Objective:To investigate the effect of PBL+LBL double-track in long-term-system clinical medicine in Gynecology and Obstetrics.Methods:We divided the students of 2001-seven-year-progrems in random into two groups: trial group practiced PBL+LBL double-track teaching,control group practiced LBL teaching.Results The results showed that although the two groups had no significant difference in examinational total score and in foundational subjects,but the trial group had a significant higher score in comprehend subjects.The students exhibited great enthusiasm to the PBL.And the students learned and absorbed more knowledge of gynecology and obstetrics and literature retrieval.The education method played a comprehensive functional role for the teacher-directed and student-oriented tutorial process,and the teaching effects improved.Meanwhile,the teachers need to be prepared with more knowledge to meet the students query.Conclusions:PBL+LBL double-track teaching method can improve the students'activeness and can culture their ability of self-study;and at the same time the new teaching method can remain the systematicness,profundity and extent of knowledge.It is a better way in clinical education,and is well accepted by both students and teachers as it can greatly improve teaching efficacy.

ObjectiveTo improve the teaching quality of medical humanity education in medical university.MethodsA cluster sampling survey was given to 448 sophomores who studied the outline of medical humanities course in military medical university,and the data were descriptively and statistically analyzed.ResultsThe survey shows that 90％ sophomores satisfy with this course,95％ sophomores understand the importance of medical humanity education,and the students have more requirements on education resources and teaching ways.ConclusionOutline of medical humanities course is important to cultivate the medical humanity spirit of medical students,and the course still needs more improvements.

AIM: To detect the changes of inducible nitric oxide synthase (iNOS) expression in kidney following ischemia-reperfusion(I-R)of hindlimbs and to elucidate their significance. METHODS: I-R was established using the occlusion of the femoral arteries for 4 h and re-opening for 2-24 h in rats. The expression of iNOS mRNA,and iNOS protein and the nitrotyrosine (NT),a marker of peroxynitrite (ONOO -),in renal tissue were detected with reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemical technique,respectively. The superoxide dismutase (SOD) activity and malondialdehyde (MDA) contents in renal tissue were spectraphotometrically measured. The observation of pathologic changes of renal tissue was made following the inhibition of iNOS by aminoguanidine (AG). RESULTS: Compared with control group,the relative expression level of iNOS mRNA significantly increased in I-R group. There were more iNOS and more NT positive product in the epithelial cells of renal proximal convoluted tubules and thick segments of Henle′ loops in I-R group than control group. The contents of MDA markedly increased,while the activity of SOD significantly decreased in I-R group,compared to those in the control groups. The pathologic changes of kidney became milder in I-R group following the inhibition of iNOS by AG. CONCLUSION: The expression of iNOS mRNA and protein in renal tissue were significantly upregulated,excess induction of NO contributed to the kidney injury during the I-R of hindlimbs.

AIM: To detect the changes of heme oxygenase-1 (HO-1) expression in kidney following ischemia-reperfusion of hindlimbs and to elucidate their significance. METHODS: Health SD rats were randomly divided into normal (N), sham (S), 4h ischemia without reperfusion (I), 4 h ischemia-2, 6, 12, 18 or 24 h reperfusion (I-R) groups and I-R18h+zinc protoporphyrin (ZnPP) group. I-R was established using the occlusion for 4 h and re-opening for 2-24 h of the femoral arteries. In I-R 18 h+ZnPP group, ZnPP (5 ?mol?kg~(-1) body weight) was intravenously injected 6 h and 12 h after reperfusion, respectively. The expression of HO-1 mRNA in kidney was detected with reverse transcription-polymerase chain reaction (RT-PCR). The expression and location of HO-1 protein were detected with immunohistochemical technique. The observation of pathologic changes of kidney was made following the inhibition of HO-1 by ZnPP. RESULTS: The relative expression level of HO-1 mRNA significantly increased in I-R group, compared to those in the control groups, It was maximal in I-R 18 h group, and thereafter expression level of HO-1 mRNA decreased, however significant expression was still detected in I-R 24 h group (P

Objective To speculate the precipitating factors,clinical features and histopathological changes in patients with granuloma annulare (GA).Methods A study was performed in 53 patients with GA . Results The incidence of female was more prevalent than male in our study. The exposure of sunlight was found more relatedly in GGA than LGA.The onset age of GGA was inclined to be elder and GGA seemed to last longer.The histopathological study showed that palisading granuloma pattern accounted for 71.7% in all patients,and scattered histiocytic infiltration accounted for 28.3%.Such as cryotherapy,topical steroids were used for LGA and systemic administration was an alternative to GGA. Conclusions Ultraviolet may be associated with the development of generalized GA. The most common pattern is the palisading granuloma though the histopathological changes were variable.Topical therapy is effective in LGA,while the systemic therapy is mainly used for GGA.

