As essential part of teachers' teaching practice, the design and arrangement of assignments is the main carrier of interaction between teachers and students, and is also an important learning way for students. According to the discipline characteristics and teaching modes of histology and embryology courses, we have developed a systematic assignment design model that covers theory, practice, and application with four types of assignments—pre-class assignments, exploratory assignments, practical assignments, and innovative assignments distributed before class, in class, after class, and throughout the teaching process. Behind this assignment design strategy is the concept of learner-centered teaching, which aims to help students learn professional knowledge and develop comprehensive literacy.

【Objective】 To investigate the significance of granulocyte macrophage colony-stimulating factor (GM-CSF), nerve growth factor (NGF) and interleukin-17 (IL-17) in the prostate tissue of rats with experimental autoimmune prostatitis(EAP). 【Methods】 EAP rat models were established and divided into control group, EAP group, anti-GM-CSF group (blocking control group) and anti-GM-CSFEAP group (blocking EAP group). Pain behaviors were tested. The pathological changes were observed with HE staining. The mRNA and protein expressions of GM-CSF, NGF and IL-17 were detected with RT-PCR and Western blot. 【Results】 Pain test showed the anti-GM-CSF group had less chronic pelvic pain than the EAP group. HE staining showed the anti-GM-CSF group had less tissue inflammatory response. The EAP inflammation score was higher in the control group than in the anti-GM-CSF group. Immunohistochemistry showed GM-CSF was positive in the EAP group (mainly in the nucleus). RT-PCR and Western blot results showed the mRNA and protein expressions of IL-17 and NGF significantly decreased 50 days after EAP in the anti-GM-CSF group. 【Conclusion】 Increased expressions of GM-CSF, NGF and IL-17 in prostate tissue of EAP rats may be important inflammatory mediators of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS);decreased expressions of NGF and IL-17 after resistance against GM-CSF indicate that GM-CSF may be a potential therapeutic target for CP/CPPS.

To investigate the clinical and endoscopic characteristics and endoscopic treatment efficacy of cap polyposis, data of 14 patients (56 polyps) who were histologically diagnosed as having cap polyposis after endoscopic submucosal dissection (ESD) or endoscopic mucosal resection (EMR) in Beijing Friendship Hospital from June 2017 to February 2021 was retrospectively analyzed. Of the 14 patients, 8 were males and 6 were females. The age ranged from 14 to 74 years, including 7 cases of <60 years old and 7 cases of ≥60 years old. 7 patients (50.0%) had clinical manifestations. Four cases had multiple polyps and 10 cases (71.4%) had single polyps. There were 42 polyps (75.0%) located in the rectum, 13 (23.2%) in the sigmoid colon and 1 in the transverse colon. According to the classification of Yamada, 44 polyps (78.6%) were type Ⅰ, 3 polyps were type Ⅱ, 5 polyps were type Ⅲ and 4 polyps were type Ⅳ. Under endoscopy, there were 41 polyps (73.2%) with obvious white cap-like coverings on the surface and 23 polyps with obvious hyperemia and redness on the mucosa, 8 of which were both visible. Two cases were treated with ESD and 12 cases were treated with EMR, all of which were completely excised. No bleeding, perforation, infection or other complications occurred during and after operation. The clinical symptoms of 7 patients were relieved. During the follow-up period, 11 cases (78.6%) completed colonoscopy, and no polyp recurrence was found. In conclusion, there is no gender or age difference in patients of cap polyposis. It is usually single and located in the rectum and sigmoid colon with Yamada type Ⅰ. The surface of lesions is mostly covered with white cap. Patients may have no obvious clinical symptoms. Treatment of ESD and EMR is safe and effective for cap polyposis.

