In order to adapt to teaching reform of Medical Immunology and create a"golden course",through teaching prac-tice,our research group proposes a"three-dimensional curriculum teaching system",which organically combines teaching concepts with teaching design and process,with construction of various resources(material libraries),and finally,multi-level teaching evalua-tion is completed to achieve overall unity of teaching.

In order to adapt to teaching reform of Medical Immunology and create a"golden course",through teaching prac-tice,our research group proposes a"three-dimensional curriculum teaching system",which organically combines teaching concepts with teaching design and process,with construction of various resources(material libraries),and finally,multi-level teaching evalua-tion is completed to achieve overall unity of teaching.

The DNA characterization of Cannabis sativa L.has been one of the key directions of anti-drug research at home and abroad.Previous research mainly focused on the identification of cannabis-species and gender differentiation,and have constructed a number of corresponding composite amplification systems.With the rapid development of high-throughput sequencing technology,the whole genome of C.sativa and the sequences of key enzyme genes for its major physicochemical components have been sequenced successively,and intra-species differentiation studies of C.sativa based on specific molecular markers have gradually emerged.However,due to the high variability of cannabis subspecies-and variety-specific molecular markers,relevant foreign studies failed to provide ideal molecular marker support for the identification of intra-specific distinctions of Cannabis sativa in China.Based on this,this paper comprehensively analyzes the current situation and shortcomings of domestic and international research on intra-specific differentiation of C.sativa,and combines the previous research results of this group to elaborate on how to use high-throughput sequencing technology to solve the problem of the lack of intra-specific molecular markers of C.sativa in China.

CRISPR/ Cas9 gene editing system is a new tool of gene editing technology based on the im-mune mechanism of archaea against foreign nucleic acid invasion. Due to its high efficiency and accuracy, CRISPR/ Cas9 genome editing technology has been widely used in tumor therapeutic research,such as targeted knockout of oncogenes,repair of tumor suppressor genes,breaking immune tolerance,and construction of tumor models,which brings revolutionary development to tumor gene therapy.

Objective To develop and validate a model based on deep learning for automatic diagnosis of early gastric cancer ( EGC) to improve detection and diagnosis of EGC. Methods A total of 5159 images ( including 1000 images of EGC and 4159 images of other benign lesions or normal patients) obtained from May 2014 to December 2016 were collected from endoscopic database in changhai Hospital. Then 4449 images were selected randomly for a deep convolutional neural network ( CNN ) training, of which 768 were diagnosed as EGC and 3681 diagnosed as other benign lesions or normal. The remaining 710 images were used to test the model by comparing with diagnostic results of four endoscopists. Results The deep learning model showed accuracy of 89. 4％ ( 635/710 ) , sensitivity of 88. 8％ ( 206/232 ) and specificity of 89. 7％ ( 429/478) for EGC. The mean time required for diagnosis was 0. 30 ± 0. 02 s. The performance of the model was superior to that of four endoscopists. Conclusion The model based on deep learning has high accuracy,sensitivity and specificity for detecting EGC,which could assist endoscopists in real-time diagnosis.

OBJECTIVETo investigate the effect of laparoscopic sleeve gastrectomy(LSG) on sex hormone in male patients with severe obesity.

METHODSRetrospective analysis was performed in 31 male patient with severe obese [body mass index(BMI) ≥28 kg/m, obesity group] who underwent LSG in Shanghai Tenth People's Hospital of Tongji University from December 2012 to May 2016. The anthropometric parameters(weight, BMI, waist circumference, hip circumference, waist-hip ratio, body fat percentage), glucose metabolic indices [fasting plasma glucose(FPG), fasting insulin (FINS), glycosylated hemoglobin (HbA1c), homeostasis model assessment-insulin resistance index(HOMA-IR)], and sex hormone parameters [estradiol(E2), total testosterone (TT), follicle-stimulating hormone (FSH) and luteinizing hormone (LH)] were collected preoperatively and 1, 3, 6 months postoperatively. In addition, 31 healthy male volunteers with normal BMI were consecutively recruited in this study as control group. The above-mentioned parameters were also determined in control group. Changes of these variables before and after surgery were analyzed. Pearson method was used to analyze the correlation of TT with anthropometric parameters and glucose metabolic indices before and after surgery.

