The application of case-based teaching in medical curriculum can enhance discussion, motivate students learning interest,enhance their abilities of clinical practice and clinical thinking.To highlight the key points of course,the application of problem-based learning(PBL) is helpful.The combination of PBL and case-based teaching will reduce redundant content and improve the quality of clinical teaching.

Objective To study the expression of hypoxia-inducible factor-1 α (HIF-1 α) in children with attention deficit hyperactivity disorder(ADHD),and its relationship with respiratory function.Methods Sixty children with ADHD confirmed by DSM-IV were admitted as ADHD group.60 healthy children were selected as the normal control group.The serum level of HIF-1α was determined by enzyme-linked immunosorbent assay(ELISA).Respiratory rate and respiratory amplitude were measured by biofeedback instrument.The PEF was measured by peak speed meter.The differences of HIF-1 α level and respiratory function between different ADHD groups and control group were analyzed.The influence of age and sex on HIF-1 α level and respiratory function was analyzed.Results The serum levels of HIF-1 α in ADHD group and healthy control group were (43.22-± 11.68) ng/L and (21.48 ± 12.70)ng/L respectively,the respiration rates were (17.47 ±-2.82)/min and (15.28 ± 2.35)/min respectively.The HIF-1 α and respiration rate of ADHD group were higher than healthy control group (t =9.003,4.363,all P ＜ 0.05).The respiratory amplitude in ADHD group and healthy control group were (2.36 ± 1.18) cm and (3.03 ± 1.05)cm respectively,the PEF in the two groups were (191.42 ± 30.06) L/min and (206.62 ± 33.35) L/min respectively.The respiratory amplitude and PEF of ADHD group were lower than healthy control group (t =4.007,8.534,all P ＜0.05).There were no significant differences in HIF-1α level,respiratory rate,respiratory amplitude and PEF between boys and girls with ADHD (P ＞ 0.05).There were no significant differences in HIF-1 α level,respiratory rate,respiration amplitude and PEF between different age in ADHD children (P ＞ 0.05).There was a negative correlation between HIF-1 α and PEF in children with ADHD (r =0.422,P ＜ 0.05).Conclusion HIF-1 α and lung function are correlated with ADHD,ADHD children have small lung capacity,which may result in the hypoxia of the brain and the increase of HIF-1 α expression.

Objective To assess the safety and effectiveness of prenatal multiple and single course glucocorticoids treatment on preterm birth infants. Method Seven researches on the treatment of preterm birth infants with glucocorticids were meta analyzed. Results Multiple courses of glucocorticoids treatment before labor may lower the incidence of patent ductus arteriosus (PDA) of preterm babies (OR=0.51,95% CI 0.49~0.54),and so did the respiratory distress syndrome (RDS), (OR=0.72,95% CI 0.49~1.07).But it may increase the septicemia of preterm infants (OR=1.62, 95%CI 1.07~2.44),and could not decrease the morbidity and mortality of intracranial hemorrhage (ICH)(OR=0.65, 95% CI 0.37~1.15)? necrosis enterocolonitis (NEC)(OR=1.30, 95% CI 0.79~2.12)and chronic lung disease (CLD)(OR=0.94,95%IC 0.59~1.49)? It cound not decrease the use of pulmonary surfactant after the birth of preterm infants. (OR=0.86,95% CI 0.48~1.55). Conclusions It suggests that multiple courses treatment with glucocorticoids is not safer and more effective than single course before labor.

Objective To evaluate the rationality of medication in Pediatric Intensive Care Unit (PICU).Methods The medication of 46 children in PICU of the First Affiliated Hospital of Sun Yat-Sen University with the average age of (34.74 ±45.5) months during May 3, 2011 and December 5, 2011 were retrospectively analyzed.The study was conducted statistically on the basis of pharmacopoeia, medical documents and other related medical materials.Results Among 46 ca-ses, irrational drug use was found in 28 patients (60.87%).A total of 100 irrational drug using habits such as potential drug interactions and incompatibility were presented.Compatibility taboo and pDDIs top four drugs were16 cases of furosemide (16%), 12 cases of vancomycin and dexamethasone (12%), 11 cases of midazolam injection (11%), and 9 cases of Phe-nobarbital (9%).Conclusion According to the characteristics of pediatric medication, pharmacists should take advantage of drug synergy when vigilant about the side effects of multi -medication, especially paying close attention to the potential inter-action of some commonly-prescribed drugs as well as reducing the prescriptions of multi -medications in order to improve the rationality of drug use in PICU.

Objective To evaluate the effects of antiviral therapy in prevention of tumor recurrence after curative treatment for patients with hepatocellular carcinoma (HCC). Methods Between Apr. 2006 and Jun. 2009,60 patients undergone curative treatment for HCC were enrolled in the retrospective analysis. Patients were assigned into four groups (15 each):patients in groupⅠ(serum HBV-DNA≥1.0?105copies/ml) and groupⅡ(serum HBV-DNA

ObjectiveTo study the mechanism of hyperbaric oxygen (HBO) on treatment of the late-onset fetal growth restriction (FGR). MethodsSixty-one pregnant women, who were first diagnosed as FGR after 32 weeks, were voluntarily devided into group-A (Routine management, n=28) an d group-B (HBO combined with routine management, n=33). Thirty cases of normal pregnant women were served as control group, called group-C (n=30).Results(1)Before treatment, the values of umbilical artery systolic/diastolic Ratio (S/D), pulse index (PI), resistant index (RI) and the blood viscosity at the low shear rate (LBV) of both group-A and group-B were significantly higher than those of group-C, P

