Based on the analysis on the present status and importance of medical humanity education for inter-national medical students during the clinical internship, this paper discussed the importance of strengthening medi-cal students′humanistic education during the clinical internship and proposed ways to promote the humanity educa-tion:optimizing the setting of humanity education curriculum and adhering to the humanity education throughout the whole process of clinical internship;improving the clinical supervisors′humanity quality and ensuring the quality of humanity education;holding the orientation of evaluation and adding the humanity quality as one of the evaluation indicators; establishing hospital atmosphere with humanity spirit and highlighting environmental education effect;building theuniversity-intern hospital two-grade platform of humanity education and standardizing the relevant systems.

OBJECTIVE:To investigate the clinical efficacy and safety of cilostazol combined with alprostadil in the treatment of peripheral arterial disease(PAD). METHODS:A total of 68 PAD patients in our hospital from Jan. 2015 to Jan. 2016 were di-vided into observation group(34 cases)and control group(34 cases)according to random number table. Control group was given basical treatment,and Alprostadil injection 2 mL+0.9% Sodium chloride injection 100 mL,ivgtt,qd. Observation group was addi-tionally given Cilostazol tablets 100 mg,po,bid,on the basis of control group. Both groups were treated for 30 days. Clinical effi-cacies of 2 groups were observed. The hemorheology indexes(hematocrit,whole blood high-shearing viscosity,erythrocyte aggre-gation index,erythrocyte deformation index,plasma viscosity),inflammatory factor indexes(TNF-α,IL-6,IL-8, hs-CRP),oxida-tion stress indexes(GSH-Px,SOD,T-Aoc,MDA),arteriosclerosis indexes(ABI,TBI,dorsalis pedis artery blood flow)were de-termined before and after treatment. The occurrence of ADR was recorded. RESULTS:Total response rate of observation group (91.18%)was significantly higher than that of control group(79.41%),with statistical significance(P<0.05). Before treatment, there was no statistical significance in hemorheology indexes,inflammatory factors indexes,oxidant stress indexes or arteriosclero-sis indexes between 2 groups(P>0.05). After treatment,hematocrit,whole blood high-shearing viscosity,erythrocyte aggregation index,erythrocyte deformation index,plasma viscosity,the levels of TNF-α,IL-6,IL-8,hs-CRP and MDA in 2 groups were de-creased significantly;while the levels of GSH-Px,SOD,T-Aoc,ABI,TBI and dorsalis pedis artery blood flow were increased sig-nificantly;the improvement of above indexes in observation group was significantly better than control group,with statistical signif-icance(P<0.05). There was no statistical significance in the incidence of ADR between observation group(14.71%)and control group(11.76%)(P>0.05). CONCLUSIONS:For PAD,cilostazol combined with alprostadil can effectively improve hemorheolo-gy indexes,inflammatory factor indexes,oxidation stress indexes and arteriosclerosis indexes with good safety.

Objective:To perform textual researches on name, origin and distribution of Maidong to clarify the medicinal varieties and history recorded in ancient literatures and provide evidence for clinical use. Methods:Ancient herbal works were performed textual research, and the resource investigation and modern data were analyzed. Results:According to the ancient herbal records and modern researches, Maidong had lots of alias, while only Maimendong and Maidong were used as the medicine common names. According to the records of main origin, original plant morphological and medicinal characteristics of Maimendong, it was preliminarily concluded that Maidong recorded in the ancient herbal records was mainly produced in Jiande of Zhejiang province, Mianyang of Sichuan prov-ince, Xiangyang of Hubei province and the surrounding areas. The chemical compositions and pharmacological activities of Maidong and Shanmaidong were similar;therefore, they both could be used as the medicines. Conclusion:In the light of the ancient and mod-ern medicinal customs, modern chemistry and pharmacology researches and clinical practice of TCM, it deserves further discussion on whether Maidong and Shanmaidong can be used as multi source varieties of traditional Chinese medicines just like Polygonaceae plants palmatum L. , Rheum tanguticum Maxim, ex Balf. and Rheum officinale Baill. , and Ranunculaceae plants Coptis chinensis Franch. , Coptis deltoidea C. Y. Cheng et Hsiao and Coptisteeta Wall.

