To meet with the need for culivating high-quality medical talents,the new teaching mode of problem-based learning (PBL) is attracting a lot of attention. Pathophysiology, which bridges basic medicine courses and clinical medicine courses,is more suitable for implementing PBL teaching mode. The teaching mode of incorporating case analysis is used into pathophysiology teaching by many ways is studied and an ideal result has been achieved.

AIM: To investigate the feasibility of establishment for chronic graft-versus-host disease (cGVHD) model in rats after allo-bone marrow transplantation (allo-BMT), in order to provide premise conditions for further studying the immuno-regulation role of mesenchymal stem cell (MSC) on GVHD after allo-BMT. METHODS: This experiment was finished in Laboratory of Pathology and Pathophysiology in Sun Yat-sen University from April to September 2006.①Six-week-old male Fischer344 rats (RT1Al) were used as donors while six-week-old female Waster (RT1Au) rats were used as recipients.②Recipient rats were given water supplemented with gentamycin (320 mg/L) and erythromycin (250 mg/L) three days before BMT. On the day of transplantation, recipient rats received 8.0 Gy (60Co ?, 0.7 Gy/min) total body irradiation. Within 6 hours following the irradiation, recipient rats in BMT group were transplanted with 0.8?108 cells via tail vein injection, while rats in control group only received the same volume injection of phosphate buffer. Each group included 10 animals. Evaluation of common living status was monitored including daily diet, activity, stool and urine, fur and body mass. Shaved skin, liver and intestine tissues were also analyzed histologically. RESULTS: ①All rats in the control group died within 17 days following the irradiation and most of them died on day 11 or 12 post-transplantation, while BMT group had higher survival rate, in addition to three rats died on days 12, 16, 18 respectively, whereas others were all alive through 60 days expectation period.②Rats in the BMT group had no clear symptoms of acute GVHD, such as rapid weight loss and severe diarrhea, however, the weight growth in rats of the BMT group was quite slow. Furthermore, 1 month following BMT, depilation phenomenon was evident in the head and back of recipients, and then extended to abdominal part and extremity with the increase of time. Two months following BMT, skin follicular dropout and slight dermal mononuclear infiltration were found. Hepatic disease was characterized by portal tract lymphocyte infiltration, fibrous thickening and sclerosis of the bile duct wall. Small bowel specimens showed clear inflammatory cell infiltration (neutrophils, acidophils, macrophages) within lamina propria. CONCLUSION: ①The cGVHD model can be established through allo-BMT from F344 to Wistar rats.②The typical histological signs of cGVHD are evident in skin, liver and intestine tissues, among which hepatic sign is the most dominant including portal tract and bile duct mononuclear infiltration followed by fibrous thickening and sclerosis of the bile duct wall.

Objective:To explore influence of standardized secondary prevention on prognostic outcome of patients with coronary heart disease (CHD).Methods:A total of 128 CHD patients were randomly and equally divided into secondary prevention group and routine treatment group.Routine treatment group received routine CHD therapy during hospitalization,received routine discharge guidance,and they were followed up once/six months.Secondary prevention group were served by specific physicians and received secondary prevention intervention,and they were followed up once/month after discharge.CHD patients received questionnaire to know their knowledge about CHD risk factors and compliance taking secondary prevention drugs after discharge.Risk factor control and recurrence rate of CHD etc.were assessed.Results:Compared with routine treatment group,after one-year follow up,there were significant rise in awareness rate of risk factors (34.38% vs.78.18%);control of risk factors (blood pres-sure,blood lipids,smoking,diet and exercise etc.)and administration rate of secondary prevention drugs after dis-charge (18.75% vs.87.50%),and significant reductions in clinic events [heart failures (18.75% vs.4.69%),an-gina pectoris (28.13% vs.6.25%),rehospitalization (21.89% vs.3.13%)and myocardial infarction (15.63% vs. 4.69%)]in secondary prevention group,P <0.05 or <0.01. Conclusion:Standardized secondary prevention is ef-fective in patients with coronary heart disease,which is worth clinic extending.

