[Objective To evaluate the teaching effects and advantages of problem-based learning (PBL) teaching mode based on network in the clinical practice of obstetrics and gynecology. Methods 2007 grade intern students in department of obstetrics and gynecology in Beijing Tongren Hospital of Capital Medical University were divided into 2 groups:control group (18 seven-year program and 11 five-year program)and experiment group (17 seven-year program and 10 five-year program). Traditional teaching was conducted in control group:interns and teacher completed teaching ward round several times according to the teaching requirement. PBL based on network was conducted in experiment group:tea-chers asking questions-data collection-learning and discussing-demonstrating and arguing-discussing and summarizing teaching process. Then the effects of different teaching methods were evaluated by clinical practice skill and theoretical test. SSPS13.0 statistical software was used for data analysis and measurement data were expressed as x±s. T test was conducted among groups. Results As for clinical practice skills, scores in PBL group (seven-year program and five-year program )were higher than those of traditional group [seven-year program:(190.47±2.30)vs (87.42±2.93);five-year program:(92.95±2.20)vs (90 . 09 ± 2 . 70 )] . There was no difference between the two groups in scores of theoretical test . In clinical practice skills,scores of general skill and clinic case analysis showed significant differences be-tween PBL group and traditional group. Conclusions PBL tea-ching mode based on network can improve the quality and effectiveness of the clinical practice of obstetrics and gynecology, especially in the social, technical,and knowledge dimension.

Objective: To evaluate value of application of intravascular ultrasound imaging (IVUS) in diagnosing borderline lesions in left anterior descending artery (LAD) and left main coronary artery (LM). Methods: According to results of coronary angiography (CAG) in 60 cases with coronary borderline lesions, including 20 cases in LM, 20 cases in proximal segment of LAD and 20 cases in middle segment of LAD, the diagnostic value of IVUS in coronary borderline lesion was evaluated. Results: Compared with CAG, mean diameter stenosis rate of each coronary artery [LM: (65.3l±7.81) % vs. (75.28±8.89) %，proximal segment of LAD: (66.67±8.79) % vs. (78.89±7.88) %，middle segment of LAD: (71.55±6.83) % vs. (75.3l±7.81) %, P<0.01 all] significantly increased in IVUS. The differences of detection rate of plaque calcification and plaque rupture were no significant between CAG and IVUS（＞0.05）. Conclusion: Different degrees of underestimation of coronary artery stenosis exist in CAG, especially in proximal segment of LAD. IVUS can be an effective complement to CAG.

Adult ; Aged ; Breast Neoplasms ; genetics ; metabolism ; pathology ; surgery ; Female ; Gene Amplification ; Genital Neoplasms, Male ; genetics ; metabolism ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Paget Disease, Extramammary ; genetics ; metabolism ; pathology ; surgery ; Paget's Disease, Mammary ; genetics ; metabolism ; pathology ; surgery ; Penile Neoplasms ; genetics ; metabolism ; pathology ; surgery ; Receptor, ErbB-2 ; genetics ; metabolism ; Scrotum ; Vulvar Neoplasms ; genetics ; metabolism ; pathology ; surgery

Objective To compare the effect of four-in-one teaching method and traditional teaching method in clinical clerkship teaching in the department of obstetrics and gynecology. Methods Totally 70 clinical probationer were enrolled(35 from 2007 grade were taken as control group and 35 from 2008 grade were taken as experiment group ). Four-in-one teaching method and traditional teaching method were respectively in experiment group and control group. Examination score and clinical skill re-sults were analyzed by t test and satisfaction degree was analyzed byX2 test. P<0.05 signifies statistical sig-nificances . Results Examination score of experiment group and control group were 86 . 9 ± 7 . 7 and 76.5 ±8.7 respectively with statistically significant differences(P=0.000). Clinical skill score of experi-ment group and control group were 87.6±6.9 and 75.9±7.5 respectively with statistically significant dif-ferences(P=0.000). Each questionnaire index was significantly higher in experiment group than in con-trol group with statistically significant differences(P=0.000). Conclusions Four-in-one teaching method can make students understand theoretical knowledge and master obstetrics and gynecology basic clinical skills,enhance interests in learning,build up self-confidence and establish preliminary clinical thinking ability and innovation ability which will lay a solid foundation for future clinical and research practice.

