The integrated courses in pathophysiology have been implemented for clinical medicine in Nanfang Medical University with experimental contrast method since 2006 to compare the advantages of the teaching effect of the integrated courses with traditional learning in pathophysiology with the questionnaire. The results have showed that the students on the integrated track are more positive in the knowledge learning,problem analysis and solving as well as the subsequent clinical knowledge learning.

CXCR4, a receptor for stromal cell-derived factor-1 (SDF-1, also know as CXCL12) and a member of the chemokine receptor family, has been shown to play an important role in the proliferation, migration, invasion and metastasis of breast cancer cells. CXCR4 expression is an early event in breast cancer development and may serve as a biomarker for early detection and diagnosis of breast cancer. Expression of CXCR4 has been demonstrated to correlate with metastasis and poor prognosis in breast cancer. Inhibition of CXCR4 expression may be a potential target of breast cancer treatment.

Objective To investigate the surgical treatment of male gynecomastia. Methods The clinical data of 116 cases(156 sites) of male gynecomastia were treated by using micro incision of areola with tumescent anesthesia in the past 4 years were reviewed. Results In this series, 50 to 150 grams mammary gland tissue were resected from the breast. There were no severe postoperative complications,such as nipple or areola necrosis and apparent scar . Follow up was done for 12 to 36 months, the scars were obscure, and the configuration of the breasts were good. Conclusions The operation for male hynecomastia via micro incision of areola with tumescent anesthesia is a good, reliable and convenient technique. It is easily performed with milder injury,less bleeding, and quick recovery.

Objective To study the effects of hypothermia therapy on coagulopathy in neonates with hypoxic-ischemic encephalopathy(HIE) of different degrees.Methods Twenty-five newborns with HIE were divided into 2 groups (moderate HIE group and severe HIE group) by amplitude integrated electroencephalogram(aEEG).The platelet (PLT) count,activated partial thromboplastin time (APTT),prothrombin time(PT),thrombin time(TT),fibrinogen (Fbg) and international normalized ratio (INR) were measured before hypothermia therapy and those after 24 hours,48 hours,72 hours after hypothermia therapy were collected.The hematological parameters of 2 groups were analyzed by repeated measurement analysis of variance.Results The APTT(t=2.239,P<0.05)and PT(t=2.453,P<0.05) of severe HIE group were significantly longer than those of moderate HIE group and significantly different.PLT,PT,APTT and Fbg(all P>0.05)showed no statistically significant difference between 2 groups after hypothermia therapy.The differences in INR(F=12.470,P<0.05),TT(F=8.275,P<0.01)between 2 groups were significant.Fbg at diffe-rent time points showed no significant difference (P>0.05) between 2 groups.The differences in PLT(F=32.420,P<0.01),PT(F=9.377,P<0.01),APTT(F=15.420,P<0.01),TT(F=7.326,P<0.01)and INR(F=12.699,P<0.01)at different time points were significant between 2 groups.The degree of brain injury and time had no interactive effects in PLT,INR and Fbg(all P>0.05).But the degree of brain injury and time had interactive effects in PT(F=3.374,P<0.05),APTT(F=4.227,P<0.05)and TT(F=3.585,P<0.05).It indicated that the change trend in PT,APTT and TT were different between 2 groups.The increase range of PT,APTT and TT of severe HIE group was higher than moderate HIE group after hypothermia therapy for 24 hours.The percentages of severe HIE group who received transfusion with blood product were higher than those of moderate HIE group(P>0.05).Conclusion The coagulopathy function is worse in neonates with severe HIE in hypothermia therapy which may aggravate the hemorrhage risk.And the effect of hypothermia on neonates with moderate HIE is less evident.So hierarchical intervention on coagulopathy in neonates with HIE during hypothermia should be adopted to relieve the hemorrhage risk.

