To establish the PBL designed experiment teaching model and to evaluate its teaching effectiveness.we use the questionnaires and the experiment skill test and the experiment content related written examination and the theoretic examination to evaluate its teaching effectiveness. The PBL group is significantly higher in the comprehension and the synthesizing ability and so on than the control group (P<0.05). The PBL group has significantly higher mean scores in the experiment content related written examination than the control group (P< 0.01). The PBL group has significantly higher scores in the theoretic examination than the control group (P< 0.01). The PBL designed experiment teaching can better train students for the innovative thinking ability and the scientific research capabilities.

Objective To investigate the clinical roles of lysine methyltransferase 5A(KMT5A)in human hepatocellular carcinoma(HCC)and its functions in cell migration and invasion. Methods The expression levels of KMT5A of 60 cases were detected by immunohistochemistry(IHC). KMT5A siRNA was used to down-regulate the expression of KMT5A in SMMC-7721 cells. Cell migration and invasion were measured by wound healing assays and transwell assays,respectively. Immunoblotting was used to detect the expression of MMP-2 after siRNA trans-fection. miR-186 mimics were transfected into SMMC-7721 cells and the mRNA levels of KMT5A was detected by qRT-PCR after transfection. Results High expression of KMT5A was associated with large tumor diameter (>5 cm,P=0.047)and advanced TNM stage(Ⅲ+Ⅳ,P=0.035). The expression of KMT5A was knocked down by siRNA in SMMC-7721 cells. Down-regulation of KMT5A suppressed cell migration(P=0.031,P=0.006)and invasion(P=0.010),and impaired MMP-2 expression(P=0.040). Overexpression of miR-186 could significantly inhibit the expression of KMT5A(P = 0.007). Conclusions Over-expression of KMT5A in HCC tissues associ-ates with poor clinical features. KMT5A knockdown inhibits the migration and invasion on HCC cells.

Problem based learning(PBL) pedagogy has been widely used in medical teaching process.But how to best use and develop PBL teaching,many universities try actively.According to PBL philosophy and the disciplines characteristics,the department of Pathophysiology in Central South University designed and carried out CPBL(Case and Problem Based Learning,CPBL) pedagogy.From the perspective of students,the authors have compared the CPBL pedagogy with PBL pedagogy in other academies,and make some positive recommendations.

Objective Based on the published articles,this paper aims to study the pattern and probability of lymph nodes metastasis in nasopharyngeal carcinoma (NPC) and establish a radiotherapy standard for selecting and delineation of clinical target volume of neck lymphatics for NPC patients with N0 or N1.Methods Clinical trials about NPC by MRI as the main or only diagnostic imaging way were collected and extracted from database,such as WanFang,CBM,PubMed,Cochrane Library.Statistical analyses were performed using Stata software,version 12.0.Results Twenty-one clinical trials from 963 original articles were included in this analysis.The most commonly involved regions included retropharyngeal (67％) and level Ⅱ lymph nodes (71％).The overall probability of levels Ⅲ,Ⅳ and Ⅴnodal involvement were 37％,14％ and 21％,respectively.Low-risk node groups included levels ⅠA,ⅠB,Ⅵ nodes,and the rates of lymph node metastasis were 0,2％,2％ and 1％,respectively.Nodal metastases followed an orderly pattern of top-down,and the probability of skip metastasis between levels varied between 0.5％ ～7.9％.Conclusion Lymph node metastasis in NPC follows a predictable and orderly pattern.The rarity of metastasis in certain nodal groups andskip metastasis suggest that reduced treatment volume is feasible in conformal radiotherapy for NPC patients with No or N1.

Objective To research the distribution and the characteristics of the plasmid mediated quinolone resistant genes in Shewanella algae. Methods The qnr, qepA, aac(6')-Ib-cr genes were amplified by PCR, then the positive PCR products were sequenced to determine the gene type. The transferability of plasmid mediated quinolone resistance was ensured by conjugation experiment. MICs were measured by E-test. qnrA gene was mapped to plasmids to locate it. Results The qnrA gene were detected in the Shewanella algae, this is a newfound subgroup qnrA7, the GenBank accession no. was GQ463707, qnrB, qnrS,qnrC, qnrD, qepA and aac(6')-Ib-cr genes were not detected. qnrA7 reside in a plasmid about 33 kb, conjugation experiment was unsuccessful. The strain was susceptible to quinolones. Conclusion It deserves paying close attention to the report of an original qnrA subgroup in an isolate of water-borne species of Shewanella algae.

OBJECTIVETo objectively evaluate the clinical efficacy, safety and technical operating standard of percutem clamp fixation (PCCF), an operation designed by imitating bone setting method of TCM, in treating unstable tibiofibular fracture (UTF).

METHODSA prospective controlled multicentre clinical study was carried out on 200 patients with UTF, they were assigned to the treated group (99 cases) treated with PCCF and the control group (101 cases) treated with unilateral multifunctional external fixator (UMFEF).

RESULTSPCCF showed better effects than UMFEF in reducing the time of fixing operation and healing time; and the immediate effect after removing the fixating apparatus and long-term efficacy as well as safety in the treated group were also superior to those in the control group (P < 0.01).

CONCLUSIONIt is convenient, safe and effective to treat UTF by fixation with percutem clamp.

