To improve the quality of the pediatric education in clinical clerkship and to bring us more in line with international practice,we applied the PBL bedside teaching in the clini-cal clerkship of the pediatric education.Compared with the traditional bedside teaching,better re-sults could be obtained with improvement in the consciousness of study,communication skill,the combination of basic and clinical knowledge,and the establishment of the clinical thought and evi-dence-based thought.

Objective:To explore the relationship between social support,well-being source and subjective well-being of city teachers.Methods:168 city teachers were measured by questionnaires of "Teacher's Well-being Source Scale" "Index of General Affect" "Life Satisfaction Scale" and "Teacher's Social Support Scale".Results:①Teacher's well-being source could predict teacher's subjective well-being.②Teacher's well-being source was a mediator factor between social support and subjective well-being.Conclusion:The social support from direct leader affect the subjective well-being with well-being source.

Objective To construct an eukaryotic vector with expression of human survivin gene with green fluorescent protein which is named pIRES2-EGFP/survivin and transfected into K562 cell line.Methods Using pDNR/Survivin plasmid as a template, the full length of survivin cDNA was amplified by PCR and subsequently cloned into T-A vector and then subcloned into pIRES2-EGFP vector. After identified by digestion of restrictive endonucleases, pIRES2-EGFP/survivin was further confirmed by sequencing. Then it was transfected into K562 cells with superfect reagents. The mRNA was isolated and survivin gene was detected by Western blotting. Results The exact sequences of pIRES2-EGFP/survivin vector were confirmed by digestion of restrictive endonucleases and sequencing. After transfection, the expressions of green fluorescent protein were present. The mRNA expression of survivin has been detected in transfected cells by RT-PCR. Conclusion The vector pIRES2-EGFP/survivin has been constructed and could express survivin gone in K562 cells successfully.

Objective To explore the effect of costimulatory moleculars expressed peripheral CD4+ T lymphocyts on graft-versus-host disease(GVHD) after allogeneic hematopoietic stem cell transplantation (alloHSCT). Methods 21 patients who suffered of hematology diseases or malignant solid tumors were underwent allo-HSCT and 10 normal individuals were enrolled in the study. The levels of CD28, CD80 and CD152expressions on peripheral CD4+ T lymphocytes were detected by FCM in different time(before allo-HSCT, 7 day,14 day, 21 day, 30 day after allo-HSCT, thetime of GVHD and the time after GVHD treated). STR-PCR was used to detect micro-satellites chimeras forming. Results All 21 patients achieved engraftment. By STR-PCR assay, 12 cases formed complete chimeras (CC) and 9 cases formed mixed chimeras (MC). A multivariate COX survival function modle analysis showed: CD4 CD152 was independent prognostic factors for GVHD (x2=13.128,P ＜0.0001). Patients with GVHD demonstrated higher CD4+ CD28+, CD4+ CD80+ and CD4+ CD152+ T cell levels than those without GVHD (P ＜0.01); patients with aGVHD demonstrated higher than those with cGVHD (P ＜0.05)and without GVHD (P ＜0.05); Patients with GVHD demonstrated lower CD4+ CD152+ T cell level than those without GVHD (P ＜0.01); the same result occured between aGVHD and cGVHD and without GVHD.Conclusion The incidence of GVHD between NST and traditional HSCT have no difference. B7-CD28/CD152 costimulatory pathway plays a critical role in the development of GVHD.

Objective: To investigate the contamination of phthalic acid esters (PAEs) and assess the health risk of PAEs contamination in market-available yellow rice wine in Huzhou City, Zhejiang Province, so as to provide the safety safeguard for consuming yellow rice wine. Methods: Yellow rice wine samples were collected from markets in Huzhou City from 2021 to 2022, and 16 PAEs were determined in yellow rice wine using magnetic solid-phase extraction coupled with gas chromatography-tandem mass spectrometry. The carcinogenic and non-carcinogenic risks of PAEs were evaluated using the health risk models proposed by United States Environmental Protection Agency. Results: A total of 75 yellow rice wine samples were collected, and 44 samples were detected with PAEs contamination (58.67%). Dimethyl phthalate (DMP), di-isobutyl phthalate (DIBP) and di-butyl phthalate (DBP) were detected, and there were 17 samples (22.67%) detected with DBP overdose (DMP and DIBP had no limit standard). DMP, DBP and DIBP, which were not classified as Class 2B and higher carcinogens by WHO's International Agency for Research on Cancer, had no definitive carcinogenic risks. Under mean PAEs, the five types of yellow rice wine all had no carcinogenic risks. Under 75% percentile of PAEs concentrations, the DBP in beverage wine with plastic packaging had a carcinogenic risk score of 1.207 5, with a gross carcinogenic risk score of 1.207 5. Under the maximum PAEs concentration, the ross carcinogenic risk scores of cooking wine with plastic packaging, beverage wine with plastic packaging, beverage wine with glass bottle packaging, and beverage wine with jar packaging were 2.751 0, 2.782 0, 1.298 2 and 2.944 0, presenting non-carcinogenic risks. Conclusion There is PAEs contamination in market-available yellow rice wine in Huzhou City, and no carcinogenic risk is evaluated. Non-carcinogenic health risk requires to be given a high priority.

