The current teaching material system of laboratory medical science is based on the idea of"superimposed single-subject"and causes severe conflict of teaching time restriction and a large quantity of teaching content.In order to enable students to access to more important knowledge and cultivate their creative thinking ability,it is essential to conduct reform on single-subject curriculum model and reconstruct the course system of the laboratory medical.In addition,it is of great importance to re-evaluate,optimize and reorganize the new laboratory medicine courses and make rational use of educational resources.

The cultivation of college students' innovative ability should be strengthened in order to keep up with the development of our society and improve the students' quality to adapt themselves to their future career.In order to cultivate college students' innovative ability,on the one hand,we should advance quality education,enhance teaching staff training and improve teaching methods to provide helpful external factors;on the other hand,we also should equip students with solid basic knowledge,enhance their awareness of innovation,change their study concept and improve their practicing ability to provide beneficial internal causes.

Objective To analyze the cause and clinical characteristics of maternal cardiac arrest.Methods The data of all cases of maternal cardiac arrest from January 2005 to December 2009 in Third Affiliated Hospital of Guangzhou Medical College was retrospectively studied.Results ( 1 ) A total of 41 maternal cardiac arrests (6 in prenatal period,2 in the first stage of labor,7 in the third stage of labor,26 in postpartum period ) were included.All patients regained spontaneous circulation after basic life support.Twelve (29％) mothers survived.Twelve cardiac arrests occurred in the hospital,and the totaldelivery number from January 2005 to December 2009 was 17101,with occurrence rate of 1:1425.(2) Thecauses of arrest were hemorrhagic shock (12,29％),amniotic fluid embolism (7,17％),severepreeclampsia/eclampsia (7,17％),septic shock (6,15％),cardiac disease (2,5％),unidentified cause (2,5％ ) and other occasional causes.(3) Thirty-seven (90％) in-hospital maternal cardiac arrest occurred in operation room (16,39％ ),ICU (7,17％ ),maternity wards (6,15％ ),delivery room (5,12％ ) and the emergency room (3,7％ ).Three (7％) arrest occurred out of hospital and one in the ambulance.Matemal survival rate was 2/3 in the emergency room,8/16 in the operation room,1/5 in the maternity wards,and 1/6 in the delivery room.No mother survived in ICU,ambulance or out of hospital.(4) Five of the 12 survived women showed ischemic encephalopathy after cardiac arrest and one of them developed cerebral infarction in the right corona radiate.(5) In 4 of the 8 cases of cardiac arrest in pregnancy,perimortem caesarean section (PMCS) was performed.In the four PMCS,2 mothers and 2 children survived.In the 4 cases that PMCS was not carried out,no infant survived.Conclusions Hemorrhagic shock,severe preeclampsia and eclampsia,amniotic fluid embolism are the major obstetric causes of maternal cardiac arrest.Septic shock and cardiac diseases are the major non-obstetric causes.Cardiac arrests occurred in emergency room and operation room has a higher maternal survival rate than those occurred in the delivery room and maternity wards.Timely PMCS may ensure the optimal outcome for mothers and fetuses.

Objective To explore the clinical value of transvaginal color Doppler ultrasound(TV-CDS)in the detection of blood flow changes within the ovarian stromal artery in patients with ovarian endometriosis.Methods Blood flow indices within the ovarian stromal artery were measured by TV-CDS in 60 patients and60 normal controls.Results In ovarian endometriosis group,TV-CDS examination showed the color signal pattern was dot-like with high-resistance ovarian stromal arterial flow which manifested significant higher resistance index(RI),pulsatility index(PI)and systolic/diastolic(S/D)ratio than those in normal group(P<0.01).Analysis on clinicopathologic data showed that cystic history and diameter were risk factors affecting the absence of ovarian stromal blood signal,while cystic history,diameter and category were associated with the significant difference of blood flow display area(P<0.05).Conclusions TV-CDS can be used as a non-invasive,convenient and sensitive method for assessing blood flow changes within the ovarian stromal artery,indicating ovarian interstitial damage as well as pathological conditions of ovarian endometriosis that contributes to clinical diagnosis and treatment.

