Institute for International Medical Education(IIME)established the Global Minimum Essential Requirements(GMER)in Medical Education in 2001.This article is to unscramble the connotation of GMER,reveal the transformation of the medical model and gives some thoughts on how to let GMER become the standard and carried out in our country so as to benefit the current reform of medical education.

In artistic esthetic education process,the joyful potency can be realized through empathy function,purification function,sublimation function and other intuition function. Cultivating students’ esthetic skill,guiding their esthetic appeal,exercising their esthetic volition,establishing artistic esthetic education environment and encourages students to set up the lofty esthetic ideal are the teacher’s important strategy.

In the current multimedia application of medical theory teaching there exist many problems such as infusion,relation estrangedness between teachers and students,the moral education marginalization,the abstract thinking ability attenuation and so on.Facing these problems,in the medical theory teaching,the multimedia application should take"help","reality","transfer"as the value pursue,and be located in the exaggeration atmosphere,the interest stimulation,induction inspiration,difficulty breakthrough,thought expansion and memory optimization,emotion cultivation and moral promotion.

Objective For providing a reference of the publishing in future, this paper explores the characteristics and laws of Researches in Medical Education by analyzing the published articles, authors and citation statistic situation of it. Methods With statistical method of bibliometric, this paper analyzes 615, published in the journal in 2010 in three aspects of papers, authors and quotations. Specific indicators include the published paper amount, fund projects, columns, co-authors, distribution of authors, citing quantity, citing types, citing language and the comparative analysis of indicators. Results The number of paper published in this journal in 2010 is 615. Total number of pages is 1728. The average pages of paper is 2.18. Article density is 0.36 article / page. Teaching reform and clinical teaching as the main sections account for 19.51% and 16.75% in the published paper amount. The total number of authors is 2084. No author and sole author paper is 87, co-author papers is 528, co-author rate is 85.85%. Cooperation degree is 3.39 person / article. The number of citations is 4331. The average number of citations in each article is 7.04, citation rate is 99.51%. Conclusion This journal is informative, focused, rich in column, and having a significant impact on the country, but there are some shortages such as the slightly lower number of citation and less foreign citation.

Objective A retrospective study was carried out for the analysis of correlation of traditional Chinese medical syndrome patterns of asthma patients at period of onset with five-element motions and six climatic factors. Methods All of the subjects were the inpatients of the First Affiliated Hospital of Guangzhou University of Chinese Medicine admitted from January 20, 2011 to January 19, 2014, matching the year of Xinmao, Renchen, Guisi correspondingly in ancient Chinese calendar. The patients were confirmed as asthma at period of onset and were differentiated into various traditional Chinese medical syndrome patterns. The time of onset was classified into various Yunqi periods according to the theory of five-element motions and six climatic factors, and then the correlation of syndrome patterns with the Yunqi periods was analyzed. Results A total of 308 inpatient case files were collected. In the year of Xinmao (2011) , 31 cases were differentiated as cold pattern asthma, 48 as heat pattern asthma, 6 as turbidity pattern asthma, 5 as wind pattern asthma. In the year of Renchen (2012) , 37 cases were differentiated as cold pattern asthma, 58 as heat pattern asthma, 13 as turbidity pattern asthma, 7 as wind pattern asthma. In the year of Guisi (2013) , 32 cases were differentiated as cold pattern asthma, 47 as heat pattern asthma, 14 as turbidity pattern asthma, 10 as wind pattern asthma. The results of statistical analysis showed that the differences of the distribution of syndrome patterns were insignificant among the year of Xinmao, Renchen, Guisi (P>0.05) . During the 3 years, heat pattern asthma had the highest incidence, cold pattern asthma came next, and turbidity pattern asthma and wind pattern asthma came last. Distribution of syndrome patterns of asthma in the year of Xinmao was consistent with the law of five-element motions and six climatic factors of the year of Xinmao. On the aspects of the theory of six Jianqi ( climatic periods) , the distribution of patterns of asthma in the climatic periods of Chuzhiqi, Erzhiqi, Sizhiqi was consistent with the law of climatic periods, while that in the climatic periods of Sanzhiqi, Wuzhiqi, Liuzhiqi was not consistent with the law of climatic periods. In the year of Renchen, syndrome pattern distribution was not consistent with the law of five-element motions and six climatic factors of the year of Renchen. In the climatic periods of Chuzhiqi, Erzhiqi, Sanzhiqi, the distribution of patterns of asthma was not consistent with the law of climatic periods, while that in the climatic periods of Sizhiqi, Wuzhiqi, Liuzhiqi was consistent with the law of climatic periods. In Guisi year, the distribution of syndrome pattern was not consistent with the law of five-element motions and six climatic factors of Guisi year either. On the aspects of the theory of six Jianqi, except for Erzhiqi, the distribution of patterns of asthma in the other five climatic periods was consistent with the law of climatic periods. Conclusion The theory of five-element motions and six climatic factors has some significance in predicting the pathogenic characteristics of asthma and in guiding the prevention and diag nosis of asthma, but convinced conclusion needs more proof from large-sample clinical trial.

