According to the current situation of the medical education in vocational colleges and the problems in the practical skills examination of the associate physician qualification for this type of medical students,the reformation of training and evaluating the practical skills of diagnosis for such students is studied in the paper.As a result,the clinical practical ability of the students is improved,and it can make the graduates obtain the graduation and qualification diploma successfully.

OBJECTIVE: To evaluate the in vitro drug release properties of modified hyaluronic acid films. METHODS: The drug release rates of the films were measured by dictyo-dish method and UV-Vis absorption spectroscopy. The effects of modifier contents and the solubility of medicines on the release were investigated. RESULTS: The release of some hydrophobic drugs from the films were sustained. The drug release pattern followed Higuchi equation, and was controlled by diffusion mechanism. Drug release rates were delayed by increasing contents of modifier. CONCLUSION: The films made of modified hyaluronic acid have excellent potentials as carriers for the sustained release of some hydrophobic drugs. Copyright 2012 by the Chinese Pharmaceutical Association.

Animals ; Chick Embryo ; physiology ; Electrocardiography ; methods ; Heart ; embryology ; physiology ; Heart Rate ; physiology

Objective To investigate the effects of artesunate( Art) on renal function and the expression of monocyte chemotactic protein-1(MCP-1)and tumor necrosis factor-α(TNF-α)in rats with type 2 diabetic nephropathy(DN). Methods Thirty six male SD rats were randomly divided into six groups, six rats in each, as the normal control, model control, low-dose Art, middle-dose Art, high-dose Art groups which were intragastrically administrated with Art at the dose of 10, 20 and 30 mg·kg-1 ·d-1 for consecutive 8 weeks, enalapril group, which were intragastrically administrated with enalapril 10 mg·kg-1 ·d-1 for consecutive 8 weeks. Rats were injected with low dosage streptozotocin and fed with high fat and high sugar diets to establish type 2 diabetic nephropathy rat model. After 8 weeks’ treatment, the plasma glucose, 24-hour urine protein, serum creatinine and blood urea nitrogen were measured to evaluate renal function. The pathological morphology of rats was performed. Immunohistochemistry and enzyme linked immunosorbent assay ( ELISA ) were performed to examine the expression levels of MCP-1 and TNF-α,respectively. Results Compared with the model control group, 24-hour urine protein, serum creatinine, blood urea nitrogen and blood glucose were significantly decreased in the treatment groups (P<0. 01). Art significantly decreased the serum expressions of MCP-1 and TNF-α in low-, middle-, high-dose Art group ( 157. 47 ± 38. 53, 138.65±18.03,105.09±12. 64 and 3. 14±0. 38,2. 58±0. 11,2. 25±0. 16) pg·mL-1, compared with model control group (181.71±23.06 and 3. 98±0. 24) pg·mL-1(P<0. 05). Conclusion Art has beneficial effects on type 2 diabetic nephropathy. The mechanism of which may be related to the inhibition of inflammatory factor MCP-1 and TNF-α,further relive the pathological injury of kidney and delay the progress of diabetic nephropathy to some extent.

