on the basis of analyzing the teaching methods available.the article explores the reverse thinking teaching method of Pharmacdogy and the characteristics of the course and the students,in order to stimulate students'interest and initiative in study as well as culture their clinical thinking ability.

ObjectiveTo study the effect of microteaching on entrance education of internship in neonatal intensive care unit ( NICU ).Methods80 interns of clinical medicine speciality were divided into experimental group and control group.Microteaching was used in the entrance education of experimental group,and traditional teaching method was used in that of control group.To compare the teaching effects by analyzing the results of immediate evaluation,evaluation of clinical teacher and satisfaction survey in parents of hospitalized children.ResultsThe results of immediate evaluation,evaluation of clinical teacher and satisfaction survey in parents of hospitalized children were significantly increased in experimental group compared with control group.ConclusionMicroteaching could dramatically improve the teaching effects of entrance education of internship in NICU.

Objective To investigate the clinical value of combined detection of H‐FABP with cTnI in the diagnosis of myo‐cardial damage caused by hypoglycemia .Methods Levels of blood H‐FABP and cTnI were examined at 0 to 3 h ,24 h ,48 h after hy‐poglycemia diagnosed ,and were compared with the control group .The levels of H‐FABP and cTnI at 24 h after hypoglycemia diag‐nosed were compared among different groups separated according to the decreasing extent of blood sugar (1 .0 to 2 .1 mmol/L ,<1 .0 mmol/L group) ,the duration of hypoglycemia (< 24 h ,≥ 24 h group) and clinical feature of hypoglycemia (symptom and no symptom group) .The sensitivity and specificity of H‐FABP and cTnI in myocardial damage was also statistical analyzed in this study . Results The statistic difference of the increasing H‐FABP levels was found for 0 to 3 h(P<0 .01) and 24 h (P<0 .01) ,but not found for 48 h(P>0 .05) .The statistic difference of the increasing cTnI levels existed for 24 h (P<0 .01) and 48 h (P<0 .01) ,but not for 0 to 3 h (P>0 .05) .The increasing extent of H‐FABP and cTnI levels was obvious for group with blood sugar <1 .0 mmol/L ,duration of hypoglycemia ≥24 h and have hypoglycemia symptom ,these data have obvious statistic difference compared with other groups(P<0 .05 ,P<0 .01 ,P<0 .01) .The sensitivity and specificity of H‐FABP methods were higher than those of cTnI ac‐cording to the 0 to 3 h and 24 h detection data ,while the opposite result was found for 48 h .Conclusion Combined detection of H‐FABP with cTnI could be well applied in the diagnosis of myocardial damage caused by hypoglycemia .

Objective To investigate the application of OSCE evaluation system on the medical skills examination of clinical medical students and the significance of this system on the training of their medical skills.Methods 20 teachers examed 150 students by the OSCE evaluation system with 4 test stations,by comparing the score of the students of different test stations by one-way ANOVA and evaluating the system by questionnaire survey with Likert 5 on the degree of satisfaction and Likert 3 on effects and intrinsic influencing factors of the system.Results The score of the first and forth test stations was lower than that in the other stations(P＜0.05).8/5.48％ students and 1/5％ teachers were not satisfied with the system.The OSCE evaluation system could exam the psychological diathesis,ability of communication,cooperation,and clinical thinking,practical skill of the students and its effects are moderate (the score was more than 2.0).Evaluation on the intrinsic influencing factors:Students considered the questions were more difficulty in the 2nd,3rd,1st,4th test stations order.4/20％ teachers considered the questions of the second test station was easy.8/40％ teachers considered the duration of the second test station was too long.More than 70％ students and teachers considered the other indexes were rational.Conclusion The OSCE evaluation system can play an effective role in directing the teaching and learning.It can also help to culture the comprehensive capacity of the students.We should gradually improve the design of the system by considering the intrinsic influencing factors.

