Objective To compared the effect of combined teaching method of lecture,case analysis and GasMan@software (LAG) and traditional teaching method (LBL) in inhalation anesthesia practice course.Method 78 anesthesiological undergraduates were randomly assigned to G group (n=39) or Control group (n=39).According to the requirements of clinical anesthesiology in the syllabus,G group used classroom lectures,case analysis and GasMan@software (LAG) teaching method,while Control group used lecture based learning (LBL) teaching method.The students took anonymous quiz and filled teaching effect evaluation form after practice course.Then the exam results were compared between groups to evaluate the teaching effect.SPSS 19.0 was applied to do statistical analysis and t test and x2 test were used.Results Compared to the Control group,G group got better results in objective questions like choosing,judgment,case analysis and average ranks (P=0.000),and there was no significant difference in the identification section (P=0.087),while G group also got better results in subjective questions like learning interests,study efficiency,memorize,logical thoughts,ability of analysis,solving problems and cooperation (P＜0.05).Conclusion Compared to traditional teaching method,the combined use of lecture,case analysis and GasMan@software make students immersive,develop their clinical thinking ability,and improve the teaching effect of inhalation anesthesia practice course significantly.

[Objective]To design a method of in vitro preparation and seperation for metallic wear particles around joint prosthesis and evaluate its feasibility in medical experiments.[Method]Ti-6Al-4V and Co-Gr-Mo alloys were used to make two friction jars respectirely. National inventive patent applied number 03142073.7.Lots of quadrate blocks made of the same materials are put into the jars respectively,which were then.lubri cated by man-made body fluid and vibrated on a bottle shaker.After 21 days the fluid was harvested and centrifuged to get the produced wear particles.The collected particles were studied by using element trace analysis,laser countersizer and scanning electron microscopy.The J774.A1 macrophages cultured together with these particles for 24 hours were observed under inverted phase contrast microscopy and transmission electron microscopy.[Result]A got great amounts of metallic particles with 1?m diameter coned beproduce using this method.The aver age diameter of titanium alloys(Dv90) is 1.011 and that of Co-Gr-Mo is 1.010.Particle size distribution had good consistency in different materials.Under scanning electron microscopy ,the particles had irregular shapes just like those got from revision operations.The particles taken into the J774.A1 macrophages could be seen under inverted p hase contrast microscopy and transmission electron microscopy.[Conclusion]This method is good enough to producl lots of metallic wear particles mosth like those around total joint prosthesis and can be used in further in vivo and in vitro studies about joint prosthesis loosening.

Objective: Analyze the impact of NCMS(new cooperative medical scheme) on rural medical institutions,and give suggestions for the sustainable development of medical institutions and the NCMS.Methods: Collect and analyze the efficiency and the account materials of the county-level healthcare departments and the town-level health centers of Zhen'an County in 2003 and 2006.Results: The implementation of NCMS produced an effect on the increase of the outpatient medical service;the service quality of the county-level medical institutions and the town-level health centers needs to be enhanced in spite of the increase of in-patient medical service;the medical institutions' income increased,and the medical service fees increased rapidly;the expenditure per person and time rose sharply.Conclusions: Management mechanism of NCMS should be further developed,construction and supervision of the county-level medical sectors and the town-level health centers,especially supervision of the quality of medical sectors be enhanced;the payment system be changed to control the growth rate of medical expenses.

Metallothionein is a sulfhydryl-rich,and chelating a large number of metal ions,which is widely found in biological world.It is very highlighted that MT had the same physical and chemical features from different origins.Plenty of research data indicated that MTs contain 20 free sulfhydryl genes,as well as their sulfhydryl clusters,It is a multifunctional protein in health.Many experiments demonstrate that MTs may be a novel target of original new drugs because they play a role in regulating and controlling the organ fibrosis and tumor.

Urid acid is one of the terminal metabolites of human body.More and more attention was paid to its metabolic mechanisms in intestinal tract;however, few studies were seen so far.This study aims to illuminate the metabolic mechanism of uric acid in intestinal tract by two ways:one is the transporters associated with intestinal epithelium, including ABCG2 and SLC2A9, the other is decomposition of uric acid by intestinal flora.We hope this review can provide new insights to decrease blood uric acid and treat urate-related diseases, and also provide a new way to alleviate drug-induced kidney damage.

