Objective To investigate the application effect of the new trinity teaching mode of clinical practice,which combines bedside teaching,simulation teaching and web-based teaching to-gether. Methods Totally 375 students of clinical medicine,enrolled into Guangzhou Medical Univer-sity in 2006,were randomly divided into department I of clinical medicine (control group,188 stu-dents)and department II of clinical medicine (experimental group,187 students). The students of these two groups were taught respectively with the conventional bedside teaching mode and the trinity teaching mode. Then at the end of clinical practice,assessment results of comprehensive theory and clinical skill in the graduation exam were compared by t test (significance level α=0.05)using SPSS 17.0 software and the questionnaire results of students in experimental group were analyzed. Results There were statistical differences in comprehensive theory and clinical skill assessment scores between two groups(P<0.05). The questionnaire survey showed an approval rate of 92.73%(153/165)for trini-ty teaching mode. Conclusions Facing the shortage of clinical teaching resources,the trinity teach-ing mode is better than the simple bedside teaching mode. The trinity teaching mode can alleviate the pressure brought by the lack of clinical teaching resources at present,create more learning and prac-ticing opportunities for students,and improve the effects of clinical practice teaching.

AIM: To evaluate the antihistamine effects of domestic azelastine hydrochloride. METHODS: Histamine increased skin vascular permeability and induced shock model in guinea pigs. In isolated guinea pig ileal rings, the contraction of smooth muscle induced by histamine was determined. RESULTS: Pretreament with azelastine hydrochloride( 0.05, 0.15,and 0.45 mg?kg -1,ig) significantly inhibited the increase in skin vascular permeability induced by histamine in a dose-dependent manner in guinea pigs. Pretreament with azelastine hydrochloride( 0.05, 0.1,and 0.2 mg?kg -1,ig)produced a significant improvement of shock, as shown by a decrease in reactivity degree, mortality and a prolongation of latency. In isolated guinea pig ileal rings, azelastine hydrochloride (10 -8,3?10 -8,10 -7,3? 10 -7 mol?L -1)significantly inhibited contraction of smooth muscle induced by histamine in a concentration-dependent manner and caused a parallel right shift of the dose-effect curve of histamine (pA 2= 8.55). CONCLUSION: Domestic azelastine hydrochloride shows significant the antihistamine effects.

Objective To observe the effect of sedative drugs applied on uncooperative children in CT examination. Methods 204 samples were divided into groups of baby, infant and preschool children. 20 minutes before CT scan, chloral hydrate and diazepam were taken by those uncooperative children seperately. Drug dosage was calculated according to body weight (kg). Results The effective rate of chloral hydrate were 96.8%(30 cases) in baby group,54.2%(13 cases) in infant group and 53.9%(21eases) in preschool children group, while that of diazepam were 100%(9 cases), 82.6%(19 cases) and 87.2%(68 cases) respectively.Conclusion When approriate sedative drugs were taken by uncooperative children, satisfactory scanning images can be obtained in CT examination

Objective To study the effect of different family nursing methods on major catheter-re-lated complications in cancer patients with peripherally inserted central catheter (PICC) during chemother-apy intermission so as to reduce the incidence of complications and prolong the indwelling time and service life of the catheter. Methods We randomly divided 213 cancer patients who were discharged from hos-pital with PICC into two groups. One group(108 cases) routinely came back to our outpatient clinic and the other (105 cases) went to the community for nursing of the catheter. Results The total incidence rate of complications of the group who came back to our outpatient clinic for nursing of the catheter was 13.8%(15/ 108) and the other group was 51.4%(54/105). There existed statistical significance between the two groups (P<0.01). Conclusions There exists correlation between different family nursing methods and catheter complication rate. We suggest patients come back to our outpatient clinic for nursing of the catheter as pos-sible as they can.

