With the changes in medical model and the enhancement of ethical standard as well as the patients' awareness of right protection,clinical teaching resource shortages have been increasingly prominent.This article analyzes the characteristics and status of clinical medical education and points out that the development of medical simulation education has great significance for building a harmonious clinical training environment centering on the content classification,functional positioning and outstanding advantage of medical simulation education.

Objective To valuate the effects of Balloon dilatation on shorting the duration of labour. Methods Vaginal-cervical Balloon dilatation were used to dilate the vaginal and cervix in 303 cases of pregnant women (67 cases in latent stage and 236 cases in active stage)in labor. At the same time,284 cases of pregnant women did not use the Balloon dilatation as control. Rusults The length of first stage,second stage and the length of labour were shorter when Balloon dilatation were used in latent phase than those in the control group(7.58,0.53 and 9.27 hours v.s 10.86,1.12 and 12.23 hours) P

ObjectiveTo investigate the protective mechanism of emodin(大黄素) on intestinal mucosal injury induced by intestinal ischemia/reperfusion(I/R) in rats.Methods Thirty male Wistar rats were randomly divided into three groups,namely sham operation group(Group A),group of ischemia 45 minutes followed by reperfusion 6 hours(Group B),emodinpretreated group(Group C).The superior mesenteric artery was occluded and then released to produce the intestinal I/R model in rats.Group C was administrated emodin intravenously(2.5 mg/kg) before 30 minutes of the operation.In the sham operation group and model group,similar volume of normal saline was administered respectively.After 45 minutes of ischemia and 6 hours of reperfusion, the blood was collected from the inferior vena cava respectively in each group.Afterwards,the rats were sacrificed,and the mesenteric lymph node(MLN) and small intestinal tissues were taken for pathological analysis by light microscopy.The serum levels of intestinal fatty acid binding protein(IFABP),nitrogen monoxidum(NO),tumor necrosis factor-?(TNF-?),and the activities of malondialdehyde(MDA),superoxide dismutase(SOD),myeloperoxidase(MPO)in the small intestinal tissues were measured,and the rates of bacterial translocation(BT) in blood and MLN were examined at 6 hours after reperfusion in each group. Results The contents of IFABP,NO,TNF-?,MDA and MPO were significantly lower(all P

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 collect the basic information on publications in Chinese Journal of Perinatal Medicine,and understand the current situation and set the goals for the future. Methods Information on all publications in this journal from 1998 to 2007 was collected.The distribution of all publications,Price Index and relative data were analyzed. Results There were 1368 publications altogether during the past 10 years.The first six kinds of papers were original articles(508,31.7%),short articles(258,18.9%),case reports(194,14.2%),reviews(122,8.9%),experimental studies(90,6.6%)and brief communications(83,14.2%).47.9% of all publications were from Beijing,Guangdong and Shanghai.The first three areas who had the most submissions were Beijing,Shandong and Guangdong in 2007.The citation frequency analysis showed that 708 publications were cited at 1east once and only two were cited over 80 times.53.4% of all cited publications were original articles and experimental studies. Conclusions Original articles and short articles are the two main types of publications in this journal,however original articles and experimental studies contributed to half of the publications being cited.Publications in this journal are focused in few areas and this might be related to the number of submissions.

AIM:To set up a method of simultaneously determining the contents of ephedrine and pseudoephedrine in Zhisou Lixiao Oral Liquid (Herba Ephedrae, Radix et Rhizoma Glycyrrhizae, Semen Raphani, etc). METHOD: The HPLC-quantitative analysis was carried out on a column of Sinochrom ODS-BP by using a mobile phase of acetonitrile-0.02 mol/L potassium dihydrogen phosphate (pH=2.7), (4∶100, with 0.1% triethylamine) under a flow rate of 1.5 mL/min. 207 nm was selected as the wavelength of detector. RESULTS: The linear range of ephedrine was 20.8-208.0 ?g/mL(r=0.999 7) and pseudoephedrine's was 15.0-150.0 ?g/mL(r=0.999 8). The recoveries of them were all between 95% and 105%(RSD

