Objective To explore the effects of problem-based learning (PBL) method on the efficiency of teaching of Chinese medicine dermatology based on medical records. Methods Undergraduate students who were in the same grade were divided into experimental group and control group. The experimental group was taught with the PBL method based on medical records. Teachers selected medical records, combed knowledge points, designed questions and carried out teaching in response to questions. The control group was taught with traditional teaching method. The teaching efficiency of two groups was evaluated by using test scores and questionnaire survey. Results The scores of syndrome differentiation scores, medication scores, and the overall score of experimental group were better than those in the control group. Compared with the control group, learning initiative, ability to involve in the teaching and master knowledge, and ability of logical analysis and communication of experimental group were all improved remarkably. Conclusion PBL method based on medical cases is beneficial for the improvement of the level of diagnosing and treating skin diseases based on syndrome differentiation and ability of solving problem.

Objective To further explore the genetic characteristics of oidiomycetes mutant strains like bacterial morphology on the basis of the study on morphology and structure of mutated candida.Methods The standard strains of candida albicans were induced by low temperature and under the condition of low temperature and nutrient deficiency.Variation of standard strains of Candida albicans were induced by clinical antifungal drugs such as fluconazole with different concentration gradient.Fungal gene template was prepared by boiling method,sequences of 16SRNA and 18SRNA were amplified using bacteria conservative gene sequence of 16SRNA and fungal conserved gene sequence of 18SRNA,and observed and recorded the results agarose gel electrophoresis.At the same time,the amplified fragment of bacterial conservative gene 16SRNA was sequenced,and the sequence was analyzed by BLAST comparison.Results the 16SRNA sequences of candida variant were amplified positive,while the standard strain of candida albicans did not show the corresponding amplification band.Except 2 strains which showed a faint band,the other variants of the 18SRNA sequences did not amplified the target band,while the standard strains of candida albicans showed a corresponding amplification bands.Suggested that proportion of 18SRNA sequences in the genome of oidiomycetes mutant strains like bacterial morphology was not much even lack.The 16SRNA fragments amplified of oidiomycetes mutant strains like bacterial morphology did determination of DNA sequence after purification.BLAST comparison analysis,it was found that sequence of oidiomycetes mutant strains like bacterial morphology had higher similarity with bacterial sequences in the database.Conclusion Oidiomycetes mutant strains like bacterial morphology contained bacterial and a small amount of fungus conservative gene.Oidiomycetes mutant strains like bacterial morphology with original nuclear biological character are ones from eukaryotes.This study is great significance in biological evolution,especially in the evolution of prokaryotic cells and eukaryotic cells.

BACKGROUNDThe optimal timing of surgical revascularization for patients presenting with ST-segment elevation myocardial infarction (STEMI) and impaired left ventricular function is not well established. This study aimed to examine the timing of surgical revascularization after STEMI in patients with ischemic heart disease and left ventricular dysfunction (LVD) by comparing early and late results.

METHODSFrom January 2003 to December 2013, there were 2276 patients undergoing isolated coronary artery bypass grafting (CABG) in our institution. Two hundred and sixty-four (223 male, 41 females) patients with a history of STEMI and LVD were divided into early revascularization (ER, <3 weeks), mid-term revascularization (MR, 3 weeks to 3 months), and late revascularization (LR, >3 months) groups according to the time interval from STEMI to CABG. Mortality and complication rates were compared among the groups by Fisher's exact test. Cox regression analyses were performed to examine the effect of the time interval of surgery on long-term survival.

RESULTSNo significant differences in 30-day mortality, long-term survival, freedom from all-cause death, and rehospitalization for heart failure existed among the groups (P > 0.05). More patients in the ER group (12.90%) had low cardiac output syndrome than those in the MR (2.89%) and LR (3.05%) groups (P = 0.035). The mean follow-up times were 46.72 ± 30.65, 48.70 ± 32.74, and 43.75 ± 32.43 months, respectively (P = 0.716). Cox regression analyses showed a severe preoperative condition (odds ratio = 7.13, 95% confidence interval 2.05-24.74, P = 0.002) rather than the time interval of CABG (P > 0.05) after myocardial infarction was a risk factor of long-term survival.

CONCLUSIONSSurgical revascularization for patients with STEMI and LVD can be performed at different times after STEMI with comparable operative mortality and long-term survival. However, ER (<3 weeks) has a higher incidence of postoperative low cardiac output syndrome. A severe preoperative condition rather than the time interval of CABG after STEMI is a risk factor of long-term survival.

Aged ; Coronary Artery Bypass ; methods ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; mortality ; surgery ; Myocardial Ischemia ; mortality ; surgery ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Time Factors ; Treatment Outcome ; Ventricular Dysfunction, Left ; mortality ; surgery

OBJECTIVETo investigate the molecular mechanism of arsenic trioxide(ATO) inhibiting K562 cell proliferation, and explore the new targets for treating chronic myeloid leukemia(CML).

