It is essentially indispensable to use multimedia methods in teaching "Clinical Medicine Outline". Such usage can diversify the teaching approaches and play a very important role in improving teaching methods and deepening students’ comprehension of course knowledge. Some problems existing in application of multimedia in the teaching process need to be settled.

ObjectiveTo investigate the risk factors in ischemic stroke following total hip replacement. MethodsThe clinical data of 18 patients who suffered ischemic stroke following total hip replacement were compared with other 142 patients without ischemic stroke following total hip replacement who were randomly selected as control. ResultsThe incidence rate of ischemic stroke following total hip replacement in our hospital was 1.8%. Age,hypertension, history of stroke,falling of systolic pressure and diastolic pressure during opereration were significantly different between patients and controls(P<0.05).There was no significantly different in sex,previous cardiac diseases, diabetes, hyperlipemia,and the bleeding in operation between patients and controls(P>0.05).ConclusionAge,hypertension, history of cerebrovascular disease,falling of systolic pressure and diastolic pressure during opereration are the important risk factors of ischemic stroke following total hip replacement.

Objective To investigate the relationship between family function and unhealthy mood in patients with vascular dementia (VD).Methods 120 VD patients were investigated by the Family APGAR index (APGAR),Hamilton Depression Scale (HAMD),Hamilton Anxiety Scale (HAMA),and Mini-Mental State Examination (MMSE).Results 98 cases (81.7％) were in depression with anxiety.Family dysfunction was presented in 83.3％ of 120 VD patients.The mild and moderate cognitive impairment were present in 55.8％ and 44.2％.The score of MMSE,the total score and factors scores of APGA were negatively related to the score of HAMD and HAMA.The score of MMSE was positively related to the total score and factors scores of APGA.The family dysfunction,self-reported financial burden and cognitive disorder were the risk factors of unhealthy mood (OR＞1).Conclusions The results suggest that improvement of VD patients' family function,reducing the economic burden and enhancing cognitive function can possibly relieve the unhealthy mood of patients.

Objective: To discuss the procedure and clinical effect of retroperitoneal laparoscopic nephropexy (RLN).Methods: From August 2001 to June 2006, RLN was performed on 28 female patients aged 26-45 years old (mean, 34±2.5) with symptomatic nephroptosis, including 15 with the right kidney, 12 with the left, and 1 with both. The preoperative complaint of patients included subjective symptoms (constant and recurring pain in 28 patients) and objective symptoms (upper urinary infections in 16, hematuria in 12, and upper tract obstruction in 12). One patient underwent nephropexy via the transperitoneal approach and the others underwent nephropexy via the retroperitoneal approach. A retroperitoneoscopic procedure was performed after positioning the patients in the flank position. Digital preparation of the retroperitoneal space was made and standardized trocar was placed. The key step of the surgery was complete exposure of the kidney within Gerota' fascia, which was aimed to separate the potential adhesions between the colon and kidney or between the inferior blood vessels of the kidney. Nephropexy was performed between the fibrous capsule at the lower pole of the kidney and the dissected psoas muscle, using three sutures placed by intracorporeal technique or the percutaneous needle both for introduction and removal of the suture; the sutures were separately tied over the sacrospinalis fascia. Results: The mean operative time was (125±9) min (ranging 115-240 min); the mean postoperative hospital stay was (9±1.2) days, largely owing to the required 5-12 days' bed rest. During a mean follow-up of (24±4.2) months(ranging 3 to 70 months), 3 patients had paresthesia, 5 had constant and recurrent ache, 20 were completely free of pain, and 4 had micro-hematuria. One patient had further episodes of pyelonephritis and upper tract obstruction after operation. Intravenous pyelogram(IVP) revealed that the ptosis incorporated into more than one vertebral body in 2 patients. Postoperative renal function test showed an improvement in renal function. Conclusion: RLN is mini-invasive and has less complication. The procedure should be considered as one of the optimal therapy for nephroptosis.

