Objective To investigate the application effect of the new trinity teaching mode of clinical practice,which combines bedside teaching,simulation teaching and web-based teaching to-gether. Methods Totally 375 students of clinical medicine,enrolled into Guangzhou Medical Univer-sity in 2006,were randomly divided into department I of clinical medicine (control group,188 stu-dents)and department II of clinical medicine (experimental group,187 students). The students of these two groups were taught respectively with the conventional bedside teaching mode and the trinity teaching mode. Then at the end of clinical practice,assessment results of comprehensive theory and clinical skill in the graduation exam were compared by t test (significance level α=0.05)using SPSS 17.0 software and the questionnaire results of students in experimental group were analyzed. Results There were statistical differences in comprehensive theory and clinical skill assessment scores between two groups(P<0.05). The questionnaire survey showed an approval rate of 92.73%(153/165)for trini-ty teaching mode. Conclusions Facing the shortage of clinical teaching resources,the trinity teach-ing mode is better than the simple bedside teaching mode. The trinity teaching mode can alleviate the pressure brought by the lack of clinical teaching resources at present,create more learning and prac-ticing opportunities for students,and improve the effects of clinical practice teaching.

Objective To explore more satisfactory results in correcting the aesthetically short nose combined with low and blunt nasal tip by using autologous cartilage grafts.Methods External rhinoplasty approach was preferred.Nasal septal cartilage and auricular cartilage or rib cartilage of patients were adopted,as necessary,various shapes of grafts were carved,such as septal extention graft,columella strut and shift graft.Then we used these autologous cartilage grafts with suture and removal techniques to correct the aesthetically short nose combined with low and blunt nasal tip.The length of the nose (n-prn) and the projection of nasal tip (sn-prn) were measured before and after the operation.Paired t-test was adopted to evaluate the results.Results Thirty-one patients accepted the nasal tip rhinoplasty with autologous cartilage whose nasal tip was over rotation,blunt and low.All the patients were followed up for 3 months.Thirty patients satisfied with the results,accounting for 96.7 ％ of the total.()ne (3.3 ％) patient dissatisfied with the result because of postoperative asymmetry nostrils.Nose length before and after surgery was significantly different (P＜0.05).Nasal tip projection before and after surgery was also significantly improved (P＜0.05).Conclusions It is an effective method to use autologous cartilage graft for correcting the aesthetically short nose combined with low and blunt na sal tip,with low complications.

Objective To observe effects of conditioned place preference (CPP) of morphine dependent rats,variation of dopamine neurotransmitter and its receptor 2 of the striatum in rats suffered from 1-tetrabydropalmatine(l-THP).Methods The CPP model was established by morphine injection in rats with a increasing dose for 10 days,with the initial dose of 10 mg · kg-1 and the final dose of 100 mg · kg-1,10 mg · kg-1 was increased each day,thus 100 nmg · kg-1 Was injected by day 10.Treatments with administration of 1-THP(3.76,1.88 and 0.94 mg/kg) were performed respectively for 6 days,and the effects of CPP for psychological dependence in these rats were observed.Striatum samples were taken out and their variable contents of dopamine neurotransmitter and its receptor 2 in striatum were detected by high performance liquid chromatography and immunohistochemisty,respectively.Results Compared with the NS treatment group,the time of animals treated with 1-THP (3.76 and 1.88 mg/kg) staying in drug-paired compartment were reduced (354 ± 58,373 ± 79) (P＜ 0.01) ;the raised of variation contents of dopamine neurotransmitter were reduced in striatum from those rats(5.49 ± 1.95,6.11 ± 1.05),while the expression level of dopamine receptor 2 was increased(0.08 ± 0.02,0.07 ± 0.03) (P ＜ 0.01 or P ＜0.05).Conclusion Reversing dopamine neurotransmitter and its receptor 2 in striatum of morphine dependent rats may be one of the possible mechanisms that 1-THP effectively inhibit the effects of morphine CPP.

