This study was aimed to explore the resource diversity and microbial inhibition activity of endophytic fungi from medicinal plant Plantago asiatica L. The endophytic fungi were isolated from the root, stem and leaf of the host by tissue inoculation culture and five plant pathogenic fungi and four bacteria strains used as indicating microbes to test microbial inhibition activity by agar plate antagonistic action and modified agar gel diffusion methods. The results indicated that thirteen fungal endophytic strains were isolated from the host. Most of them came from stem, then leaf, and root as the least in number. The isolated strains attribute to five genera, two fam-ilies, and two orders based on morphological characteristics. For the isolated strains, eleven of them were found to have some microbial inhibition activities against one or more indicating fungi, making up 84.6% of the total iso-lates. Six isolated strains had some antimicrobial activities against one or more indicating bacteria, amounting to 46.2% of the total isolates. Three isolated active strains, which are PAEFS001, PAEFS007 and PAEFS008, ex-hibited evident inhibition activities against five kinds of pathogenic fungi used in the trials respectively. The strain of PAEFS001 ascribed to Ozonium sp. Both strains of PAEFS007 and PAEFS008 ascribed to Aspergillus sp. One active strain of PAEFS003 showed evident antibacterial activities to Bacillus subtilis and Staphyloccus aureus, which belonged to Fusidium sp. The endophytic fungi from medicinal plant Plantago asiatica L. have evident an-timicrobial activities. Their inhibition activities against pathogenic fungi have relatively broad spectrum. And their inhibition activities to both Bacillus subtilis and Staphyloccus aureus as G+ are evident and have certain selectivi-ty. It is feasible to find new bioactive compounds associated with endophytic fungi from Plantago asiatica L. Fur-ther research and development of the endophyic fungi will be important for the integrated utilization of the host.

Objective To examine the teaching effects of case-based learning in the class of functional experiment. Methods Students (n=139) of five-year clinical medicine specialty were ran-domly divided into control group (n=70) and case group (n=69). The students of control group were taught with traditional teaching method and the case-based learning was adapted in the case group. Namely the clinical cases were led into teaching and the teaching process was completed through case import, problem sets, and the literature review and discussion. The teaching effects were evaluated through questionnaire survey (Analysis by the χ2-test, the test level is 0.05) and the analysis of test scores (Analysis by the t-test, the test level is 0.05). Results The score of the case group was better than the control group in the operation test (P=0.042 0). The total evaluating score and test score were also better in the case group in comparing to the control group (P=0.007 8 or P=0.008 2). As indicated by the questionnaire survey, more than 80%students thought the case teaching method could improve their learning interests and the independent learning abilities. Moreover, the skills of problem analysis and knowledge application were increased through case teaching. Conclusion The teaching effects of case-based learning were superior to the traditional teaching.

To explore the application of potassium titanyl phosphate (KTP) laser delivered via bronchofiberscope in the treatment of endobronchial tuberculosis. 36 patients with a diagnosis of endobronchial tuberculosis, with age ranging from 15 to 40 y were treated with KTP laser between Dec. 2002 and July 2004 (designated as treatment group). The other 36 patients diagnosed as having endobronchial tuberculosis (aged 18 to 42 y, with a mean age of 33. 5 y) without having received KTP laser treatment were included in a control group. Our results showed that the effective rates, in terms of recovery of bronchial lumen and cleanup of caseous necrotic mass were significantly higher in the treatment group 8 weeks after the treatment (P<0.01), and the healing rates of atelectasis and obstructive infection were also significantly higher in the treatment group (P<0.05 and P<0.01), but the incidence of complication after 8 weeks was no significant difference (P >0.05). No significant changes were found in SaO2 and HR before, during and after the operation in the treatment group (P>0.05). It is concluded that KTP laser is an effective therapy for endobronchial tuberculosis.

BACKGROUND:Induced pluripotent stem cel s have great prospects in tissue repair, due to the characteristic of self-renewal, multi-directional differentiation, no immunological rejection and ethics controversy.
OBJECTIVE:To summarize the differentiation of induced pluripotent stem cel s towards cardiomyocytes and endothelial cel s, and their applications in the cardiovascular diseases.
METHODS:The first author performed a data retrieval of PubMed and CNKI databases from 2000 to 2015 to search articles addressing the differentiation of induced pluripotent stem cel s towards cardiomyocytes and endothelial cel s, and reviewed the literatures systematical y. Final y, 78 articles were chosen for further analysis.
RESULTS AND CONCLUSION:Induced pluripotent stem cel s can differentiate into cardiovascular cel s through a variety of methods. Factors such as cyclosporin A and ascorbic acid C may improve myocardial differentiation of induced pluripotent stem cel s, while vascular endothelial growth factor and basic fibroblast growth factor may improve the endothelial differentiation of induced pluripotent stem cel s. Cardiovascular cel s derived from induced pluripotent stem cel s can be applied to build disease models in vitro, transplantation in vivo and drug screening.

