We analyzed the minus of present medical education,basing on questionnaires of 1773 medical students,including the students' participation rates in lectures of multiple fields and their demands on future lectures.We gave some pieces of advice to solve the problems as well as some references to boost our lectures.

Objective To investigate the species and drug resistance of pathogens causing bloodstream infections in hospitalized patients,and provide scientific evidence for antimicrobial use and control of healthcare-associated blood-stream infection.Methods From January 1 to December 31,2012,16 428 blood specimens were performed blood culture,pathogens were isolated and performed antimicrobial susceptibility testing.Results Of 16 428 blood speci-mens from 5 546 patients,384 (6.92%)were positive for blood culture,398 pathogenic isolates were detected,of which gram-positive bacteria,gram-negative bacteria,and fungi accounted for 23.62% (n=94),68.34% (n=272),and 8.04% (n=32)respectively,positive rate of blood culture were highest in 61-80 age group(8.26%), the top five departments of positive rate of blood culture were departments of burn,traditional Chinese medicine, cardiac intensive care unit,transplantation and traumatology;gram-positive cocci were highly susceptible to vanco-mycin,teicoplanin and linezolid,one Enterococcus faecium strain was found to be resistant to vancomycin;Among gram-negative bacilli,Enterobacteriaceae were highly susceptible to amikacin and carbapenems;drug resistance rates of Acinetobacterbaumannii and Pseudomonasaeruginosa to carbapenems was 70.97% and 35.90% respective-ly.Conclusion Gram-negative bacteria are the major pathogens causing bloodstream infection,positive rate of blood culture of elderly people is high.It is necessary to conduct regular surveillance on distribution and drug resistance of pathogens.

ObjectiveTo determine the cerebral protection effect and mechanism of propofol on global cerebral ischemia and reperfusion damage in rats.Methods19 adult male Wistar rats were randomly divided into 3 groups, ischemia group (n=7), propofol group (n=7), and sham injury group (n=5). Global cerebral ischemia and reperfusion model were made by means of Pulsinelli's method. Rats in propofol group were anesthesia with propofol at the dosage of 1.5 ml/h for 30 min at the beginning of reperfusion. Apoptosis and necrosis rate were detected by cytometry. In the same time, bcl-2, Bax and p53 protein expression in hippocampus neurons were detected. ResultsThe apoptosis and necrosis rate in propofol group were significantly decreased as compared with ischemia group ( P<0.05). Bax and p53 protein expression in hippocampus neurons were also significantly decreased as compared with ischemia group (P<0.05), however, no significant findings in bcl-2 protein expression (P>0.05).ConclusionPropofol can decrease apoptosis and necrosis rate in cerebral ischemia reperfusion injured neuron, and the mechanism maybe related to decreasing the expression of Bax, p53 protein.

This paper elaborates on the importance and necessity of implementing information technology in medical education,the application of information technology in the whole process of medical education,the conceptual construction of medical students' life-long education,the construction of practical teaching resources and the cultivation of information capacity both in teachers and students,etc.In the meantime,this paper introduces the basic framework of medical network and remote education center of Sun Yat-sen University under construction.

Objective To investigate the relationship between antibiotic use and antimicrobial resistance in Acinetobacter bau-mannii for rational use of antibiotics.Methods Antibiotic use density (AUD)of common antibiotics in hospitalized patients were collected in a tertiary hospital between 2006 and 2010.Clinical isolates of A.baumannii from those patients were collect-ed.The resistance to common antimicrobial agents were tested by disk diffusion method according to Clinical and Laboratory Standards Institute (CLSI,2012)guidelines.Relationship between antibiotic use and antimicrobial resistance in A.baumannii was analysed by SPSS 16.0.Results The resistant rates of A.baumannii isolated from inpatients were high.Consumption of cephalosporins and quinolones were large.There was a positive correlation between the resistant rate of A.baumannii to imi-penem and AUD of carbapenems (r=0.975,P <0.05).The resistant rate of A.baumannii to meropenem showed significantly positive relation to AUD of carbapenems (r= 0.975,P <0.05).Resistant rates of aminoglycosides,quinolones,cephalospo-rins and beta-lactamase inhibitors was not correlated to AUD of those antibiotics.Conclusions We should pay more attention to the high prevalence of resistant A.baumannnii strains.Application of imipenem and meropenem should be strictly controlled.Amikacin and beta-lactamase inhibitors are better choice for empirical antibiotic therapy in the treatment of infections caused by A. baumannii.

