ObjectiveTo explore the clinical-pathway-based teaching effect in teaching urological postgraduate students in department of urology.Methods36 students were divided to two groups:18 students are the clinical pathway based teaching group, and the other 18 students are traditional teaching group.Examination was used to compare the effect of each teaching method after 6 month.The examination including history collection,physical examination and case file writing,clinical case analysis,clinical operational skills test and basic theory.ResultsThe record of history collection,physical examination and case file writing and basic theory test in clinical pathway based teaching group is not different between the two groups,but the record of clinical case analysis and clinical operational skills test in clinical pathway group is better than the traditional teaching group.ConclusionClinical pathway based teaching can improve the teaching effect of clinical case analysis and clinical operational skills in urological postgraduate students,and can improve the strengthen of clinical thinking and working ability.

[Objective]To establish an in vitro two-dimensional culture model of degenerated nucleus pulposus and detect samples' cell cycle by flow cytometry to study why nucleus pulposus cells don't grow well after passage. [Method]Nucleus pulposus tissues taken from protruded discs of 24 patients were treated by Trypsin and collagenase after surgical procedures,and then the cells were cultured in DMEM/F12 medium.Cell morphology was observed by an invert microscope and cell cycle of the primary and P2 cells were detected by flow cytometry after proliferation in monolayer culture.[Result]1.Primary culture cells of nucleus pulposus grew well in the medium,and 90% cells adhere to layer after about 7d.2.The rate of apoptosis of NP: primary(38.10?11.7)%,P2(44.74?17.6)%.The rate of S period : primary(7.88?2.1%),P2(2.76?0.7)%.[Conclusion]When going down to posterity the cells' apoptosis rate grows while S period cells decrease.

Objective To explore the relationship between plasma Tumor necrosis factor-alpha(TNF-α),Interleukin-6(IL-6) levels and brain edema caused by hypertensive intracerebral henorrhage.Methods 62 patients with hypertensive intrscerebral hemorrhage( the observation group) and 50 healthy persons( the control group) were selected.The expression of plasma TNF-α and IL-6 were determined by ELISA pre-therapy and 1d,3d,7d,14d after treatment in two groups;The volume of cerebral edema was measured by CT.The relationship between plasma TNF-α,IL-6 levels and brain edema caused by hypertensive intracerebral hemorrhage were analyzed.Results Before treatment,the levels of TNF-α and IL-6 in the observation group were( 15.62 ±9.49)μg/L and (67.47 ±6.31 )ng/L,which were significandy higher than(8.28 ± 3.36) μg/L and(31.02 ± 3.51 ) ng/L of the control group( t =9.17,64.28,P =0.01 ),and Spearman analysis showed that the levels of TNF-α and IL-6 were positively correlated with the volume of cerebral edema(r=0.934,P=0.02;r=0.922,P =0.026).Conclusion There was an up-regulation of TNF-α and IL-6 levels in the plasma of patients with hypertensive intracerebral hemorrhage.TNF-α and IL-6 may promote the formation of cerebral edema during the course of hypertensive intracerebral hemorrhage.

The National Surgical Adjuvant Breast and Bowel Project (NSABP) is a clinical trials cooperative group supported by the National Cancer Institute (NCI).The NSABP has conducted clinical trials in breast and colorectal cancer for nearly 40 years,many of which have greatly improved the therapies in breast and colorectal cancers.There have been some new advances on new adjuvant chemotherapy regimens,targeted therapy,adjuanvt and neoadjuvant therapies for rectal cancer in recent 5 years.

Objective To evaluate the status of P-selectin and platelet activating factor(PAF) in vivo in patients with deep venous thrombosis(DVT) and to observe their changes under interneving of medicines.Methods P-selectin and PAF of fourty patients and twenty normal subjects were fluorescence labled with corresponding monoclonal antibodies by flow cytometry( FCM ) and immunologic method respectively. Results P-selectin and PAF in patients with DVT were higher than that in normal subjects in early period of the disease, and they significantly decreased in different time after patients were treated. P-selectin was significantly different between patients who received sodium ozagrel treatment and those who not (P ＜0.05 ), but PAF was similar( P ＞ 0. 05 )after fourteen days. One month later, P-selectin and D-dimer in DVT patients were lower than before. However, the positive rate of P-selectin of DVT was still higher than normal subjects. Conclusions The platelet is activated in vivo in patients with DVT, so does fibrinolysis. Sodium ozagrel can decrease activity of platelet. P-selectin and PAF may be used diagnostic markers. Post-discharge patients are still at high-risk and must be regularly followed-up.

Objective To explore the relationship between the HBV‐DNA ,ALT ,AST and NO ,iNOS ,SOD levels in serum of patients with chronic hepatitis B(CHB) .Methods 24 patients with mild CHB ,30 patients with moderate CHB ,18 patients with se‐vere CHB and 30 healthy individuals were selected and set in group A ,B ,C and D ,respectively .The serum levels of HBV‐DNA , ALT ,AST ,NO ,iNOS ,and SOD were detected by FQ‐PCR and chemical analysis respectively .Results There were significant difference in the levels of ALT ,AST ,NO ,iNOS and SOD between group D and group A ,B and C (P<0 .05) .The serum level of ALT was positive relative to the levels of NO and iNOS(r=0 .487 ,0 .521 ,P<0 .05) ,and was negative relative to the level of SOD (r= -0 .574 ,P<0 .05) .The serum level of AST was positive relative to the levels of NO and iNOS(r=0 .453 ,0 .545 ,P<0 .05) , and was negative relative to the level of SOD(r= -0 .484 ,P<0 .05) .Conclusion With the increase of ALT and AST levels ,the levels of NO and iNOS increase ,and the level of SOD decreases simultaneously in CHB patients .It is suggested hepatocellular inju‐ry .

