Language,as a cartier of specified social culture,is closely and complementarily associated with it.Considering the especial education targets of medical universities and colleges,the present curriculum and the trend of international communication,College English is obliged to focus on humanistic value and necessarily plays its constructive role in heightening students' humanistic quality.

Objective: To search for a new method for synthesis of 9 fluorenylmethoxycarbonyl amino acid tert-butyl ester. Methods: Glycine, L-Proline, and L-Phenylanaline were separately allowed to react with 9-fluorenylnmthylchloroformate to obtain the corresponding 9-fluorenylmethoxycarbonyl amino acids. With 4-(dimethylamine) pyridine (DMAP) used as catalyst, the 9-fluorenylmethoxycarbonyl amino acids were allowed to react with Tert butyl dicarbonate for the corresponding 9-fluorenylmethoxycarbonyl amino acid tert-butyl esters. Results: Three 9-fluorenylmethoxycarbonyI amino acid tert-butyl esters were successfully synthesized by this method and their structures were confirmed by 1 H NMR. Conclusion: Ours is a simple method with mild condition and high yielding rate for synthesis of 9-fluorenylmethoxycarbonyl amino acid tert-butyl esters.

Brain metastasis is among the most common complications of non-small celllung cancer (NSCLC) and may obviously influence the survival and quality of life in the NSCLC patients. Recently, the development in traditional treatments, the widely-used micro-molecular targeted drugs, and the combined treatment have improved the overall survival and the quality of life of these patients. In addition, the exploration of new therapeutic targets and cognitive function protective methods for current treatments also deserves at-tention. This review emphasizes the relevant clinical and basic problems and the therapeutic strategies in NSCLC with brain metastases.

The progression of liver fibrosis directly affects treatment options and prognosis.Early diagnosis and classification of liver fibrosis and dynamic monitoring are clinically needed.Noninvasive diagnostic techniques can avoid or reduce liver biopsy to enable early identifica-tion of liver fibrosis and to dynamically monitor the progression of fibrosis.But various limitations have restricted its application.Noninvasive diagnostic techniques,such as liver transient elastography using the different probe mode,controlled attenuation parameter,spleen stiffness measurement,ultrasound-based transient elastography for the early prediction of hepatic fibrosis,and risk assessment of hepatitis B virus-related hepatocellular carcinoma,have been applied in clinical studies.In order to better understand and apply these diagnostic models,the progress in clinical studies of noninvasive diagnosis of liver fibrosis,as well as the limitations,is reviewed.

Objective To explore the effect and experience of problem-based (PBL) teaching in neurosurgical clinical training and improve the quality of the neurosurgical clinical training. Methods 600 clinical medical students of Grade 2011 in their probation in our department of neurosurgery were chosen as the subjects of study and were randomly divided into the experimental (PBL, 15 groups, 20 people/group, over 300 people) and control groups (CBL+ LBL, 15 groups, 20 people/group, over 300 people). In experimental group, PBL which is a problem-based, student-centered and teacher-directed pedagogy was adopted. In control group, CBL (case-based learning) + LBL (lecture-based learning) were adopted. After probation, two groups of students had the unified test and assessed their teaching methods by questionnaire survey and at the same time, the questionnaire survey about PBL' impact on the various aspects was done only to experimental group students. SPSS 15.0 software was used to do statistical analysis and data were processed by description analysis, t test, Mann-Whitney U test and correlation analysis. Results The scores of theoretical knowledge and general ability in PBL group [(40.57 ±3.24), (41.23 ±4.56) individually] were higher than these in control group [(37.21 ±4.05), (36.51±4.11) individually]. The differences demonstrated statistically meanings. Through the surveys, the students in experimental group showed the high satisfaction (97.0%, n=291) in PBL teaching. Most of the students considered that their abilities of team cooperation (96.7%, n=290), and self-directed learning (92.7%, n=278) were improved by PBL teaching. The students in experimental group illustrated their attitudes in satisfaction of teaching; interests of clinical training, participation of teaching and understanding of knowledge were superior to the control group. The differences demonstrated statisti-cally meanings. Conclusion PBL teaching got a good effect in neurosurgical clinical training. This method, which improved students' participation and motivation of study and contributed to the training of medical students' comprehensive abilities, is suitable for modern neurosurgical clinical training.

Objective To discuss the value of amnionic fluid lamellar body count(LBC) as a predictor of fetal lung maturity. Methods Amnionic fluid was obtained during the cesarean section of 41 normal term pregnancies. LBC was performed on each specimen, and lecithin-sphingomyelin(L/S) ratio was detected simultaneously. Results (1)Amnionic fluid LBC was (86?43)?10 3 (72.5?10 3~99.4?10 3) in normal term pregnancy. (2) Positive correlation was shown between the amnionic fluid LBC and L/S ratio(r=0.66,P=0.001). Conclusion The LBC is a rapid and accurate method to determine the fetal lung maturity.

