Case based teaching or case discussion teaching of basic medical courses can deepen students' understanding of basic medical subjects and allow them to acquire practical and real problem solving skills while leaning the fundamental knowledge of their subjects.This paper discusses the features and advantages of case based teaching and gives a detailed discussion of an effective way to implement case based teaching by taking case based teaching of medical immunology as an example.

Objective To investigate the value of ultrasound-guided microcatheter pericardiocentesis in the management of malignant pericardial effusion.Methods A total of 13 patients with malignant pericardial effusion entered the study.Under the guidance of ultrasonography, the pericardial puncture was performed to introduce an epidural catheter(microcatheter).Through the microcatheter,the pericardial fluid was drawn out and chemotherapy drugs were injected into.Results Pericardial puncture and microcatheter implantation was conducted successfully in all the 13 patients.The total drainage volume was 400~780 ml(mean,530 ml).The survival rates at 3,12,and 24 months after the treatment were 92.3%(12/13),77.8%(7/9),and 60%(3/5),respectively.No recurrence of pericardial effusion was found. Conclusions Ultrasound-guided microcatheter pericardiocentesis in the treatment of malignant pericardial effusion is safe,minimally invasive,effective,and feasible.

To explore diagnostic acuity of helical CT colonscopic examination, simulated polyps were reproduced in 10 pig colons and 6 human colons obtained from colon resection. Helical CT colonoscopic scanning with different parameters was performed. The images were evaluated with Nav, Axial+MPR, SSD+Raysum. The diagnostic sensitivity of each method for the detection of simulated colonic polyps were assessed. The results indicated that the image quality of CT colonoscopy was improved with the decrease in collimation and pitch. The optimal angle of the colon lumen to the gantry was 90?. CT colonoscopy was superior to other imaging methods. Therefore, the performance of CTVC has a close relationship with the scanning parameters. The optimal scanning parameters were 5mm collimation, 1 5 pitch, and filling the colon with air. The combination of CTVC with other imaging methods would contribute to improving the diagnostic accuracy for the detection of colonic polyps.

Objective To investigate the protective effect of lentivirus-mediated silencing information regulation protein 6(SIRT6)overexpression on radioactive lung injury in rats.Methods 72 male 150-200 g Wistar rats were randomly divided into three groups(n=24).The 6 MV-X-ray linear accelerator was used to irradiate the lungs.The rats in each group were injected with normal saline(TNF-α)were measured at 1, 2, 4, and 8 weeks after radiotherapy(Lent-SIRT6), and the levels of tumor necrosis factor-α(TNF-IL-6 and IL-1β were measured by HE staining.The levels of TNF-α, IL-6 and IL-1β in liver tissue were detected by HE staining.The levels of TNF-α, IL-6 and IL-1β in liver tissue were detected by HE staining.Results The alveolar wall and alveolar stroma were normal in the control group.The alveolar wall of the irradiated group was thickened and fibrosis, and a large number of hypertrophic fibrous tissues were found in the alveolar stroma.The alveolar wall of Lent-SIRT6 group was thickened And alveolar stromal fibrosis symptoms were lighter than the irradiation group.Compared with the control group, the levels of serum TNF-α and IL-6, neutrophil count and the levels of TNF-α, IL-6 and IL-1β in the liver tissue were significantly higher than those in the control group (P<0.05).The lentiviruses overexpressing SIRT6 could alleviate the abnormalities caused by radiation (P<0.05).The difference was statistically significant (P<0.05).Conclusion SIRT6 can effectively inhibit the inflammatory reaction, reduce the lung injury symptoms of radiation pneumonia, and have some protective and prevention effect on lung injury.

ObjectiveTo observe the clinical efficacy of hair needle therapy in treating dry eye syndrome (DES).Method Eighty patients diagnosed with DES were randomized into a treatment group and a control group, 40 cases in each group. The treatment group was intervened by 0.1% Sodium Hyaluronate eye drops plus Hair needle therapy; the control group was by 0.1%Sodium Hyaluronate eye drops alone. The subjects were re-examined after 1-month treatment. The therapeutic efficacy was evaluated by observing the subjective symptoms, SchirmerⅠtest (SIT), tear break-up time (BUT), and fluorescein test (FL).Result The subjective symptoms, SIT, BUT, and FL scores were significantly improved after intervention in the treatment group (P<0.05);the control group only had the subjective symptoms improved after intervention (P<0.05), while other indexes didn’t show significant differences (P>0.05); after treatment, there were significant differences in comparing the subjective symptoms, SIT, BUT, and FL scores between the two groups (P<0.01).ConclusionHair needle therapy plus Sodium Hyaluronate eye drops can produce a more significant efficacy than Sodium Hyaluronate eye drops alone in treating DES.

