evacuated was 2. 7 days vs. 3. 7 days, P

Objective To evaluate protective effects of recombinant human thioredoxin(TRX) in myocardial injury of mice with viral myocarditis. Methods We established viral myocarditis models by intraperitoneal injection with 0.1 ml 100TCID50 Coxsackie virus 3m(CVB3m), along with tail vein injection of recombinant human TRX (2 mg/kg) for protection. The control group was given equivalent volume of normal saline. The mice were killed 7 days following the injections. Serum lactate dehydrogenase (LDH) activity was determined and myocardial injury was examined with light microscopy. Results The somm LDH activity in Coxsackie virns-infected mice [(3130.50±390.57)U/L] was higher than that of animals in the control group[ (1617.86±155.42)U/L] and that of TRX protection group[ (1959.43±540.75)U/L], the difference being statistically significant (P<0.05); there was no significant difference between TRX protection group and the control group(P 0.05). Light microscopy showed that five of the eight Coxsackie rims-infected mice had myocardial lesions, including focal myocardial necrosis and inflammatory infiltration. There was no myocardial injury in the TRX protection group. Conclusions Recombinant human TRX can lessen myocardial injuries induced by infection with CVB3m, and so can protect myocardium.

Objective To observe the protective function of recombinant human thioredoxin(TRX) on HeLa cell injury induced by Coxsackie virus 3m(CVB3m) and to study the inhibiting effect of TRX on viral replication. Methods We infected HeLa cells with 10TCID50 CVB3m and then protected these cells with TRX (2,5,10 mg/L). The protective group of TRX, viral group, control group of TRX, and normal control group were included. Six parallel wells were set up in each group. The cell growth was observed by methyl thiazolyl tetrazolium(MTT) and contrast phase microscope. Results The results of contrast phase microscope revealed that HeLa cells were arranged tightly and polygon in normal control group; untightly, became circle and abscission in viral group; HeLa cells morphous improved by increasing TRX concentration in TRX protective group(2,5,10mg/L). MTT results of the inhibitory ratio on cell growth of TRX(2,5,10 mg/L) control group(1.2%,2.9%,6.3%) were compared with normal control group(0), there was no significant difference(all P > 0.05); and while the inhibitory ratio on cell growth of TRX(2,5,10 mg/L) protective group(32.0%,28.0%,27.0%) was compared with virus infective group(51.7%), there was a significant difference (all P < 0.05). The inhibition study of viral replication showed that compared the inhibitory ratio on cell growth of TRX(2,5,10 mg/L) protective group(26.0%,27.0%, 10.9%) with virus infective group(60.0%), there was a significant difference(all P < 0.05). In the protective groups, there was a significant difference (all P < 0.05) between low dose groups(2,5 mg/L) and high dose groups( 10 mg/L). Conclusions The recombinant TRX(2,5,10 mg/L) may alleviate HeLa cell's injury induced by virus and the construct has no significant toxicity. TRX(2,5,10 mg/L) is effective in inhibiting virus CVB3m replication.