Objective To study clinical manifestations and imagine features (CT and MRI) on toxic encephalopathy after inhaling heroin. Methods 13 patients with toxic encephalopathy induced by inhaling heroin were observed and analyzed on its clinical and imagine features (CT and MRI).Results 13 patients all were male, and were intoxicated by way of inhaling heroin vapour. Nine cases had appearances of clinical manifestations during abrupt abstinence. The main clinical manifestations of the disease were of the sub-acute diffuse cerebral lesions, especially of early mental symptoms and cerebellum ataxia. The CT of all 13 cases showed multiple white matter lesions involving in the frontal, parietal, occipital,temporal, and cerebellum hemisphere dentate nucleus. There was no occupational mass shown in general. The MRI of 6 cases showing focus was the same as of the CT. Conclusion The diagnosis of HTE should be dependent on the definite inhaling heroin vapour and their clinical features and neuroradiological appearance. CT should be valuable for the diagnosis of HTE, and the MRI as well. Corticosteroids show less therapeutic effect on such diesease.

The goal of medical education is to train good doctors.Only by understanding the trend of medical education development,call medical schools effectively promote educational reform and improve the quality of medical education.In this paper,we analyze the trend of course plans,teaching content,teaching strategies and the evaluation mode of the domestic and international medical education reform and development,introduce the ideas and practices in reform of management system,training pattern,course plans and assessment methods based on the education platform of"mutual promotion of teaching and research,mutual integration of medicine and humanities and simultaneous improvement of knowledge and ability"in Chongqing Medical University.

Contents of laboratory diagnosis is complex.Traditional teaching method cannot arouse students' interest in study and the teaching effect is poor. Teachers should choose different teaching emphasis for students in different specialty,increase and decrease theory teaching contents according to the demands of students' future actual work,introduce case analysis,train students' capability of clinical logical thinking,enhance students' perceptual knowledge of theory through the training of experiment skills and using PBL teaching method to make students truly participate in teaching course so as to arouse their enthusiasm,These reforming measures will benefit the improvement of teaching quality.

Aim: To search for new compounds with stronger anti-inflammatory activities and less gastrointestinal side effects. Methods: 2-(2, 4-Dichlorophenyl) -3-(3, 5-dimethoxyphenyl) - propenoic acid(Ⅰ) was converted to amides(Ⅱ). Their anti-inflammatory activities against xylene-induced mice ear swelling were evaluated. Results: Twelve target compounds (Ⅱ_(1-12)) were synthesized, and their structures were confirmed by IR,~1H NMR and HR-MS.Ⅱ_3 exhibited significant anti-inflammatory activity compared with CMC-Na ( P < 0. 01) and aspirin ( P < 0. 05). Conclusion: Compound Ⅱ_3 deserves further investigation.

Objective To investigate the effects of 5-fluorouracil (5-FU) on the distribution, pro-portion and immunosuppressive activities of myeloid-derived suppressor cells (MDSCs) in a mouse model of liver cancer.Methods Orthotopic transplantation of H22 cell line was performed to establish the mouse model of orthotopic liver cancer.Forty mice were randomly divided into four groups (n=10) on the 7th day after transplantation.Three different doses of 5-FU (10 mg/kg, 30 mg/kg and 50mg /kg) and 0.4 ml of PBS were respectively given to the mice in each group for 10 consecutive days .A control group without canc-er cell transplantation was set up correspondingly .The distribution of MDSCs in mice liver tissues was detec-ted by immunohistochemistry .The proportions of MDSCs in spleen tissues were tested by flow cytometry . The levels of IFN-γand Arginase-I ( Arg-I) in serum samples were analyzed by enzyme-linked immunosor-bent assay.The activities of nitric oxide synthetase (NOS) in serum samples were tested by chemical colori-metry.The proliferation of T lymphocytes was assessed by 3-(4,5-Dimethylthiazol-2-yl)-2, 5-diphenyltet-razolium bromide (MTT) test.Results 5-FU reduced the tumor size and alleviated the adhesion between liver tissues and abdominal cavity in mice with liver cancer in a dose-dependent manner .The proportions of MDSCs in liver and spleen tissues from mice in four model groups were significantly higher than those in con - trol group (P<0.05).The highest proportions of MDSCs were observed in PBS treated group , followed by 10 mg/kg of 5-FU treated group , 30 mg/kg of 5-FU treated group and 50 mg/kg of 5-FU treated group .Ex-cept for comparing between PBS treated group and 10 mg/kg of 5-FU treated group, there were significant differences with the proportions of MDSCs in liver tissues among other groups (P<0.05).The levels of Arg-I and the activities of NOS in mice with liver cancer were higher than those in control group (P<0.05).The mice in PBS treated group showed the highest level of Arg-I and the strongest activities of NOS that were de-creased as concentrations of 5-FU increased( P<0.05).The levels of IFN-γin serum samples from mice with liver cancer were lower than those in control group , and the lowest level was detected in PBS treated group.IFN-γlevels were increased as concentrations of 5-FU elevated.Except for comparing between PBS treated group and 10 mg/kg of 5-FU treated group , significant differences with the levels of IFN-γin serum samples (P<0.05) were observed among other groups .No significant differences with the proliferation of T cells were observed among all groups after 24 hours of culture (P>0.05),but that were decreased in model groups than those in control group after 48 hours of culture (P<0.05).T cells from mice in PBS treated group showed the lowest level of proliferation .T cell proliferation was enhanced upon the treatment of 5-FU in a dose-dependent manner .Except for comparing between PBS treated group and 10 mg/kg of 5-FU treated group, significant differences with T cell proliferation were observed among other groups (P<0.05).The proportions of MDSCs in liver and spleen tissues were positively correlated with the levels of Arg -I and the activities of NOS, but negatively correlated with IFN-γlevel and T cell proliferation at the time point of 48 h.Conclusion To a certain extent , 5-FU could reduce the numbers of MDSCs in liver and spleen tis-sues from mice with liver cancer , inhibit immunosuppressive activities of MDSCs and restrain the growth of the tumor in a dose-dependent manner .