Objective To investigate whether genotypes of CYP3A5,MDR1 and cyclooxygenase-2 are associated with the sensitivity of vinorelbine-platinum to NSCLC.Methods The genotypes of CYP3A5(*3),MDR1 (2677G>T at exon 21 and 3435C>T at exon 26 and their haplotypes),cyclooxygenase-2 (-1 195G>A) were determined by RFLP-PCR and chemotherapy responses were analyzed in 69 non-small-celllung cancer (NSCLC) Chinese Han patients.They received a combination chemotherapy of vinorelbine-cispla-tin.Chi-square test was used to investigate the potential association of genotype with chemotherapy response.OR and 95% C1 were calculated.Results The 3435 CC genotype was associated with a significantly betterchemotherapy response compared with the combined 3435 CT and 1Tr genotypes(P=0.033).The 2677 GG genotype was also associated with a significantly better chemotherapy response compared with the combined 2677 GT and IT genotype(P=0.012).Moreover.patients with the 2677 G-3435 C haplotype seemed to have a better response to chemotherapy compared with those with the other haplotypes(P=0.063).CYP3A5*3 was not likely to correlate with sensitivity of vinorelbine-platinum to NSCLC.Cyclooxygenase-2-1195G>A was likely to have better response to vinorelbine but not statistically significant(P=0.067).Conclusion Polymor-Dhisms of MDR1 3435 C>T and MDR1 2677 G>A/T can be used for predicting treatment response to vinorel-bine-cisplatin chemotherapy in NSCLC patients.

Objective To explore changes of toll like receptor(TLR) 2, 4 in peripheral blood mononuclear cells (PBMC) in acute abdomen patients with systemic inflammatory response syndrome(SIRS) and their significance. MethodsA clinical study was done on 103 patients in which 65 were with SIRS. The mRNA expression of TLR2, 4 were detected by RT PCR; the expression of TNF ? and IL 6 were observed by ELISA; the correlation between TLR2, 4 mRNA, the level of TNF ? and IL 6,and the clinical course was evaluated. ResultsTLR2 mRNA, TNF ? and IL 6 were upregulated markedly on the first day of hospitalization, then decreased gradually; TLR2mRNA maintained on high level till the 5th day. The expression of TLR2, 4 mRNA was positive correlated with the level of TNF ? and IL 6, and the length of stay. TLR2, 4 mRNA expression increased in patients with multiple organ failure. ConclusionsIn acute abdomen patients with SIRS, the expression of TLR2, 4 of PBMC increased markedly, indicating its important role in the pathogenesis of SIRS.

Objective To assess the value of susceptibility weighted imaging (SWI)in the diagnosis of different cerebral diseases complicated with cerebral microbleeds (CVBs)and cerebral vascular malformations (CVMs).Methods The MRI data of 76 cases with CMBs and 25 cases with CVMs were retrospectively analyzed and the data were translated as follows:(1 )To compare the counts and detecting sensitivity of CMBs on routine MRI sequences (T1 WI,T2 WI,T2 FLAIR,DWI)with SWI.(2)To assess the difference of SWI,MIP and Phase in detecting the size,counts,intensity and edge features of CMBs.(3)To assess the advantages of SWI in the diagnosis of different CVMs.Results (1)In all 1 524 CMBs detected on SWI,294,87,361,391 CMBs were detected on T1 WI,T2 WI,T2 FLAIR and DWI respectively.The sensitivities were 19.3%,5.7%,23.7% and 5.7% on T1 WI,T2 WI,T2 FLAIR and DWI respectively.It was of statistical significance (P <0.05)in the counts and detecting sensitivity on different MRI sequences.(2) 1 524 and 1 539 CMBs were detected on SWI and MIP respectively.CMBs showed oval,dotted hypointensity or hypointensity domi-nated mixed intensity lesions which were ≤10 mm in size on SWI and MIP.1 521 CMBs were detected on Phase,which appeared as hyperintensity or hyperintensity dominated mixed intensity lesions.MIP and SWI were similar in detecting the size,counts and edge features of CMBs.And Phase was inferior compared with MIP and SWI .(3)12 cases of cerebral venous malformation were detec-ted,which all appeared as the classic Medusa head sign on SWI.6 cases of intracerebral capillary telangiectasia were detected , which were characterized as multiple small rounded even hypointense lesions ortarget signon SWI .2 cases of arteriovenous malformation (AVM)were detected on SWI,in which one case only showed multiple small vessels and gross drainage vein,and the other showed clear nidus and gross drainage veins into the sigmoid sinus.4 cases of cerebral cavernous angioma were detected.Mulberry sign, which was characterized as dotted mixed intensity lesion with hypointense ring,was noted in all the cases on SWI.One case of Sturge-Weber syndrome was detected,which showed gyriform low signal lesion on MIP imaging.And many broadened,tortuous veins in the cerebral hemispheres and near the tentorium were also noted.Conclusion SWI can be used as an important sequence for detecting CMBs.Different CVMs show their specific signs in SWI sequence.Combined with conventional MRI sequences an accurate diagnosis can be achieved most of the time.

