Objective:To explore and evaluate the application of flipped classroom in the integrated curriculum of pathology and pathophysiology overview.Methods:This study included in 172 students from the 8-year program of clinical medicine of Batch 2016 (observation group), and 142 students of Batch 2014 (control group). The observation group adopted traditional classroom teaching combined with flipped classroom teaching, and the control group used only traditional classroom teaching. In the observation group, the teaching contents were redesigned in the form of flipped classroom. The relevant knowledge points were provided before class. Group discussions and in-class presentations were used in the teaching. And the cultivation of students' learning autonomy, interaction and innovation were emphasized. The teaching evaluation was obtained from the questionnaire survey and final exam performance of the two groups of students. SPSS 21.0 was used for t test. Results:Students in the observation group had high satisfaction with flipped classroom which was helpful to improve students' independent learning ability, oral expression ability and innovative thinking ability. However, there was no significant difference in the final exam scores between the two groups ( P=0.306). Conclusion:Flipped classroom teaching can improve students' interest in learning and stimulate their independent learning and innovation. However, the teaching effect evaluated only by the final performance can't reflect the superiority of flipped classroom, which should be assessed by more evaluation indexes.

Objective To observe the effect of Tanggankang on the expression of CREB in diabetic-fatty liver rats;To investigate the mechanism of Tanggankang. Methods STZ and feeding high fat forage induced diabetic rats were randomly divided into model group, Huganning group, Tanggankang high dose group, Tanggankang medium dose group, Tanggankang low dose group, 10 rats in each group, with 10 normal rats as control. After 12 weeks of drug intervention, rats were killed, the livers were removed, and the expression of CREB was detected by Western blot. Results Compared with normal group, the level of CREB of model group was significantly decreased (P<0.01). Compared with model group, Tanggankang low, medium and high dose group significantly decreased the level of CREB (P<0.01). Conclusion Tanggankang may play an active role in glucose and lipid metabolism by affecting the expression of CREB.

OBJECTIVE:To provide reference for rational use of carbapenem antibiotics in the clinic. METHODS:Enterobac-teriaceae bacteria were collected from our hospital during Jan. 2014-Dec. 2015;semiautomatic microbiological assay instrument was used for strain culture,identification and drug sensitive tests. Modified Hodge test and K-B test were adopted to confirm Klebsiella pneumoniae carbapenemases (KPC)-producing and ESBLs-producing drug resistant strains. RESULTS:During 2014-2015,1 035 strains of Enterobacteriaceae bacteria were detected in our hospital,among which there were 732 strains of Escherichia coli,157 strains of K. pneumonia,136 strains of Enterobacter cloacae and 10 strains of Serratia marcescens. Citrobacter freundii was not found. E. coli and K. pneumonia were highly sensitive to amikacin and carbapenems,but slightly sensitive to most cephalosporin. A total of 64 strains of carbapenems-resistant Enterobacteriaceae bacteria(6.18%)were detected,among which there were 31 strains of carbapenems-resistant E. coli(4.23%),30 strains of carbapenems-resistant K. pneumonia(19.11%),1 strain of carbapenems-re-sistant E. cloacae(0.74%)and 2 strains of carbapenems-resistant S. marcescens(20.00%). The samples were mainly from sputum and urine specimens,which were mainly from neonatal department and ICU. Of 64 drug resistant strains,there were 59 KPC-pro-ducing strains (92.19%) and 3 ESBLs-producing strains (4.69%). CONCLUSIONS:E. coli occupies high proportion among En-terobacteriaceae bacteria,and the number of carbapenems-resistant E. coli and carbapenems-resistant K. pneumoniae is in high lev-el. Drug resistance of Enterobacteriaceae bacteria to carbopenems may be associated with KPC and ESBLs producing. Carbapenem antibiotics should be selected rationally in accordance with medication indications and the results of drug sensitivity test.

