Developing the clinical thinking ability and therefore improving the clinical practice ca-pacity are the core of the quality-oriented education and in the current medical education reforms. The rea-sons for retarding the development of clinical thinking ability in dental clinical probation were herein dis-cussed. According to the similarity between mind mapping and clinical thinking, drawing mind map was used in the creation of the clinical knowledge system; various teaching techniques were used and classical clinical cases were shown; role playing as dentist and patient was used to mimic the clinical circumstance;dentist-patient communication was emphasized and methods to evaluate the clinical thinking ability were also developed. These strategies effectively developed the clinical thinking ability of the dental students.

As the understanding of science creativity becomes more profound,people find out that organizational barriers are greatly deterring and discouraging the advent and development of science creativity.Drawing upon the Situation Theory of Creativity and earlier researches,we identified crucial organizational factors that imposed influence on science creativity and considered those factors as gauge to reflect on the current practice of science research management in China.The findings show that science research funding mode,collaboration and communication opportunities and accesses,science researchers' career development and evaluation system,research group leadership,size and diversity of research teams are all key components of the organizational barriers that failed to nurture and spur Chinese researchers to solve long existed and challenging problems with original approaches and creative thinking.Therefore,innovations of science research management are necessary and urgent.

Objective To evaluate long term effect and related factors in patients with menorrhagia treated by microwave endometrial ablation(MEA).Methods Total of 334 women with menorrhagla were treated hy MEA,the range of age was from 29 to 59 years old.Among them,59 cases were complicated by adenomyosis.All the patients were followed up on the change of menstrual cycle.the amount of flow,improvement of anaemia and complication.Fifty-three women underwent outpatient diagnostic hysteroscopy,the biopsy tissue was taken from the endometrium for histopathological examination.The mean duration of follow-up was 64.7 months (3-96 months).Results The overall curative rate wag 91.3%(305/334),of which amenorrhea rate was 49.7%(166/334),menstruation reduction rate was 41.6%(139/334):71.1%(140/197) of the cases who previously had dysmenorrhea had relieved their pelvic pain and the satisfactory rate was 91.9%(307/334).Among patients＞40 years,92.9%(196/211) of operation effective rate,93.8% (198/211) of satisfactory rate and 64.9% (137/211) of amenorrhea rate were obtained.while patients≤40 years,88.6%(109/123) of operation effective rate,88.6%(109/123) of satisfactory rate and 23.6%(29/123) of amenorrhea rate were obtained.There was significant difierence in rate of operation effectiveness,satisfaction and amenorrhea (P＜0.05).Forty-two cases required subsequent treatment due to recurrence,of which 9 cases were given by secondary MEA and 33 cases (9.9%、33/334) underwent hysterectomy indicated by frequent menorrhagla,adenomyosis or leiomyoma.A completely destroyed endometrium was observed by hysteroscopy after MEA,pathologic characteristics of MEA showed two zones of necrotic tissue:the inner zone was coagulation necrosis and the outer zone of necrosis was hypocellular hyalinized myometrium.Conclusions MEA is the safe and efficacious management to treat menorrhagia.Incomplete removal of endometrium was the major reason resulting in postoperative recurrence.Young age and complicated with adenomysis were the main factors influencing long term clinical effect of MEA.

Objective We evaluate if supplementary grading system can refine patient selection and accurately predict neurological outcome in BAVM. Methods We retrospectively study 221 BAVM patients who were treated micro?surgically by our hospital. The score of pre and post operation mRS and relative clinical, radiology data were collected. Two different logistic models (Spetzler-Martin, Supplementary Spetzler-Martin grading model) were constructed to com?pare the area under ROC. Results Some factors are significant different between worse outcome patients and good out?come patients:Non-hemorrhagic presentations prior surgery, AVM bigger than 3cm, diffuse shape of AVM and the elder patients. Predictive accuracy was higher for the supplementary model (ROC area, 0.91), than the Spetzler-Martin model (ROC area, 0.774). So the predictive accuracy of supplementary model was significantly better than that of the Spet?zler-Martin model (P=0.0362). Conclusions Supplementary Spetzler-Martin model can improve preoperative risk pre?diction and subgroup the patients more efficiently. When the score less than 5(including 5) in supplementary Spet?zler-Martin patients seem to have lower risk relative to surgery.

