By exploring the fitting teaching methods and models oriented to these foreign students,the problems such as language,teaching materials,objectives existing in the basic medicine subjects teaching for South-Asian students are discussed,in order to further enhance the quality of teaching and reinforce the international cooperation of medicine education.

Objective　To explore the effect of dexamethasone (Dex) given with the intention of prevention or treatment on endotoxin shock in rabbits and its relationship with tumor necrosis factor (TNF). Methods　Fifty-three health rabbits were divided into 4 groups, including normal control (n=13), endoxin shock group (n=16), preventive Dex group (n=12) and therapeutic Dex group (n=12). Except normal control was given with saline, the other 3 groups were administered with lipopolysaccharide (LPS) infusion, and the preventive Dex group was treated with Dex (5 mg/kg body weight) 30 min before LPS infusion and the therapeutic Dex group 20 min after LPS infusion. Mean arterial blood pressure (MABP), survival rate, TNF level in circulatory blood and other parameters were detected. Results　In preventive and therapeutic Dex groups, MABP was increased and survival rate was reduced compared with the animals from endoxin shock group (P<0.05, P<0.01), and TNF activity in the circulating blood was significantly suppressed (P<0.01). In addition, dexamethasone administration could alleviate the elevation of plasma glucagon, glucose, lactic acid, and β-glucironidase (P<0.05, P<0.01) in shocked animals. It was also found that administration of dexamethasone in vitro prevented the release of TNF by Kupffer cells. Conclusion　These results indicate that the preventive and therapeutic effect of dexamethasone on endotoxin shock, which may relate to its direct inhibition of the release of TNF induced by LPS.

BACKGROUND: Chinese medicine xinmailong (XML) injection is a kind of new nucleoside compound which comes from American giant cockroach of insects. A lot of studies show that XML has obvious effect on cardiovascular activity which can treat acute or chronic congestive heart failure and shock and improve microcirculation.OBJECTIVE: To observe the effect of XML on anti-aging of mice.DESIGN: Controlled observational study.SETTING: Department of Physiology and Pathology, Basic Medical College of Dali College.MATERIALS: The experiment was carried out at the Functional Laboratory of Basic Medical College between July 2002 and September 2004. A total of 40 ICR mice of both sexes were provided by Kunming Medical College,Yunnan Naturally Occurring Drugs Key Laboratory. XML injection was provided by Yunnan Tengchong Pharmacy Factory [batch number: 94 (ZL) 03].METHODS: A total of 40 ICR mice were randomly divided into 4 groups:young control group, aging control group, XML group at high dosage and XML group at low dosage with 10 in each group. All mice were fed routinely with standard feed. Mice in young control group aged 3 months and weighed (20±2) g; meanwhile, mice in other groups aged 20 months and weighed (40±3) g. From the 20th month, mice in XML groups were intraperitoneally injected with 6 mg/kg and 8 mg/kg, respectively, for 30 days with once every day. Mice in young and aging control groups were intraperitoneally injected with the same volume of saline. On the 31st day,heads of mice were cut off to obtain blood which was maintained at hepalean anti-coagulated tube. Brains and livers were obtained rapidly for homogenate with 10% saline. Activities of catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in serum, content of malondialdehyde (MDA) in brain tissue and content of lipofuscin in cerebral and hepatic tissue were measured according to introduction of kits.MAIN OUTCOME MEASURES: ① Activities of CAT, SOD and GSHPx in serum; ② content of MDA in brain tissue and contents of lipofuscin in cerebral and hepatic tissues.RFSULTS: A total of 40 animals were involved in the final analysis without any loss. ① Activities of CAT, SOD and GSH-Px in serum of mice were lower in aging control group than those in young control group; however,activities of CAT, SOD and GSH-Px in serum of mice were increased in the two XML dosage groups, and there was significant difference from those in aging control group (P ＜ 0.05 or P ＜ 0.01). ② Content of MDA in brain tissue and contents of lipofuscin in cerebral and hepatic tissues of mice in aging control group were higher than those of mice in young control group, but those in the two dosage groups were decreased, which was significant difference from those of mice in aging control group (P ＜ 0.01). However, there was no significant difference between the two dosage groups.CONCLUSION: XML has an effect on anti-aging through improving metabolism of free radicals.

Objective To evaluate the efficacy of surgical repair for non-circumferential defect of bile duct in Mirizzi syndrome.Method The clinical data of 32 patients with Mirizzi syndrome with non-circumferential defect of bile duct were repaired using the patient's own tissues such as gallbladder pedicle flap,umbilical venous flap and omental flap.Results All the patients were operated success fully.There was no operative mortality.The defects in the bile duct were repaired using gallbladder pedicle flap in 25 patients,umbilical venous flap in 5 patients and omental flap in 2 patients.There were 2 patients who developed postoperative complications.There was one postoperative bile leakage in a patient who was repaired using an umbilical venous flap.The other complication was residual bile duct stones.The patient with postoperative bile leakage was drained through a drainage tube which was removed after 7 days.The residual bile duct stones were removed by endoscopy through a T-tube sinus after 9 months.All patients were confirmed by T-tube cholangiography after 9 to 12 months to have no stones,bile duct stenosis or any other abnormalities.The T-tube was then removed.All patients were followed -up for 1 to 5 years.All patients had no cholangitis,abdominal pain,jaundice or fever.Conclusions Using the patients' own tissues such as gallbladder pedicle flap,umbilical venous flap and omental flap to surgical repair the defect in the bile duct of patients with Mirizzi syndrome was effective.This surgical treatment is a good choice.