Background:Vitamin D receptor( VDR)is a member of the steroid hormone receptor superfamily,which plays roles in various biological processes including cell proliferation,differentiation,apoptosis and immune responses,and is low expressed in many malignant tumors. Aims:To evaluate the expression and regulation mechanism of VDR in colorectal cancer. Methods:A total of 30 patients with colorectal cancer admitted from February 2010 to December 2012 at Ren Ji Hospital,School of Medicine,Shanghai Jiao Tong University were enrolled. Expression of VDR in cancerous tissue and para-cancer noncancerous tissue was determined by immunohistochemistry. Clinical data of 224 patients with colorectal cancer were collected from Gene Expression Omnibus( GEO)for analyzing the correlation between VDR expression in cancerous tissue and clinicopathological characteristics as well as survival time. Expression of VDR in human colon cancer cell lines HCT116 and SW620 transfected with enhancer of zeste homolog 2( EZH2 )-siRNA or treated with 5-azacytidine (5-AZA)was determined by real-time PCR,and methylation level of VDR promoter was determined by methylation-specific PCR( MSP). Results:Positivity rate of VDR was significantly lower in colorectal cancer tissue than that in para-cancer noncancerous tissue( 26. 7% vs. 70. 0%,P < 0. 001 ). Expression of VDR was negatively correlated with histological staging,distant metastasis,vascular metastasis and lymph node metastasis of colorectal cancer(P<0. 05). Survival time was significantly longer in patients with high expression of VDR than patients with low expression of VDR (P=0. 032). Compared with cells transfected with control-siRNA,expression of EZH2 mRNA and methylation level of VDR promoter in HCT116 and SW620 cells transfected with EZH2-siRNA were significantly decreased(P<0. 05),and expression of VDR mRNA was significantly increased(P<0. 05). Compared with negative control group,methylation level of VDR promoter in HCT116 and SW620 cells treated with 5-AZA was significantly decreased(P<0. 05),and expression of VDR mRNA was significantly increased(P<0. 05). Conclusions:Expression of VDR in colorectal cancer is down-regulated and positively correlated with a favourable prognosis. Transcriptional repression of VDR in colorectal cancer is co-regulated by histone methylation and DNA methylation.

Objective To investigate the clinical significance of N-terminal pro-B-type natriuretic peptide(NT-proBNP) detection in evaluation of acute type A aortic dissection (AAAD) prognosis .Methods Medical records of patients with confirmed diagnosis of AAAD were retrospectively analyzed .64 patients were enrolled in accordance with the inclusion and exclusion criteria ,and were di-vided into survival group(n=56) and death group(n=8) according to prognosis .Multivariate Logistic regression analysis was em-ployed to screen the independent risk factors which would affected the prognosis .Receiver operator characteristic ,ROC) curve was used to evaluate the predictive value of NT-proBNP for AAAD prognosis .Results Differences of history of smoking ,incidence sea-son ,disturbance of consciousness ,misdiagnosis ,low density lipid-cholesterol(LDL-C) ,fasting C-peptide(FCP) ,hypersensitive C-re-active protein(hs-CRP) ,cardiac troponin I(cTnI) ,NT-proBNP ,mean arterial pressure(MAP) and prothrombin time(PT) of pa-tients between the survival group and the death group showed statistical significance (P<0 .05) .Multivariate Logistic regression a-nalysis demonstrated that smoking history ,disturbance of consciousness ,high LDL-C ,high cTnI ,high NT-proBNP and low MAP were independent risk factors for patients with poor prognosis .ROC area under the curve(AUC) of NT-proBNP prediction for peri-operative mortality risk of patients with AAAD was 0 .697(P< 0 .05 ,95% CI:0 .643~0 .733) ,and its specificity and sensitivity were 75 .85% and 70 .07% ,respectively .When NT-proBNP was 909 .69 pg/mL ,its predictive value for AAAD was the best .Set the critical value as the threshold ,the patients above were divided into the threshold above group and the threshold below group . The survival rate of patients in the threshold below group [98 .18% (54/55)] was significantly higher than that in the threshold a-bove group[22 .22% (2/9)](χ2 = 7 .211 ,P< 0 .05) .Conclusion NT-proBNP level is closely related to the prognosis of patients with AAAD and NT-proBNP detection may be conducive to predicting high risk of AAAD .

Objective:To investigate the biological characteristics, wild resources distribution, chemical constituents, pharmacologi-cal effects and clinical application of She medicine fresh herb tea. Methods: The related literatures on fresh herb tea in CNKI, CBM, Wanfang and Vip database from 1989 to 2014 were sunmmrized and analyzed. Results:Fresh herb tea showed narrow distribution, and mainly contained volatile oils, alkaloids and flavonoids etc with the effects of antioxidant, immune regulation, antibiosis and so on. Con-clusion:The researches on the chemical composition of fresh herb tea provide reliable basis for the separation and extraction of specific chemical components, which also provide reliable support for the development of health products and other products containing fresh herb tea.