Objective To study the clinical and pathological characteristics of HPV-negative cervical cancer patients. Methods Retrospective analysis of 785 cervical cancer patients in Guangdong Women and Children Hospital from Jan. 2005 to Oct. 2015. By detecting high-risk HPV infection by flow-through hybridization genechip technique. Results (1) Among 785 cases of cervical cancer, 71 cases were negative for HPV infection tested by genechip technique, accounting for 9.0%(71/785), and the relative light units/cut off (RLU/CO) ratios of these 71 cases were less than 1 by hybird captureⅡ(HC-Ⅱ) methods. The results showed that the positive coincident rate of genechip technique detecting result with HC-Ⅱmethod was 100.0%(71/71). (2) There was no difference between 43 (60.6%) cases from 41-55 years old of 71 cases of HPV-negative patients and 392 (54.9%) cases from 41-55 years old of 714 cases of HPV infection patients (χ2=15.63, P=0.571). Among 71 cases of HPV-negative patients, 32 cases of patients with doing TCT, 6 (18.8%) cases for normal, 10 (31.2%) cases for atypical squamous cells of undetermined significance (ASCUS), 3 (9.4%) cases for atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (ASC-H), 3(9.4%) cases for low-grade squamous intraepithelial lesions (LSIL), 8 (25.0%) cases for hight-grade squamous intraepithelial lesions (HSIL), 2 (6.2%) cases for squamous cell carcinoma (SCC). And there were 391 cases of patients with doing thin-prep cytologic test (TCT) of 714 HPV infection patients, 60 (15.3%) cases for normal, 61 (15.6%) cases for ASCUS, 28 (7.2%) cases for ASC-H, 29 (7.4%) cases for LSIL, 164 (41.9%) cases for HSIL, 49 (12.5%) cases for SCC. There was no difference of TCT between HPV infection and HPV-negative patients (P>0.05). Among 70 cases from 71 patients with negative for HPV infection, there were 8(11.4%) cases in stage Ⅰa, 26 (37.1%) cases in stage Ⅰb1, 12 (17.1%) cases in stageⅠb2, 11 (15.7%) cases in stageⅡa, 10 (14.3%) cases in stageⅡb, 3 (4.3%) cases in stageⅢ-Ⅳ. There were 118(16.6%) cases in stageⅠa, 261 (36.8%) cases in stageⅠb1, 72 (10.1%) cases in stageⅠb2, 152 (21.4%) cases in stageⅡa, 87 (12.3%) cases in stageⅡb, 20(2.8%) cases in stageⅢ-Ⅳin 710 cases of HPV infection patients, in which there were no difference of clinical stage between HPV infection and HPV-negative patients (P>0.05). Among 69 cases from 71 patients HPV-negative infection, there were 51 (73.9%) cases for squamous carcinoma, 13 (18.8%) cases for adenocarcinoma, 5(7.2%) cases for adenosquamous carcinoma;and 593 (87.2%) cases for squamous carcinoma, 38 (5.6%) cases for adenocarcinoma, 39 (5.7%) cases for adenosquamous carcinoma, 10 (1.5%) case for others were in 680 patients of HPV infection, in which there was significant difference of adenocarcinoma between HPV infection and HPV-negative patients (χ2=11.96, P=0.001). Conclusions Flow-through hybridization genechip technique is the method of high sensitivity to detect high-risk type HPV, as like HC-Ⅱ method. HPV-negative of cervical cancer occurs mainly in 41-55 years old. Adenocarcinoma incidence is significantly higher in HPV-negative cases than those patients with infection of HPV positive.

Background and purpose: Resistance of cancer cells to chemotherapy is a major clinical obstacle to successful treatment and leads to poor prognosis for the patients. MicroRNA (miRNA) plays a vital role in tumor cells response to chemotherapeutic agents. This study plans to investigate the expressions of miRNA27a and miRNA451 in ovarian cancer and breast cancer cells and its correlation with drug resistance. Methods:A2780/Taxol cells were established using stepwise selection;Stem-loop quantitative real-time PCR (stem-loop RT-PCR) was used to detect expression of miRNA27a and miRNA451 in ovarian cancer and breast cancer cells. The A2780 and A2780/Taxol cells were transfected with the mimics or inhibitors of miRNA27a or negative control (NC) RNA and the mimics of miRNA451 or NC were transfected into MCF-7/ADM cells by LipofectamineTM 2000. The expression levels of MDR1 mRNA and P-glycoprotein (P-gp) were examined using RT-PCR and Western blot respectively. MTT method was used to analyze drug sensitivity. Results:The expression of miRNA27a was an average of (2.2±0.30) times higher in A2780/Taxol cells than in A2780 cells, with a significant difference between the two groups (P<0.05). The expression of miRNA451 was lower by 84%in MCF-7/ADM cells than in MCF-7 cells, with a signiifcant difference between the two groups (P<0.05). A2780/Taxol cells transfection with inhibitors of miRNA27a showed that the levels of MDR1 mRNA was decreased by (39±0.14)%, P-gp level [(26±5.3)%] decreased compared with the NC group [(43±6.7)%], the IC50 (0.53μmol/L) was less than the NC group (6.8μmol/L), and there was a signiifcant difference between two groups (P<0.05). Transfection of A2780 cells with mimics of miRNA27a led to increase MDR1 mRNA expression by (121±0.11)%and decrease the sensitivity to paclitaxel (IC50:0.2μmol/L vs 0.06μmol/L). There was a signiifcant difference between two groups (P<0.05). Transfection of MCF-7/ADM cells with mimics of miRNA451 showed that expression of MDR1 mRNA was decreased by (65±12)%, P-gp [(31±19)%] was less than the NC group [(83±12)%], the sensitivity of cells to adriamycin enhanced and the IC50 of adriamycin (4.61μmol/L) was less than the NC group (26μmol/L), and there was a signiifcant difference between two groups (P<0.05). Conclusion:The expressions of miRNA27a and miRNA451 are deregulated in A2780/Taxol and MCF-7/ADM cells respectively, which may play vital roles in drug resistance by regulating MDR1/P-gp expression directly or indirectly.