Objective To investigate effect of artesunate on expressions of Toll-like receotor-4 (TLR4) and interleu?kin-8 (IL-8) in renal tissue of diabetic nephropathy rats. Methods Male SD rats of over 200 g in body weight (n=45) were injected with low dosage streptozotocin and fed with high fat and sucrose diets to establish diabetes nephropathy (DN) model. Among all rats of successful model, thirty-two were randomly selected and divided into four groups (n=8 in each group), Mod?el group (Group B), Artesunate at high dose treatment group [30 mg/(kg · d)] (Group C), Artesunate at low dose treatment group [10 mg/(kg·d)] (Group D), Enalapril treatment group [10 mg/(kg·d)] (Group E). Another eight rats without STZ injec?tion whose body weight is under 200 g were assigned as Normal group (Group A). Then, rats in Group A and B were given the same volume of normal saline [10 mg/(kg·d)] while rats in Group C, D and E were given 30 mg/(kg·d) Artesunate, 10 mg/(kg·d) Artesunate and 10 mg/(kg · d) Enalapril respectively intragastrically for consecutive 12 weeks. Fasting blood glucose, body weight, kidney index, 24-hours proteinuria, serum creatinine (Cr) and blood urea nitrogen (BUN) were measured. Expression level of TLR4 in renal tissue of rats were examined by Western blot;ELISA was used to quantify the concentration of IL-8 in serum and renal tissue of rats. Results Compared with rats in Group A, the levels of Fasting blood glucose, kidney index , 24-hours proteinuria, Cr and BUN as well as the level of TLR4 in kidney, levels of IL-8 in serum and kidney all significant?ly increased in rats in Group B, C, D and E(P<0.05). On the other hand, body weight were decreased in rats of Group B, C, D and E compared to rats in Group A(P<0.05). The level of TLR4 in kidney, levels of IL-8 in serum and kidney, 24-hours proteinuria, Cr and BUN in rats of Group C, D and E were significantly lower than those in rats of Group B(P<0.05). Furthermore, compared with rats in Group D, the levels of TLR4 in kidney, IL-8 in serum and kidney, 24-hours proteinuria, Cr and BUN were decreased in rats in Group C and E(P<0.05). Pearson correlation analysis showed that the expression lev?el of TLR4 positively correlated with IL-8 level in serum (r=0.969, P<0.05), IL-8 level in kidney (r=0.972, P<0.05), 24-hours proteinuria(r=0.965, P<0.05), Cr(r=0.944, P<0.05)and BUN(r=0.903, P<0.05). IL-8 level in kidney positively correlated with 24-hours proteinuria(r=0.962, P<0.05), Cr(r=0.929, P<0.05)and BUN(r=0.940, P<0.05). Conclu?sion Artesunate decreases expression of TLR4 and IL-8, reduce 24-hours proteinuria, inhibits the inflammation of the DN,relives the pathological lesions of nephron rats with diabetic nephropathy.

Clinical data of 62 children with dilated cardiomyopathy (DCM)admitted to hospital from January 1998 to December 2008 were retrospectively analyzed. The age of patients was from 14 months to 14 year with the average of 8. 2 years. Respiratory infection was the main triggering factor. Cardiac dilatation was the basic conditions for diagnosis of DCM. Arrhythmia was characteristic for DCM, and color cardio uhrasonography was an important procedure of diagnosis and evaluation for cardiomyopathy. With the integrated treatment 38 cases were discharged with improvement ( 61% ), 11 cases died ( 18% ). Early diagnosis and integrated treatment are critical for management of cardiomyopathy in children.

The radix,leaf,flower and bud of raw medicinal materials and extraction of total alkaloids of Aconitum kusnezoffii Reichb.were all involved in this investigation.All the compositions from the samples were analyzed through fourier transform infrared spectroscopy (FTIR) combined with second derivative IR spectroscopy and two-dimensional IR correlation spectroscopy (2D-IR).It was found that the spectra of raw medicinal materials showed that the radix of A.kusnezoffii Reichb.featuring a large quantity of starch was the same as starch with the characteristic peaks at 1,155,1,070 and 1,019.The leaf,flower and bud contained the similar aromatic hydrocarbons (1,600),glycosides (1,050-1,070),while lipids were not clear.The characteristic peaks of the buds,flowers and leaves were all at 1,595 cm-1 (vibration of phenyl framework) and 1,262 cm-1 (=C-O).Therefore,it was suggested that the common compound of the three parts be diterpenoid alkaloids.Second derivative IR spectroscopy showed that the characteristic peaks of radix was stronger than those of the flower,leaf and bud at 1,712 cm-1 (C=O),which proved that the quantity of characteristic peaks in the radix was larger than those in the flower,leaf and bud.In addition,six autopeaks at 1,745,1,650,1,560 (the most strong),1,465,1,400,1,300 were detected from the radix.The similar autopeaks at 1,745,1,650,1,560 (the most strong),1,465,1,400,1,300 were found in the leaf,bud and flower.In conclusion,it was demonstrated that the macro-fingerprint infrared spectroscopic identification method provided a large quantity of the comprehensive information and entirely grasped the quality of A.kusnezoffii Reichb.Besides,FTIR and 2D-IR provided massive information of the integral structures of the radix,leaf,flower and bud of A.kusnezoffii Reichb.and verified the differences between the four parts of the herb in physical structure and the contents,laying a foundation for further systematic work.

