Some problems, such as the differences of intelligence and knowledge basis among the students, ambiguity of teaching goal and lack of proper textbooks for instrumental analysis as well as "double-teacher", should be solved urgently. The authors try to find out some solutions to them.

Heart Aneurysm ; mortality ; pathology ; surgery ; Humans ; Mitral Valve Insufficiency ; mortality ; physiopathology ; surgery ; Myocardial Infarction ; mortality ; physiopathology ; surgery ; Ventricular Dysfunction, Left ; pathology ; surgery

Animals ; Bile ; Carps ; Hemofiltration ; Humans ; Poisoning ; therapy

Objective To investigate the association of AcrAB-tolC efflux pump and marA-soxS-rob regulon with ciprofloxacin-resistance in Shigella flexneri isolates.Methods Forty five strains of Shigella flexneri were isolated in stool samples collected from outpatient diarrhea clinics in Tianjin from 2009 to 2013.The antimicrobial susceptibility of bacteria was analyzed by Kirby-Bauer disk diffusion method.Ten ciprofloxacin-resistant Shigella flexneri isolates and 10 ciprofloxacin-sensitive isolates were randomly selected.The gyrA and parC genes,plasmid mediated quinolone resistant (PMQR) determinants,efflux pump genes (acrA,acrB) and regulation genes (marA,soxS,rob) were screened and sequenced.Minimum inhibition concentrations (MICs) of the strains were determined before and after efflux pump inhibitor carbonyl cyanide m-chlorophenylhydrazone (CCCP) was added.The expression of acrA,acrB,marA,soxS and rob genes in ciprofloxacin-resistant and ciprofloxacin-sensitive strains was detected by realtime fluorescence quantitative RCR (RT-PCR),and the differences of expression were evaluated using t test.Results Both gyrA and parC mutations were detected in all ciprofloxacin-resistant strains; qnrS1 was positive in ciprofloxacin-resistant strain CR2 and aac(6')-Ib-cr was positive in ciprofloxacin-resistant strain CR5.Efflux pump genes and regulation genes were not detected in ciprofloxacin-sensitive strains,while soxRS mutation was detected in all ciprofloxacin-resistant strains except CR10.MICs of quinolones in ciprofloxacin-resistant strains decreased to one-fourth or one-eighth when CCCP added,while not changed or only decreased to one-half in ciprofloxacin-sensitive strains.Expressions of acrA,acrB,marA and soxS were significantly higher in ciprofloxacin-resistant strains than those in ciprofloxacin-sensitive strains (P ＜ 0.05 or P ＜ 0.01).Conclusion Efflux pump may involve in the high-level ciprofloxacin resistance in Shigella flexneri through activating transcription of efflux pump genes by marA-soxS-rob regulon,in which soxRS mutation may play an important role.

AIM: To evaluate the clinical effect and the rotational stability of AcrySof Toric intraocular lens ( IOL ) implantation to correct preexisting corneal astigmatism in cataract surgery.
METHODS: Twenty-three patients ( 28 eyes ) were enrolled from the department of ophthalmology in the first Affiliated Hospital of Nanjing Medical University. All patients underwent similar phacoemulsification procedure combined with AcrySof Toric IOL implantation from June 2012 to December 2013. The uncorrected visual acuity ( UCVA ) , best corrected visual acuity ( BCVA ) , anticipated residual astigmatism, postoperative residual astigmatism, and Toric IOL axis were detected and measured.
RESULTS:Three months after operation, the UCVA of all eyes were 0. 75±0. 16 and the BCVA were 0. 84±0. 15, there was no significant difference between UCVA and BCVA ( t = 1. 036, P>0. 05 ). The anticipated residual astigmatism was ( 0. 28±0. 12 ) D. The actual residual astigmatism after 3mo of the operation was (0. 42±0. 17) D. There was no significant difference between anticipated and actual residual astigmatism (t=1. 259, P>0. 05). The mean axis rotation of Toric IOL was 3. 02o±1.56o (0o-7o) after 1d of operation and 3. 28o±1. 85o (0o-7o) after 3mo. Among all the eyes, 25 eyes ( 89%) rotated <5o, in 3 eyes (11%) rotated 5o-7o.
CONCLUSION: The AcrySof Toric IOL implantation shows good effectiveness, predictability and stability in correcting pre-existing astigmatism in cataract patients.