Objective To explore the clinical characteristics and management of kidney transplantation in the older adults.Method Forty older kidney recipients (≥60 years old) and 777 younger (18～59 years old) recipients from June 2009 to December 2012 were retrospectively reviewed to evaluate the clinical characteristics and managements.Result Of 40 older recipients,the comorbidities of diabetes and coronary artery disease in older group were higher than in the younger (25％ vs.4.9％,and 32.50％ vs.11.38％).During the first 6 months,7 older patients died,among which 4 died from severe pneumonia,2 from heart failure and 1 from pulmonary embolism.There were 31 deaths in younger group,among which 21 died from severe pneumonia,4 from heart failure,5 from cerebrovascular accident and 2 from pulmonary embolism.The mortality in the older group was higher than in the younger group (17.5％ vs.4.6％).Six-month and 3-year survival rate in the older recipients was lower than the younger recipients (81.56％ vs.95.35％,and 81.56％ vs.94.5％,respectively).Six-month graft survival rate and 3-year survival rate in the older group were also lower than in the younger group (78.75％ vs.92.02％,and 68.82％ vs.85.40％).At the 1st and 2nd year during follow-up,the serum creatinines in the older group were close to those in the younger group,while lower level was observed 3 years after transplantation in the older patients (89.38 ± 11.34 (mol/ L vs.116.57±48.68 (mol/L).Conclusion The patients with ESRD older than 60 years have more preoperative concomitant diseases and worse health status,which contribute to the complex clinical characteristics.More aggressive indication selection,sufficient pre-operative preparation,wellmatched histocompatibility and high quality of donor kidney are the key factors of successful transplantation.Optimized immunosuppressant therapy,delicate perioperative management,preventve and effective treatment of related complications are necessary to promote the survival of recipients and graft in long term.

Adolescent ; Endoscopy ; Ethmoid Sinus ; Frontal Sinus ; surgery ; Humans ; Male ; Osteoma ; surgery ; Otorhinolaryngologic Surgical Procedures ; methods ; Paranasal Sinus Neoplasms ; surgery

Objective:To check RNA binding protein QKI-5's expression level in breast cancer cells and inhibiting effect on cancer cell proliferation.Methods:QKI-5's expression level was checked in different breast cancer cells by Western blotting,cancer cells of overexpressed QKI-5 gene could be stabilized by slow virus infection construction,MTT and FCM were used to check cell period to express QKI-5's influence on cell proliferation and period.Results:MCF-7 cells have relatively low QKI-5 expression level in three breast cancer cells,MTT experiment result has obvious reduced influence on QKI-5's expression of MCF-7 cell proliferation P＜0.05,mean-while,cell period inspection shows that overexpressed QKI-5's MCF-7 cells have obvious G1 retardant,cells in S and G2/M periods are reduced.Conclusion:High expression of QKI-5'in breast cancer could cause slow cell proliferation by inhibiting cancer cell period,hence causing limited tumor growth.