Objective To investigate the high risk factors of persistent pulmonary hypertension (PPHN) in preterm and full-term neonates.Methods Fifty-six newborns with PPHN were divided into preterm neonates group and the full-term neonates group according to their gestational ages.The relationship between PPHN and high risk factors such as the primary diseases,mother's complications during pregnancy,and the prognosis were analyzed retrospectively in each group.A retrospective review of lung samples of 3 neonates who died of respiratory failure were carried out.Results Thirty-one (55.36％) out of 56 neonates with PPHN including 27 preterm and 29 full-term newborns had parenchyma diseases.The first and the second primary diseases were meconium aspiration syndrome (MAS,9/29 cases,31.03％) and congenital heart diseases (8/29 cases,27.59％) in the full-term group,and respiratory distress syndrome (RDS,16/27 cases,59.26％) and infection (8/27 cases,29.63％) in preterm group,respectively.There were 15 cases (55.56％) whose mothers had complications during pregnancy among the 27 preterm neonates,and 8 ca ses (27.59％) among the 29 full-term neonates.The morbidity of mothers' complications during pregnancy in preterm neonates was higher than that in full-term neonates (x2 =4.519,P =0.034).The mortality rate was 33.33％ (9/27cases) in the preterm neonates group while 27.59％ (8/29 cases) in the full-term neonates group.There was no significant difference in mortality rate between each group (x2 =0.218,P =0.640).The primary diseases were RDS (9/9cases,100％) and MAS (4/8 cases,50％) in preterm and full-term neonates who died of PPHN,respectively.One case of pulmonary hypertensive vascular remodeling,1 case of alveolar capillary dysplasia (ACD) and 1 case of interstitial pneumonia were found in 3 lung samples of neonates died of PPHN.Conclusions The ratio of preterm increased in neonates with PPHN.RDS and infection were the first two primary diseases in preterm neonates with PPHN.MAS was the first primary disease in full-term neonates with PPHN.Primary pulmonary hypertension should be considered for neonates with severe PPHN.

Objective To study the expression and clinical significance of Notch intracellular domain (NICD) in cervical cancer and the effects of N-[N-(3,5-difluorophenyl)acetyl-L-alanyl]-S-phenyl glycine t-butyl ester (DAPT), a γ-secretase inhibitor on the proliferation and apoptosis of cervical cancer cell lines. Methods Western blot was used to detect the expression of NICD in the tissues of 40 cervical cancers and 21 normal cervix and its relationship with clinical features of cervical cancer was also analyzed. Proliferation of SiHa and HeLa cervical cells was determined by methyl thiazolyl tetrazolium (MTT) assay, cell cycles and apoptosis and index of proliferation were detected by flow cytometry method. The expression of NICD in SiHa and HeLa cells incubated with DAPT was detected by western blot. Results The expression level of NICD in cervical cancers was significantly higher than that of normal cervical tissues (1.237±0.353 vs 0.938±0.105, P<0.05). The NICD expression was higher in cervical cancers with high grade,lymph node involvement and parametrial invasion than that with low-middle grade (1.496±0.540 vs 1.150±0.216), without lymph node involvement (1.419±0.532 vs 1.159±0.210) and no parametrial invasion (1.718±0.710 vs 1.183±0.258), respectively (all P<0.05). The expression of NICD in cervical adenocarcinoma was higher than that of squamous cell cancer (1.463±0.395 vs 1.162±0.187, P<0.05). After SiHa and HeLa cells were incubated with DAPT, NICD expression was significantly lower than that in control (P<0.05). The effects of DAPT inhibited the proliferation and prompted the apoptosis of SiHa and HeLa cells was depended on its concentrations and times. Conclusions NICD may play a key role in the occurrence and progress of cervical cancer. The mechanism of DAPT inhibited the proliferation and prompted the apoptosis of SiHa and HeLa cells may be due to decreased the formation of NICD.

Objective To investigate inhibitory effect of Telmisartan on carotid arterial intima-media thickness in patients with essential hypertension. Methods 104 patients with mild or mid essential hypertension were randomly divided into three groups, which include telmisartan group( telmisartan 80 mg/d PO), ramipril group( ramipril 5 mg/d PO), and control group( other anti-hypertension agents). Blood pressure was monitored during treatment. Carotid arterial intima-media thickness(CIMT) were measured in all patients at beginning and patients who had the 12 months course. Results There were 91 patients who had the 12 months course,which include telmisartan group33 cases,ramipril group28 cases, and control 30 cases. The CIMT was significantly decreased in telmisartan group and ramipril group ( all P < 0. 05 ), and not changed in control while blood pressure fall effectively. In ramipril, group5 cases were ceased the course because of severe cough. Conclusion Both telmisartan and ramipril could decrease blood pressure and CIMT effectively, and there were less side effects in telmisartan group.

