The training of clinical thinking ability is the key point of obstetrical teaching to medical students in eight-year program.Obstetrical department of the third affiliated hospital of Sun Yat-sen university has put forward specific methods of SP inquiring and PBL case analysis teaching.The well-designed teaching methods have an active role in the training of case history collecting ability,diagnosing and treating ability to medical students in eight-year program.

OBJECTIVE:To improve the quality and efficiency of ADR monitoring in hospital for the convenience of reporters and ADR monitoring personnel.METHODS:Combined with the characteristics of hospital information system,computer technology such as network,ASP.NET programming language,SQL server 2005 database and data transformation were used to develop and apply ADR monitoring system based on hospital local area network.RESULTS:The ADR reporting quality has been improved and the quantity of ADR reports increased markedly and was kept stable.CONCLUSION:The system contributed to a informationalized and networking administration of ADR reporting,and it improved ADR reporting level thus deserving to be recommended.

Objective To explore the effects of nutritional intervention on body composition,blood biochemical parameters and blood pressure of overweight adults with metabolic syndrome.Methods Forty overweight adults with metabolic syndrome (body mass index (BMI) ＞ 28.0 kg/m2,waist circunference ≥85 cm(for male)or ≥80 cm(for female))participated in this investigation.Changes of serum lipid profiles,blood glucose,blood pressure and other indicators were compaired before and after 2-months'intervention.SPSS 18.0 Software was used for data analysis.Results After two rnonths' nutritional intervention,body weight,body fat,BMI,visceral fat area and waist hip ratio were significantly improved(t =17.02,11.07,5.11,10.35,9.58 ; P ＜ 0.05).The glutamic-pyruvic transaminase,glutamic-oxalacetic transaminease,cholesterol,triacylglycerol,fasting blood-glucose,systolic blood pressure and diastolic blood pressure were also significantly improved after nutrition intervention(t =2.87,2.91,3.33,2.24,2.56,5.74,6.99 ;P ＜ 0.05).Conclusion Nutrition intervention may contribute to improved levels of blood pressure,blood glucose and serum lipid profiles of obesity individuals through body weight and body fat control and lead to reduced insulin resistance caused by obesity.

Objective To investigate the relationship between chronic gastropathy with intestinal metaplasia (IM) and caudal type homeobox genes 2 (Cdx2),tumor necrosis factor-α (TNF-α),Helicobacter pylori (Hp) infection.Methods Onehundred and thirty patients underwent gastroscopy were divided into 2 groups by typical pathological type:gastritis group (30 cases) and IM group [100 cases,including mild IM group (30 cases),moderate IM group (35 cases),severe IM group (35 cases)].Hp infection was confirmed.The expressions of Cdx2 and TNF-α protein was evaluated by immunohistochemistry.Results The positive expression rates of Cdx2 and TNF-α protein in IM group were significantly higher than those in gastritis group [78.0％(78/100) vs.6.7％(2/30),60.0％(60/100) vs.16.7％(5/30)],and there were statistical differences (P ＜ 0.01).The positive expression rates of Cdx2 and TNF-α protein in positive and negative Hp infection in IM group were significantly higher than those in gastritis group [Cdx2 protein:79.4％(50/63) vs.1/10,75.7％(28/37) vs.5.0％(1/20);TNF-α:74.6％(47/63) vs.4/10,35.1％(13/37)vs.5.0％ (1/20)],and there were statistical differences (P ＜ 0.01).The positive expression rate of Cdx2 protein in moderate IM group and severe IM group were significantly higher than those in mild IM group [80.0％ (28/35) and 97.1％ (34/35) vs.53.3％ (16/30)],in severe IM group were significantly higher th.an those in moderate IM group,and there were statistical differences (P ＜0.05).There were no statistical differences in the positive expression rate of Cdx2 protein of difference Hp infection among the 4 groups (P＞0.05).There were no statistical differences in the positive expression rate of TNF-α protein between mile IM group and moderate IM group (P ＞ 0.05).The positive expression rate of TNF-α protein in severe IM group was significantly higher than that in mild IM group and moderate IM group [80.0％(28/35) vs.40.0％(12/30) and 57.1％(20/35)],and there were statistical differences (P ＜ 0.05).The positive expression rate of TNF-α protein of positive Hp infection patients in gastritis group,mild IM group,moderate IM group and severe IM group were significantly higher than those of negative Hp infection patients (4/10 vs.1/20,47/63vs.13/37,10/18 vs.2/12,15/21 vs.5/14,22/24 vs.6/11),and there were statistical differences (P ＜ 0.05).Conclusions The expressions of Cdx2 and TNF-α protein and Hp infection are closely related with IM.Therefore,testing the level of Cdx2 and TNF-α protein expressions can help to judge the degree of IM,which provides a basis for reversing IM.

AIM:To explore the characteristics of hepatitis B virus S gene mutation in the vertical transmission after active and passive vaccination .METHODS:Fifteen cases of immunoprophylaxis failure were enrolled in the study . HBV S gene (including pres-S and S) from the mothers, newborns before active and passive vaccination and 7-month-old infants with immunoprophylaxis failure were detected by PCR amplification .The characteristics of HBV S gene mutation were compared among the 3 groups.RESULTS: The genotype of HBV in the newborns and the infants was the same as that in the mothers .The frequencies of mutation in the 2 fragments of the HBV S gene had no significant difference between the 3 groups.The homology tree model based on HBV S gene was analyzed in the 3 groups, in which every group had their own cluster.There were 15 different mutation sites between 7 pairs of mothers and newborns .There were 3 different muta-tion sites between 3 pairs of newborns and infants (nt273A→A/G, nt512C→C/T and nt1139C→A), among which the first 2 were located in the S gene region but not in the “a” determinant , and the latter was located in the overlap region of S and X genes .There were 25 different mutation sites between 9 pairs of mothers and infants , but only 1 case had a differ-ent mutation site between the mother , newborn and infant .CONCLUSION: The HBV species in newborns and infants with immunoprophylaxis failure were transmitted from the mothers .The mutations in the HBV S gene with immunoprophy-laxis failure happened before and after active and passive vaccination , mainly before vaccination .The relationship between HBV S gene mutations and immunoprophylaxis failure should be further explored .

