Clinical surgical teaching is an important course of undergraduate teaching.Aiming at the problem of disconnection between operation and case in traditional video teaching and observing teaching in operation room,a new model of live surgery teaching based on case teaching was launched:intraoperative diagnosis and preoperative medical history collection were combined;intraoperative surgical anatomy and similar comparative study;teaching surgery were combined with pathology and postoperative adjuvant therapy.Through the questionnaire it was found that all of the students were satisfied with live surgery teaching,96.5％ of the students believed the model would contribute to their understanding of textbook knowledge and memory,and 94.8％ of the students thought the model could improve their interest in clinical learning.

MicroRNAs are endogenously expressed non-coding RNAs, which are composed of approximately 18 nucleotides to 25 nucleotides. Mature microRNAs regulate gene expression by base pairing with the 3'-untranslated region of target mRNAs. These mature microRNAs can degrade target mRNAs or inhibit translation. This process is a type of post-transcriptional regulation of gene ex-pression. Studies have shown that microRNAs are important in physiological and pathological processes, such as cell proliferation, cell differentiation, and cell death. This article provides an overview of the function of microRNAs in the regulation of macrophages.

Objective To explore the clinical outcome of individuals with Clinical High Risk (CHR) for psychosis and its relationship with Theory of Mind (ToM) function.Methods The Structured Interview for Prodromal Symptoms/Scale of Prodromal Syndromes (SIPS/SOPS) was applied to assess prodromal psychosis.The Reading the mind in the Eyes and faux pas Task were conducted to assess the function of Theory of Mind among the individuals of clinical high risk of psychosis.All participants had completed the 2-year follow-up.Conversion was determined using the criteria of presence of psychotic symptoms (POPS).According to the outcome,CHR individuals were divided into conversion group (n=20) and no-conversion group (n=50).The baseline clinical symptom characteristics and Theory of Mind were compared between groups.Results There was no significant difference in clinical symptom characteristics among individuals with CHR (P＞0.05).In the faux pas text,there were significant differences in Faux Pas Detection (P=0.01),Faux Pas Understanding (P=0.01) and Faux Pas Total (P=0.02) but not in control stories and the Reading the Mind in the Eyes Test between convertors and non-convertors (P＞0.05).Conclusion The ToM disability in clinical high risk population increases risk for conversion to psychosis.

Objective To investigate the mechanisms of fluconazole resistance in clinical and experimental induced isolates of C.glabrata.Methods Efflux of rhodamine 6G was performed to evaluate the effects of efflux pumps.The expression levels of transporter genes CDR1,CDR2,SNQ2 and ERG11 were examined by real-time RT-PCR.Meanwhile,sequence of PDR1 was determined by PCR based DNA sequencing.Results Efflux pumps of all fluconazole-resistant isolates had stronger effects than that of susceptible isolates,consistently with significant upregulation of CDR1,but no obvious difference was found in CDR2 or SNQ2.Also,no notable change in the expression level of ERG11 between susceptible and resistant isolates.PDR1 mutations existed in both clinical and experimental induced isolates of C.glabrata,among which P927S,L543P and S947L haven't been reported previously.Conclusion Mutations of PDR1 were induced by fluconazole both in vivo andin vitro,which will result in overexpression of CDR1 and strengthen the effect of efflux pump.

Objective To investigate the role of PDR1 gene in azole-resistant Candida glabrata (C.glabrata).Methods Thirty-eight clinical isolates of C.glabrata were collected from five different hospitals.The minimal inhibitory concentrations (MIC) of azole antifungals including fluconazole,itraconazole and voriconazole against C.glabrata were determined by broth microdilution.Sequencing and amplification of PDR1 gene was achieved by real-time quantitative polymerase chain reaction (PCR).The mutation was cloned into an expression plasmid and then transferred into C.glabrata.The efflux of rhodamine 6G and drug sensitivity test were performed,and expressions of CDR1 and CDR2 were examined to verify function of mutation.Results Among these 38 isolates of C.glabrata,17 were resistant to at least one of azole antifungals.Moreover,mutations of PDR1 gene existed in every resistant isolates.Results of phenotyping test showed that in the isolate that expressed PDR1P927S,the expression of CDR1 and CDR2 were increased by 20.53 and 4.03 fold,respectively.And the fluorescence intensity of rhodamine 6G was decreased to 0.62 in efflux experiment.Conclusion P927S mutation of PDR1 gene could induce azole resistance of C.glabrata by increasing the expressions of CDR1 and CDR2,which results in drug resistance due to enhanced effect of efflux pump.

Aim To investigate the effect of total flavonoids of Chrysanthemum indicum on proliferation of synoviocytes and TRAIL/TNF-? expression of synovial tissue with adjuvant arthritis rats.Methods SD rats were divided randomly into six groups including normol,model,TFC(84,168,336 mg?kg-1)and control drug Tripterygium glycosides(30 mg?kg-1)groups.Adjuvant arthritis rat model was induced by a single intradermal injection of 0.1 ml of the complete Freund's adjuvant into the the right hind feet pads of the SD rats.The proliferation of synoviocyte was measured by MTT;The expression of TRAIL and TNF-? on synovial tissue were detected by means of immunofluorescence.Results TFC was shown to suppress the excessive synoviocyte proliferation;The expression of TRAIL was lower in model group than that of the normal group.TFC can increase the expression of TRAIL protein;The contrary to TNF-? protein.Conclusions TRAIL play a role in the development of AA.TFC can increase the lower expression of TRAIL protein,that maybe one of the mechanisms of TFC improvement AA.

