The application of MOOCs (massive open online courses) in internal medicine education is feasible with the construction of MOOCs in internal medicine, internet and mobile terminal availability, and the improvement of college student quality. We reviewed the progress of MOOCs in the medical teach-ing. The chapter of coronary heart disease was exemplified to illustrate how to apply MOOCs in internal medicine teaching. The MOOCs was carried out with the following steps: the share of MOOCs courses, self-guided learning, online question and answer section, in-class teaching and exams post MOOCs, which achieved good teaching effect, enhanced students' subjectivity, and promoted the sharing of high-quality medi-cal teaching resources. At the same time, in view of the limited nature of MOOCs in internal medicine, we need to overcome it in the development of teaching practice.

Objective:To observe the effect of Allicin in cardial fibroblasts (CFs) proliferation and Collagen secretion,and to explore its role on TLR4/NF-κB signal pathway.Methods:CFs of neonatal Wistar rats were isolated and cultured ,then was stimulated with AngⅡ.CFs proliferation was measured by thiazolyl blue ( MTT) assay.The expression of collagenⅠ,collagenⅢ was measured by ELISA.mRNA expression of TLR4 and NF-κB were detected by reverse transcription-polymerase chain reaction ,protein expression of TLR4 and NF-κB were detected with Western blot.Results: Allicin could reduced MTT value of cardial fibroblasts ( P<0.01 ) , and inhibited expression of collagenⅠ,collagenⅢ(P<0.01),which in a dose-dependent manner.Allicin could reduced mRNA expression of TLR4 and NF-κB and protein expression of TLR 4 and NF-κB in CF induced by Ang Ⅱ ( all P<0.01 ) .Conclusion: Allicin can inhibit Myocardial fibrosis ,which mechanism is possible by inhibiting TLR 4/NF-κB signal pathway.

In this paper, three spoilage organisms were separated from five transmutative soy milks, and all the three spoilage bacteria could survive condition of both 1?105Pa,30min and 300mg/kg Nisin. Morpha character, physiological and biochemical characteristics, and a phylogenetic analysis based on 16S rDNA gene sequences reveal that these three strains are Bacillus licheniformis, Bacillus pumilus and Brevibacillus borstelensis respectively. GenBank accessions for these three strains are EF439666-EF439668。

Objective To study the antigenicity of human thyrotropin receptor(hTSHR)amino terminus (amino acid 29～280)and its association with Graves' disease.Methods Total thyroid RNA was prepared from human normal thyroid tissue.RNA was then reversely transcripted and cDNA was subjected to PCR amplification.PCR product was cloned into pcDNA3.1 and the recombinant plasmid was named pcDNA3.1/hTSHR188～940bp. Balb/c mice were immunized with peDNA3.1/hTSHR188～940bp. The levels of serum thyroxin,anti-TSHR antibody(TRAb)and thyroid stimulating antibody(TSAb)were measured,and the pathological changes of thyroid tissue were also observed.Results A 753 bp fragment encoding hTSHR ectodomain amino end was obtained after PCR amplification.Confirmed by Hind Ⅲ restriction enzyme digestion and DNA sequencing,pcDNA3.1/hTSHR188～940bphad been constructed successfully,with the correct sequence and direction of hTSHR188～940bp.In the Balb/c mice treated with pcDNA3.1/hTSHR188～940bp,elevated TRAb in week 6(0.148±0.018)were observed compared with those at week o(0.106±0.006,P＜0.01),and kept a higher level till week 10(0.134±0.011,P＜0.01).T4 and TSAb index values were significantly increased in week 10.Serum T4 concentration increased from(41.02±7.97)μg/L in week 0 to(62.20±12.77)μg/L in week 10(P＜0.01);TSAb index values rose from 0.864±0.076 at week 0 to 1.392±0.615(P＜0.01).Thyroid pathological examination showed that proliferated thyroid follicular epithelial cells and foll icular eapacity increased.Inflammatory cells were occasionally found.Conclusions There are antigen epitopes in hTSHR ectodomain amino acid 29～280,which can stimulate the production of TSAb.And the latter induces hyperthyroidism and Graves' disease like manifestations.It suggests that hTSHR ectodomain amino acid 29～280 is closely associated with Graves' disease,and maybe one of important etiological factors leading to the disease.

BACKGROUNDTo determine the binding activity of nuclear factor-kappa B (NF-kappa B) and the transcription of transforming growth factor-beta 1 (TGF-beta 1) induced by oxidized low density lipoprotein (Ox-LDL) in rat mesangial cells and to elucidate the mechanism of renal injury of Ox-LDL.