Objective To evaluate the effectiveness of several methods in eliminating Mycoplasma contamination in cell culture of human hepatoma-derived cell line C3A. Methods PCR was performed to detect the Mycoplasmas contamination in cell cultures. The contaminated samples were treated by ciprofloxa-cin, heating, Plasmocure or co-culturing with macrophages. Transmission electron microscope ( TEM) and Q-PCR were used to comparatively analyze the cell morphology and gene expression before and after Plas-mocure treatment. Results Plasmocure succeeded in eliminating Mycoplasma contamination, while cipro-floxacin showed temporary efficacy. Heating and co-culturing with macrophages failed to eliminate Mycoplas-ma contamination. No Mycoplasma contamination in the Plasmocure-treated group was observed under TEM and the expression of ALB, TF and CYP3A4 genes were higher than the genes expressed in the contaminated group (P<0. 01). Conclusion Plasmocure treatment was effective in eliminating Mycoplasma contamina-tion in cell culture. Moreover, the cell morphology and gene expression in Plasmocure-treated group were re-stored to normal.

Objective To determine the methylation status and expression of Ras association domain family 1A (RASSF1A), and the possible effect between promoter aberrant methylation and pathogenesis of pancreatic cancer. Methods The methylation status of RASSF1A promoter CpG island (CGI) pancreatic cancer cell line BxPC3 was detected in 5 cases of normal pancreatic tissue and 13 pairs of pancreatic cancer tissues (tumor and peri-tumor) by using COBRA (combined bisulfite restriction analysis) and the methylation rate was calculated. The RASSF1A mRNA expression of BxPC3 was compared between pre- and post-treatment of the inhibitor of DNA methyltransferase (5-Aza-2-deoxycitydine, 5-Aza-dC). Results The average methylation rate of RASSF1A promoter CGI was 62.90% in BXPC3, 9.14% in normal pancreas, 53.79% in peri-tumors (TP), and 55.82% in tumors. The methylation rates in port-tumors and tumors were significantly increased when compared with that of normal pancreas (P < 0.01), while there was no significant difference between in peri-tumors and tumors (P > 0.05). After 5-Aza-dC treatting BxPC3 cells, the methylation rates decreased to 42.5% (P < 0. 05) and RASSF1A mRNA expression was enhanced. Conclusions Aberrant hypermethylation of RASSF1A promoter CGI could be considered as an early event in the process of pancreatic cancer and participates in the pathogenesis of pancreatic cancer.

Objective To investigate the expression and methylation status of HOXA7 gene in human pancreatic cancer cell lines, and to explore the relationship between them.Methods HOXA7 mRNA expression of human pancreatic cancer cell lines BxPC3, CFPAC1, PANC1 and SW1990was detected by RT PCR.Bisulfite sequencing PCR (BSP) and combined bisulfite restriction analysis (COBRA) was used to test promoter methylation status.All the cell lines were treated by 5-aza-2-deoxycytidine (5-aza-dC), and HOXA7mRNA expression, methylation status was detected before and after this treatment.Results HOXA7 mRNA was expressed in BxPC3, CFPAC1 and SW1990, while there was no expression of HOXA7 mRNA in PANC1.HOXA7 promoter methylation rates of CFPAC1, BxPC3, PANC1 and SW1990 were 93.16%, 90.65%,90.09% ,52.30%.HOXA7 promoter methylation rate of SW1990 was significantly lower than those in other 3cell lines ( P ＜0.01 ).After 5-aza-dC treatment, HOXA7 mRNA of PANC1 was expressed again, and HOXA7mRNA of BxPC3 was increasingly expressed;while the expression of HOXA7 mRNA in CFPAC1 and SW1990was not significantly changed after 5-aza-dC treatment.Conclusions The expression of HOXA7 mRNA in BxPC3 and PANC1 was closely correlated with promoter hypermethylation, while there was no obvious relation in CFPAC 1 and SW1990.