Objective To evaluate the reporting and methodological quality of randomized controlled trials (RCTs) related traditional Chinese medical nursing which published in key Chinese journals.Methods Electronic databases were searched for collecting RCTs related traditional Chinese medical nursing which published in key Chinese journals.The impact factors of all these journals ranked the first three in the Chinese S & T journal citation reports,2013.The CONSORT statement and Cochrane collaboration risk of bias tool were applied to evaluate the reporting and methodological quality respectively.Results A total of 135 articles were identified to meet the criteria.To the best of our knowledge,however,none of these articles have reported the 14 items in the CONSORT statement,either without the CONSORT flow diagram.According to the Cochrane Collaboration Risk of Bias Tool,17.0％(23/135) of these articles was confirmed to be high risk of bias,with the rest uncertain in the degree of bias.Conclusions The reporting and methodological quality of RCTs on traditional Chinese medical nursing were poor.It is urgent to improve the methodological and reporting quality of RCTs on traditional Chinese medical nursing researches.

Objective To investigate the status of the plague natural focus and assess the risk of plague in regions with large scale engineering construction project,in order to provide a basis for plague prevention and control.Methods The survey was carried out in 14 regions with large scale engineering construction project of 40 counties in Guizhou Province in 2000-2011,2-3 towns were selected in each county and 2-3 villages in each town,the plague hosts and flea vectors in the residential houses and outdoors were investigated,the sera of 5 animals were collected in each village.The capture rate of hosts and flea index were calculated.Then the samples were cultured and serological tested for plague.Results The density of rodents was 1.14％-3.87％ in the reservoir region' residential building of hydro power station (Tianshengqiao,Pingban,Silin,Guangzhao,Sanbanxi,Dongqing,Qianzhong,Shatuo) and Xingyi airport,and Rattus flavipestus was the dominant species.The density of rodents was 0.00％-0.84％ in the reservoir region of hydro power station (Hongjiadu,Yingzidu,Goupitan,Longtan) and Jinyang district; the total flea index in Yinzidu,Pingban,Longtan reservoir regions of hydro power stations were 3.16,2.00,1.06,3.47 and 1.99,respectively.A total of 21 rodent and flea samples from Tianshengqiao hydro power station were tested positive for F1 antigen of the plague.Three strains of Yersiniapestis were isolated.Nine rat filter paper blood samples and 7 sera of indicative animals were tested plague F1 antibody positive.Other regions with large scale engineering construction project were tested negative.Conclusions The reservoir region of Tianshengqiao hydro power station is endemic areas of the plague,where belong to high risk areas.The density of Rattus flavipestus is higher than the controlling standard of the country in the reservoir region of hydro power station (Pingban,Silin,Guangzhao,Sanbanxi,Dongqing,Qianzhong,Shatuo),where belong to potential risk areas.The plague prevention and monitoring should be continually strengthened to reduce the risk of plague.

Objective To test the reliability and validity of Chinese version of Stressful Life Events Questionnaire and the influence of preinjury stressful life events on the life quality and mood symptoms of the patents following cerebral concussion.Methods 285 patients with cerebral concussion were assessed by Stressful Life Events Questionnaire(SLESQ),PTSD Checklist civilian version(PCL-C),Thirty-Six-Item Short-Form Health Survey (SF-36),Hamilton Depression Rating Scale(HDRS),Hamilton Anxiety Scale(HAMA) at baseline.The patients had been reassessed with the HDRS,HAMA,SF-36 at 3 months after cerebral concussion.The hierarchical regression analyses were used to determine the influence of Stressful Life Events for the life quality and mood symptoms of the patient with cerebral concussion.Results The incidence of stressful life events was 42.8％.The multiple regression analysis showed the experience of stressful life events were the influence factor of scores on the SF-36,HDRS,HAMA after adjusted by the age,gender,education,income,social support,the scores of anxiety and depression before injury and the R 2 value of SLESQ to SF-36 physical health factor,mental health factor,HDRS,HAMA was 0.064,0.111,0.145,0.028,respectively.Conclusion The history of stressful events is the influence factor of the patient with cerebral concussion to have poor life quality and mood disorder.