In this paper the basic feature of the participating teaching approach is elaborated,and the problems needing to be paid attention to in the process of its application and fulfillment are also discussed.

AIM:To observe the effects of fasudil on inflammatory reaction in cerebral ischemia/reperfusion rats.METHODS:Focal cerebral ischemia/reperfusion model in rats was made by transient occlusion of middle cerebral artery for 1.5 h followed by 24 h reperfusion.Fasudil was injected intraperitoneally before operation and 12 h after operation.The neurological function was scored and the infarct volume was measured after operation.The water content of brain was measured with dry-wet weight;The myeloperoxidase(MPO)activity was determined by spectrophotometer;The permeability of the blood brain barrier was evaluated by measurement of the Evans Blue(EB)content in the brain with spectrophotometer;The brain content of IL-8 was evaluated with ELISA;The level of NF-?B p65 mRNA expression was determined by RT-PCR;The expressions of ICAM-1,VCAM-1 and NF-?B p65 protein were observed by immunohistochemistry;The MCP-1 and the expression of NF-?B p65 protein in the nuclear extracts were detected by western blotting.RESULTS:Fasudil improved the neurological function,decreased the infarct size,reduced the permeability of blood brain barrier and brain water content,inhibited the MPO activity,decreased the content of IL-8 and the protein expressions of ICAM-1,VCAM-1 and MCP-1 in brain tissue,inhibited the expressions of NF-?B p65 mRNA and protein and reduced the content of NF-?B p65 protein in the nuclear extracts significantly(P

Objective To investigate the correlation of postoperative cognitive dysfunction (POCD)and the preoperative he-moglobin (HbA1c)in elderly patients with type 2 diabetes mellitus (T2DM).Methods 82 patients with T2DM who were underwent non-cardiac surgery were included in this study,group A had 37 patients with POCD after surgery,group B had 45 patients with non POCD,the patients in two groups used the same anesthesia method,compared the general data and pre-operative HbA1c,fasting blood glucose levels of two groups,compared the incidence of POCD in patients with HbA1c in dif-ferent levels.Results There was no significant difference in gender composition,age,body mass index,preoperative MMSE score,hypertension rate,operation time and bleeding volume in operation,and there was no significant difference in fasting blood glucose of patients in two groups.Fasting blood-glucose (FBG)of two groups were 7.1±2.6 and 6.7±1.8 mmol/L (t=0.821,P=0.424),it was no significant difference;HbA1c of two groups were (7.2±1.3)% and (6.3±1.0)%,the group A was higher than the group B (t=3.543,P=0.001),there was significant difference.The incidence rate of POCD of the group AH was 58.1%(25/43),while the group AL was 30.8% (12/39),the group AH was higher the group AL(χ2=5.131,P=0.024),there was significant difference.Conclusion Preoperative determination of HbA1c in elderly patients with T2DM after surgery has forecast values for the occurrence of POCD,to control HbA1c in the low level can reduce the occurrence of POCD in elderly patients with T2DM.

Aim To investigate the effects of fasudil on neuronal apoptosis after cerebral ischemia/reperfusion(I/R) injury in rats.Method Focal cerebral ischemia/reperfusion model in rats was made by transient occlusion of the middle cerebral artery for 90 minutes followed by 24 h reperfusion.The number of neural apoptotic cells was measured by the method of TUNEL staining;Bcl-2,Bax,Caspase-3 protein expressions were observed by immunohistochemical staining;the expression of phospho-MYPT and phospho-Akt protein was determined by Western blot.Result Compared with the MCAO group,fasudil could decrease the number of neural apoptotic cells,upregulate the expression of Bcl-2 and phospho-Akt protein and inhibit the expression of Bax,Caspase-3 and phospho-MYPT protein significantly(P

Peptide nucleic acid (PNA) is a DNA surrogate in which the phosphate deoxyribose backbone of DNA is replaced by repeating N-(2-aminoethyl)glycine units. PNA can hybridize to the complementary DNA and RNA with higher affinity than their oligonucleotide counterparts. This character of PNA not only makes it a new tool for the studies of molecular biology but also the potential candidate for gene-targeting drugs. The non-ionic backbone of PNA leads to stable hybrids with the nucleic acids, but at the same time, the neutral backbone results in poor cellular uptake. To address this problem, studies on modified PNA progress rapidly in recent years. We reviewed literature reports combined with our study about the delivery methods, including backbone modified PNA and PNA-ligand conjugates, and the cellular uptake of modified PNA. In addition, we summarized the problems and future prospect of the cellular delivery of modified PNA.
DNA, Complementary ; Drug Delivery Systems ; Glycine ; analogs & derivatives ; Humans ; Nucleic Acid Hybridization ; Oligonucleotides ; Peptide Nucleic Acids ; chemistry ; RNA

Objective To explore baccalaureate nursing students' perception of caring, so as to provide evidence for promoting their caring behaviors. Methods Phenomenology was the chosen methodology, 11 baccalaureate nursing students were interviewed in depth. Results Themes of caring were formed into four categories: caring behavior was reciprocal; the motives of caring included fear, concern, responsibility and obligation; knowledge, technical competency and professional helping relationship constituted caring; the confusions of caring came from many factors in clinical practice. Conclusions Baccalaureate nursing students can understand the connotation of caring accurately. To encourage their caring behaviors,clinical supervisors and managers should take all kinds of measures to maintain their faith in caring.

