Using Li Ka Shing Medical School of Hong Kong University as an example, this paper introduced the medical humanities education in Li Ka Shing Medical School of Hong Kong University from four aspects of the medical humanities curriculum implementation in detail. Secondly, it expounded the relationship between students and art through two typical cases. Finally, this paper pointed out the enlightenment for medical humanities educa-tion in Medical Schools. For curriculum, the core curriculum of medical humanities must be determined. For teachers, exchanges and cooperation with foreign mature medical humanities education should be carried out active-ly. For teaching methods, the novelty and diversity must be emphasized.

To study the effect of different exercise intensities on cardiac endocrine function, with radioimmunoassay, immunohistochemistry and the technique of computer image analysis, the level of plasma ANP and the expression of ANP in myocardial cells of rats with different training intensities were investigated. The result showed that with the increasing of exercise intensity,the level of ANP in plasma increased progressively, the expression of ANP in myocardial cells increased remarkably after moderate and heavy exercise training while it decreased remarkably after exhaustive exercise training. Results suggested that different exercise intensities revealed different effects on adaptation of cardiac endocrine function.

Internal fistula is the most ideal hemodialysis approach and the life channel of patients with chronic renal failure. However, the existence of complications may affect the efficacy of hemodialysis, reduce the quality of life of patients, and even endanger the life of patients in serious cases. Among them, vascular stenosis, internal fistula occlusion, thrombosis, steals syndrome, upper extremity edema syndrome, heart failure and pseudoaneurysm are the most common and dangerous. Based on relevant studies, this paper intends to summarize the clinical symptoms, causes and nursing strategies of internal fistula complications in hemodialysis patients, in order to provide ideas for the nursing treatment of hemodialysis patients for the majority of medical workers.

Objective To investigate the pharmacodynamic interactions between remifentanil and sevoflurane during general anesthesia for laparoscopic operation.Methods Sixty-five ASA I patients undergoing selective laparoscopic operations at the Department of Gynecology and the Department of General Surgery in People's Hospital were enrolled in this study.Sevoflurane was used for anesthesia induction with its expired concentration being kept stable,and different dosages of remifentanil(0,1,2,4,6,and 8 ng/ml)being added during the operation.When the expired concentration of sevoflurane reached an expected level(pseuto-state),the block somatic and cardiovascular responses to electrical tetanus stimuli(ETS;100 Hz,60 mA,5 s)were measured.The data were analyzed using NONMEM software to establish concentration-effect curves.Logistic regression was used to calculate the minimal alveolar concentration of sevoflurane under ETS(MACETS).Results In the cases received sevoflurane only,the somatic response was inhibited when MACETS reached 1.52%;while the cardiovascular response was inhibited when MACETS reached 2.24%.The MACETS was decreased significantly by adding low-dosage remifentanil.When the target-controlled concentration of remifentanil was 8 ng/ml,the MACETS for the inhibition of somatic and cardiovascular responses decreased by 70.0% and 76.3%,respectively.Conclusions There is a synergic effect between remifentanil and sevoflurane on the suppression of somatic and cardiovascular responses to ETS.Remifentanil produces a dose-dependent decrease of MACETS of sevoflurane.The effect is especially strong in low-dosage remifentanil group,but shows ceiling effect characteristics.

To study the effect of exercise on gene expression of natriuretic peptide receptors (NPRs) in the heart, using immunofluorescent method, in situ hybridization, laser confocal scanning microscopy and the technique of computer image analysis, the distribution of NPRs in the heart and the alterations of gene expression of NPRs on the animal model of different training intensity were investigated. The result showed that NPRs located mainly in the endocardium, the sarcolemma of myocardial fiber, the connective tissue around myocardial fiber and the wall of coronary artery branch. After moderate and heavy exercise training, the gene expression of natriuretic peptide receptor-A (NPR-A) upregulated and natriuretic peptide clearance receptor (NPR-C) downregulated, whereas the gene expression of NPR-A downregulated and NPR-C upregulated after exhaustive exercise.

AIM: To determine the interactions with response-surface modeling methodologies when sevoflurane (Sevo) and remifentanil (Remi) were administered simultaneously. METHODS: (1) Patients, Study design and drug delivery: Based on parallel slices design, sixty-five patients were randomly assigned to inhale a specific end-tidal concentration of sevoflurane (0.3% to 3.4%), with different level of remifentanil (0-10 ng/mL). The responses to laryngoscopy were observed for each given concentration pair. (2) Pharmacokinetic/pharmacodynamic analysis with response surface mode: The probability of no response (P) was assessed in the modeling process as below. P=(Us+Ur)r/[U50/I(Q)]r+(Us+Ur)r RESULTS AND DISCUSSION: NONMEM estimated average values (RSE%) of the model parameters for laryngoscopy of C50,Sevo, C50,remi, U50, r, Imax and Qmax are 1.71% (12.9), 12.4 ng/mL (19.0), 6.62 (10.6), 1.53 (8.76), 2.31 (8.23), 0.706 (2.46), respectively. The inter-individual variability (CV%) in parameter Imax and inter-occasion variability (S.D.) in this model are 12.7 and 0.0316, respectively. It is concluded that the response-surface modeling approach provided a novel method to study drug-drug interactions.

