Objective To investigate the effects of case-based learning (CBL) applied in the clinical probation of anesthesiology.Methods Totally 313 undergraduates from the department of anesthesiology were randomly divided into 2 groups:CBL group (n =157) and LBL group (n =156).CBL methods were used to teach students in CBL group while traditional teaching methods were used to teach students in LBL group.After the causes being finished,a combination of theoretical examination and questionnaire were used to evaluate the teaching effectiveness between the two groups and a questionnaire was used to evaluate the recognition of teachers on CBL method.Data were managed by SPSS 17.0 software package.Quantitative data between groups were compared by t-test,enumeration data between groups were compared by chi-square test.Results Students in CBL group acquired higher score (86.7 ± 5.4) than those in LBL group (75.8 ± 4.5).82％ students in CBL group considered that their overall quality was improved while 42％ students in the LBL group thought so (P ＜ 0.05).75％ of faculties preferred the CBL methods.Conclusions Effect of CBL methods is better than traditional teaching methods and it's preferred by faculty and students.

Objective To evaluate the safety and efficacy of nephron sparing surgery (NSS) for renal angiomyolipoma (RAML). Methods Thirty-nine patients of RAML were underwent NSS. Tumor enucleation was done in 23, partial nephrectomy in 16, and selective arterial embolization in 2. Results The average diameter of enucleated tumor was 5.8 cm(from 3.0 to 14.0 cm), the average of blood loss was 190 ml(from 75 to 800 ml),none of the patients developed hemorrhage or urinary fistula. The average follow-up of 38 patients was 48 months(from 1 to 120 months). Postoperative serum level of creatinine was stable, no patients had a local recurrence. Conclusions NSS can be performed with satisfactory result in RAML. Effective control of hemorrhage and conservancy of renal function are the key points.

Breast cancer is a major disease which threatens the health of women around the world.Breast cancer patients have acquired resistance to existing treatment methods become the current clinical problems.MicroRNA(miRNA) is an endogenous non-coding RNA that participates in the regulation of a variety of biological processes,including cell proliferation,invasion,metastasis,epithelial interstitial transformation and drug resistance.Acquired resistance includes a variety of complex mechanisms that can affect the expression of cell-associated proteins through the abnormal expression of specific microRNAs,the binding of antineoplastic agents to the corresponding target,and the pathways associated with apoptosis.This article will focus on the expression of abnormal microRNA in acquired drug resistance which was caused by endocrine therapy,chemotherapy and molecular targeted therapy of breast cancer.miRNAs are considered as promising biomarkers and targets for diagnosis,treatments for acquired drug resistance of breast cancer.

BACKGROUND:Both microfracture and osteochondral transplantation are effective tools in the clinical treatment of articular cartilage defects.
OBJECTIVE: To observe the implementation results of microfracture and osteochondral transplantation in the treatment of articular cartilage defects.
METHODS:The clinical data of 50 cases (50 knees) of articular cartilage defects were retrospectively analyzed. There were two groups according to surgical repair methods: autogenous osteochondral transplantation+ microfracture in observation group (n=25), and microfracture in control group (n=25). Patients in the two groups were folowed up for over 24 hours to compare the Hospital for Special Surgery scores, clinical efficacy, adverse effects and complications.
RESULTS AND CONCLUSION:The number of patients whose Hospital for Special Surgery score was > 85 points and 60 to 85 points in the observation group was significantly larger than that in the control group (P< 0.05), and the total treatment effective rate of patients in the observation group was significantly higher than that of the control group (92%vs. 60%,P < 0.05). No complications occurred in both two groups. These findings indicate that osteochondral transplantation has better implementation results in the treatment of articular cartilage defects than microfracture.