Objective To investigate the safety and feasibility of laparoscopic hepatic left lateral lobectomy. Methods Five cases of liver cancer, 4 cases of hepatic hemangioma, and 2 cases with suspected liver tumors were included in this series. Tumors were all located at left lateral lobe, with a diameter less than 10?cm. Tumors were resected by laparoscopy under a combination of pneumoperitoneum and non-pneumoperitoneum, with hand assistance through a mini-incision. Several manoeures were used for the dissection of liver tissue, including microwave coagulation, ultrasonic dissection, tainium clips clamping, rotating suction, endogia ligation. ResultThe procedure was successful in all cases with the operation time ranging from 1.5?h to 6?h, and bleeding was 50?ml to 500?ml. The hospitalization time were from 5?d to 15?d. ConclusionLaparoscopic liver resection is safe and feasible for the left liver lateral lobe tumor when the diameter is less than 10?cm, and not involving surrounding organs.

ObjectiveTo observe the efficacy of maintenance hormonal treatment after response to chemotherapy in advanced breast cancer. Methods8 patients with advanced breast cancer were treated with chemotherapy,maintenance hormonal therapy were given after response to chemotherapy.The efficacy was evaluated every 2 cycles of chemotherapy and 2 months of endocrine therapy according to RECIST standard.Results8 patients received chemotherapy for 2-8 cycles (median 4 cycles). All patients got PR, the duration of chemotherapy was 1-6 months (median 2 months), the time to failure of chemotherapy was 4 months. Until the last follow-up day (31th December 2010), the time to progression was 6-86 months (median 13.5 months).Survival was 6-86 months(median 21.5 months).Seven patients quit the chemotherapy due to severe side effects of hematologic toxicity,fatigue or nausea vomiting.One patient died because of allergy to paclitaxol.Conclusion Maintenance hormonal treatment after patients with metastatic breast cancer response to chemotherapy may prolong the duration of effective therapy and improve the QOL.

Objective To investigate the effects of preconditioning with different concentrations of sevoflurane on the expression of Toll-like receptor 4 (TLR4) in rats with acute lung injury (ALI) induced by lipopolysaccharide (LPS).Methods Thirty adult male Sprague-Dawlcy rats,wcighing 200-250 g,were randomly divided into 5 groups (n =6 each):normal saline group (group NS),group ALI,and preconditioning with different concentrations of sevoflurane groups (groups S1-3).ALI was induced by intratracheal instillation of LPS 5 mg/kg.Groups S1-3 inhaled 1.2％,2.4 ％ and 4.8 ％ sevoflurane for 30 min respectively,and ALI was induced 30 min later.The rats were sacrificed at 12 h after administration of LPS or normal saline and lungs were removed for microscopic examination and for determination of TLR4 mRNA and protein expression in lung tissues and concentrations of TNF-α and IL-1β in broncho-alveolar lavage fluid (BALF).W/D lung weight ratio was calculated.Results Compared with group NS,W/D lung weight ratio and concentrations of TNF-a and IL-1β in BALF were significantly increased and the expression of TLR4 mRNA and protein was up-regulated in groups ALI and S1-3 (P ＜ 0.01).Compared with group ALI,the parameters mentioned above were significantly decreased in groups S2 and S3,and the concentrations of TNF-α and IL-1 β in BALF were significantly decreased and the expression of TLR4 mRNA was down-regulated in group S1 (P ＜ 0.05 or 0.01).The parameters mentioned above were significantly lower in groups S2 and S3 than in group S1 (P ＜ 0.05).The pathologic changes were significantly attenuated in groups S1-3 compared with group ALI.Conclusion Preconditioning with sevoflurane can concentration-dependently reduce LPS-induced ALI in rats through inhibiting the up-regulation of TLR4 expression in lung tissues and reducing the inflammatory response.

ObjectiveTo investigate the clinical significance and characteristics of recurrent laryngeal nerve lymph node metastasis of thoracic esophageal cancer.MethodsOne hundred and twenty-four patients who had undergone thoracic esophageal resection with recurrent laryngeal nerve lymph node dissection in our hospital from March 2007 to February 2010.All clinical data were retrospectively analysed.ResultsRecurrent laryngeal nerve lymph node metastasis was found in 34 of 124 cases,with the metastatic rate of 27.41% (34/124).The left recurrent laryngeal nerve lymph node metastasis was 16.13% and the right was 8.06% .The recurrent laryngeal nerve lymph node metastasis was found in 9 patients with the upper segment esophageal cancer,20 with middle third esophageal cancer and 5 with lower segment esophageal cancer,6 patients with T2 disease had recurrent laryngeal nerve lymph node metastasis,while 27 with,T3 disease.Also there were 4,13,17 cases with metastasis in well-differentiated,moderately differentiated,poorly differentiated respectively.Poorly differentiated esophageal carcinoma was more susceptible to recurrent laryngeal lymph node metastasis than well-differentiated and moderately differentiated esophageal carcinoma.Recurrent laryngeal nerve injury was found in 11 cases,7 cases of them recovered.ConclusionNearly 1/3 of patients with esophageal carcinoma have recurrent laryngeal nerve lymph node metastasis,especially for tumor located in the upper third esophagus,poor differentiation or deep invasion (T2 or more) of esophageal carcinoma were more susceptible to recurrent laryngeal nerve lymph node metastasis.