METHODShuman CML cell line K562 cells were cultured in vitro, and were treated with different concentrations of ATO; MTT was used to detect the cell proliferation; flow cytometry(FCM) was used to determine cell apoptosis, cell cycle and the expression of CD44; Transcriptional levels of β-catenin and cyclin D1 were assayed by RT-PCR.

RESULTS2 µmol/L ATO could inhibit the cell proliferation obviously in a time-and-dose-dependent manner. With drug concentration increasing and time prolonging, the expression rate of CD44 was declined gradrually. FCM with AnnexinV/PI double staining showed that K562 cells were induced to apoptosis after exposure to 2.5-10 µmol/L ATO for 48 hours and in dose-dependent manner. Treating with different concentration ATO for 48 hours, cell ratio of G/Gphase increased and cell ratio in S phase decreased gradually. RT-PCR showed that the expression of β-catenin and CyclinD1 decreased with increasing of drug concentration.

CONCLUSIONATO in certain concentration range can inhibit K562 cell proliferation, and induce the cell apotosis, the mechanismin influencing the Wnt/β-catenin pathway may be the downregulation of CD44 expression, arresting K562 cells in G/Gphase, and affecting the gene transcription, thus inhibiting K562 cell proliferation.

OBJECTIVETo compare the perioperative outcomes of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) for treatment of complex coronary artery disease and left ventricular dysfunction.

METHDOSThe clinical data of 966 patients admitted to our hospital from January 2003 to December 2013 with coronary artery disease and left ventricular dysfunction (ejection fraction ≤50%) were retrospectively reviewed. Among the patients, 386 underwent CABG and 580 received PCI. After matching for EuroSCORE risk factors and preoperative echocardiographic parameters, 135 patients with CABG and 135 with PCI were enrolled in this study. With hospital mortality and perioperative major complications as the endpoints, the early outcomes of the procedures were evaluated. Perioperative echocardiography was performed to evaluate the change of left ventricular geometry and function.

RESULTSCompared with CABG group, PCI group had significantly higher incidences of chronic lung disease (8.1% vs 0.7%, P=0.003) and recent myocardial infarction (64.4% vs 31.9%, P=0.000) but significantly lower left-main disease (12.6% vs 23.7%, P=0.018); the other baseline characteristics were comparable between the two groups. Patients with CABG had a greater number of treated target vessels than those with PCI (2.90±0.81 vs 1.67±0.73, P=0.000), and complete revascularization was more common in CABG group (94.8% vs 51.8%, P=0.000). No significant difference was found in perioperative variations of LVEF between the two groups, but patients with CABG had a greater variation in LVEDD than those with PCI. The hospital mortality and other major complications were similar between the two groups.

CONCLUSIONBoth CABG and PCI are safe and reliable revascularization strategies for complex coronary artery disease and left ventricular dysfunction, but CABG can achieve a higher rate of complete revascularization and better improves the left ventricular function.

Coronary Artery Bypass ; Coronary Artery Disease ; surgery ; therapy ; Echocardiography ; Humans ; Incidence ; Percutaneous Coronary Intervention ; Retrospective Studies ; Risk Factors ; Treatment Outcome ; Ventricular Dysfunction, Left ; therapy ; Ventricular Function, Left

OBJECTIVETo explore the effect of anti-CD44 monoclonal antibody A3D8 on expression of transcription factor AP-1 in acute myeloid leukemia cells.

METHODSAfter acute leukemia cell line HL-60 was treated by different concentrations of A3D8, the proliferation and cell cycle were detected by MTT and FCM respectively. The expressions of c-JUN and c-FOS at mRNA and protein level were detected by RT-PCR and Western Blot respectively.

RESULTSThe proliferation of HL-60 was inhibited by A3D8. The A3D8 treatment increased the percentage of G/Gcells. The expressions of c-JUN at mRNA and protein level were both decreased in HL-60 cells treated with A3D8. The expressions of c-FOS at mRNA and protein level in rapamycin treatment groups showed no statistically significant difference as compared with that in control group.

CONCLUSIONSA3D8 can affect the activity of AP-1 through inhibiting the expressions of c-JUN at mRNA and protein level.

OBJECTIVETo compare the mid- to long-term outcomes of patients receiving isolated coronary artery bypass grafting (CABG) versus surgical ventricular restoration (SVR) plus CABG for left ventricular aneurysms.

METHODSThe clinical data were retrospectively analyzed in 205 patients with left ventricular aneurysms admitted to our hospital between January, 1997 and December, 2012, including 115 patients receiving SVR plus CABG and 90 undergoing isolated CABG. By matching preoperative echocardiographic parameters including aneurysm size, left ventricular ejection fraction (LVEF), left ventricular end-systolic volume index (LVESVI) and EuroSCORE risk factors, 32 patients receiving SVR plus CABG and another 32 with isolated CABG were enrolled in this study. The patients were compared for survival rates, major adverse cardiac or cerebrovascular events (MACCEs), left ventricular geometry and function at 1, 3 and 5 years of follow-up.

