Laboratory diagnostics is an important discipline functioning as a bridge between basic and clinical medicine and it is closely associated with the diagnosis of clinical physician.But there are some problems in the laboratory diagnostic teaching including unreasonable curriculum standard,simple teaching method and unpractical theory.This paper explored and summarized the problems and the reform of laboratory diagnostics teaching mode for students of clinical medicine.

Objective In this paper,we aimed at discussing the impacts of follow-up nursing on treatment compliance and lung function of patients with chronic obstructive pulmonary disease(COPD)during the rehabilitation period after discharge.Methods COPD patients(68 cases)were divided randomly into the intervention group and the control group with 34 cases in each group.We gave the intervention group follow-up nursins during the ensuing 6 months after discharge to give them guidance on health problems in order to promote the treatment compliance of patients.On the contrary,the control group did not take any follow-up nursing.Six months later,we conducted an evaluation of the tmalment compliance and amelioration of lung function in the t wo groups.Results As a result,six months after discharge,the patients'treatment compliance status and lung-function indicators in the intervention group were significantly better than those of the control group(P＜0.01).Conclusions The follow-up nursingcan promote the COPD patients'treatment compliance status and amelioration of lung function during the rehabilitation period.

Objective To investigate the effect of early nutritional support on the growth and immature retinal vessels of very low birth infants.Methods Total 360 infants, admitted to our hospital from January 2003 to December 2013, who were born with birth weight lower than 1500g, without congenital malformation, being hospitalized for at least two weeks and safely discharged, were recruited.They were divided into 2 groups according to their time of hospitalization.200 infants ad-mitted from January 2010 to December 2013 were involved as group A and were given amino acid [ initial dose 1.6g/( kg· d), increased at 1.0 g/(kg· d)]in 12 h after birth and fat emulsion [initial dose 1.0 g/(kg· d), increased at 1.0 g/(kg · d) ] in 24 h after birth.168 infants admitted from January 2003 to December 2009 were involved as group B and were giv-en amino acid [initial dose 0.5 g/(kg· d), increased at 0.5 g/(Kg· d)] in 12~24 h after birth and fat emulsion [initial dose 0.5 g/(kg.d), increased at 0.5 g/(kg· d)] in 24h after birth.General condition at birth, enteral and parenteral nu-trition intake, growth parameters, retinal vessels development and other complications between two groups were retrospectively compared.Results No statistically significant differences(p>0.05) were found in gestational age, gender, general condi-tions at birth, faster time, average growth rate of Length and heat circumference, occurrences of complications, such as re-spiratory distress syndrome (RDS), necrotising enterocolitis (NEC), periventricular-intraventricular hemorrhage(PVH -IVH), parenteral nutrition associated cholestasis, infection, and the duration of oxygen therapy and mechanical ventilation between the groups.Group A compared to Group B, had less weight decrease [(6.12 ±1.15) vs (8.85 ±2.35)%, p =0.032]) ] and less time to regain birth weight [(9.0 ±3.5 ) vs (12.5 ±4.5) d ]and to reach 120 kCal/(Kg· d)[(10.02 ±4.99) vs (14.79 ±6.04) d,p=0.029)], had higher average weight growth rate after regain birth weight[(20 ±5.2 ) vs (14.1 ±4.6) g/(Kg· d)], had shorter hospital stay[( 30.9 ±10.5 ) vs ( 40.5 ±13.5) d ] and lower rate of immature retina at gestational age 34 weeks and retinopathy of prematurity(ROP).These comparisons were all statistically significance ( p<0.05 ) .Conclusion Early nutritional support can improve the growth velocity and visual function of very low birth weight infants, and reduce the incidence of immature retina at gestational age 34 weeks and retinopathy of prematurity (ROP), shorten hospital stays, and had no influence on the occurrences of other complication.

Hepatic ischemia-reperfusion injury,a relatively common phenomenon in clinical pathophysiology, is one of the currently difficult and hot issues in liver surgery and liver transplantation clinical studies. p38 mitogen activated protein kinases are activated in a variety of diseases and stress conditions. p38 signaling pathway activation is one of the important mechanisms leading to hepatic ischemia-reperfusion injury. This article reviews the roles and mechanisms of P38 signaling pathway recently years in the liver ischemia reperfusion injury.

In order to improve the teaching quality of experimental teaching of laboratory diagnosis and to cultivate the clinical ideation of medical students,we have been trying a series of reform in this course and obtained good results.Here,our experience in the selection of teaching contents,the improvement of teaching methods,and the setting of experimental assessment have been summarized and investigated.

AIM　To assess the pharmacokinetic profile of single doses of meloxicam in healthy Chinese volunteers. METHODS　The plasma concentrations of meloxicam after an oral dose of 15 mg to twenty healthy male volunteers were analized by means of a validated HPLC method. The pharmacokinetic parameters were subjected to Shapiro-Wilk test to determine whether these data were fitted to a normal distribution. RESULTS The twenty volunteers can be classified into extensive metabolizers and poor metabolizers according to pharmacokinetic parameters. The main parameters in the two groups obtained were as follows: T1/2 were 21±4 and 38±9 h, AUC0-∞ were 49±10 and 110±8 μg*h*mL-1, respectively. Even the AUC data in extensive metabolizers were 1.7 times as that reported in White volunteers following the same doses of meloxicam. CONCLUSION　There were significant individual differences in the pharmacokinetics of meloxicam in Chinese volunteers, which may be due to the genetic polymorphism of CYP2C9.