Objective To evaluate the body burden of Cadmium(Cd) in normal children from Shenyang city,and to analyze the effect of Cd on kidney.Furthermore,to investigate the influences of living factors on the level of Cd in children,so as to make recommendations for children's health.Methods The subjects was composed of 1 170 healthy children recruited from 0 to 17 years old by cluster random sampling method.They were divided into three groups(0-5 years old group,6-11 years old group,12-17 years old group).Questionnaires were used to obtain essential information about age,gender,weight,socioeconomic status,medication,and so on.Second morning urine samples were collected to make routine analyses,urinary Cd(Cdob),urine microalbumin(MALB) and α1-microglobulin(α1-MG).Results 1.A total of 1 070 children including 544 males and 526 females were enrolled.2.The concentration of Cdob increased with age,in agreement with the level of urinary Cd corrected by urine specific gravity (Cdsg).However,the level of Cd in urine corrected by urinary creatinine(Cdcr) presented the opposite status with the age increasing.3.Cdcr and urine MALB adjusted by urinary creatinin(MALBcr) revealed a positive correlation(rs =0.45,P ＜ 0.01).4.Preference values for Cdob and Cdsg,Cdcr respectively were:0-5 years old ＜0.56 μg/L,＜0.83 μg/L and ＜2.17 μg/g Cr;6-11 years old ＜0.65 μg/L,＜1.01 μg/L and ＜1.23 μg/g Cr;12-17 years old ＜0.74 μg/L,＜1.15 μg/L and ＜ 1.25 μg/g Cr.Conclusions There is an age-dependent cumulative increases in Cdob.Although renal damage was not found in this study,the uptake of Cd should be reduced as much as possible and it is necessary to strengthen the follow-up study of Cdob in body burden.

Objective: To develop an HPLC-ELSD method for the simultaneous determination of six saponins constituents including notoginsenoside R1, ginsenoside Rg1, ginsenoside Re, ginsenoside Rb1, ginsenoside Rc and ginsenoside Rd in Xinling pills.Methods: HPLC-ELSD was used, and the chromatographic separation was performed on an Agilent Eclipse XBD-C18 column (150 mm×4.6 mm,5 μm) with acetonitrile-water as the mobile phase with gradient elution at the flow rate of 1.0 ml·min-1, the column temperature was maintained at 20℃, the drift tube temperature was 60℃, and the gas pressure was 4.00 bar.Results: Notoginsenoside R1, ginsenoside Rg1, ginsenoside Re, ginsenoside Rb1, ginsenoside Rc and ginsenoside Rd was linear within the range of 0.30-6.00μg(r=0.999 5), 1.14-22.80μg (r=0.999 6), 0.17-3.40 μg (r=0.999 7), 0.81-16.20 μg (r=0.999 7), 0.08-1.60 μg (r=0.999 8) and 0.07-1.40 μg (r=0.999 8), respectively.The average recovery was 98.23%, 97.98%, 99.14%, 99.15%, 98.72% and 98.37%, and the RSDs were 1.56%, 1.31%, 1.16%, 1.07%, 0.73% and 0.92%(n=6), respectively.Conclusion: The method is convenient, accurate and reproducible in the quality control of saponins components in Xinling pills

Objective To observe the difference of lung injury between toll-like receptor 4 (TLR4) mutant mice and wild type mice in a model of lipopolysaccharide (LPS) induced acute lung injury (ALI),discuss the role of TLR4 in ALI.Methods Different doses of LPS solution (1,5mg?kg~(-1)) were injected in vein tail to reproduce ALI model in both TLR4 mutant (TLR4~(-/-)) and wild type (WT,TLR4~+(/+)) mice.Lung tissues were collected for gross and micrographic histological injury analysis and for assessment of lung edema.Meanwhile,the levels of myeloperoxidase (MPO) in lung tissues in both strains were assessed to evaluate the extent of polymorphological neutrophils (PMN) infiltration.Results The gross and micrographic injury of lung was milder in TLR4 mutant mice than that in wild type mice.The extent of lung edema (W/D) was also reduced compared with wild type mice,especially in 5 mg?kg~(-1) group [(4.08?0.1)vs.(4.55+0.2),n=10,t=12.71,P＜0.01].With high dosage of LPS,the value of W/D in both mice strains was higher than that in sham operation group (P＜0.01).The extent of PMN infiltration in lung tissues in TLR4 mutant mice was reduced compared with wild type mice.But they were higher than sham operated mice (P＜0.01).Conclusion TLR4 May involve in the development of ALI,by sequestration of PMN into lung tissues.