Since 1988,our school has been enrolling in increasing numbers students in 7-year programs of clinical medicine and stomatology. During the period, we have accumulated some experience, which can be embodied in five major points. On this basis, we have, starting from this year, enrolled students working on doctoral degree in 8-year programs with candidates who have completed 4-year undergraduate programs of science and engineering, designed to further intensify reforms in medical education programs.

OBJECTIVE:To study the pharmacokinetics of oral single dose adefovir dipivoxil(ADV) tablet in Chinese healthy volunteers.METHODS:The study was a randomized,open,three-way crossover study.Twelve healthy volunteers were randomly assigned to receive single oral dose of 5 mg(Group A),10mg(Group B) or 30 mg(Group C) ADV tablets in three weeks.The plasma concentrations of ADV were determined by LC/MS/MS method.The pharmacokinetic parameters were computed.RESULTS:The main pharmacokinetic parameters in Group A,B and C were as follows:Cmax were(11.4? 3.7),(25.4? 8.2) and(76.3? 23.0) ng? mL-1;tmax were(1.69? 1.41),(0.90? 0.56) and(0.94? 0.50) h;AUC0～ t were(102.7? 51.7),(235.0? 82.3) and(715.4? 267.6) ng? h.mL-1;AUC0～ ∞ were(168.7? 30.7),(266.2? 83.7) and(741.5? 273.9) ng? h? mL-1,respectively.CONCLUSION:ADV tablets had a rapid absorption in healthy volunteers and the Cmax and AUC of adefovir tablets were directly correlated to doses.It is safe for healthy volunteers to take ADV tablets at a dose of 5～30mg.

Complicated characteristic of facial modality acquisition and measurement is commonly needed in clinical environment.Two different methods were compared, one method was acquisition two-dimensional character based on the principle of machine vision with a charge-coupled device (CCD) capturing image, and another method was acquisition three-dimensional character based on the technology of Reverse Engineering with laser scanning capturing image. The principle, composition of the system, calibration and characteristics of different method are analyzed. Two-dimensional and three-dimensional facial data of thirty undergraduates was used to compare different methods. The application and restriction of different methods are concluded. The conclusion of this paper provided a reference for face plastic surgery, facial paralysis, facial surgical evaluation and rehabilitation design.

Objective: Expression of Bcl\|2 and Bax oncoproteins was tested in laryngeal squamous cell carcinoma (LSCC) in order to find the relationship between the two genes and LSCC, and to explrore their clinical significance by retrospectively study of pathological and clinical doouments. Methods: Immunohistochemical S\|P method was emioyed in testing the expression of Bcl\|2 and Bax oncoproteins in 74 patients with LSCC, 24 laryngeal atypical hyperplasis (LAH) and 24 laryngeal normal membrane (LNM). Results: Bcl\|2 oncoprotein was mainly expressed in cytoplasm of epithelium cells and a small part of cell membrances were stained, appearing brow or yellow, granular distribution.There were no expression in the cell nuclear and stroma. Bax oncoprotein was expressed in cytoplasm and cell membrane and there were a little expression in stroma, appearing light brown and yellow, granular distribution. Bax was less stained than Bcl\|2. The positive expression percentages of Bcl\|2 oncoprotein in LSCC, LAH, LNM tissues were 59.46%,66.67% and 20.83% respectively. The Bcl\|2 expressions in LSCC, LAH tissues were significantly higher than that in LNM (P＜0.05); The positive expression percentages of Bax oncoprotein in these three groups were 56.76%, 50.0% and 66.67% respectively which were no significant difference. The results of Spearman correlated analysis showed that expression of Bcl\|2 and Bax oncoproteins had no obvious correlations with pathological grade, clinical stage and metastasis of lymph node. Both were correlated only with smoking. Conclusions: The imbalance of Bcl\|2/Bax mainly induced by the high expression of Bcl\|2 oncoprotein played an important role in the development of LSCC and LAH, Bcl\|2 may act as a reference index in judging the biological speciality of LSCC; Expressions of Bcl\|2 and Bax oncoprotein had obvious corelation with smoking in LSCC, indicating Bcl\|2 and Bax genes may be a target of carcinogenic substance in tobacco; Expression of Bcl\|2 oncoprotein was blocked may be an important part in studying gene therapy for the future.

