Problem based learning(PBL) is a new teaching method that centers on the problems of patients' diseases,the learning of students,guided by the instructors,but students positive.However,nowadays,it can not be completely implemented in our nation.We should choose the combination of the traditional and innovatory methods,and execute the reformation gradually.

Aim To Study the inhibition mechanism of edelfosine on cytokinesis in Schizosaccharomyces pombe. Methods To observe the inhibition of cytokinesis and growth, the experiments of inhibition of cyto-kinesis and parallel growth were carried out. To explore the inhibition mechanism of edelfosine, the experiment of retransfection of yeast genes was carried out. Results Edelfosine inhibited the cytokinesis of S.pombe in low dosage and cell growth in high dosage. The mid2△、spm1△ and pmp1△ strains were resistant to edelfosine in high dosage. However, these strains retrieved the sensitive to edelfosine in high dosage by retransfected the relevant genes, respectively. A reciprocal action, which was the Mid2p induced the phosphorylated Spm1, while the Pmp1 dephosphorylated Spm1, existed among the Spm1、Mid2 and Pmp1 in S.pombe treated with edelfosine. Conclusion The inhibition of edelfosine on cytokinesis and cell growth due to the effect of Spm1、Mid2 and Pmp1.

Objective To study imaging features of neuronal tumors, and to evaluate the value of CT and MRI in diagnosing these tumors. Methods The CT and MRI studies in 10 patients with pathologically proved neuronal tumor were retrospectively reviewed. Results (1) CT showed a mixed attenuation cystic solid mass with calcification in 3 gangliogliomas; The mixed signal intensity on T 1 or T 2WI with heterogeneous contrast enhancement was common in ganglioglioma. (2)Three central neurocytomas had mixed signal intensity. (3)Three dysembryoplastic neuroepithelial tumor (DNT) had decreased signal intensity on T 1 weighted MR images and well demarcated increased signal intensity on T 2 weighted images without peritumoral edema and calcification. Prominent MR imaging features were a gyriform configuration on T 1 or T 2WI. The tumor contrast enhancement was not common; (4)A desmoplastic infantile ganglioglioma (DIG) was located in the frontal and parietal lobes, appearing as cystic tumors with a solid cortical component enhanced intensely. Conclusion Some neuronal tumors possess of specific imaging features, but diagnosis of the tumor with imaging modalities alone may be difficult. Therefore, combined clinical history could help to establish a correct diagnosis.

Aromataseinhibitors(AI)aretheleadingcarefortheadjuvanttreatmentofhormone responsive carcinoma of the breast as demonstrated in a number of large international phase III randomised tri-als.Aromatase inhibitor-associated arthralgia (AIA )was a somewhat unexpected side effect of this class of agents and has proven to be potentially problematic in clinical practice.The pathogenesis of AIA is not very clear currently,with the cause of most research focusing on estrogen deprivation,immune abnormalities,tenosy-novial changes and joint effusions.It is extremely urgent that we evaluate this syndrome and select appropriate therapeutic strategies to reduce the incidence of AIA,thereby improving breast cancer-related outcomes.

Objective To investigate the feasibility and superiority of combined spinal epidural anesthesia incesarean section.Methods 100 lying-in women who experienced cesarean section were collected and divided into combined spinal epidural anesthesia group(CSEA,n=50)and continuous epidural anesthesia group(CEA,n=50).The change of heart rate(HR),blood pressure(BP)and saturation of peripheral oxygen(SpO2),HR and BP of lyingin womeu in pre-anesthesia,5min,15min post-anesthesia and the time of taking effect,time between beginning of anesthesia and laboar of newborn were observed.The side effects of surgical anesthesia and Apgar score of newborn were compared between the two groups.Results There were no difference in clinical data,change of HR,BP and spO2 between two groups.The anaesthetic time of taking effect and the time between beginning of anesthesia and labour of newborn in group CSEA were shorter than in group CEA(all P＜0.05).Conclusion The combined CSEA and CEA was safe and efficient in cesarean section,and CSEA had greater efficacy than CEA in cesarean section.

Objective To study the feasibility of transperitoneal laparoscopic radical prostatectomy. Methods Laparoscopic radical prostatectomy was performed according to Montsouris technique. Results All the operations were successfully completed. The operating time was 330~540 min (mean, 433 min) and the estimated blood loss was 100~550 ml (mean, 274 ml). No patients required a blood transfusion. Bladder injury was found in 1 patient and was sutured promptly during the operation. The postoperative hospital stay was 15~23 days (mean, 17 days). The catheterization time was 14~23 days (mean, 16 days). In 2 patients presenting with urinary leakage, the catheter was removed at 20 and 23 days after surgery respectively, while in the remaining 8 patients, at 2 weeks after operation. Mild urinary incontinence occurred in 3 patients and disappeared after 4 weeks of supportive treatment. Pathological examinations revealed stage pT_ 1c) in 3 patients, stage pT_2 in 6, and stage pT_3 in 1. A follow-up for 3~21 months (mean, 7.5 months) was carried out. The postoperative prostate-specific antigen (PSA) level was 0~2.70 ?g/L(mean,0.05 ?g/L). Two patients returned a normal sexual function. Conclusions Strict following surgical indications, adequate preoperative preparation, improvement of surgical techniques, and proper application of surgical instruments and devices make transperitoneal laparoscopic radical prostatectomy feasible.