Objective To discuss the role of platelet-actived factors and hepatic and renal function in the development of pre-eclampsia and eclampsia by detecting the levels of the GP Ⅱb/Ⅲa in the blood, Pt and hepatic and renal function of the patients with pre-eclampsia and eclampsia. Method GP Ⅱb/Ⅲa, Pt and hepatic and renal function were measured in the normal non-pregnancy women, normal late-pregnancy women and pre-eclampsia and eclampsia women. Results The level of GP Ⅱb/Ⅲa in patients with severe pre-eclampsia and eclampsia was higher than that in non-pregnancy, normal late-pregnancy and mild pre-eclampsia (P<0.01). The count of Pt in patients with severe pre-eclampsia and eclampsia was lower than that in non-pregnancy, normal late-pregnancy and mild pre-eclampsia (P<0.01). Except ALB, the hepatic and renal function had significant difference among severe pre-eclampsia and eclampsia, normal late-pregnancy and mild pre-eclampsia. Conclusion Detecting the GP Ⅱb/Ⅲa, Pt and hepatic and renal function have clinical significance in severe pre-eclampsia and eclampsia.

Objective To investigate the expression of serum amyloid A (SAA) in patients adipose tissue with gestational diabetes mellitus (GDM) and the correlations between SAA and insulin resistance (IR) and body mass index (BMI).Methods A total of 60 single full-term pregnant women underwent cesarean section from June 2013 to December 2013 was enrolled in this study (GDM group,n =30;control group,n =30);serum SAA level was detected with Enzyme-Linked Immunosorbent Assay (ELISA);and mRNA expression of SAA1 in adipose tissue was determined by reverse transcription PCR (RT-PCR);SPSS software was used to compare these markers,and the correlations between SAA and HOMA-IR,BMI were analyzed with Pearson correlation method.Results SAA,mRNA expressions in omental and subcutaneous fat in GDM group (0.447 ± 0.069,0.291 ± 0.067) were significantly higher than those in control group (0.194 ± 0.070,0.231 ± 0.068,P ＜ 0.01).Serum SAA levels [(21.038 ± 6.648) mg/L] and homeostasis model assessment of insulin resistance(HOMA-IR) (4.168± 2.416) in GDM group were significantly higher than those in control group [(14.384 ± 12.770) mg/L,2.045 ± 1.008,P ＜ 0.05];SAA1 mRNA expression levels in omental and subcutaneous fat were positively correlated with serum SAA (r =0.353,0.342,P ＜ 0.01).SAA1 mRNA expression levels in omental were positively correlated to pregestational BMI,late gestational BMI,weight gain in pregnancy and HOMA-IR (r =0.543,0.644,0.340,0.473,P ＜ 0.01),and SAA1 mRNA expression levels in subcutaneous fat were positively correlated to pregestational BMI,late gestational BMI,and HOMA-IR (r =0.788,0.693,0.504,P ＜ 0.01),but was no correlation with weight gain in pregnancy(r =0.013,P ＞ 0.05).Conclusions SAA mRNA expressions in omental and subcutaneous fat in GDM group and serum SAA levels increase,which is positively correlated with BMI and the degree of insulin resistance,SAA may participate in the formation of GDM by increasing insulin resistance.SAA may be used as a new monitor of GDM.

AIM:To observe the effect of atorvastatin(ATV) on myocardial ischemia-reperfusion injury and the role of inducible nitric oxide synthase (iNOS). METHODS: The rabbits were randomly divided into control group, ATV group, ATV+S-Methylisothiourea sulfate (SMT) group, SMT group. All rabbits were subjected to 40 min ischemia and 240 min reperfusion. The hemodynamic variables, CK-MB, LDH-1 and nitric oxide synthase were detected after reperfusion. RESULTS: LVDP and +dp/dtmax decreased by 24.6% and 35.3% respectively following ischemia-reperfusion. Pre-treated by ATV (10 mg?kg-1?d-1) for three days, LVDP and +dp/dtmax decreased by 21.7% and 41.3%, CK-MB and LDH-1 by 31.4% and 19.1% and iNOS increased to 102.6%. The reduction of LVDP and +dp/dtmax, CK-MB, LDH-1 and iNOS in ATV+SMT group was no statistically significant with those in control group. CONCLUSION: ATV pretreatment protected myocardial ischemia-reperfusion injury by upregulating iNOS.

Objective To investigate the therapeutic effects of recombinant human endostatin (RHES) combined with radiotherapy on brain metastases (BM) of non-small cell lung cancer (NSCLC) and the patients suitable for this therapy.Methods Eighty patients with BM of NSCLC were randomly divided into RHES combined with radiotherapy group (combination group) and radiotherapy alone group (each group with 40 patients).The short-term effective rate,overall survival time,cerebral edema index and adverse reactions were observed and the expressions of vascular endothelial growth factor receptor 2 (VEGFR2) protein in primary lesions were detected with immunohistochemical method in all patients.Results Compared with radiotherapy alone group,brain edema was significantly relieved (t=4.9,P=0.000) and there were no marked adverse reactions in combination group.In short-term effective rate,there was no statistical significance in total population (n=80,90％ vs.75％,x2=3.11,P=0.07),but there was statistical significance in the patients with positive VEGFR2 (93％ vs.67.7％,x2=6.31,P=0.012).In overall survival time,there was no statistical significance in total population (n=80,P=0.35,95％ CI:0.25-1.30) or in the patients with positive VEGFR2 (P=0.109,95％ CI:0.40-1.34).Conclusion Compared with radiotherapy alone,RHES combined with radiotherapy can relieve brain edema in the patients with BM of NSCLC and obtain better short-term effective rate in the patients with positive VEGFR2.