Objective To evaluate the association between the polymorphisms of BT-H4 gene and the risk of breast cancer, a case-control study was conducted in the population of Heilongjiang province, China. Methods We genotyped the single nucleotide polymorphisms of rs10754339, rs10801935 and rs3738414 in B7-H4 gene by PCR-RFLP in a Chinese population consisting of 287 breast cancer cases and 305 controls matched for age and sex, tagged all common haplotypes (frequency ≥ 1%), and analyzed the differences between patients and normal controls. Results Our data indicated that in rs10754339, the frequencies of G allele, AA genotype and AG genotype were significantly different between patients and controls (P=0.030, OR 1.359, 95 % CI 1.030-1.794; P=0.018, OR 0.671, 95 % CI 0.482-0.935; P=0.029, OR 1.455, 95 % CI 1.038-2.038, respectively). In rs3738414, the frequencies of A allele, GG genotype and AG genotype were significantly different between patients and controls (P=0.0008, OR 0.604, 95 % CI 0.455-0.803; P=0.001, OR 1.804, 95 % CI 1.289-2.253; P=0.005, OR 0.612, 95 % CI 0.435-0.862). The frequencies of AAA haplotype and GAG haplotype were significantly different between patients and controls (P=0.0015, OR 0.614, 95 % CI 0.456-0.828; P=0.0003, OR 1.954, 95 % CI 1.363-2.803). Conclusion Polymorphisms of B7-H4 gene appear to be associated with breast cancer in the population of Heilongjiang province, China.

Objective To assess the left ventricular synchronization and global systolic function in patients with implanted dual-chamber (DDD) mode cardiac pacemakers by real-time three-dimensional echocardiography(RT-3DE). Methods Left ventricular systolic synchronization and global function were evaluated in 20 patients with implanted DDD mode cardiac pacemakers and 20 normal people by RT-3DE. The left ventricular end-diastolic volume (LEDV), end-systolic volume ( LESV), stroke volume (SV), left ventricular ejection fraction (LVEF), the mean value of time from the start of electrocardiographic QRS wave to the point of minimal systolic volume (Tmean) of the 17 segments and those standard deviation(T-SD),the maximal difference of time among all 17 segments(Tmax) were obtained by RT-3DE. Results Compared with control group, LESV was significantly increased,SV, LVEF were significantly decreased and T-SD,Tmax were significantly prolonged (P <0.01 ). There were no differences in LEDV and Tmean between the two groups (P>0.05). In patients group,LVEF correlated closely with T-SD (r =-0.674, P<0.05) and Tmax (r = - 0. 634, P < 0. 05). Conclusions There were left ventrieular systolic asychronization and global systolic dysfunction in patients with implanted dual-chamber (DDD) mode cardiac pacemakers,which could be assessed by RT-3DE.

Abstract: Objective To investigate the prevalence and influencing factors of depressive symptoms among primary and middle school students in Xihu District, Hangzhou City, so as to provide insights into depression control among primary and middle school students. Methods: Students were sampled from two primary schools, two junior high schools, two ordinary high schools and one vocational high school in Xihu District using a stratified cluster random sampling method from September to November, 2021. Participants' demographics, diet, exercise, sleep and campus bullying were collected using questionnaire surveys. The depressive symptoms were evaluated using the Chinese version of the Center for Epidemiologic Studies-Depression Scale (CES-D), and factors affecting the depressive symptoms were identified among primary and middle school students using a multivariable logistic regression model. Results: A total of 1 518 students were investigated, including 518 primary school students (34.12%), 363 junior high school students (23.91%), 463 ordinary high school students (30.50%) and 174 vocational high school students (11.46%). Of all participants, there were 805 males (53.03%). The prevalence of depressive symptoms was 38.87% among the participants, and was 36.10%, 42.42%, 42.33% and 30.46% among primary school, junior high school, ordinary high school and vocational high school students, respectively. The multivariable logistic regression analysis showed that gender (OR=1.601, 95%CI: 1.289-1.989), type of school (junior high school, OR=1.299, 95%CI: 0.974-1.734; ordinary high school, OR=1.351, 95%CI: 1.025-1.780; vocational high school, OR=0.862, 95%CI: 0.585-1.272), frequency of fresh vegetable intake (less than once daily, OR=0.454, 95%CI: 0.304-0.679; once and more daily, OR=0.359, 95%CI: 0.235-0.548), duration spent on the internet (0.5 to 1 h daily, OR=1.447, 95%CI: 1.044-2.006; 1 h and longer daily, OR=1.456, 95%CI: 1.072-1.978), sufficient sleep (OR=0.525, 95%CI: 0.371-0.744), suffering from campus bullying (OR=1.992, 95%CI: 1.491-2.661) were associated with the development of depressive symptoms. Conclusions The prevalence of depressive symptoms is high among primary and middle school students in Xihu District. Gender, type of school, dietary behaviors, sleep duration and campus bullying are factors affecting the development of depressive symptoms.

