The difficult knowledge was analyzed in detail from such aspects as medical students' cognitive ability of the female pelvic anatomy structure,their learning of female reproductive endocrine physiology,their understanding of delivery mechanism and gynecological tumor clinical staging in gynecology and obstetrics.Through such strategies as the diversification of teaching to deepen students' cognition of female pelvic anatomy structure,presentation method to strength their understanding of the delivery mechanism and repeated memory to reinforce their learning of female reproductive endocrine physiology and smart memory to remember gynecologic oncology clinical staging,not only the students' learning ability was improved,but also the teaching quality was enhanced.

At present, the particularity and importance of ethical consciousness in the teaching of clinical obstetrics and Gynecology has become increasingly prominent while the education of medical students in the ethics and social responsibility is relatively weak. This study explored a series of practical methods under WEIGHT guide through the real cases, conducting clinical training and sides debate, com-bining multimedia and interview form, in order to strengthen the cultivation of medical students' moral quality and improve the students' comprehensive ability.

Objective:To explore the resource of rice bran by comparing antioxidative activities and growth promotion of Bacillus bifidus between supernatant of formented rice bran(RBF) by Bacillus natto and water extract of rice bran(RBW) . Method:The reducing capacity the?OH and ??O 2 scavenging capacity and the inhibitory effect to oxidize lard were determined in vitro. The growth promotion for Bacillus bifidus by photodensity with simulated condition was investigated in vivo. Results:RBF and RBW had antioxidant activity in vitro. The IC50 of scavenging?OH and ??O 250 of RBF was 3.55 mg/ml and 23.5 mg/ml,0.3 and 10 folds higher than that of RBW respectively. In inhibiting oxidation of lard,RBF had a little higher antioxidative activities than RBW,near VE. RBF and RBW could promot growth of Bacillus bifidus by 65.2% and 17.8% respectively. By enzymatic digestion,the promotive rate of RBF was still 51.6%. Conclusion:RBF had higher antioxidant activity and growth promotion to Bacillus bifidus.

Objective To investigate the value of the cold supernatant in the clinical practice. Methods 25 cases of TTP got a direct infusion of cold supernatant or plasma exchange using cold supernatant as fluid replacement and with medications at the same time. Then we observed the clinical treatment effect of all the cases. Results The clinical remission rate of 25 cases of TTP was 80%. Conclusion The cold supernatant could be used as a new blood component in clinical application,especially for the treatment of thrombotic microangiopathy (TMA). It not only can save valuable blood resources,but also can reduce the economic costs of patients.

BACKGROUND:It has been proved that miR-34a plays an inhibitory role in the growth of lung cancer stem cels, but the underlying mechanism remains unclear.
OBJECTIVE:To explore the inhibitory effect of miR-34a on lung cancer stem celsand the underlying mechanism.
METHODS:The CD133+lung cancer stem cels were separated from lung cancer A549 cel lines using magnetic activated cel sorting method. And miR-34a-overexpressing CD133+lung cancer stem cels were established by liposome transfection technology. Besides,the targeted relationship between miR-34a and Notch1 was analyzed by the dual-luciferase reporter. Afterwards, Notch1 silencing was performed by gene knockout, and its effect on lung cancer stem cels was determined.
RESULTS AND CONCLUSION:After sorted and detected by immunomagetic selection and flow cytometry assay respectively, a high rate of CD133+lung cancer stem cel was obtained. And qRT-PCR detected that the expression level of miR-34a in CD133+lung cancer stem cels was significantly lower than that in CD133-lung cancer stem cels. Moreover, miR-34a-overexpressing CD133+lung cancer stem cels were successfuly constructedandmiR-34a significantly inhibited proliferation and induced apoptosis of lung cancer stemcels. Dual-luciferase reporter assay indicated that Notch1 mRNA was a target of miR-34a. In addition, Notch1 silencing obviously inhibited proliferation and induced apoptosis of lung cancer stem cels. These findings suggest that miR-34a can inhibite lungcancer stem celsviathe Notch1 signaling pathway.

Objective:To establish and validate the rat model of syndrome of stagnation of liver qi,followed by a primary study on this model with 1H NMR based on metabonomics to explore the essence of syndrome of stagnation of liver qi. Methods:Twelve Wistar male rats were randomly divided into two groups(model group and control group).The rats of model group were restrained by special equipment for 21 days to get into stagnation of liver qi.The behavior,fluid consumption test and plasma CORT of rats were recorded.At 22th day,animals were sacrificed and biopsies of gastric mucosa and adrenal gland were collected for pathological check,and serum samples for 1H NMR spectroscopy.The NMR data were analyzed using principal component analysis.Results:There were abnormal behaviors,such as decrease of elusion,slackness,looser stools,and matte fur were observed among model group rats.After one week the body weight of model group was significantly lower than that of control group(P