Objective To analyse the causes and clinical characteristics of re-exploration after peripartum hysterectomy due to postpartum hemorrhage. Methods Clinical data was analysed retrospectively including 88 critically ill obstetric patients who underwent peripartum hysterectomy due to postpartum hemorrhage in the Obstetric Critical Care Center of Guangzhou from January 1999 to July 2009, which were divided into re-explored group (n= 14) and non-re-explored group (n=74)depending on whether the patient underwent re-exploration after peripartum hysterectomy. The main demographic data and clinical details were compared between the two groups, including mode of delivery, indication and type of hysterectomy, interval from hysterectomy to re-exploration, surgical intervention, complications, blood loss, blood transfusion,Glasgow Coma Score(GCS), the need for mechanical ventilation, intensive care unit stay and hospital stay. Results Fourteen out of the 88 (15.91%) patients underwent re-exploration due to internal bleeding after peripartum hysterectomy.Removal of cervical stump was performed in five patients and stump hemostasis in eight cases.Significant difference was found between the re-exploration and non-re-explored group on thepercentage of patients complicated with disseminated intravascular coagulation(92.9% vs 43.2%,x2=11.598,P=0.001) and amniotic fluid embolism (28.6% vs 2.7%, x2 =8.663, P=0.003).0.000], blood transfusion [(8163.6± 3903.1 ) ml vs (2958.8± 2323.0) ml, P = 0.000], intensive care unit admission rate (100.0% vs 41.9%, x2 = 15.909, P= 0.000), the need for mechanical ventilation (100.0% vs 24.3%,P=0.000), the number of patients with GCS≤8 score (71.4% vs 25.7% ,x2 = 9.179, P = 0.002 ), the number of multiple organ dysfunction syndrome ( 71.4% vs 14.9%, x2 = 17.735, P = 0.000), intensive care unit stay [ ( 11.4 ± 10.0 ) d vs ( 1.3 ± 2.3 ) d, P =0.000] and hospital stay[(24.0±13.1) d vs (12.7±7.0) d, P=0.000]. Allof the 14 cases were clinical recovered before discharge. Conclusions The rate of re-exploration after peripartum hysterectomy is not low, and internal bleeding is the most common causes. The re-exploration after peripartum hysterectomy might be associated with coagulopathy and the mode of hysterectomy, and patients may experience more severe complications.

Objective To investigate the inhibitory effect of testosterone on oxidized low-density lipoproteins ( ox-LDL)-stimulated phenotypic transition and proliferation of vascular smooth muscle cells ( VSMCs) in vitro, and to explore its possible mechanisms. Methods Rat VSMCs cultured in vitro were divided into control group, ox-LDL group(50μg/mlox-LDL),fetalbovineserum(FBS)group(10% FBS),andtestosteronegroups(5×10-8 or5×10-7 mol/L testosterone plus 50μg/ml ox-LDL) . The effect of testosterone on ox-LDL-induced proliferation of VSMCs was explored by WST-1 assay. The cell cycle distribution was determined using flow cytometry. Western blotting was used todetecttheexpressionsofmitofusin2(Mfn2),phosphorylatedextracellularsignal-regulatedkinases1/2(p-ERK1/2) , proliferating cell nuclear antigen ( PCNA) ,α-smooth muscle actin (α-SMA) ,and osteopontin ( OPN) . Results Compared with control group, the proliferation of VSMCs was promoted by ox-LDL, the number of VSMCs decreased in G0/G1 phase and increased in S phase significantly, the expression levels of Mfn2 and α-SMA were significantly reduced, and the expression levels of p-ERK1/2, PCNA, and OPN were significantly raised in ox-LDL group. Compared with ox-LDL group, the proliferation of VSMCs was inhibited, the number of VSMCs increased in G0/G1 phase and decreased in S phase in two testosterone groups, along with the increased expressions of Mfn2 andα-SMA, and the descended expressions of p-ERK1/2, PCNA, and OPN. Conclusions Testosterone inhibits phenotypic transition and proliferation of VSMCs induced by ox-LDL in vitro, which may be related to the up-regulated expression of Mfn 2 and the suppression of ERK1/2 pathway.