With the emerging of aging society and advances of information sciences, telemedicine has gradually become a new medical model.Telemedicine can be used in health monitoring, disease diagnosis, counseling, education, chronic disease management and long-term care in elderly population;particularly in management of chronic heart failure, diabetes and other chronic diseases, as well as in referral and continuous medical care.To promote telemedicine in the elderly population can break the physical limitations of different health care settings, so that geriatrician and the allied team members are enable to maximize their values in providing corresponding health services.This article reviews the progress of telemedicine in foreign countries, which would be of reference value for development of telemedicine for elderly people in China.

Objective To construct tissue microarray with astrocytic tumor microvessels(AstMV) of human brain and investigate astrocytic tumor angiogenesis.Methods Thirty-six specimens containing different microvessels from 200 specimens were selected as donor blocks,which was followed by punching,sampling and seeding samples with tissue microarray apparatus.The tissue microarrays were used to detect the expression of CD34,FⅧ-RAg and CD105.Results Tissue microarray of AstMV was successfully constructed and an instrument for location was made.CD34,FⅧ-RAg and CD105 were expressed on endothelial cell membrane or(and) plasma.There were difference in microvessel number between astrocytic tumors and between endothelial markers.In the gradeⅡ,Ⅲ and Ⅳ astrocytomas,microvessels labeled by CD34 and FⅧ-RAg antibodies were more than those detected by CD105 antibody.There were number difference in microvessels labeled by CD34 and FⅧ-RAg antibodies between grade Ⅰ and gradeⅡ,Ⅲ and Ⅳ tumors.Conclusion Construction of tissue microarray containing different tumor microvessels might be of significance in evaluating tumor angiogenesis.This study may be the basis for constructing digital tumor microvessel models and exploring the mathematic relation between astrocytic tumor microvessels and vascular growth factors.

Objective To study the effect of pioglitazone(PIO) on AdipoR1 and cholesterol ester(CE) in foam cells derived from THP-1-derived macrophages.Methods THP-1-derived macrophages were incubated with increasing concentrations of PIO for 24 hours.After co-cultured with low density lipoprotein(LDL),the accumulation of cholesterol in macrophages was measured by fluorescence spectrophotometric method.The lipid peroxide within cells was detected by TBARS method,the foam cells were observed by oil red staining.AdipoR1 levels were determined by Western blot.Results Compared with the ox-LDL group (0 μmol/L),oil red O-positive cells of the PIO protective groups were greatly reduced.TC,CE,MDA of the PIO protective groups were also obviously decreased.TC (53.6 ± 1.2) μg/mg,CE (30.2 ± 3.6) μg/mg,MDA (3.42 ± 0.06) μg/mg of 5 μμ mol/L PIO group were lower than those of 0μmol/L PIO group[(98.2 ± 3.5),(65.5 ± 6.5),(8.50 ± 1.21)] μg/mg (P ＜ 0.05).TC (25.6 ± 1.8) μg/mg,CE (22.5 ± 4.5) μg/mg,MDA (1.90 ± 0.42) μg/mg of 50 μmol/L PIO group.TC (16.8 ± 2.2) μg/mg,CE(5.9 ± 1.4) μg/mg,MDA (0.65 ± 0.05) μg/mg of 100μmol/L PIO group.Concomitantly,PIO significantly increased AdipoR1 protein expresion,AdipoR1 of 5μmol/L PIO group(0.06±0.05) was higher than that of 0μmol/L PIO group(0.03 ±0.07).AdipoR1 of 50μmol/L PIO group(0.11 ±0.07) was higher than that of 5μmol/L PIO group (0.06 ± 0.05).AdipoR1 of 100 μmol/L PIO group (0.40 ± 0.05) was obviously higher than that of 50 μ mol/L PIO group (0.11 ± 0.07).Conclusion PIO inhibited THP-1-derived formation by up-regulation the expression of AdipoR1,which may play an important role in the development and progression of atherosclerosis.

Objective To measure the expressions of HSP10 and 60 in cutaneous squamous cell carcinoma (SCC), basal cell carcinoma (BCC) and solar keratosis (AK) tissue. Methods Lesion samples were resected from patients with SCC (n = 50), BCC (n = 50) and AK (n = 50), and control samples were obtained from the normal skin adjacent to the operation sites of 14 of the 50 patients with SCC, BCC and AK. Immunohistochemical Envision two step method was used to detect the expression of HSP60 and 10 in the tissue samples.Results The expression of HSP10 was significantly higher in BCC tissue samples (Z = 3.24, P ＜ 0.001 ), but not in AK (Z= 0.74, P＞ 0.05) or SCC (Z= 0.52, P＞ 0.05) tissue samples than in the normal control tissue samples. Statistical significance was observed in the expression of HSP10 between AK and SCC and between AK and BCC tissue samples (both P ＜ 0.05), but not between SCC and BCC tissue samples (P ＞ 0.05 ). Elevated expression of HSP60 was found in AK, BCC and SCC tissue samples compared with the control samples (Z =-2.90, -2.15, -2.78,P ＜ 0.01, 0.05 and 0.01, respectively). Furthermore, the expression of HSP60 in SCC tissue samples was higher than that in BCC tissue samples (P ＜ 0.05 ) but similar to that in AK tissue samples. Conclusions There is likely to be a correlation between the high expression of HSP60 and biological behavior of SCC, and between the elevated HSP60 and HSP10 expressions and BCC initiation and development.