Currently , social demands from basic education field , medical humanities education , the main threat to the national health service for medical psychology in our country is urgent and extensive .So, service di-rection of medical psychology also is shown as:medical psychology workers should play a role in basic education , in cultivating medical students and medical workers humanity take responsibility , and actively explore in residents′lifestyle changes .

Curcumin is the main active component in turmeric, which possesses many pharmacologic effects, including anti-in-flammatory, antioxidant, anti-tumor, anti-atherosclerosis, liver and kidney protection and so on. However, due to its poor bioavail-ability, its clinical application is limited. Therefore, the methods for improving the bioavailability of curcumin were reviewed by refer-ring to a large number of literatures. The bioavailability of curcumin can be improved by different administration routes and various dos-age forms. The review provides theoretical basis and research ideas for the development of new drugs.

Objective:To review the progress in vaginal mucoadhesive drug delivery systems. Methods:Based on the recently published papers,the research on the application of vaginal mucoadhesive drug delivery systems was classified and summarized. Re-sults:Vaginal mucoadhesive drug delivery systems not only showed safety,effectiveness and strong permeability but also avoided the first pass effect,prolonged drug residence time and improved bioavailability and compliance of patients. Conclusion:Vaginal mucoad-hesive drug delivery systems are becoming research hotspots and exhibit broad application prospects to replace the traditional delivery systems.

Objective:To review the drug absorption evaluation methods for pulmonary delivery. Methods: The drug absorption cell models, in vitro pulmonary membrane model and in vivo animal model were systematically summarized, and the advantages and disadvantages of those models and applications were reviewed by referring to the databases in CNKI and Pubmed. Results:The appro-priate animal model and method for the study of pulmonary absorption should be chosen according to the experimental purpose and char-acteristics of drugs. Conclusion:The review provides the thoughts and theoretical basis for the research and development of pulmonary delivery.

BACKGROUND:Hot-melt adhesive is safe and environmental friendly adhesive due to free of solvent, which is particularly suitable for medical applications. OBJECTIVE:To describe the types and characteristics of currently used hot-melt adhesives and to prospect the technical research and development of hot-melt adhesive for polyolefin tubes or catheters as wel as to point out the corresponding key points to the hot-melt adhesion. METHODS:Literature search was carried out in SCI, Elsevier, and CNKI with the key words of“hot melt adhesive, medical application”in English and Chinese, respectively, for the initial retrieval of relevant articles or patents published January 1995 to December 2015. RESULTS AND CONCLUSION:To date, the medical hot-melt adhesives reported in the literature could be grouped as amorphous polyolefin, thermoplastic elastomer, acrylic and polyurethane types. The heat resistance of the most of the hot-melt adhesives does not meet the requirement for steam sterilizing process. In the present review, a strategy is proposed to develop a novel hot-melt adhesive which is good for binding polyolefin parts and can undergo the sterilization process. Given this, it is essential to choose a kind of polypropylene random copolymer with a suitable melting point as a substrate. With the aid of an adjuvant agent, therefore, we can develop a novel hot-melt adhesive that exhibits a lower melting point than the polyolefin tube, withstands steam sterilization temperature to ensure that the tube is not deformed during melt adhesion and is not become invalid during sterilization.

Various new ophthalmic formulations have been prepared to enhance ocular bioavailability,while lots of irritant sub-stances are applied,including surfactants,polymers and other cationic materials. Therefore,safety of the preparations has been paid more and more attention besides the efficacy. Since in vitro experiments lack of associated enzymes and integral reaction of organiza-tion,the reasonability and correlation of the results extrapolated to the animal experiments still need to be further proved. The in vivo common eye irritation methods( winking,histopathological slices,Draize score and confocal microscopy test etc)were reviewed,eval-uated and analyzed in the paper.

