PBL teacheing mode has satisfactory postive influence to the learning motivation,because it has a different characteristic compared with the traditional teaching mode,and can stimulate the curiosity and the desire of learning more effectively,thus arousing the initiative of the students. It can also cultivate their spirit of master and consciousness of responsibility more effectively,and it is beneficial to teaching students in accordance with their aptitude and developing their personality.In the course of the PBL teaching mode,the principles of moderate difficulty,precise occasion,in association with practice and encourage by feedback should be paid enough attention to.

The impacts of humanistic quality development for medical students include various factors such as family,society and school education,in which family influence plays a direct role,social environment plays a decisive role,and school education plays a leading role.We must pay attention to and coordinate various factors,give full play to the leading role of school education,improve humanistic education,guide and promote humanistic quality development effectively for medical students.

Objective To evaluate the efficacy and safety of lamivudine combined with thymosin α1 therapy for patients with chronic hepatitis B.Methods Sixty-eight eligible patients with chronic hepatitis B were enrolled in this multi-center randomized controlled rlinical trial.Patients were randomized into the trial group and the control group(n=34 for each).Patients in trial group received thymosin α1 for 6 months and lamivudine for 12 menths:patients in control group received lamivudine for 12 months only.The rates of serum HBV DNA clearance.HBeAg loss,HBeAg seroconversion,ALT normalization and the safety of thymosin α1 were observed at 3rd.6th,12th and 18th month during and after the treatment.Results At 12th month of the treatment,there were significant differences in the rates of serum HBV DNA clearance,HBeAg loss and ALT normalization between two groups(χ2=31.17,7.17 and 5.92,P＜0.05);at 6th month after the treatment.there were significant differences in the rates of sernm HBV DNA clearance and HBeAg loss between two groups(χ2=4.53 and 7.17,P＜0.05).HBV DNA was not detected in 2 patients during 6-month follow-up study and no sever side effect was observed throughout the study.Conclusion The conlbination of lamivudine and thymosin α1 is safe and has better effect than the monotherapy of lamivudine in patients with chronic hepatitis B.

Objective To understand the anxiety among gerontal patients with osteoporosis,and to analyze the correlated factors of the anxiety.Methods The social information of the gerontal patients with osteoporosis were investigated,as well as by SAS for the anxiety,and by NRS,PSQI,AHSMSRS for their pain level,sleep quality and healthy management.Results The incidence rate of anxiety was 20.3%,and the average score was (41 .1 4 ± 9.71 )points.Some factors had influence upon the rate,which included sex,month income,sleep quality,self -care ability,pain level,self -management and exercise.Multivariate logistic regression analysis showed that exercise and pain level were the major risk factors.The differences were statistically significant(t =3.033,2.727,P =0.003, 0.007).Conclusion It's higher that the incidence rate of anxiety among gerontal patients with osteoporosis maybe influenced by species of factors,and the quality of life among them needs to be improved by intervention clinically implicated in those factors.

AIM: To establish a method for the quality standard of Chanfukang Granules (Radix Astragali, Herba Leonuri, Fructus Aurantii, Herba Agrimoniae, Radix Rehmanniae, etc.). METHODS: TLC was used for identification of Herba Leonuri, Fructus Aurantii, Herba Agrimoniae, Radix Rehmanniae. The content of astragaloside Ⅳ was determined by HPLC-ELSD. RESULTS: The TLC identification was highly specific and the spots clear and concentrated. The linear range of astragaloside Ⅳ was 0.336-2.016 ?g, r=0.999 4. The average recovery was 97.13% and RSD was 1.3%. CONCLUSION: The method is simple and accurate. It can be used for quality control of Chanfukang Granules.

A UPLC-MS/MS method based on metabonomic skills was developed to study the serum metabolic changes of rats after acute liver injury induced by CCl4 and to evaluate the action mechanism of Si-Ni-San. The integrated data were exported for principal components analysis (PCA) by using SIMCA-P software, in order to find the potential biomarkers. It showed that clear separation of healthy control group, model group, silymarin group, Si-Ni-San group was achieved by using the PCA method. Nine significantly changed metabolites were identified as potential biomarkers of acute liver injury. Compared with the health control group, the model group rats showed higher levels of phenylalanine, tryptophan and GCDCA together with lower levels of LPC 16 : 0, LPC 18 : 0, LPC 18 : 1, LPC 16 : 1, LPC 20 : 4 and LPC 22 : 6. These changes of serum metabolites suggested that the disorders of amino acid metabolism, lipid metabolism, bile acid biosynthesis and anti-oxidative damage were related to acute liver injury induced by CCl4. Si-Ni-San might have the anti-liver injury effect on all these four metabolic pathways.

Construction of learning-oriented hospital must establish a clear goal,and under the guidance of the target,comrehensive mearures of whole advancement must be adopted and staffs study must be emphasized according to their different needs to motivate them,and meanwhile incentive mechanism should be established to realize the benign circulation and sustainable development of construction of learning-oriented hospital.