Objective To explore the expression and clinical significance of soluble Axl and Tyro3 receptor tyrosine kinase in systemic lupus erythematosus (SLE).Methods Sandwich enzyme linked immunosorbent assay (ELISA) was used to detect sAxlTK and sTyro3TK in the serum of 140 SLE patients,150 disease controls and 100 healthy controls (HC).The relationships between the serum levels of sAxlTK/sTyro3TK and clinical manifestations,laboratory parameters,disease activity were analyzed in SLE patients.Analysis of variance,Dunnett's t-test,chi-square test and spearman's test were used for statistical analysis.Results The concentrations of sAxlTK [(56±18) ng/ml] and sTyro3TK [(3.9±1.6) ng/ml] were both elevated in serum of SLE patients,which were significantly higher than disease controls [sAxlTK:(41±17) ng/ml;sTyro3TK:(2.6± 1.2) ng/ml] and healthy controls [sAxlTK:(37±10) ng/ml;sTyro3TK:(2.1±0.7) ng/ml].The SLE sAxlTK levels were negatively correlated with lymphocyte count (r=-0.266,P=0.002),hemoglobin (r=-0.480,P＜0.01),platelet count (r=-0.374,P＜0.01),albumin (r=-0.465,P＜0.01),estimated glomerular filtration rate (eGFR,r=-0.230,P=0.006),complement C3 (r=-0.399,P＜0.01) and complement C4 (r=-0.374,P＜0.01).However,the levels of sAxlTK in SLE patients were positively correlated with D-dimer (r=0.371,P＜0.01),creatinine (r=0.278,P＜0.01),24-hour urinary protein quantification (r=0.383,P＜0.01),erythrocyte sedimentation rate (r=0.422,P＜0.01),titre of anti-nuclear antibodies (r=0.271,P=0.002),anti-dsDNA antibody (r=0.299,P＜0.01),anti-nucleosome antibody (r=0.263,P=0.013) and anti-cardiolipin antibody (r=0.309,P＜0.01).In addition,the levels of serum sAxlTK in SLE patients showed positive correlation with the scores of SLEDAI (r=0.307,P＜0.01).Comparisons of sAxlTK levels between patients with high and low disease activity demonstrated a higher level of sAxlTK in the former [(64±17) ng/ml vs (52±16) ng/ml;t=-3.939,P＜0.01].Conclusion The levels of sAxlTK and sTyro3TK are elevated in the serum of SLE patients.The concentration of sAxlTK is correlated with autoantibodies production,hematological and renal involvement in SLE,which may be a serolgical marker for disease activity.