Objective To investigate the relationship between serum homocysteine (Hcy) and large artery atherosclerosis (LAA).Medods The consecutive stroke patients with LAA and small artery occlusion (SAO) were enrolled.The demographics,baseline clinical data,and laboratory test results were compared.Multivariate logistic regression analysis was used to identify the independent risk factors for LAA.Spearman correlation analysis was used to analyze the correlation between serum Hcy concentration and carotid plaque scores.Results A total of 117 patients with LAA and SAO were enrolled,42 were in the LAA group and 75 were in the SAO group.The plasma Hcy levels (median [interquartile range] 15.35 [12.20-20.43] μmol/Lvs.12.40 [10.40-15.00] μmoFL; Z=-2.540,P=0.011),the carotid plaque scores (6.30 ±4.11 mm vs.4.19 ±2.84 mm; t =2.952,P=0.004),and the proportion of plasma Hcy level at tertile groups of the patients (x2 =10.697,P =0.005) of the LAA plasma group were all significantly higher than those of the SAO group.Multivariate logistic regression analysis showed that the plasma Hcy concentration was in the third tertile (＞ 15.3 μmol/L),and it was an independent risk factor for LAA (odds ratio 4.739,95％ confidence interval 1.696-13.241; P =0.003).Moreover,there was a significant positive correlation between the serum Hcy concentration and the carotid plaque scores (r =0.245,P =0.008).Conclusions The plasma Hcy levels were positively correlated with the severity of carotid atherosclerosis.The Hcy ＞ 15.3 μmol/L was an independent risk factor for LAA.

Objective To investigate the expression of survivin and B7-1 mRNA in acute leukemia and the prognostic significance in AL.Methods The expression of survivin and B7-1 mRNA was measuredin 64 AL patients with semi-quantity reverse transcription(RT)-PCR.14 adults were tested as normal controls(NC)and K562,NB4 cell lines were also tested as positive controls.Results The positive rates of survivin was higher than that of normal controis(NC).The expression of survivin in de novo AL Was higher than that in NC,while it decreased in complete remission(CR)patients.In relapsed patients the expression of survivin increased again.Meanwhile the expression of B7-1 has no signifieient change,but the expression Was lower than that in NC.In AL patients,the CR rate of positive survivin cases was lower than that of negative survivin cases.Conclusion Abnormal expression of survivin and B7-1 genes Was related to pathogenesis and progression of AL and it can serve as a marker of relapse and poor prognosis in AL.

Objective:To establish the HPLC fingerprints of Atractylodes lancea in northwest of Hubei province to provide the basis for the quality control and variety identification of Atractylodes lancea. Methods:The fingerprints were detected by HPLC. The separa-tion was achieved on a Diamonsil 2# C18(250 mm ×4.6 mm,5 μm)chromatographic column at 30℃ using acetonitrile-water (gradient elution) as the mobile phase at a flow rate of 1. 0 ml·min-1 . The detection wavelength was 340nm. Results: There were 13 common peaks in the HPLC fingerprints of 14 batches of Atractylodes lancea with promising separation. According to the results of clustering a-nalysis,Atractylodes lancea in northwest of Hubei province was clustered into two categories. Conclusion:A simple, feasible and relia-ble method is provided for the quality control of Atractylodes lancea.

Objective: To study the UPLC-MS fingerprint of Bupleurum marginatum DC. in northwest Hubei and establish the quality evaluation system for the herb. Methods:A UPLC-MS method was used to analyze 10 samples of B. marginatum DC with the following chromatographic conditions:an ACQUITY UPLC? RBEH C18 column (100 mm × 2. 1 mm, 1. 7 μm) was used, the mobile phase consisted of acetonitrile-0. 3% formic acid water with gradient elution, the flow rate was 0. 2 ml·min-1, and the detection wavelength was 203nm with ESI(-). Results:There were 8 common peaks in the UPLC-MS fingerprint of B. marginatum DC. Through analyzing the information of mass spectrometry and combining the references, 6 peaks were identified. Conclusion:The UPLC-MS fin-gerprint method is simple,rapid and feasible. The acquired UPLC-MS fingerprint of B. marginatum DC. and the evaluation indices can provide the scientific quality assessment of B. marginatum DC.

Objective To explore whether 5 to -7-day of folic acid supplementation prior to pemetrexed therapy is needed. Methods We retrospectively evaluate the outcomes of non-small cell lung cancer patients received less than the advised folic acid premedication. Seventy patients with Ⅲ-Ⅳ NSCLC were randomly divided into two groups: patients who initiated vitamin supplementation on 7 days before the first dose of pemetrexed (group A) and patients who initiated vitamin supplementation on the day of the first dose of pemetrexed (group B). Results In group A and group B, CR 0 and 0, PR 10 and 8, the response rates of 28.6% and 22.9% were observed, respectively. There was no statistically significant differences between these two groups. No significant differences were observed in the incidence of hematologic and non-hematologic toxicities. Conclusions The initiation of pemetrexed-based chemotherapy does not need to accommodate a vitamin supplementation schedule.