Rapid development in medical technology has posed new challenges to higher medical education,especially to education of eight-year program students.How to survive the challenges has thus become a question for medical institutions.By analyzing the features of medical development and the new demand of medical education,we proposed the following innovations for education in eight-year program.It should emphasize combination of different disciplines and construction of integrated medical course system.Research on translational medicine should be conducted,and cooperation between institutions should be promoted.

Objective To observe the therapeutic effect of Shilin Qinghua Decoction(SQD) for the treatment of urinary calculi.Methods Two hundred urinary calculi patients were equally randomized into two groups: the treatment group received SQD(mainly composed of Herba Lysimachiae,Endothelium Corneum Gigeriae Galli,Radix Paeoniae Alba,Talcum,Radix Clematidis,Poria,Semen Vaccariae,Herba Plataginis,Herba Polygoni Avicularis,Herba Dianthi,Succinum powder),and the control group received uralyt.Twenty days constituted one treatment course,and the treatment lasted 1～3 course(s) according to the illness state.The therapeutic effect was evaluated after 2 months.Results The total effective rate was 96.0% in the treatment group and 81.0% in the control group,the difference being obviously significant(P

Gingseng is commonly used in traditional Chinese medicine community for the treatment of depression-like disorders. Ginsenosides is considered to be the major active components of ginseng. Previous studies have demonstrated that ginsenosides produced antidepressant-like action in various mouse models of behavioral despair. The present study aimed to examine whether ginsenosides could affect the chronic unpredictable mild stress (CUMS)-induced depression in rats. The mechanism(s) underlying the antidepressant-like action was investigated by measuring serum corticosterone level, glucocorticoid receptor (GR), mineralocorticoid receptor (MR) and brain-derived neurotrophic factor (BDNF) mRNA levels in brain tissues. CUMS, being lasted for 6 weeks, caused depression-like behavior in rats, as indicated by the significant decrease in sucrose consumption and increase in immobility time in the forced swim test. Whereas serum corticosterone level was significantly increased in rats exposed to CUMS, expressions of GR mRNA in hippocampus, and BDNF mRNA in hippocampus and frontal cortex, were decreased in CUMS-treated rats. Daily intragastric administration of ginsenosides (12.5, 25, 50 mg x kg(-1)) during the six weeks of CUMS significantly suppressed behavioral and biochemical changes induced by CUMS. However, there was no significant difference in MR mRNA level among groups. The results suggest that the antidepressant-like action of ginsenosides is likely mediated by modulating the function of hypothalamic- pituitary -adrenal axis and increasing the expression of BDNF in brain tissues.
Adrenal Glands ; drug effects ; metabolism ; Animals ; Brain-Derived Neurotrophic Factor ; genetics ; metabolism ; Depression ; drug therapy ; genetics ; metabolism ; Drugs, Chinese Herbal ; administration & dosage ; Ginsenosides ; administration & dosage ; Humans ; Hypothalamus ; drug effects ; metabolism ; Male ; Panax ; chemistry ; Pituitary Gland ; drug effects ; metabolism ; Random Allocation ; Rats ; Rats, Wistar

Objective To explore the value of serum insulin-like growth factor-1 (IGF-1) levels in diagnosis and treatment of primary hyperthyroidism. Methods 150 patients with primary hyperthyroidism (hyperthyroidism group) and 85 patients with hypothyroidism (hypothyroidism group) were selected as study subjects. During the same period, 60 healthy individuals were selected as control group. The levels of serum IGF-1, thyroid peroxidase antibody (TPOAb), thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), triiodothyronine (T3) and total thyroxine (T4) were measured in the three groups. The serum visfatin levels in the three groups were detected using an enzyme-linked immunosorbent assay. Multifactor Logistic regression analysis was used to screen for risk factors of primary hyperthyroidism. Results The levels of IGF-1, FT3, FT4, T3 and T4 in the hyperthyroidism group were significantly higher than those in the hypothyroidism and control groups, while TSH levels were significantly lower (P < 0.05). TPOAb and visfatin levels in the hyperthyroidism group were significantly higher than those in the control group, but significantly lower than those in the hypothyroidism group (P < 0.05). The serum IGF-1 levels in patients with primary hyperthyroidism before and after 3 months of treatment were (60.11±7.23) and (30.23± 3.22) μg/L, respectively, showing a statistically significant difference (t=8.436, P < 0.001). Serum FT3, FT4, T3, T4, TPOAb, IGF-1 and visfatin levels increased and serum TSH levels decreased as risk factors for primary hyperthyroidism (P < 0.05). Conclusion The level of serum IGF-1 is closely related to thyroid function and may serve as an important reference indicator for the diagnosis and monitoring of the efficacy of primary hyperthyroidism treatment.