By analyzing the present condition of communication courses in some medical colleges and universi -ties and the clinical practice situation , this paper emphasized the significance of the clinical professional courses :it is beneficial to promote the reform of medical education , is advantageous to the medical students′humanistic spirit , to improve clinical teachers′humanistic quality , is helpful to reduce medical disputes .And on the future develop-ment of clinical communication course put forward the following suggestions: extended content , the integration of related courses , reform teaching methods , intensify communication course value .

Objective To compare the effect of inhaled corticosteroids and montelukast in children with asthma .Methods Data were obtained from Pubmed ,Embase and Central databases ,CNKI and VIP .Only randomized controlled trials (RCT ) that evalua-ting inhaled corticosteroids and montelukast for children were included .The Cochrane collaboration risk bias tools was used to eval-uated the quality of literature .Results The patients with inhaled corticosteroids had a better effect in FEV 1% and PEF than pa-tients with montelukast ,the incidences of adverse drug reactions had no statistically significant difference .The patients with inhaled corticosteroids combined with montelukast had a better effect in FEV 1% or PEF than patients with inhaled corticosteroids only . Conclusion The effect of inhaled corticosteroids is better than montelukast ,the effect of inhaled corticosteroids combined with montelukast is better than inhaled corticosteroids only ,and has drug safety .

Objective To investigate the effects of Kidney nourishing decoction in the treatment of reproduce patients in serum hormone .Methods 120 cases with reproduce patients from June 2014 to June 2016 in hangzhou traditional chinese medical hospital were selected,and divided into control group and experiment group, 60 cases in each group.The control group was given artificial cycle treatment, the experiment group was treated with Kidney nourishing decoction, two groups were treated for three months.Serum sex hormone and AMH content, clinical effect and pregnancy rate were compared before and after treatment.Results Compared with before treatment, levels of FSH, LH, E2 and FSH/LH in two groups decreased, AMH content increased after treatment,the thickness of endometrium and ovarian antral follicle number increased,symptom scores decreased after treatment (P <0.05);Compared with the control group, levels of FSH, LH, E2 and FSH/LH in the experiment group were lower, AMH content were higher, the thickness of endometrium and ovarian antral follicle number in the experiment group were higher,and the symptom scores were lower (P<0.05).The total effective rate of the study group was 90.00% higher than the total effective rate of the control group 73.33% (P<0.05).There was no significant difference in adverse reaction rate between the two groups, the pregnancy rate in the experiment group 30.00% was higher than the control group 11.67% ( P <0.05 ) .Conclusion Kidney nourishing decoction can reduce the sex hormone and increase the content of AMH , and increase the pregnancy rate in the treatment of reproduce patients.

Objective To investigate the role of interleukin-6(IL-6), interleukin-8(IL-8) and tumor necrosis factor-?(TNF-?) in the pathogenesis of secondary syphilis, and their relationship with RPR titers and clinical manifestations in secondary syphilis. Methods The serum IL-6, IL-8 and TNF-? were tested by ELISA. RPR titers of the patients were determined simultaneously. Histopathology was performed if skin lesions were present. Results Thirty three cases of secondary syphilis were studied. The average levels of serum IL-6, IL-8 and TNF-? were 78.7?82.5 pg/mL, 171.9?117.9 pg/mL and 115.7?67.9 pg/mL, respectively, in syphilis group, which were significantly higher in comparison with those in controls (P

