Objective To explore the effect of applying problem-based learning(PBL)in clin-ical anesthesiology demonstration for clinical undergraduates. Methods Eighty-nine 2009 clinical undergraduates were divided into two groups:experimental group and control group. Students in ex-perimental group received PBL while those in control group received traditional teaching. The effect was evaluated according to the results of case examination and investigation table. The results were analyzed by X2 test. Results Most students (42/45) answered questions correctly in experimental group while only 30 of 44 students(30/44)did in control group(P<0.05). Concerning the results of investigation,PBL had more advantages than traditional teaching method in the following 5 aspects:self-studying ability(86.7%,39/45),clinical thinking ability(73.3%,33/45),information seeking ability (75.6%,34/45),expressing ability (82.2%,37/45),communicating between students (75.6%, 34/45)(P<0.05). Conclusions PBL has evident advantages in anesthesiology clinical demonstration. It can inspire students,cultivate abilities,enhance critical thinking and finally improve teaching effect.

Objective To summarize the clinical features,neuroimaging findings and pathological characteristics of demyelinating pseudotumors(DPT)of the brain,and to differentiate it from glioma. Methods The clinical features,neuroimaging findings and pathological characteristics of 35 patients with demyelinating pseudotumors of the brain were summarized,and the diagnosis for 18 of them was confirmed by bioscopy.Results Demyelinating pseudotumors affected adults of both sexes.The onset age of patients ranged from 9 to 69 years old.There was no definite antecedent,and the clinical syndromes were atypical. Neuroimaging scans showed multiple lesions in cerebral hemisphere,while the lesion in brain stem and spinal cord was single.The symptom and neuroimaging were not parallel.While with many or large lesions, the symptoms and signs were less.The lesions were not enhanced on CT scan,but appeared round or patch enhancement on MRI scan.Nine patients with DWI all appeared high density.The myelin basic protein was useful for diagnosis.The typical pathological changes were demyelination,perivascular inflammatory infiltration and reactive gliosis.The Creutzfeuldt cells were also found in these patients.The lesions might become small or disappear after treatment,but could not serve as the criterion to exclude brain neoplasm. Conclusions DPT is a distinct demyelination disease entity,which is confusable with brain neoplasm.It is difficult to distinguish DPT from brain neoplasm with the clinical features and conventional neuroimaging scan.But DWI scan is useful.The pathological changes accord with demyelination,and Creutzfeuldt cells are also found.It is important to apply corticosteroid treatment or biopsy rather than being anxious to excise the lesions.

(P < 0.05 ).Scanning electron microscopy showed that the three-dimensional structure of mix-biofilm in control group was more complex.As real-time PCR showed,after 6-hour culture,the expressions of icaA,fbe,aap,hwp1, als3 and efg1 genes in Farnesol group were down-regulated compared to those in control group and after 24-hour culture the expressions of aap,hwp1,als3 and efg1 genes in Farnesol group were down-regulated compared to those in control group.Conclusion With the intervention by fungal quorum sensing molecules Farnesol,the structure in control group became denser and more complex than that in Farnesol group.This change may have a closer correlation with the down-regulated expressions of als3,hwp1 and efg1 genes,which are related to the formation of Candida albicans biofilms.

"Coming from clinical experiences and serving for the clinical application", which is the basic mode of academic development and technological progress of Chinese medicine. Clinical data embodies clinical experience and medical innovation and technology. Clinical data is also an important carrier to spread Chinese medicine and knowledge wealth for the whole country. The author thoroughly discussed the scientific value, necessity and significance of Chinese medicine clinical data in this article.

