?AIM:To improve the efficiency and quality of teaching, and to cultivate students’ ability to analyze and solve clinical problems, the case - based learning ( CBL ) combined with problem-based learning ( PBL ) teaching mode is introduced into the clinical teaching of ophthalmology.?METHODS:Two classes ( total 131 students ) of 2013 grade major in clinical medicine, Kunming Medical University, were randomly selected as experimental group using CBL combined with PBL teaching mode, and control group using traditional teaching mode. The part of acute angle-closure glaucoma was taught. The scores of the experimental group were compared with that of control group at the end of term.?RESULTS:The mean scores of CBL combined with PBL teaching group were significantly higher than that of traditional teaching group.?CONCLUSION: The application of CBL combined with PBL in the clinical teaching of ophthalmology has obvious advantages in improving the learning interests and promoting students’ self-learning ability. It is helpful in improving the students’ ability of independent-thinking, analyzing and solving problem.

Objective: To investigate the signal molecules and signal transduction involved in endophytic fungal elicitor-induced atractylodin biosynthesis and the effect of an endophytic fungal elicitor on the key enzyme activity in Atractylodes lancea. Methods: Content changes of nitric oxide (NO), salicylic acid (SA), and atractylodin were detected under the endophytic fungal elicitor treatment by plant cell suspension culture technology. Results: The endophytic fungal elicitor remarkably promoted NO burst and the biosynthesis of SA and atractyodin by activating nitric oxide synthase (NOS), phenylalanine ammonia lyase (PAL), and acetyl coenzyme A carboxylase (ACC), respectively. NOS inhibitor PBITU could inhibit the NO and SA accumulation and the atractyodin biosynthesis induced by the elicitor. And atractyodin biosynthesis could also be triggered by exogenous NO or SA. The results indicated that NO and SA were the necessary signal molecules and NO burst was mediated by NOS induced by endophytic fungal elicitor. NO quencher cPITO could effectively remove NO burst in A. lancea cell induced by endophytic fungal elicitor and notably inhibit the biosynthesis promotion of SA and atractyodin in A. lancea cell induced by endophytic fungal elicitor. Exogenous SNP could reverse the cPITO inhibition on the activity of PAL and ACC and the synthesis of SA and atractylodin. This suggested that NO was an upstream signal molecule mediated endophytic fungal elicitor to accelerate the biosynthesis of SA and atractyodin. Conclusion: Endophytic fungal elicitor mediated through NO followed by SA could promote atractyodin biosynthesis by activating ACC in A. lancea.

Objective: To investigate the effect of endophytic fungal elicitor on key enzyme activity, inducing pathway and mechanism involved in the secondary metabolites of Atractylodes lancea. Methods: NADPH oxidase, HMGR activities, the concentration of hydrogen peroxide (H2O2) and β-eudesmol were determined by the co-culture of endophytic fungal elicitor and A. lancea suspension cell. Results: NADPH oxidase activity was notably enhanced by Fusarium sp5 elicitor which could induce oxidative burst, significantly promote H2O2 accumulation, and activate HMGR in the sesquiterpenoids metabolic pathway. Compared with the control, the yield of β-eudesmol increased 257.6% and reached 66.59 μg/g. CAT and DPI could inhibit the HMGR activity and β-eudesmol biosynthesis in A. lancea cell induced by Fusarium sp5 elicitor. Exogenous H2O2 also induced HMGR and promoted the β-eudesmol biosynthesis. Conclusion: H2O2 is necessary to induce β-eudesmol synthetic signal molecule by activating the HMGR.

China ; epidemiology ; Databases, Bibliographic ; Humans ; Lead Poisoning ; epidemiology ; Occupational Exposure ; Workplace

Objective To investigate the metabolic routes and metabolites of Rehmannia glutinosa and Cornus officinalis herb pair produced by gut microbiome from rats. Methods A rapid and sensitive ultra-performance liquid chromatography/quadrupole-time-of-flight mass spectrometry (UPLC-Q-TOF/MS) technique combined with Metabolynx™ software was established and successfully applied to identify the metabolites of the main bioactive components in the herb pair extract by rat intestinal bacteria. Results Four parent compounds (loganin, morroniside, catalpol, and acteoside) and their eight corresponding metabolites were detected and tentatively identified by the characteristics of their protonated ions. Hydrogenated and demethylated loganetin, dehydroxylated morronisid aglycone, caffeic acid, and its methylated product were the main metabolites. These metabolites suggested that the glycosides were firstly hydrolyzed to their aglycones by hydrolytic enzymes of the enteric microbial flora and subsequently to the other metabolites through hydrogenation, (de)-methylation, and de-hydroxylation. Conclusion The results may be helpful for the further investigation of the pharmacokinetic study of R. glutinosa and C. officinalis herb pair in vivo.