OBJECTIVETo identify the human hematopoietic stem cells from the human/goat xenogeneic model with molecular techniques.

METHODSDNA and total RNA were extracted from 11 transplanted goat peripheral blood cells. Human CD(34), GPA and SRY genes were amplified with PCR in these samples, and CD(34), GPA mRNA transcripts were detected using RT-PCR in 5 and 6 goat peripheral blood cells, respectively. Southern blot analysis was performed in 8 goat DNAs to detect the human specific alpha-satellite sequence. Meanwhile FISH was also performed to detect the human cells in goat blood with a probe of human Y chromosome.

RESULTSHuman CD(34) and GPA genes could be detected with PCR in all the 11 goats, and SRY gene did in 5 goats transplanted with hematopoietic stem cells derived from male human babies. Southern blot showed that human specific alpha-satellite sequence was present in 8 goats. By RT-PCR, human CD(34) mRNA was detected in 5 experimental goats, GPA mRNA was found in the other 6 experimental goats and FISH assay showed that some peripheral blood cells of the human/goat xenogeneic model were positive.

CONCLUSIONExistence of human cells in the recipient goats was identified by molecular detection, which was feasible for the examination of human/goat xenogeneic models.

Animals ; Antigens, CD34 ; genetics ; Blotting, Southern ; Female ; Genes, sry ; genetics ; Glycophorin ; genetics ; Goats ; Hematopoietic Stem Cell Transplantation ; methods ; Hematopoietic Stem Cells ; cytology ; metabolism ; Humans ; In Situ Hybridization, Fluorescence ; Male ; Polymerase Chain Reaction ; Transplantation Chimera ; genetics ; Transplantation, Heterologous

OBJECTIVETo establish a high sensitive and specific method of interphase fluorescence in situ hybridization (IFISH) to detect the low-frequency human cells in human/goat xenogeneic models.

METHODSHuman-specific Y-chromosome satellite DNA CEPY and 17-chromosome satellite DNA p17H8 were used as probes for IFISH. The peripheral blood samples from 2 goats transplanted with human male hematopoietic stem cells (HSC), 1 normal negative goat and 1 normal man were analyzed. The actual FISH efficiency was confirmed by serial dilutions (1/100, 1/500 and 1/1000) of the cell mixture of normal man and normal negative goat. A set of signal scoring criteria was determined to guarantee the stability and reliability of the method.

RESULTSPositive cell (human cell) frequencies were consistent with the established frequencies for the human/goat cell mixture. The average frequencies of positive cells were 98.60% (CEPY) and 100% (p17H8) for normal man, 0 for normal negative goat, 0.23% (CEPY) and 0.11% (p17H8) for human/goat xenogeneic models. The results demonstrated that low-frequency human cells (male cells confirmed by Y-chromosome probe) existed in human/goat xenogeneic models.

CONCLUSIONThe IFISH developed in this study is of high sensitivity and specificity and can identify the actual frequency of human cells, which offers a direct, sensitive and specific approach to the detection of low-frequency human cells in human/goat xenogeneic models.

Animals ; Chromosomes, Human, Pair 17 ; genetics ; Chromosomes, Human, Y ; genetics ; DNA Probes ; Goats ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; cytology ; metabolism ; Humans ; In Situ Hybridization, Fluorescence ; methods ; Interphase ; genetics ; Microsatellite Repeats ; genetics ; Transplantation Chimera ; blood ; genetics ; Transplantation, Heterologous

Objective? To investigate the significance,evaluation methods and blocking factors of evaluating continuous care for stroke, and to explore the evaluation strategies, so as to provide reference to improve and standardize the effect evaluation of continuous care for stroke. Methods? By convenience sampling, 125 nursing staff from 60 communities, 15 regions in Shanghai were selected in October of 2018 as the research objects, the self-designed questionnaires: Significance of Evaluation of Continuous Care for Stroke, Effect Evaluation of Continuous Care for Stroke Questionnaire, Blocking Factors of Effect Evaluation Questionnaire were used in the investigation, SPSS 20.0 software was used to analyze the data. Results? The top three most-chosen items in Significance of Evaluation of Continuous Care for Stroke were:"improving the ability of family nursing" (92.0%,115/125), "promoting the improvement and improvement of nursing quality"(86.4%,108/125) and "promoting patient's disease self-monitoring" (80.8%,101/125); in the Importance of Evaluation Content of Continuous Care for Stroke, the dimensions ranked from high to low were:"health outcome of patients" (4.63±0.43), "the outcome of caregivers" (4.58±0.51), and "the implementation rate of nursing services" (4.56±0.46); in the aspect of evaluation subjects, 74.4% of nursing staff thought that it should be evaluated by specialist nurses, 32.0% by quality control staff and 26.4% by patients; the main blocking factors of effect evaluation were: "shortage of human resources" (96.0%,120/125), "heavy workload" (88.0%, 110/125) and "patients' and family members' noncooperation"(81.6%,102/125). Conclusions? The evaluation of the effect of continuous care for stroke is of great significance to hospitals, patients and family caregivers. It is necessary to pay more attention to the evaluation of the effect of continuous care for stroke. The content of the evaluation should be standardized from the aspects of patients' health outcomes, home caregivers' outcomes and the implementation rate of nursing services. The advantages of evaluation subject, scientific selection of evaluation subject, strengthening the support of health policy, and eliminating the blocking factors of effect evaluation.

