Objective To understand the application and effect of problem based,case based and evidence based (PCE) combined teaching method in urology surgery clinical teaching.Methods A total of 50 clinical medicine students were selected.PCE combined teaching method was applied in urology surgery clinical teaching and the teaching effect was evaluated.Results The ratios of student who thought PCE combined teaching method could stimulate learning enthusiasm,improve learning efficiency and improve the abilities of logical thinking,inductive analysis,practical application,self-study,literature retrieval,innovation and team cooperation were 96％,94％,95％,94％,100％,88％,100％,96％ and 95％ respectively.All students thought this new teaching method could be extended in other subjects.Conclusions Application of PCE combined teaching method in urology surgery clinical teaching can achieve good teaching effect and it is worth recommending in clinical teaching.

Objective To summarize the experience of anterolateral percutaneous vertebroplasty (PVP) in the treatment of cervical metastases in advanced lung cancer,and to evaluate its therapeutic effect on patients with cervical metastases in advanced lung cancer.Methods A total of 27 patients with advanced cervical spine metastases were enrolled from July 2009 to September 2018 in Department of Orthopaedics,Beijing Friendship Hospital,Capital Medical University.A retrospective analysis was performed on 20 patients who underwent PVP and had complete follow-up data.There were 12 males and 8 females,aged (59.15±7.55) years.A total of 32 cervical metastases were performed.Bone cement leakage was observed by X-ray and CT after operation,and complications were recorded during and after operation.Follow-up visits were made by outpatient or telephone until the 3rd month after the operation.By comparing visual analogue scale (VAS),analgesic use score,cervical dysfunction index (NDI) and KPS before and after operation,the improvement of the quality of life of patients after operation was comprehensively evaluated.The measurement data were expressed as (Mean ± SD).The paired t test was used to test the normal distribution of the paired difference before and after the operation,and the paired rank sum test was used to test the difference before and after the operation which did not conform to the normal distribution.Results The preoperative Tokuhashi correction score was (7.15 ± 2.87) score in 20 patients and the Tomita score was (7.55 ± 2.21) score.The single-segment cervical vertebrae cement injection volume was (1.17 ± 0.25) ml.The postoperative cement leakage rate was 53.13％ (17/32),but no serious complications.VAS before surgery and 3 months after surgery [preoperative (8.30 ± 1.08) score,postoperative (3.60 ± 1.67) score,P =0.000)],analgesic use score [preoperative (3.35 ± 0.59) score,postoperative (1.70 ± 0.80) score,P =0.000],cervical dysfunction index [preoperative (63.10 ± 7.94) score,postoperative (42.55 ± 15.69) score,P =0.000)] and KPS [Preoperative (54.50 ± 6.86) score,postoperative (61.67 ± 12.95) score,P =0.011] were significantly improved,and the difference was statistically significant.Conclusion PVP via anterolateral approach is effective in the treatment of advanced cervical metastases of lung cancer,and can effectively improve the quality of life of patients with advanced cervical metastases,but the surgical leakage rate is high and needs attention.

Objective To analyze the enzymatic activity of Leptospira interrogans ( L. interrogans) LA_2144 gene product to hydrolyze platelet activating factor acetylhydrolase ( PAF-AH) and phosphatidase A2(PLA2). Methods Bioinformatic softwares were used to predict transmembrane regions, signal peptides and domains of the LA_2144 gene of L. interrogans strain Lai. A prokaryotic expression system for signal peptide-free LA_2144 gene was established. The expressed target recombinant protein rLep2144 was extrac-ted by Ni-NTA affinity chromatography and then renatured. Spectrometry was used to detect the activity of rLep2144 to hydrolyze PAF-AH substrate 2-thio PAF and the Km and Kcat values as well as the activity to hy-drolyze PLA2 substrate arachidonoyl 2-thio PC. Real-time fluorescence quantitative RT-PCR and Western blot were performed to detect the transcription, protein expression and secretion of LA_2144 gene during infection of human and mouse vascular endothelial cells ( HUVEC and EOMA) with L. interrogans. Results L. interrogans LA_2144 gene contained a signal peptide and a domain belonging to SGNH hydrolase super-family, but no transmembrane regions. The established prokaryotic expression system for signal peptide-free LA_2144 gene could efficiently express rLep2144. The extracted rLep2144 was shown as a single protein fragment in separation gel and then successfully renatured. rLep2144 had a stronger PAF-AH activity with the Km and Kcat values of 688. 235 μmol/L and 0. 976/s, but its PLA2 activity was relatively weak. Expres-sion of the LA_2144 gene at mRNA and protein levels in HUVEC and EOMA was rapidly increased after the cells were infected with L. interrogans (P<0. 05) and the secretion of LA_2144 gene product could be detec-ted. Conclusions L. interrogans LA_2144 gene product had a stronger PAF-AH and a certain PLA2 activi-ty, which might involve in the hemorrhage and inflammatory response in leptospirosis.