Objective To explore the value of applying personalized medicine in the clinical teach-ing of glioma surgery. Methods Totally 80 7-year program undergraduates were divided into experimental class and control class randomly, with 40 cases in each group. The experimental class received personalized medical teaching through introducing idea and method of personalized medicine. The control class received conventional teaching. The effect of teaching was evaluated by questionnaire and examination. The data were analyzed through Chi-square and t-test test. Result Questionnaire survey of satisfaction showed that 37 students of experimental class (92.5%) were interested in the new course. Questionnaire survey of teaching effect showed that in experimental class 36 students (90%) felt it could increase learning interest, 37 students (92%) believed it improved glioma diagnosis and treatment, 34 students (85%) felt their medical view ex-panded, 38 students had consolidated clinical thinking, and 32 students (80%) improved negotiation with patients. All issues were significantly better than control class (P<0.05). Meanwhile, statistical difference was found in average score between experiment class and control class [(88.71 ±6.54) vs. (76.49 ±7.32)] (P=0.000). Conclusion The introduction of personalized medicine concept helps medical students to make personalized diagnosis and treatment plan for glioma patients, and is conducive to the cultivation of their clinical thinking ability and evidence based medicine concept, which is worthy of promotion.

The knowledge absence of neurosurgical regional anatomy is the major shortcoming which makes seven-year program medical students feel difficult in studying neurosurgical special course.The reasons for this phenomenon include the limited teaching time for basic medical course and the continuous progress in the field of neurological anatomy.The teacher should make good use of clinical resources to carry on the additional teaching of neurosurgical regional anatony.The detailed plans include small-class teaching and individual case analysis using the data of neuroimaging and angiography of the brain and spinal cord.All these measures are intend to let the students grasp of the basic knowledge clinical neurosurgery during the internship and make the smooth transition from interns to doctors,providing references for other department.

Objective To evaluate the analytical performance of 7 homogeneous HDL-cholesterol reagents. Methods An altracentrifugation-HPLC method was used as the comparison method. Fourty fresh patient samples were analyzed by homogeneous methods and the comparison method. The homogeneous methods were all performed on a Hitachi 7170A chemistry analyzer according to the manufacturer's instructions, Precision, accuracy and total errors were analyzed. Results The homogeneous assays typically demonstrated within run coefficient variance(CV) of < 1%, and total CV of < 3%. Methods A, B and D showed average bias, bias at the medical decision points and total errors all within the NCEP performance criteria and method C and F unacceptable biases (-19.74% and 11.46%, respectively) and total errors according to the NCEP criteria. However, all the homogenous methods (A-F) had total errors of < 30%, as required by the US Clinical Laboratory Improvement Amendment (CLIA). Conclusions Homogeneous HDL-C assays have been shown to be reasonably precise, but discrepant results have been observed with some of the assays. Clinical laboratories should pay more attention on selecting and validating homogeneous HDL-C reagents.

Objective To investigate the efficacy and feasibility of combination of leflunomide and clopi-dogrel in the treatment of IgA nephropathy. Methods 84 patients with primary IgA nephropathy were randomly divided into four groups: Control group (group 1) received valsartan; test group (group 2) received valsartan +clopidogrel; group 3 received valsartan + leflunomide; group 4 received valsartan + clopidogrel + leflunomide. The level of 24 h urinary protein,serum creatinine, glomerular filtration rate and therapeutic efficacy, adverse reactions were detected and recorded during the 48 weeks follow-up. Results The 24 h urinary protein of 84 patients showed a downward trend during the course of treatment , but there were statistical differences between groups since 8 weeks after treatment (P < 0.05). The level of urine protein in group 3 and group 4 decreased significantly to 61.48% and 67.23% respectively in 48 weeks after treatment. At the end of the follow up , the serum creatinine levels in group 1 and group 2 significantly increased while the glomerular filtration rate de-creased obviously (P < 0.05). Conclusion The combination of leflunomide with clopidogrel could reduce the level of urinary proteins and slow renal function deterioration in the treatment of IgA nephropathy with less ad-verse reactions. This study provides a new idea for treatment of IgA nephropathy.

Objective To obtain a novel tool-enzyme for genetic engineering with good solubility,strong specificity of enzyme digestion and maintaining the enzyme activity at low temperature by using E.coli expression system to express self-processed re-combinant MBP-HRV 3C fusion protease.Methods The cDNA encoding HRV 3C protease was cloned into pRSF-Duet vector.The recombinant plasmid was transferred into E.coli BL21 (DE3)for expression.HRV 3C protease was obtained through Nichol col-umn affinity purification.The cleavage activity of HRV 3C protease was determined by in vivo experiment.Results HRV 3C prote-ase was highly expressed in E.coli expression system,and the obtained HRV 3C protease could recognize and digest HRV 3C site. Conclusion A novel tool-enzyme for genetic engineering is obtained.