BACKGROUND: Preliminary study has proven that adult human bone marrow-derived mesenchymal stem cells (MSCs) suppress peripheral blood lymphocytes proliferation.But the mechanism was still to be investigated.OBJECTIVE: To study the negatively regulatory effect of adult human MSCs on allogeneic lymphocyte proliferation by cell-free condition.DESIGN,TIME AND SETTING: Cytological observation in vitro,which was performed in the Lanzhou General Hospital,Lanzhou Military Area Command of Chinese PLA between October 2005 and December 2007.MATERIALS: The bone marrow sample was provided by the allo-transplantation donor.The peripheral blood lymphocytes were provided by the healthy volunteer.METHODS: Adult human MSCs were separated with Percoll + adherence method.Allogeneic peripheral blood lymphocytes were obtained from healthy donors with Ficoll solution and the cell concentration was adjusted as 2×109/L for use.100μ L MSCs culture supernatant was taken out in 96-well plates.The groups were following: A superuatant + 3-day MSCs culture media (100 μ L/well); B superuatant + phytohemagglutini (PHA; 1 g/L,5 μ L); C medium + LG-DMEM culture media containing 10% fetal bovine serum (100 μ L); D medium + PHA (1 g/L,5 μ L).The cells were incubated at 37 ℃ with 5% CO2 in a fully humidified atmosphere for three days.MAIN OUTCOME MEASURES: Effect of MSCs supematant on proliferation and transformation of variant lymphocytes.RESULTS: Peripheral blood lymphocytes proliferation was suppressed as compared with the blank control group and PHA group after MSCs culture,and the inhibition ratio was 9.00% (P ＜ 0.05).When lymphocytes were stimulated by PHA,the suppression effects were even stronger and the inhibition ratio was 20.91% (P ＜ 0.01).CONCLUSION: Adult human MSCs supernatant can suppress peripheral blood lymphocytes proliferation and transformation; furthermore,PHA can enhance the inhibitory effect,suggesting the negative regulation is at least in part due to indirectly inhibiting lymphocytes via soluble cytokines.

Objective To explore the role of CD4+ CDhigh25 regulatory T cells in the pathogenesis of chronic abacterial prostatitis/chronic pelvic pain syndrome (CAP/CPPS).Methods The percentage of CD4+ CD+25 and CD4+ CDhigh25 regulatory T cells was detected by flow cytometry from 45 CAP/CPPS pa-tients and 18 normal controls.The levels of interleukin-6(IL-6),IL-10,tumor necrosis factor-α(TNF-α) and transforming growth factor-β1 (TGF-β1) in serum and seminal plasma were measured by ELISA in the same cohort.Results There was no significant difference in the percentage of peripheral blood CD4+CD+25 and CD4+Cdhigh+ cells between CAP/CPPS patients and normal control (P>0.05).The ser-CD4+CD+25 and CD4+Cdhigh+ cells between CAP/CPPS patients and normal control (P>0.05>.The ser-um levels of TGF-β1 in patients with CAP/CPPS were markedly lower than those in controls (P<0.05),serum TNF-α and seminal plasma IL-6,TGF-β1 and TNF-α in CAP/CPPS patients were markedly higher than those in controls (P<0.05).There was a positive correlation between the IL-6 and the NIH-CPSI.There was also a positive correlation between the IL-10 and the pain index.In ad-dition,the percentage of peripheral blood CD+4CDhigh25 cells was positively correlated with serum TGF-β1.But the percentage of CD+4CDhigh25 cells had no correlation with ages,duration of CAP/CPPS pa-tients,NIH-CPSI and the other cytokines.Conclusions The defective function of peripheral blood CD+4CD+25 regulatory T cells may be related with the pathogenesis of CAP/CPPS.The cytokines may also play an important role in the process of pathogenesis of CAP/CPPS.

Objective To investigate the difference of nerve behavior among the different types of fullterm small for gestational age infants(SGA) infants and the reasons.Methods The neonatal behavioral neurological assessment(NBNA) scores were given for 148 full-term SGA infants aged 7,14 and 28 days born in Affiliated Hospital of Hebei University.The comparason analysis was conducted among three types including symmetic,asymmetric and the mixture of them.Results Significant differences (P ＜ 0.05) were found between the NBNA scores for full-term SGA infants and normal infants.The NABA scores of full-term SGA infants were lower than those of normal infants.The NBNA scores for three types of full-term SGA infants followed the order of asymmetric ＞ symmetric ＞ mixture of them,significant difference was found between any two types of three types(P ＜ 0.05).Conclusion Full-term SGA infants show the poorer quality of nerve behavior compared with the nomal infants.The neurodevelopment levels for three types of full-term SGA infants are asymmetric,symmetric,mixture of them in the order.

