Double main teaching model can be applied in the teaching of pharmacology. To be spe-cific,for complex and difficult theory,we applied 'transmission-acceptancee' teaching method while for simple and easy theory,we used 'discovery' teaching method. Compared with the traditional teaching mod-el, double main teaching model improved teaching results and enhanced students' enthusiasm for learn-ing,their autonomous learning ability and cooperative ability. On the other hand,there still existed some prob-lems. We should keep on making great efforts to achieve better teaching results.

Objective To observe the effect of micro-pulse laser in the treatment of acute central serous chorioretinopathy (CSC).Methods 105 cases (114 eyes) with clinically diagnosed acute CSC were included in the study,including 78 males (86 eyes) and 27 females (28 eyes) with an average age of (40.40±7.80) years,and mean duration of 26 days.All patients were examined for best corrected visual acuity (BCVA),slit lamp microscope and pre-lens,direct ophthalmoscopy,color fundus photography,fluorescein angiography combined with indocyanine green angiography (ICGA),and micro-perimetry.Patients were randomly divided into micro-pulse laser treatment group (treatment group,61 eyes) and control group (51 eyes).The age (Z ＝-0.374),gender ratio (x2=0.010),disease duration (Z=-0.525),BCVA (t=1.885),foveal thickness (CFT) (t=-1.754) and macular light sensitivity (t=1.255) were similar between the two groups.The micro-pluse laser treatment was performed with an 810 nm infrared diode laser at the active leakage site on retinal pigment epithelium guided by ICGA.The exposure time was 0.2 s,effective working time was 15％,the laser spot diameter was 100 μm,and the distance between 2 spots was 100 μm.The control group received pseudo-treatment using the same laser parameters.After 2 weeks,1month,3 months and 6 months of treatment,all patients were examined with BCVA,ocular fundus,optical coherence tomography and micro-perimetry.These parameters were compared between the 2 groups.Results The subretinal fluid of 39 eyes in the micro-pulse laser group and that of 3 eyes in the control group were absorbed completely.The cure rates in the micro-pulse laser group (61.9％) was higher than that in the control group (x2 =38.015,P＜0.01).In the micro-pulse laser group,the mean BCVA was 67.81±11.70 at baseline,which increased significantly to 75±9.91,76.78± 9.43,78.56 ± 8.57 and 78.52 ± 8.60 at 2 weeks,1 month,3 months and 6 months after treatment respectively.In the control group,that was 63.86±10.35,64.20±11.43,63.90±10.88,64.55±11.04,64.10±11.12 at baseline,2 weeks,1 month,3 months,6 months post-treatment respectively.The mean post treatment BCVA at each time point were significantly higher in the micro-pulse laser group than that in the control group (P＜ 0.01).The mean CFT was (380.94 ± 50.73) μm at baseline,which reduced to (268.44±44.20),(242.78±41.31),(235.46±38.44),(235.56±38.71) μm at 2 weeks,1 month,3 months and 6 months post-treatment respectively in the nmicro-pulse laser group.In the control group,that was (397.98±52.61),(334.55±59.15),(316.16±55.25),(314.47±53.27),(321.51±55.74) μm at baseline,2 weeks,1 month,3 months,6 months post-treatment respectively.The mean post-treatment CFT at each time point in the micro-pulse laser group were decreased significantly compared to that in the control group (P＜0.01).The mean central retinal sensitivity was (15.03 ± 2.00) dB at baseline,which enhanced to (17.06 ± 1.71),(17.37 ± 1.61),(17.56 ± 1.58),(17.48 ± 1.53) dB at 2 weeks,1 month,3 months and 6 months post-treatment respectively in the micro-pulse laser group.In the control group,that was (14.54±2.22),(14.80±2.16),(14.88±2.09),(14.82±2.07),(14.69±2.11) dB at baseline,2 weeks,1 month,3 months and 6 months post-treatment respectively.The mean central retinal sensitivity at each time point of post-treatment in the micro-pulse laser group were enhanced significantly compared to that in the controlled group(P＜0.01).Conclusion In the treatment of acute CSC,micro-pulse laser can improve BCVA,reduce the mean CFT and improve the mean central retinal sensitivity.It is an effective and safe method to treat acute CSC.

Objective To understand the pregnancy outcomes and risk factors in pregnant women infected with Toxoplasma gondii. Methods Toxoplasma IgM and IgG antibodies in sera from 2 740 cases of pregnant women were detected by using enzyme-linked immunosorbent assay(ELISA)in Zhuozhou Municipal Maternal and Child Health Care Center from 2010 to 2013,and the pregnancy outcomes were followed up. The risk factors for Toxoplasma infection were investigated with questionnaires. Results Among the 2 740 cases of pregnant women,195 cases were found with antibodies to T. gondii(7.12%),and among them,44 cas-es were IgM positive(22.56%),and 151 cases were IgG positive(77.44%). There were 41 cases with adverse pregnancy out-comes among the 195 cases(21.02%),including 32 cases of IgM positive(78.05%)and 9 cases of IgG positive(21.95%). There were 6 cases of adverse pregnancy outcomes in uninfected pregnant women(2.86%). The difference between the two groups was statistically significant(P<0.05). The close contact with animals,eating raw meat,eating chafing dish or barbeque,and eating raw meat stuffing were important risk factors in pregnant women infected with T. gondii(compared with the uninfected group,P<0.01). Conclusion The Toxoplasma infection may lead to adverse pregnancy outcomes,therefore,to develop good habits of life and health is an effective way to avoid adverse pregnancy outcomes.

