In teaching forensic medicine as a common optional course for clinical medicine undergraduate students, we carried on the beneficial attempt in the overall set-up of teaching program, the effective implementation of the case-based and discussion-based teaching methods, the use of multimedia and internet classroom, plentiful of teaching models such as demonstration and practice, discussion forums between teachers and students etc. Through these efforts, we enhanced the teaching quality of the public elective course offorensic medicine.

Objective To develop a HPLC method for the determination of oxymatrine in Oxymatrin Injection.Methods A RP-HPLC method with Lichrospher 5 ODS C18 column(4.6 mm? 250 mm,5 ? m) was used,and the mobile phase was the mixture of acetonnitrile-pH2.0 sulphate buffer solution(7∶93) at the f low rate of 1.0mL/min.The column temperature was 30 ℃,the UV detection wave length was 220 nm and the injection volume was 20 ? L.Results The calibra tion curve was linear(r=1.0000) in the range of 3.63～ 116.04 ? g/mL for oxyma trine.The mean recovery was 100.1 %(RSD=0.86 %,n=6).Conclusion Thi s method is effective and can be used for the determination of oxymatrine in Oxymatrine Injection.

We review the literature about Heterotopic Ossification (HO) and introduce its pathophysiology, classification, incidence, clinical presentation, diagnosis, prophylaxis and treatment in this article. HO is the presence of bone in soft tissue where bone normally does not exist. Mature HO has the same morphology as callus. It is considered that 3 conditions are necessary for HO: osteogenic precursor cells, inducing agents, and a permissive environment. Fever, swelling, erythema, and occasional joint tenderness appear in the early stage of HO. The most sensitive imaging modality for early detection of HO is three-phase bone scintigraphy which can also monitor the metabolic activity and degree of maturity of HO. Non-steroidal antiinflammatory drugs (NSAIDs) are the most effective for the prophylaxis of HO after the operation of hip replacement or acetabulum fracture. Surgical resection is the only treatment for patients with severe joint tenderness following HO.

Background and purpose:Gastric cancer is the most common malignant tumor of digestive tract, and the possibility of postoperative recurrence and metastasis is higher. Our previous studies showed that protein tyrosine phosphatase1B (PTP1B) gene is closely correlated with tumor size, lymph node metastasis and TNM stage of gastric cancer. The purpose of the present study was to explore the effect ofPTP1B gene on cell proliferation and migration of gastric cancer cell lines.Methods:Short hairpin RNA (shRNA) sequence targetingPTP1B gene and PTP1B cDNA were transfected into MKN28 and MKN45 cells, respectively. The expression of PTP1B mRNA and its protein in MKN28 and MKN45 cells were detected by quantitative real-time PCR (qRT-PCR) and Western blot, respectively. The effect of PTP1B on cell proliferation and migration was respectively assessed by cell counting kit-8 (CCK-8) assay, Transwell migration assay and wound healing assay.Results:Compared with blank and negative controls, the expressions of PTP1B mRNA and protein in MKN28 cells were successfully suppressed after the cells were transfected with shRNA (P<0.05). As CCK-8 test showed, the proliferation of MKN28 cells was successfully restrained at 48, 72 and 96 h after transfected with shRNA compared with blank control and negative control (P<0.05). Transwell and wound healing test were performed after PTP1B expression was interfered by shRNA. The result demonstrated that migration of MKN28 cells was signiifcantly inhibited (P<0.05). On the contrary, the expressions of PTP1B mRNA and protein in MKN45 cells were obviously enhanced after the cells were transfected with PTP1B cDNA. And the proliferation and migration of cells were significantly increased.Conclusion:PTP1B gene is an important enchancer for the proliferation and migration of gastric cancer.