Objective To investigate the role of peripheral blood lymphocyte apoptosis through Fas/ Fas ligand pathway in the development of viral myocarditis. Methods Twenty-five viral myocarditis (VMC) and 25 healthy children were chosen for study. The apoptosis percentage in peripheral blood iymphocytes was quantitatively examined, flow cytometry with Annexin V/PI double parameter was used. And the expressions of Fas and Fasl protein in peripheral blood lymphocytes were analyzed with flow cytometry. Results The percentage of apoptosis in peripheral blood lymphocytes in children with VMC [(0. 6976 ± 0. 1109)%] was significantly higher than that of healthy children [(0. 1288 ± 0. 1069) %] (t = 18.459, P ＜ 0.001). Moreover, the apoptosis cell percentage showed a significant positive correlation with the serum levels of myocardium enzyme (creatine kinase-MB, lactate dehydrogenase, creatine kinase, hydroxybutyrate dehydrogenase)(r =0. 817 ,P ＜0. 01 ;r =0. 785 ,P ＜0.01 ;r =0. 726 ,P ＜0. 01 ;r =0. 712 ,P ＜0. 01). The expression of Fas and Fasl protein in VMC patients(2. 8804 ± 0. 3020,4. 4496 ± 0. 4836) were higher than those of health children(2. 1300 ±0. 6200,0. 1238 ±0. 0384) ,which had significant difference(t = 17. 321 ,P ＜0. 001 ;t' =44. 577, P ＜ 0. 001). The apoptosis percentage of peripheral blood lymphocytes in children with VMC showed a significant positive correlation with the Fas and Fasl protein expression in peripheral blood lymphocytes(r =0. 972, P ＜ 0. 01; r = 0. 958, P ＜ 0. 01). Conclusion Apoptosis percentage of peripheral blood lymphocytes increases among children with VMC, probably because immune response decreased or it is related with the degree of myocardium damaged. Fas and Fasl play an important role in apoptosis of peripheral blood lymphocytes in children with VMC.

Objective To explore the protection for ischemic myocardium with warm-up phenomenon and KATP channel blocker interventional effect on it. Methods Patients with chronic stable angina who came into the study were divided into three groups according to the presence of diabetes and its treatment ways: 25 patients without diabetes came into a NDM group, 22 patients with diabetes treated with glibenclamide came into a DMG group and 25 patients with diabetes but on diet only came into a DMD group. All the patients underwent sequential bicycle ergnmeter exercise test twice (EX1, EX2)with a time interval of 15 min. Parameters including exercise duration (ED), time for 1 mm ST-segment depression (T-STD), maximum STD (mm) and corresponding heart-rate systolic blood pressure product (RPP) were observed respectively. The parameters obtained during EX2 were compared with those obtained during EX1.Results In the group NDM,ED and T-STD were prolonged [(546. 04±103.78)s vs (617.52±106. 96) s, P < 0.05 and (378.64±92.34)s vs (436.84±91.25)s, P<0.05], STDmax was shortened [(2.06± 0.37) mm vs(1.75±0.41)mm,P<0.01]and RPP was increased[(173.77±34.73) beats±min~(-1)·nun Hg~(-2) vs (199.23±37.07 beats·min~(-1)·mm Hg~(-2), p<0.05]as the parameters during EX2 were compared with those during EX1. In the group DMG, there was no difference in these analysed parameters except that T-STD was prolonged [(328.45±64.66)s vs (363.00±81.48)s, P<0.01]when these of EX2 and EX1 were compared. In the group DMD,all the analysed parameters improved significantly during the second test (EX2) in comparison with the first test (EX1) as the results in the group NDM. Conclusions Exercise test can induce warm-up phenomenon in patients with chronic stable angina poctoris.The KATP channel blocker glibenclamide can block the warm-up phenomenon.