Objective To observe the level of dopamine and its receptor in striatum from conditioned place preference (CPP) of rats administrated of morphine.And explore the mechanism of opioid-psychic dependence involving the levels of neurotransmitter and receptor.Methods CPP model was validated in morphine-dependence rats for 10 days.Striatum samples were harvested from two separate groups involving the saline group and morphine treated group (n =10 per experiment).The DA contents in striatum were detected in rats with colorimetry.Immunohistochemistry was applied to detect the differential expression levels of dopamine receptor 2 (DRD2)in samples.Results Compared with the saline group,higher content of neurotransmitter dopamine was observed in the morphine dependent rats (7.63 ±0.98 vs 5.23 ± 1.01,P＜0.01),while the expression level of DRD2 was down regulated (0.06 ± 0.02 vs 0.08 ± 0.02,P ＜ 0.01).Conclusion The increased expression of neurotransmitter dopamine and the decreased of DRD2 may be contributed to morphine-induced psychological dependence in morphine dependent rats.

Objective To observe effect of Compound Ruikangxin Capsula(CRC) on anxiety-like symptoms of morphine-withdrawal rats and investigate its mechanism.Methods The elevating doses were applied to validating anxiety-like behavior in SD male rats with sc morphine for 10 d.Treatments with ig administration of CRC(100,200,and 300 mg/kg) and buspirone(15 mg/kg) were performed during 1—3 d morphine withdrawal(twice every day).The plus elevated maze was applied to validating anxiety-like symptom in rats.The expression levels of synaptophysin were detected on hippocampus in groups by immunohistochemitry 72 h after sc morphine.Results As compared with the control group,animals treated with CRC(200 and 300 mg/kg) and buspirone had higher ratio of entry into open arm (P

Objective To investigate expression level of endoplasmic reticulum stressmarker GRP78 in the testicular tissue in rats with different phases of morphine-dependence. To explore the role of ERS in morphine-de-pendence. Methods SD rats were divided into 6 groups: morphine (mor) -withdrawal group, mor-extinct group, mor-kindling group and their control groups, normal saline (NS)-withdrawal group, NS-extinct group, NS-kindling group. The experimental rats were injected with morphine subcutaneously on increasing dosage to establish the con-ditioned place preference (CPP) model. The rats in control groups were injected NS. Then the rats were suffered from withdrawal for 48 h, extinction and kindling by morphine, separately. The GRP78 expression level in testicular tissues of rats in the time point mentioned above were measured using Western Blot. Results The time of rats in the paired-box was (528.0 ± 81.0) s, which was significantly higher than that in the NS control group (P<0.001). It was (396.8 ± 116.9) s after extinctive phase, which was significantly higher than that the withdrawal phase of rats (P < 0.001). Also it was (396.8 ± 116.9) s after kindling with morphine which was significantly higher than that the extinctive phase of rats (P < 0.001). These changes of the time indicated that the animal models of extinction and kindling were established in the study. The GRP78 levels were down-regulated in 48 h after withdrawal (P <0.05), and increased a bit afterextinctive phase, but up-regulated highly after kindling with morphine (P < 0.01). Conclusion ERS may be related in the morphine dependence and it might play an important role of testicular dys-function in male drugabuser.

Objective To investigate the molecular mechanisms of synergistic effects of BFA and CDDP on human lung cancer GLC-82 cells, and to test the levels of PERK-ATF4 pathway. Methods GLC-82 cells were incubated with 50 ng/mL of BFA or/and 2 μg/mL of CDDP for 24 or 48 hours. The levels of PERK, p-PERK and ATF4 in GLC-82 were analyzed by real-time PCRand/or Western Blot. Results The levels of PERK were lowest in CDDP group, but higher in BFA group (P < 0.05), the highest in group of BFA+CDDP (P < 0.05 or P < 0.01). The p-PERK level decreased in group of BFA+CDDP (P < 0.05 or P < 0.01). There was no significant change of ATF4 expression in CDDP group, but ATF4 expression increased slightly in BFA group, and increased further in group of BFA+CDDP (P < 0.05 or P < 0.01)which was also higher than that in BFA group or CDDP group (P < 0.05 or P < 0.01). Conclusions The upregulated levels of PERK and ATF4 by the combination of BFA and CDDP may be one of the mechanisms of synergistic anti-cancer effect of BFA and CDDP on GLC-82 cells.