Objective To investigate the distribution of traditional Chinese medical syndromes and clinical characteristics of influenza in South of Five Ridges.Methods A retrospective analysis was carried out in 162 cases of influenza patients admitted from outpatient department,emergency department and inpatient department of the First Affiliated Hospital of Guangzhou University of Chinese Medicine from 2014 to 2016.The distribution of clinical manifestations and syndrome types of the included influenza patients was analyzed.Results The average age of the included influenza patients was 35.76 ± 11.4 years old.The clinical syndromes were mainly characterized by fever,aversion to cold and chills,fatigue and weakness.And damp-accumulation manifestations of heaviness in the body,poor appetite,dry mouth without willing to drink,nausea and vomiting were also predominant.The main syndrome types were wind-heat attacking defense phase syndrome,wind-cold fettering exterior syndrome,heat-toxin attacking lung syndrome,heat-toxin accumulating lung syndrome,and damp syndrome.Of the syndrome types,wind-heat attacking defense phase syndrome and heat-toxin attacking lung syndrome were the leading types,accounting for 77.79％ and interweaving with damp syndrome and heat-damp syndrome.Conclusion The syndromes of influenza patients in South of Five Ridges are usually complicated by damp syndrome or damp-heat syndrome,and the predominant syndrome type is wind-heat interweaved with damp syndrome,which is correlated with the climate being damp and hot in South of Five Ridges.

ObjectiveTo investigate the changes in mammalian target of rapamyein (mTOR) with aging in rat kidneys.MethodsMale Wistar rats at the ages of 3, 12, 24 months were used for this study. Therenaltissuesandmesangialcellswereprocessedfor senescenceassociated β-galactosidase (SA-β-gal) staining. The expression and location of roTOR in kidneys and mesangial cells were studied by immunohistochemistry and immunocytochemistry, respectively. The mRNA and protein levels of the roTOR and p-roTOR were detected by Western blot assay and RT-PCR,respectively.ResultsThe expression of neutral β-galactosidase activity was increased in kidneys and mesangial cells with advancing age. Percentages of SA-β-gal staining positive ceils were (11.9±3.6)% versus ( 39.0±4.0)% versus ( 86.9±7.4) % in young, middle and aging glomerular mesangial cells (P<0.05). The mTOR staining appeared in the mesangial matrix and interstitium in kidneys, while the mTOR protein showed localization in cytoplasm and nucleus in mesangial cells. The staining intensity of mTOR in kidneys and mesangial cells in aged rats was markedly increased as compared to that in young and middle aged rats (P<0.05). The mRNA level of roTOR was significantly increased in kidneys and mesangial cells of agedrats versus young and middle aged rats,meanwhile, the roTOR and p-mTOR protein expressions were dramatically increased with advancing age (P<0.05 ).ConclusionsmTOR expression is increased with aging, which may play an important role in the aging process of kidneys.

OBJECTIVETo investigate the role of tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) in regulating both angiogenesis and the expressions of phosphatase and tensin homologue deleted on chromosome 10 (PTEN) and vascular endothelial growth factor (VEGF)/Flk-1 expression in human proximal tubular epithelial cells (HKC).