Objective To investigate the predictive value of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) calculated from 18F-FDG PET-CT results for postoperative recurrence and prognosis in patients with resectable pancreatic cancer. Methods From may 2009 to December 2015, 30 patients with pancreatic cancer who underwent curative resection after PET-CT examination were enrolled, and the clinic pathological data and 18F-FDG PET-CT data were retrospectively analyzed. The prognostic value of SUVmax, SUVmean, MTV, TLG and other prognosis factors were analyzed. Results In 30 patients with pancreatic cancer, preoperative 18F-FDG PET-CT detected all primary lesion (10 0%). 29 patients were recurrence or metastasis, and 26 patients were died with median of 17.8 months (2.6-39.6 months) follow-up. The median progression-free survival (PFS) time was 6.5 months and the median overall survival (OS) time was 11.6 months. The multivariate analysis revealed the histological differentiation and MTV were the independent influencing factors for PFS (both P<0.05). The lymph node metastasis, MTV and TLG were the independent influencing factors for OS (all P<0.05). Conclusion The MTV and TLG of PET-CT may be predicting the recurrence and survival of patients with pancreatic cancer after curative resection, suggesting that it can be used to guide the individual treatment.

Objective To investigate the effect of PBL method in the pathogen and immunology teaching. Methods PBL teaching was practised in trial group,while LBL teaching was practiced in control group.The writers made an analysis of this teaching by way of questionnaire and exam. Results Many students by PBL teaching accept PBL teaching Method,and improve their self-study ability,understanding ability,analyzing ability and so on. Conclusion PBL teaching method is much better than LBL teaching method,and can improve the quality of pathogen and immunology teaching.

Objective To investigate the expression of Caspase-9 and heat-shock protein-90 (HSP 90) in rats after focal cerebral ischemia-reperfusion injury.Methods The male SD rats (200-250 g) were divided into three groups by the random number table: normal group, sham group and cerebral ischemia-reperfusion (CIR) group.Each group was sorted into four subgroups including group 6 h, group 24 h, group 48 h and group 72 h according to the reperfusion time.Suture-occluded method was adopted to prepare focal cerebral ischemia-reperfusion(CIR) injury in rat model.Enzymelinked immunosorbent assay (ELISA) method was used to detect the variations of Caspase-9 and HSP-90 expression in rats.Results The changes in Caspase-9 and HSP 90 expression in the brain cells were observed by ELISA method.The expression of Caspase-9 and HSP-90 was weakly expressed in sham group, and was at peak in CIR group within 24 h-48 h, then began to decline at 72 h after the reperfusion time.The differences in the expression of caspase-9 and HSP-70 between sham group and normal group were not statistically significant.Conclusions Apoptotic cells gradually increase along with reperfusion time and reach the peak at 48 h after cerebral ischemia-reperfusion.In ischemia half dark stripe, the expression of Caspase-9 and HSP 90 is increased in neuronal cells after cerebral ischemia-reperfusion, and the positive cells number is at peak at 48 h after cerebral ischemiareperfusion.Apoptosis of neuronal cells after cerebral ischemia and reperfusion is a dynamic evolutionary process.The expression of Caspase-9 and HSP 90 in nerve cells plays an important role in regulating cell apoptosis.

Objective To explore the status of glucocorticoid application in patients with systemic lupus erythematosus (SLE) in China.Methods Epidemiological survey was used.The SLE patients who met the 1997 classification criteria of American College of Rheumatology were enrolled.The usage of glucocorticoid and related adverse reactions were recorded and analyzed.Results A total of 400 SLE patients were enrolled,including 35 men and 365 women.The average age was (37.4 ± 14.0) years old,and the average duration of disease was (6.7 ± 5.8) years.There were 310 patients using glucocorticoid as maintenance.Sixty-one percent (n =244) patients started using medium dose (prednisone 30-＜ 60 mg/d) as the initial treatment of glucocorticoid,which lasted for (37 ± 11) days.The time of drug duration in patients with low dose prednisone (7.5-＜30 mg/d)and high dose (60-100 mg/d) was(92 ± 20)and (17 ± 3) days respectively (P ＜ 0.05 between 3 groups).However,patients receiving different initial dosage were of no discrepancy in the maintenance therapy.During maintenance,even though 51.0％ (n =158) patients were on prednisone 2.5-5 mg/d,the duration of drug use in ＞ 5-10 mg/d groupwas longer [(29.9 ± 3.3) months].Patients with involvement of internal organs had a higher tendency to use 60-100 mg/d prednisone or pulse-dose therapy in the initial treatment,nevertheless these two groups had no difference of maintenance dosage.Among all 400 patients,62 patients withdrew glucocorticoid,including 17 patients with disease remission (4.3％),44 by self-withdrawal and one with adverse reaction.Conclusion In China,the medium dosage of glucocorticoid is the most common initial treatment in patients with SLE.Prednisone 2.5-5 mg/d was the most common choicefor maintenance therapy.Currently,the proportion of glucocorticoid withdrawal remains low in SLE patients achieving remission.