Objective The feasibility and effectiveness of bilingual teaching combined with CBL (case-based learning) was evaluated in our study. Methods From 2011 to 2012, 69 students from Shanghai Jiaotong University were randomly divided into Bilingual CBL group (36 students) and Chinese CBL group(33 students). A case of salvage of multiple trauma patients was selected as a text-book case and students' acceptance to textbooks and teachers was assessed. Besides, students' self-evaluation, teachers' evaluation of students, students' achievement in procedures and the final theory test scores were evaluated as the outcome of the assessment. Results Students' acceptance of textbook in Bilingual CBL group is lower than that in the Chinese CBL group(P=0.035). Differences in students' evaluation of teacher (P=0.093), students' self-evaluation (P=0.816), and teachers' evaluation of the student(P=0.812) were not statistically significant. Final written examination scores(P=0.100), operat-ing procedures in tracheal intubations (P=0.489), and cardiopulmonary resuscitation (P=0.764) were not statistically different . Only central venous puncture showed a statistical difference ( P=0 . 011 ) . Conclusions Medical bilingual CBL teaching is feasible, without affecting the original teaching of medical knowledge. Bilingual teaching can improve students' English proficiency and enhance their interest in learning.

Objective To investigate the antitumor effect of tumor necrosis factor-related apoptosis-inducing ligand(TRAIL) gene transfection mediated by adenovirus into human pancreatic carcinoma cell line Panc-1,and the mechanisms involved in this effect.Methods TRAIL gene was transfected into pancreatic cancer cell line Panc-1 by an adenovirus vector(Ad-TRAIL).Level of TRAIL mRNA expression was determined using RT-PCR,and TRAIL protein synthesis was evaluated with Western blot.Cell-growth activities were determined by MTT assay.The bystander effect was observed by co-culturing the Panc-1 cells with and without the transfected TRAIL gene at different ratios.Apoptosis in pancreatic cancer cells was detected by flow cytometry.Proaspase-8 and procaspase-3 proteins were determined by Western blot.Results The stable overexpression of TRAIL was detected in Panc-1 cells transfected by Ad-TRAIL.Ad-TRAIL significantly inhibited cell viability of Panc-1 cells.Furthermore,co-culture of cancer cells transfected with TRAIL resulted in the nontransfected cell inhibition by bystander effect.Moreover,the percentage of apoptotic cells was significantly higher in the Ad-TRAIL-treatment group compared to the control groups(P

Objective To determine whether a prophylactic tolterodine administration before surgical operation on non-urologic patients under general aneathesia can prevent the occurrence of catheter-related bladder discomfort (CRBD) ; and to assess patients’ tolerance to the symptoms as well as the impact on related consultation work of urologic surgeons.Methods One hundred and eighty cases of non-urology patients who need general aneathesia operations were divided into 2 groups:90 cases in tolterodine group and 90 in control group.The assessment of CRBD is categorized into 4 steps and statistics for adverse events ( dry mouth,dizzyness and facial flushing) was also conducted.A record of the patients’ needs for urologic surgical consultation during their reservation of catheter was also kept.SPSS 13.0 used in the statistical analysis of data in terms of X2 examination,where the divergence P ＜ 0.05 was regarded statisticly valid.Results 82 cases were followed up in the tolterodine group with a 24.4％ CRBD occurrence,which included 7.2％ shows moderate and severe symptoms,and there were also 23 cases with dry mouth ( 28.0％ ),4 cases with dizzyness (4.8％),13 cases with facial flussing ( 15.8％ ),and 1 case who needs further consultation (1.2％).In the 86 followed-up cases in control group,CRBD occurance rate was 54.7％,with 30.2％ showed moderate and severe symptoms,plus 2 cases suffered from severe consequences.Nine cases ( 10.5％) in control group requires further consultation ( X2 =19.499,P =0.000 ＜ 0.05 ).Conclusions A prophylactic tolterodine administration before surgery to the patients underwent general aneathesia can prevent the occurrence ofcatheter-related bladder discomfort (CRBD) and reduce the consultation work of urologic surgeons.Patients using tolterodine show a higher rate of adverse events,yet to which most patients can tolerate.

