Classroom teaching is an important part of university education.We explore the methods to improve classroom teaching and the four criteria of it,and believe that cultivating people is much more important than barely imparting knowledge in modem society.And this,for university teachers,is duty-bound and challenging as well.

Background and purpose:18?-glycyrrhetinic acid(GA) is one of the important components of glycyrrhiza.Recent years,studies showed that GA has the effect of proliferation inhibition in human acute lymphoblastic leukemia cells,human liver carcinoma and lung cancer cells.We investigated the effects of GA on induction of apoptosis in human breast carcinoma(MCF7) cells.The previous studies have demonstrated that the dynamic change of intracellular free Ca~(2+) concentration([Ca~(2+)]i)plays important roles in many links of apoptosis-induced process.Therefore we also researched the relationship between GA-induced apoptosis and [Ca~(2+)]i in MCF-7 cells.Methods:After MCF-7 cells were treated with 50-250 ?mol/L GA for 24 h,cell viability for proliferation was assessed by MTT assay.MCF-7 cells treated with 100 ?mol/L and 150 ?mol/L GA for 24 h,the apoptotic rates in MCF7 cells were examined by terminal deoxynucleotide transferase mediated dUTP nick-end-labeling method,flow cytometry with Annexin V/ propidium iodide fluorescent stain and single cell gel electrophoresis assay(SCGE).For cells treated with 150 ?mol/L GA for 24 h,i was measured by Fure-2 fluorescein load method.For cells treated with 150 ?mol/L GA combined with 100 ?mol/L BAPTA-AM or 0.5 mmol/L EGTA for 24 h,cell apoptosis were examined by SCGE.Results:For cells treated with GA from 100 ?mol/L to 250 ?mol/L,the rate of proliferative inhibition was increased significantly(P

Objective To investigate the influencing factors for post-discharge treatment compliance of patients with multidrug-resistant tuberculosis (MDR-TB).Methods MDR-TB patients who were hospitalized in a tubercu-losis hospital between November 2011 and January 2013 were chosen,post-discharge follow-up was conducted regu-larly through telephone call.Medicine-taking and re-examination of patients was inquired,factors influencing pa-tients’treatment compliance were analyzed.Results 299 patients were included in the study,the total treatment compliance rate was 81 .94% (n=245);249(83.28%)patients regularly took medicine,50(16.72%)didn’t regu-larly take medicine;254 (84.95%)were re-examined on time,45 (15.05%)were not re-examined on time;37 (12.37%)discontinued treatment,260 (86.96%)continuously treated till the survey deadline.Univariate analysis revealed that treatment compliance (including regular medication rate,timely re-examination rate,interrupted treat-ment rate,and total compliance rate)was significantly different among MDR-TB patients of different ages,education levels,treatment time,and with or without adverse reactions(all P <0.05 ).Logistic regression analysis revealed that treatment compliance of MDR-TB patients was negatively correlated with treatment time(β=-1 .47,Wald χ2=24.28,P <0.05)and adverse reactions(β=-2.02,Waldχ2 =24.24,P <0.05 ),while positively correlated with education levels(β=0.79,Wald χ2 =6.50,p <0.05 ).Conclusion Prolonged treatment time and adverse reactions can reduce the treatment compliance of MDR-TB patients,the higher education levels of MDR-TB patients have, the better treatment compliance they implement.

Objective To evaluate the feasibility and efficiency of transthoracic echocardiography(TTE) combined with real-time three dimensional echocardiography(RT-3DE)in guiding transcatheter closure of atrial septal defect(TCASD)without X-ray.Methods Eleven patients with atrial septal defects(ASD)underwent the procedure of TCASD guided by TTE combined with RT-3DE.The position of the catheter and transporting sheath,the location and deploying of ASD occluder(ASO)were monitored by muhisection echoscan.especially in RT-3DE.The results were compared with those guided by conventional method(TTE and X-ray).Results All the operations were held successfully.The complications of cardiac tamponade,shedding of occluder,residual shunt,atrioventricular valve regurgitation,embolism and arrhythmia were not observed.Compared with the conventional procedure of the control group,the operation time was significantly prolonged[(65.76±14.15)min versus(45.50±20.88)min,P＜0.000)].Conclusions TCASD was tested to be safe and efficient guided by TTE combined RT-3DE without X-ray,especially for children and pregnant women.It may be expected used widely in the future independently from X-ray.