Objective To evaluate the value of electrospun polymethyl methacrylate (PMMA) nanofibers with different topological structures as scaffolds for growth of Schwann cells (SCs).Methods Electrospun PMMA nanofibers with random or aligned topological structures were fabricated and measured with biocompatibility.Lentivirus-transfected green fluorescent protein was used as the reporting gene to monitor form and growth manner of SCs on different substrates and dependency of cell body and process with fiber structure,with PMMA thin films served as the control.Results Electrospun PMMA nanofibers revealed good biocompatibility and could exert contact guidance to the growth of SCs.Topological structures of the electrospun nanofibers influenced cell morphology.SCs were aligned with the orientation of substrate fibers and form longer cell process when growing on aligned nanofibers (P ＜0.01).Primary SCs preferred to follow the cue of aligned nanofibers compared to random fibers.Conclusion Aligned electrospun PMMA nanofibers have the potentiality as transplantable scaffolds for loading SCs after neural injury.

To improve the quality control of private hospital is urgent in China. Through the visiting to International Neuroscience Institute, Hannover, Germany, the author analyzed the advantages of Germany Medical System, and provided several beneficial aspirations for Chinese Medical System Reformation, including sound Medical Insurance System, efficient quality control based on information platform, powerful government and civilian regulator, elastic Salary Administration, and high self-discipline of medical staff.

OBJECTIVES: The aims of this study were to update the latest data on the prevalence of hypertension (HTN) in the elderly Chinese population and to assess relationships between new anthropometric indices and HTN. METHODS: Data were obtained from the Basic Public Health Service (BPHS) survey for Jiangsu Province, China. A total of 944,760 people aged 65 years and older were included in this study. Blood pressure was measured by trained investigators. Body weight, body mass index (BMI), waist circumference (WC), waist-to-height ratio (WtHR), conicity index (COI), body roundness index (BRI), and a body shape index (ABSI) were included in the analysis as anthropometric indices. Logistic regression analysis and restricted cubic splines were used to evaluate the association of anthropometric indices with HTN. RESULTS: The prevalence of HTN among elderly residents of Jiangsu Province was 64.7% (95% confidence interval, 64.6 to 64.8). After adjusting for multiple covariates, all anthropometric indices except ABSI showed significant non-linear positive dose-response associations with HTN across sex (pnonlinear<0.001). Among participants with BMI <28 kg/m2, abnormal weight, WC, WtHR, BRI, COI, and ABSI were positively associated with HTN. CONCLUSIONS The prevalence of HTN in the elderly in Jiangsu Province is gradually increasing. It is necessary to consider the combination of ABSI and COI with BMI for screening elderly individuals for HTN in follow-up prospective studies.

Objective To investigate the effect of lumboperitoneal (L-P) shunt and ventriculoperitoneal(V-P) shunt for trea-ting the patients with communicating hydrocephalus .Methods The databases of PubMed ,Web of Science ,Scopuss ,Karge , EBSCO+MEDLINE ,OVID ,EMBASE ,CNKI ,CBM disc databases ,Wanfang databases ,Weipu databases were retrieved by com-puter .The relevant literatures about L-P shunt and V-P shunt for treating communicating hydrocephalus included in these databases during 1990-2016 were collected and performed the meta analysis by using the STATA 12 .0 software .Results The success rate of L-P shunt in treating communicating hydrocephalus was apparently higher than that of V-P shunt(P<0 .05) .Moreover ,postopera-tive infection rate ,obstruction rate of shunt system and total postoperative complications rate in L-P shunt were apparently lower than those of V-P shunt(P<0 .05) ,However ,there was no statistical difference in shunt poor rate between L-P shunt and V-P shunt(P>0 .05) .Conclusion L-P shunt is worth recommending .But due to lower quality of the evidences ,it is needed more high quality primary studies to remedy the insufficiency of the study .

OBJECTIVETo evaluate the impact of the topographic features of electrospun polymethylmethacrylate (PMMA) nanofibers on growth pattern of primary rat astrocytes.

METHODSRat astrocytes were cultured on fabricated random and aligned electrospun nanofibers. Using PMMA film as the control, the cells were transfected with a lentivirus harboring GFP gene to reveal the cell growth pattern on different substrates.

RESULTSoth random and aligned electrospun PMMA nanofibers could support the growth of rat astrocytes, but the topographic features of the fibers significantly affected their growth pattern. On aligned nanofibers, astrocytes extended long cell processes along the direction of the substrate fibers, and on random fibers the astrocytes formed shorter processes. On merged images of GFP expressions and substrate fibers, the cell processes of the astrocytes were shown to adhere to and elongate along the fibers both on random and aligned nanofibers.

CONCLUSIONThe topographic features of PMMA nanofibers can significantly influence the growth pattern of primary rat astrocytes. Aligned electrospun nanofibers has the potential to serve as scaffold material for reducing glia scar formation after spinal cord injury.