Western developed countries have already made multi-site physician practice a mainstream in their physicians'regulatory system,which remains however at the beginning stage in China during the ongoing health reform since 2009.This article justified the significance of this practice,then analyzed its main roadblocks encountered in China,and in the end proposed countermeasures in terms of better awareness,better policy support and practicality of the practice.

OBJECTIVE:To establish a cluster analysis method applied in plant classification and the identification and assessment of traditional Chinese medicine.METHODS:The raw data of the shape,the chemical composition and the UV-spectra data of plants were collected,and these data were assigned with values in accordance with the binary assignment then subjected to a cluster analysis.RESULTS:The 11 species of plants under study were accurately classified into the proper categories by the new method.CONCLUSION:By this method,the analytic data are comprehensive and the conclusion is detailed and reliable,which serves as the supplement and development for traditional cluster analysis method.

Many researches have focused on the wnt-frizzled cascade in the recent years, while much work has been done in neoplastic diseases and embryology, the role of the wnt-frizzled signal transduction pathway in cardiovascular diseases has only recently begun to be explored. It plays a very important role in many physiological and pathophysiological processes, such as its transduction pathway, the healing after myocardial infarction, the proliferation, differentiation and orientation of cardiomyocytes, angiogenesis/neovascularization, cardiac hypertrophy and heart failure, the deposition of the extracellular matrix and so on. This article is aimed at its relation with myocardial infarction and the role of this pathway in cardiovascular diseases.[

Objective:To explore the relationship between wearing of functional appliance and systemic metabolism of PGE2 in the blood of growing rats.Methods:54 male Wistar rats aged 4-weeks were randomly divided into 3 groups(n =18):Daytime group,all-day group and control group.Self-guided functional appliance was made for mandible advancement of the rats in the 2 experimental groups.One week after appliance wearing,rats were sacrificed at the corresponding time points and blood in femoral artery was taken. PGE2 levels in the blood samples were measured,data were analysed by cosine equation.Results:Hypothesis was true in the control group(P ＜0.05),and was not true in both 2 experimental groups(P >0.05).Conclusion:PGE2 level in rat blood is circadian rhyth-mic,wearing of functional appliance made may disturb the rhythm.

Objective To better understand students' professional perception,humanistic education status quo and their preference to different humanistic education methods.Methods Questionnaire was conducted for 990 undergraduate students (2006 grade- 2010 grade) at medical school of Shanghai Jiao Tong university.SPSS 17.0 statistical software was used to analyze results of the questionnaire.Results Nearly 45％ students chose to major in clinical medicine out of personal interest.The identification of students for humanistic quality was lower than that for clinical knowledge and skills.More than 50％ students believed doctors were with high humanistic quality and there was a gap between students′ action and their understanding of the medical career identity and medical humanistic cultivation.More than 50％ students preferred activities that train medical and auxiliary skills.Nearly 67％ students also showed a shallow reading habit from regular internet surfing.Conclusion The professional perception of medical students are influenced by both social and historical factors influence.The gap between understanding and action is a consequence of current humanistic educational system.The humanistic educational methodology should conform to the psychological and s~ial characteristics of contemporary students.

AIM: To observe the effects of norepinephrine (NE) on the cardiopulmonary and lung injury in goats with acute respiratory distress syndrome (ARDS) induced by endotoxin. METHODS: A model of septic ARDS was induced by intravenous infusion of low dose endotoxin in six goats. Then 40?10~ -6 NO inhalation was applied to the animals. After 30 min, combined intravenous infusion of NE at concentration of 0.5 mg?kg~ -1 ?min~ -1 was conducted. The dynamic changes in gas exchange and hemodynamics were measured with the aid of Swan-Ganz catheter. Arterial blood gas analysis before and after the onset of ARDS, 30 min after NO inhalation and combined NE was detected. Histology of the lung was also observed. RESULTS: Inhalation of NO rapidly reduced mean pulmonary arterial pressure (MPAP), increased PaO_2, decreased P_ (A-a) O_2 and Qs/Qt in septic ARDS goats. These decrease and increase were more significant than those in NO inhaled alone when animals received NE. The combination of NO inhalation and NE injection resulted in increase in mean arterial pressure. NO inhalation did not ameliorate lung injury and combined NE intravenous injection ameliorated lung injury. CONCLUSION: Injection of low dose norepinephrine improves the beneficial effects of inhaled nitric oxide on lung gas exchange and ameliorates lung injury in goats with acute respiratory distress syndrome induced by endotoxin.