Objective To explore the value of human epididymis protein 4(HE4),cancer antigen 125(CA125) and the risk of ovarian malignancy algorithm(ROMA) in the diagnosis of ovarian cancer.Methods Electrochemical luminescence and Enzymelinked immunosorbent assay (ELISA) were used to determine the levels of serum HE4,CA125 in 56 patients with ovarian carcinoma,73 cases of ovarian benign tumor and 50 health women,and the ROMA was calculated by HE4 and CA125 levels depending on the menopause state,drawing the receiver operating characteristics(ROC) curve and calculating the area under the curve(AUC).Results The average levels of the HE4,CA125 and the value of the ROMA were (345.33±605.03)pmol/L,(701.46±1 500.30) U/mL,(58.72±31.00) ％ in the ovarian carcinoma group,(53.84± 14.68)pmol/L,(44.25±45.81)U/mL,(10.80± 6.75) ％ in the ovarian benign tumor group,and (46.03±10.26)pmol/L,(17.39±10.64)U/mL,(6.92±3.85)％ in the health control group respectively,compared with the benign tumor group and the health control group,the ovarian carcinoma group were higher in HE4,CA125 and the ROMA value,and the difference were significantly (P＜0.05),whereas compared in the ovarian benign group and the health group,except the CA125 was higher in the benign group and the difference had statistical significance(P＜0.05),the HE4 level and the value of the ROMA had no statistical significance(P＞0.05).The sensitivities of the HE4,CA125 and ROMA were 71.43％,76.79 ％,89.28％,the specificities were 93.15 ％,53.42％,94.52 ％ and the ROC-AUCs were 0.930,0.809,0.937 respectively.When the specificity for the diagnosis of the ovarian carcinoma was 95.00％,the sensitivities of the HE4,CA125 and ROMA were 80.40％,53.60％,83.90％ respectively.Conclusion HE4 and CA125 combined detection to calculate the ROMA can elevate the sensitivity and specificity for the ovarian carcinoma diagnosis.

OBJECTIVE:To investigate the effects and safety of Sophoraflavescens preparation combined with Fuzheng huayu capsule on hepatic hemodynamics and fibrosis indexes in patients with hepatitis B liver cirrhosis.METHODS:One hundred and two patients diagnosed as hepatitis B liver cirrhosis in our hospital during Feb.2013-Jun.2014 were divided into combination group and control group according to random number table,with 51 cases in each group.Control group was treated with Adefovir dipivoxil capsules 10 mg,po,qd;combination group was additionally given Fuzheng huayu capsules 1.5 g,po,tid+Sophora flavescens preparation (Matrine glucose injection 250 mL,ivgtt,qd,in the first 3 months,oxymatrine capsules 200 mg,po,tid,after 3 months) on the basis of control group.Both groups were treated for 12 months.The levels of HBV-DNA,liver function indexes (AST,ALT,TBIL),portal hemodynamic indexes [main portal vein inner diameter (D),mean blood flow velocity (Ⅴ)] and liver fibrosis indexes [laminin protein (LN),hyaluronic acid (HA),type Ⅳ collagen (Ⅳ-C)] were observed in 2 groups before and after treatment.The negative conversion rate of HBV-DNA and incidence of ADR were recorded.RESULTS:Three cases lost to follow up,and a total of 48 effective cases were included in control group;5 cases lost to follow up,and a total of 46 effective cases were included in combination group.Before treatment,there was no statistical significance in HBV-DNA levels,liver function indexes (AST,ALT,TBIL),liver fibrosis indexes (LN,HA,Ⅳ-C) and portal vein hemodynamic indexes (D,V) between 2 groups (P＞0.05).After treatment,above indexes of 2 groups were decreased significantly,and the combination group was significantly lower than the control group,with statistical significance (P＜0.05).The negative conversion rate of HBV-DNA in combination group was 93.5％,which was significantly higher than 79.2％ of control group,with statistical significance (P＜0.05).There was no statistical significance in the incidence of ADR between 2 groups (P＞0.05).CONCLUSIONS:Sophora flavescens preparation combined with Fuzheng huayu capsules can promote the recovery of liver function,regulate liver hemodynamics and alleviate hepatic fibrosis in patients with hepatitis B liver cirrhosis with good safety.