Objective To analyze the effect of extralateral approach interbody fusion in the treatment of degenerative lumbar diseases. Methods A total of 50 patients with lumbar degenerative diseases admitted to our hospital were selected, and were treated with extralateral approach interbody fusion, and the therapeutic effect was observed and analyzed. Results All patients successfully completed the operation. The average amount of bleeding during operation was (145. 5 ± 4. 7) m L, the average operation time was (56. 3 ± 2. 2) min, and the average hospitalization time was (7. 2 ± 1. 5) days. Four patients suffered from hip flexion weakness after operation, and the symptoms recovered completely after two months. Six patients suffered from sensory numbness in front of thighs after operation, and the symptoms disappeared or relieved after 6 to 8 weeks. No complications such as abdominal organs and blood vessels injury, cerebrospinal fluid leakage, mislocation of intervertebral space, paralytic intestinal obstruction and permanent injury of genitofemoral nerve occurred. All patients were followed up for 24 months. The results showed that at the last follow-up, the Visual Analogue Scale (VAS) scores of low back pain and lower limb pain were significantly lower, and the lumbar spine scores of Japanese Orthopaedic Association (JOA) were significantly higher than before operation (P ＜ 0. 05). Conclusion Extralateral approach interbody fusion can achieve satisfactory results in the treatment of lumbar degenerative diseases, with fewer complications and higher fusion rate.

Objective To analyze the effect of extralateral approach interbody fusion in the treatment of degenerative lumbar diseases. Methods A total of 50 patients with lumbar degenerative diseases admitted to our hospital were selected, and were treated with extralateral approach interbody fusion, and the therapeutic effect was observed and analyzed. Results All patients successfully completed the operation. The average amount of bleeding during operation was (145. 5 ± 4. 7) m L, the average operation time was (56. 3 ± 2. 2) min, and the average hospitalization time was (7. 2 ± 1. 5) days. Four patients suffered from hip flexion weakness after operation, and the symptoms recovered completely after two months. Six patients suffered from sensory numbness in front of thighs after operation, and the symptoms disappeared or relieved after 6 to 8 weeks. No complications such as abdominal organs and blood vessels injury, cerebrospinal fluid leakage, mislocation of intervertebral space, paralytic intestinal obstruction and permanent injury of genitofemoral nerve occurred. All patients were followed up for 24 months. The results showed that at the last follow-up, the Visual Analogue Scale (VAS) scores of low back pain and lower limb pain were significantly lower, and the lumbar spine scores of Japanese Orthopaedic Association (JOA) were significantly higher than before operation (P ＜ 0. 05). Conclusion Extralateral approach interbody fusion can achieve satisfactory results in the treatment of lumbar degenerative diseases, with fewer complications and higher fusion rate.

Objective To investigate the effect of different pressure CO2pneumoperitoneum on postoperative gastroeuteric function in female patients undergoing gynecological laparoscopic surgery. Methods A total of 120 female patients,aged 30-60 years,ASA physical status Ⅰ or Ⅱ,scheduled for elective gynecological laparoscopic surgery were randomly into three groups (n=40 in each).The pressure of CO2pneumoperitoneum were set at 6-8,9-11 and 12-14 mm Hg in group L,group M and group H,respectively.All patients were detected on an empty stomach of serum concentrations of D-lactic acid 6 hours before operation and after opration.In addition,pH,PaCO2and PaO2were recor-ded before anesthesia (T1),before pneumoperitoneum (T2),1 hour after pneumoperitoneum (T3)2 hours after pneumoperitoneum (T4)and 1 hour (T5)after stopping pneumoperitoneum.The time of pneumoperitoneum,the time of first flatus,intake and defecation,length of primary hospital stays after operation were recorded.Results Compared with 6 hours before operation,the serum concen-trations of D-lactic acid were obviously increased at postoperative 6 hours in all groups (P<0.05). Compared with group L,the serum concentrations of D-lactic acid at 6 hours after operation were ob-viously increased in group M and group H (P<0.05).PaO2in three groups was not different at T1-T5.Compared with group L,pH at T3,T4was significantly decreased in group M and group H (P<0.05).Compared with group L,PaCO2was significantly increased at T3-T5in group M and group H (P<0.05 ).Compared with group L,the time of first flatus,intake and defecation,length of primary hospital stays after operation were obviously delayed in group M and group H(P<0.05). Conclusion The low pressure of CO2pneumoperitoneum can reduce the damage of CO2pneumoper-itoneum on postoperative gastroeuteric function and avail the recovery of parents’postoperative gas-troeutericfunction in female patients undergoing gynecological laparoscopic surgery.