Clinical research is to provide guidelines for the clinical practice.First clinical re search should follow the ethics,and the researcher should have correct scientific attitude.Furthermore clinical research should be closely integrated with clinical practice and innovated with its feasibility taken into account.

Ubiquitin-proteasome pathway is one of the primary pathway in intracellular protein degrada-tion,therefore the ubiquitin conjugating enzyme D3(UbE2D3)which involved in the ubiquitin mineralization process can affect the biological effects accordingly to affect some protein and nucleic acid content and activity. The function that participate in modification and degradation of some cancer factors is vital in tumor cells,and followed by tumor biological behavior changing. Researches show that UbE2D3 correlates with human telomer-ase reverse transcriptase( hTERT),radiation sensitivity,aggressive,etc in breast cancer.

Objective To investigate the clinical charactors and treatment of IgM nephropathy with nephrotic syndrome(NS) in children.Methods Thirty-six IgM nephropathy patients hospitalized in Hunan Children's Hospital as research group(group A),from June 2005 to June 2012.One hundred and six patients with minimal change disease (MCD) as control group (group B),followed up for 1 ～ 8 years.Results (1) Hematuria at presentation of the two groups respectly 3.8％ vs 30.6％ (x2 =20.403,P ＜ 0.05).(2) Renal pathology revealed that there were 26 (72.2％)patients with minimal change disease,9 cases (72.2 ％)with moderate membranoproliferative glomerulonephritis,1 cases with focal segmental glomerulosclerosis.(3) According to renal pathology,group A patients were divided into two sub groups:mild group and moderate group.To compared with group B,the steroid-resistant incidence of the 3 group were respectly 12.3％,19.2％,77.8％ (x2 =24.369,P ＜ 0.05).There was no significant difference between control group and mild group.(4)The remission rate of proteinuria in steroid-resistant patients who combined to use mycophenolate mofetil (MMF) with the two groups were respectively 50％ and 85.7 ％ (x2 =3.60,P ＞ 0.05).Conclusion Incidence of hematuria is higher in IgM nephropathy patients and patients with renal pathology for moderate lesions have a high steroid-resistant,and need use immunosuppressive early.MMF may be a good immunosuppressive for theses patients.

Objective Paraquat(PQ) is an effective herbicide which is widely used in agricultural production .PQ poisoning is frequently seen in humans with the lung as the target organ ,but the poisoning mechanisms is not very clear .Studies show that endoplasmic reticulum stress(ERS) is closely associated with poisoning , but there are few reports on the relationship between ER stress and PQ poi-soning.This article was to investigate the effects of ERS-induced apoptosis and total flavonoids from astragalus complanatus (FAC) in a-cute lung injury(ALI) following paraquat poisoning in rats . Methods A total of 30 adult healthy Sprague-Dawley (SD) rats were ran-domly divided into 3 groups:control group, ALI group, ALI+FAC group and ALI+saline group.Biochemical method was applied to de-tect superoxide dismutase (SOD), catalase (CAT) and malondialdehyde (MDA) in lung tisssue,TdT-mediated dUTP nick end labeling (TUNEL) assay in observing lung apoptosis, Western blotting and real-time PCR(RT-PCR) in detecting the changes in expressions of C/EBP homologous peotein (CHOP), activating transcription factor 4 (ATF4) and X-box binding protein 1 (XBP) following ALI, and HE staining in observing the pathological changes of lung tissue . Results Compared with control group , the expression of MDA content was enhanced in ALI group ([3.26 ±0.24] vs [5.04 ±0.36],P<0.01), along with significantly decreased activity of SOD and CAT ([300.26 ±35.69] vs [187.21 ±25.66]), ([5.78 ±1.28] vs [2.15 ±1.12],P<0.01), increased cell apoptosis , upregulated pro-tain level of CHOP ([0.74 ±0.20] vs [0.23 ±0.07],P<0.01) and mRNA expression of ATF4, XBP1 and CHOP.However, FAC sig-nificantly attenuated ALI following PQ , as showed by reduced MDA content , enhanced activity of SOD and CAT , decreased cell apopto-sis, inhibited protain level of CHOP and mRNA expression of ATF 4, XBP1 and CHOP ([5.04 ±0.36] vs [3.99 ±0.27],P<0.01). Furthermore, the activity of SOD and CAT were higher in FAC pretreatment group than those in ALI group ([ 0.74 ±0.20 ] vs [0.42 ±0.11],P<0.01). Conclusion From the research, ERS-induced cell apoptosis is involved in ALI following PQ , and the protec-tive role of FAC in lung tissue following PQ is due to its effect in atten-uating ERS-induced apoptosis .