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.

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 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.

Objective To investigate the effect of lineal polypeptide injection on immune function of severe sepsis patients in ICU.Methods 40 severe sepsis patients in ICU were randomly divided into two groups after signed the consent form:the treatment group (20 cases)and the control group (20 cases).On the 1st day of antibiotic therapy, the patients in the treatment group were simultaneously treated with lineal polypeptide intravenous injection,while the patients in the control group received the same routine treatment,but without lineal polypeptide injection,all with a 10 days treatment course.Blood bacteria culture and drug sensitivity test were completed after entering the hospital. The scores of Sequential Organ Failure Assessment(SOFA)before treatment and at day 3,7 and 10 of therapy were evaluated.The peripheral blood of patients was taken and send to the clinical laboratory.The WBC,NEU%,PCT, hs -CRP,IL -6,total T lymphocytes (CD +3 )and T lymphocyte subgroup (CD +4 ,CD +8 ,CD +4 /CD +8 )were detected in both the treatment group and the control group.Adverse drug events were also detected in the process of therapy. Results Compared with before treatment[(5.56 ±2.03)points],after 7 days of lineal polypeptide therapy,the SOFA score of the treatment group[(3.48 ±1.83)points]decreased significantly(t =2.793,P <0.05),and after 10 days therapy,the descending degree in the treatment group was more significantly and declined earlier than the control group (t =4.401,P <0.01 ).In the aspect of improving the inflammatory markers,two groups were all improved after therapy,but the degree of improvement in the treatment group was better than the control group.After 7 days therapy,IL -6 level was (37.61 ±7.51)mg/L in the treatment group,while (50.49 ±7.68)mg/L in the control group (t =1.969,P <0.01),and the improvement of NEU% was not found in control group.In the aspect of improving the immune function,the CD +3 ,CD +4 ,CD +4 /CD +8 ratios were increased significantly [before therapy:(41.27 ±6.91)%,(19.65 ±5.29)% and (0.96 ±0.42);after 3 days therapy:(46.57 ±7.11 )%,(24.99 ± 7.70)%,(1.27 ±0.39)],and CD +8 [before therapy:(25.62 ±5.18)%,after 3 days therapy:(23.51 ±3.19)%] was decreased dramatically after 3 days of lineal polypeptide injection treatment,there was significant improvement in time and degree in the treatment group compared with the control group (t =1.390,t =1.407,t =3.974,t =2.081, all P <0.05).No severe adverse drug events were found.Conclusion As an immune modulator,lineal polypeptide injection could effectively improve the immune function of severe sepsis patients in ICU.

Objective To investigate the dynamic changes of the contents of brain water and Ca,Fe,Cu,Zn,Mg and microvascular damage in hippocampal tissue of radiation-injured rat brain.Methods The rats were randomly divided into control group,protective group (with intraperitoneal injection of 10％ MgSO4,400 mg/kg body weight + a single dose of 20 Gy electron beam irradiation in whole brain) and irradiation alone group (with intraperitoneal injection of normal saline,400 mg/kg body weight + a single dose of 20 Gy electron beam irradiation to the entire brain) with 18 rats assigned to each group and 3 rats sampled at each time point.Radiation-induced brain injury (RBI) was modeled by irradiating the rat' s whole brain with 5 MeV electrons.A dry-wet weight method was used to detect brain water content (BWC),and the level of microvascular damage was detected with HE staining of brain tissue slices,and the contents of Ca,Fe,Cu,Zn,Mg in hippocampus were detected with inductively coupled plasma atomic emission spectroscopy at different time points after radiation.Results BWC in the irradiated rats at 7,14 and 30 d post-irradiation was higher than that of control group (t =3.21,-2.11,2.82,P ＜0.05),andBWC in the protective group was less than that in the irradiated group (t =2.84,4.33,1.90,P ＜ 0.05).Microvascular thrombosis was induced in the radiated brain but this thrombosis was reduced by MgSO4.Thecontents of Ca and Fe in the brain tissue after 1,3,7 d of irradiation was higher than that of control group(t =11.41,6.81,14.03,17.17,6.89,9.12 and 5.43,5.66,3.60,P ＜ 0.05),and the content of Cain the protective group at various time post-irradiation was less than that in the irradiated group (t =5.35,5.28,11.02,14.26,5.68,9.10,P ＜0.05).The content of Cu (1,7,14,60 d post-irradiation) andZn (1,7,14,30,60 d post-irradiation) of the irradiated group was less than that of the control group(t =4.24,3.76,4.76,3.86 and 5.25,4.78,26.53,6.67,11.37,P ＜ 0.05),and the content of Cuin the protective group at different time points post-irradiation was less than that of the irradiated alonegroup (t =4.23,3.57,4.01,4.73,3.78,3.44,P ＜0.05),the content of Zn in the protective group(14 d post-irradiation) was higher than that of the irradiated group (t =6.21,P ＜ 0.05).The content ofMg in the irradiated group (7 d post-irradiation) was less than that of the control group (t =5.85,P ＜0.05).Conclusions The contents of Ca,Fe,Cu and Zn were imbalanced in the radiation-injured ratbrain,and the supplement of MgSO4could recover the balance of Ca,Fe,Cu and Zn content and alleviateradiation-induced brain injury.

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 observe the efficacy of 810 nm diode laser therapy for keratosis follicularis.Methods A total of forty-eight patients with keratosis follicularis were treated by 810 nm diode laser,energy range from 9 to 10 J/cm2,frequency 10 Hz,pulse width 400 ms.Treatments were carried out in three times at 8-week intervals,and clinical efficacy was evaluated after third treatment (6 months).Results The total effective rates of keratosis follicularis were 91.7％.With the increase of the number the curative effect were obviously improved.The treatment effective rate was 52.1％ (25/48) for the first time.The treatment effective rate was 75.0％ (36/48) for the second time.And the third time was 91.7％ (44/48).the patients skin texture was obviously improved in the six-month of follow-up except adverse reaction appeared in five patients in the short term.Conclusions 810 nm diode laser is safe and effective for keratosis follicularis.