This article reviewed pharmacological study development of Punica granatum L. both at home and abroad in recent years. P. granatum has a long medical usage history. Different parts of P. granatum have wide applications in both traditional Chinese medicine (TCM) and other ethnic medicine. Its main chemical compositions were tannins, flavonoids, alkaloids and organic acids. It has obvious pharmacological activities. In recent years, the pharmacological research progress on P. granatum in terms of antibacterial, antiviral, hypoglycemic, antitumor, adjusting blood lipids, antioxidant, and immunoregulation has rapid development. The scientific collection and analysis on effects and new pharmacological research results of P. granatum are hoped to provide references for the study, clinical application, development and utilization of P. granatum and its products.

Objective To investigate the efficacy and toxicity of neoadjuvant chemotherapy of modified FOLFOX7 regimen in the treatment of advanced gastric cancer. Methods The clinical data of 30 patients with advanced gastric cancer who had been admitted to Beijing Friendship Hospital from June 2005 to January 2009 were retrospectively analyzed. All patients received modified FOLFOX7 regimen [oxaliplatin (100 mg/m~2) + fluorouracil (2400 mg/m~2) + calcium folinate (400 mg/m~2)] for 2-4 courses before operation. The efficacy and toxicity of the modified FOLFOX7 were evaluated before and after the operation. All data were analyzed via chi-square test. Results The pre-and postoperative downstaging rates were 27% (8/30) and 47% (14/30), respectively. The total effective rate of modified FOLFOX7 regimen was 43% (13/30). Complete remission was observed in 1 patient. The toxicity was mild. Radical resection was accomplished in 28 patients (93%). There was no statistical difference between the 2 criteria in evaluating the efficacy of modified FOLFOX7 regimen (χ~2= 2.584, P>0.05). Conclusion Modified FOLFOX7 regimen is effective and well-tolerable for patients with advanced gastric cancer.

Objective To investigate the prottective effect of ulinstatin on lung of rats with sepsis and its mechanism of ameliorating cell apoptosis. Method A total of 40 female SD rats were randomly (random number)divided into the control group and the therapy group (ulinastatin 300 000 u/kg). The rat models of sepsis were produced by the classical method of cecal ligature and puncture (CLP), and the designed doses ulinastatin were given intra-peritoneally to the rats of the ulinastatin group and the same amounts of PBS (phosphate buffered solution) instead of ulinastatin were administered intra-peritoneally to the rats of the control group when the sepsis symptoms appeared usually in 3 hours after modeling. In 12 hours after treatment, lung tissues of rats in two groups were taken for observation under the transmission electron microscopy and detecting the levels of Bcl-2 and Bax protein in lung tissues by using immunohistochemical technique. The levels of the integrated optical density(IOD)of Bcl-2 and Bax protein were detected by using Image-pro plus software and the ratio of Bcl-2/Bax was calculated. Results Transmission electron microscope showed that lung tissue in control group had inflmmatory changes such as severe congestion and consolidation, and those changes in ulinastatin treatment group (300 000 u/kg)were significantly slighter. There were significant differences in the levels of antiapoptotic protein Bcl-2 in lung tissue of rats between two groups(P＜0.01), and the level of protein Bcl-2 in ulinas tatin group were higher than those in control group. The level of pro-apoptotic protein Bax in control group were higher than that in ulinastatin group (P＜0.01). The ratio of Bcl-2/Bax in ulinas tatin group was higher than that in control group (P ＜ 0.05).Conclusions Ulinastatin has protective effect on lung tissue in septic rats, and it may inhibit the inflammatory response and in the same time plays a role in inhibiting cell apoptosis.

