- OBJECTIVE: The aim of this study was to identify sex-specific biomarkers for ischemic stroke (IS) prophylaxis in elderly individuals. MATERIALS AND METHODS: The GSE22255 dataset for elderly individuals with IS was retrieved from the gene expression omnibus database. Thereafter, gene ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed, as well as gene set enrichment analysis (GSEA). Furthermore, protein-protein interactions (PPIs) were explored using the STRING database, and to screen central genes from the Cytoscape PPI network, corresponding to peripheral blood samples from elderly individuals, we used the molecular complex detection plug-in and cytoHubba. Moreover, a Venn diagram was used to visualize the key genes common among elderly women and men with IS. Statistical analysis was also performed, and receiver operating characteristic (ROC) curves were constructed to evaluate the specificity and sensitivity of the prediction of IS in the elderly. RESULTS: Compared with the healthy controls, in elderly women with IS, 511 biological process (BP) terms, 16 molecular function (MF) terms, and 34 KEGG terms were significantly enriched, whereas in the elderly men with IS, 681 BP terms, 12 MF terms, and 44 KEGG terms were enriched. The GSEA revealed 99 and 140 significantly enriched gene sets in elderly women and men with IS, respectively. Furthermore, in the PPI network, 10 hub genes for each sex with high specificity and sensitivity were identified using ROC curves. CONCLUSIONS: Ten genes for each sex with significant differential expression were also identified in individuals with IS. The novel sex-specific gene targets may be promising diagnostic or prognostic markers and potential therapeutic targets for IS in the elderly.

OBJECTIVE:To investigate the role of acetylated modification induced by coactivator p300 in lipopolysaccharide (LPS)- induced inflammatory mediator synthesis and its molecular mechanism.METHODS:Agilent SurePrint G3 Mouse Gene Expression V2 microarray chip and Western blotting were used to screen the molecules whose expression levels in mouse macrophages (RAW246.7) were correlated with the stimulation intensity of LPS. Electrophoretic mobility shift assay (EMSA) and chromatin immunoprecipitation (chip-qPCR) were used to verify the binding of the molecules to the promoters of IL-6 and TNF-α genes. The effects of transfection of RAW246.7 cells with overexpression or interfering plasmids on IL-6 and TNF-α synthesis were evaluated with ELISA, and the binding level of the target molecules and acetylation level of H3K27 in the promoter region of IL-6 and TNF-α genes were analyzed by chromatin immunoprecipitation sequencing technique (chip-seq).RESULTS:Gene microarray chip data and Western blotting both confirmed a strong correlation of p300 expression with the stimulation intensity of LPS. Immunocoprecipitation confirmed the binding between p300 and c-myb. The results of EMSA demonstrated that c-myb (P < 0.05), but not p300, could directly bind to the promoter region of IL-6 and TNF-α genes; p300 could bind to the promoters only in the presence of c-myb (P < 0.05). The expressions of p65, p300 and c-myb did not show interactions. Both p300 overexpression and LPS stimulation could increase the level of promoter-binding p300 and H3K27 acetylation level, thus promoting p65 binding and inflammatory gene transcription; such effects were obviously suppressed by interference of c-myb expression (P < 0.05). Interference of p65 resulted in inhibition of p65 binding to the promoters and gene transcription (P < 0.05) without affecting p300 binding or H3K27 acetylation level.CONCLUSION:LPS can stimulate the synthesis of p300, whose binding to the promoter region of inflammatory genes via c-myb facilitates the cohesion of p65 by inducing H3K27 acetylation, thus promoting the expression of the inflammatory genes.

目的 探讨基于学习通平台的7E教学模式在诊断学问诊教学中的应用效果.方法 选取2018级临床医学专业本科三年级学生126名(对照组)和2019级临床医学专业本科三年级学生133名(观察组)作为研究对象.对照组采用传统教学法进行教学,观察组采用基于学习通平台的7E教学方法进行教学.教学结束后对两组学生进行问诊技能考核,比较两组学生的问诊技能考核评分及对问诊教学模式的评价情况.结果 观察组学生的问诊技能考核成绩及对问诊教学模式的满意程度均高于对照组(均P<0.05);观察组学生对激发学习兴趣、提高学习效率、增强与患者沟通的信心与能力、加深对常见症状的理解、明确常见症状的问诊内容和思路、提升人文关怀能力等方面的评价均优于对照组(均P<0.05).结论 基于学习通平台的7E教学模式能更好提升临床医学生诊断学问诊的教学效果,提高学生临床问诊的实践技能水平.

"临床医学概要"是医学影像技术专业的核心课程及专业基础必修考试课程,在教学过程中存在临床思维能力弱、运用知识的能力不足、授课形式及考核方式单一、学时少内容多、教学资源共享性差等问题.为有效解决上述问题,根据医学影像技术专业特点,结合湖南医药学院办学定位及特色,合理设置教学目标,对"临床医学概要"课程进行教学改革及探索,取得了较好的成效,旨在提高教学质量,提升教学效果,提高学生的综合素质,培养合格的医学应用型人才.