Objective To study the level and influencing factors of sense of coherence (SOC) among elderly patients with Parkinson's disease (PD).Method Totally 118 elderly patients with PD were investigated by a self-designed demographic questionnaire,sense of coherence-13 (SOC-13) and social support rating scale (SSRS),and to explore the level and influencing factors of SOC among the patients.Results The total score of SOC-13 was (52.27±9.30),and it was at a low level.Multiple regression analysis showed that educational level,severity of the disease,family economic status and social support were the influencing factors of SOC.Conclusion SOC of elderly patients with PD is at a low level,which is influenced by individual factors,nurses should take targeted measures to improve the patients' SOC status by the influencing factors.

Objective To compare image-guided radiotherapy(IGRT) and intensity-modulated radiotherapy(IMRT) treatment in patients with recent efficacy and toxicity of radioactive reaction ,discuss factors affecting prognosis .Methods Collection of 52 cases of IGRT and 55 cases of IMRT patients with non-small-cell lung cancer(NSCLC) ,satisfy the requirement of target prescription dose in the case ,the recent efficacy of tumor ,comparing two treatments in patients with radioactive toxic effects and factors affect-ing the prognosis .Results The incidence of radioactive pneumonia in IGRT group was lower than the IMRT group (P<0 .05) ,the incidence of radiation esophagitis had no statistical differences in the two groups (P>0 .05) .The survival rates of IGRT group 1 , 1 .5 ,2 years after radiotherapy were 57 .7% ,35 .0% ,27 .3% ,IMRT group were 50 .9% ,34 .1% ,21 .8% .The median survival time of IGRT group and IMRT group was 17 months and 13 months respectively ,there was no statistically significant difference(P>0 .05) .Conclusion In NSCLC treatment ,compared with IMRT ,TGRT could reduce the toxic reaction of radiotherapy ,but the effect of two kinds of treatment for the recent difference is not obvious .

Objective To study the morbidity rate of and relevance to coronary stenosis in cerebral infarction patients. Methods CT coronary angiography was performed in 112 cases of cerebral infarction after CT cerebral angiography. Multivariate logistic regression analysis was carried out between the clinical data and coronary stenosis. Results In 112 cases receiving CT cerebral angiography, the morbidity rate of coronary stenosis was 46.4%. In 95 cerebral infarction patients, the morbidity rate of coronary stenosis was 51.6%. Multivariate logistic analysis showed that age, hypertension, hyperlipeidemia, significant narrowing of cerebral artery were identified as independent predictors for coronary stenosis. Conclusions Heart examination with 64 row CT should be routinely performed after cerebral angiography in cerebral infarction patients,especially in those with age greater than 65 years, hypertension, hyperlipoidemia and significant narrowing of cerebral artery so as to detect coronary stenosis early.

Objective To study the expression of p27kip1 and Ki67 proteins in various types of gastric polyp and the relationship be-tween gastric polyp and gastric carcinoma (CA:). Methods The expression of p27kip1 and Ki67 proteins were detected in normal gastric mu-cosa, hyperplasie polyp, adenomatons polyp, and carcinoma by S-P immunohistochemical staining. Results In the normal gastric mucosa,hyperplasie polyp, adenomatous polyp and gastric carcinoma, the expression rate of the p27kip1 protein was 90. 00% ,70. 00% ,65.00% and 30. 43%, respectively. The positive rate of p27kip1 protein in gastric cancer was significantly lower than that in other tissues. The rate of Ki67 protein expression in those tissues was 10. 00%, 15.00%, 45.00%, and 73.33%, respectively. The positive rate of Ki67 protein in gastric cancer was significantly higher than that in other tissues. And the positive rate of Ki67 in adenomatous polyp was significantly higher than that in the normal gnstric mucosa and hyperplasic polyp. There were significant differences among them(P <0.05). There was no correlation between the expression of p27kip1 and Ki67 proteins in gastric polyp(rs=-0. 093, P >0. 05). Conclusion Detection of p27kip1 and Ki67 proteins in gastric polyp was very helpful in early diagnosis and prognosis of GC.

