Objective The purpose of this study was to explore the teaching method PBL in gynecology and obstetric education. Methods We took PBL in teaching Acute Gynecological Abdomen Pain in 102 students between 2008 and 2009. Results Questionnaire results and high scores in tests suggested that the students showed great subjective initiative in studies.PBL can cultivate students'self-learning capability,improve their ability of analyzing and solving prob-lems. Conclusion PBL is a better way in clinical medical education and worthwhile to be further researched and carried out.

Air Pollutants, Occupational ; analysis ; Ammonium Sulfate ; analysis ; Chromatography, Ion Exchange ; methods ; Workplace

From the Chinese medicine point of view on the physiological functions of healthy atmosphere and vitality, healthy atmosphere and vitality of the relationship, we can know that healthy atmosphere and vitality has important role in the life activities of the body. They complement each other. In the pathogenesis of AIDS, AIDS epidemic poi-son has the characteristics of wounding healthy atmosphere. When it attacks the body upright, vitality will be injured firstly. Because of that it is inextricably linked with the characteristics of the AIDS epidemic poison and vitality physiological functions. Therefore, AIDS epidemic poison attacks healthy atmosphere and vitality co-exist, the injury of healthy atmosphere and vitality is throughout the whole process of AIDS .

Objective To determine whether mutation of Hepatitis B virus (HBV) X gene is associated with hepatitis B virus-associated glomerulonephritis (HBV-GN).Methods The venous blood was collected from 50 patients with HBV-GN and 60 patients with asymptomatic HBV carriers (control group).Serum HBV DNA was extracted to determine the serum titer of HBV-DNA and then polymerase chain reaction (PCR) was used to detect the HBV X gene mutation.Results (1)There were not statistical significance between age and gender in HBV-GN group and control group (P ＞0.05).There were not statistical significance of serum replication level of HBV DNA in HBV-GN with X gene mutation and control group (P ＞ 0.05).Urine protein excretion in HBV-GN group with or without X gene mutation was found with statistical significance (P ＜ 0.05).(2)Nucleotide mutations [84％ (42/50)] resulted in amino acid substitution in HBV-GN.Nucleotide mutations changed in transfunction control region of X gene,including position nt1653,nt1726,nt1727,nt1730,nt1753,nt1762 and nt1764.(3)Nucleotide mutations [8％(5/60)] resulted in amino acid substitution in control group.Nucleotide mutations changed in position nt1632 and nt1635,located in non-functional region.Conclusions HBV X gene mutations and the subsequent amino acid substitutions are found in HBV-GN.The urine protein excretion level increases in patients with X mutation,suggesting that these mutations may play an important role in the pathogenesis of HBV-GN.

Objective To probe into the value of micro-perfusion examination at the early stage after right lobe living donor liver transplantation by contrast-enhanced ultrasound(CEUS). Methods Twenty-six recipients of right lobe living donor liver transplantation received CEUS examination at 1,7,15 and 30 days respectively after operation using contrast medium SonoVue. Perfusion patterns were observed and analyzed considering operation method. Results Of 26 recipients, 15 cases showed normal perfusion patterns with normal hemodynamics; 11 cases showed abnormal perfusion patterns with abnormal hemodynamics:8 had conduit venous obstruction,4 high portal vein blood flow. The abnormal patterns was in the early arterial phase of enhancement process at the first day examination, showing hyper- and hypo- enhancement area compared with normal liver parenchyma. And the difference gradually disappeared in the subsequent examination. Conclusions Abnormal micro-perfusion patterns are highly related to abnormal inflow and outflow in the early post operation stage. The main reasons are conduit venous obstruction and excessive perfusion of portal vein. CEUS can be used as an effective method in evaluating the graft micro-perfusion.

