For adapting the demands of modern society to medical talents,we applied problem-based learning pattern to urology practice teaching.By breaking the limits of subjects,we enable students to acquire more knowledge of science and problem-solving skills and self-learning skills in the limited time available.The role of teacher shifts from imparting knowledge to leaders.

Objective To investigate the risk factors of postoperative infectious complications (PIC) after liver resection for hepatocellular carcinoma (HCC) using evidence based medicine to provide a basis for prediction and prevention of PIC.Methods The fixed-effects or random-effects model was performed on studies on risk factors of PIC in HCC patients published from January 1990 to May 2015 by searching the PubMed,Embase,CNKI,VIP and Wanfang Data.Results Fourteen studies involving HCC 5 841 patients were included in this meta-analysis.The level of serum albumin was significantly lower in the PIC group than the NPIC group (WMD =-1.80,95％ CI:-2..79 ～-0.80 ; P ＜ 0.05) ; Patients with diabetes mellitus had a higher incidence of PIC than those without diabetes mellitus (OR =1.94,95％ CI:1.27 ～ 2.95 ; P ＜ 0.05) ; Patients with operation time less than 5 h had an decreased incidence of PIC than the other group (OR =0.31,95 ％ CI:0.22 ～ 0.45 ; P ＜ 0.05).Patients with blood loss less than 2 000 ml had a lower incidence of PIC than the other group (OR =0.30,95％ CI:0.19 ～ 0.48 ; P ＜ 0.05).Patients with blood transfusion had a higher incidence of PIC than those without transfusion (OR =2.83,95％ CI:2.04 ～ 3.93 ; P ＜ 0.05).Patients with postoperative bile leakage had a higher incidence of PIC than those without bile leakage (OR =3.79,95％ CI:2.06 ～ 6.96; P ＜ 0.05).Patients after primary hepatectomy had a higher incidence of PIC than those after repeat hepatectomy,but there was no significant difference between the two groups (OR =1.52,95％ CI:0.99 ～ 2.33 ; P =0.05).Patients with tumor diameter less than 5 cm had a higher incidence of PIC than the other group,but there was no significant difference between the two groups (OR=1.09,95％CI:0.76 ～1.56; P＞0.05).Conclusion A low level of serum albumin,diabetes mellitus,operation time more than 5 h,blood loss more than 2 000 ml,blood transfusion,bile leakage were risk factors for the development of PIC.

Objective To investigate the result of colonoscopic positioning in laparoscopic treatment of colon tumors . Methods A retrospective analysis was made in 16 cases of colon tumors treated with laparoscopic colon resection from January 2014 to November 2015.During the operation, the lesion could not be locatized and the resection range could not be determinated because the serous layer was not involved or the lesion was located in the lateral abdominal wall .Transanal colonoscopic positioning of the lesion with light transmission method was carried out . Results The pathological changes were found under colonoscopy in all the 16 cases and the laparoscopic resection was successfully completed without conversion to open operation .No missed resection or incorrect resection occurred.The operation time was (112.5 ±31.0) min and the blood loss was (22.8 ±11.2) ml.Among 9 cases of preoperative pathological diagnosis of benign tumors , there were 6 cases of malignant tumors after surgery , including 4 cases of moderately differentiated adenocarcinoma , 1 case of moderate to severe atypical hyperplasia with cancerous lesions , and 1 case of moderately differentiated adenocarcinoma with mucous adenocarcinoma .A total of 15 patients were discharged from hospital at 12-24 days after the operation , whereas 1 patient was dismissed 1 month after the operation due to anastomotic fistula .The 16 patients were followed up for 3 months with no recurrence under colonoscopic examiantion . Conclusions During laparoscopic colon resection , if the tumor can not be locolized , colonoscopic positioning can help prevent missed resection or incorrect resection , which increases the indication and safety of laparoscopic and colonoscopic minimally invasive treatment .It has good clinical application value and deserves further promotion .