Objective Via targeted inhibition of oncogene Bmi-1 expression by RNAi interfering technology in vitro, to observe its effect on the proliferation and cell cycle of gallbladder cancer cells. Methods Four miRNABmi-1 recombinant plasmids were constructed according to different Bmi-1 sites. RT-PCR and Western blot were used to mRNA and protein expression of Bmi-1 in gallbladder cancer cells were measured by RT-PCR and Western blot. mRNA and protein expression of Bmi-1 in gallbladder cancer cells. The most effective interfering plasmids in the miRNABmi-1 groups were transfected into GBC-SD cells. Cell proliferation and cell cycle were analyzed 48 h after transfection by BrdU and flow cytometry. Results Bmi-1mRNA expression in miRNAbmi1-1,-3 and-4 was significantly lower than the control group (P<0.05);and Bmi-1 protein expression in miRNAbmi1-2,-3 and-4 was significantly lower than the control group (P<0.05). The recombinant plasmid in miRNAbmi1-4, with the strongest inhibitive effect of Bmi-1mRNA and protein expression, was transfected into GBC-SD cells,then the cell proliferation rate (46.63 ± 5.31) was significantly lower in mRNABmi1-4 group than the control groups (P<0.05);G0/G1 phase cells increased (72.20 ± 1.71) and G2/M and S phase cells decreased (18.30 ± 7.21, 9.50 ± 6.01) in miRNABmi1-4 group. Both were significantly different from the control groups (P<0.05). Conclusions Targeting and silencing Bmi-1 expression can effectively inhibit the proliferation of GBC-SD cells and restrain the cell cycle atin G0/G1 phase. Bmi-1 gene may be a novel target for geneic therapy of gallbladder carcinoma.

[Abstract ] Objective Cardiac shock wave therapy (CSWT) can promote arteriogenesis in ischemic myocardia , but the mo-lecular mechanism remains unclear .The study aimed to explore the effect of CSWT on arteriogenesis in human cardiac microvascular endothelial cells ( HCMEC ) and the role of focal adhesion kinase (FAK) and Calcium-activated potassium channels (KCa) in the sig-nal conduction pathway of CSWT arteriogenesis . Methods HC-MEC cells cultured in vitro were randomly divided into control group , CSWT group , CSWT +T ( FAK inhibitor PF-573228 ) group and CSWT+F( SCa inhibitor iberiotoxin ) group.Each group received one CSWT(0.09 mJ/mm2, 200Times) 48 h after added stimulant.24 hours'conventional culture later , tests were made on the levels of endothelial nitric oxide synthase ( eNOS ) and vascular endothelial growth factor ( VEGF) mRNA as well as the changes of related protein expression . Results ①QPCR test showed that eNOS , VEGF mRNA expressions increased in CSWT group compared with control group (4.61 ±0.19 vs 3.99 ±0.17, P<0.05), while compared with CSWT group, eNOS, VEGF mRNA expressions in CSWT +T group were decreased (0.62 ±0.10 vs 0.40 ±0.02, P<0.05), eNOS, VEGF mRNA expressions in CSWT +F group were also decreased (0.53 ±0.02 vs 0.64 ±0.02, P<0.05), all the differ-ences were of statistical significance .②Western blot showed that eNOS , VEGF protein expressions increased in CSWT group compared with control group(0.63 ±0.02 vs 0.43 ±0.02, P<0.05), while compared with CSWT group , eNOS, VEGF protein expressions in CSWT+T group were decreased (0.36 ±0.01 vs 0.29 ±0.02, P<0.05), eNOS, VEGF protein expressions in CSWT +F group were also decreased (0.37 ±0.02 vs 0.30 ±0.02, P<0.05), all the differences were of statistical significance . Conclusion CSWT can improve eNOS , VEGF mRNA and protein expressions in HCMEC cells and FAK and KCa may participate in the signal conduction pathway of CSWT arteriogenesis .

Objective To evaluate the safety and efficacy of endoscopic ultrasonography(EUS) guided ethanol ablation in patients with insulinoma. Methods The data of 10 patients with insulinoma trea-ted at the First Affiliated Hospital of Guangxi Medical University from December 2013 to January 2015 were prospectively analyzed. Results The patients were given EUS-guided ethanol ablation with dose of 0. 10 to 2. 00 ml(average 0. 70 ± 0. 62 ml)in pancreatic lesions for 15 times. No complications were observed dur-ing and after the procedure. The blood glucose improved after the procedure[4. 8(3. 9-5. 5)mmol/ L VS 2. 4 (1. 9-2. 5)mmol/ L,P < 0. 05]and the serum insulin level significantly decreased[83. 7(40. 1-143. 5) pmol/ L VS 177. 3(66. 5-200. 6)pmol/ L,P<0. 05]. The average hospital stay was(4. 3±1. 5)days. The patients were followed up for 6-12 months. EUS indicated that the echo of pancreatic lesions changed from high to low. CE-EUS revealed low enhancement and lack of blood supply. Conclusion EUS-guided ethanol ablation may become a promising minimally invasive treatment for insulinoma because of its safety,efficacy and low price. Trail registration Clinical Trial.gov,NCT02121366.

