Objective Set up virtual experimental teaching platform of medical molecular biology, and explore effective operating system of virtual experiment teaching. Methods 400 students of majored in clinical medicine in Kunming Medical University in Grade 2011 were randomly divided into the virtual experiment teaching group (n = 195 ) and the traditional experiment teaching group (n = 205 ). We realized the teaching effect by questionnaire survey, and analyzed the final exam results of two groups statistically. Results The experiment teaching way of virtual experiment has been widely accepted by students, and it could help students to understand and master experiment operations and theory knowledges.No statistical difference was found between two groups on the final exam. Conclusion Virtual experiment technology as a new teaching method has a lot of advantages, but it can't completely replace traditional experiments. We should use both the two kinds of teaching methods reasonally in the medical molecular biology experiment teaching.

Objective To investigate the feasibility and clinical value of ultrasound elastography in assessment of sternocleidomastoid fibrosis in patients after radiotherapy for nasopharyngeal carcinoma . Methods Forty‐five patients with nasopharyngeal carcinoma after radiotherapy ( study group) and 52 healthy volunteers ( control group ) underwent ultrasound elastography . Bilateral sternocleidomastoid elasticity score , thickness , width , resistance index ( RI ) , and pulsatility index ( PI ) were analyzed and compared . Results The sternocleidomastoid elastography in study group was mainly blue ,and that in control group was mainly green . The difference of sternocleidomastoid elasticity score ,width ,and thickness was significant between study group and control group ( P <0 .05) ,reseparately . There was no significiant difference in the RI ,PI between study group and control group ( P > 0 .05) . Conclusions Ultrasound elastography could be effectively and noninvasively used for evaluating the sternocleidomastoid fibrosis in patients after radiotherapy for nasopharyngeal carcinoma . It has a potential clinical value in the grading and classification of fibrosis .

Objective To explore the value of multislice computed tomography (MSCT) in diagnosis of vascular rings associated airway abnormalities in children. Methods CT image data were retrospective analysis in 159 cases of vascular rings, including multiplanar reconstruction (MPR), maximum and minimum density project reconstructions. The relationship between the vascular rings and airway had been observed. Results Of 159 cases of vascular rings as-sociated with airway stenosis in 101 cases, the main airway stenosis in 79 cases, left main bronchial stenosis in 14 cas-es, right main bronchus in 8 cases, tracheal bridge in 14 cases, tracheal bronchial in 11 cases, symmetry bronchial in 2 cases. Conclusions Vascular ring often causes compression of airway narrow and dysplasia. MSCT can clearly display vascular rings and its relationship with airway, providing help for surgical and reasonable treatment.

Objective To discuss the diagnostic value of ultrasonography in piriformis syndrome . Methods Ultrasonography was performed in thirty‐eight patients with unilateral piriformis syndrome and forty healthy volunteers . The morphological structures and the internal echoes of their bilateral piriformises and sciatic nerves were observed and their thicknesses were measured . These parameters of the patients and voluteers were recorded and compared . Results The ultrasonographic images of piriformis and sciatic nerve of the healthy voluteers showed no abnormal change . The thickness difference of their bilateral piriformises and sciatic nerves had no statistical significance ( P > 0 .05 ) . The ultrasonography image of the morphological structure and the internal echo of the sick side piriformis and sciatic nerve of the patients with piriformis syndrome showed a change ,that the sick side piriformis was significantly thicker than the healthy side piriformis [(25 .74 ± 3 .12) mm vs (22 .48 ± 2 .60) mm , P < 0 .05] . The area under the operator characteristic curve ( AUC ) for the thickness difference of bilateral piriformises in diagnosing piriformis syndrome was 0 .896 ,with the optimal cut‐off value of 2 .15 mm . However ,the thickness difference of their bilateral sciatic nerves had no statistical significance ( P >0 .05) . Conclusions Ultrasonography can show piriformis and sciatic nerve clearly . The ultrasonographic images and the thickness difference of the bilateral piriformises is helpful to diagnose piriformis syndrome ,and can provide more informations for clinic .

