[ ABSTRACT] AIM:To investigate the effect of sodium valproate ( VPA) on bleomycin-induced pulmonary fibro-sis ( PF) and its mechanism.METHODS: SD rats ( n =42 ) were randomly divided into model group and treatment group.Bleomycin at dose of 5 mg/kg was intratracheally injected to establish a rat PF model.The rats in treatment group were given normal saline (NS, 0.5 mL/d), VPA (300 mg· kg-1· d-1) or dexamethasone (DEX, 0.6 mg· kg-1· d-1 ) via intraperitoneal injection from the 14th day to the 28th day after modeling.The rats in model group were sacrificed on 0 d, 14 day and 28 d after modeling .The rats in treatment group were killed at 14th day after treatment.The effects of VPA on PF were evaluated by HE and Masson staining.The hydroxyproline ( HYP) content in the rat lung tissues was de-tected, and the expression ofα-smooth muscle actin (α-SMA) and E-cadherin was determined by Western blotting.RE-SULTS:HE staining showed that the alveolar structure and interstitial morphology in VPA group were better than those in NS group and DEX group.The level of collagen in VPA group was significantly lower than that in DEX group and NS group by determining the HYP content and Masson staining.VPA reduced the expression ofα-SMA, a mesenchymal marker pro-tein of PF, while increased the expression of epithelial marker protein E-cadherin.CONCLUSION:VPA reduces collagen content and distribution, and up-regulates the expression of the epithelial marker protein E-cadherin, while down-regulates mesenchymal marker proteinα-SMA, thereby preventing the rat lung tissues from bleomycin-induced PF.

Problem-based learning (PBL) is a student-centered pedagogy in which a subject is approached in the context of realistic problems.We have applied PBL into intemnal medicine of general medicine for up to three years.The results suggest that the PBL method could promote the clinical competencies and self-learning capacities of students.However there is still room for improvement.

Objective To discuss the effect of the teaching mode of technological pedagogical and content knowledge in biochemistry theory teaching. Methods 400 students in 8 classes of clinical medicine undergraduate in Grade 2013 were selected and randomly divided into 2 groups. The traditional teaching mode was applied in the control group of 198 students in 1-4 classes, while the technological pedagogical and content knowledge teaching mode was applied in the experimental group of 202 students in 5-8 classes. 385 students in 8 classes of clinical medical undergraduates in Grade 2014 were selected and randomly divided into 2 groups. The control group of 189 students in 1-4 classes adopted the traditional teaching mode, while the experimental group of 196 students in 5-8 classes adopted the technological pedagogical and content knowledge teaching mode, which used the micro-lesson and network platform as learning resource superior to the flipped classroom. Flipped classroom was divided into two major learning links:extracurricular self-study and class digestion. Through the network platform the micro-lesson was presented to the learners. Learners could make self-study according to their own specific circumstances and in the classroom many activities were increased such as the mutual cooperation between the students, the students' PPT teaching, the students' questions and the discussion, and the interaction between teachers and students, etc. The results of the examinations of the two terms students of the same profession and the questionnaire were analyzed. The related data were processed by SPSS 15.0, and the data between groups were compared by t test . Results The test scores analysis showed that the individual test scores in experimental group of Grade 2013 were [(17.94±2.02) vs. (12.28±4.17)], and the individual test scores in experimental group of Grade 2014 were [(18.21 ±1.78) vs. (12.45 ±5.13)], which were obviously higher than the control group, and there was statistical significance. The final exam scores in experimental group of Grade 2013 were [(78.28±11.18) vs. (68.65±12.51)], and the final exam scores in experimental group of Grade 2014 were [(81.73 ±9.12) vs. (74.41 ±11.87)], which were obviously higher than the control group, and there was statistical significance. The results of survey showed that the students thought the teaching mode aroused their study interests while 393 (93.7%), thought the teaching mode developed their self-study ability while 357 (89.7%), thought the teaching mode beneficial to cultivating their ability of solving the problems. Conclusion The teaching mode of technological pedagogical and content knowledge is of certain signifi-cance to break the plight of the traditional teaching, inspire the students interest in learning, improve the teaching quality of biochemistry, and make for the teachers' professional development.

