Firstly, this paper analyzed the significance of strengthening medical students’ ecological moral ed-ucation under the view of Beautiful China. Secondly, it discussed the present situation of ecological moral and the reasons of lacking of ecological moral in medical students. At last, the authors pointed out the countermeasures to strengthen the moral cultivation of medical students’ ecological countermeasures under the view of Beautiful China. Therefore, we must strengthen the top-level design to ensure the ecological moral education enter into the national education system, enhance to maintain power to build the full-area coverage ecological moral teaching system, and strengthen institutional construction to establish long-term mechanism of ecologic moral education.

Regional anatomy of inguinal hernia is one of the teaching difficulties.The students always feel confused due to deficiency of visual and vivid teaching materials.The thesis analyzed the efficacy of using high-definition video of laparoscopic inguinal hernia repair (LIHR) in the clinical teaching of inguinal region anatomy aiming to deepen the understanding,inspire the enthusiasm and initiative of students and improve the quality of teaching.

Objective To discuss whether it is necessary to integrate metabolic indices into diagnosis of polycystic ovary syndrome(PCOS).Methods Taking ESHRE /ASRM diagnosis standard as gold standard,the case group composed of 51 women with PCOS and the control group composed of 47 women without PCOS were selected.By using classification tree C5.0,significant variables chosen by single factor analysis were used to establish a new diagnostic model which combined reproductive indices and metabolic indices.The validity and reliability of the new diagnostic model by using ROC curve analysis were evaluated.Finally,the consistence and difference between the new diagnostic model and the gold standard were analyzed.Results Single factor analysis chose 13 significant variables. ROC analysis showed an area under the curve of 0.930(P =0.000)and the optimal cut -off point was 0.190 with a sensitivity of 94.10%,a specificity of 91.50% and a consistency of 92.86%,which told us the new diagnostic model had superior validity and reliability.The two diagnostic methods had excellent consistence (Kappa =0.857,P =0.000)and there was no statistically significant difference (P =1.000).Conclusion Considering that whether metabolic indices are integrated into diagnosis of PCOS doesn′t change the diagnosis result,and it is unnecessary to integrate metabolic indices into diagnosis of PCOS.

Objective To discuss whether it is necessary to integrate metabolic indices into diagnosis of polycystic ovary syndrome (PCOS).Methods Taking ESHRE/ASRM diagnosis as the gold standard,51 women with PCOS and 47 women without PCOS were selected and divided into the intervention group and control group respectively from the Department of Gynecology in the Second Affiliated Hospital of Kunming Medical University between January 2013 and July 2014.Logistic regression based on principal component analysis and significant variables chosen through single factor analysis were used to establish the new diagnostic model which combined reproductive indices and metabolic indices.We evaluated the validity and reliability of the new diagnostic model by using ROC curve analysis.Finally,we analyzed the consistence and difference between the new diagnostic model and the gold standard.Results Thirteen significant variables were chosen using single factor analysis.ROC analysis showed that an area under the curve was 0.976 (P＜0.001) and the optimal cut-off point was 0.526 with a sensitivity of 96.08％,a specificity of 93.62％ and a consistency of93.88％.The new diagnostic model had superior validity and reliability.The two diagnostic methods had strong consistence (Kappa=0.877,P＜0.001) and no difference (x2=0.167,P=0.688).Conclusion Considering that the integration of metabolic indices does not change the diagnosis result,we come to a conclusion that it is unnecessary to integrate metabolic indices into diagnosis of PCOS.

