The content of optical isomerism is the difficult point of organic chemistry teaching, and so case-based learning (CBL), theoretical-experimental integration teaching method and micro class teaching methods are tried to be used in classroom teaching according to the actual teaching situations. For CBL teaching method, the course is guided by the step of introduction-question-discussion and summary-exten-sions; For theoretical-experimental integration teaching method, combined with the theory class, the two experiments including the determination of optical rotation and organic molecular model are set for the opti-cal isomer content, to enhance the students' understanding of theoretical knowledge through the hands-on operation;For micro class teaching method, the key and difficult points of this chapter are dug out and about 10 minutes of video are recorded by using common video software before class, which are introduced in the classroom or provided to students after class for repeated watching, to deepen the students' understanding of the concept and phenomenon of optical isomers. In brief, it is important to combine various teaching method to improve the classroom instructing effectively and stimulate the students' interest in organic chemistry.

Objective To compare the clinical effect of non-operative and operative treatment for flail chest.Methods A retrospective case control study was made on 60 cases of flail chest treated from March 2013 to April 2016.There were 42 males and 18 females,at the age range of 36-62 years [(49.8 ± 10.3)years].According to the treatment methods,the patients were divided into non-operation group (28 cases) and operation group (32 cases).Chest CT,pulmonary function and 36-item short-form health survey(SF-36) were measured in all patients 3 months and 6 months after injury.Differences in atelectasis,chest wall deformity,delayed fracture healing,pulmonary function and life quality were analyzed between the two groups.Results Compared to non-operative group at postoperative 3 months,rates of atelectasis,chest wall deformity and delayed fracture healing in operation group were obviously lower,while indices of pulmonary function pulmonary function including forced vital capacity (FVC),forced expiratory volume in one second(FEV1),one second rate (FEV1/FVC) and maximal voluntary ventilation measured value (MVV) in operation group wcre higher,and SF-36 parameters including physical functioning (PF),role-physical (RP),bodily pain (BP),general health (GH),vitality (VT),social functioning (SF) and mental health (MH) in operation group were better (all P ＜ 0.05).As to the data measured 6 months after injury,there were no significant differences between the two groups,except that the rate of chest wall deformity in non-operative group (6 cases,39％) was higher than that in operation group (11 cases,19％) (P ＜ 0.05).As to c hest CT,indices of pulmonary function and SF-36 parameters (P ＜ 0.05),there were no significant differences within operation group at postoperative 3 months and 6 months (P ＞ 0.05).Non-operation group showed better results in rate of atelectasis,rate of delayed fracture healing,indices of pulmonary function and SF-36 parameters measured 6 months after injury than the detections at postoperative 3 months (P ＜ 0.05),without difference in rate of chest wall deformity (P ＞ 0.05).Conclusions Surgical treatment of flail chest can accelerate fracture healing,reduce rate of chest wall deformity and improve life quality of patients early compared to non-operative treatment.Although there is no obvious difference in life quality of patients between operative and non-operative treatment 6 months after injury,but the chest wall deformity remains significantly different.

Objective To observe the effect of abdominal obesity on lung function in the perioperative period of complete video-assisted thoracoscopic lobectomy.Methods Collected 36 cases of peripheral lung cancer and could complete video-assisted thoracoscopic lobectomy by access conditions,18 cases in abdominal obesity group who had body mass index (BMI) ＞ 35 kg/m2 and the waist circumference ＞ 95 cm on men the waist circumference ＞ 90 cm on women,18 cases in normal weight group who had BMI ＜ 25 kg/m2 and the waist circumference ＜ 85 cm on men the waist circumference ＜ 80 cm on women.All cases had complete video-assisted thoracoscopic lobectomy and lymph node dissection with 4 holes,and recorded the operation time,before and after operation had blood gas analysis and lung function,at the same time recorded the cases of complication after operation,compared the parameters in two groups.Results The blood gas analysis had no difference before operation,but after 12 h of operation,the arterial blood oxygen partial pressure (PaO2) declined and alveolar-arterial blood oxygen partial pressure difference(PA-aO2) increased in abdominal obesity group,while the PaO2 declined and arterial blood CO2 partial pressure (PaCO2),PA-aO2 increased compared with normal weight group(P ＜ 0.05).The forced vital capacity (FVC),forced expiratory volume in 1 second(FEV1) had statistical significance in two groups before operation(P ＜ 0.05),on the third day after operation,the abdominal obesity group to himself the FVC,FEV1,maximal voluntary rentilation (MVV),functional residual capacity (FRC),carbon monoxide diffusion amount (DLCO) declined obviously except FEV1/FVC (P ＜ 0.05),compared with normal weight group,the FVC,FEV1,FRC,DLCO declined obviously (P ＜ 0.05).After operation,the lung function in abdominal obesity group,the FVC,FEV1,MVV,FRC,DLCO declined 25.8％,27.8％,20.4％,32.1％,39.1％,compared with normal weight group the FVC,FEV1,FRC,DLCO declined 31.8％,37.2％,30.2％,30.6％.The abdominal obesity group had more complication.Conclusion In the perioperative period of complete video-assisted thoracoscopic lobectomy,the abdominal obesity has more effect to lung function and must have more attentions on it,and effective weight control has important significance to operation patients.