Objective To study the imaging findings and patholoical characterizes of chondromyxoid fibroma in order to improve its differential diagnosis.Methods 8 cases with chondromyxoid fibroma had all proceeded x-ray checked before operation. Of these cases , 4 cases were examed by CT scan .All cases were confirmed by operation and pathology. The imaging findings and pathological characterizes were analysed.Results The lesions located at metaphysis of long bone and presented as a round or elliptic transparent area which were consistent with long axis of involved bone. There were osseous crests inside the lesions and sclerosis bone around the lesions. The density of lesions was homogeneous and CT numbers were about 26 HU. On histopathology,lesions presented grey. Lobular and some what transparent . In the center of lesions there were a lots of mucus and stellate cells. The lesions were surrounded by hyperplastic area including multinuclear giant cell and chondroblast fibroblast. Conclusion chondromyxoid fibroma has characterizes on imagiology and pathology , but it has often been misdiagnosed.

Polycystic ovary syndrome (PCOS) is a common syndrome in adolescent women and women of reproductive age. Main manifestations are oligomenorrhea, anovulation, polycystic ovarian, and hyperandrogenism with metabolic abnormalities such as dyslipidemia, insulin resistance, and glucose intolerance. PCOS can lead to type 2 diabetes mellitus, cardiovascular diseases, and endometrial cancer, which seriously threat the health of women. The pathogenesis of PCOS is not clear. Over 60% of women with PCOS are obese or overweight. Appetite and energy intake regulation plays an important role in body weight management. Nutrients are mainly digested and absorbed in gastrointestinal track, which is also one of the largest endocrine organs in human body. Special endocrine epithelial cells in stomach, proximal small intestine, and distal small intestine can secrete ghrelin, CCK, GLP-1, and PYY, which involve in the regulation of appetite and are also known as appetite regulating hormones. This review focuses on changes in the secretion of gastrointestinal hormones and related weight loss treatment in patients with PCOS.

To construct a cDNA library of gerbil′s cochlea, the mRNA was separated from the cochlea of gerbil and the first strand cDNA was synthesized through reverse transcription by a modified oligo(dt) primer. The double strand cDNA was amplified by Ld pcR. After cDNA size fractionation , the ds cDNA was ligated in the ? TripIEx2 vector . The cDNA library was identified with special primers of prestin genes of cochlea by PCR .The results showed that the titer of library was 1.8?10 6 pfu and the percentage of recombinant clones was 80% . Prestin gene was contained in the library , the size of the fragment was 863bp . The results suggest that the established cDNA library has a high titer, recombinant percentage and large insert fragments of genes . The study lays the foundation of molecular biological study of the cochlea.

Objective To explore motivation alteration influencing factors of internet addiction disorder (IAD) undergraduates.Methods The study sampled randomly 793 undergraduates from China University.According to CIAS-R and Young's internet addiction diagnostic criteria,a total of 37 internet addicts were selected.Internet addiction survey was used to study the motivation alteration influencing factors of IAD undergraduates.Results (1) The negative effect of internet using on academy,personal relationship etc.(damage from internet using) had a significant positive correlation with motivation alteration (r =0.672,0.699,0.658,P ＜ 0.01 ; r =0.653,0.673,0.628,P ＜ 0.01 ; r =0.604,0.681,0.703,P ＜ 0.01).(2) Benefit from psychological satisfactory level of internet using had no significant difference with motivation alteration.(3) Self-efficiency of behavioral control on using internet had a significant negative correlation with motivation alteration (r =-0.397,-0.370,P ＜0.05).Conclusion The motivation alteration of IAD undergraduates is influenced by the factors of damage from internet using,sense of achievement,self-efficiency of behavioral control on using internet and so on.