Objective This study is to investigate the protective effect of creatine phosphate so-dium on circulatory function in unilateral total knee replacement surgery using bone cement implanta-tion.Methods Forty patients undergoing unilateral total knee replacement surgery with bone cement were randomly assigned into 2 groups:test group (group CP,n=20)and control group (group NS, n=20).The easophageal doppler ultrasound probe was placed at the level of the third rib transorally after induction in each patient.In group CP,creatine phosphate sodium (2 g in 100 ml normal saline) was infused (within 30 min)at 30 min before the operation,as well as normal saline 100 ml in group NS.SBP,DBP,HR,SpO2 ,PET CO2 and BIS were monitored and recorded before (T0 )and 1 (T1 ),3 (T2 ),5 (T3 ),10 (T4 )min after insertion of bone cement.Cardiac output (CO),stroke volume (SV)and left ventricular end-diastolic volume (LVEDV)were simultaneously monitored and recorded with esophageal doppler ultrasound.WhileⅡ-lead electrocardiogram were recorded to monitor ven-tricular arrhythmia perioperatively.Results SBP,DBP and HR decreased at T2 and T3 in group NS, and were lower than those in group CP (P <0.05 );Meanwhile,compared with group CP,CO and SV were significantly lower,while LVEDV was significantly higher in group NS (P <0.05 ).Com-pared with T0 ,CO and SV decreased and LVEDV increased at T2 and T3 in group NS (P <0.05 ). After insertion of bone cement,the incidence of arrhythmia in group CP was obviously lower than that in group NS (P < 0.05 ).Conclusion Pretreatment with creatine phosphate sodium can effectively prevent the incidence of bone cement implantation syndrome (BCIS)by stabilizing hemodynamic in elderly patients undergoing total knee replacement with bone cement.

To study the abnormal distribution of type Ⅳ collagen and laminin chains in glomerular basement membrane (GBM) in membranous nephropathy (MN).Methods 52 cases of MN were collected and staged according to electron microscopic morphological characteristics,and 10 cases of kidney tissues of minimal change disease were used as normal GBM control.Distribution pattern of or5 (Ⅳ) chain,laminin α5and β2 chains,and laminin α2 and β1 chains were detected using immunofluorescence method.Results In minimal change disease,α5 (Ⅳ) chain,laminin α5 and β2 chains all showed continuously linear positive expression along GBM,and laminin α2 and β1 chains were negatively expressed in GBM.In stage Ⅰ MN,α5 (Ⅳ) chain,laminin α.5 and β2 chains all showed continuous linear positive expression along GBM.In stage ⅡMN,the expression of α5 (Ⅳ) chain was increased and showed abundant spikes on the basis of continuous linear positive staining along GBM,and the expression of laminin α5 and β2chains was increased,and segmental spikes were seen on the basis of continuous linear positive staining along GBM.In stage ⅢMN,the expression of α5 (Ⅳ),laminin α5 and β2 chains was also enhanced and segmental double tracks were seen.The expression of laminin α2 chain was negative in GBM in stage ⅠMN,but granular positive expression along GBM was seen in stage Ⅱ and stage Ⅲ MN.No positive expression of laminin β1chain was seen in GBM in different stages in MN.Conclusion The GBM thickness in MN originates not only from intrinsic type Ⅳ collagen chains and laminin chains,but also from laminin α2chain,which only exist in glomerulus mesangium in normal condition.

Objective Construct the reasonably effective performance assessment mode of clinical departments,which is suitable for the continuous development of modern hospital.Method Use of balanced scorecard (BSC) principle,using the analytic hierarchy process (AHP) and Rank sum ratio method (RSR)to establish a performance assessment system. Results Constructed the performance assessment mode of clinical departments,which can be dynamically adjusted based on management objectives strategy.The mode takes the BSC as the baseline,the strategy of hospital development as the guide,performance assessment index system as the key element. Conclusion The performance assessment mode of clinical departments,base on BSC,achieve the strategic performance management,and is conducive to the hospital for continuous improvement of medical care quality,in line with the long-term strategic needs of the hospital.