Objective To observe the clinical effects of phosphocreatine treatment on left ventricular function and on amino-terminal pro-brain natriuretic peptide (NT-proBNP) level in elderly patients with chronic heart failure. Methods In our department, the 172 elderly patients with chronic heart failure were randomly divided into treatment group and control group (n= 86, each).The control group received routine anti-heart failure treatment. The treatment group received conventional therapy plus creatine phosphate sodium for 4 weeks. The cardiac function was evaluated and the NT-proBNP level was measured in all subjects. Results Four weeks after treatment, the improvements of left ventricular ejection fraction (LVEF), left ventricular end-systolic diameter (LVESD) and left ventricular end-diastolic dimension (LVEDD) were better in treatment group than in control group (all P＜0.05). The plasma NT-proBNP level decreased significantly in treatment group as compared with control group [before treatment: (956.4 ± 644.2) pmol/L and (973.6 ±639.8) pmol/L; after treatment: (414. 5 ± 163.8 ) pmol/L and ( 719.3 ± 477. 5 ) pmol/L, all P＜0. 05]. Conclusions Phosphocreatine could improve left ventricular function and decrease plasma NT-proBNP level in elderly patients with chronic heart failure.

Objective To explore the efficacy and prognostic factors of postoperative intensity?modulated radiotherapy ( IMRT) with or without chemotherapy in rectal cancer. Methods A retrospective analysis was performed on the clinical data of 218 patients with rectal cancer, who underwent postoperative IMRT in our hospital from January 2009 to December 2013. The Kaplan?Meier method was used to calculate survival rate;the log?rank test was used for survival difference analysis and univariate prognostic analysis;the Cox regression model was used for multivariate prognostic analysis. Results The follow?up rate was 97. 7%. The 1?and 3?year overall survival rates were 90. 8% and 75. 2%, respectively, the 1?and 3?year disease?free survival rates were 85. 3% and 70. 5%, respectively, and the 1?and 3?year locoregional recurrence?free survival rates were 96. 7% and 88. 1%, respectively. The incidence of grade 3?4 acute adverse reactions was 28. 4%, mainly manifested as leukopenia ( 13. 8%) and diarrhea ( 11. 0%) . Univariate prognostic analysis showed that preoperative carcinoembryonic antigen ( CEA) and CA199 levels, maximum tumor diameter, tumor location, degree of differentiation, depth of tumor invasion, number of lymph node metastases, TNM stage, perineural invasion, surgical procedure, total mesorectal excision, preoperative bowel obstruction, and preoperative anemia were the predictors of survival ( P=0. 006, 0. 000, 0. 000, 0. 017, 0. 000, 0. 016, 0. 000,0. 011,0. 001,0. 006,0. 037 and 0. 010) . Multivariate prognostic analysis showed that preoperative CEA level, tumor location, TNM stage, preoperative bowel obstruction, and preoperative anemia were the predictors of survival ( P=0. 000,0. 000,0. 000,0. 001 and 0. 001) . Conclusions Postoperative IMRT with or without chemotherapy is an effective method for rectal cancer with mild adverse reactions and high compliance. Preoperative CEA level, tumor position, TNM stage, preoperative bowel obstruction, and preoperative anemia are independent prognostic factors for the overall survival.

Objective To discuss the Survivin protein expression in different salivary gland tumor.(Methods)This experiment was based on tissue chip technology.Expression of Survivin protein in the salivary gland tumor was analyzed with immunohistochemical methods.Results ① Survivin expression showed significant difference in the salivary gland benign and malignant tumors(P0.05).The gland around the malignant tumor showed diversity compared with malignant tumor(P0.05).Conclusion Survivin expression has correlation with the relay tumor canceration,and the gland around malignant tumor has correlation with occurrence,progress,prognosis in the salivary gland malignant tumor,and it is a reliable marker of earlier period diagnosis and prognosis of the malignant tumor of salivary gland.

Objective To investigate the clinical efficacy of percutaneous kyphoplasty(PKP) in treatment of elderly osteoporotic vertebral compression fractures(OVCF).Methods 122 elderly OVCF patients from Oct.2009 to Oct.2013 in Lihuili Hospital of Ningbo Medical Center were selected,and were randomly divided into group A,and group B.There were 61 cases in each group.Group A received percutaneous kyphoplasty(PKP),and group B were treated with percutaneous vertebroplasty(PVP).The two groups were observed in terms of pain,activity,vertebral compression rate and Cobb angles after treatment.The two groups were followed up at least for 3 months.The postoperative side effects were recorded and analyzed.Results After the treatment,the two groups significantly improved in VAS score and activity(P ＜ 0.05),but no significant difference was found between the two groups (P ＞ 0.05).After the treatment,vertebral compression rate and Cobb angle got better than before in the two groups,but group A recovered more obviously than group B,and the difference had statistical significance (P ＜ 0.05).The postoperative recurrence rate was 18.03 ％ (11/61) in the observation group and 9.84 ％ (6/61) in the control group,and the difference had statistical significance (P ＜ 0.05).Conclusion PKP and PVP can significantly relieve pain,but PKP had better effect than PVP in vertebral body and spinal kyphosis improvement,which is worth of clinical application.