Objective To assess the diagnostic value of contrast enhanced ultrasound (CEUS) in liver metastases. Methods Thirty-six patients were examined with conventional ultrasonography, then underwent continuous real-time CEUS with low mechanical index. The size, location, number and perfusion patterns of liver metastases were evaluated. Results In 36 patients, 67 liver metastases were found with conventional ultrasound and 106 liver metastasis were found with CEUS. The perfusion patterns of lesions were in four types: ①Thirty-seven lesions (34.91%) showed as total enhancement during the early arterial phase and hypoechoic appearance during the portal venous phase and the late phase;②Fifty-six lesions (52.83%) showed a peripheral rim-like hyperechonic enhancement during the arterial phase and fast wash-out in the portal phase;③Twelve lesions (11.32%) showed as isoechoic enhancement during the arterial phase and the portal phase and was hypoechoic in the late phase;④One lesion (0.94%) showed hypoechoic appearance during all phases. The dimension of the lesions played an important role in the perfusion patterns. Conclusion The enhancement pattern and time of lesions are closely correlated with the tumor arterial supply. CEUS has high value in diagnosing liver metastases.

Objective To investigate the synergistic effects of tannic acid(TA) and cis-dichlorodiamine platinum(CDDP) on hepatocellular carcinoma HepG2 cells and its activation situation of endoplasmic reticulum stress(ERS) pathway.Methods Human hepatocellular carcinoma HepG2 cells were divided into the control group,TA group,CDDP group and TA+CDDP group,and were cultured in vitro for 24 h.The growth inhibitory effect of medication on HepG2 cells was detected by MTT assay.The pharmacodynamics synergistic effect between the two drugs was analyzed by the drug interaction index,drug dose reduction index and equivalent graphical method.The nucleus changes were observed by DAPI staining.Real time fluorescent quantitative PCR(q-RT-PCR) and Western blot were used to detect the levels of ERS markers glucose regulated protein (GRP)78 and GRP94.Results TA and CDDP had dose-dependent growth inhibition effect on HepG2 cells,their median effective concentrations(IC50) were 360.00 μmol/L and 1.80 μg/mL respectively.The combination treatment of 180.00 μmol/L TA and 0.90 μg/mL CDDP on HepG2 cells could enhance the inhibitory effect on cell growth.Ta and CDDP had synergistic effect for inhibiting hepatocellular carcinoma cells growth.Compared with the TA group and CDDP group,cell shrinkage and rounding were accelerated in the combined group,apoptotic cells were increased,nuclear had pyknosis,irregular edge and dense staining,nuclear fragmentations were increased and the expressions of GRP78 and GRP94 were up-regulated.Conclusion TA can enhance the effect of CDDP on anti-hepatic carcinoma HepG2 cells,and the synergy mechanism may be related to the activation of ERS pathway.

The oral and maxillofacial region contains oral organs and facial soft tissues. Due to the complexity of the structures and functions of this region, the repair of related defects is complicated. Different degrees of defects require different repair methods, which involve a great combination of medicine and art, and the material requirements are extremely high. Hence, clinicians are plagued by contemporary oral repair materials due to the limitations of bone harvesting, immune rejection, low osteogenic activity and other problems. Decellularized extracellular matrix has attracted much attention as a bioactive scaffold material because of its nonimmunogenic properties, good osteogenic properties, slow release of growth factors, promotion of seed cell adhesion and maintenance of stem cell characteristics. This article reviews the sources, preparation methods, application and research progress of extracellular matrix materials in the repair of oral and maxillofacial defects to provide an overview for fundamental research and clinical development.