Trace elements is the main content in Biochemistry and Molecular Biology courses through students' self-study.This topic takes the trace elements as the content of open video courses to make the medical students and the public be able to scientifically understand the relationship between trace elements and human health and pay attention to the influence of dietary nutrition and environmental pollution on human society.This course is based on audience online teaching rules and online learning needs,to achieve high-quality resources sharing and popularity as the goal,using typical case,vividly describes the source of the common trace element,function,and the relationship between health and disease.In the course construction,we realize that the selection of teaching content,optimization of teachers,professional recording team are the basic elements of the success of open video courses production.The combination of open video courses and flipped classroom teaching has gained a high degree of satisfaction in improving students' independent learning ability,expanding knowledge and so on.

Objective To investigate the relationship between bone mineral density (BMD) and the changes of serum adiponectin (APN) level in elderly men.Methods A total of 240 elderly men was enrolled in this study.Measurement of BMD of lumbar spine with dual energy X-ray absorptiometry was performed.All subjects were divided into three groups (normal,osteopenia,and osteoporosis) according to the T value of BMD.Serum APN level was tested using enzyme-linked immunosorbent assay (ELISA),meanwhile were recorded as bone lurnover markers.Results (1) The level of serum APN in osteopenia group was lower than in normal group,the level of serum APN in osteoporosis group was significantly lower than in osteopenia group,while the level of serum APN in osteoporosis group was significantly lower than in normal group (all P ＜ 0.05).(2) Serum APN was positively correlated with T value of BMD (r =0.475,P ＜0.01).(3) The stepwise multiple linear regression analysis showed serum APN,25-hydroxyvitamin D,β-isomerized carboxyterminal propeptide (β-CTX),and osteocalcin could enter into the equation.Conclusions Serum APN might play an important role in pathogenesis of osteoporosis in elderly men.

Objective:To explore the efficacy of group cognitive-behavioral therapy (GCBT) to generalized anxiety disorder (GAD).Methods:In this randomized controlled trial,the control group (n =23) and the intervention group (n =33) were included,all of the participants received duloxetine (30-120 mg/d) as pharmacotherapy.The intervention group received 8 group cognitive-behavioral therapy sessions weekly,90 minutes for each time.Assessments were conducted with the Hamilton Anxiety Scale (HAMA),Hamilton Depression Scale (HMAD) and Clinical Global Impression (CGI) at baseline,mid-treatmentand post-treatment.CGI included three factors,the severity of illness (SI),the globalimprovement (GI) and the efficacy index (EI).Results:The repeated measures analysis of variance of HAMA showed that,there were statistical significance on the HAMA for interaction between measure time and group processing (F =4.35,P ＜ 0.05).Compared with the control group,the intervention group got higher decreased scores of HAMA at the 4th week and 8th week,and higher prevalence of being cured and efficient at the 4th week.At the 8th week,the decreased scores of HMAD were higher in the intervention group than in the control group,and the scores of CGI-SI and the CGI-IE were lower in the intervention group.Conclusion:It suggests that group cognitive-behavioral therapy combined with pharmacotherapy could be earlier to be effective,and the symptoms of anxiety,depression and the state of illness could be improved more significantly compared with pharmacotherapy alone.