Objective To explore the changes of QRS combined data and myocardial enzymes during ischemia-reperfusion in rabbits,and observe the changes of ST segment and T wave of lead Ⅱ,and arrhythmias.Methods The models of ischemia-reperfusion(A,B,C and D group)were made by ligating the left circumflex territory for 10,20,30,40 min and then reperfusion for 60 min.The sham-operated control was designed.The changes of the QRS combined data,ST segment and T wave and rises of arrhythmias about electrocardiogram of lead Ⅱ were observed.Meanwhile,the activity of serum myocardial enzymes was measured.Results The QRS combined data of the group D was higher significantly than the sham-operated control,group A and group B(P<0.05).T waves of different groups were not significantly different(P>0.05).The J spot elevation of lead Ⅲ in 19 rabbits of the ligating group and 5 rabbits of the sham-operated control was observed before operation.The changes of ST segment were clearly observed in the ligating group after operation:apparent mono-phasic curve elevation in 21 rabbits,level type depression in 2 and no change in 1.ST segment of other animals was declined more than 0.2 mV in 60 min reperfusion,except ST segment of 2 rabbits elevated again more than 0.1 mV,2 rabbits were normal and 1 rabbit was depressed.Two rabbits of the group D respectively died of sinus bradycardia in reperfusion 40 min and 43 min,and two rabbits appeared premature ventricalar contraction during reperfusion 3-5 min.The activity of serum aspartate aminotransferase(AST)and lactate dehydrogenase(LDH)obviously increased in the group D(P<0.05).Creatine kinase(CK)was high significantly except the sham-operated control(P<0.05).The activity of serum CK-MB of the groups C and group D was significantly higher than that of the sham-operated control(P<0.05).Conclusion The rising of LDH,CK-MB and QRS combined date in the group D is related with ischemia-reperfusion injury.

Fecal microbiota transplantation (FMT) technology originated in China during the Eastern Jin Dynasty and has rapidly developed over the past two decades, becoming a primary method for studying the causal relationship between gut microbiota and the occurrence and progression of diseases. At the same time, the therapeutic effects of FMT in the field of gastrointestinal diseases have gained widespread recognition and are gradually expanding into other disease areas. The FMT procedure is relatively complex, and there is currently no standardized method; its success is influenced by various factors, including the donor, recipient, processing of the fecal material, and the method of implantation. Given the increasingly recognized relationship between gut microbiota and various diseases, FMT has become a research hotspot in both scientific studies and clinical applications, achieving a series of significant advancements. To help researchers better understand this technology, this paper will outline the development history of FMT, summarize common operational methods in research and clinical settings, review its application progress, and look forward to future development directions.

Objective To explore the significance of MYCN gene amplification in children with neuroblastic tumors(NT).Methods The clinicopathological data of 154 cases with NT were reviewed,including general data, classification of pathology,clinical stage and prognosis.MYCN gene amplification was detected by fluorescence in situ hybridization(FISH) and its relationship between pathological characteristics and prognostic significance was analyzed.Results There was 154 cases of NT aged 1 day to 11 years,with a mean age of 26.1 months,and the median age of 20.5 months.Male and female ratio was 1.48 : 1.00.According to International Neuroblastoma Staging System (INSS) ,20 cases were of stage Ⅰ (13.0％) ,23 cases of stage Ⅱ (14.9％) ,43 cases of stage Ⅲ (27.9％) ,64 cases of stage Ⅳ(41.6％) and 4 cases of Ⅳs (2.6％).There were 72 cases(46.8％) with favorable histology,and 82 cases(53.2％) with unfavorable histology.MYCN amplification was found in 20 cases (13.0％) and the signal ratio of MYCN and chromosome 2 (CEP2) was 4.08-43.29.One hundred and thirty-four cases of MYCN non-amplification included MYCN gain in 91 cases(68.0％) ,MYCN negative in 43 cases(32.0％).MYCN expression showed the significant differences in ages, neuroblastoma type, international neuroblastoma pathology classification (INPC), mitosis karyorrhexis index (MKI), and clinical stages (all P ＜ 0.05).No significant difference was found in gender(P ＞ 0.05).Of 20 MYCN amplification cases,4 cases (20.0％) survived and 16 cases (80.0％) died,and the overall survival rate was 20.0％ (4/20 cases) ,with survival time was (17.10 ± 2.24) months;of 134 MYCN non-amplification cases,96 cases (71.6％) survived and 38 cases (28.4％) died, with survival time of (28.71 ± 1.28)months.Survival analysis showed the cases with MYCN amplification had worse prognosis (x2 =19.596, P ＜ 0.05).Conclusions Patients with MYCN amplification had poorer prognosis and lower incidence of MYCN amplification of pediatric NT was found in China.