Objective To evaluate the safety and efficacy of endoscopic ultrasound (EUS) guided ethanol ablation of benign insulinoma and compare its' advantages and disadvantages with surgical treatment. Methods From April 2011 to February 2016, clinical data of 38 patients with benign insulinoma treated by EUS-guided ethanol ablation or surgical treatment were retrospectively analyzed. Results 97.4% (37/38) patients had a typical clinical manifestation of Whipple's triad, and the I/G ratio of 82.9% patients (29/35) was more than 0.3 with their onset of hypoglycemia. The positive preoperative etiologic diagnosis rates of transabdominal ultrasonography, CT, MRI, PET/CT and EUS were 50.0%, 67.6%, 66.7%, 75.0%, 89.7% respectively. In the current study, 18 patients underwent EUS-guided ethanol ablation (EUS-FNI group) and 20 patients received surgicaltreatment (surgical group). Compared with the surgical group, the operation time, intraoperative hemorrhage volume, postoperative complications, length of stay and hospitalization costs were significantly reduced in the EUS-FNI group (P < 0.05). No treatment-related complications was observed in EUS-FNI group, while 40.0% (8/20) patients in surgical group had complications. During the follow-up period, all these patients maintained stable blood glucose without taking medication, and there's no recurrence of insulinoma in EUS-FNI group after the last treatment with alcohol injection; In surgical group, only 90.0% (18/20) patients had no recurrence, episode of hypoglycemia was less after the operation in 10.0% (2/20) patients. Conclusion EUS-guided ethanol ablation of benign insulinoma is safe and effective, compared with traditional surgical treatment, EUS-guided ethanol ablation is minimally invasive, costs less, recovers fast after treatment and has fewer complications.

Objective To study the feasibility of domestic single-port surgical robot assisted endoscopic system for partial nephrectomy,and analyze its safety in clinical partial nephrectomy based on experimental results Methods Three qualified experimental pigs were selected,two senior urological professors and a senior resident doctor used a domestic single-port surgical robot to perform partial nephrectomy on the left and right kidneys.Recorded the operation duration,hot ischemia duration,suture time,estimated blood loss,volume of renal parenchyma excision and other information.Results There were 8 wedge resection and 4 heminephrectomies.The kidney volume of wedge resection was(7.35±0.81)mL and the blood loss was(8.50±11.09)mL.The total operation time was(41.67±8.50)min,and the time of resection was(5.88±3.27)min and the stitching time was(11.75±2.82)min.The kidney volume of heminephrectomy was(24.30±2.18)mL,and the blood loss was(6.25±4.35)mL.The total operation time of heminephrectomy was(47.00±11.27)min,and the time of resection was(3.25±1.5)min and the stitching time was(10.00±5.25)min.No bleeding was observed on the wound after the Bull dog was released in all operations.There was no significant difference in operation time and blood loss between the heminephrectomy group and the wedge resection group.There was no significant difference in operation time or blood loss between the senior doctor group and the senior resident doctor group.The NASA-TLX scale was used to assess the degree of workload of the operator during surgical operations,and the results showed that none of the three surgeons had a high level of frustration.There were no adverse events related to the single-port surgical robot system during the operation.Conclusion It is safe and feasible for a domestic single-port surgical robot system to perform a partial nephrectomy.

OBJECTIVETo evaluate the long-term clinical outcomes of fractional flow reserve (FFR)-guided versus intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) for intermediate coronary lesions.

METHODSA total of 226 patients with 293 intermediate coronary artery lesions (stenosis of 40%-70%) confirmed by coronary angiography were randomized into 3 groups to undergo PCI for a minimal lumen cross sectional area (MLA)<4 mm(2) (IVUS group, 98 lesions) or for a FFR<0.80 (FFR group, 101 lesions), or to receive standard medical treatment (medication group, 94 lesions). The primary outcome was major adverse cardiac events including death, myocardial infarction, and ischemia-driven target vessel revascularization at 1 year after the index procedure.

RESULTSThe baseline percent diameter stenosis and lesion length were similar between the 3 groups, but more patients in IVUS group than in FFR group received PCI (P<0.001). No significant difference was found in the incidence of major adverse cardiac events between the 3 groups (P=0.182).

CONCLUSIONBoth FFR- and IVUS-guided PCI strategy for intermediate coronary artery disease are associated with favorable outcomes, but IVUS-guided PCI based on the single index of MLA can increase the rate of revascularization therapy.