Cancer has become the leading cause of mortality in the urban area of China. Whole body diffusion weighted imaging (WB-DWI), also known as virtual positron emission tomography, has gradually become accepted as an image tool in tumor localization, characterization, staging and monitoring response to therapy or tumor recurrence. Our article aimed to summarize the limited initial clinical use of WB-DWI in the referred area, and to analyze the most potential advantage of WB-DWI in therapeutic monitoring and tumor staging. WB-DWI as a highly sensitive, completely non-invasive, well-tolerated and low price technique has a promising furture in tumor assessment. Profound clinical study is necessary for its further application improvement.
China ; Diffusion Magnetic Resonance Imaging ; methods ; Humans ; Neoplasm Staging ; Neoplasms ; diagnosis ; pathology ; Whole Body Imaging ; methods

Adolescent ; Adult ; Cat-Scratch Disease ; diagnosis ; therapy ; Child ; Child, Preschool ; Female ; Humans ; Lymphadenitis ; diagnosis ; etiology ; therapy ; Male ; Middle Aged ; Young Adult

Objective To observe the tolerance of contemporaneous multiplane operations in obstructive sleep apnea-hypopnea syndrome(OSAHS). Methods Twenty-three patients were enrolled. According to the different obstructive level, the different operations were chosen to complete upper airway reconstruction in contemporaneous operation group (group A, 13 patients). In the simple palatopharynx level obstructive group (group B, 10 patients), bilateral tonsillectomy and H-UPPP was chosen. Results The operation time in group A was significantly longer than that in group B:(121.0 ± 35.4) min vs.(80.7 ± 25.3) min, P<0.01. The hospital days and adverse events in two groups had no significantly difference (P>0.05). Conclusions Individual therapeutic schedule for OSAHS patients should be formulated. Operating the different obstructive levels simutaneously, which would solve upper airway occlusion and complete the upper airway reconstruction at the same time. No more adverse events happen, compared with the simple palatopharynx level obstructive group, though the operation time may be longer.

AlM: To evaluate the application of phacoemulsification of different nucleus density using ozil and traditional mode.METHODS: A total of 89 eyes (72 patients ) ( visual acuity was of 0. 6 and above after 1mo follow - up) of different nucleus density level (LOCS Ⅱ criteria grade Ⅲ 46 eyes, grade Ⅳ and more 43 eyes ) were randomly assigned into 2 groups: ozil group (group A), grade Ⅲ 22 eyes (torsional energy 80% lP on);grade Ⅳ and more 17 eyes (torsional energy 100% lP on); Traditional mode group(group B), grade Ⅲ 24 eyes (energy 50% ), grade Ⅳ and more 26 eyes (energy 60% ~ 70% ) . All surgeries were performed by the same experienced surgeon,who use the chop to split the nucleus in the application of phacoemulsification. lntraoperative parameters were total equivalent pawer ( TEP ), cumulative dissipated energy ( CDE ) and effective phaco time ( EPT ) and surgical complications. The effectiveness of the two modes in dealing with hard - core cataract phacoemulsification were compared.RESULTS: GradeⅢ nucleus dealing: TEP of ozil group was significantly higher than that of the traditional mode group [(24.58±7.78)% vs (13.84±1.97) %]and EPT of ozil group was significantly lower than that of the traditional mode group (50. 59±14. 73 s vs 60. 19±9. 04 s, P<0. 05). CDE showed no difference between two groups [(13.12±6.03)% vs (13.38±2.85)]. Grade Ⅳ and more nucleus dealing: CDE [( 34. 10 ± 13. 48 )%] and EPT (104. 64±32. 4s) of the ozil group was higher than CDE [(30. 31 ± 13. 48)%] and EPT (93. 01 ± 41. 01s) of the traditional mode group, but there were no difference between two groups. Obstacles in the needle of phacoemulsification surgery: ozil group 4/17, traditional mode group 2/26 (χ2=2. 16, P=0. 14).CONCLUSlON: Bothozil and traditional mode can deal with all kinds of nucleus effectively and safely. Ozil mode is more efficacy and quick deal in gradeⅢnucleus. With the increase of nucleus hardness, the traditional mode still have the advantage of high efficiency and no obstacle to dealing patients with grade Ⅳ and more nucleus. Choose according to different nuclear hardness ultrasonic model can improve the operation efficiency and security.

Abstract?AlM: To compare the in- the- bag lOL stability of different size of continuous curvilinear capsulorhexis ( CCC) in super high myopic eyes with cataract underwent phacoemulsification.?METHODS: A total of fourteen cataract patients with bilateral super high myopia were included, Phaco+lOL implantation were performed on both eyes, one eye was randomly classified into 5mm diameter CCC observation group, the fellow eye was 6mm diameter CCC observation group. Cataract extraction combined with in-the-bag intraocular lens implantation ( lOL ) with the type of hydrophilic acrylic aspheric intraocular lens ( MCX11 ) by well experienced surgeon. The operation was running smoothly, the next day after operation, all patients were confirmed by lmage-pro plus6. 0 image analysis software for the measurement of main meridian sac diameter with target capsulorhexis diameter no more than ±0. 2mm. Slit lamp examination of lOL shape and position, changes of anterior capculorhexis edge, refraction, anterior chamber depth was measured and observed of all eyes after operation 1wk;1, 3, 6mo.? RESULTS: Compared with postoperation 1wk, the former sac diameter of two groups were slightly smaller at postoperation 1mo, with no statistically significant difference between two groups. 5mm diameter CCC observation group had slightly hyperopic shift in follow-up 1-3mo, 6mm diameter CCC observation group had hyperopic shift in follow-up 1mo, and getting stable after 1mo. Refraction change was related to anterior chamber depth changes. 5mm diameter CCC observation group had 3 minor loop folding in follw-up 3mo.?CONCLUSlON:Relatively smaller continuous curvilinear capsulorhexis in super high myopic eyes underwent cataract surgery may cause a tendency of uneven construction or effective lens position change of in-the-bag lOL. Unusual refraction change or shift after operation 1mo could suggest instability of lOL, early noticing or interruption could prevent further complications.