Objective To investigate the effects of small interference RNA (siRNA) targeting vascular endothelial growth factor (VEGF) on VEGF expression and cell proliferation of cervical carcinoma HeLa cells,in order to provide a theoretical basis for the treatment of human cervical carcinoma.Methods siRNAs plasmids targeting VEGF165 were constructed and stably transfected into HeLa cells.HeLa group,Mock group and VEGF siRNA group were set up.The expressions of VEGF mRNA and protein in stable transfectants were confirmed by RT-PCR,Western blotting and ELISA assay,respectively.The cell proliferation was analyzed by MTT and flow cytometry.Apoptosis was measured by Hoechst33342 staining.Results VEGF siRNA stably transfected cell lines were successfully established.The siRNA targeting human VEGF gene effectively decreased the expression of VEGF at RNA and protein levels,and inhibited the proliferation of HeLa cells (P

In order to study the effects of ethyl pyruvate on cardiomyocyte apoptosis following ischemia/reperfusion (I/R) in vitro and the expression of Bcl-2 and Bax proteins, isolated rat hearts were perfused in a Langendorff model. Twenty-four rats were randomly divided into 3 groups (n=8 in each group): control group was perfused for 120 min. In the I/R group, after 30 min stabilization the injury was induced by 30 min global ischemia followed by 60 min reperfusion. Ethyl pyruvate (EP) group was set up with the same protocol as I/R group except that it was supplied with 2 mmol/L EP 15 min before ischemia and throughout reperfusion. Myocardial malonaldehyde (MDA) content was measured. Myocardial apoptotic index (AI) was tested by terminal deoxynucleotidyl transferase mediated dUTP nick end labeling (TUNEL) method. The expression of anti-apoptotic protein Bcl-2 and pro-apoptotic protein Bax in cardiac myocytes was detected by immunohistochemistry. As compared with control group, the content of MDA, myocardial AI and the expression of Bcl-2, Bax proteins were increased significantly in I/R group, but the content of MDA, myocardial AI and the expression of Bax protein were decreased obviously and the expression of Bcl-2 protein was up-regulated in EP group (P<0.05). These results demonstrate that EP could inhibit apoptosis of cardiac myocytes possibly via alleviating oxidative stress, up-regulating Bcl-2 and down-regulating Bax proteins.
Apoptosis ; In Situ Nick-End Labeling ; Malondialdehyde/pharmacology ; Myocardium/*pathology ; Myocytes, Cardiac/cytology ; Oxidative Stress ; Proto-Oncogene Proteins c-bcl-2/*metabolism ; Pyruvates/*pharmacology ; Rats, Sprague-Dawley ; Reperfusion Injury ; Tissue Distribution ; bcl-2-Associated X Protein/*metabolism

Objective To investigate the correlation between executive function(EF) and characteristic of symptom in children with Tourette′s syndrome(TS).Methods EF were measured with Wisconsin Card Sorting Test(WCST) in 53 patients with TS,and symptom characteristics were evaluated with Achenbach Child Behavior Checklist(CBCL) and Yale Global Tic Severity Scale(YGTSS).Results Compared with healthy control,TS had poor executive performances significantly in WCST(all P

ObjectiveTo assess rat behavior, observe apoptotic morphology of neurons and measure expression of caspase-3 in substantia nigra(SN) of Parkinson's disease(PD) animal model. Methods6-OHDA was stereotacticly injected into the right striatum of the rats at two sites to produce PD models. After 5 weeks, the behavior tests including modified Morris Water Maze and narrow beam test were measured. Then tyrosine hydroxylase (TH) histochemistry, Hoechst 33258 staining, Western blotting for caspase-3 in right substantia nigra was separately conducted.ResultsEscape velocity significantly decreased and its latency was obviously enlarged in modified Morris Water Maze, and the latency and total time in narrow beam test were also markedly increased (P<0-05) in 15 successful PD rats compared with either the sham group or the normal group. Furthermore, there were obvious less TH-positive neurons in lesioned SN while more apoptotic cells appeared there. In addition, the expression of caspase-3 was highly upregulated in lesioned SN.Conclusion6-OHDA induced neuronal apoptosis in SN is associated with high levels of caspase-3, and the results of rat behavior tests are correspondent with the morphological changes including TH immunohistochemistry and Hoechst 33258 staining. Thus modified Morris Water Maze and narrow beam test are beneficial for assessments of effects of new drugs in PD animal model.