The clinical teaching of ICU is a new challenge.According to the problem encountered in the practice we should improve and better the teaching methods such as asking students to pay more attention to the combination of substructural subjects and critical medicine and having a clinical macrocosm thinking,good responsibility,and the "intensive" concept during their work so that student can learn more initiatively and get more as well.

Objective To screen the liver cell proteins interacting with the novel protein encoded by the 2.2 kb singly spliced variant of hepatitis B virus genome. Methods The splicing-specific gene TPss generated by the 2.2 kb singly spliced variant of HBV genome was amplified by PCR and cloned into the bait vector pGBKT7. After exclusion of self-activatian capacities of TPss protein, a two-hybrid library screening was performed using a pre-transformed human liver cDNA library to screen the liver cell proteins interacting with TPss. Mammalian two-hybrid assay was also done to further confirm the interactions between the bait and prey proteins in Huh7 and HepG2 hepatacytes. Results TPss gene with the size of 336 bp was successfully amplified and cloned, and the TPss protein expressed well in AHI09 yeast cells. Four liver cell proteins interacting with TPss, i. e. , cathepsin B, epoxide hydrolase 1, cathepsin D and fibrinogen gamma chain, were screened by yeast two-hybrid assay and further confirmed by mammalian two-hybrid assay. Conclusion TPss could interact with liver cell proteins.

Objective To study the effects of purified rabies vaccine for human use (RV) on specific Th1/Th2 cytokines in human. Methods Twenty cases were injected intramuscularly with 5 full doses of RV. PBMCs were isolated from the blood sample collected at day 0, 14, 45 after the RV inoculation. Neutralizing antibody was determined by ELISA, and the proliferation of lymphocyte by in vitro test. The levels of RV specific IFN-γ, TNF, IL-2,IL-4, IL-5, IL-10 in the culture supernatants were detected by cytometric bead array (CBA). Results The neutralizing antibody was tested positive in 19 cases 45 days after inoculation and 1 case after 60 days, with the positive rate reaching 100%. After stimulation with RV, the lymphocyte transformation index at day 14, 45 in cases were significantly higher than those day of 0 (P< 0.05), and similar results were confirmed with IFN-γ, IL-2, IL-4, IL-5 tested by CBA (P<0.05). Condusion The RV could induce humoral and antigen-specific cellular immune responses in human, tested by showing good protective effect on rabies virus.

Objective: To investigate the association between the CYP3A5 genetic polymorphism and the serum concentrations of carbamazepine (CBZ), to provide guidance for individualized drug dosing. Methods: Eighty-four epilepsy patients taking CBZ were included in this study. Their clinical data were recorded and CBZ serum concentrations were measured. The CYP3A5 6986 genetic polymorphism was assessed using a polymerase chain reaction-restriction fragment length polymorphism (PCRRFLP) assay. Patients were divided according to genotype into CYP3A5 expressor (CYP3A5*1/*1 genotype and CYP3A5*1/*3 genotypes) and non-expressor groups (CYP3A5*3/*3). The two groups were compared for the total dose of CBZ, dose of CBZ/kg body weight, serum drug concentration, dose-corrected serum concentration, and standardized serum concentration. Results: The total dose of CBZ and the dose of CBZ/kg body weight was higher in the CYP3A5 expressor group than the non-expressor (P = 0.043 and P = 0.014, respectively). The dose-corrected and standardized serum concentrations were lower in the CYP3A5 expressor group than the non-expressor (P = 0.001 and P < 0.001, respectively). There was however, no signifi cant difference in serum drug concentration between the two groups (P = 0.487). Conclusions: There was a close relationship between CYP3A5 genetic polymorphism and the serum concentrations of carbamazepine.

Objective To evaluate clinical effect of Compound Fanshiliu Recipe(CFR) for the treatment of over-weighted type 2 diabetes mellitus(T2DM). Methods One hundred and twenty over-weighted T2DM patients were randomized into treatment group and control group, 60 cases in each group. Both groups were given oral use of Metformin Hydrochloride Enteric-Coated Tablets, and additionally the treatment group was treated with CFR orally. The treatment of both groups lasted for 12 continuous weeks. Before and after treatment, we detected the waist circumference (WC), body mass index (BMI), and the levels of fasting blood glucose(FBG), postprandial 2-hour blood glucose(P2hBG), glycosylated hemoglobin(HbA1c), total cholesterol(TC), triglyceride (TG), and free fatty acid (FFA). The therapeutic effect of the two groups was also evaluated after treatment. Results (1) The total effective rate for traditional Chinese medical symptoms was 95.00% in the treatment group, and was 70.00%in the control group, the difference being significant(P<0.01).(2) After treatment, WC and BMI were decreased in the treatment group(P<0.01 compared with those before treatment), but had no significant decrease in the control group(P>0.05). The decrease of WC and BMI of the treatment group was superior to that of the control group(P<0.05).(3) After treatment, levels of FBG, P2hBG, HbA1c, TC, TG, and FFA of both groups were significantly improved (P<0.05), and the improvement of the treatment group was superior to that of the control group(P<0.05).(4) Three patients of the treatment group suffered from slight gastric discomfort, and the discomfort was relieved without any special treatment. Other patients of the two groups had no adverse reaction. Conclusion Treatment of CFR combined with Metformin has been proved to be an effective and safe approach to decrease blood glucose and blood lipid levels, promote weight loss, and ameliorate traditional Chinese medical symptoms.