Objective To discuss the effects of curcuma on different phases of the Hela cell proliferation in order to find the effective medicine in cervix cancer treatment.Methods MTT colorimetry and flow cytometry were used to measure the inhibitory rate of Hela cell proliferation and the changes of cell cycle, and transmission electron microscope(TEM) was used to observe the changes of the Hela subcells treated with the different concentrations of curcuma(0,10,20 and(40 mg?L~(-1))).Results Curcuma(0,10,20 and 40 mg?L~(-1))had obvious inhibitory effects on the Hela cell proliferation in a dose-dependant manner,the inhibitory rates were 3.0%,21.4%,32.8% and 49.2%,respectively.Furthermore,flow cytometry showed that the number of cells in G_1 phase increased and the number of cells in S phase decreased,the number of cells in G_2/M phases relatively increased.The changes of subcell structure could be seen,such as cavernous cells,cytoplasm agglutination,increasing apoptosis.(Conclusion Curcuma) can inhabit the Hela cell proliferation, prevent the cells in G_1 phase from entering into(S phase),and promote Hela cell apoptosis.

Objective:To observe the role of Zhike Qingfei Oral Liquid in treatment of the airway inflammation of chronic obstructive pulmonary diseases(COPD).Methods:50 cases with COPD at stable stage were divided into a treatment group and a control group,25 cases in each.Patients in both groups were treated with conventional therapy,including oxygen therapy,cardiactonic diuresis and relieving cough and asthma,etc.Zhike Qingfei Oral Liquid was added to the patients,of the treatment group,20ml each time,3 times each day,for 6 weeks.Clinical scores,pulmonary function,cell count and classification,interleukin-8(IL-8)and tumor necrosis Factor-?(TNF-?)in the sputum before and after treatment were investigated.Results:In the treatment group.the clinical score,FEV_1 and FEV_1/FVC(%)improved significantly(P

Objective To investigate the expression changes of the protein tyrosine phosphatase receptor T (PTPRT) in temporal lobe epileptic foci in the experimental animals and epileptic patients and the relationship between PTPRT and epileptogenesis.Methods After getting the epilepsy lobe tissue from the experimental and control groups,immunohistochemistry,immunofluorescence and Western blot analysis were used to assess the expression of PTPRT and its changes.Results In the temporal lobe tissue of intractable patients and control group,PTPRT was mainly expressed in the neurons.PTPRT was significantly increased in patients with intractable epilepsy (0.277 ± 0.048) than that in the control group(0.171 ±0.025 ; t =9.586,P ＜ 0.05).PTPRT was mainly expressed in the neurons in the temporal lobe brain tissue of the rats in the control group and experimental group.Compared with control group,the expression of PTPRT in the temporal lobe tissue was increased within 24 h post-seizure,and decreased 1 and 2 weeks post-seizure,then it was increased 1 and 2 months post-seizure (A ratio:control 0.443 ± 0.039,6 h 0.840±0.032,24 h 1.113 ±0.064,7 d 0.564 ±0.039,14 d 0.570 ±0.029,30 d 0.899 ±0.034,60 d 1.011 ± 0.074,F =256.427,P ＜ 0.05).Conclusions Through researches into the expression and function of PTPRT in the temporal lobe brain tissue of patients with intractable epilepsy and animal models,we presume that the PTPRT plays a role in the synapses reorganization and mossy fiber sprouting,and participates in the reconstruction of the neural network which leads to the intractable epilepsy.