METHODSNF-kappa B binding activity was measured by gel shift assay in mesangial cells with or without inducement of Ox-LDL. Protein kinase inhibitors and activators were then used to determine the signal transduction pathways. In this course I kappa B protein expression was analyzed by Western blot assay. TGF-beta 1 mRNA was measured in mesangial cells exposed to Ox-LDL by RT-PCR assay. TGF-beta 1 promoter from -1551 to +57 were constructed into a pGL3-Basic vector with a luciferase reporting gene. A putative binding site of NF-kappa B was mutated. The wild and mutant promoters activity was analyzed by transfection into mesangial cells.

RESULTSNF-kappa B was activated by Ox-LDL persistently and rebounded in the early period. Ox-LDL induced NF-kappa B activation in a dose dependent way. It also induced I kappa B degradation in 2 hours and resumed to normal levels. NF-kappa B activation was not alleviated by inhibitors of protein kinase A (PKA), extracellular signal-regulated kinase (ERK), and p38 MAP kinase (p38MAPK). Inhibitors of protein kinase C (PKC) and proteinsome inhibited the enhancement of NF-kappa B binding activity. Ox-LDL induced the transcription of TGF-beta1 in a time and dose dependent manner. Mutation of the putative binding site of NF-kappa B reduced the activity of TGF-beta1 promoter.

CONCLUSIONOx-LDL induced activation of NF-kappa B persistently. It was probably regulated by the degradation of I kappa B mediated by PKC pathway. NF-kappa B may be involved in the enhancement of TGF-beta 1 induced by Ox-LDL in rat mesangial cells.

Animals ; Blotting, Western ; Electrophoresis ; Glomerular Mesangium ; cytology ; Lipoproteins, LDL ; pharmacology ; physiology ; Mutation ; NF-kappa B ; metabolism ; physiology ; Rats ; Rats, Sprague-Dawley ; Reverse Transcriptase Polymerase Chain Reaction ; Transcription, Genetic ; physiology ; Transfection ; Transforming Growth Factor beta ; genetics ; Transforming Growth Factor beta1

AIM To establish an HPLC method for the simultaneous content determination of huperzine A and huperzine B from seventeen species Huperzioideae subfamily (including 2 ineditus new species).METHODS The analysises of tartaricacid extracts of huperzine A and huperzine B were performed on a room temperature column (4.6 mm × 250 mm,5 μm),with the mobile phase comprising of methanol-spiritus mindereri flowing at 1.0 mL/min in a isocratic elution manner,and the detection wavelength was set at 310 nm.The contents were determined by external standards.RESULTS Huperzine A and huperzine B showed good linear relationships within 0.002 0-0.30 μg,0.001 8-0.27 μg (r=0.999 9),whose average recoveries were 103.86％,101.3％ with the RSDs of 1.85％,1.30％,respectively.Huperzine A and huperzine B were found in seventeen species,and there were significant differences in contents from species to species.The content of huperzine A in Phlegmariurus hamiltonii was the highest,which reached up to 0.22％,with higher levels of it in Phlegmariurus cryptomerianus,Phlegmariurus petiolatus,and Phlegmariurus phlegmaria;The content of huperzine B was the highest in P.phlegmaria.CONCLUSION This accurate,stable and reproducible method can be used for the quality control of huperzine A and B from Huperzioideae subfamily.

Background Studies showed plasma fibrinogen (FIB) is not only the independent risk factor of cardiovascular disease,but also associated with the prevalence and incidenc of hypertension.A gender difference was shown in the association of FIB with hypertension,while no epidemiological study has been reported in Chinese population.Objective To explore the association between plasma FIB concentration and ten-year accumulative risk of hypertension.Methods A prospective study of relationship between blood pressure and other traditional risk factors were carried out in a cohort of Chinese population of 2115 people aged 35-64 years old in 1992 and 2002. The association of plasma FIB concentration with ten-year accumulative risk of hypertension was analyzed.Results The ten-year accumulative incidence rate of hypertension was 34.8%,and incidence in males (39.3%) was signifi- cantly higher than that in females (31.5%) (P

Objective To examine the benefits of ECMO for potential organ donors with hemodynamic instability after brain death.Methods Three brain-dead potential donors who presented with hemodynamic instability despite maximal medical management,finished a declaration of brain death,that were supported by extracorporeal circulation membrane oxygenation (ECMO).Results Donor organs,including six kidneys,and two livers,were harvested from the three donors under ECMO support,leading to 8 successful transplantations.The organs functioned well and the recipients made full recoveries.Conclusion Our experience indicates that ECMO allows for the maintenance of abdominal organ tissue perfusion without warm ischemia before organ procurement,providing sufficient time for safe organ donation procedures and reducing the risk of unpredictable cardiac arrest that could result in the donor death and graft loss.

