Throughin-depth study and thinking ofthe current situation of medical education,this paper exploredtraining strategies of applied talents in medical colleges under the new situation.From the training ofapplication talents in medical colleges under new situation,we should focus on the current reality,learn experience.Combined with the characteristics of medical specialty,we should explore the model of strengthening the humanistic quality moral training of current medical application talents from the curriculum,teaching content selection,teachers' construction,environment shaping,teaching methods,assessment and evaluation,and thus to adapt to the medical mode conversion,alleviate the doctor-patient contradiction and promote medical students employments.

Objective:To observe the expression of interleukin-17 and the infiltration of eosinophilic cells in nasal polyps and allergic rhinitis, and investigate the roles of IL-17 and eosinophils in the etiology of nasal polyps and allergic rhinitis.Method:A study was conducted on 21 patients of nasal polyps, 18 ones of allergic rhinitis and 12 normal individuals. Immunohistochemical stain with the rabbit monoclonal antibodies of IL-17 was carried out.The eosinophilic cells infiltrated in different tissues were stained with HE, then counted under high power filed.The data was analyzed with ANOVA of SPSS12.0 software.Result:Many IL-17 stained cells were found in the samples of nasal polyps and allergic rhinitis, which were significantly higher than those in normal individuals(P<0.05). Positive cell number in tissues of allergic rhinitis was similar to that in nasal polyps, but higher than in normal individuals. As for HE staining, there was no significant deviation of numbers of eosinophilic cell in tissue between allergic rhinitis and nasal polyps,while which differed from the normal ones(P<0.05).Conclusions:①IL-17 is a newly cytokine which expressed in mucosa of allergic rhinitis and nasal polyps tissue. It indicates the degree of immunological reaction and inflammatory reaction, and can be used as an index to research the mechanism of nasal polyps as well as allergic rhinitis.②The eosinophilic cells count was correlated with the amount of IL-17 positive cells in nasal ployps and with allergic rhinitis correlation coefficients were R=0.606(P<0.01)and R=0.446(P<0.05) respectively . It seems that eosinophils, which are regulated by IL-17, play an important roles in the development of nasal polyps and allergic rhinitis.

ObjectiveTo explore the imaging of the thrombosis after pharmacological triggering of plaque rupture in atherosclerotic rabbit model by using 3.0 T high-resolution magnetic resonance imaging.MethodsTwenty male New Zealand white rabbits were divided into an experimental group (n = 16) and a control group (n = 4).The aortic wall injuries were induced by an intravascular balloon in experimental group rabbits after high cholesterol diet.The pharmacological triggering with Russell's viper venom and histamine was performed after 3 months of establishment of model.All of the animals underwent pre-trigger and post-trigger MR examinations including 3D time of fight (3D TOF),T1 WI,T2WI and post contrast T1 WI.Euthanasia was performed in all rabbits and gross anatomy and histological specimen of aorta were obtained.Comparing the location and length of the thrombus between MRI images and histopathology was used Pearson test.Comparing the calculated indexes of abdominal aorta between rabbits with and without thrombosis was used AVONA test and LSD-t test.Results After triggering,8 in 14 survived rabbits developed thrombosis in experimental group,meanwhile,no thrombus was found in control group.The accuracy of multi-sequences MRI for detecting of thrombus was 87.1％ (27/31).MRI data correlated with the histopathology regarding thrombus length ( r = 0.85,P ＜ 0.01 ) and thrombus location ( r = 0.94,P＜0.01 ).Compared with rabbits without thrombosis,the rabbits with thrombosis had narrower lumen of abdominal aorta in the pre-triggered MR images [ ( 5.71 ± 2.38 )mm2 vs.( 8.93 ± 5.36) mm2,P ＜ 0.01 ].ConclusionMRI is useful tool to determine the thrombosis and plaque rupture in atherosclerotic rabbit model.

Objective To prepare carcino-embryonic antigen (CEA) targeted and paclitaxel loaded phase-shifting PLGA nanoparticles (Ab-PTX-NPs),and investigate the targeting capability and inhibition to the ovarian cancer cell in vitro.Methods Single-emulsion/solvent evaporation (O/W) and carbodiimide method were used to prepare the Ab-PTX-NPs.The size of nanoparticles was determined by Malvern analyzer.The encapsulation and drug loaded efficiency of paclitaxel were detected by high performance liquid chromatography.And the drug release characteristics was measured by dialysis method in constant temperature shaker.The targeting ability of Ab-PTX-NPs to the ovarian cancer SKOV3 cell was evaluated by the laser scanning confocal microscope and flow cytometry.And the inhibition ability of Ab-NPs was investigated by the CCK-8 assays.Results The size of Ab-PTX-NPs was (397.70±99.95)nm.The encapsulation efficiency and drug loading capacity of PTX were (67.26±4.15) ％ and (6.31±0.39) ％,respectively.The conjugating rate of Anti-CEA antibody was (92.74 ± 5.75) ％.The targeting study in vitro showed that such a number of contrast agents landed around the SKOV3 cells in targeting group,and the mean fluorescence intensity of ovarian cells in targeting group was significantly higher than other groups (P＜0.05).After 24 h,the viability rate of ovarian cells in targeting group was lower than the non-target group (P＜0.05),only higher than that of the pure PTX group (P＜0.05).But there was no significant difference between the targeting group and the pure PTX group (P＞0.05) at 48 h.Conclusion The CEA targeted and paclitaxel loaded phase-shifting PLGA nanoparticles are successfully prepared.It can enhance ultrasound imaging well after activated by LIFU.With high drug-loading efficiency and fast drug release velocity,the Ab-PTX-NPs appeares great targeted ability.