Objective To explore the effects ofPolygonum multiflorum Thunb. by different processed temperature on acute liver injury induced by CCl4 in mice. MethodsA total of 140 KM mice were randomly divided into the control group, the positive drug group, the model group, the 100℃, 110℃, and 120℃ processed group and crude drug group, all the groups above were in sequence given the equal normal saline, silymarin (10 mg/kg), 100℃ extract (100 mg/kg), 110℃ extract (100 mg/kg), 120℃ extract (100 mg/kg) and crude drug extract (100 mg/kg) each day, respectively. After 7 days, apart of the control group, the other groups were established the acute liver injury model by the carbon tetrachloride. The blood and liver of mice were taken after 24 h post-model made. The levels of AST, ALT, Alb, TP, IL-6, TNF-a, IL-1, SOD, MDA and GSH-Px were detected, and liver pathological features of each group were observed.Results Compared with the model group, the levels of ALT (132.14 ± 19.66 U/L, 81.55 ± 12.67 U/L, 169.37 ± 24.18 U/Lvs. 261.84 ± 31.61 U/L), AST (231.57 ± 38.38 U/L, 181.73 ± 36.52 U/L, 318.36 ± 39.68 U/Lvs. 624.79 ± 49.98 U/L), IL-6 (10.35 ± 1.62 pg/ml, 6.26 ± 1.36 pg/ml, 12.57 ± 1.88 pg/mlvs. 18.73 ± 5.54 pg/ml), TNF-α (243.74 ± 13.02 pg/ml, 189.36 ± 9.85 pg/ml, 273.13 ± 14.64 pg/mlvs. 314.36 ± 29.67 pg/ml), IL-1 (235.36 ± 30.14 pg/ml, 208.07 ± 9.33 pg/ml, 48.21 ± 33.15 pg/mlvs.264.76 ± 32.55 pg/ml) in the 100℃, 110℃, 120℃ group significantly decreased (P<0.05). The levels of TP (69.16 ± 2.96 g/L, 74.14 ± 3.17 g/L, 65.73 ± 2.22 g/Lvs. 62.06 ± 2.65 g/L), Alb (35.86 ± 2.64 g/L, 36.67 ± 2.81 g/L, 34.06 ± 2.64 g/Lvs. 32.16 ± 2.05 g/L) in the 100℃, 110℃, and 120℃ group significantly increased (P<0.05). The levels of SOD (82.94 ± 6.21 U/mg, 101.33 ± 9.16 U/mg, 71.32 ± 5.15 U/mg vs. 66.22 ± 1.13 U/mg), GSH-Px (153.39 ± 15.23 U, 199.25 ± 12.04 U, 159.26 ± 17.18 Uvs. 64.79 ± 32.56 U) in the 100℃, 110℃, and 120℃ group significantly increased (P<0.05), while the level of MDA (0.96 ± 0.22 nmol/mg, 0.69 ± 0.13 nmol/mg, 1.29 ± 0.13 nmol/mgvs.1.71 ± 0.33 nmol/mg) in the 100℃, 110℃, and 120℃ group significantly decreased (P<0.05). Conclusions Different processed temperature ofPolygonum Multiflorum Thunb. water extract on liver injury in mice caused by carbon tetrachloride is not the same. The 110℃ processed temperature showd the best liver protection.