Objective To evaluate the value of 18F-FDG PET/CT in preoperative diagnosis and staging of suspected extrahepatic cholangiocarcinoma (EHCC).Methods The clinical data of 116 patients (72 males,44 females;age range 26-89 years) with suspected EHCC from January 2013 to October 2014 were retrospectively analyzed.All patients received preoperative whole body 18F-FDG PET/CT scan.The imaging results were compared with final clinical diagnosis.The diagnostic sensitivity,specificity,positive predictive value,negative predictive value and accuracy of 18F-FDG PET/CT were calculated.Two-sample t test was applied to compare lesion SUVmax of malignant and benign diseases.One-way analysis of variance was applied to compare SUVmax of highly,moderately and poorly differentiated tumors.x2 test was used to compare the difference of diagnostic sensitivities for hilar cholangiocarcinomas and common bile duct tumors.Results All patients were confirmed by exploratory laparotomy and subsequent histologic examination.A total of 94 cases (93 adenocarcinomas and 1 squamous carcinoma) were confirmed malignant and 22 cases (11 biliary calculi,9 cholangitis,1 choledochal cyst,1 tuberculosis) were confirmed benign.The diagnostic sensitivity,specificity,positive predictive value,negative predictive value and accuracy of 18F-FDG PET/CT for primary tumor were 61.7％ (58/94),77.3％ (17/22),92.1％ (58/63),32.1％ (17/53),64.7％ (75/116),respectively.The diagnostic sensitivity and specificity for regional lymph node metastasis were 45.5％(15/33),91.4％(53/58),and those for distant metastasis were 3/4,94.3％(82/87).The SUVmax of malignant tumors were higher than that of benign lesions (4.57± 3.75,2.72± 2.48;t =2.83,P＜ 0.05),while the differences of SUVmax among highly,moderately and poorly differentiated tumors were not significant (4.89±4.75,4.23±2.49,4.47±2.73;F=0.269,P＞0.05).18F-FDG PET/CT showed a lower sensitivity in hilar cholangiocarcinomas than that in common bile duct tumors,while no statistical significance was observed:48.6％ (17/35) vs 69.0％ (40/58),x2=3.827,P＞0.05.Conclusions The value of 18F-FDG PET/CT in preoperative diagnosis and staging of EHCC is limited.It can distinguish some benign diseases from malignant tumors,but with higher false positive for cholangitis.It can help to adjust treatment strategies by detecting distant metastasis.

Objective To investigate the protein expression of stanniocalcin 1 (STC1) in papillary thyroid carcinoma (PTC) in gerontal patients versus non-gerontal subjects,and its relationship with clinicopathological features.Methods The protein expression levels of STC1 in PTC,nodular goiter and normal thyroid tissues in the gerontal patients versus non-gerontal subjects were detected by immunohistochemistry.The protein expressions of STC1 were detected by Western blotting.Results The protein expression of STC1 in gerontal patients was higher in PTC than in nodular goiter and normal thyroid tissues (60.9％ vs.30.0％,15.0％,P＜0.05 or 0.01).The relative expression of STC1 protein in gerontal patients was higher in PTC than in nodular goiter and normal thyroid tissues [(0.647 ± 0.076) vs.(0.280 ± 0.039),(0.248 ± 0.065),F =9.965 and 1.143,both P＜0.01].STC1 protein expression had no correlations with age,gender,tumor diameter and tumor position in patients (P＜0.05),while it was associated with tumor lymph node metastasis and clinical stage (P＜0.05).There was no significant difference in above indexes between the elderly and non-elderly patients with papillary thyroid carcinoma (F=0.007,P=0.934).Conclusions STC1 protein may be associated with the development of papillary thyroid carcinoma,and it may has a some reference value in differentiating benign from malignant thyroid neoplasms and in predicting the prognosis of thyroid carcinomas.

Objective To investigate the correlation of HBV DNA level with clinicopathological characteristics and prognosis of HBV-associated glomerulonephritis ( HBV-GN ) .Methods One hundred and two patients with HBV-GN admitted in Affiliated Hospital of Qingdao University during January 2009 and October 2012 were successively enrolled.Fluorescence quantitative polymerase chain reaction was used to determine the serum titer of HBV DNA.According to HBV DNA levels the patients were divided into three groups:low-replication group (HBV DNA <103 copies/mL), moderate-replication group (103 copies/mL ≤HBV DNA≤105 copies/mL) and high-replication group ( HBV DNA >105 copies/mL) .Renal biopsy was performed to determine the pathological type, and immunofluorescence assay was used for quantitative detection of HBV related antigens ( HBsAg, HBcAg and HBeAg ) in kidney. All patients received lamivudine (100 mg/d) plus adefovir dipivoxil (10 mg/d) combination therapy and followed up for 18 months.The renal function, biochemical and immunological indexes before and after the treatment were measured.One-way ANOVA was used to analyze the differences of above parameters among patients in three groups.Spearman correlation coefficient was used for correlation analysis between HBV DNA level and pathological stages in kidney.Results There were 20 patients in low-replication group, 51 in moderate-replication group and 31 in high-replication group.With the increase of serum level of HBV DNA, 24-h urine protein excretion, plasma cholesterol, and triglycerides increased (F=34.64, 40.10 and 31.72, P<0.01), plasma level of albumin decreased (F=24.04, P<0.01), and the immune complexes of HBV related antigens ( HBsAg, HBcAg and HBeAg) in kidney increased ( F=41.49, 15.64 and 10.41, P<0.01).For 78 patients with HBV-membranous nephropathy ( HBV-MN), the pathological injury was aggravated with the increase of serum level of HBV DNA (r=0.38, P<0.01).The level of 24-h urine protein excretion declined after treatment in three groups ( t =7.86, 19.28 and 16.74, P <0.01 );complement C3 increased, but no statistical significance was observed ( t =1.05, 1.04 and 1.94, P >0.05);no change in creatinine was found (t =0.14, 0.52 and 0.57, P >0.05).After 18-month treatment, clinical remission rates in three groups were 95.0% ( 19/20 ) , 70.6% ( 36/51 ) and 54.8%(17/31), respectively.The clinical remission rate was significantly lower in the high-replication group as compared with that in low-replication group (χ2 =9.44, P<0.01).Conclusion Serum level of HBV DNA is closely correlated with renal function, renal pathology and clinical remission rate in HBV-GN patients, which may be used for the evaluation of kidney biopsy, treatment and prognosis in patients with HBV-GN.

