Human anatomy is an important component of the medical course. It is not only the basis of medical basic courses, but also the basis of medical clinical courses. By using the wonderful introduction, multi-media teaching, the introduction of fusion experiments in combination with clinical cases of interest teaching, we can mobilize and train the students' interest, and fully improve the quality of classroom teaching.

Objective To evaluate the long-term efficacy and safety of donepezil in treating patients with Alzheimer's disease(AD).Methods Totally 86 patients with AD were randomly divided into control group(n =43)and treatment group(n =43).The control grou,p received conventional therapy with aniracetam,nimoldipine and ginkgo tablet,while the study group was administrated with donepezil(10 mg/d)on the basis of conventional therapy.The improvements of recognitive ability,mental state,activities of daily life were graded by mini-mental state examination (MMSE),Alzheimer's disease assessment scale-cog(ADAS-cog),activity of daily living(ADL)and global deterioration scale(GDS).The scores were compared between the groups before the treatment and 3,6,12,18,24,30,36,42,48,54,60,66 and 72 months after the treatment,respectively.Results The scores of MMSE,ADAS-cog and GDS after 3 months and ADL score after 6 months (t=2.361,-2.198,-1.790,-2.420,P＜0.05 or P＜0.01)were improved in treatment group than in control group with the best effects at 12 months(all P＜0.01)and the scores continued to decrease after 36 months.At 72 months,the score improvements in treatment group were 7.5 for MMSE,20.3 for ADAS-cog,19.5 for ADL,and 1.4 for GDS as compared with control group(all P ＜0.01).In contrast to pretreatment,there were statistically significant differences in the scores of MMSE,ADAS-cog and GDS at 3,6,12,18 and 24 months,and in the score of ADL at 6,12,18,24 and 30 months after treatment(P＜0.05 or P＜0.01).The differences in the scores of ADAS-cog and GDS after 24 months as well as MMSE and ADL after 30 months were not found(P＞0.05)between pre-treatment and post-treatment.Conclusions Donepezil might be long term effective and safe in slowing down the recognitive and overall function deterioration of AD.

ObjectiveTo investigate the risk factors for acute renal injury (AKI) in patients with ischemic stroke.MethodsPatients with ischemic stroke were enrolled retrospectively.The general clinical data, vascular risk factors, drug use, stroke etiological typing, stroke severity, and baseline biochemical indices were collected.They were divided into either an AKI group or a control group according to whether AKI occurred or not.Multivariable logistic regression analysis was used to analyze the independent risk factors for occurring AKI in patients with ischemic stroke.ResultsA total of 214 patients with ischemic stroke were enrolled, including 32 (14.95%) had AKI and 182 (85.05%) did not have AKI.The proportions of patients in heart failure (62.50% vs.41.21%;χ2=4.998, P=0.025), mannitol use (87.50% vs.43.96%;χ2=20.643, P<0.001), furosemide use (87.50% vs.43.96%;χ2=20.643, P<0.001), contrast agent use (37.50% vs.19.23%;χ2=5.300, P=0.021), and contrast dosage >200 ml (28.13% vs.9.89%;χ2=6.637, P=0.010), as well as NIHSS score (18.0±4.5)vs.8.0±3.2;t=15.249, P<0.001), diastolic blood pressure (89.98±9.1 mmHg vs.80.56±8.19 mmHg, 1 mmHg=0.133 kPa;t=5.898, P<0.001), fasting blood-glucose (10.54±4.31 mmol/L vs.6.32±1.32 mmol/L;t=5.898, P<0.001), blood urea nitrogen level (11.21±2.13 mmol/L vs.7.98±2.34 mmol/L;t=7.293, P<0.001), and arterial lactate concentration (3.98±0.12 mmol/L vs.0.91±0.25 mmol/L;t=68.003, P<0.001) in the AKI group were significantly higher than those in the non-AKI group.Multivariate logistic regression analysis showed that after adjusting various confounding factors, higher NIHSS score (odds ratio [OR] 1.910,95% confidence interval[CI] 1.517-6.012;P=0.024), higher diastolic pressure (OR 1.816, 95% CI 1.652-3.876;P=0.018), arterial lactate concentration (OR 1.553, 95% CI 1.256-1.763;P=0.019), mannitol use (OR 3.765, 95% CI 2.081-9.658;P=0.017), furosemide use (OR 5.329, 95% CI 3.085-8.763 P=0.010), contrast agent use (OR 2.097, 95% CI 1.364-2.456;P=0.031), and contrast dosage >200 ml (OR 3.294, 95% CI 1.464-2.786;P=0.021) were the independent risk factors for AKI in patients with acute ischemic stroke.ConclusionsThe NIHSS score, diastolic blood pressure, arterial lactate concentration,mannitol use, furosemide use, contrast agent use and contrast dosage >200 ml were associated with AKI in patients with ischemic stroke.