Objective To evaluate the clinical efficacy and adverse effects of brucea javanica oil emulsion combined with DP chemotherapy in treating advanced non-small-cell lung cancer.Methods Totally 48 patients with advanced non-small-cell lung cancer were divided into two groups randomly by mechanical sampling method.Twenty-four cases in treatment group were treated by brucea javanica oil emulsion combined with DP chemotherapy, while 24 cases in control group were treated by DP chemotherapy only.The clinical effects were evaluated after treatment of two cycles.Results The short-term effective rate was 54.2% (13/24) in treatment group and 45.8% (11/24) in control group, and there was no significant difference between two groups ( χ2 = 0.333, P = 0.564).The rate of increased and stable life quality was 87.5%(21/24) in treatment group and 58.3%(14/24) in control group,and there was significant difference between two groups (χ2 = 5.169,P = 0.023).The rate of increased and stable weight was 79.2% (19/24) in treatment group and 45.8%( 11/24) in control group, and there was significant difference between two groups (χ2 = 5.689,P = 0.017).The incidence of nausea or vomiting was 45.8% (11/24) in treatment group and 41.7%( 10/24 ) in control group, and there was no significant difference between two groups (χ2 = 0.085, P = 0.771 ).Compared with those in control group, patients in treatment group had less adverse effects in decreasing of peripheral blood leucocytes and showed better immune function.Conclusion Brucea javanica oil emulsion combined with DP chemotherapy in treating advanced non-small-cell lung cancer has good clinical effect, especially enhances the quality of life, improves immune function and decreases the adverse effects of chemotherapy.

Corona Virus Disease 2019 (COVID-19) occurred in Wuhan in December, 2019, with the number of the infected cases gradually increasing. The pregnant women are susceptible to the virus due to their specific immune tolerance. Both the maternal and fetal safety will be imperiled if the pregnant women were infected with COVID-19. Therefore, antenatal care and perinatal management are crucial for guaranteeing the safety of the pregnant women infected with COVID-19.

Objective:To explore the effects of health education based on Heider's balance theory and mobile medicine in continuous nursing after surgery for gynecological cancer.Methods:Totally 68 cancer patients hospitalized in the Department of Gynecology, Jiangshan People's Hospital of Zhejiang Province, from April 2018 to July 2019 were selected, and randomly divided into control group ( n=34) and intervention group ( n=34) according to the time of admission. Patients in the control group received conventional nursing, while patients in the intervention group received health education based on Heider's balance theory and mobile medicine on this basis. The incidence of complications was compared between the two groups after intervention; the Hospital Anxiety and Depression Scale (HADS) was used to assess the patient's anxiety and depression status; and the Chinese version of the Mishel's Uncertainty in Illness Scales (MUIS) was used to evaluate the uncertainty and complexity between the two groups. Results:Totally 8 patients in the control group and 1 patient in the intervention group developed complications, and the difference was statistically significant ( P<0.05) . The anxiety and depression scores of the intervention group were (7.7±1.4) and (7.3±1.3) , lower than (11.4±1.5) and (10.2±1.5) in the control group, and the differences were statistically significant ( P<0.05) . The disease uncertainty and complexity scores of the intervention group were (30.5±2.1) and (19.8±2.7) , lower than (51.7±3.3) and (28.8±2.6) in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Health education based on Heider's balance theory and mobile medicine can significantly reduce the incidence of complications and disease uncertainty in patients with gynecological cancer after surgery, and ameliorate their symptoms of anxiety and depression.

Objective: To analyze the characteristics of a norovirus outbreak in a kindergarten, and factors affecting the detoxification time, so as to provide a scientific basis for targeted control measures. Methods: On February 24,2023, the basic personal information, clinical manifestations，morbidity and treatment of 16 kindergarten cases with a norovirus outbreak in Wuhan were collected. Anal swabs were collected every 7 d after the outbreak to detect norovirus. Chisquare test was used for comparison of intergroup rates. The comparison of detoxification time between different groups was conducted by Logrank test, and the influencing factors of detoxification time in cases were analyzed by Cox multiple regression analysis. Results: From February 19-28, 2023, a total of 18 cases were reported and 16 of them participated in the detoxication time monitoring. In the first, second, third and fourth sampling after the outbreak, the positive rates were 60.00%, 100.00%, 75.00% and 0, respectively. The reverse transcriptionpolymerase chain reaction cycle threshold (Ct values) were (25.83±5.74, 28.83±5.55, 36.13±4.30), and undetected, respectively. The median time of detoxification was 19.42 d with 95%CI=(18.21-20.64)d. The results of Cox regression showed that the detoxication time was shorter in the treatment group than in the nontreatment group[HR(95%CI)=5.09(1.39-18.58), P<0.05]. Conclusion Children infected with norovirus has a long duration of detoxification,and case management, which could be shortened by drugs, and disinfection should be strengthened after the case returned to school.