Objective To explore the effect classroom teaching quality evaluation on the improve-ment of teaching quality. Methods In-service teachers offering classes to undergraduates majoring in clinical medicine during the period of 2010 to 2011 in Tangshan Clinical Hospital of Hebei Medical University were enrolled as research objectives. Totally 128 teachers(majored in 16 disciplines), screened out from the enrolled teachers, met the criteria and passed through the evaluation in terms of class quality of lessons. They were arranged in descending order and the top 15%were grouped as the preeminent group while the 15%at the bottom were classified as standard group and the rest 70%as good group. Descriptive analysis was made to appraise results from four respects:major and discipline, records of formal school-ing, professional ranks and titles and length of teaching experience. Results Based on the analysis of teaching situation in major disciplines, the top 3 disciplines possessing the largest proportion of preemi-nent teachers were neurology ( 50%) , otolaryngology-head and neck surgery ( 40%) and surgery (20.6%). When it comes to the analysis of formal schooling records of teachers , there is no distinct dis-crepancy in rate of standard reaching between teachers with postgraduate degree and teachers with gradu-ate degree. However, rate of standard reaching was slightly higher in teachers with other degrees than teaching with undergraduate degree or above. In the analysis of professional ranks and titles, the proportion was 94.6%in teachers with senior professional title(associated senior professional title and senior profes-sional title) and the teachers with medium grade professional title only occupied a proportion of 5.4%. In the dimension of teaching years, rate of outstanding and good teachers was relatively high in teachers with 8 teaching years and teacher with less than 3 teaching years, whereas the outstanding rate was low and rate of standard reaching was high in teachers with the 3-4 teaching years. Conclusions Measures to enhance the quality of teaching can be found out according to the analysis of influencing factors of teaching quality evaluation.

Objective To investigate the variation of immune index in patients with systemic lupus erythematosus (SLE) treated with autologous purified CD+34 cells transplantation and to clarify the relationship with pathogenesis and prognosis. Methods Flow cytometry (FCM) and enzyme linked immunosorbent assay(ELISA) were used to test lymphocyte subsets, C3, C4, CH50, autoantibodies and immunoglobulin for 18 cases of SLE before and after transplantation. Results The results showed that the ratio of all the T cell subsets reduced obviously in early postgraft and recovered gradually in 1 to 3 months after transplantation except CD45 RO+CD+4 cells. The levels of serum C3, C4, CH50 increased significantly after transplantation. No case relapsed within one year after transplantation, but 2 patients relapsed one year after transplantation. The levels of the indexes in the patients with relapse were significantly lower than those in the patients with persistent remission, including C4 in the entire course, CH50 in the 3rd and 12th month after transplantation and CD45 RA+ CD+8 cells in the 6th month after transplantation. However, the ratio of CD45 RO+ CD+4 cells in the first month after transplantation in the patients with relapse was higher than that in the patients with persistent remission. Conclusion Autologous purified CD+34 cells transplantation is effective for treating SLE. Survey of immune indexes before and after transplantation is important to investigate the pathogenesis of SLE. Moreover, these immune indexes can be used to predict therapeutic efficacy of SLE.

BackgroundDiabetic retinopathy (DR) is the result of the cytokine network disorders,the imbalance of angiogenic factor and vascular inhibitory factor is the start factor.ObjectiveTo analyze the levels of CXC chemotatic factors of type 2 diabetes mellitus patients,evaluate the clinical application value of them in different clinical types of DR using receiver operating characteristic (ROC)analysis and to approach the new way of individualized treatment.Methods This was a prospective research.The gold standard was ophthalmolscope and fundus fluorescein angiography.The levels of CXC chemotatic factors and multiplicaiton factors were measured in 96 cases with type 2 diabetes mellitus (66 cases with retinopathy and 30 cases without retinopathy as control).The assessment tasks were performed for these index and courses of DR with ROC curve.Results The expression of age,course of disease has significant difference in different courses of DR ( F =8.507,P =0.001 ; F =28.143,P =0.000).Compared with the control group,the expression of growth-related oncogene-α ( GROα ) ( t =- 2.172,P =0.035,AUC =0.625 ),whole blood viscosity 200 ( t =- 3.724,P =0.001,AUC =0.904 ) and neutrophilic leukocyte (t=-2.562,P =0.013,AUC =0.577 ) has significant difference in the group of mild NPDR.Compared with the control group,the expression of interferon-γ-inducible protein 10 ( IP-10 ) ( t =-3.591,P =0.001,AUC =0.592 ),platelet derivation growth factor-BB ( PDGF-BB ) ( t =- 3.233,P =0.003,AUC =0.735 ),vascular endothelial growth factor(VEGF) ( t =- 3.617,P =0.001,AUC =0.776 ),C peptide ( t =- 3.366,P =0.002,AUC =0.962 ),leukocyte ( t=-3.201,P =0.003,AUC =0.852) and neutrophilic leukocyte(t =-4.201,P=0.000,AUC =0.852) has significant difference in the group of moderate and severe NPDR.ConclusionsCXC chemotatic factors may act as reactivator in the pathogenesis of DR,GROα and IP-10 may be useful for clinical monitoring of the severity of DR,and evaluating the imbalance state of chemotatic factors maybe a new approach to clinical monitoring and prognosis of DR.