Objective To investigate the effect of remote ischemic preconditioning on myocardial infarction and the involved protective mechanisms. Methods Twenty-four male SD rats were randomly divided into four groups: ischemia-reperfusion (I/R) group, rote ischemic preconditioning (RIPC) group, remote ischemic preconditioning + ischemia-reperfusion (RIPC+I/R) group, and RIPC+AG490+I/R group. The blood samples and myocardial specimens were collected and prepared for tests. The related enzymes were detected and the size of myocardial infarction was measured. The cardiac cells were determined by electron microscopy and light microscopy. Results The size of myocardial infarct and myocardial enzymes were significantly reduced in RIPC+I/R group compared to those in I/R group (P < 0.05). The size of myocardial infarction and myocardial enzymes were significantly increased in AG490 group compared to those in RIPC+I/R group (P < 0.05), but were significantly reduced in AG490 group compared to those in I/R group (P < 0.05). Conclusions Remote ischemic preconditioning may be effective in cardioprotection. The JAK/STAT pathway is involved in the cardioprotection of remote ischemic preconditioning.

Objective To investigate the clinical therapeutic effect of Xuebijing injection for treatment of patients with diabetic nephropathy(DN)and its mechanism. Methods 60 DN patients were randomly divided into Xuebijing group and control group(each,30 cases). The patients in both groups received western conventional treatment,and the patients in Xuebijing group received additionally Xuebijing injection intra-venous injection once a day for 14 days. The fasting blood glucose(FBG),glycosylated hemoglobin(HbA1c),urinary albumin excretion rate(AER),blood urea nitrogen(BUN),serum creatinine(SCr),hematocrit(HCT),fibrinogen(Fg),whole blood viscosity,total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)and interleukin -6(IL-6),tumor necrosis factor-α(TNF-α)and urine β2-microglobulin(β2-MG)levels before and after treatment were detected,and the curative effect was also observed in both groups. Results In the control group blood FBG,BUN,SCr,TC,IL-6 and TNF-αafter treatment were significantly decreased and HDL-C significantly increased compared with those before treatment(all P<0.05). Compared with those before treatment,in Xuebijing group after Xuebijing therapy,blood FBG,β2-MG,AER,BUN, SCr,TC,TG,HCT,blood viscosity,IL-6 and TNF-αwere significantly decreased,and HDL-C was obviously increased,but there were no significant differences in HbA1c,LDL-C and Fg before and after treatment. The above indexes were changed significantly in Xuebijing group compared with those in control group〔FBG(μg/L):6.98±1.14 vs. 9.73±1.62,β2-MG(μg/L):32.1±10.9 vs. 57.2±15.1,AER(μg/min):86.0±28.1 vs. 152.0±51.6,BUN (mmol/L):12.4±8.1 vs. 19.5±8.9,SCr(μmol/L):301.2±151.9 vs. 371.3±168.6,HCT:0.283±0.075 vs. 0.351±0.059,TC(mmol/L):3.4±1.8 vs. 4.1±1.5,TG(mmol/L):3.4±1.5 vs. 3.6±1.7,HDL-C(mmol/L):1.90±0.75 vs. 1.50±0.25, IL-6 (ng/L):8.96±2.07 vs. 12.75±2.47, TNF-α(pmol/L):17.85±4.75 vs. 20.87±4.90,P<0.05 or P<0.01〕. The total efficiency in Xuebijing group was significantly higher than that in control group(83.3%vs. 36.7%,P<0.01). Conclusion Xuebijing injection has significant protective effects on patients with DN,and the mechanism might be associated with increasing tissue perfusion and inhibiting excessive inflammatory cytokines release.

Objective To explore the application value of platelet parameters detection in early diagnosis of breast cancer.Methods Platelet parameters of intravenous blood from 103 breast cancer patients and 117 fibroadenoma patients within 24 hours of admission between January 2015 and December 2015 were collected and retrospectively analyzed,including platelet count(PLT),plateletcrit(PCT),mean platelet volume(MPV),mean platelet component concentration(MPC),mean platelet component mass (MPM),platelet distribution width(PDW),and compared with control group of 100 healthy women.The diagnostic efficiency of platelet parameters were assessed using receiver operating characteristic(ROC) curve.Results PLT and PCT in breast cancer group and fibroadenoma group were significantly higher than those in control group(P＜0.01);MPC,PMM and PDW were significantly lower than those in control group(P＜0.01);MPV had no significant statistically difference(P＞0.05).The levels of MPC in breast cancer group were obviously lower than that in fibroadenoma group(P＜0.01).The diagnostic efficiency of MPC in breast cancer had the highest area under curve(AUC=0.835).While the cutoff value of MPC was 249.5 g/L,sensitivity and specificity were 82.5 ％ and 73.6 ％,respectively.Conclusion The detection of platelet parameters,especially MPC,have certain application value in early diagnosis of breast cancer.

Aim To investigate changes of MAP2 expression level in rat hippocampal pyramidal cells induced by chronic stress, and to explore effects of tianeptine on them. Methods 25 rats were divided randomly into three groups:Control group,Stress group and Stree-tianeptine group. The forced-swimming was performed to rats in stress group and stress-tianeptine. Using the immunohistochemistry and the computerized image technique, expression levels of phosphorated MAP2 and the number the Positive cells were assayed quantitatively in each group. Results Compared with control group (149.34?1.81), the phosphorated MAP2 average gray degree in pyramidal cells of stress group (144.99?4.40) was significantly lower, that of the stress-tianeptine group (148.84?2.73) was significantly higher than that of stress group; The number of phosphorated MAP2 positive cells in stress group (40.36?1.35) was significantly less compared withthat of control group (42.73?1.56); that of stress-tianeptine group (42.14?1.62) was significantly more than that of stress group. Conclusion It is suggested that tianeptine could inhibit the enhancement of phosphorated MAP2 expression in hippocampal pyramidal cells induced by chronic stress.