Objective To investigate the distribution differences of Porphyromonas gingivalis(Pg) FimA genotypes between periodontitis patients with and without type 2 diabetes for a better understanding of the relationship between diabetes and periodontitis.Methods Questionnaires and detailed periodontal examinations(6 sites per tooth) were conducted in 80 subjects with moderate-severe chronic periodontitis in the Department of Periodontology, Peking University School and Hospital of Stomatology.There were 40 type 2 diabetic patients and 40 systemicly healthy patients enrolled respectively.The periodontal parameters including plaque index(PLI), probing depth(PD), bleeding index(BI), attachment loss(AL) by 6 sites per tooth and numbers of missing teeth were also recorded.Pooled subgingival plaque samples using pocket method with Whatman No3 filterpaper were collectedat each of the 6 sites from one incisor and one molar.Pg and its FimA genotype distributions were investigated using DNA extrctedfrom plaque samples by PCR.Results Diabetic patients had a significantly higher score of PLI[2.35(0.58) vs 1.64(0.76), P＜0.05] , while rest of periodontal indexes observed(PD, BI and AL) did not differ significantly between diabetic patients and systemicly healthy controls(P＞0.05).The detection rate of Pg did not show statistically significant difference between the two groups(50％ vs 60％, P＞0.05).However, the proportion of FimA Ⅱ was significantly higher in diabetic group than systemicly healthy group(80％ vs 42％, P＜0.05).Conclusions Type 2 diabetic patients were prone to be infected by highly virulent strains of Pg: FimA Ⅱ Pg.

Objective The dynamic detection of endotoxin is of great significance for the early diagnosis and treatment of prosthesis loosening after joint replacement. This study aimed to explore and analyze the clinical significance and efficacy of endotoxin detection in prosthetic joint loosening after joint replacement.Methods Fifty-eight patients who underwent arthroplasty in the department of orthopedics in Nanjing General Hospital from January 2015 to June 2016 were selected for prospective study. The patients were divided into the infection loosening group (patients with infectious loosening after arthroplasty, n=15), the aseptic loosening group (patients with aseptic loosening of after arthroplasty, n=23) and the control group (patients were normal after arthroplasty, n=20) according to the postoperative complications. Endotoxin was detected with MB-80 microbial dynamic rapid detection system. We compared the endotoxin level and the ROC curve was made to acquire the sensitivity and specificity under the different cut-off values. Eventually find the best diagnostic threshold.Results The levels of endotoxin in the infection loosening group and the aseptic loosening group \[(0.56±0.11, 0.49±0.08) ng/mL\] were significantly higher than that in the control group \[(0.24±0.06) ng/mL\]. The difference was statistically significant (P<0.01). The difference was not statistically significant between the infection loosening group and the sterile loosening group (P>0.05). ROC curve analysis showed that when the serum endotoxin concentration was 0.36 ng/mL, the Youden index was the highest, which could be the best cut-off value for diagnosis. It had the best accuracy to judge the prosthesis loosening with a sensitivity of 66.7% and specificity of 88.2%.Conclusion The endotoxin can be a good indicator for early diagnosis of prosthesis looseness. It is helpful to the diagnosis of the prosthesis loosening after arthroplasty.