OBJECTIVETo evaluate causes and clinical management of postoperative pain after total knee arthroplasty (TKA).

METHODSFrom January 2004 to June 2009, 41 patients (44 knees) with knee pain post TKA were treated. There were 9 male and 32 female patients aging from 51 to 84 years with a mean of 63.5 years. The diagnosis followed to Brown diagnostic system. One case of extraarticular pain was complex regional pain syndrome type 1 (CRPS-1) and underwent conservative treatment, the remaining 5 cases were treated by surgery. Three cases of joint instability, 1 case of patellar baja, 2 cases of soft tissue impingement caused by overhang of the prosthesis, 1 case of popliteal tendon impact underwent conservative treatment, the other 27 cases underwent surgical intervention. The patients were followed up and the Knee Society Score (KSS) knee score, pain visual analog scale (VAS) score were recorded.

RESULTSForty-one cases were followed up for 1 to 6 years. At the last time of follow-up, the 5 cases received surgical treatment to extra-articular pain showed VAS score as 2.5 ± 0.2, KSS clinical and functional score as 92.8 ± 2.6 and 89.0 ± 3.4. There was significantly difference compared with preoperative (P < 0.05). One case of CRPS-1 performed conservative treatment, the therapy was effective. In the infected 12 cases of intra-articular pain, 1 case received amputation, 3 cases received antibiotic bone cement insert, 8 cases received two stage revision. All infections were cured, and VAS score was 3.8 ± 0.2, KSS clinical score was 88.3 ± 4.6, function score was 85.0 ± 4.6 postoperatively, with significantly difference compared with preoperative (P < 0.05). In the 8 cases received conservative treatment in non-infected group, at the last time of follow-up, VAS score was 4.5 ± 0.4, KSS clinical and functional score was 85.4 ± 4.2 and 84.2 ± 2.3, with significantly difference compared with preoperative (P < 0.05). Fifteen cases underwent surgical treatment, at the last time of follow-up, VAS score was 3.4 ± 0.1, KSS clinical and functional score was 86.6 ± 5.4 and 87.1 ± 2.4, with significantly difference compared with preoperative (P < 0.05).

CONCLUSIONSPatients with knee pain post TKA need systematic assessment to identify the causes. Appropriate treatment due to the positive diagnosis generally lead to satisfactory results, surgical intervention with indefinite causes is strictly prohibited.

Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee ; adverse effects ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Pain, Postoperative ; etiology ; therapy ; Retrospective Studies

Objective To build a multi‐level hierarchical structure model of the influencing factors for hierarchical medical system ,to identify the role relationship between all the factors and transmission pathways ,and to recommend on developing China′s hierarchical medical system . Methods Thirty influencing factors were identified in a screening based on literature review for the hierarchical medical system .On such basis ,16 influencing factors were identified by three health policy experts ,which affect operations of the current system .Interpretative structural modeling was called into play in the end to analyze the hierarchy relationship between various influencing factors and the conduction loops .Results There exist among the 16 factors a 3‐level hierarchical structureand two conduction loops .The factor directly limiting the hierarchical medical system is two‐way referral,and most internal core drivers arehuman resources development and governance mechanism.By means of self‐growth and external constraints ,they exert their influence on the operation of hierarchical medical system .Conclusions There are interactive hierarchical effects among the factors ,merging into three node elements of functional role,inter‐entity relationshipand patient participation.