AIM: This study aimed at elucidated the possibility that prevent tissue from secondary injury by regulating polymorphonuclear neutrophil (PMN) apoptosis in vitro . METHODS:Neutrophils, isolated from peripheral blood, were incubated with sodium arsenite (Ars), tumor necrosis factor (TNF-?), interleukin-6 (IL-6), burned serum and traumatic serum, respectively. Apoptosis rate, expression of CD11b, respiratory burst and concentration of Ca 2+ were then measured. RESULTS:The elevation of PMN apoptosis rate was Ars concentration dependent, but activated PMN became insensitive to Ars. IL-6 delayed PMN apoptosis (compared with control at 24 h, P

Objective To evaluate the effect of debridement hepatectomy with selective hepatopetal blood occlusion in the treatment of severe hepatic trauma.Methods The clinical data of 55 patients with severe hepatic trauma treated by debridement hepatectomy with selective hepatopetal blood occlusion were retrospectively analyzed.20,20 and 15 patients were with grade Ⅲ,Ⅳ and Ⅴ hepatic trauma respectively,combined with major peripheral hepatic vascular injury in 14 cases and with other trauma in 35 cases.Additional procedures including liver suture repair in 7 cases,perihepatic gauze packing in 3 cases,inferior vena cava repair in 5 cases,hepatic vein repair in 4 cases,hepatic vein ligation in 3 cases and hepatic artery ligation in 2 cases were performed.Other operations such as craniotomy debridement in 3 cases,cholecystectomy in 6 cases,T tube drainage of common bile duct in 4 cases,splenectomy in 5 cases,pancreatic tail resection in 2 cases,left kidney resection in 1 case,thoracic cavity closed drainage in 9 cases,partial small bowel resection or repair in 4 cases and stomach repair in 1 case were performed as needed.Results The operations were successful in 47 patients.Postoperative complications were observed in 19 cases (34.5％) including coagulation disorders in 1 case,postoperative abdominal bleeding in 2 cases,intestinal obstruction in 1 case,liver and renal dysfunction in 4 cases,abdominal infection in 3 cases,incision infection in 2 cases,pulmonary infection in 4 cases,pleural effuion in 10 cases.Death occurred in 8 patients (14.5％),the cause of death were hemorrhagic shock in 3 cases,combined with severe craniocerebral injury in 2 cases,septic shock in one case,and multiple organ failure in 2 cases.Conclusions Debridement hepatectomy with slective hepatopetal blood occlusion is an effective treatment for severe hepatic trauma.

Objective To study the results of laparoscopic approach in the treatment ot gallbladder and common bile duct stones.Method The authors reviewed data of 60 patients with gallbladder and bile duct stones treated laparoscopically.Results All the 60 patients treated with laparoscopic cholecystectomy and laparoscopic transcystic common bile duct exploration (LcTDE) were successful.There were 1 bile duct stone in 32 patients,and 2 to 6 bile duct stones in 28 patients.The operation time was (38.7±15.1) min and the hospitalization time was (5.5±2.1) days.One patient developed biliary fistula postoperatively which healed after 7 days of conservative treatment.One patient had bile duct residual stone which was treated by ERCP.The remaining patients were well.Conclusion Laparoscopic transcystic common bile duct exploration using a mini incision and primary suturing of the bile duct was simple,safe and efficacious.

Xinmailong injection solution was invented at 1988 by prof. Li Shunan in Dali medical college. It was made from the material which has high biological activeness to the cardiac and vascular system. During the experimental shock caused by excessive loss of blood in monkey and dog, it was found by ECG that the T-wave of anterion lead on left chest elevated and became high and sharp after acute blood loss. Arterial blood pressure dropped to 8-5.3 kPa for dog and 8-5.3-2.7 kPa for monkey, changes of T-wave all recovered to near normal level after xinmailong solution was injected intravenously (0.05-0.2 mL/kg). These Results implied that xinmailong might improve the ischemia of myocardium induced by hemorrhagic shock.

As the development of international education in our school,concern with the culture shock,which caused by the differences cultural background,is increasing.We talk about our feelings of how to solve the culture shock by summarizing the culture shock and its manifestation for exploration of further improving our management level and teaching work.

Objective To measure the normal sagittal and coronal diameters of thumb and great toe distal phalanx bottom by ultrasonography. Methods One hundred and twenty volunteers' sagittal and coronal diameters of thumb and great toe distal phalanx bottom were measured by ultrasonography. The measurements was analysed by the statistical method. Results The thumb and great toe distal phalanx bottom showed hyperechoic zone,clear boundary with the adjacent fascia and tendon tissue showed low echo area at cross section by high frequency ultrasound. The sagittal diameters of thumb distal phalanx bottom was (8. 07 ± 0. 67)mm in men, while that of great toe distal phalanx bottom was (8. 34 ± 1. 02) mm( t = 1.73, P =0.86).The coronal diameters of thumb distal phalanx bottom was (11.61 ±0.89)mm in men, while that of great toe distal phalanx bottom was (14. 25 ± 0. 84)mm( t = 16. 77, P = 0. 00). The sagittal diameters of thumb distal phalanx bottom was (7. 52 ± 0. 62) mm in women, while that of great toe distal phalanx bottom was (7. 72 ± 0. 67) mm( t = 1. 72, P =0. 14). The coronal diameters of thumb distal phalanx bottom was (10.94 ± 0.97) mm in women, while that of great toe distal phalanx bottom was (13. 51 ±0. 75) mm( t =16.21, P = 0.00). Conclusions The normal sagittal and coronal diameters of thumb and great toe distal phalanx bottom measured by the ultrasonography can guide the operation of wrap-around flap of a great toe with phalanx ungual for thumb II degree defect reconstruction.