Objective Few clinical studies have been reported on the reversibility of uremic cardiomyopathy (UC) after renal transplantation. This article aimed to investigate the cardiac structure and function of end-stage renal disease (ESRD) patients undergoing renal transplantation using cardiac magnetic resonance (CMR). Methods This study included 38 ESRD patients undergoing renal transplantation in the National Clinical Research Center for Kidney Diseases, General Hospital of Eastern Theater Command, from September 2015 to February 2017. All the patients received initial CMR examination at 1－2 days before renal transplantation and during the postoperative follow-up. At the median follow-up time of 3.5 (3.4-3.7), 7.0 (3.7-9.5) and 8.4 (7.1-12.7) months, we recorded the CMR parameters, including the left ventricular end-diastolic volume (LVEDV), end-systolic volume (LVESV), end-diastolic mass (LVEDM), end-systolic mass (LVESM), ejection fraction (LVEF), and native myocardial T1 relaxation time, and compared the parameters obtained before and after surgery. Results Twenty-five of the patients completed the postoperative follow-up, who averaged 27.5 years of age, with no history of diabetes mellitus or ischemic heart disease, and treated by dialysis for 1.7 (1.5-2.2) years. At 7.0 months after renal transplantation, as compared with the baseline, the patients showed significant decreases in the LVEDV ([96.7 ± 22.8] vs [83.4 ± 17.4] mL/m², P < 0.05), LVESV ([44.3 ± 14.8] vs [33.0 ± 10.9] mL/m², P < 0.05) and LVEDM ([67.1 ± 24.2] vs [59.0 ± 17.0] mL/m², P < 0.05), but an increase in the LVEF ([54.1 ± 10.6] % vs [60.9 ± 9.6] %, P < 0.01). The LVEDV and LVESV were also remarkably lower at 3.5 and 8.4 months than the baseline (P < 0.001), and so were the left ventricular at basal, mid, apical and global native T1 relaxation times at 3.5, 7.0 and 8.4 months (P < 0.05). Conclusion For young ESRD patients with no history of diabetes mellitus or ischemic heart disease and on short-term dialysis, left ventricular dilatation, systolic dysfunction and diffuse myocardial fibrosis are reversible after renal transplantation. Native T1 relaxation time can be used as a sensitive indicator to evaluate the degree of diffuse myocardial fibrosis in ESRD patients.

Objective:To analyze the influences of leukocytes on improving blood glucose control in patients with type 2 diabetes mellitus (T2DM) and periodontitis after periodontal mechanical therapy.Methods:Thirty-five patients visiting Peking University Third Hospital from March 2011 to August 2012, as well as thirty-four patients visiting Peking University School and Hospital of Stomatology from March 2011 to August 2012 and December 2016 to December 2018 were selected in this research. These subjects were non-smokers, and with moderate to severe chronic periodontitis and T2DM. The full set of periodontal examinations including probing depth (PD), attachment loss (AL), bleeding index (BI) and plaque index (PLI) were conducted. Besides, counts of white blood cells (WBC), parameters of glucose and lipids metabolites such as fasting blood glucose (FBG), glycosylated hemoglobin (HbA 1c), total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL) in serum were examined before treatment. Then, oral hygiene instruction, scaling and root planing (SRP) were carried out. Three months after SRP, the baseline examinations were repeated in all patients. According to the baseline leukocyte counts, the patients were divided into subgroups: low WBC group (WBC<6.19×10 9/L) and high WBC group (WBC≥6.19×10 9/L). Paired t-test for comparison of changes after treatment, analysis of co-variance for comparing the intervention effects between subgroups, and multifactor Logistic regression analysis were performed. Results:Three months after SRP, all periodontal indexes were significantly improved in both groups. Leukocyte counts decreased significantly in high WBC group (6.89±1.53 vs. 7.64±1.51, P=0.008). In high WBC group, HbA 1c (7.18±1.09 vs. 7.67±1.35, P=0.001) and LDL (2.67±0.85 vs. 3.28±0.76, P=0.042) decreased significantly, while there were no such differences in low WBC group. Influence of leukocyte level on HbA 1c ( OR=0.12, P=0.038) and LDL ( OR=0.15, P=0.001) improvement was statistically significant. Hierarchical analysis showed such improvement notably perform in female [HbA 1c ( OR=0.30, P=0.021), LDL ( OR=0.34, P=0.001)] and severe periodontitis group [HbA 1c ( OR=0.15, P=0.025), LDL ( OR=0.24, P=0.017)]. Through interaction test, female and leukocyte counts at baseline had relative excess risk affecting the effect of periodontal intervention on HbA 1c ( P=0.036) and LDL ( P=0.005). Conclusions:SRP could significantly improve the blood glucose and lipid control in patients who had T2DM and chronic periodontitis with relative higher leukocytes level. Female patients with severe periodontitis showed more obviously effects.