AIM: To investigate effects of rBMMSC on hematopoiesis and immune reconstitution after allo-hematopoietic stem cells transplantation (HSCT). METHODS: Allogeneic BMT model from Fischer344 rats (RT-1Al) to Wistar rats (RT-1Au) was established. The effects of MSCs on hematopoietic reconstitution and immune reconstitution were studied by observing the survival rate, peripheral blood counts, thymus counts, spleen counts, bone marrow counts and immune function analysis at 30 days after transplantation. RESULTS: 1. Cotransplantation of MSCs and bone marrow (BM) was demonstrated to improve hematopoietic reconstitution. Lymphocyte and platelet counts in peripheral blood in cotransplantation groups were higher than those in control groups. More bone marrow neucleated cells were also observed in cotransplantation groups. 2. Cotransplantation of MSCs and BM improved immune reconstitution. First, overall thymic cellularity and spleen cellularity significantly increased in cotransplantation groups at day 30. Secondly, cotransplantation improved immune functional recovery. Non-specific lymphocytes proliferation reaction induced by ConA and LPS increased in cotransplantation group, and so did for allogeneic mixed-lymphocyte reaction. CONCLUSION: Hematopoietic reconstitution and immune reconstitution were significantly enhanced by MSCs cotransplanted with BM.

Objective Aiming at detecting Staphylococcus aureus、Pseudomonas aeruginosa and Klebsiella pneumoniae in laboratory animals,the paper provides a rapid,sensitive and simple test method.Methods According to Staphylococcus aureus nuc gene,Pseudomonas aeruginosa LasI gene,Klebsiella pneumonia PhoE gene and general 16S rRNA gene, designed specific primers;Through the optimization of multiplex PCR primer concentrations and annealing temperature, the specificity and sensitivity of detection, establishing multiplex PCR system.Application of the PCR system test specimens of artificial infections and experiment animal feces is compared with traditional test method.Results Multiplex PCR amplification of Staphylococcus aureus (153 bp), Pseudomonas aeruginosa (600 bp) with Klebsiella pneumoniae (368 bp) and general (520 bp).The multiplex sensitivity for the purpose of 10pg, specificity of detection was not detected from other pathogens.Application of establishing multiplex PCR system to detect the artificial positive samples, and detect 1 Pseudomonas aeruginosa positive case in 76 fecals.Conclusions This paper established the multiplex PCR method which has the advantages of specific,sensitive,simple and rapid, and provides a reliable way for rapid test in laboratory animals microbiology.

The aim of this study is to establish a multiplex polymerase chain raction (PCR) to identify of four kinds of laboratory animal pathogens: Pasteurella multocida, Bordetella bronchiseptica, Mycoplasma pneumoniae and Klebsiella pneumoniae.Methods Specific primers were designed based on GenBank data.The multiplex PCR system was established through optimization of multiple PCR and detection of its specificity and sensitivity.This technique was used to test artificially infected samples and tracheal secretions of experimental animals (rat, mouse, guinea pig, rabbit, hamster), and comparing the detection results by this method and traditional detection test.Results Target bands of Pasteurella multocida (356 bp), Bordetella bronchiseptica (237 bp), Mycoplasma pneumoniae (266 bp), and Klebsiella pneumoniae (142 bp) were obtained, with a detection sensitivity of Klebsiella pneumoniae of 10 pg, and that of Pasteurella multocida, Bordetella bronchiseptica and Mycoplasma pneumoniae of 1 pg by this newly developed multiplex PCR assay.No target bands were observed from the non-specific pathogens of artificially infected samples.The tracheal secretions taken from 45 experimental animals (mice and rabbits) were tested with this new PCR assay, among which 15 cases of Klebsiella pneumonia and 9 cases of Pasteurella multocida were detected as positive, while all the results of traditional method and serological test were negative.Conclusions A simple, rapid, specific and highly sensitive multiplex PCR system has been successfully established.It is valuable for detection of Pasteurella multocida, Bordetella bronchiseptica, Mycoplasma pneumoniae, and Klebsiella pneumoniae in laboratory animals.