Objective To investigate the effects of goal‐directed volume therapy (GDVT )on the intracranial pressure(ICP) and the balance of cerebral oxygen consumption and supply in selective neurosurgery. Methods Twenty‐four patients sched‐uled for intracranial tumor resection were randomly divided into 2 groups:conventional fluid management group (group C ,n=12) and GDVT group(group G ,n=12). Patients in group C received introperative fluid transfusion according to classical fluid management strategies while those in group G received GDT according to stroke volume variation (SVV) ,guided by Flotrac‐Vigileo system.Mean arterial pressure(MAP) ,heart rate(HR) ,cardiac index(CI) ,ICP ,SVV and jugular bulb oxygen saturation (SjvO2 )were recorded before the anesthesia induction(T1 ) ,at the moment of intubation(T2 ) ,at the moment of opening the hard meninges(T3),1hafteropeningthehardmeninges(T4),andattheendofthesurgery(T5).Thecerebraloxygenextractionra‐tio(CERO2 )was calculated. The duration of surgery ,crystalloid volume ,colloid volume ,blood transfusion volume ,urinary output and bleeding volume were recorded as well.Results The colloid transfusion volume ,the total fluid transfusion volume and uri‐nary output were significantly increased in group G when compared with those in group C (P<0.05).MAP ,CI ,and SjvO2 were much higher and CERO2 were much lower at T4 and T5 in group G than in group C(P<0.05). There was no significant differ‐ence in the ICP at each time point between groups G and C (P>0.05).Conclusion Goal‐directed fluid therapy optimizes the cardiac preload without increasing the ICP in selective neurosurgery ,and it also improves the balance of cerebral oxygen con‐sumption and supply.

Objective:To investigate the effect of heat shock protein 60(HSP60) on the functions of dendritic cells of ApoE-/-mice (mDCs) in vitro by signal transduction of mitogen-activated protein kinase (MAPK) family mediated by Toll-like receptors (TLRs).Methods:Myeloid mDCs were extracted in vitro from ApoE-/-mouse marrow,which were incubated as atherosclerotic animal model,and divided into three groups:HSP group,LPS group and control group.The three groups of mDCs were incubated to mature with mHSP60,LPS and normal saline,respectively and then examined the expression of TLR protein and mRNA by flow cytometry and real-time RT-PCR.In addition,the expression level of CD80 was examined by flow cytometry.The expression of MAPK family proteins was determined by Western blot analysis.The levels of cytokines secreted by mDCs,such as IL-6 and TNF-?,were analyzed by ELISA.Results:The expression of TLRs and MAPK families (p38 and ERK) was increased in the samples of HSP group,when compared with control group (P0.05).Conclusion:HSP60 is involved in activation of mDCs of atherosclerotic animal model by means of the signal transduction of MAPK family mediated by TLRs.

Objective To investigate the expression of E26 transformation-specific-1 (E26ts-1),matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) in choroidal melanoma and the correlation with the tumor′s infiltration and metastasis. Methods Immunohistochemistry was used to detect the expression of E26ts-1,MMP-1and TIMP-1 in 78 cases of choroidal melanoma who were divided into shuttle-cells,paraepithelial-cells and mixed-cells type according to the configuration of tumor cells.The patients were followed up and their average existing time was calculated.The results were statistically computed with statistic SPSS 10.0 package. Results In the 78 cases,shuttle-cells type was found in 21,paraepithelial-cells type in 34,and mixed-cells type in 23. Expression of TIMP-1was low in uveal melanoma,while expression of E26ts-1 and MMP-1 was obviously found in the three types of choroidal melanoma;the sequence of expression intensity was shuttle-cells,mixed-cells and paraepithelial-cells type.Among 37 cases who had been followed up,the shuttle-cells type was in 18 with the average existing time of (78.33?24.69) months,the mixed-cells type was in 10 with the average existing time of (61.44?20.46) months,and the paraepithelial-cells type was in 9 with the average existing time of (36.76?12.19) months.The existing time was negative correlated with the intensity of expresion of E26ts-1 and MMP-1. Conclusion The high expression of E26ts-1 and MMP-1and low expression of TIMP-1may relate to the choroidal melanoma′s infiltration and metastasis.

Objective To investigate the therapeutical effect of Tetrandrine(Tet)combined with Glutathione(GSH)in rats with Parkinson's disease(PD).Methods The PD model rats were established through stereotactic microinjection of 6-hydroxydopamine,then they were randomly divided into PD group,GSH group,L-dopa group,GSH+Tet+L-dopa group and GSH+Tet group.The rats were peritoneal injected with corresponding medicines.The circling behavior of rats were observed induced by Apomorphine.The levels of GSH in substantia nigra and MAO-B in striatum were assayed after treatment,the numbers of dopaminergic neuron were observed by immunohistochemistry and the contents of TH mRNA were also be assayed in each group.Results(1)Compared with pretherapy,the rotation times of groups L-dopa,GSH +Tet+L-dopa,GSH+Tet had statistical significance(P