The college students innovative test project,which advocates student-centered teaching pattern focusing on questions and subjects is an important component of the project on undergraduate teaching quality and teaching reform in medical college of Shanghai Jiao Tong university.The innovative test project has effectively fostered the innovative spirits,practical abilities,scientific attitudes and learning initiatives of the college students after being implementing for more than four years.Besides,it has changed the teaching philosophy of teachers and created a favorable atmosphere of innovative practice.Several problems have emerged during the implementation of the project including broad topics,limited sample size and incorrect motives for doing tests.Exclusive mechanism aiming at the long-term effect of the project should be established, the concept of the project should be promoted and the communication platform should be built in order to consummate this project.

A girl who aged eight years and seven months presented with prunosus patches on the right buttock for 8 years,gradual unilateral enlargement of the right lower limb for more than 7 years,and multiple vegetations for 1 year.Dermatological examination showed nevus flammeus and multiple malodorous vegetations over the right lower limb with high skin temperature.The right lower limb was thicker and longer than the left lower limb.X-ray examination,magnetic resonance imaging and Doppler ultrasound examination revealed high-flow vascular malformations.Pathological examination of the vegetations showed vascular proliferation,fibroblast proliferation and erythrocyte extravasation.She was diagnosed as Parkes-Weber syndrome accompanied by pseudo-Kaposi's sarcoma.

Aim To investigate the renoprotective effect of berberine in diabetic nephropathy rat model. Methods The rat model of DN was induced by intra-peritoneal injection of streptozotocin ( STZ ) after fed with high sugar and high fat diet for six weeks. The rats were divided into 5 groups randomly, i. e. normal control group, model group, BBR ( 50 mg · kg-1 ) , BBR ( 100 mg · kg-1 ) and BBR ( 200 mg · kg-1 ) treatment group. The fasting blood glucose ( FBG) was evaluated at 2, 4, 6,8 week respectively. The patho-logical changes in the kidney were determined by PAS staining. The expression of vascular endothelial growth factor ( VEGF) was detected by immunohistochemistry and Western blot respectively. Results Compared with normal control group, the value of FBG, SCr, BUN and UTP of model group were sharply increased.
Compared with model group, the value of FBG in ber-berine different dosage treatment groups were signifi-cantly decreased to various degrees, and berberine dif-ferent dosage treatment could decrease the levels of SCr, BUN and UTP in different degree. Berberine could surpress the alterations of pathological changes in the kidneys and downregulate the expression levels of VEGF in the kidney of diabetic rats with nephropathy. Conclusion Berberine could significantly ameliorate the biochemical indicators and renal injury of the model rats through affecting the abnormal expression levels of VEGF in the kidney.

Objective To explore the effect of aspiration of hematoma on the serum neuron-specific enolase(NSE)concentration in patients with hypertensive intracerebral hemorrhage and its clinical meaning.Methods 45 cases of intracerebral hemorrhage with hematoma volumes of 30ml to 50ml were selected and divided into operative group(23 cases)and conservative group(22cases).The control group(18 cases)were healthy.Serum NSE was detected with ELISA method.Results ①The concentration of NSE in conservative group was obviously higher than that in control group within 21 days(P0.05).③The concentration of NSE in operative group was no significant difference than that in conservative group with in 7 days,but decreaced rapidly and was obviously lower than that in conservative group respectively in 14 days and 21 days(P

In this research, Casuarina eguisetifolia Linn was used to verify the broadly suitability of DNA bar-codes in identification of Li-medicine plants and systematic development of species. The genomic DNA of 22 samples collected C. eguisetifolia and its adulterants were amplified by 4 pairs of primers respectively (ITS (inter-nal transcribed spacer), ITS2 (internal transcribed spacer 2), trnH-psbA , rbcL) and sequenced bi-directionally. Obtained sequences were assembled using CodonCode Aligner. The dates were analysised using MEGA5.1 in ac-cordance with the kimura 2-parameter (K2P) model. The neighbor-joining (NJ) phylogenetic trees were construct-ed. Our study demonstrated the efficacy of ITS/ITS2 to distinguish between C. eguisetifolia and other adulterants species at the molecular level. Comparative to the primer of trnH-psbA and rbcL, there was a obviously DNA gap. The NJ trees showed that the several species of Casuarina can be classified to same types to show a obvi-ously monophyly, which the nearest family was Guttiferae. Therefore, ITS/ITS2 regions can accurately distinguish the original plant of Li-medicine. The systematic evolution of Casuarina can be verified in the molecular level.

Objective To analyze lesional and clinical characteristics of Langerhans cell histiocytosis in children.Methods A clinical retrospective study was performed on 126 patients with Langerhans cell histiocytosis collected from 2006 to 2011 at the Hunan Children's Hospital.Results Of the 126 patients,the youngest was 2months old,and the oldest was 9 years old.The ratio of male to female was 2.5 ∶ 1.Clinical manifestations included eczematid,seborrheic lesions,hemorrhagic maculopapules,yellow nodules and white macules.Of the three clinical phenotypes of Langerhans cell histiocytosis,Letter-Siwe disease was the most prevalent,and most cases of LetterSiwe disease were associated with hepatosplenomegaly,abnormal chest X-ray,impaired hematopoietic function and multifocal bone injuries.The clinical grade was mainly Ⅲ and Ⅳ in patients with Letter-Siwe disease,Ⅰ in patients with eosinophilic granuloma,and varied from Ⅰ to Ⅳ in patients with Hand-Schuller-Christian disease with Ⅱ as the most common.Of these patients,those with eosinophilic granuloma had the oldest average age with bone as the only affected organ,while those with Letter-Siwe disease had the youngest average age with the greatest number of affected organs.The treatment of Langerhans cell histiocytosis included surgical operation and combined chemotherapy.Conclusions Langerhans cell histiocytosis has characteristic skin lesions and diverse clinical manifestations.Pathology has diagnostic significance to Langerhans cell histiocytosis.Therapy strategies and curative effects are dependent on the severity of,and the organs affected by Langerhans cell histiocytosis.