Objective To explore the effect of iodine on the pathogenesis of postpartum thymiditis.Methods Forty-four female C57BL/6J mice,8-week old,fed by low iodine dietary(the concentration of iodine≤35 μg/kg),were randomly divided into 4 groups:non-pregnancy experimental autoimmune thymiditis(non-pregnancy EAT)group with 8 mice,EAT of mice was induced by immunization with pig's thyroglobulin(Tg)in the presence of complete Freund's adjuvant.Six mice in non-pregnancy EAT group survived at the end of experiment;normal iodine-PPT(NI-PPT)group,10-fold high iodine-PPT(10HI-PPT)group and 50-fold high iodine-PPT(50HI-PPT)group with 12 mice in each group.The last 3 groups mice,who received the same immunization schedule as the above,were mated with adult male mice followed by induction of EAT.In the end,7,6 and 6 mice were noticed to be pregnant in each group.All animals were killed 4 weeks after postpartum.Histological severity of thyroid specimens was evaluated.The serum level of thyroglobulin antibody(Tg-Ab),thyroid pomxidase antibody(TPO-Ab),TT3 and TT4 were measured by radioimmunoassay(RIA).The expression level of IFN-γ/IL-4 mRNA in spleenwere assayed by RT-PCR.Results Pathological examination showed the infiltration of inflammatory cells.epithelial cell applanation,follicle atrophy or destruction.The severity of inflammation in non-pregnancy EAT bgroup.NI-PPT group and 10HI-PPT group was less serious than that in the 50HI-PPT group,the difference has bstatistical significance(P＜0.05).The level of TPO-Ab in non-pregnancy EAT group,NI-PPI-group,10HI-PPTgroup and 50HI-PPT group wag(14.32±8.85)%,(64.45±10.52)%,(38.46±5.57)%and(90.09±9.98)%.respectively the difference being statistically significant between any two groups(P＜0.05).There was no statisticaldifference(F＝0.484,P＞0.05)of Tg-Ab among non-pregnancy EAT group[(33.74±3.71)%],NI-PPT group [(29.65±2.06)%],10HI-PPT group[(37.21±3.87)%]and 50HI-PPT group[(33.87±4.17)%].There was no statistical difference(F＝1.596,P＞0.05)of TT3 among non-pregnancy EAT group (2.47±0.69)%,NI-PPT group(1.57±0.25)%,10HI-PPT group[(1.60±0.28)%]and 50HI-PPT group[(1.82±0.75)%].The level of TT4 in 50HI-PPT group[(66.68±5.47)%]was lower than that in non-pregnancy group,NI-PPT group and 10HI-PPTgroup[(99.87±5.97)%,(89.13±7.64)%and(91.05±5.82)%],the difference being statistically significant(P＜0.05).The expression level of IFN-γ mRNA was increasing,being 1.02±0.10,1.37±0.10,1.39±0.12 and 1.68±0.06 in non-pregnancy EAT group,NI-PPT group,10HI-PPT group and 50HI-PPT group.The difference had a statistical significance between any two groups except for NI-PPT group and 10HI-PPT group(P＜0.05).The expression level of IL-4 mRNA in 10HI-PPT group(0.49±0.04)and 50HI-PPT group(0.53±0.06)were all higher than non-pregnancy EAT group(0.24±0.05)and NI-PPT group(0.35±O.05),the differences being statistically significant (P＜0.05).Conclusions Adequate iodine supplementation during pregnancy and postpartum period is necessary,but iodine excess could induce postpartum thyroiditis.So iodine supplementation during pregnancy and postpartum should be adequate and reasonable.

Objective To study the clinical significance of fecal smear examination on diagnosing intestinal flora imbalance in infantile diarrhea.Methods A sterile cotton swab was used to spread a layer of fresh feces quantum satis from a sterile container on a clean slide;the smear was fixed and stained with Gram′s methods after it was air-dried,then the specimen was observed with a microscopy(field lens 100 ? eye lens 10) and recorded.Results In the acute diarrhea group(40 cases),the distribution feature of 3 floras on the fecal smears:≥50% Gram-negative bacilli in 6 cases(15%),≥50% Gram-positive cocci in 30 cases(75%) and ≥68% Gram-positive bacilli in 4 cases(10%).In the delayed and chronic diarrhea group(62 cases),the distribution feature of 3 floras on the fecal smears:≥50% Gram-negative bacilli in 7 cases(11.29%),≥50% Gram-positive cocci in 44 cases(70.97%) and ≥68% Gram-positive bacilli in 6 cases(9.68%).In the normal control group(32 cases),the distribution feature of 3 floras on the fecal smears:≥50% Gram-negative bacilli in 1 case(3.13%),≥50% Gram-positive cocci in 1 case(3.13%),and ≥68% Gram-positive bacilli in 17 cases(53.13%).For the distribution of 3 floras in the 3 groups,chi-squared test was performed,and the results showed that the difference was significant in Gram-positive cocci(?~2=47.76 P0.05).Conclusions Acute,delayed or chronic diarrhea can lead to flora imbalance.In order to timely and rapidly know the flora imbalance in children with diarrhea,clinically the simple,easily operated and practical smear staining method shall be widely applied.