Objective To reform the traditional teaching pattern of Heart Failure theory by evaluating the application efficiency in the teaching of heart failure, which is the combination of micro-course with traditional teaching pattern. Methods Totally 232 five-year undergraduate students of eight classes of 2015 from Hunan University of Medicine, who major in clinical medicine, were randomly divided into experimental group and control group, with 116 students in total for each group. Apply the new teaching pattern which combined micro-course with traditional teaching to the experimental group on the lectures of Heart Failure. On the other hand, the traditional teaching pattern was adopted to the control group. Use the theoretical test method to understand the learning situation of the two groups. Employ questionnaire survey method to reveal the experimental group students' evaluation to the new teaching pattern which combined micro-course with traditional teaching. Results The average scores of the experimental group ( 75. 34 ± 8. 86 ) in classroom examination was higher than the control group(65. 28±8. 04). There was a statistical significance between the two groups ( t=9. 06, P<0. 01) . Questionnaire indicated that students from the experimental group evaluate that the new teaching pattern combined micro-course with traditional stimalated thier interests and improved their capacity solve problems, make the key points convenient to memorize and activate classroom teaching. Conclusions The new teaching pattern combined micro-course with traditional teaching adapted to the characteristics of heart failure, which is an efficient and practical teaching method to stimulate the students' learning motivation and improve the teaching quality.

以提高医学生自学能力为目的,探讨微课结合传统教学模式在内科学理论教学中的运用.内科学作为临床医学的一个专科,几乎是其他所有临床医学的基础,一直在培养高质量的医学专业人才中发挥重要作用.本文基于内科学的学科特点,在内科学基本理论知识教学这个方面,通过比较“微课”与“传统课堂”的教学模式特点,把两者结合起来应用于内科学课堂教学中,讨论微课在内科学教学中的应用及意义.将微课与传统教学方法进行有机结合、优势互补,以激发学生的学习兴趣,从而提高学生的自学能力.

In order to reveal the role of H3K9 deacetylation in IL-6 expression from RAW246.7 caused by alpinetin,we detected the acetylation state of H3K9 and the expression level of transcription factors (P40 and CREB) combined in promoter region or nucleus.Firstly,RAW246.7 were divided into control group,alpinetin groups (with final concentration of 50,100,200 μg/ml),200 μg/ml alpinetin+GW9662 group,200 μg/ml alpinetin+ HDAC1,and Pgene SiRNA group.After incubation,concentration of IL-6 in media was tested by ELISA,while Western blot was used to detect P40,CREB and PPAR in nucleus;content of deacetylated H3K9,P40 and CREB binding in promoter region of IL-6 were tested by chip-qPCR.Date showed that alpinetin promoted the expression of PPAR and deacetylated H3K9 in IL-6 promoter in a dose-dependent manner,meanwhile inhibited generation of IL-6,accompanied by a decline of transcription factor both binding in promoter and nucleus.Compared with 200 μg/ml alpinetin group,GW9662 could suppress the promotion of PPAR and deacetylated H3K9 binding caused by alpinetin,recover the content and binding capacity of transcription factors in nucleus,and improve synthesis of IL-6;HDAC1 intervention had no influence on total synthesis of P40 and CREB in nucleus and promotion of PPAR,but could also repress the promotion of deacetylated H3K9 and promote the down-regulated binding content of P40 and CREB,thus increased synthesis of IL-6,which was still lower than GW9662 group.In conclusion,the PPAR agonist alpinetin could promote deacetylation state of H3K9 combined in the promoter of IL-6 via specific deacetylase,which could affect the binding capacity of corresponding transcription factors,thus regulate gene expression.However,synthesis of transcription factors are not interfered by deacetylation of H3K9.

目的 通过检测山姜素作用下鼠巨噬细胞(RAW246.7)炎症基因启动子部位结合组蛋白乙酰化修饰状态以及炎症因子表达,初步揭示山姜素调节炎症因子表达的表观遗传学作用机制.方法 采用不同质量浓度(10～200 μg/ml)山姜素培养RAW246.7,培养结束后ELISA法检测养基中IL-6以及肿瘤坏死因子a(TNF-α)质量浓度,染色质免疫共沉淀(Chip-qPCR)法检测上述基因启动子片段结合的去乙酰化/乙酰化组蛋白(H3K9以及H3K14)表达比值,Pearson相关分析比值与炎症因子质量浓度的关联情况.结果 山姜素呈剂量依赖性抑制RAW246.7细胞IL-6以及TNF-α表达,同时明显上调RAW246.7胞内IL-6以及TNF-α启动子片段结合的去乙酰化/乙酰化H3K9比值,且上述比值与炎症因子的表达水平呈负相关(P＜0.05);山姜素作用下炎症基因启动子片断结合的去乙酰化/乙酰化H3K14比值无明显变化.结论 山姜素可能通过诱导炎症基因的启动子部位组蛋白H3K9去乙酰化以调节炎症因子的合成,提示表观遗传学修饰很可能是山姜素干预炎症性疾病的重要机制.