Background:The incidence of ischemic colitis(IC)is increasing in recent years with the aging of population,and the rate of delayed diagnosis or misdiagnosis is high because of the lacking of specific clinical characteristics. Aims:To study the clinical characteristics of IC so as to improve its early diagnosis and treatment. Methods:The clinical and endoscopic characteristics of 75 IC patients from Jan. 2009 to Dec. 2014 at Urumqi General Hospital were retrospectively analyzed. Results:IC usually occurred in elderly patients with age ≥60 years,females were more common. Most patients had underlying diseases,including hypertension,coronary heart disease,diabetes,hyperlipidemia and arrhythmia,etc. Colonoscopy and medications could also induce IC. The main clinical presentations were abdominal pain,hematochezia and diarrhea. The lesions were mostly located in left colon and of the transient type. Conclusions:IC should be suspected when elderly patients with underlying diseases,complaining abdominal pain,hematochezia and diarrhea,colonoscopy and pathologic study should be undertaken as early as possible. Prognosis is good when treated timely.

Objective To investigate the clinical treatment of nonpenetrated cornea trauma caused by crops. Methods Clinical data of 128 cases of nonpenetrated cornea trauma caused by crops were retrospectively analyzed. According to the interval time between occurrence of trauma and clinic visiting, the patients were divided into 3 groups:group A (33 cases,<24 h), group B (72 cases, 24 h≤interval time<1 week) and group C (23 cases, ≥ 1 week). The therapeutic effects and prognosis were analyzed. Results There was statistical difference in the incidence of corneal ulcer among group A, group B and group C: 6.1% (2/33), 62.5% (45/72) and 100.0% (23/23), χ2= 52.32, P<0.01. In group B, 12 cases were treated with conjunctival flap covering, 2 cases received keratoplasty and 2 cases undertook enucleation. In group C, 10 cases were treated with conjunctival flap covering, 4 cases received keratoplasty and 2 patients undertook enucleation finally. All the other patients were cured with local debridement and medical treatment. Conclusions Patients with nonpenetrated cornea trauma caused by crops may develop infectious keratitis, and prompt and proper treatment can avoid the secondary infection and improve the outcome. Local debridement in combination with iodophors disinfection can prevent the incidence of infectious keratitis. Conjunctival flap covering is an effective technique in the treatment of corneal ulcer caused by nonpenetrated cornea trauma.

Objective:To describe the clinical,radiological and pathological characteristics of idiopa-thic pulmonary haemosiderosis(IPH) in adults and to evaluate the methods of diagnosis and treatment.Methods:Two patients were successfully diagnosed and treated in our hospital and the literature on the subject was reviewed.Results:Two adult patients(19 and 34 years old) diagnosed in our hospital had 5 and 10 years of history of hemoptysis respectively,and chest CT showed bilateral diffuse alveolar opacities over mid and lower zones.Tests of antinuclear antibodies(ANAs),rheumatoid factor(RF),antineutrophilic cytopasmic antibodies(ANCA) and Anti-glomerular basement membrane(anti-GBM) antibody were negative.Haemosiderin-laden macrophages were found in bronchoalveolar lavage fluid(BALF) whose color was yellow.Microscopic examination of the lung tissue specimens obtained by transbronchial lung biopsy(TBLB) revealed hemorrhage and numerous hemosiderin-laden macrophages in the alveoli and no vasculitis or capillaritis were seen.These findings were consistent with a diagnosis of IPH.Steroid therapy had good effects.Conclusion:IPH is a diagnosis of exclusion of other causes of diffuse alveolar hemorrhage(DAH).IPH adults have relatively good drug responses and relatively good prognoses.