Objective To observe the changes of immunological parameters and the effects of intravenous immunoglobulin (IVIG) in children with idiopathic thrombocytopenic purpura (ITP),schonlein-Henoch purpura(HSP) and mucocutaneoas lymph node syn-drome(kawasaki disease, KD).Methods T cell subsets and serum immunoglobulins and complements were measured with the flow cytometry and enhanced trubidimetric immunoassay. Routine therapy combined with IVIG. Results CD3+ CD4+ T cells were de-creased in children with ITP accompanied by increased serum IgG;Serum IgA and CD3+ T cells were increased in children with HSP; CD3+ CD8+ T cells were decreased in children with KD. Clinical features were markedly improved after treatment with IVIG. It was noted that the incidence of damage to coronary artery decreased after the use of IVIG. Conclusions T cell subsets, serum immunoglobulins should undergo the clinical routine examinations in ITP,HSP and KD. Early administration of IVIG might be important to improve disease prognosis and shorten its course of treatment in children with three kinds of immunology related diseases.

Objective To evaluate the effectiveness of applying simulation based medical education (SBME) in critical care medicine PBL teaching. Methods Totally 46 undergraduates in medical college of Shanghai JiaoTong University , who participated in critical care medicine PBL teaching in our Hospital from 2012 to 2013 were chosen as research objects. These students were divided into two groups: PBL group (2009 grade, n=24) and SBME-PBL group (2010 grade, n=22). The teaching effectiveness was evaluated by questionnaire survey, theoretical exam, direct observation of procedural skills (DOPS) and mini-clinical evaluation exercise (Mini-CEX). Data were analyzed by SPSS 17.0 software. The data of questionnaire survey were expressed as percentage and the assessment results were expressed as x±s. Chi-square and t test were used to do statistical analysis. P<0.05 signi-fies for statistically significant differences . Results ①The results of questionnaire survey showed that:there was no significant difference between two groups in study interests(P=0.665, 0.937, 0.746) and study ability(P=0.937, 0.665). But regarding collaboration ability, SBME-PBL group performed better than PBL group (P=0.019, 0.038, 0.024). ②These was no significant difference in the theo-retical knowledge exam between PBL and SBME-PBL group(P=0.743). But the DOPS scores of car-diopulmonary resuscitation (P=0.000), endotracheal intubation (P=0.023), defibrillation (P=0.002) and central venous catheterization(P=0.047) were all significantly higher in SBME-PBL group than in PBL group. ③In Mini-CEX, there was no statistical difference in physical examination skills (P=0.790) and clinic judgment(P=0.426) between the two groups. However, SBME-PBL group performed better in medical interviewing capacity(P=0.002), humanistic care (P=0.001), counseling skills(P=0.017), organization efficiency(P=0.029) and overall clinical competence(P=0.024) than PBL group. Conclusions SBME can promote the students' team work spirit, basic clinical skills and comprehen-sive clinical capacity in critical care medicine PBL teaching and can improve the teaching quality of critical care medicine.

Objective To investigate the expression of Bcl-2,survivin and pancreatic cancer stem cells markers Oct-4 and ABCG2 in pancreatic cancer cells resistance to chemoradiotherapy.and explore its mechanism.Methods Concurrent ehemoradiotherapy was used to obtain pancreatic cancer cells resistant to chemoradiotherapy,the pancreatic cancer cells without chemoradiotherapy treatment were used as control.Western-blot was applied to detect the expression of Bcl-2,survivin,Oct-4,ABCG2.Results The expression of Bcl-2 was 0.7955±0.0326,0.5718±0.0212,0.6137±0.0382 and 0.8733±0.0461,respectively;the expression of survivin protein was 0.8207±0.0490,0.6973±0.0211,0.7967±0.0346 and 0.8013±0.0398,respectively;the expression of Oct-4 protein was 0.8728±0.0177,0.7861±0.0139,0.4794±0.0932 and 0.4216±0.1043,respectively;the expression of ABCG2 protein was 0.7810±0.1370,0.4957±0.1126,0.6102±0.1358 and 0.4670±0.1274,respectively.in resistant pancreatic cancer cells of SW1990,BxPC3,pc3,jf305 cell line.The corresponding values in the control group were 0.4723±0.018,0.2954±0.0103.0.3587±0.0201 and 0.2718±0.0136;0.4717±0.0274,0.3587±0.0113,0.3891±0.0147 and 0.3326±0.0124;0.6053±0.0142,0.4236±0.0086.0.2385±0.0671 and 0.1985±0.0582;0.3156±0.0582.0.2360±0.0423,0.2813±0.0512 and 0.1808±0.a0370.The expression of all the four proteins significantly increased after ehemoradiotherapy(P＜0.05).Conclusions Pancreatic cancer cells resistant to chemoradiotherapy may contain cancer stem cells.

