Biochemistry is one of the important basic courses for medical speciality.This article discussed the four aspects of how to improve the quality of biochemistry instruction,such as strengthening young teachers'sense of responsibility in teaching,and building up their professional knowledge training and so on.To young teachers,this paper may be useful for improving the quality of medical biochemistry teaching.

Objective:This study aimed to investigate the role of mitochondrial fusion protein 2 (Mfn2) in chronic renal injury caused by cyclosporine A (CSA) and the possible mechanism.Methods:The model of chronic CSA nephropathy was established in rats. The rats were divided into solvent control group, CSA model group and normal control group. Serum creatinine and urinary protein levels were detected. The tubulointerstitial injury was observed by light microscopy. The changes of mitochondrial structure were observed by electron microscope, and the expression of Mfn2 was detected by Western blot.Results:The levels of serum creatinine and urinary protein in CSA model group at 2 and 4 weeks were significantly higher than those in control group and solvent group ( P<0.05). In CSA model group, tubulointerstitial injury was obvious, mitochondria swelling and deformation were found in tubular epithelial cells, and ridge disappeared. Compared with normal control group and solvent control group, the expression of Mfn2 in CSA model group was significantly decreased at 2 and 4 weeks ( P<0.05), and the expression of Mfn2 in CSA model group at 4 weeks was further decreased compared with 2 weeks ( P<0.05). Conclusions:Mfn2 may play an important role in the injury of tubular epithelial cells caused by cyclosporine.

Climacteric ; Depression ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Middle Aged ; Phytotherapy ; Sleep Initiation and Maintenance Disorders ; Syndrome

Disorders of sex development(DSD) include anomalies of sex chromosomes,gonads,reproductive ducts,and genitalia.Here,the term "intersex" is avoided because of its imprecision.The purpose of this review is to assist health care professionals in the provision of treatment,education,and support to children born with DSD and to their families.The goal of DSD treatment is to achieve the long-term physical,psychological,and sexual well-being of the patients.In the case of DSD it involves several principles.Providing medical and surgical care to deal with a complication that threatens to the patient's physical well-being;minimizing the potential for the patient and family to feel ashamed,stigmatized,or overly obsessed with genital appearance;delaying elective surgical and hormonal treatments until the patient can actively participate in decision-making;telling the truth to the family and the child and addressing psychosocial distress of the children and their parents.This approach is termed as "patient-centered".

BACKGROUND: Because the continuity and integrity of the trachea are likely damaged to some extent after tracheostomy, the implementation of sequential ventilation has certain difficulties, and sequential invasive-noninvasive ventilation on patients after tracheostomy is less common in practice. The present study aimed to investigate the feasibility of invasive-noninvasive sequential weaning strategy in patients after tracheostomy. METHODS: Fifty patients including 24 patients with withdrawal of mechanical ventilation (conventional group) and 26 patients with sequential invasive-noninvasive weaning by directly plugging of tracheostomy (sequential group) were analyzed retrospectively after appearance of pulmonary infection control (PIC) window. The analysis of arterial blood gases, ventilator-associated pneumonia (VAP) incidence, the total duration of mechanical ventilation, the success rate of weaning and total cost of hospitalization were compared between the two groups. RESULTS: Arterial blood gas analysis showed that the sequential weaning group was better than the conventional weaning group 1 and 24 hours after invasive ventilation. The VAP incidence was lowered, the duration of mechanical ventilation shortened, the success rate of weaning increased, and the total cost of hospitalization decreased. CONCLUSION: Sequential invasive-noninvasive ventilator weaning is feasible in patients after tracheostomy.

Adult ; Aged ; Aged, 80 and over ; DNA Primers ; Female ; Humans ; Lymphoma ; genetics ; Male ; Middle Aged ; Mutation ; Myeloid Differentiation Factor 88 ; genetics ; Polymerase Chain Reaction