RESULTSCompared with the patients receiving isolated CABG, those receiving SVR and CABG showed greater improvements in echocardiographic parameters and NYHA functional class. The differences in the echocardiographic parameters between the two groups gradually reduced with time and became comparable at 5 years after the operation (P>0.05). No significant difference was found in the mid- to long-term survival or the incidence of MACCEs between the two groups (P>0.05).

CONCLUSIONCompared with isolated CABG, SVR plus CABG does not reduce the incidence of MACCEs or improve the mid- to long-term survival rate of patients with left ventricular aneurysm with a LVESVI <60 mL/m(2).

Aneurysm ; surgery ; Coronary Artery Bypass ; Echocardiography ; Heart Ventricles ; surgery ; Humans ; Incidence ; Retrospective Studies ; Risk Factors ; Stroke Volume ; Survival Rate ; Treatment Outcome ; Ventricular Function, Left

This study was aimed to investigate the effect of COX-2 inhibitor celecoxib on proliferation, apoptosis of human acute myeloid leukemia cell line HL-60 and its mechanism. HL-60 cells were cultured with different concentrations of celecoxib for 24 h. Cell proliferation was analyzed by CCK-8 assay, cell apoptosis and cell cycle distribution were detected by flow cytometry. Cyclin D1, cyclin E1 and COX-2 mRNA expressions were determined by RT-PCR. The results showed that after the HL-60 cells were treated with different concentrations of celecoxib for 24 h, the cell growth was significantly inhibited in a dose-dependent manner(r = 0.955), IC50 was 63.037 µmol/L of celecoxib. Celecoxib could effectively induce apoptosis in HL-60 cells also in dose-dependent manner(r = 0.988), blocked the HL-60 cells in the G0/G1 phase. The expression of cyclin D1, cyclin E1 and COX-2 mRNA were downregulated. It is concluded that celecoxib can inhibit the proliferation of HL-60 cells in dose-dependent manner, celecoxib causes cell G0/G1 arrest and induces cell apoptosis possibly through down-regulation of the cyclin D1 and cyclin E1 expression, and down-regulation of COX-2 expression respectively.
Apoptosis ; drug effects ; Celecoxib ; Cell Proliferation ; drug effects ; Cyclin D1 ; metabolism ; Cyclin E ; metabolism ; Cyclooxygenase 2 ; metabolism ; Cyclooxygenase 2 Inhibitors ; pharmacology ; Gene Expression Regulation, Leukemic ; HL-60 Cells ; Humans ; Oncogene Proteins ; metabolism ; Pyrazoles ; pharmacology ; Sulfonamides ; pharmacology

AlM: To observe clinical effect of vitrectomy with intravitreal ranibizumab for the treatment of diabetic retinopathy ( DR) .
METHODS:From February 2011 to February 2013, there were 90 cases in our hospital diabetic retinopathy patients withvitrectomy surgery. lt was randomly divided into observation group ( 45 cases ) and control group ( 45 cases ) . Two groups of patients were performed vitrectomy. Patients in observation group were injected intravitreal ranibizumab before surgery, then vitrectomy was underwent for diabetic retinopathy. Vitrectomy was only underwent in control group.
RESULTS:The patients in observation group with good effect accounting for 71% (32/45) and good rate was 89%(40/45 ), which were significantly higher than that in control group 51% ( 23/45 ) , 71% ( 32/45 ) . Differences were statistically significant ( P < 0. 05 ). Amount of bleeding was 9. 64 ± 2. 27mL, intraocular pressure was 13. 64 ± 3. 27mmHg. lt was significantly less than that in control group 10. 21 ± 3. 14mL, 16. 00 ± 3. 14mmHg. Differences were statistically significant (P<0. 05).
CONCLUSlON: The vitrectomy with intravitreal ranibizumab treatment of diabetic retinopathy can not only reduce blood loss, but also reduce edema and improve effectiveness and safety. lt's worth recommending for clinical practice.

Objective:To explore the influence of esmolol on the dosing of remifentanil in total intravenous anesthesia(TIVA). Methods:A total of 40 female patients scheduled for thyroid surgery were randomly divided into 2 groups,with 20 patients in each group.The patients in the study group received a loading dose of esmolol through continuous intravenous infusion after tra-cheal intubation.The infusion was stopped after extubation.The control group received the same volume of 0.9% sodium Chlo-ride.The target concentration of propofol was adjusted by bispectral index,and the target concentration of remifentanil was ad-justed by heart rate and mean artery pressure.Intraoperative heart rate,mean artery pressure and bispectral index,as well as postoperative pain scores,were recorded.Results:There was no significant difference in heart rate,mean artery pressure and bispectral index between the two groups(P >0.05).The dosage of remifentanil in the study group was lower than that in the control group(P <0.01).The pain score was higher in the study group at 5 min after entering postanesthetic care unit(PACU) than that in the control group(P <0.05).There was no statistical significance in pain scores at 30 min after entering PACU and at 24 h after surgery (P <0.05)between the two groups.Conclusions:Continuous low dosage infusion of esmolol could signifi-cantly decrease the consumption of remifentanil in TIVA.