Objective To develop a teaching strategy which is suitable for training talents and improving teaching quality in field of clinical gynecological oncology.Methods Seventy-eight clinical students of grade 2020 in a medi-cal university were divided into control group(n=38)and research group(n=40).The"3+2"teaching mode of team-based learning(TBL)and workshop(WS)were adopted,and the learning outcome was evaluated at preview preparation,knowledge application and the questionnaire survey of students,so as to promote the cultivation of clinical reasoning of medical students.Results Compared with traditional teaching method,TBL+WS teaching group had better academic performance.The difference of before class tests and final exams was more significant[17.53±6.15 points and(76.81±5.10)points,respectively,P＜0.001].However,among the eight dimensions of the classroom teaching questionnaire,the teaching quality dimension was the highest(97.5%).More students think that this model had a positive effect on cultivating clinical thinking and developing new knowledge.Conclu-sions This integrated teaching strategy improves the quality of obstetrics and gynecology teaching and suppots students'capacity building on clinical reasoning.

Objective To explore the effect of paclitaxel with carboplatin combined chemotherapy on hemocyte re-lated indexes,vascular endothelial growth factor(VEGF)and tumor markers in ovarian cancer(OC)patients.Methods OC patients combined chemotherapy(CC)group and ovarian benign tumor control group with 50 cases in each.The pathological changes in the ovarian cells were observed by HE staining and the expression of VEGF was observed by immunohistochemical staining(IHC).Blood cell was counted by flow cytometry(FC).Serum car-bohydrate antigen 125(CA125)and human epididymal protein 4(HE4)were measured by electrochemical lumi-nescence(ECL).Results Compared with control group,the ovarian tissue structure was disordered and the cell atypia was obvious in OC.VEGF expression was significantly enhanced.Platelet count(PLT),CA125 and HE4 were significantly increased(P＜0.01).However,necrotic cells were observed in ovarian tissue of CC group.VEGF expression was inhibited.PLT count and the level of CA125 and HE4 were significantly lower than those of control group after chemotherapy(P＜0.01).Conclusions Combined chemotherapy may regulate the level of VEGF,CA125 and HE4 in OC patients.

Objective To explore the characteristics and efficacy of manual treatment for postpartum hypogalactia.Methods To retrieve the CNKI from 2007 to 2017 on the massage and manual treatment for postpartum hypogalactia,and analyze its syndrome differentiation,acupoint selection,manipulation rules,treatment frequency,treatment courses and clinical efficacy.Results Among the 83 articles included,the massage therapy for postpartum hypogalactia were based on the diseases and syndromes,and the selection of acupoints was diverse and combined with local and distance such as Danzhong (CV 17),Rugen (ST 18),Shaoze (SI 1),Zusanli (ST 36),Pishu (BL 20).The therapy were rich in techniques which often use acupoint stimulation and manipulation.Conclusions Tuina therapy for postpartum hypogalactia is widely used with safety and reliablility.But the operational procedures and efficacy standards need to be further standardized.

Objective To establish tree shrew model of type 2 diabetes mellitus (T2DM) combined with cerebral ischemia (IS),and to explore the regulatory mechanism of ischemic postconditioning (PC) on gene differential expression in cerebral cortex under metabolic abnormalities and cerebral ischemia condition.Methods Seventy tree shrews were divided into control,T2DM,IS,T2DM+IS and T2DM +IS +PC groups (n =14 each group).The experimental diabetes model was established by the combined use of high fat diet breeding with streptozocin injection in tree shrew.The local cerebral thrombosis was induced by photochemical reaction in tree shrews,and ischemic PC was established at 4h after cerebral ischemia followed by clipped ipsilateral common carotid artery three times (5 min/time).The metabolic status of tree shrews was measured by serum biochemical markers.TTC staining,HE staining,and electron microscopy were used to observe the changes of the body's metabolic status at 24h after IS.RNA-seq was used to analyze differentially expressed genes.Results The ultrastructure of brain cells was abnormal and the cerebral infarction area was the largest in T2DM+IS tree shrews (P＜0.01).Compared with control group,body weight of tree shrews in T2DM + IS group was significantly reduced (P＜ 0.01) while blood glucose,total cholesterol,low density lipoprotein-cholesterol,triglyceride,and C-reactive protein (CRP) levels were markedly increased(all P＜0.01).The RNA-seq analysis showed that there were 1 629 differentially expressed genes (1 109 up-regulated genes and 520 down-regulated genes) in T2DM + IS group vs control group.However,ischemic PC deceased the cortical infarction area (P＜0.01)and reduced blood glucose,lipid and CRP levels (P＜0.05),with 520 differential expression genes (203 up-regulated genes and 317 down-regulated genes).Conclusion Ischemic PC improves the metabolic disturbance-aggravated ischemic brain injury in T2DM tree shrews,which may be related to its regulation on gene expression in cerebral cortex.

Objective To investigated the relationship between plasma sclerostin(SOST)and knee osteoar-thritis(KOA). Methods A total of 95 patients with KOA and 95 healthy people were involved.Plasma sclerostin, CTX-II, AGG1 and AGG2 levels were measured by ELISA. The 95 patients were divided based on Kellgren-Law-rence classification. The correlation between plasma SOST level and KL classification, CTX-II, AGG1 and AGG2 were analyzed.Results Plasma SOST level in KOA was significantly lower than that in control group(P<0.001). SOST level was negatively correlated with KL grade (r =-0.828,P < 0.001),also with CTX-II (r =-0.917,P <0.001),AGG1 (r =-0.658,P < 0.001) and AGG2 (r =-0.583,P < 0.001). Conclusions SOST level in KOA patients is related to the degree of cartilage degeneration. Thus, it helps to monitor the progress and evaluate the severity of the KOA.