Objective By detecting the mutations spectrum of phenylalanine hydroxylase(PAH)gene in phe-nylketonuria(PKU)patients and their parents. The researchers analyzed the gene mutation features and high - frequency mutations and determined the relationship between the genotype and the phenotype,which would provide a theoretical basis for the early diagnosis and genetic consultation of PKU children in the region. Methods In this study,13 exons and their flanking introns of the PAH gene in 32 PKU patients and their parents from Wuxi and Suqian in Jiangsu province were sequenced by using the next - generation sequencing(NGS)technology. Results Sixty - one mutant sites and 32 mutant genes were detected in 32 PKU patients,and the mutation detection rate was 95. 31%(61 / 64 cases). The variants at c. 721C ﹥ T,c. 1068C ﹥ A,c. 611A ﹥ G,c. 1197A ﹥ T,c. 728G ﹥ A,c. 331C ﹥ T and c. 442 -1G ﹥ A were common mutations in the region with mutation frequency over 5% . What's more,4 novel variants of c. 699C ﹥ G,c. 265C ﹥ T,c. 722G ﹥ A and c. 1194A ﹥ G were found. Of those,c. 699C ﹥ G was not recorded in the PAH variant database and HGMD database and. c. 265C ﹥ T,c. 722G ﹥ A,and c. 1194A ﹥ G were first reported in the Chi-nese population. Genotype - accurate biochemical phenotype correlation by using the Guldberg AV system revealed con-sistency rate of 38. 0%(8 / 21 cases),which the consistency rate between accurate biochemical phenotype and predic-tive phenotype of moderate to severe genotype was 92. 3%(12 / 13 cases),and mild genotype was 50. 0%(4 / 8 cases). Conclusions The PAH gene variants of PKU patients in Jiangsu province are distributed mainly in exons 7,of which the highest frequency gene mutation is c. 721 c ﹥ T. Moreover,one novel variant c. 699C ﹥ G was reported for the first time. The PKU children inherit the PAH mutation gene mainly from both parents. There are definite correlation between the genotypes and phenotypes.

Objective To explore the effects of flunarizine hydrochloride on plasma calcitonin gene-related pep-tide and substance P levels after CSD in a rat migraine model of cortical spreading depression (CSD). Methods Thirty adult rats were randomly and evenly divided into three groups:control Group, CSD group and flunarizine group. The CSD waves were evoked by application of potassium chloride on brain surface with filter paper. Funarizine hydrochloride was intravenously administered to rats five minutes prior to application of potassium chloride. The plasma levels of CGRP and SP were measured by using radioimmunity assay. Statistical analyses were performed using two-sample t test and analy-sis of variance. Results CSD waves were absent in control group whereas CSD waves were induced in CSD and flunari-zine groups. The latency of the first CSD wave was longer in flunarizine group (167.90 ± 25.18 s) than in CSD group (130.90 ± 13.30 s) (P<0.01). The number of CSD waves was smaller in flunarizine group (4.50 ± 1.84) than in CSD group (8.50 ± 2.07) (P<0.01). The amplitude of CSD waves was lower in flunarizine group (11.40 ± 4.12 mv) than in CSD group (24.40±3.57 mv) (P<0.01). The levels of CGRP and SP in both CSD group (CGRP, 32.95±11.61 pg/mL;SP, 27.80±7.51 pg/mL) and flunarizine group (CGRP, 25.13 ± 5.67 pg/mL; SP, 19.45 ± 6.10 pg/mL) were higher than in control group (CGRP, 14.44 ± 6.39 pg/mL; SP, 12.36 ± 4.22 pg/mL) (P<0.01). The levels of CGRP and SP in flunarizine group (CGRP, 25.13±5.67 pg/mL;SP, 19.45±6.10 pg/mL) were lower than those in CSD group (CGRP, 32.95±11.61 pg/mL;SP, 27.80± 7.51 pg/mL) (P<0.05). Conclusions Flunarizine hydrochloride can inhibit CSD and reduce the plama levels of CGRP and SP in the rat model of CSD.

Objective To evaluate the role of heparanase in endotoxemia-induced destruction of vascular endothelial glycocalyx in rats.Methods Forty-eight pathogen-free male Sprague-Dawley rats, aged 8-10 weeks, weighing 200-250 g, were randomly divided into 3 groups (n=16 each) using a random number table: control group (group C), lipopolysaccharide (LPS) group (group L) and LPS+ heparin group (group LH).Endotoxemia was induced by intravenous LPS 15 mg/kg in L and LH groups, and heparin sodium 100 U · kg-1 · h-1 was infused simultaneously in group LH.At 3 and 6 h after LPS injection, blood samples were collected from the femoral vein for determination of the serum concentrations of serum heparin sulfate (HS), syndecan-1, E-selectin and intercellular adhesion molecule-1 (ICAM-1) concentrations.The rats were then sacrificed, and lungs were removed for microscopic examination and for determination of wet/dry lung weight ratio (W/D ratio).Results Compared with group C, the serum HS, syndecan-1, E-selectin and ICAM-1 concentrations and W/D ratio were significantly increased in group L, and the serum HS and ICAM-1 concentrations were increased in group LH (P＜0.05).Compared with group L, the serum HS, syndecan-1, E-selectin and ICAM-1 concentrations and W/D ratio were significantly decreased in group LH (P＜0.05).The pathological changes of lungs were obvious in group L, and were significantly mitigated in group LH.Conclusion Heparanase is involved in endotoxemiainduced destruction of vascular endothelial glycocalyx in rats.