Objective To compare the efficacy of MRI and DSA in assessment of carotid artery stenosis and atherosclerotic plaque.Methods Forty-six patients with carotid plaque detected by ultrasound were enrolled in this study,and 89 carotid arteries were evaluated by MRI and DSA.MRI examination was acquired with 3.0 T MR scanner and 8 channel phase-array surface coil.The MRI sequences consisted of pre-and post-contrast T1WI,T2WI,PDWI,TOF.Anterior-posterior and lateral views of carotid artery were performed on DSA.The degree of carotid artery stenosis was evaluated by the NASCET standard.Fibrous cap rupture,intraplaque hemorrhage,and calcification were also evaluated on MRI and DSA.Statistical comparison was performed with the Kappa value and paired Chi-square test.Results The degree of carotid artery stenosis was 50％ (16％-78％) on MRI and 47％ (7％-73％) on DSA.Two imaging modalities were in good consistency in evaluation of the degree of stenosis ( Kappa =0.882,P ＜ 0.01 ).There was statistical difference in detecting fibrous cap rupture by MRI and DSA (34 vessels vs 10 vessels,respectively,x2 =20.346,P ＜ 0.01 ).Furthermore,thirty-seven vessels with intraplaque hemorrhage and 71 vessels with calcification in the plaque were found on MRI but none on DSA.Conclusion MRI is a reliable tool in assessment of the degree of the carotid stenosis and it is superior to DSA in detecting fibrous cap rupture,intraplaque hemorrhage,and calcification.

This study was aimed to observe the therapeutic effect onendometritis rat model by Gui-Zhi Fu-Ling (GZFL) capsuleand its mechanism. Endometritis rat model was replicated. After 15 days, rats were randomly divided into six groups, which were the sham operation group, model group, lowdosage (0.5 g·kg-1) of GZFL capsule group, middle dosage (1.0 g·kg-1) of GZFL capsule group, large dosage (2.0 g·kg-1) of GZFL capsule group, and Fu-Ke Qian-Jin (FKQJ) capsule (1.2 g·kg-1) group. After 28-day intragastric administration of medication, pathological changes of endometrium were observed. The contents of monocyte chemoattractant protein-1 (MCP-1), interleukin-1β (IL-1β), interleukin-10 (IL-10) were determined in blood serum.The expression of TGF-β1 in endometritis rats were measured by immunohistochemistry. The results showed that GZFL capsule canobviously alleviate the pathologi-cal damage of endometrium in rat model. In comparison with sham operation group, the serum IL-10 content in the model group was significantly decreased, contents of MCP-1and IL-1β were significantly elevated; the TGF-β1 pro-tein expression was significantly elevatedin the uterus tissues. After the treatment of GZFL capsule, compared with the model group, the serum IL-10 was obviously elevated in the treatment group. The contents of MCP-1 and IL-1βwere obviously decreased. The expression of TGF-β1 in the uterus tissues was obviously decreased. It was concluded that GZFL capsule had treatment effect on endometritis. The mechanism may be related to the regulation of inflam-matory cytokines.

Objective To observe the learning and memory ability of rats after injection of Aβ25-35 protein in different concentrations into the lateral ventricle assessed by Morris water maze test, and to explore the optimal concentration of Aβ25-35 in the preparation of AD model rats.Methods Male SD rats were randomly divided into sham operated group and model group.The rats of model group received Aβ25-35 injection in concentrations of 2 μg/μL, 4 μg/μL and 8 μg/μL, respectively.According to the Rat Brain Stereotaxic Atlas, 5 μL of aggregation of Aβ25-35 was injected into the right lateral ventricle to establish the AD rat model.7 days after successful modeling, Morris water maze was used to test thechanges of learning and memory ability of the rats.Results There was no significant difference in the average swimming speed between the two groups (P > 0.05).The escape latency time of rats in the model group was significantly increasedcompared with the sham group (P < 0.05).In the model group, the escape latency time of rats treated with 4 μg/μL and 8 μg/μL Aβ25-35 was significantly increased compared with the rats injected with 2 μg/μL (P < 0.05), while there was no significant difference between rats treated with 4 μg/μL and 8 μg/μL Aβ25-35 (P > 0.05).The activity time and distance of target quadrant of the rats injected with different concentration of Aβ25-35in the model group were significantly reduced compared with the sham group (P < 0.05), but no significant difference amongthe rats treated with different Aβ25-35 concentrations (P > 0.05).Compared with the sham-operated group, the number of platform-crossing of rats injected with different doses of Aβ25-35in the model group were significantly reduced (P < 0.05).In the model group, the rats treated with 4 μg/μL and 8 μg/μL was significantly reduced compared with the group with 2 μg/μL injection (P < 0.05).There was no significant difference between the rats injected with 4 μg/μL and 8 μg/μL (P > 0.05).Conclusions The recommended dose and concentration of Aβ25-35 to be injected into the unilateral ventricle to establisha rat model of Alzheimer's disease is 4 μg/μL in a volume of 5 μL.