ObjectiveTo observe the effects and safety of early high-loading-dose clopidogrel in treatment of patients with acute coronary syndrome.Methods178 patients with STEMI were divided into two groups randomly.96patients were treated with clopidogrel 600 mg immediately when they came to the hospital, and then were treated with clopidogrel 75mg daily for 1 year;82 patients were treated with clopidogrel 300mg immediately when they came to the hospital,and then were treated with clopidogrel 75mg daily for 1 year.The attacks of postinfarction angina pectoris,events of heart failure and the composite of death,reinfarction or stroke were observed.ResultsCompared with control group, the high-loading-dose group had obvious reduction in the attacks of postinfarction angina pectoris and the composite of death, reinfarction or stroke (all p ＜ O.05).There were no major and minor bleeding events in the two groups.ConclusionEarly treatment with high-loading-dose of clopidogrel in ACS could significantly improve its prognosis,and was safe and well tolerated.

OBJECTIVE:To observe the efficacy and safety of mirtazapine in the treatment of perimenopausal syndrome with sleep disorders. METHODS:100 perimenopausal patients with sleep disorders were randomly divided into study group(52 cases) and control group(48 cases). Study group was given Mirtazapine tablet with initial dose of 15 mg,once a day,taking 1-2 hours before going to bed,increased and maintained to 30 mg after 1 week. The control group was given Oryzanol tablet 10 mg after meals,3 times a day. Both groups were treated for 8 weeks. Scores of HAMD-17 and PSQI before and after treatment were ob-served,efficacy of depression and sleep were evaluated and and incidence of adverse reactions in 2 groups was observed. RE-SULTS:After treatment,HAMD-17 scores and PSQI scores in 2 groups were significantly lower than before,and study group was lower than control group,8 weeks<4 weeks<2 weeks,the differences were statistically significant(P<0.05 or P<0.01). Total ef-fective rates of depression and sleep in study group were significantly higher than control group(P<0.05). There was no significant difference in the incidence of adverse reactions(P>0.05). CONCLUSIONS:Mirtazapine can improve the sleep disorders of peri-menopausal syndrome with rapid onset,but the adverse reactions need futher observation.

Objective To explore the effect of D-galactose(D-gal) on murine pancreatic injury and its pathogenesis.Methods C57BL/6J mice were randomly divided into control group and D-gal model group [D-gal 120 mg/(kg · d) for 42 days].On the 2nd day after drug injection completed,the peripheral blood was taken for measuring the level of fasting blood glucose(FBG) and fasting insulin(FINS);and then the organ index of pancreas was calculated by the ratio of pancreatic wet weight(mg) and mouse body weight(g);HE stain was routinely prepared to observe the histologic structure of pancreatic tissue;the TEM was used to analyze ultrastructural changes of pancreatic cells;the pancreatic frozen sections were prepared to test senescence-associated β-galactosidase (SA-β-gal) and its relative absorbance(RA) of positively stained cells in the pancreatic islets;immunohistochemistry assays to study advanced glycation end products (AGEs) and its RA;pancreas tissue homogenate was made to detect the content of superoxide dismutase(SOD),malonaldehyde(MDA) and total antioxidant capacity(T-AOC).Results In D-gal group mice,the FBG increased(P＜0.05) and FINS reduced;pancreas wet weight and organ increased obviously (P＜0.01);light microscopic structure of the pancreas presented without typical pathologic change,however the single nucleated cell's area within the islet was increased significantly(P＜0.05);the pancreas endocrine and exocrine cells were showed the ultrastructure damaged and lipofuscin formation increased;the RA of positive pancreas cells in SA-β-gal staining increased(P＜0.05);the RA of AGEs positive regional expression markedly increased (P＜0.01);the content of SOD and T-AOC decreased (P ＜ 0.05),the content of MDA increased (P ＜ 0.01).Conclusions Aging mice model replicated by D-gal can cause the pancreatic injury,its mechanisms may be closely related to oxidative injury of pancreatic cells caused by D-gal.

BACKGROUND:The use of three-dimensional cel culture techniques can better simulate the cel ular microenvironment, providing new tools for tissue engineering research.
OBJECTIVE:To analyze the biomaterial selection and application characteristics in three-dimensional cel culture as wel as applications in tumor tissue engineering.
METHODS:We searched Wanfang database and PubMed database 1998-2015 years for relevant literature using keywords of“three-dimensional cultures;scaffold;cel growth;cel differentiation;tumor tissue engineering”in Chinese and English, respectively.
RESULTS AND CONCLUSION:The selection and application of three-dimensional scaffold materials is one of the keys. So far, scaffold materials, such as col agen gels, gelatin sponge, agarose, chitosan, demineralized bone matrix, cannot provide the extracel ular matrix similar to the micro-environment in which seed cel growth and proliferation are not affected, and the ability to secrete type II col agen and glycosaminoglycan is decreased, although they can provide three-dimensional space for seed cel s. Biomimetic scaffold characterized as little trauma and strong plasticity gradual y shows its unique advantages. Three-dimensional culture conditions raise pro-angiogenic growth factor secretion from tumor cel s, and this feature is positively correlated with the occurrence of in vivo tumor angiogenesis.