AIM To investigate the effect of β-cyclodextrin-assisted extraction on Cassiae Semen.METHODS The chemical constituents in aqueous extract and β-cyclodextrin extract determined and analyzed by UPLC and principal component analysis had their antioxidant activities tested by six methods (protective effects on lipid peroxidation injuries induced by spontaneous liver,CCl4,H2 O2,FeSO4-vitamin C,and scavenging effects on DPPH,hydroxyl free radicals).RESULTS Compared with aqueous extract,the component content and antioxidant activity of β-cyclodextrin extract were increased by 10.476％ and 80.88％,respectively.CONCLUSION β-Cyclodextrin can effectively enhance the component extraction rate and antioxidant activity of Cassiae Semen.

The relationship between gut microbiota and disease has become one of the hotspots in recent years. The gut-brain axis may be involved in the pathogenesis of metabolic diseases such as obesity， diabetes and polycystic ovary syndrome （PCOS）， yet the mechanism of gut-brain axis in neuroencrine regulation is still unclear and the gut microbiota as a target to influence hypothalamic-pituitary-ovarian （HPO） axis remains uncertain. Recent reports indicate that enteroendocrine hormones may play a role. Incretins， including glucagon like peptide-1 （GLP-1） and glucose-dependent insulinotropic peptide （GIP）， could promote insulin release and reduce serum glucose level. While the research on incretins and HPO axis is still in its infancy， and the effects of incretins on PCOS has not yet been clarified. This review focuses on the possible role and mechanism of incretins in the pathogenesis of PCOS.

OBJECTIVETo assess the association between brain-derived neurotrophic factor (BDNF) gene Val66Met polymorphism and clinical characteristics of first episode schizophrenia in a Chinese Han population.

METHODSGenotyping of BDNF Val66Met polymorphism was carried out for 135 schizophrenic patients and 483 healthy controls with TaqMan probe technology. The patients' psychotic symptoms were assessed using the positive and negative syndrome scale (PANSS).

RESULTSA significant difference was found in genotype distribution and allelic frequency of the Val66Met polymorphism between the two groups (P< 0.01). In patients, Met homozygotes had a significantly higher score in anxiety/depression factor, cognitive factor and total score of PANSS than Val carriers.

CONCLUSIONBDNF gene Val66Met polymorphism is associated with the pathogenesis of schizophrenia. The Met/Met genotype of BDNF Val66Met variant may be a risk factor for symptoms in first episode schizophrenia patients.

Adolescent ; Adult ; Brain-Derived Neurotrophic Factor ; genetics ; China ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Humans ; Male ; Middle Aged ; Polymorphism, Single Nucleotide ; Schizophrenia ; genetics ; Young Adult

Objective: To explore the genetic cause for abnormal pregnancies through detecting chromosomal copy number variations (CNVs) in abortic tissues by next generation sequencing (NGS). Methods: NGS technique was used to detect CNVs in abortion tissues. Parental chromosomal karyotypes were predicted based on the results. The aberrant chromosomal segments of the parents were accurately mapped by G-banding karyotyping analysis and fluorescence in situ hybridization (FISH). Results: In addition to numerical chromosomal aberrations, 12 microdeletion/microduplications were detected by NGS. For 8 families where both parents accepted chromosomal karyotyping, 4 carriers of chromosomal abnormalities were identified. One marker chromosome was missed by karyotyping analysis, and a mother was confirmed to carry a cryptic balanced translocation by FISH. Conclusion NGS can facilitate detection of cryptic chromosomal translocations in couples with repeated pregnancy failure and is of great value for detecting abnormal CNVs for its high sensitivity.

Objective To investigate the mechanism of klotho reversing the resistance of breast cancer to paclitaxel in MCF-7/PTX cells.Methods The Klotho expression in MCF-7 and MCF-7/PTX cells was detected by Western blot.The effects of Klotho on paclitaxel resistance in MCF-7/PTX cells was measured by MTT assay.The effects of Klotho and 3-methyladenine (3-MA) on proliferation and expression of Beclin1 in MCF-7/PTX cells were detected by MTT and Western blot assay,respectively.Results The expression of Klotho in MCF-7/PTX cells was decreased compared with MCF-7 cells.Klotho could sensitize MCF-7/PTX cells to paclitaxel.The expression of Beclin1 in MCF-7/PTX cells was higher than that in MCF-7 cells.Klotho and 3-MA could decrease the expression of Beclin1 in MCF-7/PTX cells,and the effects of Klotho on paclitaxel resistance in MCF-7/PTX cells was similar to that of 3-MA.Conclusion Paclitaxel resistance in breast cancer cells is related to expression of the Klotho which can reverse the resistance of breast cancer to paclitaxel by inhibiting autophagy.