Objective To evaluate the NuMED covered CP stent for the treatment of adult aortic coarctation.Methods 6 patients with coarctation of the aorta received covered CP stent implantation.There were 4 males and 2 females cases with mean age of (20.13±5.16) years old.The size of the covered CP stents and balloons were determined by preoperative aortic CTA assessment.Stent implantation was per formed through femoral approach and the puncture site was sealed by vascular closure device after the operation.Results All the NuMED covered CP stents were implanted successfully.The pressure gradient dropped from (59.32±15.78) mmHg to (10.83±3.66) mmHg (P<0.001) after stenting.The diameter of the coarcation at the narrowest point increased from preoperative (5.1±1.2) mm to (19.7±2.4) mm after stenting (P<0.001).In 2 cases with PDA, the shunting disappeared spontaneously after operation with normalized of lower limb blood pressure.All the patients were followed up clinically for 12-36 months and all of them reported improvement in clinical symptoms post operation.Follow up Doppler echo or aorta CTA examinations at 3 months showed no restenosis.No mortality recorded during follow up.Conclusions NuMED covered CP stent for the treatment of aortic coarctation in adults showed satispactony short term outcome.Its long term outcome still requires further in vestigation.

Objective To observe the baseline characteristics and visual outcomes after two years follow-up of exudative age-related macular degeneration (AMD) patients treated with ranibizumb. Methods Forty-four eyes of 44 patients with exudative AMD were enrolled into this retrospective study, 19 were men and 25 were women. The mean age was 78 years (range 64–92 years). All patients were underwent best corrected visual acuity (BCVA, Early Treatment of Diabetic Retinopathy Study), fundus color photography, fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT). The mean BCVA was (50.36±14.43) letters, the mean central foveal thickness (CFT) was (291.95± 82.19)μm, and the fluorescence leakage area of choroidal neovascularization (CNV) was (7.61±5.84) mm2. All patients received three initial intravitreous injection of ranibizumb (IVR) and were retreated with monthly IVR when needed. The mean follow up time was 25.6 months (range 24–29 months). On 1, 2, 3, 6, 12, 18 and 24 months after treatment, BCVA and OCT were repeated. On 3, 6, 12, 18 and 24 months after treatment, FFA and ICGA were repeated. The change of BCVA, CFT and fluorescence leakage area of CNV were observed. The association of baseline characteristics and two year visual outcomes were analyzed. Results On 1, 2, 3, 6, 12, 18 and 24 months after treatment, the BCVA were improved significantly (t=?1.89,?3.51,?4.61,?4.04,?5.77,?4.69;P<0.05), the CFT were decreased significantly (t=1.51, 2.30, 3.40, 3.28, 3.54, 3.88, 3.73;P<0.05). On 3, 6, 12, 18 and 24 months after treatment, the fluorescence leakage area of CNV were reduced significantly (t=2.12, 2.90, 3.51, 4.12, 4.06;P<0.05). The lower baseline BCVA, the more improved after treatment. The BCVA improvement degree has a negative relationship with baseline BCVA and fluorescence leakage area of CNV (r=0.505,?0.550;P<0.05), but no correlation with baseline CFT (r=0.210, P>0.05). Conclusion Two year visual outcomes of exudative AMD patients treated with ranibizumb is negative correlated with baseline BCVA and fluorescence leakage area of CNV, but not correlated with baseline CFT.

Objective To study the expression and significance of fatty acid synthase ligand ( sFas ) and soluble fatty acid synthase receptor (sFasL) on the neoadjuvant chemotherapy of breast cancer.Methods 84 cases of patients with breast cancer neoadjuvant chemotherapy were recorded from January 2015 to January 2016 in our hospital as breast cancer group,another 84 cases of healthy subjects as control group,the two groups were measured sFas,the positive rate of sFasL.At the same time,respectively before and after neoadjuvant chemotherapy, detection of patients serum sFas, sFasL levels and breast cancer.According to the clinical curative effect were divided into effective group and ineffective group , compared two groups of serum sFas, sFasL levels.Results Breast cancer group called sFas and sFasL positive rate was 58.33% (49/84) and 100.00%(84/84),were significantly higher than that of control group 38.10%(32/84) and 0.00% (0/84);The level of sFas in patients with neoadjuvant chemotherapy was significantly lower than that of neoadjuvant chemotherapy, and the level of sFas in neoadjuvant chemotherapy group was significantly higher than that in ineffective group, the difference was statistically significant (P<0.05).Conclusion In the course of neoadjuvant chemotherapy for breast cancer,the efficacy of neoadjuvant chemotherapy can be effectively detected by detecting the level of serum sFas in patients with breast cancer , while sFasL has no significant change in the neoadjuvant chemotherapy of breast cancer.