AIM: To investigate the possibility of transfecting siRNA into rabbit cervical cells in transformation zone by the method of solid phase in vivo and to verify the effectivity of siRNA transfection by modifying the permeability of the cervical epithelium. METHODS: A sense strand small-interference RNA (siRNA) for human papillomavirus type 16 (21 bp) was designed and labeled with Cy3. siRNA-Lipo2000-carbomer gum was prepared. Twelve rabbits were included in the study and divided into experimental group and control group. In order to modify the permeability of cervical epithelium, hypertonic saline solution at concentration of 200 mmol/L was used to infuse the cervix in the experimental rabbits for 10 min, and normal saline was used for the control animals. The siRNA-Lipo2000-carbomer gum was applied to the surface of the rabbit cervix. Twenty-four hours later, the rabbits were sacrificed, and the cervix was isolated, cut into 2 parts, one part was for rapid frozen sectioning and the efficiency of transfection was observed under fluorescence microscope, another part was prepared by paraffin embedding and sectioning, and the form of cervical histiocytes was observed. Twelve SCID mice with SiHa cell cervical tumor, divided into experimental group and control group, were also used in the study. The mice in experimental group were treated with siRNA-Lipo2000-carbomer gum for 7 d. The control mice were treated with Lipo2000-carbomer gum only. Five days later, the mice were sacrificed and the tumor was collected, and the HPV16-DNA was measured by PCR. RESULTS: (1) Red fluorescence (Cy3) in cervical epithelium was observed in all rabbits. However, no different effect of siRNA transfection was found between the ways of modifying the cervical epithelium permeability. (2) No abnormal change such as flare, swelling and ulcer at all cervical tissue was observed, the cervical cell form was normal. (3) The titer of HPV16-DNA was decreased significantly after siRNA transfection (P<0.05). CONCLUSION: Transfection of siRNA into rabbit cervical epithelium in vivo is successful by using the method of solid phase and inhibits the processes of HPV-DNA, indicating that using RNAi is a practical way to treat HPV infection in human cercix and to decrease the incidence of cercical carcinoma.

Objective To investigate the levels of serum macrophage inflammatory protein-1α (MIP-1α),inflammatory factors and pulnonary function in patients with asthma,and the correlation between thenm.Methods Eighty patients with asthma were selected who were treated in our hospital from March 2015 to August 2016,and the data of 80 healthy adults were selected as control.The differences of serum MIP-1α,inflammatory factors,imnmunoglobulin and lung function were observed in two groups.The correlation between MIP-1α and inflammatory factors,lung function and immunoglobulin were analyzed.Results The levels of MIP-1α,interleukin (IL)-6,and tumor necrosis factor-α (TNF-α) in patients with asthma were significantly higher than those in control group (t =-207.04,-33.209,-55.132,P ＜ 0.01);The levels of forced vital capacity (FVC),the forced expiratory volume in one second (FEV1),FEV1/FVC,maximal mid expiratory flow (MMEF),and peak expiratory flow (PEF) in the asthma group were significantly lower than those in the control group (t =17.100,39.154,22.791,25.391,19.356,P ＜ 0.01).The IgG and IgM of asthma group were significantly lower than those of the control group (t =9.564,7.528,P ＜ 0.01).The IgE level was significantly higher than that of the control group (t =-82.683,P ＜0.01).The level of MIP-1α was positively correlated with the levels of IL-6,TNF-0 and IgE,and negatively correlated with FVC,FEV1,FEV1/FVC,MMEF,PEF,IgG and IgM in patients with asthma.Conclusions The level of serum MIP-1 α in asthmatic patients is high,and is closely related to the inflammatory cytokines and lung function in patients with asthma.

Objective To systematically evaluate the survival rate difference between minimally invasive surgery(MIE)and traditional open surgery(Open)in treating esophageal cancer perioperative complications and long-term follow-up.Methods Embase,Pubmed,Cohorane library search,Medline,Wanfang and HowNet were retrieved,and the related researches were collected.The literatures screening,data extraction and literature quality evaluation were conducted according to the 5.0 Coehrane reviewers manual.Then the meta analysis was conducted by using the Stata11.0 software.Results This study included 20 non-randomized control trials,with a total sample size of 3 568 cases(1 859 cases in the MIE group and 1 709 cases in the Open group),the pooled results showed that the MIE group had shorter operative time,shorter hospital stay,less intraoperative blood loss and more intraoperative lymph nodes clearing(P＜0.05),and perioperative complications,respiratory system complications,circulatory system complications and perioperative mortality rates were lower(P＜0.05).But postoperative ICU stay time,perioperative complications of digestive system and surgery-related complications,incidence of anastomotic fistula and 3-year survival had no statistically significant differences between the two groups(P>0.05).Conclusion MIE surgery is feasible in the treatment of esophageal cancer,and has lower incidence of perioperative complication compared with traditional surgery.

Hepatoid adenocarcinoma of the stomach ( HAS) belongs to one of the rare cases in gastric cancer types ,which has extremely high malignant degree and poor prognosis .Lymph node metastasis and liver me-tastasis are common in HAS.In this article,we reported alpha-fetoprotein-high-producing hepatoid adenocar-cinoma of the stomach(HAS),and reviewed the related literature at home and abroad in order to improve clinical physicians understanding of these diseases and treatment experience .