Adolescent ; Adult ; Female ; Fibula ; injuries ; Fracture Fixation ; methods ; Fractures, Bone ; therapy ; Humans ; Male ; Middle Aged ; Multiple Trauma ; therapy ; Prospective Studies ; Tibial Fractures ; therapy ; Treatment Outcome

Objective To understand the prevalence of negative life events and its association with depressive, anxiety symptoms and dissatisfaction of school life among middle school students in Shaoxing, and to provide scientific evidence for further interventions. Methods A total number of 3 197 students (including 1 134 urban and 2 063 town adolescents) were recruited from 2 middle schools in Shaoxing, their average age was (13.73 ± 1.03) years. The Multidimensional Life Events Rating Questionnaire for Middle School Students (MLERQ), Depression Self-rating Scale for Children (DSRSC) and Screening for Child Anxiety Related Emotional Disorders (SCARED) were used to assess the mental health status, while the school life satisfaction was evaluated by the School Life Satisfaction Rating Questionnaire for Adolescents (SLSRQA), and the data were analyzed by descriptive statistics and multivariate logistic regression models. Results The prevalence of the negative life events was 84.9%, unsatisfactory examination performance (48.6%), unreached the teacher's expectation (46.2%), parental chatter (41.4%), unbalanced learning (37.9%), and getting parents scold (27.6%) constituted the main negative life events. The prevalence of depressive symptom, anxiety symptom, and dissatisfaction of school life were significantly higher among middle school students living with negative life events (41.1%, 22.6%, 26.0%) than those without negative life events (20.9%, 3.5%, 16.5%), (?2=71.33, 94.78, 19.83, P<0.001). The prevalence of the psychosomatic health involvement significantly increased with the increase of the number of the dimensions and events (P<0.001). The multivariate logistic regression showed that negative life events were the risk factors of depression, anxiety and dissatisfaction of school life. Their OR values were 2.483 (1.951-3.160), 7.245 (4.411-11.899) and 1.733 (1.325-2.267), respectively. The risk of occurring mental symptoms among children with the number of dimensions≥4 and/or the number of events≥12 was two times higher than those of children without such increase in numbers of dimensions and events. Conclusion The status of negative life events is serious among middle school students in Shaoxing. There are statistical associations between negative life events and mental symptoms.

Objective Pathogens from the nosocomial infection have been analyzed by MALDI‐TOF microbial identification system ,to evaluate mass spectrometry analysis advantage and explore the mass spectrometry method .Methods The pathogens have been analyzed by MALDI‐TOF microbial identification system ,by compared with the VITEK‐2 compact detection in the tes‐ting time ,detection rate and the amounts of identified strains .The homology differences have been analyzed by comparison calcula‐tion of common peaks from the fingerprint spectrums .Results Thirty‐one Escherichia coli strains ,28 Klebsiella pneumonia strains and 9 unusual pathogen strains have been identified by MALDI‐TOF MS for only 1 hours .It has more advantages than VITEK‐2 in the testing time and other aspects .Conclusion Nosocomial infection of pathogen shows a point source propagation mode centering on the department .MALDI‐TOF mass spectrometry is able to rapidly and correctly identify the pathogen .MALDI‐TOF microbial i‐dentification system is expected to be the major detecting technique in the field of the pathogen monitor and resistance monitoring a ‐nalysis .

Objective:To analyze the change of bone mineral density (BMD) in postmenopausal women,and to study the relationship between BMD and the estrogen,cytokines,and serum levels of bone metabolism.Methods: 135 postmenopausal women were divided into the OP group (n=54),Osteopenia group (n=43) and normal group (n=38) according to the results of lumbar spine bone mineral density (BMD) scan.To detected the concentration of serum estradiol (E2),bone alkaline phosphatase (BALP) and osteocalcin (BGP),tartrate resistant acid phosphatase-5b (TRAP-5b),interleukin-6 (IL-6),tumor necrosis factor alpha (TNF-α),transforming growth factor beta (TGF-β1) and IL-10 of research objects in the three groups.And to analyze the relationship between BMD and the levels of E2,BALP,BGP,TRAP-5b,IL-6,TNF-α,TGF-β1 and IL-10.Results: In the OP group and the Osteopenia group,BMD and the levels of E2,TGF-β1 and IL-10 were obviously lower than that in the normal group (P<0.05),and the levels of BALP,BGP,TRAP-5b,IL-6 and TNF-α were obviously higher than that in the normal group (P<0.05).When compared with the Osteopenia group,the BMD and E2 level in the OP group was more lower (P<0.05),and the levels of BALP,BGP,TRAP-5b,IL-6 and TNF-α were more higher (P<0.05).E2 and TGF-β1 showed the significant positive correction with BMD (P<0.05),and the BALP,BGP,TRAP-5b,IL-6 and TNF-α were all negatively corrected with BMD (P<0.05).However,no significant difference of relevance was seen between IL-10 and BMD (P>0.05).The low serum E2 levels and high serum levels of BALP,BGP,TRAP-5b,IL-6 and TNF-α were the independent factors affecting the reduction of BMD (P<0.05).Conclusion: The E2 level in patients with PMOP decreased obviously,which caused the imbalance of bone remodeling and inflammatory reaction,and which was related to the decrease of BMD.

The misuse of toxic drugsisseriousone of the threats of public health. In this study, toxic Hyoscyami Semen and its adulterants were identified by DNA barcoding. The genomic DNA was extracted from 61 samples including Hyoscyami Semen and its adulterants by reagent kit method. Their ITS2 sequences were amplified, and purified PCR products were sequenced. Sequence assembly and consensus sequence generation were performed using CodonCode Aligner v 4.25. The genetic distances, variable sites and the neighbor-joning (NJ) phylogenetic tree were computed by MEGA 6.0 in accordance with the Kimura 2-parameter(K2P) model. The results showed that the intra-specific genetic distances of Hyoscyamusniger were 0.005 which were smaller than inter -specific ones (0.360) of H. niger and their adulterants. The NJ tree showed that H. niger was clustered into one monophyletic branch, and clearly separated with other species. Therefore, ITS2 sequence was able to identify Hyoscyami Semen and its adulterants to ensure the safty of medicines.