Objective To investigate the relationship between Lys198Asn and Taq Ⅰ polymorphisms of endothelin-1 gene and essential hypertension in Chongqing residents.Methods Polymorphisms of Lys198Asn and TaqⅠ were detected in the blood samples from 86 patients with essential hypertension(HT) and 138 normotensive controls(NT) by sequence specific primer-polymerase chain reaction(SSP-PCR) and PCR-restriction fragment length polymorphism(PCR-RFLP).Results In the BMI

Objective Summary the first group of robotic bypass surgery on the beating heart and stent placement in distinct hybrid session in China. Methods 163 cases patients accepted selective operation of robotic coronary bypass grafting on the beating heart form April 2007 to January 2011. 12 cases had multi coronary vessels stenosis accepted stent placement after robotic surgery in a hybrid manner. The average age of patients was ( 56. 0 ± 9.74 ) years old. 3 case was female and 9 cases were male. All the patients had a medical history of angina. The coronary arterioangiography showed sever left anterior descend ing or diagonal branch stenosis in all patients. And 4 cases had myocardial infarction history. All the patients had good lung function and had no medical history of pleurisy. Without sternotomy, through 3 ports about 1 cm in left thorax, the left internal mammary artery was obtained and simultaneously single vessel coronary artery bypass grafting through small thoracotomy or totally endoscopic coronary bypass (TECAB) was performed on beating heart. The bridge patency and revascularization was accessed by arterioangiography. Results All cases successfully accepted robotic bypass surgery on the beating heart and stent placement in distinct hybrid session without complication. Conclusion Hybrid coronary artery revascularization enable adequate revascularization of patients with multivessel coronary artery disease without sternotomy and with the advantage of the most durable option.

Objective As the first robotic da Vinci S surgical system(Intuitive Surgical,Inc,CA) in China,atrial septal de- fect repair(ASD) were performed in 15 patients using the robotic da Vinci S surgical system.Prespectively,we evaluated safety and efficacy in performing both simple and complex ASD repairs.Methods Eligible patients had ASD with mild to moderate pulmonary hypertension.Operative techniques included peripheral cardiopulmanary perfusion,a 2 cm working port only in the forth intercostal space,transthoracic aortic occlusion,and antegrade blood cardioplegia.Transesophageal echocardiograms(TEE) were done intraoper- atively with three-dimensienal reconstructions.Successful repairs were defined.Results Enhanced three-dimensional visualization of ASD allowed safe,dexterous intracardiac tissue manipulation.All patients had successful repairs including direct suturing in 10 cases, as well as pericardial patching in 5 cases.There were no operative deaths,strokes,or device-related complications.One patient was reexplored for bleeding.There were no incisional conversions.The mean cardiopulmonary bypass times and aortic crossclamp times were (109.5?12.6) minutes and (41.2?11.7) minutes.Both robotic repair and total operating times decreased significantly re- spectively.Total ICU length of stay for patients was 1 to 2 days.Conclusion This study shows that the da Vinci S surgical system (intuitive Surgical,lnc) has no limitations in performing ASD repairs.Articulated wrist-like instruments and three-dimensional visual- ization enabled precise tissue telemanipulation.

Through the comparison of curriculum provision,curriculum content,teaching methods and evaluation methods of medical humanity education between China and the United States,this paper put forward some suggestions about integrating resources of humanities and social sciences,improving the setting of medical humanity education curriculum and optimizing the teaching methods;improving the effectiveness of teaching and tightly connecting with the clinical practice,cultivating the ability of medical humanity practice and reforming the assessing methods of medical humanities,establishing formative assessment system and so on,to promote the level of medical humanity education in China.