This study is to develop a therapeutic drug monitoring (TDM) network server of tacrolimus for Chinese renal transplant patients, which can facilitate doctor to manage patients' information and provide three levels of predictions. Database management system MySQL was employed to build and manage the database of patients and doctors' information, and hypertext mark-up language (HTML) and Java server pages (JSP) technology were employed to construct network server for database management. Based on the population pharmacokinetic model of tacrolimus for Chinese renal transplant patients, above program languages were used to construct the population prediction and subpopulation prediction modules. Based on Bayesian principle and maximization of the posterior probability function, an objective function was established, and minimized by an optimization algorithm to estimate patient's individual pharmacokinetic parameters. It is proved that the network server has the basic functions for database management and three levels of prediction to aid doctor to optimize the regimen of tacrolimus for Chinese renal transplant patients.

Objective To investigate the clinical performance of fiber post restorations in elderly patients with residual root and crown and to analyze the factors affecting the clinical success rate.Methods A total of 66 elderly patients requiring post restoration were selected.They were randomly divided into two groups:the observation group (n=33,restored with fiber post-resin cores) and the control group (n=33,restored with cast metal post-cores).All patients were rechecked 1 year and 2years after the restoration.The clinical efficacy and the failure types were recorded.The differences in clinical performance between the 2 groups were compared by using Fisher's exact test.Results The differences in the gingival index and periodontal index in the 2 groups between the experimental teeth and the control teeth were zero.There were no significant differences in dental morphology,root canal treatment failure,tooth color matching and marginal coloration between the 2 groups (all P＞0.05).1 case with post debonding and 1 case with fiber post fracture were found in the observation group and 1 case with marginal coloration was found in control group.There was no significant difference in clinical success rate between the 2 groups (93.94％ vs.96.97％,P＞0.05).Conclusions The clinical success rate in fiber post-resin core restoration is the same as in cast metal post-cores restoration in elderly patients.

Purpose To investigate the clinicopathologic changes of the lung epithelial tumor with epithelioid granuloma. Methods E-leven cases of lung malignant tumor with epithelial epithelioid granuloma reaction were studied according to the histological changes of lung epithelial tumor, immunophenotype, acid-fast staining, and tuberculosis PCR test results combined with follow-up data. Results The mean age was 62. 3 years, and male to female ratio was 10∶ 1. The main clinical manifestations displayed a cough, chest pain, fever and hemoptysis or bloody sputum. Nine cases were malignant tumors, tuberculosis or inflammatory lesions was 1 case each in pre-vious surgery. The tumor with epithelioid granuloma formation of the 11 cases displayed in the same site ( mixed) . The histopathologic changes of the lesions showed a epithelioid or typical tuberculous granulomas formation, including 4 cases of adenocarcinoma, 5 cases of squamous cell carcinoma and 2 cases of neuroendocrine tumors. The acid-fast bacilli staining was positive in 3 cases;6 cases were positive for PCR detection of mycobacterium tuberculosis. 5 patients died within 2 years due to various causes. Conclusions The lung epithelial tumors with epithelioid granuloma is more commonly found in the middle-aged, The signs and symptoms of the patients are similar to primary epithelial malignant tumors of the lung . The biological behavior was progressive with poor prognosis. The diagnosis of the lesions depends on pathological examination. It is very important to pay more attention to the pathological examination, especially in lung puncture samples, and the differential diagnosis for a definate diagnosis and treatment.

Objective To analyze the MRI features of chordoid meningioma (CM),and to compare with other meningiomas. Methods Clinical and MRI features of 7 patients with CM confirmed by pathology were analyzed retrospectively.Featrues of every MRI sequence were investigated qualitatively.Meanwhile normalized signal ratios of each sequence were analyzed furtherly,including normalized T1 weighted image intensity ratios (NT1 ),normalized T2 weighted image intensity ratios(NT2 ),normalized ADC ratios (NADC)and normalized T1 WI contast enhancement intensity ratios (NCE).Fisher ’s exact test and Dunnett T 3 test were employed to analyze the difference of CM and nonchordoid meningiomas (34 cases of WHO grade Ⅰ meningioma,1 6 cases of nonchordoid WHO grade Ⅱ meningioma,and 5 case of WHO grade Ⅲ meningioma).Results The CM showed hyperintensity on T2 WI and meanwhile other nonchordoid meningiomas demonstrated isointensity,hypointensity or slight hyperintensity on T2 WI.Evaluations of DWI revealed variable signal intensities of CM.But all 7 cases had no obvious restricted diffusion,and increased signal was seen on the ADC map in each patient.The solid parts of CM enhanced markedly after contrast agent injection.Quantitative indicators NT2 , NADC and NCE of CM were higher than other meningiomas(P <0.01),but NT1 showed no statistic difference between CM and other meningiomas (P =0.889).Whether there was cyst,necrosis,orflow void sign on T2 WI,and no matter with or without perifocal edema,dural tail sign and a broader base among meningiomas had no significance in differentiating CM and other meningiomas.Conclusion CM has typical MRI features.The tumors show hyperintensity on T2 WI,especially have no obvious restricted diffusion and enhance markedly after contrast.The measurement of NT2 ,NADC and NCE enables reliable preoperative prediction of the atypical histopathologic diagnosis.