Aim To study the relationship between the expressions of Fas,Fas-L and the spontaneous apoptosis of thymocytes in vitro. Methods The expressions of Fas,Fas-L and the apoptotic rate of thymocytes were assayed by flow cytometry. Results The apoptosis and the Fas expression of thymocytes of different culture times in vitro were increased time-dependently in vitro. The Fas-L expression of thymocytes cultured for 24 h was also significant increase. There was significant corelation between the increase of Fas expression and the increase of apoptosis of thymocytes in vitro. Conclusion Fas is an important molecule which mediates spontaneous apoptosis of thymocytes cultured in vitro.

Objective:To establish the cisplatin-resistant human lung adenocarcinoma cell line A549/(DDP) cisplatin and to study the relationship between EHD2 and drug resistance. Methods:DDP-resistant human lung cancer cell line A549/DDP was established by gradual and stepwise dose enhancement. MTT was used to measure drug sensitivity. Western blot and immunofluorescence were used to evaluate expression and subcellular localization of EHD2 and breast cancer resistance protein (BCRP). Results:The DDP-resistant cell line A549/DDP was established, with a resistance index of 7.6. EHD2 and BCRP expressions both increased and were enriched on the cell surface membrane. Conclusion:Both EHD2 and BCRP expressions were enriched on the resistant cell surface membrane, suggesting that EHD2 endocytic protein stabilizes BCRP and is involved in drug resistance.

Objective To explore the association between plasma resistin levels and acute coronary syndrome. Methods Four hundred patients were divided into coronary heart disease (CHD) group（310）and control group（90）according to the coronary Angiography (CAG). And CHD group was divided into ACS subgroup（n＝217）and SAP subgroup（n＝93）according to the clinical information. 85 cases in CHD group were underwent 64-slice spiral computed tomography coronary artery imaging. The severity and extent of coronary lesions were analyzed by CAG and graded by means of Gensini coronary score system. Resistin level in plasma of all patients was determined by enzyme linked immunosorbent assay. Results Resistin levels in CHD group［(889.1±248.2)pg/ml］ were significant higher compared with the control group［(261.6±111.9)pg/ml］ (P＜0.05), and resistin levels in ACS subgroup［(1260.0±368.0)pg/ml］ were much higher than that in SAP subgroup［(518.3±128.4)pg/ml］ (P＜0.05). Conclusions The resistin levels of patients with acute coronary syndrome increased significantly and might be associated with the vulnerable plaque. Resistin levels and 64 slice spiral computed tomography coronary artery imaging can be used to detect the vulnerable plaque in CHD patients.

Objective To evaluate the potential influencing factors associated with pathologic complete response ( pCR) after neoadjuvant chemoradiotherapy for locally advanced rectal cancer ( LARC) . Methods A retrospective analysis was performed on the clinical data 265 patients with stageⅡandⅢ( the 7th version of AJCC) rectal cancer admitted to our hospital from 2011 to 2013. All patients underwent neoadjuvant concurrent chemoradiotherapy ( CCRT ) followed by surgery with/or without induction chemotherapy during the interval between the complete of CCRT and surgery. The predictors associated with pCR were analyzed by univariate and multivariate logistic regression analyses. With the use of the independent predictive variables for pCR from multivariate analysis, a clinical risk score model was established according to the following criteria:no?risk group (0 factor);low?risk group (1 factor);high?risk group ( 2 factors) . Results Among these 265 patients, 50( 18. 9%) achieved pCR. The univariate analysis showed that carcinoembryonic antigen ( CEA) level before CCRT ( P=0. 017) , T stage before CCRT ( P=0. 001), interval between complete of CCRT and surgery (P=0. 000), and the maximum tumor thickness before CCRT ( P=0. 040) were significantly associated with pCR. The multivariate analysis showed that pre?CCRT CEA level ( P=0. 021 or 0. 446) and interval between the complete of CCRT and surgery ( P=0. 000 or 3. 774) were significant predictors of pCR. When stratifying for smoking status, only low pre?CCRT CEA level was significantly associated with pCR in the non?smoking patients ( P=0. 044) . For the prediction of pCR by the clinical risk score model, the sensitivity was 0. 805, the specificity was 0. 460, the area under the receiver operating curve was 0. 690 ( 95% CI= 0. 613?0. 767 ) , the positive predictive value was 35 . 4 9%, the negative predictive value was 8 6 . 5%, and the predictive accuracy was 7 3 . 9%. Conclusions For locally advanced rectal cancer, pCR can be achieved in some patients after neoadjuvant therapy. Low pre?CCRT CEA level and long interval time between CCRT and surgery are independent factors associated with pCR, and only low pre?CCRT CEA level is an associated factor in the group of nonsmokers. The clinical risk score model based on pre?CCRT CEA level>5 ng/ml and time interval from CCRT completion to surgery≤8 weeks can be used to predict pCR after neoadjuvant chemoradiotherapy for LARC.