Objective To determine the renal function compromised in patients after ST-segment elevation myocardial infarction (STEMI) with left ventricular aneurysms (LVA) by measurement of serum cystatin C (Cy-C) concentrations and Cy-C-based eGFR.Methods A total of 355 patients admitted from January 2011 to December 2012 could be categorized into group A (STEMI without LVA,n =183) and group B (STEMI with LVA,n =172) confirmed by echocardiography in 24 hour after admission.Of them,273 patients were treated with primary percutaneous coronary intervention (PCI) after admission and included in the analysis.Cy-C-based estimated glomerular filtration rate (eGFR) and creatinine (Cr)-based eGFR were calculated for evaluating cardiac function in tern to assess the magnitude of compromised renal function.The correlation between magnitude of compromised renal function and in-hospital mortality was analyzed.Distributions of categorical variables were compared using the chi-square test.Continuous variables were compared by one-way ANOVA with the Bonferroni test.Results The in-hospital mortality rate of whole patient cohort was 14.0％.Mortality in the group B was 18.6％ and in the group A was 9.8％ (P ＜ 0.01).With multivariable regression analysis,the compromised renal function was found when the Cr-based eGFR was ＜60 mL/ (min · 1.73 m2) or Cy-C-based eGFR was ＜ 60 mL/min/1.73m2 which were independently associated with in-hospital mortality (OR 0.13,95％ CI 0.02-0.7,P =0.02 ; OR 0.01,95％CI 0.003-0.05,P ＜ 0.01).Compared with the acute myocardium infarction (AMI) patients with chronic kidney disease (CKD) stage 2,the Cy-C based eGFR was greater in the AMI patients with LVA group (P ＜ 0.05),and compared with AMI with CKD stages 3 or CKD 3-5,this difference was also significant (P ＜ 0.01).Conclusions Renal dysfunction was an independent predictor of in-hospital mortality in patients with STEMI,especially in patients with LVA.Cy-C and Cy-C based eGFR were more sensitive to judge renal dysfunction in STEMI patients with LVA.

Objective To observe the possible relationship of cardiac troponin T (cTnT) with cardiac disease and death events in hemodialysis patients Methods The cTnT was measured with dry chemical method in 57 hemodialysis patients The patients were followed up for one year Results The concentration of cTnT was more than 0 10 ?g/L in 12 of the 57 unselected hemodialysis patients 8 in the 12 patients were diagnosed as diabetes mellitus 7 of 12 patients died and the death reason was acute left ventricular failure(33 3%) in 4 patients In other 45 patients with normal cTnT, 3 died and only 1 died of heart failure(2 22%) The cTnT concentrations of pre-and post-hemodialysis were measured in 24 patients The concentration was more than 0 1 ?g/L in 6 patients before dialysis Post-dialysis concentration was increased in 5 patients', the value was decreased in the other one Conclusions In hemodialysis patients without acute myocardial infarction, mortality and cardiovascular events are closely correlated with the increase of cTnT concentration. Patients with diabetes mellitus have higher incidence in the abnormality of cTnT concentration.The process of hemodialysis does not affect the concentration of cTnT.

Objective To study the ultra-structural features of interstitial cajal cells (ICC)in fetal enteron and then classify them.Methods Ultra-structural features of ICC in fetal enteron with spontaneous abortion or premature birth were detected under JEM-2000EX transmission electron microscope for the cause of fetal death, including two fetus specimens of a gestation 18 months and 28 months stained with lead nitrate and uranium acetate.Results ICC had a big oval karyon and a little of cytoplasm. ICC formed spindle or stellate cells with 2 to 5 long cell processes . From the esophagus to the terminal ileum ICC mostly had the same ultra-structural features, but with mitochondria and a well-developed endoplasmic reticulum and Golgi complex in the whole colon and the rectum , more than those of esophagus and small intestine. In the whole colon and rectum ICC had similar ultra-structural features. ICC also possessed an abundance of mitochondria and a well-developed endoplasmic reticulum and Golgi complex. ICC also possessed Caveloae lipid droplet with more electron dense and heterochromatin. Two types of ICC were identified under JEM-2000EX transmission electron microscope. One type was present from the esophagus to the terminal ileum and the other type was observed in the colon and rectum. The first type ICC in circular muscle layer was bipolar cells which extended to tapering processes in opposite directions. These processes rarely branched, and their appearance was similar to smooth muscle cells.Most of them ran parallel to the circular muscles . The second type of ICC in the myenteric plexus and longitudinal muscle layer was mostly multipolar and rarely bipolar cells with long processes. They showed an irregular appearance characterized by numerous short spike-like branches. Processes of multipolar cells extended in every direction and connected with each other. ICC nerve cells and smooth muscle cells were connected with gap-like junction, which was the main connection mode .Conclusions The ultra-structural features of ICC in fetal enteron varied with the diffe-rent locus and different tissue sheets in the enteron. The mitochondria and a well-developed endoplasmic reticulum and Golgi complex of the whole colon and rectum are more and more developed than that of esophagus and small intestine. Ultra-structural features of ICC will develop further with the gestational age. The gap- like junction among ICC nerve cell and smooth muscle cell are highly important for ICC to educe function.