In this study, sonography video urodynamic studies (SVUDS), which combined synchronically urodynamic studies with trans-perineal and trans-abdominal sonography, were used to detect female bladder outlet obstruction (FBOO). The dynamic changes of urethra and surrounding pelvic floor structure during storage and voiding phase were observed by SVUDS and the causes of FBOO were analyzed. And the findings were as follows: 13 patients showed organ prolapse, there was an urethral angulation deformity during urination; 5 cases had abnormal urination as the urethral opening was not good in the middle of urination period; 4 cases had urethral stricture, as the proximal end of the obstruction dilated during urination, and the obstruction site showed no relaxation; 1 case had primary bladder neck obstruction with an incomplete opening of the bladder neck during urination; 3 cases had idiopathic bladder outlet obstruction and the sphincter of bladder neck and urethra opened well during urination.

Aim To investigate the effect of berberine on the expression of nephrin, podocin and intergrinα3β1 in diabetic nephropathy ( DN ) rat model, and further probe in to the renoprotective effects of berber-ine and its potential mechanisms. Methods The rat model of DN was induced by intraperitoneal injection of streptozotocin ( STZ ) after fed with high-sugar and high-fat diet for six weeks. The rats were assigned into 6 groups randomly: normal control group, DN model group, BBR (50,100 and 200 mg·kg-1 ) treatment group and enalaprilat positive control group ( 1 mg · kg-1 ) . The distribution and expression of kidney podocyte related proteins nephrin, podocin and interg-rinα3β1 were detected by immunohistochemical meth-od following electron microscopy observation ( × 1000 ) and high magnification observation( × 400) and West-ern blot. Results The podocyte related protein neph-rin, podocin and intergrin α3β1 were mainly distribu-ted in podocyte, but slightly different. Compared with normal control group, the expresion of podocyte related protein nephrin, podocin and intergrin α3β1 was de-creased obviously; compared with model group, BBR (100 and 200 mg·kg-1 ) treatment group could sig-nificantly suppress the abnormalities of pathological changes of the kidney and upregulate the expression levels of podocyte specific protein nephrin, podocin and intergrin α3β1 in the kidney of diabetic rats with nephropathy. Conclusions Berberine could alleviate the abnormalities of kidney pathological changes and proteinuria production in the DN model rats, which may be related to the upregulation of the expression of the podocyte proteins nephrin, podocin and intergrinα3β1.

BACKGROUND:There are stil some controversies about lateral compression rotational y unstable pelvic ring injuries and fixed mode. OBJECTIVE:To evaluate the pelvic stability of locking plate fixation pelvic reconstruction repairing lateral compression rotational y unstable pelvic ring injuries. METHODS:We retrospectively analyzed 15 patients with unstable lateral compression rotational y unstable pelvic ring injuries treated with reconstruction locking plates fixation at Suzhou Xiangcheng People’s Hospital between November 2011 and November 2014. The Matta standard was used to evaluate the quality of fracture reduction. Clinical efficacy was evaluated by Majeed score. RESULTS AND CONCLUSION:Fifteen patients were fol owed up for 12-44 months (mean 24 months). According to the standard of Matta, 11 cases were excel ent, 2 cases were good, 2 cases were average, 0 case poor, and the excel ent and good rate was 87%. According to Majeed functional assessment, clinical function outcomes were graded as 9 cases excel ent, 3 cases good, 1 case average, 1 case poor;excel ent and good rate was 80%. There were no patient loss of reduction and internal fixation failure among these 15 patients in the final fol ow-up. No iatrogenic neurovascular injury occurred. Incision superficial infection was detected in 2 patients with a Morel-Laval ee lesion after subjecting to double-tube continuous negative pressure drainage, and healed after wound management. A large area of infection and skin necrosis did not occur. These results confirm that pelvic universal reconstruction locking plates in repair of lateral compression rotational y unstable pelvic ring injuries can maintain a strong and effective fixation. We should pay much attention to the cases of pelvic fractures combined with soft tissue injury around the pelvis.

Objective To observe the changes of the brain function during reading recovery by using functional MRI (fMRI),and to provide the experimental data in elucidating the mechanism on the recovery of reading and language function.Methods fMRI was performed in a native Chinese patient with pure alexia on the 45 th and 130 th day after the onset,respectively.Three kinds of Chinese characters were presented during the scan and the patient was asked to make the judgement weather he could recognize the characters or not.The brain activation maps were acquired after postprocessing,and the activated location and volume were compared between the first and second experiments.Results In both experiments,Broca area,Wernicke area,and the right extrastriate were significantly activated,while the left extrastriate around the lesion was markedly activated only in the second experiment,and the volume of activation in the right extrastriate in the second experiment was about 3 times as large as that in the first experiment.Conclusion The left extrastriate cortex is one of the key areas responsible for reading function in the brain.The recovery of reading function can be compensated in contralateral corresponding cortical area,or it can be the result of reorganization in ipsilateral peri-lesion cortex.Both mechanisms may simultaneously play important roles in reading recovery.