Objective:To observe the effect of low-intensity pulsed ultrasound (LIPUS) at different intensities on the expression of adiponectin and its receptors in C2C12 myoblasts, and to explore the potential mechanism by which LIPUS promotes the differentiation of C2C12 myoblasts.Methods:C2C12 myoblasts cultured in vitro were randomly divided into a control group and U 0.1, U 0.3 and U 0.5 groups. The control group received sham LIPUS exposure, while the U 0.1, U 0.3 and U 0.5 groups were exposed to LIPUS at intensities of 0.1W/cm 2, 0.3W/cm 2 or 0.5W/cm 2 respectively, and 1MHz for 5 min daily for 5 days. Cell viability was measured using CCK-8 assays. Fluorescence quantitative reverse transcription-polymerase chain reactions were used to detect the mRNA expression of adiponectin, adiponectin receptor 1 (adipoR1) and T-cadherin in the cells. Western blotting was employed to assess the protein expression of adiponectin, adipoR1, T-cadherin, adenosine monophosphate activated protein kinase (AMPK), activated phosphorylated adenylate-activated protein kinase (P-AMPK), embryonic myosin heavy chain (eMHC) and myogenin (MYOG). The differentiation ability of the 4 groups was measured using cell immunofluorescence chemistry. Results:After the intervention the cell viability in the U 0.1, U 0.3 and U 0.5 groups was significantly higher than in the control group. Compared with the control group, the average mRNA expression of adiponectin and the receptors of adipoR1 and T-cadherin were up-regulated significantly in the U 0.3 and U 0.5 groups. The average adiponectin, adipoR1 and T-cadherin protein expressions, and the AMPK phosphorylation level in the U 0.3 and U 0.5 groups had increased significantly compared with the control group, but all were significantly lower than in the U 0.3 group. The average protein expression of eMHC and MYOG, and the C2C12 myoblast fusion indices of the U 0.3 and U 0.5 groups were significantly higher the control group′s averages. Conclusions:LIPUS can promote the differentiation of C2C12 myoblasts. It is most effective at 0.3W/cm 2, administered for 5min/d at 1MHz with a 20% duty cycle. Its regulatory mechanism may be related to up-regulation of the expression of adiponectin, the adipoR1 and T-cadherin receptors, and the activation of AMPK phosphorylation in C2C12 myoblasts.

In order to study the accumulation of Fritillaria thunbergii cultivar, peimine content in Xiaye, Kuanye, Duozi and Xiaosanzi bulbs of different sizes and parts was determined by HPLC-ELSE. The results indicated that the peimine content varied significantly with the cultivar type, the size and part of bulb. The distribution laws of peimine were as follow: Xiaosanzi > Duozi > Xiaye > Kuanye, small-size bulb > big-size bulb, core bud > scale. The peimine yield per plant in Duozi was the highest.
Cevanes ; analysis ; Chromatography, High Pressure Liquid ; Fritillaria ; chemistry ; growth & development

Objective To explore glycogen synthase kinase -3β( GSK-3β) activity and Toll-like receptor 4 ( TLR4 ) proteins expression of microglia were tested in vitro experiments, and the possible mechanism of postoperative cognitive dysfunction(POCD).Methods The cell morphology of primary culture microglia was observed by inverted microscope;microglia were identified by glial fibrillary acidic protein ( GFAP ) immunofluorescence;the best POCD modeling conditions of microglia injury induced by lipopolysaccharides( LPS) were screened ; microglia vigor was assayed by MTT ; the proteins expressions of GSK-3βand TLR4 of microglia were detected by Western blot.Results GFAP immunofluorescence showed a positive result that primary culture of rat microglia was successful;MTT result showed that the best PODC modeling conditions of microglia injury induced by LPS (100 ng/mL) was 7h; Western blot results showed that the preotein expressions of GSK-3βand TLR4 of microglial cells were up-regulated by LPS compared with the control group,and there were significantly differences (P<0.01).Conclusion PODC pathogenesis may be associated with LPS that could up-regulat the protein expression of GSK-3βand TLR4 in microglial cells.

Biological mass spectrometry has been developed for the largE-scale protein identification. The successful identification of protein in proteomic study is based on an effective match of MS data to the sequence in database. Because of the diversity and heterogeneity of protein modification, the experimental data obtained by mass spectrometry does not match the theoretical value sometimes, which makes about 90 percent or more of the tandem mass spectra not be effectively identified. This has become one of the most important technique issues to be resolved in current proteome research. The N-terminal cyclization of peptides, as one of a variety of modification introduced in sample preparation, has been preliminarily studied in this work. The result showed that N-terminal cyclization occurred at the most of the glutamine(Q) or carbamoylmethyl-cysteine(CAM_C) residues and the reaction is often incomplete or partial, both types of peptides could often exist in its respective state at the same time, and the behavior of modified peptides in revered phase chromatography is also changed. The success rate of protein identification could be obviously improved if adding the N-terminal cyclization modification in the database searching. These results will be very helpful in the mass spectrometric data analysis of proteomic study.