Objective To investigate the effect of different pressure CO 2 pneumoperitoneum on early postoperative cognitive function in female patients undergoing gynecological laparoscopic sur-gery.Methods Ninety female patients,aged 40-60 years,ASA physical status Ⅰor Ⅱ,scheduled for elective gynecological laparoscopic surgery,were randomly divided into three groups (n = 30). The pressure of CO 2 pneumoperitoneum were set at 6-8,9-1 1 and 12-14 mm Hg in groups L,M and H,respectively.All of the patients were tested by the neuropsychology and questionnaire review to estimate whether the patient got cognitive decline at 24 h before the operation.The venous blood sam-ples 10 minutes before anesthesia (T1 ),at the end of surgery (T2 ),6 hours after surgery (T3 ),24 hours after surgery (T4 )and 72 hours after surgery (T5 )were collected for determination of serum concentrations of NSE and S100βprotein.The pH,PaCO 2 and PaO 2 were recorded before anesthesia (Ta ),before pneumoperitoneum (Tb ),1 hour after pneumoperitoneum (Tc ),2 hours after pneumo-peritoneum (Td )and 1 hour after stopping pneumoperitoneum (Te ).Results Scores of these tests in three groups were not different and there was no patient with cognitive decline after surgery.Com-pared with group H,the concentration of NSE at T2 and T3 was significantly lower in groups L and M (P <0.05).Compared with group H,the concentration of S100βprotein at T2 was significantly lower in groups L and M (P <0.05).Compared with group L,pH at Tc and Td was significantly decreased in groups M and H (P <0.05).Compared with group L,PaCO 2 was significantly increased at Tc-Te in groups M and H (P <0.05).Conclusion Different pressure of CO 2 pneumoperitoneum has no ob-vious effect on the early cognitive function,but low (6-8 mm Hg)CO 2 pneumoperitoneum can reduce the release of NSE and S100βprotein after operation.

Objective To explore excessive fluoride on expression of osteocalcin (OC) in osteoblast and glucolipid metabolism in mice.Methods 3T3-L1 preadipocyte and MC3T3-E1 osteoblast were conventionally cultured,MC3T3-E1 cells were stimulated with O,2,10 and 50 mg/L sodium fluoride (NaF) to establish fluorine cell model,and levels of OC were tested.The corresponding NaF concentration resulted in the highest OC level was used as the optimal fluorine concentration.Cell experiments were divided into four groups:3T3-L1,3T3-L1 + NaF,3T3-L1 + MC3T3-E1 and 3T3-L1 + MC3T3-E1 + NaF.The treatment groups were respectively or jointly treated with the optimal concentration of NaF (50 mg/L) or MC3T3-E1 osteoblast,enzyme linked immunosorbent assay (ELISA) was used to detect OC and adiponectin (APN) levels.At the same time,40 C57BIL/6 mice were numbered by weight,randomly divided into control and fluoride groups,20 per group,control group drunk pure water,fluoride group drunk 100 mg/L NaF solution,changes of teeth and body weight [M (P25,P75)] of the mice were observed.Serum OC and APN levels were tested by ELISA at 12 weeks after modeling.The fasting plasma glucose (FPG) and the fasting plasma insulin (FINS) were detected by glucose oxidase and chemiluminescence methods,and insulin resistance (HOMA-IR) was evaluated.Results The APN levels of 3T3-L1,3T3-L1 + NaF,3T3-L1 + MC3T3-E1 and 3T3-L1 + MC3T3-E1 + NaF groups were (0.94 ± 0.18),(1.07 ± 0.21),(1.76 ± 0.20),and (2.49 ± 0.43) μg/L,MC3T3-E1 osteoblast with NaF had promote collaborative interaction effect on APN levels (F =14.519,P ＜ 0.01).The body weight of mice in fluoride group [27.5 (25.8,28.3) g] was significantly lower than that of the control group [31.4 (30.3,32.6) g,Z =-4.695,P ＜ 0.01].The levels of FPG [(7.78 ± 1.86) mmol/L],FINS [(3.22 ± 0.75) mU/L],OC [(6.11 ± 1.49) μμg/L],APN [(8.65 ± 1.78) μg/L] and HOMA-IR (1.15 ± 0.49) were higher than those of control groups [(5.40 ± 1.51) mmol/L,(2.45 ± 0.64) mU/L,(3.14 ± 0.92) μg/L,(4.03 ± 1.45) μg/L,0.62 ± 0.31],the differences were statistically significant (t =-4.466,-3.518,-7.560,-9.002,-4.182,P ＜ 0.01).OC levels in mice were positively correlated with FPG,FINS,APN and H-OMA-IR (r =0.868,0.707,0.911,0.818,P ＜ 0.01).Conclusion The OC of osteoblast in mice exposed to fluoride is increased significantly,OC levels in mice are closely related to blood glucose and APN,it is one of the key molecules in lipid metabolism.