Objective To evaluate the cognitive impairment in epilepsy patients with Topiramate (TPM) or Valproate (VPA) treatment by using WAIS-CR. Methods30 untreated epilepsy patients were divided into two groups receiving TPM or VPA, respectively. All the patients were examined with WAIS-CR before and 3 months after treatment. ResultsThe IQ of TPM group decreased 3 months after treatment (P<0.05). ConclusionTPM may impair the cognitive function in epileptics reflected by decreased IQ.

ObjectiveTo evaluate the cognitive impairment in epilepsy patients with topiramate (TPM) or valproate (VPA) treatment by using visual completion negativity of faces.Methods30 epileptic patients were divided into two groups receiving TPM or VPA, respectively. 15 healthy volunteers were included as controls. Unfamiliar grey-scale photographs of faces (front view) were used as stimuli. Two types of visual stimuli were presented randomly: pictures of complete faces, pictures of incomplete faces (the occluded part was the left-top quadrant).ResultsN170 were elicited in all participants in each condition. The peak latency of N1 elicited by incomplete faces was delayed compared with complete faces in two groups. Under incomplete faces, a decreased and delayed N170 was observed only in TPM group (P<0.05). N170 amplitude and latency did not change in VPA group (P>0.05).ConclusionChanges of N170 is more obvious in patients with TPM than VPA. Cognitive impairment was not present in epilepsy patients with VPA treatment.

Objective It is controversial to the surgical treatment of the DeBakey I aortic dissection.The purpose of the study was to summarize the clinical experience on total arch replacement combined with implantation of stented elephant trunk into the descending aorta for DeBakey I aortic dissection.Methods From June 2005 to March 2008,41 consecutive patients with acute(in 31)or chronic(in 10)DeBakey I aortic dissection underwent total arch replacement combined with implantation of stented elephant trunk into the descending aorta.The mean age was 57(27～76)years.Thirty-two patients were male.The procedure was performed under deep hypothermic circulatory arrest and selected cerebral perfusion.The stented elephant trunk was implanted through the aortic arch under deep hypothermic circulatory arrest.The stented elephant trunk was an 8～10 cm long self-expandable graft.Concomitant procedures included Bentall operation and total arch replacement in 24,Wheat operation and total arch replacement in 6,ascending aorta and total arch replacement in 11.Computed tomography was performed in every patient before discharge to evaluate the postoperative outcomes of the procedure.Results Cardiopulmonary bypass time was(168±32)min.The cross clamp time was(109±24)min and selective cerebral perfusion and the lowerbody circulatory arrest time wsa(31±11)min.The in-hospital mortality was 4.9%(2/41).One patient died of hemorrhagic shock and another died of multi-organ failure postoperatively.Fourteen cases suffered complications and 12 cases were cured.One case died of the cerebral hemorrhage after 4 months due to inappropriate anticoagulation during follow up.Conclusion Ascending aorta and total aortic arch replacement combined with implantation of stented trunk into descending aorta is a safe,effective and feasible way in closing the residual false lumen of the descending aorta with a low morbidity and mortality.This procedure might contribute to a better long-term outcomes of DeBakey I aortic dissection.