To foster the medical scientific and humanistic spirit of medical students,a cours "eOutline of medical humanities" was designed and implemented in the Third Military Medi-cal University. This course puts great emphasis on helping students understand the meaning of medical humanities,improving their judgment of the social and moral value of medicine,giving correct guidance to young students as to the essence of medicine,promoting the harmony of medical scientific spirit and medical humanistic spirit of the medical students and making tehm become qualified medical workers.

AIM:To investigate the pathologic changes in the brain and its underlying mechansims during ischemia-reperfusion of rat hindlimbs.METHODS:SD rats were divided into the normal(N), sham(S), 4 h ischemia without reperfusion(I), and 4 h ischemia-2, 6,12,18 or 24 h reperfusion (I-R) groups at random. Ischemia and ischemia-reperfusion were established with the occlusion or/and re-opening of the terminal of abdominal aorta, respectively. The pathologic changes in the brain tissue were morphologically observed. The expression of inducible nitric oxide synthase (iNOS) mRNA, and iNOS protein and the nitrotyrosine, a marker of peroxynitrite (ONOO-)，in the brain tissue were detected with RT-PCR and immunohistochemical technique, respectively. The brain superoxide dismutase (SOD) activity and malondialdehyde (MDA) contents were spectraphotometrically measured.RESULTS:Hydropic degeneration and severe injury to neurons were only showed in I-R group. Expressions of iNOS mRNA and protein were demonstrated in I-R, I and S groups, which were maximal in I-R 6 h group. iNOS positive neurons and microglias were more spread in I-R 6 h group than those in S and I groups. NT positive neurons were localized in the cerebral cortex and hippcampus of I-R 6 h group. The contents of MDA markedly increased, while the activity of SOD significantly decreased in I-R 6 h group compared to the N, S and I groups. There were no significant changes in MDA and SOD in N, S and I groups.CONCLUSION:Severe ischemia-reperfusion of rat hindlimbs could induce brain injury, and its mechanisms might be related to enhanced expression of iNOS-NO-ONOO- in the brain.

AIM:To observe the changes in heme oxygenase-1(HO-1) expression in the lung after ischmia-reperfusion of hind limbs in rats.METHODS:Hind limbs ischemia was made by clamping infrarenal aorta with a microvascular clip and lung injury was made by following reperfusion. Lung tissue was obtained from the animals subjected to sham operation, 4 h ischemia without reperfusion and 4 h, 8 h, 16 h, 24 h, 48 h reperfusion following 4 h ischemia. The levels of HO-1 mRNA and protein were measured at different times by Northern blot and Western blot. Immunohistochemistry technique was used to determine the cell types responsible for limb ischemic reperfusion induced HO-1 expression. RESULTS:After ischemia-reperfusion of limbs, HO-1 mRNA increased by 4 h, reached a peak at 16 h, and returned toward baseline at 24-48 h. This time course correlated with increased HO-1 protein. Immunohistochemical studies showed HO-1expressed in a variety of cell types, including the airway epithelium, alveolar macrophages and vascular smooth muscular cells. There were no positive signals in sham group and ischemia group both in mRNA levels and protein levels. CONCLUSION:The expression of HO-1 in the lung is not induced by limb ischemia or sham operation, but induced by limb reperfusion after ischemia in rats.

Objective To explore the diagnostic value of N‐terminal Pro‐Brain Natriuretic Peptide (NT‐proBNP) in Kawasaki disease (KD) in children .Methods Ninety one children with KD were collected and 80 patients with acute upper respiratory infec‐tion were used as controls .Plasma NT‐pro BNP concentrations and other laboratory date were collected in the acute of KD .The re‐lationships between NT‐pro BNP values and different clinical and laboratory data in the acute phase were sought .Results The mean plasma NT‐pro BNP concentration in patients with KD in the acute phase was (1 042 .38 ± 528 .7)pg/mL ,significantly higher than those of control group(458 .6 ± 412 .3)pg/mL (P<0 .05) .The results of linear correlation analysis indicated that plasma NT‐pro BNP was positively correlated with CRP (r= 0 .442 ,P< 0 .05) ,and negatively correlated with Hematocrit ,Albumin and Na (r= -0 .216 ,r= -0 .204 ,r= -0 .315 ,respectively ;P<0 .05) .According to ROC analysis ,the AUC of NT‐pro BNP for detection of KD were 0 .881 ,sensitivity and specificity was 70 .1% and 84 .0% respectively for the cut‐off value of 530 pg/mL .Conclusion Our findings showed that NT‐proBNP would elevate in the acute stage of KD and was a reliable marker for the diagnosis of KD .A high level of NT‐pro BNP is associated with systemic inflammatory responses and increased vascular permeability .