Objective To investigate the relation between activator protein-1(AP-1)and coronary atheroselerotic changes and the potential role of AP-1 in the stabilization of atherosclerotic plaques in patients with coronary heart disease(CHD).Method 142 patients were included in this study and divided into CHD group(107)and control group(35)according to coronary angiography(CAG).The CHD group was further divided into a stable angina pectoris(SAP)group(32)and all acute coronary syndrome(ACS)group (75)according to the clinical manifestations.In addition,the CHD group was divided into A type group,B type group and C type group according to the standard of ACC/AHA coronary change in 1988.Meanwhile,the CHD group was further divided into light stenosis group,moderate stenosis group and severe stenosis group according to the degree of coronary lesion.The lysate of cells was obtained through lysis of the leucocyts from peripheral blood with cell lysis buffer.The amount of Phospho.c-Jun in lysate was measured with enzyme-linked immunosorbent assay(ELISA).The results were demonstrated with absorbance,which reflects the amount of AP-1.Results The main coronary changes in the SAP group were A type(68.7%)and the changes were mainly of light degree(53.1%);the main coronary changes in the ACS group were B type(52.0%)or C type(37.3%)and the changes were mainly of heavy degree(66.7%).The absorbance of Phospho-c-Jun in CHD group was significantly higher than that in the control subjects (1.43±0.33 vs 0.71±0.13,P＜0.001).The absorbance of Phospho-c-Jun in the ACS group was significantly higher than that in the SAP group(1.56±0.28 vs 1.14±0.25,P＜0.001).The absorbance of Phospho-c-Jun increased gradually from A type group to C type group(1.18±0.27 vs 1.42±0.26 vs 1.71±0.27,P＜0.001)and from light stenosis group to severe stenosis group(1.09±0.20 vs 1.37±0.26 ys 1.60±0.29,P＜0.001).Conclusion There is a significant relationship between AP-1 and coronary atherosclerotic changes.AP-1 may be a factor that can predict coronary arteriosclerotic progression and stability of the plaque.

Objective To investigate the relationship between the plasma adiponectin concentration and coronary arteriosclerosis change in patient with coronary heart disease(CHD).Method 142 patients were divided into CHD group and control group according to the Coronary Angiography(CAG).CHD group were further divided into stable angina pectoris(SAP)subgroup and acute coronary syndrome (ACS)subgroup according to the clinical property.According to the type of coronary change,CHD group wag divided into A type group, B type group and C type group,meanwhile according to the degree of coronary lesion,CHD group was divided into light stenosis group, moderate stenosis group and severe stenosis group.The plasma adiponectin concentration was measured by ELISA.Results The plasma adiponectin concentration in CHD group was significant lower than that in control group.The plasma adiponectin concentration in ACS subgroup was significant lower than that in SAP subgroup.The plasma adiponectin concentration decreased gradually from A type group to C type group and from light stenosis group to severe stenosis group(P＜0.001).Conclusions Adiponectin is a negative regulatory factor of coronary atherosclerosis,and Hypoadiponectin may be used to predict the change of coronary arteriosclerosis and the stability of plaque.

BACKGROUND:The living standard of farmers and herdsmen in Xinjiang Uygur Autonomous Region, China is significantly lower than that of urban residents in general. Meanwhile, the shortage of doctors and medicines and lack of medical knowledge are the main reasons for local farmers and herdsmen to suffer from knee osteoarthritis. Most of the farmers and herdsmen are not aware of or prevent knee osteoarthritis in the early days to remove pathogenic factors, which results in a serious condition at the time of their medical treatment. OBJECTIVE: To investigate the main pathogenic factors of knee osteoarthritis in Uygur, Kazakh and Han populations in pastoral areas of northern Xinjiang Uygur Autonomous Region, China.METHODS:The permanent residents of Uygur, Kazakh and Han ethnic groups in northern Xinjiang, China who met the criteria were selected by the method of stratified, multistage and cluster random sampling during June 2012 to October 2014. The investigation of knee osteoarthritis was conducted among al the residents who meet the inclusion criteria using the method of home scene closed questionnaire. X-ray lateral plain film examination of the knee joint was performed among the patients presenting with the symptoms of knee osteoarthritis. The database was established. The multi-factor and unconditional Logistic regression analysis was conducted among the 40 variables using SPSS 20.0 software. RESULTS AND CONCLUSION:The 3 402 of 3 540 questionnaires were valid. The Logistic regression analysis suggest that the common pathogenic factors in Han, Uygur and Kazakh ethnic groups are associated with older ages, female gender, high body mass and drink alcohol. Smoking, history of internal disease, high education level, standing position, climbing, trauma, family history, fried food, housing conditions and amenorrhea, different nationalities, churchgoing of ethnic minorities are also the major risk factors. Among the three ethnic groups, the prevalence of female patients in Uygur and Kazak ethnic groups is significantly higher than that of Chinese Han nationality. The morbidity is different among these three nationalities. The dietary preferences cannot be determined as the related influencing factor of knee osteoarthritis. Whether the means of transportation, residence climate and environment, the number of pregnancies and deliveries, drinking tea or not, the type of tea are related to knee osteoarthritis remains unclear.