The study was o investigate the effectiveness of problem-based learning and scenario simulated teaching in Pathological experiment course.Clinical common,multiple cardiovascular diseases related experiments were selected for reform.The case was in advance handed out to the second year students of clinical medicine,stomatology,imaging medicine and otherspecialty,requiring them to complete the data access,group discussion,PPT production,diagnoses and treatment scenarios simulation video shooting tasks.Every group showed their PPT and video in class.They were asked between groups.Summative evaluation was given before class.Curriculum effectiveness questionnaire was issued and recycled,and according to students' performance teacher gave their scores and reward.The study showed that the comprehensive application of the above teaching methods and means could effectively improve students' learning enthusiasm and initiative,cultivate their medical humanistic spirit,and help to improve the teaching quality of pathology experiment.

Objective To investigate the characters of morphology change and protein expres-sion in progressed renal cell carcinoma after the treatment of sorafinib. Methods Clinical data of 2 cases with progressed renal cell carcinoma treated with sorafenib were collected. The HE slices were reviewed. Immunochemistry was used to detect the expression of Vimentin, AE1/AE3, CK7, CK8, CK18, CD10, VEGF, VEGFR2, p53 and Ki-67 levels. Results There was no difference in patho-logic type between before and after the therapy of sorafenib. Both of the 2 cases were showed degener-ation in tumor cell in different degree with fibrosis and necrosis. The expression of renal cell carcinoma related antigens (Vimentin, AE1/AE3, CK7, CK8, CK18 and CD10) had no difference before and af-ter the treatment of sorafinib. The expressions of VEGF, VEGFR2, p53 and Ki-67 were increased, and the expression of Bcl-2 was decreased after the therapy of sorafinib. Conclusions There may be some morphologie differences between the metastatic tumor or the recurrent tumor and primary tumor because of the treatment of sorafenib. However the pathologic type is the same before and after the treatment of sorafenib. The main differences are the degeneration of the tumor cell and fibrosis after the treatment of sorafenib. The expression changes of VEGF and VEGFR2 may be related to the sor-afenib application.

To be a reference to industrial production of Chinese materia medica (CMM) and modernization of CMM and to summarize several relevant articles and consulte some publications about common key technologies in CMM production. Since 2000, some new technologies have been applied to CMM industrial production, such as SFE, macroporous resin extraction, MST, high-speed centrifugal, ultrasonic extraction, microwave extraction, HSCCC, etc. There are still some problems and difficulties lying in its application to industry. But with the innovation and further research of these new technologies, the application of these technologies to CMM preparation and production may help to expedite the modernization and industrial production of CMM. These technologies will be applied to CMM industrial production with making it more and more vigorous.

Objective To explore the feasibility and value of preservation of left colonic artery (LCA) in dealing with inferior mesenteric artery (IMA) in laparoscopic anterior resection of rectal carcinoma.Methods The clinical data of 72 cases of laparoscopic anterior resection of rectal carcinoma from April 2010 to October 2013 were retrospectively analyzed including 32 cases with preservation of LCA (observation group) and 40 cases without preservation of LCA (control group).The blood loss,operative time,postoperative exhaust time,terminal ileum stoma,the number of lymph nodes removed around the root of IMA,the rate of lymph node metastasis around the root of IMA and prognosis were compared between two groups.Results There was no significant difference in the blood loss,operative time,postoperative exhaust time,terminal ileum stoma,the number of lymph nodes removed around the root of IMA,the rate of lymph node metastasis around the root of IMA between two groups (P ＞ 0.05).No case in observation group needed to free the splenic flexure of colon and to make the terminal ileum stoma,while 3 cases in control group needed to free splenic flexure of colon because of blood supply disorder in the proximal intestine (P =0.046),and 4 cases underwent terminal ileum stoma following anastomosis (P =0.042).No anastomotic leakage occurred in observation group,while 2 cases of anastomotic leakage occurred in control group(P =0.090).After followed up for 6-48 months,no significant difference was found in local recurrence and liver metastasis in two groups (P ＞ 0.05).Conclusion Laparoscopic anterior resection of rectal carcinoma with preservation of LCA in dealing with IMA can effectively retain the blood supply of proximal intestine.

Objective To report the clinical and neuropathological features of two families with Fabry disease and discuss the role of vascular changes in pathological processes of the disease Methods The two probands came from different families were characterized as having severe pain in extremities,angiokeratoma and renal impairment In addition to burning feet,the family members presented with multi organ failure by the 4th or 5th decades Nerve suralis biopsies were performed in two probands and renal stereotactic biopsy was performed in the latter Results Much green material was accumulated in vascular smooth muscle cells and endothelial cells as well as in perineurium In semithin sections the accumulated material was composed of numerous osmiophilic granules Electromicroscopic examination demonstrated that the granules showed a electron dense or laminated pattern Similar osmiophilic granules were also found in kidney biopsy Additionally,loss of unmyelinated fibers appeared in nerve suralis Serum renin angiotensin system was activated in case 1 Conclusion Pathological findings confirmed the existence of Fabry disease in both families Vascular changes play an important role in early development of symptoms Additionally,elevated renin angiotensin activity may induce chronic hypertension ,which might accelerate the multi organ failure