Massive open online courses (MOOCs) , which has caused a large scale of medical edu-cation in recent years, has led to an exploration boom in medical education. By the end of November 2014, on four large domestic and foreign MOOCs platform, a total of 178 medical related MOOCs were found, accounting for 12.2% of the total number of courses, among which public health MOOCs accounted for 44.9%. In terms of medical education, MOOCs are not only a powerful supplement of existing medical ed-ucation and can assist dissemination of medical knowledge, they can also promote pedagogy innovation and improve teaching quality to a certain extent. Moreover, the huge amounts of data collected by MOOCs can also be used to develop research of students' learning behavior. In addition, by recruiting study objects, the researchers have begun to use MOOCs supporting scientific research. As a novel educational development, MOOCs face many challenges while they bring opportuni-ties for medical education. However, active prac-tice and exploration will bring more powerful vitality for its development in the medical field.

Objective To compare the efficacy of a self-applied modified Semont maneuver(MSM) with self-treatment using a modified Epley procedure(MEP) in patients with posterior canal benign paroxysmal positional vertigo(PC-BPPV).Methods All 70 patients with PC-BPPV were treated respctively by using MEP and MSM between July 2001 and June 2003,remission rate and treatment-related side effects were compared at the end of 1 week.Results Remission rate was 95% in the MEP group(n=37) vs 58% in the MSM group(n=33,P

β2-Microglobulin is a small molecule protein, consisting of a polypeptide chain.Previous studies have confirmed that serum β2-microglobulin is a biomarker that reflects early renal function injury, and renal function injury is closely correlated with ischemic stroke.Studies in recent years have shown that the level of serum β2-microglobulin increases significantly in patients with ischemic stroke.Thus, it can be used as a biomarker for the risk of ischemic stroke.

Objective To investigate the effect of 17β-estradiol on insulin resistance and the expression of insulin receptor-α in skeletal muscle of ovariectomized rats with insulin resistance induced by high fructose.Methods Forty-eight mature female Sprague-Dawley (SD) rats were randomly divided into four groups: the normal control group (NC, n= 12) rats were fed with the normal diet for 8 weeks; the model group (M, n= 12)rats were ovariectomized and fed with the high fructose diet for 8 weeks, meanwhile the physiological-dose of 17βestradiol (30 μg · kg-1 · d-1 ) was injected subcutaneously every day; the vehicle control group (VC, n= 12) rats were ovariectomized and fed with the high fructose diet for eight weeks, meanwhile equivalent alcohol was injected subcutaneously every day. Systolic blood pressure (SBP), fasting blood sugar (FBS), and fasting serum insulin (FSI) were measured and insulin sensitivity index (ISI) was calculated. The expressions of mRNA and protein of insulin receptor-α in quadriceps femoris were measured by RT-PCR and Western-blot. Results Compared with the normal control group, SBP (P<0.05), FBS (P<0.05) and FSI (P<0.01) were increased significantly while ISI was decreased significantly (P < 0. 05) in the model group. The expressions of mRNA and protein of insulin receptor-α and phosphorylated Akt were decreased significantly in quadriceps femoris in the model group (P<0.05), compared with the normal control group. However, these effects were reversed by 17β-estradiol in the 17βestradiol replacement group. Conclusions 17β-Estradiol inhibits insulin resistance, and up-regulates the expression of insulin receptor-α and the level of phosphorylated Akt in ovariectomized rats with insulin resistance induced by high fructose diet.

To investigate the diagnostic value of magnetic resonance cholangiopancreatography (MRCP) for di-agnosing low choledochal joint and its complications. MRCP results of 29 low choledochal joint patients con-firmed were analyzed retrospectively, and then compared with those by endoscopic retrograde cholaniopancreatography (ERCP). MRCP could display clearly the location of low choledochal joint, and the patients with complications involved 4 ones with cholecystolithiasis, 5 ones with cholangiolithiasis, 15 ones with cholecystolithiasis and cholangiolithi-asis, 3 ones with Mirizz syndrome, 2 ones with pancreatitis, 1 case with carcinoma of head of pancreas after cholecystec-tomy and 1 case of Vater ampullary carcinoma. Interoperative and ERCP findings proved that MRCP could be used for the diagnosis of low choledochal joint and its complications with no missed diagnosis. MRCP can be involved for the diagnosis of low choledochal joint and its complications, and thus can be used for preoperative planning and treat-ment of the complications.

Objective To investigate the effectiveness and safety of wound infiltration with rop-ivacaine for postoperative analgesia as a fast-track approach in patients undergoing open hepatectomy. Methods Fifty-two patients with hepatocellular carcinoma,32 males,20 females,aged 18-70 years, scheduled for selective open hepatectomy were enrolled in this trible-blind,randomized,controlled study.Patients were randomized to receive 0.75% ropivacaine (group ROP)or 0.9% normal saline (group NS)wound infiltration before incision closures at a total volume of 10 ml.Numerical rating score (NRS)at 6,12,24 and 48 hours after surgery,length of hospital stay,time to bowel recovery,ambulation and drainage tube extraction were recorded.Side effects, including post-operative liver and renal function,allergic reaction,nausea and vomiting,and wound infection,were also assessed.Results NRS was significantly decreased at 6 [(3.85±1.29)scores vs.(5.30±1.76) scores],12 [(3.38±0.85)scores vs.(5.69 ±1.38)scores]and 24 hours [(3.69 ±0.74)scores vs. (4.42±1.13)scores]after surgery in group ROP compared to group NS (P <0.05).Group ROP al-so showed shorter postoperative hospital stays [(1 7.92±1.97)d vs.(1 9.53±2.42)d],earlier anal exsufflation [(48.07±7.49)h vs.(53.42±10.38)h]and ambulation [(2.34±0.62)d vs.(2.80± 0.84)d](P <0.05).However,there were no significant differences between the two groups in re-garding post-operative liver and renal function.The incidence of nausea and vomiting was 1 5% (4 ca-ses)and 1 9%(5 cases)in group NS and group ROP,respectively.No allergic reactions occurred in either group.Conclusion The present study shows that ropivacaine wound infiltration could effectively release post-operative pain,and could be a safe and effective fast-track approach for patients undergoing open hepatectomy.