Objective To study the relationship between aquaporin 9 (AQP 9) gene and brain edema in neonatal rats of hypoxic-ischemic brain damage (HIBD) and the therapeutic mechanism of mannitol.Method Healthy and 7-day-old SD rats were randomly assigned into three groups:sham-operated group,HIBD group and mannitol group.Both HIBD and mannitol group were established on HIBD model.The mannitol group was given mannitol intraperitoneally at 0,24,48 h of HIBD.2 ml/kg of 2％ Evans blue (EB) were injected intraperitoneally before sacrifice.0,6,12,24,48 and 72 h after HIBD,the outcomes were analyzed including the brain water content,the expression of AQP 9 mRNA measured using RT-PCR and immunofluorescence staining methods,and the permeability of blood-brain barrier (BBB) measured with EB.Result In HIBD group,the brain water content was higher comparing with sham-operated group at 0 h after HIBD(P ＜ 0.05),and gradually increased over time,reaching peak at 48 h (89.3％ ± 1.9％) and then decreased.In mannitol group,brain water content started to decrease from 1 h after mannitol administration to the bottom at 12 h (86.5％ ±0.6％),then increased to peak at 72 h (87.2％ ± 1.7％),and brain water content were decreased during 0 ～ 48 h comparing with HIBD group.HIBD group's EB were higher than sham-operated group (P ＜ 0.05);Mannitol group's EB were decreased comparing with HIBD group (except 0 h,P ＜ 0.05).AQP 9 mRNA expression in the HIBD group was decreased at 0 h,and reached the bottom at 48 h (0.09 ± 0.07).Comparing with sham-operated group,it was higher in the HIBD group at0,6,72 h,and lower (P＜ 0.05) at 12,24,48 h.Higher AQP 9 mRNA expression were detected in mannitol group than HIBD group and sham-operated group at each time point (with the exception of 48 h) (P ＜ 0.05).AQP 9,which was closely related to water metabolism,were widely found in the pia mater and ependyma using immunofluorescence staining.After ischemia and hypoxia insult,an increasedecrease-increase pattern of AQP 9 expression was found.Conclusion AQP 9 is widely existed in various parts of the brain,influencing brain edema through a variety of pathways.AQP 9 also plays a role in alleviating brain edema in mannitol therapy.

Objective: To analyze the implementation status and challenges of sex education in special education schools, so as to provide a scientific basis for formulating effective promotion strategies. Methods: From November 2023 to January 2024, a census survey was conducted among 120 in service teachers from 7 special education schools in Luzhou. The questionnaire covered the current status of sex education in schools, teachers attitudes and knowledge toward sex education, and their coping methods for students inappropriate sexual behaviors. Results: About 77.5% of teachers reported having provided sex education to students, but 93.2% indicated a lack of specialized sex education textbooks for special children, 90.4% reported no full time teachers for sex education, and the methods of sex education were relatively limited (50.0% mainly based on lecture method). Nearly 95.8% of teachers held a positive attitude toward sex education, with 98.3% supporting its implementation. Only 26.7% of teachers demonstrated a good grasp of sex education knowledge, with the best understood topic being "recognition and protection of private parts" (21.6%). When dealing with students inappropriate sexual behaviors, the active response rate of teachers was 23.9%, with the highest active response rate observed for "intentionally hugging or kissing the opposite sex" (39.7%). Conclusions The special education schools in Luzhou lack comprehensive sex education curricula, teaching materials and full time teachers, sufficient knowledge among teachers, and adequate proactive responses to students inappropriate sexual behaviors. Greater emphasis should be placed on sex education for special children, including the training of dedicated teachers, to provide comprehensive and high quality sex education services for special children.