Objective To investigate the effect of macrophages on podocytes apoptosis in diabetic nephropathy. Methods Differentiated mouse macrophages (RAW264.7) were exposed to normal glucose, high glucose, then the conditioned media (CM) was collected and considered as NC-CM or HG-CM, respectively. Western blotting and immunofluorescent staining were used to detect the specific markers for M1 macrophages (iNOS) and M2 macrophages (MR). ELISA was used to detect the concentration of TNF-α in the CM. Then normal PRMI 1640 media (control), NC-CM or HG-CM was added to podocytes. In some experiments, ROS inhibitors (Tempo), p38 MAPK inhibitor (SB203580), anti-TNF-α neutralizing antibody, and IgG1 isotype control were respectively added to cells with HG-CM. Besides, recombinant mouse TNF-α alone was applied to incubate podocytes. Podocytes apoptosis was accessed by Annexin V-FITC/PI and Hoechst33342 staining. DCFH-DA staining was used to analyse ROS level. Western blotting was used to detect cleaved casepase-3, p38MAPK, and p-p38MAPK protein. Results Macrophages were activated when exposed to high glucose, displaying pro-inflammatory M1 polarization with higher iNOS and lower MR expression. HG-CM but not NC-CM trigged podocytes apoptosis, up-regulated ROS, cleaved casepase-3 and p-p38MAPK. However, the podocytes apoptosis trigged by HG-CM was abolished by either a ROS inhibitor (Tempo) or a p38 MAPK inhibitor (SB203580). Additionally, TNF-α was increased in the HG-CM. TNF-α protein in macrophage was aslo increased when exposed to high glucose. Anti-TNF-α neutralizing antibody blunted the apoptotic response, excess ROS generation and p-p38 MPAK expression in podocytes induced by HG-CM. Moreover, addition of recombinant TNF-α similarly led to podocytes apoptosis, increased ROS and p38 MPAK expression. Conclusion M1 macrophages activated by high glucose released TNF-α to promote podocytes apoptosis via ROS-p38 MAPK pathway.

Objective To investigate the influence of Addie injection combined with R -CHOP chemotherapy on immune function and quality of life in patients with non -Hodgkin's lymphoma.Methods A total of 76 patients with non-Hodgkin's lymphoma in the People's Hospital of Wenzhou from June 2015 to March 2017 were selected and randomly divided into the control group and the study group according to the digital table , with 38 cases in each group.The control group was treated with R -CHOP chemotherapy ,and the study group was treated with R -CHOP chemotherapy combined with Addie injection .After treatment,the clinical efficacy,toxic and side effects,immune function indicators ( CD3+,CD4+,CD8+,CD4+/CD8+) and quality of life ( KPS) score of the two groups were statistically analyzed.Results The total effective rate of the study group was 86.84％,which was higher than 65.79％ of the control group (χ2 =4.659,P<0.05).The incidence rates of diarrhea (18.42％),vomit and nausea(21.05％),bone marrow inhibition ( 23 .68％) and leukocyte reduction ( 21 .05％) in the study group were lower than those in the control group(42.11％,47.37％,47.37％,42.11％,χ2 =5.050,5.846,4.653,3.897,all P<0.05).There were no statistically significant differences between the two groups in CD 3+, CD4+, CD8+, CD4+/CD8+before treatment ( all P>0.05).After treatment,the CD3+,CD4+and CD4+/CD8+in the study group were higher than those in the control group,and the CD8+in the study group was lower than that in the control group , the differences were statistically significant(t=5.436,8.857,2.515,5.314,all P<0.05).After treatment,the scores of KPS of the two groups were higher than those before treatment(all P<0.05),and the KPS score of the study group was higher than that of the control group[(78.61 ±4.24)points vs.(70.04 ±4.10)points,t=8.957,P<0.05].Conclusion Addie injection combined with R-CHOP chemotherapy in the treatment of patients with non -Hodgkin's lymphoma can effectively improve the immune function of the patients ,reduce the incidence of side effects ,and improve the effect of treatment and the quality of life .