Objective To compare the levels of the serum pepsinogen (PG) in the gastric diseases, and explore the diagnostic value in gastric diseases. Methods Two hundred and fourteen patients who had undergone endoscopy were selected, and the patients were divided into 3 groups according to the results of endoscope pathological diagnosis:chronic superficial gastritis (CSG) group ( 70 cases), chronic atrophic gastritis (CAG) group (86 cases) and gastric cancer (GC) group (58 cases). The quantitative chemiluminescence method was used to test serum PGⅠand PGⅡ, and the PGⅠ/PGⅡratio (PGR) was calculated. Results The PGⅠin GC group was significantly higher than that in CAG group: (78.41 ± 55.42) μg/L vs. (53.10 ± 30.08) μg/L, and there was statistical difference (P<0.05). There was no statistical difference in PGⅠbetween GC group and CSG group (P>0.05). The PGⅡin GC group was significantly higher than that in CAG group and CSG group: (23.26 ± 17.80) μg/L vs. (13.12 ± 10.23) and (13.78 ± 9.26) μg/L, the PGR was significantly lower than that in CAG group and CSG group:3.67±2.03 vs. 4.88 ± 1.82 and 5.24 ± 1.88, and there were statistical differences (P<0.05). Helicobacter pylori (Hp) was detected in 165 patients, with positive in 29 cases (Hp positive group) and negative in 136 cases (Hp negative group). There was no statistical difference in PG Ⅰ between Hp negative group an Hp positive group:(60.46 ± 45.49)μg/L vs. (72.41 ± 31.85)μg/L, P>0.05. The PGⅡin Hp positive group was significantly higher than that in Hp negative group: (19.58 ± 1.57) μg/L vs. (14.09 ± 13.21) μg/L, the PGR was significantly lower than that in Hp negative group: 3.82 ± 0.18 vs. 4.99 ± 0.18, and there were statistical differences (P<0.05). Conclusions Compared with that in the CSG and CAG patients, the PG Ⅱ in GC patients increases significantly, while PGR descends significantly, but PG Ⅰ has no correlation with the risk of GC. The PG Ⅱ combined with PGR can predict people with high risk of GC, and help with the judgment of Hp infection.

To study the chemical constituents of the 95% ethanol extract of Psidium guajava. Compounds were separated by using a combination of various chromatographic methods including silica gel, D101 macroporous resin, ODS, Sephadex LH-20 and preparative HPLC. Their structures were elucidated by physicochemical properties and spectral data Eighteen compounds were isolated and identified as (+) -globulol (1), clovane-2beta, 9alpha-diol (2), 2beta-acetoxyclovan-9alpha-ol (3), (+) -caryolane-1 ,9beta-diol (4), ent-T-muurolol (5), clov-2-ene-9alpha-ol (6), isophytol (7), tamarixetin (8), gossypetin (9), quercetin (10), kaempferol (11), guajaverin (12), avicularin (13), chrysin 6-C-glucoside (14), 3'-O-methyl-3, 4-methylenedioxyellagic acid 4'-O-beta-D-glucopyranoside (15), p-hydroxy-benzoic acid (16), guavinoside A (17) and guavinoside B (18). Compounds 2-9 and 14-16 were isolated from this plant for the first time. The ethanol extract showed 61.3% inhibition against the proliferation of colon cancer cell line SW480.
Drugs, Chinese Herbal ; chemistry ; Organic Chemicals ; analysis ; Plant Leaves ; chemistry ; Psidium ; chemistry

A fast and sensitive liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the determination of prodrug of paclitaxel (Pro-PTX) and paclitaxel (PTX) in rat plasma was developed. The plasma samples were subjected to protein precipitation with acetonitrile (0.1% formic acid), and then separated by LC with an Ultimate AQ-C18 column (50 mm × 3.0 mm, 3 μm) and acetonitrile-1 mmol·L^-1 ammonium formate (containing 0.1% formic acid) as the mobile phase. Multiple reaction monitoring (MRM) scanning mode was used to detect the ion responses m/z 983.4→415.2 (Pro-PTX), m/z 854.4→286.1 (PTX) and m/z 808.3→527.2 (Docetaxel, internal standard) by using a triple quadrupole tandem mass spectrometer with electrospray ionization source and positive ion mode. The method validation results show that the linear ranges of Pro-PTX and PTX in plasma were 2.00-500 ng·mL^-1 (r > 0.99) and 4.00-1 000 ng·mL^-1 (r > 0.99), the lower limit of quantification was 2.00 ng·mL^-1 and 4.00 ng·mL^-1, respectively; the quality control samples with low, medium and high concentrations of Pro-PTX and PTX were within the batch, the relative standard deviation (RSD) between batches were all less than 9%; the relative deviation (RE) was within the range of ± 9%; In the stability test, both Pro-PTX and PTX in plasma were stable under various storage conditions. The method was sensitive, specific, and reproducible, and was suitable for the pharmacokinetic study of Pro-PTX in rats. Animal experiments were approved by the Ethics Committee of Laboratory Animal Management and Animal Welfare, Institute of Materia Medica, Chinese Academy of Medical Sciences (No.: 00003552).