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.

Objective To analyze the incidence,risk factors,clinical characteristics and pregnant outcomes of perinatal pulmonary embolism(PPE).Methods Clinical data of eight patients who were admitted to Beijing Friendship Hospital of Capital Medical University for PPE from January 2006 to March 2016 were collected.General condition,symptoms,laboratory examinations,images,treatments and outcomes of these patients were analyzed retrospectively.Results The ten-year incidence of PPE was 0.029％ (8/27 560) in this hospital.Among the eight cases,two cases were diagnosed in the first trimester,and treated successfully by thrombolytic therapy.But one of two cases stopped growth,while the other one was premature labor.There were one case in the third trimester who had successful anticoagulant therapy and five cases in the postpartum period after cesarean delivery.Among the five cases,three cases were recovered after anticoagulant therapy,one case was recovered after thrombolytic therapy and one case died.All of the eight patients were immobilized before the onset of PPE,and five of them were diagnosed after cesarean section.Four out of the eight patients were obese.Five patients had three or more high-risk factors for pulmonary embolism and the other three had two.Conclusions It is necessary to pay close attention to gravidas who have two or more high-risk factors of PPE due to its fatal outcome.

Objective To investigate the clinical features of rheumatoid arthritis combined with femur head necrosis. Methods The clinical data of 22 patients with rheumatoid arthritis combined with femur head necrosi were retrospectively analyzed. Results Among the 22 patients with rheumatoid arthritis combined with femur head necrosi, male was in 5 cases, female was in 17 cases, age was 28-69 (56.3 ± 1.9) years, and the disease duration of rheumatoid arthritis was 4-30 (14.1 ± 1.2) years. All patients had ≥ 2 grade femur head necrosis, with bilateral femur head necrosis in 9 cases, right femur head necrosis in 9 cases and left femur head necrosis in 4 cases. Only 2 cases did not take glucocorticosteroid, and the other 20 cases used glucocorticosteroid in the long-term. The treatment was no standardized. The multiple fracture was found in 4 cases by X-ray examination (the patients had no history of trauma); 4 cases examined bone density, and the results showed they all were osteoporosis. Conclusions Rheumatoid arthritis combined with femur head necrosis is not uncommon. The majority of patients receive long-term glucocorticosteroid treatment. Treatment is not standardized, and some patients are combined with osteoporosis.

Objective: Overexpression of the HER2/neu oncogene is a frequent molecular event in multiple human cancers. Being a cancer antigen, p185 erbB2 is an ideal target for immunotherapy. In order to decrease the immunogenicity of mouse anti-p185 erbB2 monoclonal antibody in human cancer therapy, we constructed the eukaryotic expression vector of anti-p185 erbB2 chimeric monoclonal antibody and verified expression of the chimeric antibody in CHO-dhfr - cell. Methods: The variable regions of light chain and heavy chain were amplified with RT-PCR and inserted into the chimeric antibody vector pWSD2. After CHO-dhfr - cells were transfected with recombination plasmid by lipofectAMINE, the chimeric antibody expressing level was identified with RT-PCR, indirect-ELISA, and Western blot. The specificity of the anti-p185 erbB2 chimeric antibody was testified with ELISA assay and immunoprecipitation. Moreover, the effects of chimeric antibody on the proliferation of breast cancer cell line SKBR3, which is overexpressing p185 erbB2 , were measured with MTT assay in vitro. Results: The anti-p185 erbB2 chimeric antibody eukaryotic expression vector was constructed successfully and the expression of the chimeric antibody in CHO-dhfr - was verified by RT-PCR, indirect-ELISA, and Western blot. ELISA assay showed that chimeric antibody reacted with cells overexpressing p185 erbB2 specifically, but did not react with that non-overexpressing p185 erbB2 . Immunoprecipitation test confirmed that the chimeric antibody could bind to p185 erbB2 specifically. The MTT assay demonstrated that the chimeric antibody could inhibit the growth of SKBR3 cells overexpressing p185 erbB2 . Conclusion: The anti-p185 erbB2 mouse/human chimeric antibody that was expressed in CHO-dhfr - cells can bind to p185 erbB2 specifically and inhibit proliferation of SKBR3 cells overexpressing p185 erbB2 . It has a potential application in biotherapy of cancer.

Objective To observe the distribution of sentinel nodes(SN) in gastric cancer,and investigate their clinical significance.Methods The extent and features of intraoperatively stained sentinel nodes in 288 cases of gastric cancer were analyzed retrospectively.Methylene blue was injected intraoperatively into the(subseral) muscle and submucosa of the normal gastric wall adjacent to the neoplasms,then lymphadenography was performed,and the nodes were resected for histopathological examination.Results The pathological(diagnosis) of the 288 cases with gastric cancer was T_1 in 102 cases,T_2 106 cases and T_3 60 cases.Stained nodes were detectable in 270 cases(success rate: 93.8%).One hundred and two cases were found to have lymph node metastasis;66 cases had metastasis in both SNs and non-SNs;18 cases in SNs alone;and 18 cases in non-SNs alone.Conclusions Sentinel lymph nodes can accurately predict the lymph node metastatic status of gastric cancer patients during operation.Intraoperative sentinal lymph node mapping can avoid routine lymph node dissection in patients with gastric cancer with negative lymph node metastasis.