Objective To solve the problem of castration resistant prostate cancer (castrationresistant prostate cancer,CRPC) the problem of drug resistance by studing the expression of the CUDC-101 inhibitor of castration resistant prostate cancer androgen receptor splice variant 7.Methods In this study,the expression of AR-V7 protein in prostate cancer cell lines PC-3,VCaP,22Rv1,LNCap was detected by imnmunoblotting between April 2015 and April 2016,and the highest expression level of cell lines was selected follow-up experiments.Through the cell proliferation and activity experiments,the epigenetic inhibitors:histone deacetylase inhibitor CUDC-101,histone methylation inhibitor DZNeP,DNA methylation inhibitor gemcitabine,histone acetyltransferase inhibitor MG149 to select an inhibitor that reduces the expression of AR-V7 protein in CRPC cells.22Rv1 cells were treated with 30 nmol and 300 nmol of CUDC101 and 1,10 and 20 μmol of Enzalutamide (MDV3100),respectively,and their inhibitory effects on the growth of 22Rv1 cells were examined.Results The results of immunoblotting showed that AR-V7 protein was only expressed in CRPC cell line 22Rv1 and negative in non-CRPC cell line.The expression of AR-V7 in 22Rv1 cells treated with CUDC-101 was significantly lower than that of negative control.While other inhibitors had no effect on the expression of AR-V7.In the cell proliferation and activity assay,the inhibitory rates of 30 nmol CUDC-101 and 1,10 and 20 μmol MDV3100 were 10％,35％ and 45％,respectively,higher than that of MDV3100 alone.28％ and 42％,the difference was statistically significant (P ＜ 0.05).The inhibitory rates of 300 nmol CUDC-101 and MDV3100 were 30％,60％ and 65％,respectively,which were significantly higher than those of MDV3100 alone (P ＜ 0.05).Conclusions CUDC-101 can inhibit the castration resistant prostate cancer androgen receptor splice variant 7 expression,and solved the resistance problem of CRPC.

Hereditary angioedema (HAE) is an autosomal dominant inherited disease characterized by recurrent and unpredictable episodes of subcutaneous or submucosal edema. These attacks could induce fatal risk when larynx is involved. The estimated prevalence of HAE is about 1 in 50 000. Due to its rarity and the diversity of clinical manifestations, HAE is known little by related physicians and misdiagnosis and mistreatment happens very often. Therefore, it is crucial to improve physicians′ understanding of HAE. To address this, a comprehensive management approach for the diagnosis and treatment of HAE have developed in our hospital. This approach includes intra-hospital multi-disciplinary treatment (MDT), collaboration with provincial network hospitals, patient education online and offline interacting with media propaganda. By implementing this approach, the diagnostic precision was significantly improved, the diagnostic time was significantly shortened, and the frequency of emergency interventions for severe laryngeal edema was significantly reduced. Additionally, the collection of data from HAE patients has provided valuable clinical insights for the diagnosis and treatment of HAE in China.

Hereditary angioedema (HAE) is an autosomal dominant inherited disease characterized by recurrent and unpredictable episodes of subcutaneous or submucosal edema. These attacks could induce fatal risk when larynx is involved. The estimated prevalence of HAE is about 1 in 50 000. Due to its rarity and the diversity of clinical manifestations, HAE is known little by related physicians and misdiagnosis and mistreatment happens very often. Therefore, it is crucial to improve physicians′ understanding of HAE. To address this, a comprehensive management approach for the diagnosis and treatment of HAE have developed in our hospital. This approach includes intra-hospital multi-disciplinary treatment (MDT), collaboration with provincial network hospitals, patient education online and offline interacting with media propaganda. By implementing this approach, the diagnostic precision was significantly improved, the diagnostic time was significantly shortened, and the frequency of emergency interventions for severe laryngeal edema was significantly reduced. Additionally, the collection of data from HAE patients has provided valuable clinical insights for the diagnosis and treatment of HAE in China.