The article intends to analyze the software safety problems in high-risk medical devices based on the investigation of software R & D Quality control procedures in Shanghai medical device manufacturing enterprises. The idea of improving the software pre-market safety evaluation method in China is also explored through the way of comparing those in U.S. and Europe.
China ; Equipment Safety ; methods ; Europe ; Quality Control ; Safety Management ; methods ; Software ; United States

Objective To investigate the function of JAK2-STAT3 signaling pathway in pancreatic injury and systematic inflammatory response in rats with acute necrotizing pancreatitis ( ANP) . Methods SD rats were randomly divided into the ANP group (n=48), ANP+JAK2 inhibitor Ruxolitinib group (ANP+R group, n=48), ANP+STAT3 inhibitot Stattic group (ANP+S group, n=48), ANP+Ruxolitinib+Stattic group (ANP+R+S group, n=48), and sham operation group (SO group, n=48). 5％ sodium taurocholate injection via retrograde pancreatobiliary duct was used to establish ANP model. Blood samples from abdominal aorta and pancreatic tissue were collected after 3 h, 6 h, 12 h and 18 h after modeling. Serum amylase (AMY) and tumor necrosis factor-α(TNF-α) and interleukin-4 (IL-4) were tested. JAK2 and STAT3 mRNA expression and protein expression of p-JAK2 and p-STAT3 in pancreas were examined by RT qPCR and western blot, respectively. Results AMY, TNF-α and IL-4 in plasma, and JAK2 mRNA, STAT3 mRNA, p-JAK2 protein and p-STAT3 protein at different time points in ANP group were all obviously higher than those in SO group(P<0. 05). Serum AMY, TNF-αand IL-4 in ANP+R group, ANP+S group and ANP+R+S group at different time points were lower than those in ANP group [12 h (5391 ± 1009),(6130 ± 1227),(4818 ± 992)U/L vs (8524 ± 1360) U/L;(147.25 ± 27.85),(156.25 ± 23.17),(127.87 ± 21.39) ng/L vs (187.58 ±20.09)ng/L;(45.89 ±16.95),(50.19 ±15.87),(38.87 ±14.03)ng/L vs (58.85 ±9.34)ng/L] . JAK2 mRNA and p-JAK2 protein,STAT3 mRNA and p-STAT3 protein in ANP+R group and ANP+R+S group at different time points were obviously lower than those in ANP group (12 h 0. 357 ± 0. 091 vs 0. 597 ± 0. 121,1. 115 ± 0. 203 vs 1. 217 ± 0. 213,0. 361 ± 0. 089 vs 0. 489 ± 0. 097,0. 965 ± 0. 189 vs 1. 128 ± 0. 217, 0. 362 ± 0. 092 vs 0. 597 ± 0. 121,1. 107 ± 0. 212 vs 1. 217 ± 0. 213,0. 297 ± 0. 087 vs 0. 489 ± 0. 097,0. 713 ± 0. 184 vs 1. 128 ± 0. 217). STAT3 mRNA and p-STAT3 protein in ANP+S group were obviously lower than those in ANP group(0. 319 ± 0. 107 vs 0. 489 ± 0. 097,0. 849 ± 0. 177 vs 1. 128 ± 0. 217), and the difference was statistically different (P<0.05). Conclusions The activation of JAK2-STAT3 signaling pathway in pancreas may play a key role in the pathogenesis of systematic inflammatory response in ANP.