To observe the changes in L Arginine /NO pathway of platelet in elderly patients with essential hypertension 20 elderly patients with essential hypertension and 15 healthy volunteers were entered for the study. The changes in L Arg transport, the activity of NOS and the production of NO - 2 were measured. Results showed that the activity of NOS and the production of NO - 2 were decreased, compared with those of healthy volunteers. The maximum transport velocity (Vmax) of L Arg transport in elderly patients with essential hypertension was 70% of healthy volunteers. No changes in Michaelis constant (Km) were found. This results suggested that function of L Arginine/NO pathway of platelet in patients with hypertersion is decreased. L Arginine/NO pathway of platelet played an important role in antithrombosis. Not only drugs to lower blood pressure should be given but also antiplatelet drugs to prevent thrombosis.

Objective To compare the renal function after neurosurgery performed under closed-circuit anesthesia with sevoflurane and desflurane and determine the safety of the closed-circuit sevoflurane anesthesia. Methods 36 ASA Ⅰ or Ⅱ patients aged 18-60 years were randomly divided into 2 groups to receive either sevoflurane (group S, n = 18) or desflurane (group D, n = 18) . The duration of surgery was expected to be ≥90 min. The patients were premedicated with intramuscular midazolam 0.07 mg?kg-1 . Anesthesia was induced with midazolam 0.1 mg?kg-1, fentanyl 1.5-2.0 ?g?kg-1 , propofol 1-2 mg?kg-1 and vecuronium 0.1-0.15 mg? kg-1. The patients were mechanically ventilated (VT = 8-12 ml?kg-1) after tracheal intubation. PET CO2 was maintained a 35-45 mm Hg. Fresh gas flow (FGF) was first set at 1-5 L?min-1 for 2-3 min, then reduced to 0.18-0.3 L?min-1. In group D end-tidal desflurane concentration was maintained at 6%-10% ; whereas in group S the end-tidal sevoflurane concentration was maintained at 2.7%-4.0% . BP, HR, ECG, SpO2 PET CO2, inspiratory and expiratory O2 , desflurane and sevoflurane concentrations and the temperature in the center of soda-lime canister were continuously monitored during the operation. Gases were collected from breathing circuit for determination of compound A concentration (by gas chromatography) before anesthesia, at the end of 2-3 min wash-in, every 30 min during maintenance of anesthesia and at the end of anesthesia. Venous blood samples were taken before anesthesia (baseline) , at the end of surgery (T1) and at 2, 24 and 72 h after operation (T2-4) for determination of serum F-, creatinine (Cr) and blood urea nitrogen (BUN) concentrations. Urine specimens were taken for determination of total protein (TP), ?2-microglobulin (?2-MG) and ?-N-acetyl-glucuronidase (NAG) levels, before operation (baseline) at the end of operation and at 24, 48 and 72 h after operation. TP/Cr, ?2-MG/ Grand NAG/Cr were calculated to eliminate the influence of the volume of urine.Results There were no significant differences between the two groups with respect to age, sex, body weight, height, duration of anesthesia and temperature in the center of soda-lime canister. The inspiratory O2 concentration was ≥ 75% during anesthesia. There was no significant difference in serum Cr and BUN concentrations and NAG/Cr in urine before and after operation as well as between the two groups. TP/Cr and ?2-MG/Cr in urine were significantly increased after operation compared to the baseline values but there was no significant difference between the two groups. There was no significant correlation between postoperative TP/Cr, ?-MG/Cr and compound A. Conclusion Closed-circuit sevoflurane ansthesia does not affect postoperative renal function.

Objective To explore the effect of nerve growth factor(NGF) in the lower respiratory tract and the visceral afferent system of asthmatic guinea pigs. Methods By means of immunohistochemistry and in situ hybridization combined with the micro-image analysis to investigate the alterations of NGF immunoreactivity and mRNA expression in asthmatic guinea pig. Results The positive NGF immunoreactivity was increased in airway epithelia,C-7-T-5 spinal ganglia and correspondent spinal dorsal horn in the asthmatic guinea pigs compared with the controls(P

Objective To probe the mechanism of hepatocarcinoma cell apoptosis promoted by human telomerase reverse transcriptase (hTERT) RNA interference (RNAi) by mitochondrial pathway in vitro. Methods Westernblot was employed to detect the intracellular expressions of caspase-9, hTERT, Bcl-2 and Bax, and mitochondrial and cytoplastic cytochrome C (cyt C) in HepG2 cells transfected by pSliencer 3.1-H1 neo-shTERT (small hairpin RNA hTERT). Result In the HepG2 cells transfected by pSliencer 3.1-H1 neo-shTERT, expressions of hTERT, Bcl-2 and mitochondrial cyt C were significantly down-regulated, while Bax and cytoplastic cyt C were obviously up-regulated, and active caspase-9 was found in addition to procaspase-9 compared with that in negative control cells and untransfected cells. Conculsion hTERT RNAi may suppress hTERT expression to result in reduction of Bcl-2 and increase of Bax, and then induce hepatocarcinoma HepG2 cell apoptosis by mitochondrial pathway subsequent to cyt C release from mitochondria to cytoplast.