Objective:To research rmIL-18 in vitro culture system CCs induce tumor-specific cytotoxic T lymphocytes CTL and anti-tumor effect in mice.Methods:Used Stem SepTM immune magnetic cells separation method to culture mouse spleen NK cells,T cells and DCs,established culture systems in vitro;used of different approaches,different doses rmIL-18 to immunize HCC tumor-bearing mice,researched the effect of rmIL-18 on tumor growth rate and survival time.Results:rmIL-18 could induce and promote tumor-specific CTL-mediated killing effects in vitro culture system;tumor-specific CTL could significantly inhibit tumor growth(P<0.01) of and prolong the survival time of liver cancer tumor-bearing mice(P<0.01),and the effect was increased with rmIL-18 concentration increased(P<0.01),and intratumoral injection was superior to intraperitoneal injection(P<0.01).Conclusion:rmIL-18 can induce tumor-specific CTL in vitro and play a role in anti-liver cancer in mice.

Clinical skills training is a key factor for improvement of the quality of clinical teaching.Developing highly specific clinical skills training specification is an important step to improve the quality of gynecologic oncology clinical teaching.Based on its importance,a'four steps training strategy,known groups-building specification-train thinking-make a request is developed and used by Dept.of Obsterics and Gynecology,the 3rd Affiliated Hospital,Kunming Medical University.It guides students to achieve the basic theory,basic knowledge and basic skills through a comprehensive way,and it also encourages students with highly learning initiative of gynecologic oncology clinical skills.On the other side,in the clinical skills training will lead teachers to develop their thinking and enhance the enthusiasm of teaching.This method provides a new sight for gynecologic oncology clinical skills training in a new manner.

Objective:To investigate the effects of different doses and infusion methods of recombinant mouse interleukin-18(rmIL-18) on the survival time and tumor diameter of the mice with hepatocellular carcinoma,and to elucidate the rational application of rmIL-18 in vivo.Methods:A total of 60 Babl/C mice were randomly divided into 5 μg rmIL-18 intraperitoneal injection group,0.5 μg rmIL-18 intraperitoneal injection group,0.5 μg rmIL-18 tumor injection group,cytotoxic T lymphocyte(CTL) intraperitoneal injection group,CTL tumor injection group and saline control group;there were 10 mice in each group.From the 10th day of inoculation,the mice in different rmIL-18 groups were injected with the corresponding doses and methods.The mice in different CTL groups were injected with tumor-specific CTL (1×106/mouse) by intraperitoneal and intratumoral injection.The mice in saline control group were injected with an equal volume (100 μL) of saline,the injections were performed 10 times.The diameters of mice were measured weekly and the survival time was recorded.Results:Compared with 5 μg rmIL-18 intraperitoneal injection group,0.5 μg rmIL-18 intraperitoneal injection group and saline control group,the tumor growth rate of the mice in 0.5 μg rmIL-18 tumor injection group was decreased (P<0.01)and the survival rate of the mice was increased (P<0.01);compared with 0.5 μg rmIL-18 intraperitoneal injection group,the tumor growth rate and the survival rate of the mice in CTL intraperitoneal injection group were decreased (P<0.01);compared with 0.5 μg rmIL-18 tumor injection group,the tumor growth rate and the survival rate of the mice in CTL tumor injection group were decreased (P<0.01).Conclusion:The best way for rmIL-18 anti-tumor effect is tumor injection and the effect has a dose-dependent manner.

Objective To assess the correlation between the pregnancy‐associated plasma protein A (PAPP‐A)level with gesta‐tional diabetes mellitus(GDM )in primiparous women .Methods The nonparametric test and Logistic regression analysis were used to retrospectively analyze 168 pregnant women of GDM and 273 normal pregnant women ,including age ,body weight ,PAPP‐A ,freeβ‐human chorionic gonadotropin(fβ‐hCG) .Results The age had significant difference between GDM group and control group(P<0 .01) ,the PAPP‐A concentration and corrected multiple of the median (MoM )of PAPP‐A in the GDM group were significantly lower than those in the control group(P<0 .01) .Conclusion Low level of PAPP‐A during early pregnant stage in primiparas is strongly associated with GDM and can be used as the risk factor of GDM .

Objective To investigate the expression of the preferentially expressed antigen of melanoma (PRAME) gene in acute myeloid leukemia (AML),and to evaluate its applicability in monitoring minimal residual disease (MRD).Methods Bone marrow specimens were collected from 63 cases of de-novo AML,while 34 samples from 11 patients were tracked for 28 months.The level of PRAME mRNA was measured by real time RT-PCR.Results The PRAME gene expressed in 52.4 ％ (33/63) of de-novo patients,and the positive rate was highest in M3 than that in other subtypes of AML.The expression of PRAME became negative after treatment and increased in the following months before morphology relapse.Conclusion The PRAME gene is highly expressed in AML and could be a useful marker to monitor MRD.