The multi-media teaching mode is more and more widely used in all kinds of teaching activities. This paper describes multi-media teaching and its development.It focuses on discussing the multi-media materials and their collecting methods, collecting tools as well as the common document formats.

Objective To study the clinical significance of C-reactive protein(CRP),neutrophil granulocyte ratio(N% ) in acute exacerbations of hospitalized patients with chronic obstructive pulmonary disease ( COPD ). Methods The serum CRP levels,the gross of N% were detected of the same 71 patients with acute exacerbations of COPD before treatment and after getting better. And the correlations among above-mentioned indexes,the days counter before getting better and the days counter during hospitalization were observed. Results (1) The levels of CRP and N% of patients after getting better were significantly lower than those before treatment(P ＜0. 01). (2) There was a significant correlation between N% and the days counter before getting better(r =0.240,P ＜0.05) and also a significant correlation between the days counter before getting better and the days counter during hospitalization (r = 0. 567, P ＜0.01). Conclusion The serum CRP level and N% were objective markers in estimating pulmonary infection in COPD patients with acute exacerbations. And N% was a reliable indicator of judging the days counter before getting better and better than CRP.

Objective To investigate the impact of cavoplasty on the piggy back liver transplantation and on the prevention of hepatic outflow block. Methods Three patients received modified piggy back liver transplantation with venacavoplasty under single veno venous bypass. Results All the recipients had stability of dynamic circulation, short anhepatic phase and decreased hemorrhage during operation. Postoperatively all the patients recovered quickly with good liver function without any complications. Conclusions Venacavoplasty may overcome outflow block in piggy back liver transplantation and the technique can shorten anhepatic phase and decrease complications.

Objective To investigated the prevalence of obesity and metabolic syndrome (MS) and the relationship of non-alcoholic fatty liver disease (NAFLD) with MS in Hangzhou of Zhejiang province. Methods A total of 3500 subjects who were negative for hepatitis B surface antigen marker were selected to take physical examinations. Body height, body weight, blood pressure, alanine aminotransferase,fasting blood glucose,high-density lipoprotein cholesterol,and triglyeerides were recorded. B-ultrasonography of the liver and gallbladder was undertaken. Results The prevalence of MS in the NAFLD or normal control group was 25.49% and 8. 61%, respectively ( P ＜ 0. 05 ). In multivariate logistic regression analyses, MS patients were 3. 927 times more likely to be NAFLD-related. Increased body mass index (BMI) and triglyceride were significantly associated with NAFLD among MS patients. Conclusion BMI and triglyceride level may be the main risk factors of NAFLD-related MS.

Aim To investigate the expression of CD31 , CD105 , HIF-1αand VEGF in xenografts tumor of HT-29 tumor cells during different stages of growth. Methods HT-29 tumor cells were transplanted into nude mice, the tumor was removed when the tumor volumes reached <100 mm3 , 100 ~300 mm3 and >300 mm3 respectively. Immunochemical method was a-dopted to detect the expression of CD31 , CD105 , HIF-1α and VEGF. Results HT-29 xenografts tumor vol-umes <100 mm3 , 100 ~300 mm3 , and >300 mm3 showed expressions with CD31-MVD at 37.40±4.17 , 18.80±1.72 and 14.20±2.23 respectively; CD105-MVD at 22.80 ±3.54 , 15.60 ±1.35 and 10.20 ±2.48; positive expression rate of VEGF was 26.20%
±0.83%,40.73% ±6.29% and 13.41% ±1.20%respectively; while positive expression rate of HIF-1αwas 3.20% ± 2.97%, 11.89% ± 1.94% and 80.62% ±3.47% respectively. On the other hand, for different volumes group, CD31-MVD, CD105-MVD, VEGF and HIF-1αexpression ratios had signifi-cant differences ( P <0.01 ) . Conclusions The ex-pression of MVD and vascular-related factors within the tumor caused by HT-29 xenografts tumor in nude mice at different growth stages was varied. There was a cer-tain correlation between tumor volume and MVD, VEGF, HIF-1α.

BACKGROUND: The target gene cannot be deleted at specific time by using conditional gene knockout system. Most gene knockout animals cannot survive during embryonic development and after birth, which limits the study of gene function.
OBJECTIVE: To review the recent advances about time-specific gene knockout technology.
METHODS: An online search in PubMed was performed from the initial stage of database establishment to August 2014. The key words were gene knockout, inducer and Cre/loxP system. The repeated experiment and unrelated articles were excluded during primary search. A summary was made by analyzing time-specific gene knockout technology.
RESULTS AND CONCLUTION: Most important gene knockout animals could not survive after birth, or die at early embryonic stage due to serious physical defects induced by an important gene deletion. Therefore, the progress in the functionality of a gene at a particular time, the genetic characteristics of an individual organism in a particular developmental period, and the treatment of certain acquired disease at a given time have been limited because of the limitations of research methods. However, the occurrence of conditional gene knockout animals, especial y time-specific knockout animals, provides a research model for the study of these areas. This study reviewed the recent advances, development and application about time-specific gene knockout animals, and discussed the significance and broad prospects of time-specific gene knockout technology of specific genes in the field of scientific research.

Objective: To establish a simple, stable and high success rate separation method of myocardial cells in New Zealand rabbits. Methods: Compared influence between perfusion speed of 50 r/min (8 ml/min) and 65 r/min (11 ml/min) of Langendorff perfusion device on cell separation during separation course of myocardial cells. Results: Compared with perfusion speed of 50 r/min, there was significant decrease in time to obtain cells [(33±9.10) min vs. (19.29±2.73) min], and significant increase in success rate (50% vs. 91%) and survival rate [(38.26±2.63) % vs. (85.71±2.21) %] by perfusion speed of 65 r/min, P<0.01 all. Conclusion: Perfusion speed is an important factor that affects acute separation of myocardial cells in New Zealand rabbits, and 65r/min perfusion speed may be more stable and successful to obtain single myocardial cell.

Objective To evaluate the efficacy of combination of traditional educational methodology with problem-based learning pedagogy in urology.Method The traditional educational pedagogy of urological tuberculosis was modified by combining with PBL methodology.Result More students were interested and active in this pedagogy.Conclusion The combination of traditional educational methodology with PBL is a helpful pedagogy.

To improve the clinical probation in lemology teaching,we may take the following measures:amending the teaching content,improving the teaching methods and promoting doctor-patient communications.

Objective To evaluate renal plication and nephropexy in the treatment of giant hydronephrosis. Methods 18 patients with giant hydronephrosis underwent relief of the obstruction as well as renal plication and nephropexy were reviewed. Results The patients have been followed up for three months to three years and their hydronephrosis improved a lot.The effected kidney showed some recovery of function on excretory urography. Conclusions Renal plication and nephropexy can promote recovery of renal anatomy and function after the relief of obstruction.