RESULTSThe average age of patients in obesity and control group was (32.9±9.7) (18 to 56) years and (30.7±8.9) (18 to 49) years. Compared to the control group, obesity group had significantly higher anthropometric parameters and glucose metabolic indices before surgery (all P<0.05). In obesity group, the anthropometric and glucose metabolic indices significantly decreased at 1 to 6 months after surgery compared to those before surgery (all P<0.05). At 1 month after surgery, the anthropometric parameters and glucose metabolic indices in obesity group were significantly higher than those in control group (all P<0.05). At 3, and 6 months after surgery, there were no significant differences in glucose metabolic indices between obesity and control group (all P>0.05), while the anthropometric parameters in obesity group were still significantly higher than those in control group(all P<0.05). The sex hormone parameters in control and obesity group before surgery were as follows: E2: (100.2±23.5) pmol/L and (129.2±81.9) pmol/L; TT: (18.0±4.9) nmol/L and (8.4±4.5) nmol/L; FSH: (4.5±3.1) IU/L and (4.3±2.5) IU/L; LH: (4.4±1.7) IU/L and (5.3±2.6) IU/L. Compared to control group, the TT level of obese patients before surgery significantly decreased(P=0.000), while no significant differences were observed in the levels of E2, FSH, and LH(all P>0.05). The TT levels were significantly increased at 1, 3, 6 months after surgery[(13.1±7.0), (13.6±5.7), (21.0±19.3) nmol/L, respectively, all P<0.05] and the E2 level was significantly decreased at 6 months after surgery [(91.4±44.9) pmol/L, P<0.05], while no significant differences were observed at 1 and 3 months after surgery (all P>0.05). Furthermore, the FSH and LH levels did not exhibit significant change at 1, 3, and 6 months after surgery compared to those before surgery (all P>0.05). At 1 month after surgery, no significant correlations were examined in the change value of TT levels (▹TT) with the changes of BMI(▹BMI), FPG(▹FPG), FINS(▹FINS), HOMA-IR(▹HOMA-IR), and E2(▹E2) (all P>0.05). At 3 months after surgery, ▹TT was negatively correlated with ▹BMI (r=-0.441, P=0.015), ▹FINS (r=-0.375, P=0.041), and ▹HOMA-IR(r=-0.397, P=0.030), but not correlated with ▹FPG and ▹E2 (all P>0.05). At 6 months after surgery, ▹TT was negatively correlated with ▹BMI(r=-0.510, P=0.018) and ▹HOMA-IR (r=-0.435, P=0.049), but not correlated with ▹FPG, ▹FINS and ▹E2 (all P>0.05).

CONCLUSIONSMale severe obese patients are accompanied with abnormal sex hormone levels. LSG has a significant effect on weight loss and blood glucose improvement, and may ameliorate the sex hormone unbalance by improving the insulin resistance in men with severe obesity.

Adult ; Bariatric Surgery ; Blood Glucose ; physiology ; Body Mass Index ; Body Weights and Measures ; China ; Estradiol ; blood ; physiology ; Fasting ; blood ; Follicle Stimulating Hormone ; blood ; physiology ; Follow-Up Studies ; Gastrectomy ; Glycated Hemoglobin A ; physiology ; Humans ; Insulin ; blood ; physiology ; Insulin Resistance ; physiology ; Luteinizing Hormone ; blood ; physiology ; Male ; Obesity, Morbid ; surgery ; Retrospective Studies ; Testosterone ; blood ; physiology ; Treatment Outcome ; Weight Loss ; physiology

Objective To evaluate the effect of hyperoxygenated solution on myocardial injury in the rats with acute carbon monoxide (CO) poisoning.Methods Thirty pathogen-free adult male SpragueDawley rats,weighing 250-300 g,were randomly divided into 5 groups (n=6 each) using a random number table:control group (C group),acute CO poisoning group (ACP group),and different doses of hyperoxygenated solution groups (HP1-3 groups).CO 120 ml/kg was injected intraperitoneally to establish the model of acute CO poisoning.Hyperoxygenated solution 10,15 and 20 ml/kg were infused via the caudal vein at 1 h after intraperitoneal injection of CO in HP1-3 groups,respectively.At 24 h after intraperitoneal injection of CO,blood samples were collected from the caudal vein for determination of plasma creatine kinase (CK),creatine kinase-MB (CK-MB),lactic dehydrogenase (LDH) and alpha-hydroxybutyrate acid dehydrogenase (α-HBDH) activities using the automatic biochemical analyzer.The rats were then sacrificed,and myocardial specimens were obtained for examination of the pathological changes with a light microscope.Results Compared with group C,the plasma LDH,α-HBDH,CK and CK-MB activities were significantly increased in ACP and HP1-3 groups (P＜0.01).Compared with group ACP,the plasma LDH,α-HBDH,CK and CK-MB activities were significantly decreased in HP1-3 groups (P＜0.05 or 0.01).Compared with group HP1,the plasma LDH,α-HBDH,CK and CK-MB activities were significantly decreased in HP2,3 groups (P＜0.05).The pathological changes of myocardium were significantly attenuated in HP1-3 groups as compared with group ACP.Conclusion Hyperoxygenated solution can attenuate myocardial injury in the rats with acute CO poisoning.