ObjectiveTo investigate on the impact of the serum uric acid (UA) level coronary slow flow phenomenon(CSFP).MethodsSelected 30 cases of coronary slow flow patients as CSFP group,30 cases of patients with coronary heart disease,30 cases of patients with angiographically normal as the control group.The serum UA level was measured in three groups.The CSFP group and the control group were measured left anterior descending,circumflex and right coronary artery TIMI frame count(TFC) value.To analyze the mean TFC value of CSFP patients and the relationship between the serum UA level.ResultsCompared with the control group,the left anterior descending,circumflex and right coronary TFC results were significantly higher(all P ＜ 0.05) in the CSFP group.The mean serum UA level of CSFP group ,control group and CHD group were(340.79 ± 79.40)μmol/L, (220.45 ± 82.34)μmol/L,(42625 ± 87.02) μmol/L, the difference was statistically significant (all P ＜ 0.05).The mean serum UA level and TFC value of CSFP group was positively correlated(r = 0.943, P = 0.007).ConclusionElevated level of serum UA is closely related to the occurrence and development of the CSFP.

Objective To explore the role of inquiry flipped classroom teaching model in enhancing teaching effective-ness of internal medicine. Methods A total of 125 students from 4 clinical natural classes in our department were se-lected as research objects, and then randomly divided into control group (n=64) and experimental group (n=61). Students in control group received traditional teaching method, whereas those in experimental group were administrated with in-quiry flipped classroom teaching model. After end of teaching, internal medicine scores were compared between both groups. Evaluation of teaching effectiveness was conducted by Internal medicine teaching effectiveness assessment table. Results Internal medicine scores in experimental group [(83.21±11.26)points] were higher than those in control group[(70.89±10.23)] points,the difference was statistically significant (P<0.05). Moreover, evaluation of teaching effec-tiveness was better in experimental group when compared with control group(P<0.05). Conclusion Inquiry flipped classroom teaching model can markedly enhance teaching effectiveness of internal medicine in medical students, which is an efficient theoretical teaching method.

Objective To investigate the efficacy of decompressive craniectomy (DC) combined with ipsilateral external ventricular drainage (iEVD) for severe traumatic brain injury (sTBI). Methods A retrospective case control study was performed on the clinical data of 54 sTBI patients admitted to the First People's Hospital of Taizhou from January 2015 to March 2018. There were 38 males and 18 females, aged 18-72 years [ (51. 8 ± 15. 4)years]. The Glasgow Coma Scale (GCS) of patients ranged from 3 to 8 points. Among 54 patients, 27 received DC treatment, including 18 males and nine females aged (50. 1 ± 2. 9)years (DC group);27 patients received DC combined with iEVD, including 18 males and nine females aged (53. 4 ± 3. 1) years (DC-iEVD group). Intracranial pressure after surgery and complications ( hydrocephalus and subdural hygroma) 2 weeks after surgery, andModified Rankin Scale (mRS) 3 months after surgery were compared between the two groups. Results All patients were followed up for 2.5-4 months [(3.0 ±0.8)months]. No significant difference was found in intracranial pressure at postoperative 12 hours and 24 hours between the two groups (P>0. 05). However, the intracranial pressure of DC-iEVD group were significantly lower than those of DC group at 36, 48, 60 and 72 hours after operation (P<0. 05). The hydrocephalus incidence 2 weeks after surgery of DC-iEVD group was 15％ (4/27), while that of DC group was 7％ (2/27)(P >0. 05). The subdural effusion incidence 2 weeks after surgery of DC-iEVD group was 19％ (5/27), while that of DC group was 44％ (12/27) (P<0. 05). According to mRS, patients with good outcome in DC-iEVD group accounted for 63％(17/27) while the ratio was 44％ (12/27) in DC group. The prognosis of DC-iEVD group was slightly better than that of DC group, but the difference was not statistically significant(P>0. 05). Conclusion For sTBI, combined use of DC and iEVD can better control intracranial pressure and reduce the occurrence of subdural effusion.

Nanotechnology has emerged as an ideal approach for achieving the efficient chemo agent delivery. However, the potential toxicity and unclear internal metabolism of most nano-carriers was still a major obstacle for the clinical application. Herein, a novel "core‒shell" co-assembly carrier-free nanosystem was constructed based on natural sources of ursolic acid (UA) and polyphenol (EGCG) with the EpCAM-aptamer modification for hepatocellular carcinoma (HCC) synergistic treatment. As the nature products derived from food-plant, UA and EGCG had good anticancer activities and low toxicity. With the simple and "green" method, the nanodrugs had the advantages of good stability, pH-responsive and strong penetration of tumor tissues, which was expected to increase tumor cellular uptake, long circulation and effectively avoid the potential defects of traditional carriers. The nanocomplex exhibited the low cytotoxicity in the normal cells