Objective To study the relationship between serum osteocalcin and parameters of glucose and lipid metabolism in elderly men.Methods The bone metabolism index such as serum osteocalcin was measured by electrochemiluminescence immunoas -say in 206 old male patients , incluiding 69 patients with type 2 diabetes mellitus .The parameters of glucose and lipid metabolism were also measured and the correlation between the parameters and serum BGP were analyzed .Results Serum BGP and beta-CTx concen-trations were significantly lower in patients with type 2 diabetes than those in normal glucose tolerance group [ ( 9.57 ±4.74 )μg/L vs (13.22 ±10.35)μg/L, P <0.05;(0.25 ±0.19)μg/L vs (0.35 ±0.29)μg/L, P <0.05].Compared with the group in low level of BGP, fasting blood glucose and HbA1c were reduced in high-level-BGP group[(5.89 ±2.10)mmol/L vs (5.28 ±1.38)mmol/L, P<0.01;6.30%±1.03% vs 5.98%±0.61%, P <0.01].Triglyceride (TG) was positively correlated with serum BGP ( r =0.146, P =0.032).Stepwise multiple regression analysis showed that TG and HbA 1c were independently associated with serum BGP level(β=1.995, P <0.01;β=-1.483, P <0.05).Conclusions Serum TG and HbA1c are independent factors related to serum BGP in elderly men .

Objective Analysis the expression and significance of P16INK4 ,P57kip2 and Ki67 in hepatocellular carcinoma .Meth-ods 21 normal liver tissue ,48 hepatocellular carcinoma tissues and 48 corresponding adjacent tissue were collected for this study . Immunohistochemical analysis the expression levels of P16INK4 ,P57kip2 and Ki67 .Results P16INK4 and P57kip2 in hepatocellular carci-noma tissue were significantly lower ,the positive rates were 49 .3% and 34 .2% respectively ,Ki67 was significantly higher than the normal liver tissue and corresponding adjacent tissue ,the difference was statistically significant(P<0 .05) ,the results were consist-ent with the Western blot ;different differentiated group p57kip2 ,Ki67 expression and P16INK4 were significant differences(P<0 .05) . Conclusion Low expression of P16INK4 and P57kip2 ,the higher expression of Ki67 play an important role in the development of hepa-tocellular carcinoma .

Objective To find a selection method system appropriate for China's essential drug list.Methods Collection and analysis of technical paper literature on essential drug list developement,adjustment technical papers,and literature on evidence-based medicine,pharmacoeconomics evaluation,and medical insurance budget analysis from WHO and other countries.On such basis,a method system for selecting China's essential medicine list can be proposed,with its feasibility analyzed and demonstrated.Results The GRADE assessment proposed by WHO was used to evaluate the efficacy and safety of the drug;the pharmacy economics evaluation is added to assess the economic efficiency;these were aided by the pharmacoeconomics evaluation for a comprehensive evaluation of the pharmacoeconomics of the drug in question,supplementing analysis of the medical insurance,and ensuring its affordability of essential medicine so selected.The theory of this system is well developed,and supporting software ready for application.Examples in Zhejiang Province regarding essential medicine for diabetes have proved this method feasible.Data acquisition constitutes a major roadblock for scientific selection due to barriers against medical insurance data sharing.Conclusions Theoretic basis and method tools are fully available for essential medicine selection,and the selection method system as proposed in this study prove feasible to some extent.Decision makers are recommended to scientifically select the essential drugs,and to encourage data sharing,in order to make the list more scientific and pragmatic.

Objective To investigate the inhibitory effects of CIK on the proliferation of Lewis lung carcinoma cell line and the growth of transplanted Lewis lung carcinoma in C57BL/6N mice in vivo.Methods CIK cells were induced by culturing PBMC with regular method.The proliferation of Lewis lung carcinoma cells was measured by MTT assay.Uhramicrostrueture of Lewis lung carcinoma cells was observed under a transmission electron microscope.Flowcytometric analysis was used to detect cell apoptosis.Ultrastructural observation expressions of FasL were individually determined by MTT and immunocytochemistry(ICC) analysis.Results Electron microscopic observations sbowed that CIK cells could induce the hepatoma cells to apoptosis.Flow cytometric analysis demonstrated that apoptosis cells of Lewis lung carcinoma were increased in CIK group compared with those in the control group.FasL expression on CIK increased.Cytotoxieity was blocked after addition of anti-FasmAb.Conclusion CIK has inhibitory effect on Lewis lung carcinoma cells both in vitro and in vivo.CIK cells can induce the apoptosis of Lewis lung carcinoraa cells.and Fas/FasL pathway plays an important role in apoptosis of Lewis lung carcinoma cells by CIK.