A 44-year-old pregnant woman (G5P3) who had delivered two children with DMD was admitted and underwent prenatal diagnosis at Peking Union Medical College Hospital in 2019. (1) The karyotype of the fetus in 2019 was 47,XXY. The fluorescence in situ hybridization (FISH) result showed a nucish(CSPX×2, CSPY×1)[100] and multiplex ligation-dependent probe amplification (MLPA) suggested sex chromosome abnormality. Based on the above results, the fetus was diagnosed with Klinefelter syndrome. Fetal short tandem repeat (STR) linkage analysis and Sanger sequencing indicated a heterozygous mutation of c.9543delG(p.Trp3181CysfsTer2). (2) Sanger sequencing of the proband found a novel frameshift mutation of c.9543delG(p.Trp3181CysfsTer2 ) in exon 65 of the DMD gene. (3) The male fetus performing prenatal diagnosis in 2008 was found to have the same maternal gene markers as the proband with the same genotype. While the genotype of the fetus in 2009 obtained a different maternal gene marker from the proband and did not detect the same DMD gene mutation. This fetus was delivered at full term and was good during follow-up. (4) The elder brother and cousin of the proband had the same frameshift mutation in exon 65 of the DMD gene as the proband. The mother of the proband was a heterozygous carrier of the mutation.

OBJECTIVE:To study the absorption features of Silymarin enteric coated-polyllactic-co-glycolic acid (PLGA) nanoparticles in rat in situ intestine perfusion model and colonic adenoma Caco-2 cell model. METHODS:HPLC method was used to determine the content of silymarin. The absorption rate constant(Ka)and apparent absorption coefficient(Kapp)of Silymarin sus-pension,Silymarin PLGA nanoparticles and Silymarin enteric coated-PLGA nanoparticles were investigated in duodenum,jejunum, ileum and colon of rat in situ intestine perfusion model;the apparent permeability coefficient (Papp) of those drugs containing low-concentration,medium-concentration and high-concentration(20,40,60 μg/mL)of silymarin in Caco-2 cell model were also investigated. RESULTS:Compared with Silymarin suspension,Ka and Kapp of Silymarin PLGA nanoparticles and Silymarin enteric coated-PLGA nanoparticles were all increased in duodenum,jejunum,ileum and colon(P<0.05);compared with the correspond-ing concentration Silymarin suspension,two-way Papp of Silymarin PLGA nanoparticles and Silymarin enteric coated-PLGA nanopar-ticles containing low-concentration,medium-concentration and high-concentration of silymarin were all increased in Caco-2 cell model (P<0.05);there was no statistical significance between Silymarin PLGA nanoparticles and Silymarin enteric coated-PLGA nanoparticles (P>0.05). CONCLUSIONS:Silymarin enteric coated-PLGA nanoparticles can effectively increase the intestinal ab-sorption,cellular uptake and transmembrane transport rate of silymarin.

Objective To investigate the relationship between vaspin,Apelin,leptin and polycystic ovary syndrome.Methods We determined the serum vaspin,Apelin and leptin levels of 40 cases of PCOS patients and 30 cases of control group,and divided the PCOS group into three subgroups (normal weight,overweight and obesity) according to WHO criteria for obesity.Then we compared the serum vaspin,Apelin and leptin levels in PCOS and control group,and the differences in body weight index (body mass index,BMI) in women with polycystic ovary syndrome,and analyzed roles of adipokine vaspin,Apelin and leptin in the pathogenesis of PCOS.Results In PCOS patients adipokine vaspin,Apelin,leptin,insulin resistance index (Homeostasis model assessment for insulin index in resistence,HOMA-IR),fasting insulin (INS) and blood glucose,blood lipid were higher than those of the control group and increased with the increase of body mass index (BMI),and three kinds of adipokines and PCOS patients with HOMA-IR were positively correlated,there were statistically significant differences (P ＜ 0.05).Conclusion The results of vaspin,Apelin and leptin may be involved in the occurrence of PCOS.