目的 探讨微课嵌入探究式翻转课堂在诊断学教学中的应用效果.方法 按数字表法随机选取我校2014级临床医学专业8个班学生为研究对象,随机分为对照组(119人)和实验组(124人),对照组采用传统教学模式,实验组采用微课嵌入探究式翻转课堂教学模式.比较两组学生期末理论考试成绩与实践操作考核成绩,并通过课堂教学效果评价表及学生访谈两种方式调查学生对各自教学效果的评价.结果 实验组学生期末理论考试及实践操作考核成绩均明显高于对照组(P<0.05),对教学效果的评价明显优于对照组(P<0.05).访谈结果显示,新型教学模式能提高学生学习积极性和综合能力.结论 微课嵌入探究式翻转课堂能大幅度提升诊断学教学效果,是一种新型、高效的教学模式.

为适应经济和社会发展的需要，湖南医药学院由专科已升格成为一所新晋的医学本科院校。如何抓好转型期临床医学专业课程的临床教学，充分调动临床医师从事教学的积极性，提高学生执业医师考试通过率，是学校所面临的实际问题。本文拟就如何监控、提升新升格医学院校转型期临床医学专业临床教学质量进行初步的探讨。

目的 观察神经节苷脂(GM1)对脑外伤大鼠大脑皮质和海马区神经生长相关蛋白-43(GAP-43)表达的影响,探讨GM1促进脑外伤神经修复的可能机制.方法 选择出生10周雄性SD大鼠200只,随机分为假手术组60只,无脑外伤,术前腹腔注射生理盐水3d.脑外伤模型140只,分为模型组70只,术前腹腔注射生理盐水3 d;GM1组70只,术前腹腔注射GM13 d.应用酶联免疫法检测大鼠大脑顶叶皮质和海马区GAP-43于0～24 h不同时间点的表达情况,并在术后1～5 d不同时间点进行行为学检测.结果 (1)GM1组大鼠大脑顶叶皮质0～16 h和海马区0～24 h GAP-43的表达均明显低于模型组(P＜0.01),而与假手术组比较,大鼠顶叶皮质区8～24 h GAP-43的表达,差异有统计学意义(P＜0.01).(2)GM1组大鼠大脑顶叶皮质GAP-43的表达,术后随着时间的增加而升高,至24 h已达模型组水平.(3)假手术组的行为学表现1～5 d均优于模型组和GM1组(P＜0.01),GM1组在术后2～5 d运动能力逐步增强,行为学表现优于模型组(P＜0.05).结论 预防性使用GM1有效地促进大鼠大脑皮质GAP-43的表达升高,降低脑外伤大鼠脑损伤程度,从而发挥其对实验性脑外伤大鼠的神经保护作用.

诊断学是医学基础课与临床课的桥梁，其教学效果的好坏直接关系到医学生基本素质。目前诊断学教学现状仍多以传统教学法为主，改革势在必行。如何切合临床实践进行课堂设计及具体实施，激发学生浓厚的兴趣，从而提高教学质量和教学效果，是本文探讨的重点。

诊断学是医学基础课与临床课的桥梁， CBL 教学是以病例为基础的教学方法，适合于诊断学实验教学的实施，既能有效地提高学生学习兴趣和教学质量，又能增强学生的临床实践能力，值得在临床教学中推广。

目的：分析怀化侗族高血压患者血淋巴细胞蛋白质谱，寻找高血压患者血淋巴细胞差异蛋白质。方法应用MALDI-TOF-MS技术检测130例血淋巴细胞标本（侗族高血压50例，汉族高血压40例，侗族正常人群40例）的蛋白质质谱，用MatrixScience公司的Mascot对蛋白质质谱数据进行数据库查询比对，并搜索鉴定蛋白。结果三组均获得重复性好的血淋巴细胞蛋白质双向凝胶电泳图谱。通过对其中3个差异表达蛋白点分析，并经质谱鉴定。与侗族正常人对照，侗族高血压人群α-烯醇化酶表达上调，CK-18表达差异无统计学意义（P﹥0.05），IL-1Ra表达下调；汉族高血压人群CK-18、α-烯醇化酶两个点表达上调，IL-1Ra表达下调。结论 IL-1Ra和α-烯醇化酶可作为预测高血压发生、发展程度的一个候选生物学标志物。

目的：提高医学生的心电图分析及影像阅片综合能力以实现诊断学教学培养高素质实用型医学人才的目标。方法：构建心电图及影像图片资源库并制定考评系统模块从而开发出网络考评系统软件。结果：物理诊断网络考评系统研发成功，对我校医学生非常实用。结论：该系统值得全国高等医学院校应用及推广。

通过对大专临床医学生上诊断学实验课的观察,发现学生在临床操作方面存在一些问题.为了适应大专医学教育发展的需要,教师必须不断地改进方法,让医学生真正掌握临床诊断操作技能并灵活运用,促进医学生的学习积极性,以提高诊断学实验课教学水平,培养合格的具有良好医学素质的医务工作者,这对教师教学能力提出了更高要求.