ObjectiveTo investigate the prevalence and influencing factors of diabetes mellitus among community population in Songjiang District of Shanghai， and to provide scientific basis for prevention and treatment of diabetes mellitus. MethodsBased on the baseline data of the Shanghai Suburban Adult Cohort （2016‒2017） and local medication database， the prevalence of diabetes in the cohort was described， and the influencing factors for the prevalence of diabetes in different genders were analyzed. ResultsAmong 35 928 participants， males accounted for 40.57%， and the median age was 58 years old. There were 5 342 diabetic patients with a crude prevalence rate of 14.87% and the standardized prevalence rate of diabetes mellitus was 7.57%. The prevalence rate of diabetes in males （15.81%） was significantly higher than that in females （14.23%， P<0.001）. Multivariate logistic regression analysis showed that the following factors were associated with high risk of diabetes mellitus in males： 40‒59 age group （OR=7.111，95%CI：4.900‒10.320）， 60‒74 age group （OR=8.994，95%CI：6.154‒13.144）， family history of diabetes （OR=3.369，95%CI：2.963‒3.83）， overweight （OR=1.272，95%CI：1.123‒1.439）， obesity （OR=1.912，95%CI：1.623‒2.252）， hypertension （OR=1.685，95%CI：1.512‒1.877）， and dyslipidemia （OR=1.396，95%CI：1.263‒1.542）. In females， the high risk of diabetes was associated with： 40‒59 age group （OR=2.718，95%CI：1.838‒4.02）， 60‒74 age group （OR=3.517，95%CI：2.34‒5.286）， family history of diabetes （OR=3.071，95%CI：2.761‒3.416）， overweight （OR=1.254，95%CI：1.125‒1.398）， obesity （OR=2.018，95%CI：1.764‒2.308）， central obesity （OR=1.515，95%CI：1.357‒1.692）， hypertension （OR=2.128，95%CI：1.929‒2.347）， dyslipidemia （OR=1.506，95%CI：1.379‒1.644）， exercise （OR=1.241，95%CI：1.137‒1.355）， and menopause （OR=1.967，95%CI：1.693‒2.286）. ConclusionThe prevalence rate of diabetes is high in Shanghai， and the related factors are different in different gender groups.

ObjectiveTo evaluate the efficacy of three screening questionnaires for COPD in the community residents of Songjiang District， Shanghai， and to provide a basis for selecting COPD screening questionnaire and process that are more suitable. MethodsCommunity residents aged 40 years or over were randomly selected from the Shanghai Suburban Adult Cohort and Biobank for the study with screening questionnaires and spirometry. Questionnaires included the COPD screening questionnaire （COPD-SQ）， the COPD population screener （COPD-PS） and the revised COPD diagnostic questionnaire （revised-CDQ）. Evaluation of the efficacy of these questionnaires was based on the area under the receiver operating characteristic curve （AUC） of the subjects. DeLong test was used to compare the accuracy of different questionnaires； Z test was used to compare the accuracy of different cut-off values for the same questionnaire. ResultsAmong 3 184 community residents， a total of 259 （8.1%） COPD patients were screened by spirometry. AUC values of these 3 screening questionnaires were >0.7 indicating that they were reliable COPD screening tools. The sensitivity and specificity of the questionnaires at the recommended cut-off values were COPD-SQ （63.7% and 72.2%）， COPD-PS （12.0% and 96.1%）， and revised CDQ （78.8% and 52.7%）， with the COPD-SQ having the highest screening accuracy （AUC=0.754）. The optimal and recommended cut-off values for the three questionnaires differed in this population， but the difference in accuracy was statistically significant only for COPD-PS. The optimal cut-off values for the three questionnaires differed between male and female， and the sensitivity and accuracy of COPD-SQ and COPD-PS improved when lower cut-off values were used for women. The AUC was greater when two questionnaires were utilized simultaneously for screening， but the differences were not statistically significant. ConclusionThe COPD-SQ is recommended for primary COPD screening； a lower cut-off value for women should be considered. The COPD screening questionnaire needs to be further improved for the early diagnosis and treatment of COPD patients.