Objective To investigate the occurrence and severity of behavioral and psychological symptoms of dementia(BPSD)in elderly dementia patients,and to explore the relationship of the degree of dementia and the severity of BPSD with the burden of caregivers in pension agency.Methods Using a convenient sampling method,the Clinical Dementia Rating (CDR) scale,neuropsychiatric scale (NPI)and Zarit caregiver burden scale(ZBI)were used to evaluate 145 patients with Alzheimer's disease and caregiver burden in Hangzhou.Results The incidence rate of BPSD was 51.8 ％ (72 cases),with a higher incidence rate of delusions of 22.3％ (31 cases),a higher severity of sleep disorder/nocturnal behavior [NPI symptom score (5.95 ± 4.60) points].The symptom making a greatest burden on the caregivers was delusion [ZBI score (32.81 ± 17.66) points].There were positively correlations of the burden of caregivers with the degree of dementia and the severity of BPSD (r=0.434,0.710,all P＜0.01)in patients with senile dementia.Conclusions The incidence rate of BPSD in dementia patients is higher,and the occurrence of BPSD is associated with the severity of mini mental state examination(MMSE)and dementia,which increases the burden of caregivers.More attention should be paid to BPSD in patients with senile dementia.And the social support system serving patients with senile dementia and their caregivers should be further improved.

Purpose To study the clinicopathological characteristics in 22 cases of ovarian mature teratoma with malignant transforma-tion. Methods Clinical and pathologic features were collected and analyzed in 22 out of 1 826 cases of ovarian mature teratoma by retrospective studies, together with immunohistochemical staining. Results In our study, 22 cases (1. 2%) of ovarian mature terato-ma with malignant transformation were identified. The median age was 56. 5 (range, 31~79) years. The main clinical manifestations were pelvic masses, including 13 cases in the left ovary, 8 cases in the right, 1 case was bilateral. Gross cystic teratoma were saw in 19 cases, 3 cases of cystic and solid, the bilateral one was solid in the left which the right was cystic. The teratomas size were 5. 0~30 cm with average 12. 4 cm in diameter. The malignant components’ maximum diameter was about 1. 0~10. 0 cm with average 3. 7 cm. Microscopicically, there were poorly differentiated squamous cell carcinoma in 14 cases, carcinoid carcinoma in 4 cases, adeno-carcinoma in 2 cases, papillary thyroid carcinoma in 2 cases, and the last one was sarcomatoid carcinoma. The FIGO stage distribution was as follows:16 were stage IA, 1 was stage IB, 1 was stage IIA, 4 were stage IIB. Follow up showed 6 cases recurrened, 2 patients died, the rest are survival. Conclusions A low incidence of ovarian mature teratoma in somatic cells with malignant transformation, which are common in postmenopausal women and present with pelvic mass. The main malignant components is squamous cell carcino-ma, patients of stage I have better prognosis. Both clinic and pathology should take more attention to the comprehensive examination and diagnosis of teratoma for prevent misdiagnosis.

Objective To study the characteristics of neutralization antibody in mice induced by DNA vaccines of hemagglutinin(HA) of novel H1N1 influenza A virus(2009H1N1).Methods HA encoding plasmids of 2009H1N1 or 1918H1N1(2009HA or 1918HA)were constructed.25 μg or 200 μg dosage of 2009HA plasmids were used to immunize the mice,the total antibody of anti-20O9HA or cross-reactive antibody were assayed by ELISA using 2009HA or 1918HA protein as capture antigen,and the neutralizing antibody were assayed by two kinds of virus pseudo - particles(pp) of 2009H1N1 and 1918H1N1 .Results During of 4 to 16 weeks after boost immunization,in two groups of mice immunized with 25 μg or 200 μg dosage 2009HA plasmids,both total antibody of anti-2009HA and neutralizing antibody to 2009H1Nlpp reached the similar level(P ＞0.05),and there were cross-reactive antibody to 1918HA protein in two groups of mice serum,with similar titers of cross-neutralizing activity to 1918H1N1 pp(P ＞0.05),Conclusion A low dosage DNA vaccine encoding HA of 2009 H1 N1 virus is able to induce persistent and high level of neutralizing antibody,and may be potential valuable vaccine against the new emerging influenza virus.