The enrollment scale of clinical medicine postgraduates with professional degree was expanded each year in order to meet the needs of the society.How to train high quality medical talents in line with modem medical education and people's health needs was the problem we were confronted with.The affiliated hospital of Inner Mongolia medical university lunched reform on training mode of clinical medicine postgraduates with professional degree; the concrete measures included increasing postgraduate pre-service training,implementing tutor responsible system,applying PBL teaching and focusing on the overall quality training.Students' clinical competence was improved after the reform.

ObjectiveTo study the safety and effectiveness of acute hypervolemic hemodilution (AHH) combined with tranexamic acid(TA) in neurosurgical operation. Methods Forty patients underwent selective neurosurgical operation were divided into two groups by radom digits table with 20 cases each, both groups were infused HES(130/0.4) 20 ml/kg for AHH after anesthesia, TA intravenous injection of loading 10 mg/kg, 1 mg/(kg·h) continuous infusion until the end of surgery in experimental group,only for AHH in control group. The mean arterial blood pressure(MAP), central venous pressure(CVP), heart rate (HR), pulse oxygen saturation (SpO2) were measured before AHH (T0), A HH immediately (T1), 1 h after AHH (T2), at the end of operation (T3), and in the corresponding time hemoglobin (Hb), hematocrit (Hct),prothrombin time (PT), activated partial thromboplastin time (APTT), platelet ( Plt ), fibrinogen ( FIB ) were measured; the intraoperative bleeding, blood transfusion and transfusion rate were counted in both groups.ResultsThere was no significant difference in HR and MAP at different time between two groups (P ＞0.05),compaued with T0,CVP at T1,T2 was increased (P＜0.05),Hb and Hct at T1,T2,T3 were decreased (P＜ 0.05 ). PT and APTT at T2,T3 were longer than that at T0 in control group (P＜ 0.05 ) ;Plt at T1 ,T2,T3 was lower in control group than that at T0 in two groups (P ＜ 0.05 ), Plt at T2, T3 was obviously increased in control group compared with experimental group (P ＜ 0.01 ) ; FIB at T2, T3 was lower than that at T0 in control group (P ＜0.05). The intraoperative bleeding, blood transfusion and transfusion rate in experimental group [(650 ±560) nl, (150 ± 50)ml,30％(6/20)]were lower than those in control group [(820 ±410) ml,(380 ±290) ml,60％ (12/20)],there were significant differences between two groups(P ＜0.05).ConclusionAHH combined with TA has obvious effect of saving blood and hemodynamic stability with less influence on coagulation in neurosurgical operation.

Objective To study the effects of purified rabies vaccine for human use (RV) on specific Th1/Th2 cytokines in human. Methods Twenty cases were injected intramuscularly with 5 full doses of RV. PBMCs were isolated from the blood sample collected at day 0, 14, 45 after the RV inoculation. Neutralizing antibody was determined by ELISA, and the proliferation of lymphocyte by in vitro test. The levels of RV specific IFN-γ, TNF, IL-2,IL-4, IL-5, IL-10 in the culture supernatants were detected by cytometric bead array (CBA). Results The neutralizing antibody was tested positive in 19 cases 45 days after inoculation and 1 case after 60 days, with the positive rate reaching 100%. After stimulation with RV, the lymphocyte transformation index at day 14, 45 in cases were significantly higher than those day of 0 (P< 0.05), and similar results were confirmed with IFN-γ, IL-2, IL-4, IL-5 tested by CBA (P<0.05). Condusion The RV could induce humoral and antigen-specific cellular immune responses in human, tested by showing good protective effect on rabies virus.

Objective To study the influence of different contrast injection skills in interstitial magnetic resonance lymphography( IMRL) of breast cancer, and standardize the IMRL contrast injection process. Methods A total of 36 patients with invasive breast cancer were ran-domly divided into four groups. The imaging time of different contrast agent dose and local massage time on sentinel lymph node ( SLN) were analyzed. According to the results, the best contrast injection methods technology program was choosed. Results For the same massage time, different contrast agent doses showed no significant difference in the SLN imaging time (P>0. 05);For same contrast agent dose, dif-ferent massage time showed significant statistically different SLN imaging time(P<0. 05). Conclusion In clinical work, IMRL with a con-trast agent injection dose of 0. 5 mL/person, local massage 1 min after injection can successfully achieve the lymphatic system image of breast cancer.

Objective To investigate the relationship between day-night rhythm of blood pressure and left ventricular hypertrophy(LVH) in the elderly with hypertension. Methods According to the result of ambulatory blood pressure monitoring,60 patients were divided into two groups of normal day-night rhythm(n=34) and abnormal day-night rhythm(n=26).All patients were performed ultrasonic cardiography.The interventricular septal thickness(IVST),the left ventricular end diastolic dimension(LVDd)and the left ventricular posterior wall thickness(LVPWT) were recorded,and the left ventricular mass(LVM) and the left ventricular mass index(LVMI) were calculated according to the Devereux formula. Results There were no significant differences in age,body mass index,serum total cholesterol,triglyceride,fasting blood glucose,24 h mean systolic blood pressure,24 h mean diastolic blood pressure,day time mean systolic blood pressure,day time mean diastolic blood pressure,IVST and LVDd between the the two groups.However,there were significant differences in night time mean systolic blood pressure,night time mean diastolic blood pressure,LVPWT,LVM and LVMI between the two groups(P