METHODSHKC cells were transfected with two recombinant plasmids containing sense and antisense full-length TIMP-1 cDNA (TIMP-1S-pcDNA3.0 and TIMP-1AS-pcDNA3.0, respectively) constructed previously, or treated with 100 µmol/L MMP-2/MMP-9 inhibitor III (with similar cellular enzyme suppression activity with sense TIMP-1 plasmid). The mRNA expression of TIMP-1, MMP-2, MMP-9, PTEN, VEGF and Flk-1 were examined by RT-PCR. In each group, the expression of PTEN, VEGF and Flk-1 were also detected using an indirect immunofluorescence assay.

RESULTSCompared with non-transfected cells and cells transfected with the empty vector, sense TIMP-1-transfected cells showed obviously upregulated PTEN expression (P<0.05) and significantly lowered gelatinase activity (P<0.05) and VEGF and Flk-1 expressions (P<0.05). Transfection with the antisense TIMP-1 plasmid produced the reverse results (P<0.05). MMP-2/MMP-9 inhibitor III did not obviously affected the expression of PTEN, VEGF or Flk-1 as compared with the non-transfected or empty vector-transfected cells.

CONCLUSIONIn the aging progress, the renal tissues express high levels of TIMP-1 to upregulate PTEN expression via a MMP-independent pathway, and subsequently down-regulates the expression of VEGF and Flk-1 to cause aging-related impairment of renal angiogenesis. These findings provide new evidence for understanding the role of TIMP-1 in renal aging.

Cells, Cultured ; Epithelial Cells ; metabolism ; Humans ; Kidney Tubules, Proximal ; cytology ; Matrix Metalloproteinase Inhibitors ; PTEN Phosphohydrolase ; metabolism ; RNA, Messenger ; genetics ; Tissue Inhibitor of Metalloproteinase-1 ; genetics ; metabolism ; Transfection ; Vascular Endothelial Growth Factor A ; metabolism ; Vascular Endothelial Growth Factor Receptor-2 ; metabolism

Objective:To explore a new training mode for nursing professionals suitable for the 1+X certificate system, and realize the training goal of "one specialty and multi-ability" compound technical nursing talents.Methods:To take the "1+ X" certificate standard as the basis for the construction of nursing specialty, to reconstruct the talent training program of integration of graduation certificate and certificate. To take the content of "1+X" certificate as the basis for the construction of professional courses, construct the core curriculum system of integration of curriculum and certificate. To build a "new double-qualified" teaching staff and constructing of new double-qualified teachers and accelerate the development of quality resources.Results:The talent training mode of integration of graduation certificate and certificate under the 1+X certificate system was constructed. The curriculum structure has been optimized. The teachers′ability of teaching, training and examination was improved.Conclusions:The new mode of training nursing professionals under the 1+X certificate system meets 1 degree education and X vocational training of nursing students and achieve a "1" and "X" seamless convergence. It provides innovative ideas for the promotion and implementation of 1+X certificate system pilot work in the field of nursing education nationwide.

Objective:To investigate the association of osteosarcopenia with falls, risk of fracture, malnutrition among middle-aged and elderly adults.Methods:A total of 253 participants dwelling in Guangzhou community aged 40-90 years were included in this cross-sectional study from December 2017 to December 2019.Bone mineral density(BMD)was detected by dual-energy X-ray absorptiometry(DEXA). Body composition was analyzed by a bioelectrical impedance analysis.Handgrip strength and gait speed were examined.The 10-year probability of a major osteoporotic fracture and hip fracture were evaluated by online WHO fracture risk assessment tool( FRAX?). Results:According to diagnostic criteria of AWGS and EWGSOP2, the incidences of osteosarcopenia varied from 5.1% to 7.6%, 5.1% to 11.4% respectively.After the adjustment for age and gender, Logistic regression analysis showed that osteosarcopenia was correlated with falls, risk of fracture and malnutrition.Osteosarcopenia definited by AWGS criteria was strongly correlated with falls( OR=3.27-5.68, P<0.05), osteosarcopenia definited by non-severe sarcopenia criteria was strongly correlated with the risk of hip fracture( OR=1.14-1.15, P<0.05), and fat-free mass index was strongly correlated with osteosarcopenia with different definitions( OR=0.21-0.48, P<0.05). Conclusions:Osteosarcopenia is associated with higher risk of falls, fracture and malnutrition in the Guangzhou community-dwelling middle-aged and elderly adults, and fat-free mass index is an independent risk factor for osteosarcopenia.