BACKGROUND: Homocysteine(HCY) is emerging as an independent risk factor for atherosclerosis. Its damage to the structure and function of endothelial cell(EC) is seemingly an important mechanism that leads to atherosclerosis.OBJECTIVE: To investigate the effect of HCY on fibrinolysis in elderly patients with coronary heart disease(CHD).DESIGN: A case-controlled study based on CHD patients and normal people as control group.SETTING: Department of general internal medicine and department of cardiology in a university hospital.PARTICIPANTS: The study was completed in the Department of Gerontology Internal Medicine and Department of Cardiology, Beijing Chaoyang Hospital, Capital University of Medical Science. Altogether 177 inpatients and outpatients from this hospital during December 2001 to August 2003 were selected and divided into three groups according to the results of coronary angiography(CAG): CHD group( n = 91 ) with 50 males and 41 females with the mean age of(66 ± 6) years, negative CAG group( n = 86) with 43 males and 43 females with the mean age of(60 ± 6) years, and normal control group( n = 85) with 43 healthy males and 42 healthy females with the mean age of(55± 5) years.METHODS: Peripheral blood samples were collected. ELISA double antibody method was applied to test tissue-type plasminogen activator(t-PA), plasminogen activator inhibitor-1 (PAI-1) and yon Willebrand factor(vWF). HCY was assayed with EIA method and the ratio of PAI-1 to t-PA was calculated.MAIN OUTCOME MEASURES: HCY level, t-PA, PAI-1 and vWF activities, and the ratio of PAI-1 to t-PA.RESULTS: The levels of HCY, PAI-1, PAI-1/t-PA and vWF in CHD group were significantly higher than those in negative CAG group and normal control group( P ＜ 0.01 ); however, the level of t-PA was significantly lower than that in control group( P ＜ 0. 01) . HCY was positively correlated with PAI-1,PAI-1 / t-PA and vWF, while it was negatively correlated with t-PA.CONCLUSION: The increase of serum HCY is accompanied with fibrinolytic dysfunction. HCY is positively correlated with PAI-1 and vWF but negatively correlated with t-PA. Therefore, HCY is a predictor for early coronary lesions,and can provide related laboratory data for the primary prevention and early treatment of CHD.

Objective To study on the CDKN2/P16 gene in primary osteosarcoma.Method By using molecular biological methods that inclued genome DNA extraction from paraffined tissue and PCR SSCP analysis technique, we studied alternations of CDKN2/P16 gene in 25 primary osteosarcomas.Results (1)The deletions frequency in differentiation degree of osteosarcomas was① bone brood cell, 16.7% ;② cartilage brood cell,12.5% ;③ Fiber brood cell:20% ,(P >0.05).(2)The deletion frequency in male patients was 17.6% , female patients 12.5% ,(P >0.05).(3)In early metastatic osteosarcomas the deletion rate was 33.3% ,which was significantly higher than that of the control group with the rate of 10.5% (P< 0.05).(4)The deletion rate was 16% and the mutations were not found.Conclusion (1)The deletion rate was 16% and the mutations were not found.This suggests that the deletions of CDKN2/P16 gene were closely related to the genesis of primary osteosarcoma and that the main type of the alternation of CDKN2/P16 gene was deletion.(2)In early metastatic osteosaarcomas the deletion rate was 33.3% , which was significantly higher than that of the control group with the rate of 10.5% .This indicates to great extend that the deletions of CDKN2/P16 gene were closely related to the metastatic ability.(3)The deletions frequency had no significant relationship with differentiation degree of osteosarcomas, so was with the sex of the patient.

Objective To discuss method,operative characters and curative effect of total hip arthroplasty(THA)in treatment of acetabular fractures combined with ipsilateral femoral head or neck fractures.Methods One stage THA was done in seven patients with acetabular fractures combined with ipsilateral femoral head fracture(one patient)or femoral neck fractures(six patients)7-21 days after fractures.There were five males and two females,at age range of 41-65 years(average 50 years).According to AO classification,there were one patient with type A fracture,three with type B and three with type C.Of all,five patients received biological acetabular replacement after reduction and internal fixation of acetabular fracture and two received PMMA acetabular replacement with metal enforcement ring.All patients received biological femoral stem.Results Of all,six patients were followed up for from 2 years and 3 months to 6 years and 5 months(mean 3 years and 9 months),which showed heterotopic ossitlcation in one patient and dislocation in one who recovered after manipulative reduction.The Harris score was increased from mean prooperative 48 points to mean postoperative 91 points.X-ray found no loosening of prosthesis during follow-up.Conclusions THA can improve function of hip joint significantly,avoid further operation and lessen the burden of patients mentally and economically and hence is effective in treatment of acetabular fracture combined with ipsilateral femoral head or neck fractures.