Objective To evaluate the efficacy and safety of the transobturator tension-free vaginal tape (TVT-O) surgery, a minimally invasive surgery for treating patients with the stress urinary incontinence (SUI). Methods 28 cases with female stress uri-nary incontinence treated by TVT-O procedure from April 2006 to June 2008 were retrospectively analyzed. The follow-up time is from 4 to 24 months. Results The mean operation time was 23 min (rang 10～30 min) and the mean intraoperative bleeding was 24 ml (range 15～40 ml). An indwelling catheter had been used for 3 d because of urinary retention in 3 cases. 24 patients(85.7%)reached complete control after the surgery,effective control in 4 patients(14.35%). Conclusions TVT-O surgery is an effective, safe, minimally invasive management to treat the stress urinary incontinence.

[Objective] To investigate the inhibitory effect of CTLA-4Ig fusion protein on atherosclerosis in the mice with an apolipoprotein-E gene defect fed on cholesterol diet.[Methods] Twenty-five male 10-week-old ApoE-/- mice were selected and fed on cholesterol diet for 4 weeks,5 out of which were executed at random as control group and their pathological sections were kept to observe the early fatty streaks.The other 20,divided into CTLA-4Ig treatment group,PBS group,IgG1 group,and blank group at random,5 in each.Three groups were given intraperitoneal injection of CTLA-4Ig (10 μg per time),PBS (100 μL per time),Rat-IgG1 (10 μg per time) respectively,twice a week,for 8 weeks.The blank group has no treatment.Followed by 8-week treatment,the whole aorta from the root to crotch of iliac artery was separated after anesthesia with the intraperitoneal injection of 1 % pentobarbital.Subsequently,the area ratio of plaque and lumen,the thickness ratio of endangium and tunica media,the lipid-soaking extent intra-plaque and the content of collagen fibrils and smooth muscle cells intra-plaque were analyzed by image-processing soft.[Results] After fed on cholesterol diet for 4 weeks,there were obviously atherosclerosis in the aorta in the ApoE-/- mice.There were typical atherosclerotic plaque in ApoE-/- mice fed on cholesterol diet after another 8 weeks.The area ratios of plaque and lumen in CTLA-4Ig group,PBS group,IgG1 group,and blank group were 0.27 ± 0.08,0.40 ± 0.08,0.43 ± 0.08,and 0.46 ± 0.10,and obviously increased than those in control group (0.05 ± 0.01,P ＜ 0.05).The thickness ratios of endangium and tunica media in four groups were 2.6 ± 0.6,6.0 ± 0.9,5.7 ± 0.8,and 5.9 ± 0.6 and obviously increased than those in control group (0.5 ± 0.1,P ＜ 0.05).The lipid-soaking extent intra-plaque in experimental groups were 26.0 ± 3.0,40.8 ± 5.7,40.6 ± 3.0,and 43.2 ± 5.7,and were obviously increased than those in control group (7.2 ± 1.4,P ＜ 0.05 ).It was found that the area ratio of plaque and lumen,the thickness ratio of endangium and tunica media,and the lipid-soaking extent intra-plaque in CTLA-4Ig group were significantly lower than those in PBS group,IgG1 group,and blank group (P ＜ 0.05),but there was no significant difference in those between the PBS group,IgG1 group,and blank group (P ＞ 0.05).The content of collagen fibrils in CTLA-4Ig group were 16.0 ± 1.1 and higher than those in PBS group,IgG1 group,and blank group (8.6 ± 1.2,9.2 ± 1.5,and 9.0 ± 1.3,P ＜ 0.05).The content of smooth muscle cells in plaque in CTLA-4Ig group were 11.8 ± 1.0 and higher than those in PBS group,IgG1 group,and blank group (7.8 ± 0.8,7.5 ± 0.9,and 7.3 ± 0.7,P ＜ 0.05).There was no significant difference in content of collagen fibrils and smooth muscle cells between the PBS group,IgG1 group,and blank group (all P ＞ 0.05).[Conclusion] CTLA-4Ig fusion protein could evidently inhibit the atherosclerosis progression and enhance the stability of plaque through increasing the content of collagen fibrils produced by smooth muscle cells intra-plaque in ApoE-/- mice fed on cholesterol diet.

AIM:To observe the characterization in neural cells derived from the hippocampus of embryonic rats and to examine the effect of myelin-associated glycoprotein(MAG) on the proliferation,differentiation and neurite growth of neural stem cells(NSCs).METHODS:The hippocampus cells of embryonic rats were isolated and cultured in vitro.The expressions of nestin and doublecortin,the marks of NSCs,were observed by immunocytochemical method.The rate of proliferating cells was examined by BrdU immunocytochemistry.The average neuronal neurite length and the percentage of differentiated neurons were detected by immunocytochemistry staining.RESULTS:The hippocampus cells of 16 days old embryonic rats had the characteristics of NSCs.The percentage of differentiated neurons(?-tubulin Ⅲ-positive cells) was 18.17%?2.79% and the average neuronal neurite length was(136.27?33.66)?m,seven days after the differentiation initiated in vitro in control group.After NSCs were treated with MAG-Fc(200 ?g/L),the percentage of differentiated neurons and the average neurite length were decreased,respectively,to 10.05%?3.42%(P0.05).CONCLUSION:MAG-Fc inhibits the differentiation and neurite growth of the NSCs,but has no effect on the proliferation.