Objective To evaluate the efficacy of intravitreal injections of conbercept in choroidal neovascularization (CNV) secondary to pathologic myopia (PM).Methods A retrospective case series of 37 eyes of 37 patients affected with CNV secondary to PM treated by intravitreal injections of Conbercept.All the patients were examined with best-corrected visual acuity (BCVA) of Early Treatment Diabetic Retinopathy Study (ETDRS) chart,central macular thickness (CMT) of optical coherence tomography (OCT) at baseline.The initial average letters of ETDRS BCVA was 49.86±8.87,CMT was (306.38±31.01) μm.All eyes were treated with intravitreal Conbercept 0.05 ml (10 mg/ml).Follow up visits were performed monthly after injection.The mean follow-up time was 16.8 months.Injections were repeated according to the situation of BCVA,CMT,subretinal fluid and CNV leakage in follow-up.All eyes received an average of 4.8 injections.BCVA,CMT and ophthalmoscope examination were assessed monthly.The relationship of BCVA improvement and CMT reduction with the data at baseline and number of treatments were analyzed by Spearman Rho correlation respectively.Results During the 1,3,6 and 12 months after treatment,the mean BCVA were all improved with statistically significant difference (t=17.629,P＜0.01).At 12 months,15 eyes (45.9％) had improvement of 15 letters or more,32 eyes (86.5％) had improvement of 5 letters or more,and 1 eye (2.7％) had decreased more than 5 letters.During the 1,3,6 and 12 months after treatment,the mean CMT were all decreased with statistically significant difference (F=43.726,P＜0.01).At 12 months,the retinal fluid of 34 eyes (91.9％) were absorbed completely;33 eyes (89.2％) had angiographic closure at that time.There was no significant relevance between BCVA improvement and sex,age and course of the disease (P＞0.05),but a significant negative correlation was found between the BCVA improvement and BCVA at baseline,injection times (P＜0.05).There was no significant relevance between CMT reduction and sex,age,course of the disease and injection times (P＞0.05),but a significant positive correlation was found between CMT reduction and CMT at baseline (P＜0.05).There were no systemic or ocular serious side effects during the follow up.Conclusions Intravitreal injections of Conbercept showed BCVA improvement and CMT reduction.It appeared to be effective and safe for choroidal neovascularization secondary to pathologic myopia.Intravitreal Conbercept for CNV secondary to PM showed BCVA improvement,CMT reduction and safety.

Objective To study nuclear factor E-2 related factor 2(NrF-2) and heme oxygenase -1(Ho-1) expression and to explore its clinical significance.Methods From February 2016 to June 2016, 176 cases human gastric tissue paraffin blocks selected in department of pathology in Hangzhou Cancer Hospital, including 78 cases of gastric cancer, 78 cases of normal tissue were analyzed.And the expressions of NrF-2 and Ho-1 were detected by immunohistochemistry in two groups of human gastric tissue.Results The levels of NrF-2 and Ho-1 in gastric cancer group were(0.752 ± 0.098),(0.862 ±0.081) were significantly higher than those in normal group(0.381 ±0.068),(0.412 ±0.083);NrF-2, the positive expression rate of Ho-1 in gastric wall invasion degree of T3 +T4 with lymph node metastasis, NTM stage III and IV gastric cancer tissues were significantly increased.The differences were statistically significant ( P <0.05 ) .Conclusion NrF-2 and Ho-1 play the important role in the development of gastric cancer and NrF-2, the positive expression rate of Ho-1 in the gastric carcinoma and gastric wall invasion, lymph node metastasis and NTM staging are closely related.The clinical diagnosis if the combined detection of NrF-2 and Ho-1, is conducive to the early diagnosis of gastric cancer and the prognosis of the disease.

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Objective To study the genome dynamics of Y. pestis and look for the relationship between its genome microevolution and niche adaption.Methods The DNA microarray combined with PCR was used to perform comparative genomic analysis of natural populations of Y.pestis.Results It was revealed that considerable genome dynamics of Y. pestis were the result of gene acquisition and loss in genome. We established a genomotyping system to group homologous isolates of Y. pestis, drew an outline of parallel microevolution of the Y. pestis genome, and established the link between the bacterial niche adaptation and genome microevolution.Conclusion The transmission, colonization and expansion of Y. pestis in natural foci are the results of its parallel, directional and gradual adaptation to the complex interactions among the environment, the hosts, and the pathogen itself.