Objective:To observe the therapeutic effect of electroacupuncture (EA) at Zusanli (ST 36),Guanyuan (CV 4) and Ashi points on adjuvant arthritis rats,and explore the mechanism of EA treatment of rheumatoid arthritis (RA).Methods:Sixty male rats were randomly divided into a normal group,a model group,a methotrexate group and an EA group,with 15 rats in each group.Rats in the normal group and the model group were routinely raised and did not receive treatment;rats in the methotrexate group received methotrexate at a dose of 0.35 mg/(kg·bw),twice a week for 3 weeks;rats in the EA group received acupuncture at Zusanli (ST 36),Guanyuan (CV 4) and Ashi points,and the bilateral Zusanli (ST 36) and Ashi points were connected to EA apparatus,once a day for 3 weeks.The general status,the swelling degree of the toe,the arthritis index (AI) score,the pathological morphology of the ankle joint,and the mRNA expressions of cellular inhibitor of apoptosis protein (c-IAP) 1 and c-IAP2 in joint synovial tissue cells of the rats in each group were observed.Results:The swelling degree of the toe,AI score and mRNA expressions of c-IAP1 and c-IAP2 in the model group were significantly higher than those in the normal group (all P＜0.05).Compared with the model group,the swelling degree of the toe,AI score and mRNA expressions of c-IAP1 and c-IAP2 in the methotrexate group and the EA group improved (P＜0.01 or P＜0.05);the expressions of c-IAP1 mRNA and c-IAP2 mRNA in rat synovial tissues in the EA group were significantly higher than those in the methotrexate group (P＜0.01).Conclusion:EA alleviates joint swelling in rats with adjuvant arthritis.The mechanism may be related to suppressing mRNA expressions of c-IAP1 and c-IAP2,thus to induce apoptosis of synoviocytes.

Objective To investigate left ventricular (LV) strain in patients with hypertension (HT)and myocardial hypertrophy using three-dimensional speckle tracking echocardiography.Methods Myocardial movement was analyzed in 37 primary HT patients with myocardial hypertrophy and 27 healthy volunteers.LV longitudinal,circumferential,radial and area strains were measured.The correlation between each global strain parameter and LV ejection fraction (LVEF) was analyzed.Results LV global longitudinal strain(GSL),global radial strain (GSR) and global area strain (GSA) of HT patients with myocardial hypertrophy were significantly lower than the contrast group,whereas global circumferential strain(GSC) showed no significant difference between the two groups.Longitudinal,radial and area strains were decreased in LV basal and middle levels,while decreased circumferential strain was detected only in basal level.There were significant correlations between LVEF and GSL,GSC,GSR,GSA.Conclusions Impairment of LV regional myocardial contractility can be detected by three-dimensional speckle tracking echocardiography.

Objective To investigate the dynamic changes of adenosine receptors, A1 (A1R) and A2a (A2aR) in the brain from the acute to chronic phase after kindling and to explore the correlation between seizure and expression level of A1R and A2aR. MethodsRats were randomly selected into the testing model, reference and normal control groups.Testing rats were kindled by lithium choride-pilocarpine, reference rats were treated with saline, and no treatment was given in normal control group. The dynamic expression of A1R and A2aR were detected by RT-PCR, immunofluorescence staining and Western blot at time-points of 24 hours, 1 month and 6 months post-kindling. Results In the acute phase of 24 hours after kindling, the A1R expression level (mRNA level was (1. 1483 ±0. 1182); Western blot result was ( 0. 7872± 0. 0621 ) ; immunofluorescence staining count was ( 76. 17 ± 4. 62 )/HP) was increased and A2aR (mRNA level was (0. 8338±0. 0572) ; Western blot result was (0. 2098 ±0. 0257) ; immunofluorescence staining count was (43. 83 ± 5. 12 )/HP) was decreased.The results showed statistically difference compared with the reference and normal groups (P< 0. 05 ). In the later chronic phase of 1 month and 6 months after kindling, the expression level of A1R was decreased and A2aR was increased. These data revealed statistically significant difference (P <0. 01 ). Furthermore, the comparison of the results in 1 month and 6 months after kindling found that the expression of AIR was lower in 6 months (mRNA level was (0. 5682 ±0. 0443) ; Western blot result was (0. 7749 ±0. 0262) ; immunofluorescence staining count was (38. 50 ±4. 81 )/HP) than in 1 month and that of A2aR was higher in 6 months (mRNA level was (1. 2169±0. 0332) ; Western blot result was (0. 7080 ±0. 0371 ); immunofluorescence staining count was (114. 50 ± 4. 04)/HP). The differences were statistical significant (t = - 19. 02--13.28, P < 0. 05). ConclusionsThe expressions of A1R and A2AR during and after kindling presents a bidirectional change. In the acute phas the expression of AR is regulated to suppress seizures. While in the chronic phase, the repeated seizures result in the change of A1R and A2aR expression in the opposite direction. This mechanism plays an important role in refractory seizures.