Objective To explore the effects of repetitive transcranial magnetic stimulation (rTMS) on the motor function of lower limbs of patients with cerebral infarction.Methods Sixty stroke survivors with lower limb dysfunctionwere randomly assigned to an rTMS treatment group or a control group,each of 30.Both groups were given routine medication and rehabilitation treatment,while the treatment group was additionally provided with 4 weeks of rTMS treatment of the contra-lesional M1 at 1 Hz and 90％ motor threshold.The Fugl-Meyer motor assessment (FMA) and maximum walking speed (MWS) were used to assess both groups before and after the treatment and 2 weeks later.Adverse reactions were also recorded.Results Before the intervention,no differences were found between the two groups.After the treatment and two weeks after that,significant improvement was observed in the average FMA and 10 m MWS of both groups,with significantly more improvement in the treatment group than among the controls.No obvious adverse reactions were observed in either group.Conclusions rTMS can improve the motor function of the affected lower limbs of stroke patients safely.

Objective To establish a HPLC method for the assay of psoralen and isopsoralen in different effective extracts of Fructus Psoraleae. Methods HPLC was carried out on the column of Kromasil RP-C18. The mobile phase was methanol -water(65 ∶35). The flow rate was 1.0 mL/min and the UV detection wavelength was 245 nm. Results Good linearity of psoralen was showed within the range of 10.5 ng～525 ng(r= 0.999 3)and isopsoralen within the range of 9 ng～450 ng (r= 0. 999 9). The content of psoralen and isopsoralen differed in different extractions of Fructus Psoraleae. Among them,the extract C (extracted by ethyl acetate ) contained the highest contents of psoralen and isopsoralen,while the contents of psoralen and isopsoralen were very low in the extract D (extracted by n-butyl alcohol) and E (supernatant of water extract). Conclusion The method is simple,accurate and reproducible. The anti-asthma effect and the dose-effect relationship of the different effective extracts of Fructus Psoralea need further pharmacodynamics study.

Objective To evaluate the clinical efficacy of mesalazine sustained-release tablets in combination with azathioprine in the small intestine Crohn’s disease therapy.Methods 60 cases of small intestinal Crohn disease patients were randomly divided into two groups and the control group 30 cases.Observation group mesalazine sustained-release tablets 1.5 mg ~2.0 mg/( kg? d ) , 1 ~2 times/d, the other in combination with azathioprine 1 g/times, 2 times/d treatment;control group received azathioprine alone 1 g/times, 2 times/d, both groups were treated for 30 weeks after treatment were compared activity index score, clinical remission rate, mucosal healing rate, blood biochemical parameters before and after treatment, and record adverse reactions during treatment.ResuIts The two groups of patients after treatment than before treatment activity index score decreased significantly (P<0.05), but the observation group were more than the control group decreased significantly (P<0.05); observation group complete remission rate and mucosal healing rates better than the control group (P<0.05);the WBC count, ESR and CRP level were lower than before treatment (P<0.05);AIL two levels and TLB levels were significantly increased compared with that before treatment (P<0.01), but the observation group was significantly higher than that in the control group ( P<0.05 ); the incidence of adverse observation group were 26.67%, significantly higher than the 6.67%( P<0.05 ) .ConcIusion Mesalazine sustained-release tablets in combination with azathioprine therapy compared with small bowel Crohn’s disease treatment is more effective azathioprine alone, can significantly improve the therapeutic effect, but incidence of adverse reactions is higher.

Objective To study the feasibility and security about misoprostol combined with fentanyl and propofol applied in visualization of artificial abortion.Methods 1270 cases of pregnant women who requested termination of pregnancy and voluntarily accepted abortion were selected.In the observe group,634 cases of pregnant women received oral misoprostol about 600 mg 90 minutes before surgery.After anesthetized by fentanyl and propofol,painless artificial abortion using visual abortion instrument was carried out.In the control group,636 cases of pregnant women anesthetized by fentanyl and propofol via the venous were carried out artificial abortion.The degree of cervical relaxation,loss of blood,total dose of propofol,surgical time,recovery time,the incidence of abortion complications and so on were observed.Results In the observation group and the control group,the average dosage of propofol are( 14.15 ± 2.37) ml and (16.90 ± 4.52) ml respectively;The average time required for surgery are ( 146.1 ± 38.2) s and ( 199.7 ± 37.3 ) s respectively;the average time required for awakening are ( 6.01 ± 1.90 ) min and ( 8.81 ± 2.02 )in;In the observation group,there are 405 ( 63.9% ) cases of cervical laxity markedly,in the control group,including 145 ( 22.8% ) cases of cervical laxity markedly,there is statistical significance ( P ＜ 0.05 ) between the observation group and the control group.There are no abortion syndrome in both groups.Conclusion Misoprostol combined with fentanyl and propofol was the first choice for painless artificial abortion using ultrasound visualization.

Objective To supply evidence for quality control of Herba Ephedra by determining content limit in different batches of medicinal material of Herba Ephedra.Methods A RP-HPLC method was used for the determination of ephedrine and pseudo-ephedrine. The chromatographic conditions were: Kromasil RP-C18(250?4.6 mm,5 ?m) column, a mixture of 0.3 %phosphoric acid-methanol (10∶90) as mobile phase and 213nm as detected wavelengths.Results The contents of the above two alkaloids showed great difference among the 14 patches of tested samples. The content of ephedrine ranged 0.361 %～1.538 %and that of pseudo-ephedrine 0.332～2.087 %. The suggested content limitation of ephedrine should be 1.082 %, and that of psedoephedrine be 1.008 %in the crude Herba Ephedra.Conclusion The established method has been proven to be simple, stable and repeatable, and can be applied for quality control of the crude crude Herba Ephedra and compound prescriptions containing crude Herba Ephedra.