AIM:To investigate the effect of Epstain-Barr virus latent membrane protein 1 (EBV-LMP1) on proliferation and cell cycle of nasopharyngeal carcinoma (NPC) cells. METHODS:The expression of EBV-LMP1 was detected by immunohistochemical method (LSAB). Proliferation of NPC cells was identified by MTT method. Cell cycle percentage was detected by flow cytometry analysis. RESULTS: OD value of EBV-LMP1 expressive NPC cells L-CEN1 was much higher than that of both EBV-LMP1 negative NPC cells V-CEN1 and CNE1 ( P 0.05).CONCLUSION:The expression of EBV-LMP1 on NPC cell might cause some change of cell cycle and enhance cell proliferation.

AIM: To explore the effect of EBV infection on growth and apoptosis of nasopharyngeal carcinoma(NPC) cell line.METHODS: NPC cell line CNE1 was directly infected by Epstein Barr virus (EBV). The expression of EBV-latent membrane protein 1 (EBV-LMP1) and bcl-2 were detected by immunohistochemistry method (LSAB). The growth of NPC cells was identified by MTT method. Apoptotic carcinoma cells were detected by flow cytometry analysis and the terminal deoxynucletidyl transferase-medicated dUTP-biotin nick end labeling (TUNEL) methods. RESULTS: EBV-LMP1 was positive in CNE1 infected by EBV(E-CNE1). Compared with CEN1, the growth of E-CNE1 apparently increased ( P

Objective To investigate the effects of micro alcohol on serum enzymes in vitro and vitro Methods Serum alcohol and ALT?AST?GGT?ALP?CK?LDH?AMY?LIPA activities were measured before and after alcohol consuming (1 ml/kg) in 14 volunteers Meanwhile, the direct inhibitory effects of alcohol on the serum enzymes were studied by comparing the serum enzyme activities with or without alcohol Results Alcohol consuming could depress the serum AST activity from (24 04?3 66) U/L to (22 25?3 27) U/L and LIPA activities from (155 86?93 51) U/L to (128 35?84 85) U/L, whereas increase the other serum enzyme activities, but only serum AMY were found statistic difference [from (48 78?10 66) U/L to (55 50?12 60) U/L] The inhibitory effects of alcohol on all the measured enzymes were found in vitro studies Conclusions Alcohol could obvious influence the serum enzyme activities both in vivo and vitro Avoiding the contamination of alcohol during sample collection and routine laboratory work is necessary

OBJECTIVE To evaluate the clinical efficacy of cefoperazone/sulbactam(Sulperazon) for acute exacerbation of chronic obstructive pulmonary disease(AECOPD).METHODS A total of 136 cases of AECOPD were randomized into cefoperazone/sulbactam group and ceftazidime group,and sputum culture of each case was underwent before and after treatment.RESULTS The total efficacy rates and bacterial clearance rates in cefoperazone/sulbactam group and ceftazidime group were 91.18%,96.67% and 70.59%,75.86%,respectively,and the differences between the two groups were statistically significant.CONCLUSIONS It suggested that cefoperazone/sulbactam be a more effective drug for AECOPD.

Objective To explore the clinical manifestations,diagnosis,misdiagnosis and treatment of primary hyperparathyroidism.Methods The clinical data of 36 patients with primary hyperparathyroidism admitted into the First Affiliated Hospital of Chongqing Medical University from January 2009 to October 2014 were reviewed and analyzed retrospectively.Results The manifestations of primary hyperparathyroidism were various and atypical.Primary hyperparathyroidism was often misdiagnosed as other diseases by 25.0％ (9/36).Among the patients,the ratio of male to female was 1:1,and median age was 58 years old.Of all patients,there were 9 persons with joint pain,digestive system symptoms in 7 cases,cervical mass discovered in 6 cases(3 cases were found when B ultrasonic examination),urinary calculus in 5 cases,fatigue symptoms in 4 cases,osteoporosis and urinary calculus in 2 cases,1 case with fracture,2 cases without any symptoms.Their calcium and parathyroid hormone level were increased by various degree.The accuracy rates of level diagnosis of Color Doppler ultrasound combine with CT or 99Tcm-MIBI were improved obviously,85.2％ and 93.1％ respectively.Twenty-eight patients received surgical treatment and pathology examination confirmed the accurate pathological types after surgery.There were 23 cases of parathyroid adenoma,1 case parathyroid hyperplasia,1 case parathyroid carcinoma,2 cases of parathyroid adenoma with nodular goiter,parathyroid adenoma merged thyroid carcinoma in 1 case.Serum calcium and parathyroid hormone level declined obviously after operation.The other 8 patients received non-surgical treatment,7 cases were alleviated and 1 case died due to irreformable high blood calcium crisis.Conclusion There should be pay attention to recognize primary hyperparathyroidism,check the blood calcium,and about suspected cases should be performed as early as parathyroid tested,neck color Doppler ultrasound.Early surgical treatment can significantly improve the prognosis and quality of life.