Objective To evaluate the efficiency of glycogen phosphorylase BB (GPBB) and heart-type fatty acid binding protein (H-FABP) in the early diagnosis of neonatal myocardial injury (NMI). Methods The GPBB and H-FABP levels in the blood were detected at 3, 6, 12 and 24 h after onset of the NMI. The GPBB and H-FABP levels were compared among NMI, Non-NMI and control groups. The NMI diagnosis sensitivity and specificity for GPBB, H-FABP, GPBB combined with H-FABP were compared. The relationships of GPBB, H-FABP levels with the risk factors were analyzed. Results The GPBB and H-FABP levels of NMI group were higher than those of Non-NMI and control groups (P < 0.01). The diagnosis sensitivity of four time points (3, 6, 12 and 24 h) of combined GPBB and H-FABP were higher than those of the GPBB and H-FABP (P < 0.05). The GPBB and H-FABP were negatively correlated with blood glucose level, positively correlated with asphyxia degree and septicemia degree. Conclusion The combined application of GPBB and H-FABP can improve sensitivity in the early diagnosis of NMI.

Objective To investigate the effects of ginkgo flavone on the expression of NF-κB and TLR4 in the liver of mice with nonalcoholic fatty liver disease (NAFLD). Methods 120 KM mice were randomly divided into the control group, model group, as well as high, medium and low dosage of ginkgo flavone groups. The animal model of NAFLD in mice was constructed with high fat diet. The pathological changes of liver, liver index , the serum TNF-α, IL-6 , TG , NF-κB and TLR4 in hepatic tissue was observed after 8 weeks of administration. Results Compared with the model group, the level of liver index, serum TG, TNF-α, IL-6 and the expression of NF-κBp65 in the ginkgo flavone groups dramatically decreased 8 weeks after the administration. And the hepatic steatosis was milder. There was no statistical differences in the expression of TLR4 between the ginkgo flavone groups and the control group (P > 0.05). Conclusions These results suggested the closely relationship between TLR4/NF-κB inflammatory pathway and NAFLD. Ginkgo flavone had the therapeutical effects on NAFLD by anti-inflammatory and lipid-lowering action, but no effect was observed on the expression of TLR4 in hepatic tissue.

Objective To explore the distribution of exon mutations of CDX1 gene in children with congenital anorectal malformation (ARM).Methods In a case-control study conducted between June 2003 and March 2009,108 children with congenital ARM and 120 normal children undergoing health examinations who were admitted to the Shengjing Hospital of China Medical University (85 children with congenital ARM and 60 normal children) and the Affiliated Hospital of Hebei University (23 children with congenital ARM and 60 normal children) were assigned to the case group and the control group,respectively.PCR was performed to extend exons of the CDX1 gene and then sequence analysis was conducted after genomic DNAs were extracted from the peripheral blood.Categorical data with normal distribution were presented as (x) ± s and analyzed using the t test,count data were analyzed using the chi-square test.Results Exon sequencing was performed in the case group.Four children with 4 mutations of CDX1 located at coding regions were detected,including 1 with archostegnosis,1 with rectoperineal fistula,1 with rectovestibular fistula and 1 with rectourethral fistula.Four mutations located at the highly conserved homology domain of the CDX1 gene.The mutations of 1 child located at exon 1 of CDX1 gene (c.213-214Ins GAA).The mutations of 2 children located at the splicing region to exon 3 of the CDX1 gene (c.6G ＞ C,c.27G ＞ T).The mutations of 1 child located at the idiocratic splicing region to exon 3 of the CDX1 gene(c.18A ＞ C).No mutation was detected in the controls.Mutations of the CDX1 gene at c.213-214Ins GAA,c.6G ＞ C,c.27G ＞ T,and c.18A ＞ C,respectively,resulted in amino acid substitutions at 96-98Ins E,K199N,R206S,and Q203H in the protein.Conclusion Exon 1 or 3 mutations of the CDX1 gene is identified in children with congenital ARM,and CDX1 gene may be a susceptibility gene for ARM.