ObjectiveThe purpose of this study was to evaluate the effect of prostaglandin E1 (PGE1) on blocking the development of acute respiratory distress syndrome (ARDS) induced by acid aspiration. MethodsTwenty new Zealand rabbits were used. Dilute HCl was instilled into right bronchus of the rabbits. The rabbits were then divided randomly into two groups: injury group and treatment group. In injury group ( n = 10) rabbits received no treatment except mechanical ventilation. In treatment group ( n = 10) immediately after acid instillation the rabbits received an intravenous bolus of PGE1 followed by a continuous infusion. Blood gas, airway pressure and dynamic and static compliance were measured before and after acid instillation. Blood samples were taken from artery for determination of 6-k-PGF1α, TXB2, NO2-/NO3- and ET-1. The animals were killed and the wet/dry lung weight (W/D) ratio and total protein of bronchoalveolar lavage fluid(BALF) of right lung were measured. Microscopic examination of the lung was done. ResultsIn treatment group PaO2 was significantly higher than that in injury group after acid instillation. Plasma 6-k-PGF1α and NO2-/NO3- levels were significantly higher in treatment group while plasma TXB2 and ET-1 levels were significantly lower. W/D ratio and TP of BALF of right lung were significantly lower in treatment group. The inflammatory changes were diffuse in injury group while in treatment group they were localized and less severe. Conclusions PGE1 can lessen severity of ARDS induced by acid aspiration. It may protect pulmonary vascular endothelial cells through maintaining the balance between PGI2 and TXA2 and that between NO and ET-1 .

Objective To investigate the effect of isoflurane administered before ischemia on polymorphonuclear neutrophil (PMN) infiltration and expression of adhesion molecules in the lung injured by ischemia-reperfusion.Methods One-hundred and twenty male SD rats weighing 250-350 g were randomly divided into 4 groups ( n = 30 each) :Ⅰ sham operation group (S) ;Ⅱ I/R group in which hilum of left lung was clamped for 45 min and then undamped for reperfusion; Ⅲ Iso + I/R in which 1 MAC isoflurane was inhaled for 30 min before ischemia and Ⅳ Iso + S in which 1 MAC isoflurane was inhaled for 30 min without I/R. The animals were anesthetized with intraperitoneal pentobarbital 50 mg?kg-1 then tracheostomized and mechanically ventilated with 100% O2(VT= 10-15 ml?kg-1) . PaCO2 was maintained at 35-45 mm Hg. Right jugular vein and left carotid artery were cannulated for BP monitoring, blood sampling and fluid and drug administration. Anesthesia was maintained with ketamine 10 mg?kg-1?h-1 and vecuronium 0.1 mg?kg-1?h-1. 1 MAC isoflurane (1.38% in rats) was inhaled for 30 min before hilum of left lung was clamped with an atraumatic clamp. Left lung ischemia was maintained for 45 min then the left lung was released for reperfusion. MAP was monitored and blood gases were analyzed during experiment. The animals were killed at the end of 45 minute ischemia and at 30, 60 and 120 min reperfusion and left lung was removed for: (1) determination of W/D lung weight ratio, myeloperoxidase (MPO) activity and expression of ICAM-1 mRNA; (2) light and electron microscopic examination; (3) broncho-alveolar lavage (BAL). BAL fluid (BALF) was collected and the number of cells, percentage of PMN and total protein concentration in BALF and the expression of CD18 on PMN surface were determined. Results The W/D lung weight ratio, MPO activity and expression of ICAM-1 mRNA in the lung tissue, the percentage of PMN and TP concentration in BALF and the expression of CD18 on PMN surface were all significantly increased during reperfusion in I/R group but isoflurane pretreatment significantly attenuated the I/R induced increases. Histological examination showed that the I/R induced lung injury was also ameliorated by isoflurane pretreatment. Conclusion Inhalation of isoflurane before ischemia could protect the lungs against I/R injury by inhibiting the PMN infiltration and expression of ICAM-1 mRNA and CD-18.

Objective To investigate clinical first selected method on the differential diagnosis at early stage between amyotrophic lateral sclerosis(ALS) and cervical spondylosis.Methods The clinical features and EMG in 53 patients with ALS,14 patients with cervical spondylotic myelopathy(CSM) and 23 patients with cervical spondylotic radiculopathy(CSR) were analysed.And then the value of ratio of every probability was calculated.According to the value of ratio, the clinical features and EMG were compared in differential dia gnosis.Results A multiprogram that consisted of high multiple clinical features was used in differential diagnosis, true positive rate is 98%, and true negative rate is 86.5%,EMG still couldn't be used in the differential diagnosis.Conclusion The program is the first selected method, which can be used in the differential diagnosis between ALS and CSM/CSR.

The technique of amniotic membrane transplantation is developping rapidly in treating ocular surface disease recently. Amniotic membrane is widely used in this area due to its unique structure, procurment and graft puparation. The authors describe the methods of processing and preservation of human amniotic membrane, and the histological study and clinical application experiences as well.