Objective To explore the expression and significance of CD34, CD117 on bone marrow mononuclear cells of myelodysplastic syndromes (MDS). Methods Direct immunofluorescence staining was used by means of flow cytometry. 37 patients with MDS were divided into RA/RARS/RCMD subgroup, RAEB Ⅰ/RAEB Ⅱ subgroup; favorable chromosomal subgroup, poor chromosomal subgroup; intermediate-risk Ⅰ subgroup, intermediate-risk Ⅱ subgroup, high-risk subgroup respectively according to WHO classification,cytogenetic abnormalities and international prognostic scoring system (IPSS). Results CD34 and CD117 were positive respectively in 11 of 19 patients with RMRARS/RCMD, all cases in RAEB Ⅰ/RAEB Ⅱ expressed CD34 and CD117; increased expression of CD34 and CD117 was MDS grade-related. Favorable chromosomal subgroup, 14 of 22 patients were positive for CD34, CD117, all cases in poor chromosomes expressed CD34 and CD117; there was a direct relationship between phenotytic density and poor cytogenetic risk factor. CD34 and CD117 expression was present respectively in intermediate-risk Ⅰ (9/17), intermediate-risk Ⅱ (11/11) and highrisk subgroup (9/9); the phenotypic intensity also was correlated with IPSS scores. Conclusion Detection of CD34, CD117 may be a useful tool for subtyping and predicting the prognosis of MDS.

Objective To enhance the protective immunity effects of nucleic acid vaccines against Schistosoma japonicum infection by electroporation(EP)in vivo in infected BALB/c mice.Methods Plasmids and proteins for immunization were prepared and diluted in no bacterial saline solution to final concentration of 1.5 mg/ml.pcDNA3.1-SjC23,pcDNA3.1-SjCTPI,pcDNA3.1-(CDR3)6 plasmid DNAs were mixed by equal volume to form the cocktail DNA vaccine,and also mixed with recombinant proteins SjC23-HD,SjCTPI,and NP30 by equal volume to form the cocktail protein vaccine.Seventy female BALB/c mice of 4-5 weeks old were randomly divided into 5 groups(A,B,C,D,E).In Group A(control group),each mouse was immunized with 100 ?l saline solution by intramuscular(i.m.);in Group B(pcDNA3.1/EP control group),each mouse was immunized(i.m.)with 100 ?l pcDNA3.1 followed by EP in vivo for three times at week 0,3,6;in Group C(pcDNA3.1/EP plus cocktail protein vaccine group),each mouse was immunized(i.m.)with 100 ?l pcDNA3.1 followed by EP for three times at week 0,3,6 and boosted with 100 ?l cocktail protein vaccine plus 100 ?l FCA by subcutaneous at week 9;in Group D(cocktail DNA vaccine/EP group),each mouse was immunized(i.m.)with 100 ?l cocktail DNA vaccine followed by EP for three times at week 0,3,6;in Group E(cocktail DNA vaccine/EP plus cocktail protein vaccine group),each mouse was immunized(i.m.)with 100 ?l cocktail DNA vaccine followed by EP for three times at week 0,3,6 and boosted with 100 ?l cocktail protein vaccine plus 100 ?l FCA by subcutaneous at week 9.Four weeks after the last DNA immunization or two weeks after protein boosting,all the mice were challenged with(40?1)cercariae of Schistosoma japonicum by abdominal skin penetration.Forty-two days post-challenge,the mice were sacrificed and perfused,and the numbers of recovered worms and eggs in liver were counted.The blood was collected from the tail veins of all the mice two days before the first immunization and challenge,respectively,the serum was prepared for detection of IgG,IgG1 and IgG2a.Two days before the challenge,the spleen cells of two mice from each group were cultured and stimulated with ConA and soluble egg antigen(SEA),and the supernatant was collected for detection of IL-2,IL-4 and IFN-? by flow cytometre.Results The worm reduction rates in Group C,D and E were 18.09%,45.00% and 57.09%,respectively,compared with the control group.The worm reduction rates in Group D and E were significantly higher than that in Group C(P