Objective To study of cellular immune function change of elderly patients with non-small car-cinoma after chemotherapy.Methods 62 patients with non-small carcinoma by age was divided into elderly group (≥60 years old)and youth group (<60 years old).The lymphocytes and their subsets CD3,CD4,CD8 levels were detected respectively in 2 weeks after chemotherapy and chemotherapy before compared with 20 cases of healthy vol-unteers.Results The immune condition of CD3[(51.87 ±2.56)%,(58.98 ±3.87)%]and CD4[(35.01 ± 5.12)%,(42.12 ±3.54)%],CD4/CD8[(0.89 ±0.49)%,(1.08 ±0.86)%]levels were significantly lower than those of healthy controls.Two groups of patients compared with healthy group CD3(69.38 ±8.54)%,CD4(48.21 ± 3.45)%,CD4/CD8(1.87 ±0.85)%(t=10.586,5.998,10.087,6.093,5.170,3.236,all P<0.05),and CD8 [(32.68 ±3.64)%,(30.24 ±2.45)%]levels were higher than those of healthy controls (26.10 ±2.89%)(t=6.777,5.531,all P<0.05);The CD3 and CD4,CD4/CD8 of elderly group patients were markedly lower than that of young patients (t=8.472,6.394,3.059,all P<0.05).The CD8 levels of the elderly group was higher than young patients (t=3.114 2,P<0.05);The Elderly group and young patients after 2 cycles of chemotherapy CD3 signifi-cantly was lower than before treatment (t=10.233,16.847,all P<0.05),but the two groups of patients with CD4, CD8 and CD4/CD8 levels before and after treatment (P>0.05);There was no significant difference with CD3 level of the two groups of patients after chemotherapy (P>0.05);The CD3 level of the two groups of patients after chemo-therapy was no significant difference (P>0.05),the elderly group patients after chemotherapy with CD4 levels was lower than young patients (t=7.130,P<0.05).The CD8 and CD4/CD8 level of the two groups after chemotherapy were no significant difference (P>0.05);The CD3 levels of patient withⅠ-Ⅱ stage were significantly better than patients withⅢ-Ⅳstage (t=1.584,1.721,all P<0.05),the CD4,CD8 and CD4/CD8 level of the two groups had no significant difference(P>0.05).Conclusion The senile non-small carcinoma patients need assistance targeted immunotherapy,also need to adjust according to the patient's age and clinical staging in patients with chemotherapy drug doses.

Objective:To investigate the effect of mycophenolate mofetil(MMF)on proliferation and apoptosis of cyst-lining epithelial cells in patients with autosomal dominant polycystic kidney disease(ADPKD),and to compare its effect with that of rapamycin(RAPA)in vitro.Methods: Primary cultured cyst-lining epithelial cells were treated with MMF and RAPA at different concentrations(0,0.005,0.05,0.5,5 ?g/ml)for 48 h or 72 h.The inhibitory effects of them on the cells were evaluated by MTT assay;the cell cycle distribution and apoptotic ratio were determined by flow cytometry.The morphological changes of cyst-lining epithelial cells were observed under transmission electron microscope.Results: Both MMF and RAPA significantly inhibited the proliferation of cyst-lining epithelial cells in a dose-and time-dependent manner.After 48 h treatment,the cells were blocked at S phase by MMF and at G0/G1 phase by RAPA.Both drugs induced cell apoptosis,with the maximal apoptotic rate being(5.53?0.27)% for MMF and(4.36?0.10)% for PAPA.Typical morphological changes of apoptotic cells were observed under electron microscope.Conclusion: MMF can effectively inhibit proliferation and induce apoptosis of cyst-lining epithelial cells,but its inhibitory effect is weaker than that of RAPA.

Kainic acid (KA) is now being widely used in neurobiology as a lesioning tool but, until recently, no neurohistological studies had been done on rabbits. The present study was undertaken to investigate the effect of kainic acid on hippocampal and caudate neurons in adult and young rabbits.Our results were as follows:1. Intraventricular injection of 0.8 ?g of KA caused destruction of the most of pyramidal cells in CA_3 and CA_4 in adult rabbits. At the same time damage to caudate neurons was also observed. After injection of 0.3 of 0.5 ?g of KA approximately one half of neurons in CA_3 and CA_4 was destroyed. Injection of KA with higher dose (1 ?g) caused more extensive damage to hippocampal neurons. However, after intraventricular injection of KA (0.1 or 0.2 ?g) in young rabbits (15～18 days old), the damage to some pyramidal ceils was observed only in CA_3a.2. Injection of 0.3 ?g KA into rabbit hippocampus caused destruction of neurons confined to the injected area. Intracaudate injection of KA with same dose (0.3 ?g) caused a small loss of caudate neurons, and the damage seemed less extensive.It was suggested that given proper care, KA can be also used to lesion selectively most perikarya in rabbit brain area.