Objective To analyze the Clavien-Dindo classification and risk factors of complications after pancreaticoduodenectomy and investigate the relationship between the major risk factors and Clavien-Dindo classification of complications.Methods The retrospective case-control study was adopted.The clinical data of 200 patients who underwent pancreaticoduodenectomy at the Third Affiliated Hospital of Inner Mongolia Medical University from January 2010 to June 2015 were collected.The patients underwent Whipple surgery or pylorospreserving pancreaticoduodenectomy according to the tumor location.Observation indicators included:(1)postoperative complications using Clavien-Dindo classification,(2) univariate and multivariate analyses:the basic conditions of patients,surgery-related factors,pancreas-related factors,(3) relationship between independent risk factors and Clavien-Dindo classification of complications after pancreaticoduodenectomy.The univariate analysis and count data were done using the chi-square test.The comparison between groups was done using independent samples nonparametric test (Kolmogorov-Smirnov Z) and multivariate analysis was done using the Logistic regression model.Results (1) Postoperative complication situations:of 200 patients,122 underwent Whipple surgery and 78 underwent pylorus-preserving pancreatico-duodenectomy,including 6 combined with vascular reconstruction and 1 with radiofrequency ablation of liver tumors.Ninety-eight patients had postoperative complications,including 41 patients with 2 or above kinds of complications.Pancreatic fistula was detected in 80patients,including 42 with grade A,28 with grade B and 10 with grade C,wound infection in 29 patients,delayed gastric emptying in 24 patients,postoperative intra-abdominal infection in 16 patients,postoperative intraabdominal hemorrhage in 10 patients including 8 receiving interventional treatment,postoperative biliary leakage in 7 patients and unintended reoperation in 2 patients.Three patients were dead during hospitalization.The incidence of complications in grade Ⅰ,Ⅱ,Ⅲ (Ⅲ a and Ⅲ b),Ⅳ and V of Clavien-Dindo classification was 28.00％(56/200),13.00％ (26/200),5.00％ (10/200),1.50％ (3/200) and 1.50％ (3/200).(2) The univariate and multivariate analyses:the results of univariate analysis showed that body mass index (BMI) and texture of the pancreas were risk factors affecting complications after pancreatico-duodenectomy (x2=6.483,Z =-3.189,P ＜0.05).The results of multivariate analysis showed that BMI ＞ 23.9 kg/m2 and soft pancreas were independent risk factors affecting complications after pancreaticoduodenectomy (OR =2.044,1.649,95 ％ confidence interval:1.212-3.447,1.194-2.275).(3) The relationship between independent risk factors and Clavien-Dindo classification of complications after pancreaticoduodenectomy was analyzed,there were statistically significant differences between BMI or texture of the pancreas and Clavien-Dindo classification of complications after pancreaticoduodenectomy (x2 =13.897,27.077,P ＜ 0.05).Conclusions Clavien-Dindo classification of complications after pancreaticoduodenectomy is in favor of comprehensive comparisons and quality assessments among different studies,the primary classification is grade Ⅰ and Ⅱ.And decreasing BMI and good management of pancreatic stump may affect Clavien-Dindo classification of complications after pancreaticoduodenectomy.