Aim To investigate the effects of arecoline on glucose and lipid metabolism in type 2 diabetic rats and its mechanisms in glucose metabolism.Methods A type 2 diabetic rat model was established by fed with high fructose-high fat diet.The animals were randomly divided into 7 groups: control group,high fructose-high fat diet group(HF)and high fructose-high fat diet+arecoline(1 mg?kg-1,5 mg?kg-1,10 mg?kg-1,20 mg?kg-1,50 mg?kg-1)groups.The blood glucose,lipid level,hepatic function and liver histology were measured.The mRNA expression of liver glucose-6-phosphatase(G6Pase),phosphoenolpyruvate carboxykinase(PEPCK),Forkhead Box O1(FoxO1)and peroxisome proliferator-activated receptor-? coactlvator-1? (PGC-1?)were observed through RT-PCR.Results In comparison with the high fructose-high fat diet group,the fasting blood glucose and TC of the rats were significantly decreased by arecoline in a dose-dependment manner in high fructose-high fat diet+arecoline group.But hepatic function was damaged by 10 mg?kg-1,20 mg?kg-1 and 50 mg?kg-1 arecoline.The mRNA expression of hepatic G6Pase,PEPCK,FoxO1 and PGC-1? was decreased by treatment with 1 mg?kg-1 and 5 mg?kg-1 arecoline compared with the high fructose-high fat diet group.Conclusions Low dose arecoline can decrease fasting blood glucose and TC in type 2 diabettic rats,and the mechanism in glucose metabolism may be related to its effect on the inhibition of hepatic gluconeogenesis.

Monoclonal antibody is a new treatment for severe asthma in children.It can selectively act on specific cytokines or pathways in the inflammatory cascade of asthma to block the inflammatory reaction, so as to reduce the number of acute attacks of asthma, reduce the dosage of drugs, and improve lung function.The main adverse reactions included injection site reaction and upper respiratory tract infection.At present, monoclonal antibodies for children include Omalizumab, Mepolizumab, Benralizumab, Reslizumab and Dupilumab.Although the efficacy of monoclonal antibody in children with asthma is obvious, its long-term effect and safety still need to be further confirmed by a large number of clinical studies.

OBJECTIVE: To investigate the expression of signal transducer and activator of transcription 3 (STAT3) and phosphorylated STAT3 (p-STAT3) protein in papillary thyroid carcinoma (PTC), and to explore the correlation and significance between the expression of STAT3, p-STAT3 and epithelial-mesenchymal transition (EMT). METHOD: The expression of STATS3. p-STAT3, E-cadherin and Vimentin protein in 56 cases of PTC specimens and adjacent normal tissues specimens ware detected by immunohistochemistry. The correlation of the expression of STATS, p-STAT3, E-cadherin and Vimentin protein in PTC with clinicopathological characteristics was analyzed. RESULT: The positive rates of STAT3, p-STAT3 in PTC tissue were significantly higher than those in adjacent normal tissues specimens respectively (P < 0.01). The positive rates of E-cadherin in PTC tissues were remarkably lower, compared to adjacent normal tissues specimens (P < 0.01), however the positive rates of Vimentin in PTC tissues were remarkably higher, compared to adjacent normal tissues specimens (P < 0.01). The expression of STAT3, p-STAT3, E-cadherin and Vimentin protein were associated with lymph node metastasis and clinical stage (all P < 0.05). The expression of STAT3 and p-STAT3 was negatively correlated with E-cadherin expression (r = -0.494 and r = -0.364, P < 0.01, respectively), but positively with Vimentin expression (r = 0.533 and r = 0.377, P < 0.01, respectively) in PTC tissues. CONCLUSION PTC tissues have STAT3 protein activation and EMT phenotype, as were all correlated significantly with PTC invasion and metastasis. STAT3 signaling pathway activation might mediate EMT and then promote PTC invasion and metastasis.
Adult ; Antigens, CD ; Cadherins ; metabolism ; Carcinoma ; metabolism ; pathology ; Carcinoma, Papillary ; Epithelial-Mesenchymal Transition ; Female ; Humans ; Male ; Middle Aged ; Phosphorylation ; STAT3 Transcription Factor ; metabolism ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; metabolism ; pathology ; Vimentin ; metabolism

Objective It aims to investigate the relationships among the categories of Comprehensive Version for Stroke as described in the International Classiifcation of Functioning, Disability and Health (ICF) Core Set, and to provide new supports for Judicial Appraisal of functioning in stroke by ICF functioning mapping.Methods The variables of 59 categories of ICF assessment scale and the samples of 106 persons’ are selected and used in the least absolute shrinkage and selection operator (LASSO) for mining dependencies among those variables. The graphical modeling and analyzing with the software Gephi provides a visual map of the correlations among those classiifcations. Results 59 interconnected categories which organized into the functioning mapping. b340, b735, b175 and b152 are centrally positioned categories because of their high correlation.Conclusion Functioning mapping by graphical modeling can reveal complex relational structures embedded in functioning classiifcations, which provides the support for using ICF to appraisal stroke.