Objective:To investigate the correlation between subclinical hypothyroidism (SCH) and clinical outcomes of patients with acute ischemic stroke.Methods:From July 2014 to October 2017, patients with acute ischemic stroke admitted to Jiangsu Shengze Hospital Affiliated to Nanjing Medical University were enrolled retrospectively. Their demographic and baseline clinical and laboratory data were collected. The modified Rankin Scale was used to evaluate the clinical outcome at 3 months after the onset of symptoms. Multivariate logistic regression analysis was used to determine the independent correlation between SCH and clinical outcome of patients with acute ischemic stroke. Results:A total of 200 patients with acute ischemic stroke were enrolled, including 107 males (53.5%) and 93 females (46.5%). Their age was 69.67±11.38 years. There were 45 patients (22.5%) with SCH, 160 (80.0%) with good outcomes, and 40 (20.0%) had poor outcomes. Univariate analysis showed that there were significant differences in the baseline National Institutes of Health Stroke Scale (NIHSS) score, stroke etiology classification and the proportion of patients with SCH between the poor outcome group and the good outcome group (all P<0.05). Multivariate logistic regression analysis showed that high NIHSS score (odds ratio 2.884, 95% confidence interval 2.005-4.147; P=0.001) and SCH (odds ratio 19.527, 95% confidence interval 2.334-163.386; P=0.006) were the independent risk factors for poor outcomes. Conclusion:High NIHSS score and SCH were associated with the poor outcomes at 3 months after the onset of acute ischemic stroke.

ObjectiveTo investigate the effect of milk and milk products on morphological structure and epidermal growth factor (EGF) of non-steroidal anti-inflammatory drugs (NSAIDs) induced small intestinal damage in animals.Methods Eighty male SD rats were randomly divided into 5 groups:control group,diclofenac group,diclofenac with 10% low fat milk group,diclofenac with 10% colostrum group and diclofenac with yoghurt group.The animals with milk or colostrum or yoghurt were fed for 5 days before the administration of diclofenac with 15 mg/kg by gavage,once.Then they were observed the scores of anatomical lesion and the scores of tissue damage of mucous membrane and the height of villous at the 24th and 48th hour after making the models.Observation of the change of ultrastructural organization of mucous membrane was carried out with transmission and scanning electron microscope and immunohistocbemistry of EGF.Results The scores of anatomical lesion and tissue damage of mucous membrane of the colostrum group were lower than those of the diclofenac group ( P ＜ 0.05 ).The heights of the pile on small intestine of the24th and 48th hour of the colostrum group were (145.7 ± 16.5) μm and (139.2 ± 19.0) μm,respectively.They were higher than those of the diclofenac group[( 119.2 ± 19.2 ) μm and ( 105.4 ± 18.4 )μm,P ＜ 0.05].However there was no difference of the scores and the height among diclofenac group,milk group and yoghurt group.TEM and SEM of tissues showed that the cytoplasmic membrane and other cellular components of villous epithelial cells were well preserved in colostrum group,and the microvilli in the milk group and yoghurt group were ablated more obviously.The positive area of EGF of small intestine [(6170.5 ± 1483.9) μm2]were higher 48 h after administration of diclofenac compared with the diclofenac group ( P ＜ 0.05 ).The expression of EGF in milk and yoghurt group were no significant statistical difference with the diclofenac group.ConclusionBovine colostrum may have a beneficial effect in prevention of NSAIDs induced small intestinal injuries and preserve mechanical barrier of small intestinal mucosa which is probably relative to EGF.

Objectives To explore the relationships between the current physical exercise behaviors and psychological factors of middle school students,so as to provide scientific evidence for improving health education and carrying out targeted health intervention measures.Methods The Multi-stage stratified sampling and cluster sampling method was adopted to choose 3600 students from 12 junior and senior middle schools in Hangzhou,Wuhan and Xi'an.The date was collected using the adolescent physical exercise behavior-psychological measurement scale(Chinese version).The structural equation model was built to explore the relationships between psychological factors(including the change of strategy,decision balance positive effect,decision balance negative effect and self-efficiency)and physical exercise.Results The change of strategy has biggest effect on physical exercise behaviors,with the standardized direct effect value of 0.344.The standardized direct effect value of decision balance negative effect,decision balance positive effect and self-efficiency were 0.071,0.093 and 0.169 respectively.The negative correlation among the four dimensions was significant statistically.Conclusion Psychological factors have direct effects on the change of the behaviors,and the change of the strategy has the largest impact on physical exercise behaviors of middle school students.The four psychological factors are closely correlated with one another,which is important in formulating middle school sports programs to promote the physical quality of middle school students.