This paper presents the results of the gross dissection and the histologic observation on the thyroid and parathyroid glands of Rhinopithecus. Specimens used in the studies are composed of R. roxellanae (1 (?), subad.), R. bieti (2 ♀♀, ad.; 1 ♀,juv.) and R. brelichi(2(?)(?),ad.). Besides the position and shape of the gross anatomy of the thyroid and parathyroid glands, attention was paid to the cellular types of the parathyroid glands. Material used for the histologic investigation is stained with HE and the modified Mallory-Azan methods and observed under the light microscopy. The principal results are summarized as follows:1. The thyroid gland consists of two lateral obes. The dimension of the gland measured 18.0?9.0, 15.0?8.0 and 14.0?6.0 mm. in bieti;23.0?9.0 mm. in roxellanae; 25.0?9.0 and 30.0?1.0 mm in brelichi; and one isthmus measures 3.0?10.0, 2.0?10.0 and 2.0?6.0 mm. in bieti; 4.0?6.0 mm. in roxellanae; 5.0?12.0 and 5.0?14.0 mm. in brelichi.The total weight of the gland is 1.0, 0.5 and 0.3g in bieti; 0.9g in roxellanae; 0.9 and 1.8g in brelichi.The isthmus connects the lower edges of two lateral lobes. There is no pyramidal lobe.2. The blood supply is derived from the superior thyroid arteries. There are no inferior thyroid arteries in three kinds. The thyroid venous drainage is by the superior and inferior thyroid veins, there is no median thyroid vein.3. The sizes and shapes of the thyroid vary with species. Each animal possesses two parathyroid glands, one of each side, but their position is also variable in the different animals.4. The follicular epithelium of the thyroid contains two cellular types, viz. the typical follicular epithelial cells and C cells.5. The parathyroid gland of Rhinopithecus is histologically similar to that of Macaca mulatta and man, which contains four basic cellular elements. There is an intermediary cellular type probably a variant of the oxyphil cells.6. Grey blue granules are present in the pale oxyphil cells of the parathyroid glands of both brelichi and bieti.7. There are less oxyphil cells among the parenchymal cells of the parathyroid gland in the subadult roxellanae than in both bieti and brelichi.

Objective To explore the roles of cytokines in the pathogenesis of hemorrhagic fever with renal syndrome(HFRS). Methods Double-antibody sandwich ELISA was used to determine serum interleukin (IL)-6, urine tumor necrosis factor (TNF), IL-6 and IL-8 levels in 56 patients with HFRS. Results Serum IL-6, urine TNF, IL-6 and IL-8 concentrations in HFRS patients were significantly higher than those in control group, respectively (P＜0.001). The concentrations increased at fever stage, then continued to increase during hypotension stage and peaked at oliguria stage. The concentrations of serum IL-6, urine TNF, IL-6 and IL-8 increased in accord with the severity of the disease and differed greatly among different types of the disease. Serum IL-6 had remarkable relationships with serum specific antibodies. It was positively related to serum β2-microglobulin (β2-MG), blood ureanitrogen (BUN) and creatinine (Cr). Significant positive relationships were also found both between urine IL-6 and TNF, and between IL-6 and IL-8 (r=0.5768, P＜0.05; r=0.3760, P＜0.01). Conclusion TNF, IL-6 and IL-8 activated during the course of the disease. IL-6 is associated with the immunopathological lesions caused by the hyperfunction of humoral immune response. IL-6, IL-8 and TNF are involved in the renal immune impairment. Determining them might, in certain extent, be used in predicting the prognosis and outcome of patients with HFRS.

Objective To screen the high specific and sensitive monitoring indications in the diagnosis of intestinal barrier dysfunction.Methods A total of 70 critical patients with intestinal barrier dysfunction and acute physiology and chronic health evaluation (APACHE) Ⅱ score≥8 and over the same period 41 patients without intestinal barrier dysfunction and APACHE Ⅱ score≤6 were recruited.The general information,histories,symptoms,physical signs,24 hours urine output and the condition of mechanical ventilation treatment were recorded.The venous blood was taken for bacteria culture,white blood cell counting,creatinine level,diamine oxidase (DAO) activity,D-lactic acid,intestinal fatty acid binding protein (IFABP) and endotoxin level testing.The urine was taken for urinary IFABP level testing.Twenty-four hours urine was reserved for 24 hours total urinary IFABP testing.The factors which might influence intestinal barrier dysfunction were analyzed by univariate analysis and multivariate analysis.The measurement data were analyzed by t test and the count data were analyzed by x2 test.The factors were screened according to receiver operating characteristic (ROC) curve.Results The factors related with intestinal barrier dysfunction were white blood cell counting (OR=3.971,P=0.046),plasma endotoxin level (OR=7.857,P=0.005)and 24 hours total urinary IFABP (OR=11.154,P=0.001).The areas under the ROC curve (AUC)of plasma endotoxin level and 24 hours total urinary IFABP were 0.852 and 0.820 respectively (both P＜0.01).The critical value was 8.0 pg/ml and 17.12 ng respectively.The sensitivity was 97.8％ and 84.4％.The specificity was 66.7％ and 72.7％.Conclusion Once critical patients presented certain gastrointestinal symptoms and physical signs with plasma endotoxin level ＞8.0 pg/ml and or 24 hours total urinary IFABP ＞17.12 ng,which might indicate intestinal barrier dysfunction.