Infectious bursal disease virus (IBDV) is an important member of the Birnaviridae family. IBUV mainly targets the bursa of Fabricius, the central immune organ of chicken, resulting in chicken infectious bursal disease (IBD). IBD represents one of the great challenges for ongoing development of the poultry industry. Reverse genetics for IBDV emerged over twenty years ago. Since then, the technologies behind virus rescue have continually improved leading to a deep understanding of IBDV gene function and tailored vaccine development. Our lab has also been instrumental in the field of IBDV research. Here we review studies on the pathogenic mechanism and the effective prevention and control of IBD.
Animals ; Birnaviridae Infections ; virology ; Chickens ; Infectious bursal disease virus ; genetics ; physiology ; Poultry Products ; virology ; Reverse Genetics

BACKGROUND:Studies have shown that bisphosphonates inhibit osteoclast resorption, but whether cathepsin K, a key cytokine of bone resorption, plays an effect has rarely been reported.
OBJECTIVE:To study the effect of bisphosphonate on capthesin K and bone resorption function during osteoclast differentiation.
METHODS:Osteoclasts were cultured by mouse monocyte-macrophage cellline-RAW264.7. The cells were divided into two groups:control group, treated with 100μg/L receptor activator of nuclear factorκB ligand factor;alendronate group, treated with 100μg/L receptor activator of nuclear factorκB ligand factor+10-7 mol/L alendronate. Osteoclastogenesis and resorption function of osteoclasts were examined at 7 days of culture and gene expression of capthesin K was detected by immunofluorescence method at 72 hours of culture. Western blot assay was used to detect capthesin K protein expression at 72 hours of culture.
RESULTS AND CONCLUSION:Tartrate-resistant acid phosphatase positive multinuclear cells were observed and resorption lacunae formed in two groups. Control group showed the higher number of tartrate-resistant acid phosphatase positive multinuclear cells and larger size of resorption lacunae than the alendronate group (P<0.01). Immunofluorescence showed expression of capthesin K was higher in the control group than the alendronate group (P<0.01);furthermore, the protein expression of capthesin K was also lower in the alendronate group than the control group (P<0.01). These findings indicate that bisphosphonates could strongly inhibit osteoclastogenesis and its resorption function by inhibiting gene expression of capthesin K.

BACKGROUND:Tartrate-resistant acid phosphatase is a specific marker for osteoclast differentiation and bone resorption, which is a sign of osteoclast maturity.
OBJECTIVE:To study the effect of alendronate on tartrate-resistant acid phosphatase related to osteoclast differentiation and bone resorption.
METHODOsteoclasts were cultured by mouse monocyte-macrophage cellline-RAW264.7. The cells were divided into two groupcontrol group, treated with 100μg/L receptor activator of nuclear factorκB ligand factor;alendronate group, treated with 100μg/L receptor activator of nuclear factorκB ligand factor+10-7 mol/L alendronate. Osteoclastogenesis and resorption function of osteoclasts were examined at 7 days of culture. Gene expression of tartrate-resistant acid phosphatase was detected by immunofluorescence method. Western blot assay was used to detect protein expression of tartrate-resistant acid phosphatase.
RESULTS AND CONCLUSION:Tartrate-resistant acid phosphatase positive multinuclear cells were observed and resorption lacunae formed in two groups. Control group showed the higher number of tartrate-resistant acid phosphatase positive multinuclear cells and larger size of resorption lacunae than the alendronate group (P<0.01). Immunofluorescence showed expression of tartrate-resistant acid phosphatase was higher in the control group than the alendronate group (P<0.01);furthermore, the protein expression of tartrate-resistant acid phosphatase was also lower in the alendronate group than the control group (P<0.01). These findings indicate that bisphosphonates could strongly inhibit osteoclastogenesis and its resorption function by inhibiting protein expression of tartrate-resistant acid phosphatase.