Objective To explore the best treatment strategy of pyogenic brain abscesses.Methods Clinical data of 45 patients(34 males and 11 females,ages ranged from 7 to 76 years,averaged 42.6 years) with brain abscess treated from January 1999 to March 2008 were retrospectively analyzed.Among the 45 patients,there were 40 with single brain abscess and 5 with multiple brain abscess;43 with unilocular abscess and 2 with multilocular abscess.19 patients accepted the conservative treatment with the third generation cephalosporin,16 were treated with stereotactic puncture of abscess,8 treated with stereotactic puncture and drainage,and microsurgical excision was performed in 5 patients.Results Of the 19 patients treated with conservative method,16 were cured,no recurrence was found during the follow-up period(from 6 months to 5 years) in 13 patients,and another 3 were deteriorated and accepted stereotactic operation.All the stereotactic operations were carried successfully out in 24 patients(including 3 cases after expectant treatment failure) and only one patient needed another stereotactic aspiration two weeks later because of abscess recurrence after the initial operation.Epileptic seizure was found in one patient at the end of stereotactic procedure.Total removal of brain abscess was performed by microsurgical craniotomy in 5 patients.At the time of discharge,clinical symptoms disappeared or were improved remarkably,and CT or MRI re-examination disclosed the disappearance or obviously diminution of abscess in all patients.No abscess recurred during the follow-up period(from 4 months to 3 years,average 14 months) in 22 patients.Conclusion A set of treatment strategy of pyogenic brain abscesses has been proposed and stereotactic operation seems to be the most appropriate surgical choice.

Objective To study the difference of expression of proteins in pancreatic cancer and adjacent fissue.Methods Proteomes of eight pairs of pancreatic ductal adenocarcinoma tissue samples and adjacent tissue samples were obtained by high resolution two-dimensional gel electrophoresis(2-DE).Comprehensive analyses of proteins were focused on total protein spots exhibiting statistical alternations between the two groups.Protein identification was done by peptide mass fingerprinting with tandem mass spectrometry(MS/MS).In addition,Western blotting and immunohistochemistry were performed to verify the expression of certain candidate protein.Results A total of 28 protein spot-features were found to be significantly increased and 17 significantly decreased in tumor tissues.Thirty of these protein spots were identified,which included enzymes,antioxidant proteins,signal transduction proteins,calcium-binding protein,structural proteins,chaperones and others.Western blotting and IHC further validated up-regulated expressions of one candidate protein(annexin II)in tumor tissues.Conclusions The analysis of proteomics with 2-DE on human tissue is a useful method for discovering valuable cancer marker candidates.These differential expressed proteins may serve as biomarkers for early detection and therapeutic targets to pancreatic cancer.

At present, majority of the small molecular drugs used in clinics target proteins, they exert the efficacy through the binding to specific sites on the target protein. However, the "druggable" protein targets account for a small portion of the total number of proteins, and "non-druggable" proteins account for 80%, because of not having suitable drug binding sites. In the central rule, RNA is located in the upstream of proteins and controls the transcription of proteins. The research of small molecule drugs targeting RNA can solve the problem of protein "undruggable proteins" in some extent. This review summarizes the representative research achievements of small molecular drugs targeting RNA in recent years, and the screening methods applied to this field, with the focuses on the latest progress of small molecular drugs targeting novel coronavirus RNA.

Objective To investigate the long-term clinical outcomes of porcelain laminate veneers 1-8 years following delivery.Methods A total of 310 feldspathic porcelain laminate veneers on anterior teeth or premolars in 49 patients were included in the present study 1-8 years following delivery.All the subjects underwent a detailed clinical examination utilizing medified United States Public Health service(USPHS)criteria.Restoration integrity,abrasion,color satisfaction,marginal discoloration,marginal adaptation,secondary caries,postoperative sensitivity,and gingival index(GI)of the prostheses were evaluated according to modified USPHS criteria.The 1-8 year survival rates of the veneers were statistically analyzed using the life table method.Results The survival rates of porcelain laminate veneers were98.7%,98.0%,93.8%,93.2%,89.7%,81.8%,76.3%,and 76.3%in 1 to 8 years,respectively.Conclusions The long-term clinical outcomes of porcelain laminate veneers are satisfying.