OBJECTIVEThe effect of advanced glycation end products (AGEs) on the osteogenic differentiation of humanperiodontal ligament stem cells(hPDLSCs) was discussed. Changes in the Wnt signaling pathway during glycation were also determined.

METHODSIn vitro tissue explanting method was primarily applied. Limiting diluted clone was cultured to obtain hPDLSCs in vitro. The subjects were divided into two groups: the healthy group (N-hPDLSCs) and the AGEs-stimulating group (A-hPDLSCs). Osteoblast mineralization was induced in the experimental groups. The following processes were performed: alizarin red staining; alkaline phosphatase (ALP) staining; real time polymerase chain reaction (real time PCR) for detecting osteogenic genes and Wnt classical pathway-related factors, DKK-1 and β-catenin; Western blot analysis. Bone protein and β-catenin were correlated in the nuclear expression.

RESULTSThe cells were osteogenically induced. ALP staining showed that the N-hPDLSCs displayed the deepest color. Alizarin red staining indicated that the A-hPDLSCs group had less calcified nodules than the N-hPDLSCs group. The real time PCR results suggested that the expression of relative osteogenic genes in A-hPDLSCs was quite low. Statistically significant differences in differentiation were found between groups (P < 0.05). The Western blot result was similar to that of real time PCR. Classical Wnt signaling pathway-related factor β-catenin was higher in A-hPDLSCs than in N-hPDLSCs. By contrast, DKK-1, which is an inhibitor in the Wnt pathway, had a significantly lower expression rate in A-hPDLSCs than in N-hPDLSCs. The Western blot result also showed that β-catenin expression in the nucleoprotein in A-hPDLSCs was notably higher than in N-hPDLSCs.

CONCLUSIONAGEs can inhibit hPDLSCs osteogenic differentiation. AGEs induce changes in the normal periodontal ligament stem cells classical Wnt pathway. Canonical Wnt pathway is reactivated because of AGEs stimulation.

Cell Differentiation ; Glycation End Products, Advanced ; Humans ; In Vitro Techniques ; Osteoblasts ; Osteogenesis ; Periodontal Ligament ; Stem Cells ; Wnt Proteins ; Wnt Signaling Pathway ; beta Catenin

Objective To study the hepatocyte cells infected by hepatitis C virus (HCV) positive serum. Methods Human hepatocyte 7701 was incubated with HCV RNA-positive and HCV antibody(Ab) negative sera BP52. Then, the expression of HCV antigen and the presence of HCV-RNA in cell and supernatant were assayed by RT-PCR, sequence analysis, immunofluorescent staining, Western blot, confocal laser microscopy. The ultrastructural changes of infected cells were observed by electro-microscopy. Results Plus-strand RNA and minus-strand RNA were intermittently detected in cell and/or supernatant on day 7-45 after infection. Sequence analysis demonstrated that the positive DNA nucleic acids were identified with HCV 5′-non-coding region(NCR) sequence. HCV core and NS3 protein were expressed in cytoplasm of infected cells. After 2 or 3 weeks, obvious intracellular ultrastructural changes and virus-like particles were observed. Conclusion human hepatocyte 7701 could support replication of HCV in vitro, which could be a useful tool for setting up cell model of HCV infection and studying the mechanism of HCV infection.