Objective:To explore the expression of peptidyl prolyl cis-trans isomerase (Pin1) activity in peripheral blood of patients with rheumatoid arthritis (RA) and the value and correlation of T helper cell 17/regulatory cells (Th17/Treg) cells, and to analyze the effect and influence of all-transretinoic acid (ATRA) on it.Methods:① Comparing the difference of Pin1 expression and absolute counts of Th17 and Treg between RA patients before and after treatment and healthy control group, Kruskal-Wallis rank sum test was used for analysis. ② To analyze the correlation between the expression of Pin1 and its general data, activity indicators [such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and disease activity score 28 joints (DAS28) scores], Th17, Treg and some cytokines in RA patients, and to use Pearson and Spearman correlation tests. ③ To analyze the difference of Pin1 expression and Th17/Treg in peripheral blood of RA patients treated with low-dose all-trans retinoic acid (10 mg twice a week) and traditional immunosuppressants such as hydroxychloroquine for 3 months respectively. Mann-Whitney U test was used for comparison between the two groups, and the difference was statistically significant with ( P<0.05). Results:① The activity of Pin1 in peripheral blood of the newly treated group of RA was [13.62(9.16, 19.42)] higher than that of the healthy control group [8.97(7.62, 11.45)]( Z=42.82 , P<0.05), and Th17 was [18.28(12.76, 24.08)] higher than that of the healthy control group [6.04(4.96, 4.96)]( Z=48.83 , P<0.05). Treg [11.06(5.31, 21.87). It was lower than that of healthy control group [40.41(24.33, 48.52)]( Z=42.21 , P<0.05). ② the activity of Pin1 in peripheral blood of RA patients was positively correlated with CRP, the number of involved joints, DAS28 score, interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) ( r=0.396, P<0.05; r=0.683, P<0.05; r=0.466, P<0.05; r=0.315, P<0.05; r=0.416, P<0.05). ③ Compared with the newly treated RA group, the activity of Pin1 [6.94(5.96, 8.77), Z=42.82 , P<0.05] and Th17 7.38 decreased [7.38(3.85, 11.21), Z=48.83 , P<0.05], while Treg [40.41 (17.77, 33.47)] increased ( Z=42.21 , P<0.05). ④ Compared with the traditional medicine group, Treg [28.9(21.73, 37.36)] was higher in the retinoic acid group, and the difference was statistically significant ( Z=-2.683 , P<0.05). The activity of Pin1 was [6.23(5.58, 8.75)], but there was no statistical significance ( Z=-1.622 , P=0.104). Conclusion:Pin1 in peripheral blood of RA patients is over-expressed. Th17 is increased and Treg is decreased. ATRA combined with other traditional drugs can reduce Pin1 activity, promote Treg growth and improve disease activity of RApatients to a certain extent.

Objective: To understand the current status of health related quality of life among primary and middle school students aged 9 to 15 years old in Henan Province, and to explore its relationship with negative emotions and social support. Methods: Between January and June 2016, 24 primary and middle schools were selected from 6 cities of Henan Province, and 5 867 primary and middle school students were included and completed the Pediatric Quality of Life Inventory Measurement, Stress Anxiety Depression Scale, Perceived Social Support Scale. Hierarchical linear regression analysis was used to examine the moderating effect of social support. Results: The total score of health related quality of life of primary and middle school students in Henan was (81.21±12.49). There were statistically significant differences in the quality of life among primary and middle school students with different gender, study period, family monthly income, subjective parental relationship and parental education ( P <0.05). Negative emotions were negatively correlated with quality of life ( r =-0.51, P <0.01) and social support ( r =-0.30, P <0.01), while social support was positively correlated with quality of life ( r =0.29, P <0.01). Regression analysis showed that negative emotional was negatively associated with quality of life ( β =-0.23, P <0.01), while social support was positively associated with quality of life ( β =0.16, P <0.01). The interaction of negative emotions and social support was negatively associated with quality of life ( β =-0.18, P <0.01). Conclusion Health related quality of life among 9-15 year old primary and middle school students in Henan province is satisfactory. Social support might buffer the negative impact of negative emotions including depression, anxiety and stress on quality of life of primary and secondary school students.

OBJECTIVE: To observe the expression of interleukin-17 and the infiltration of eosinophilic cells in nasal polyps and allergic rhinitis, and investigate the roles of IL-17 and eosinophils in the etiology of nasal polyps and allergic rhinitis. METHOD: A study was conducted on 21 patients of nasal polyps, 18 ones of allergic rhinitis and 12 normal individuals. Immunohistochemical stain with the rabbit monoclonal antibodies of IL-17 was carried out. The eosinophilic cells infiltrated in different tissues were stained with HE, then counted under high power filed. The data was analyzed with ANOVA of SPSS12.0 software. RESULT: Many IL-17 stained cells were found in the samples of nasal polyps and allergic rhinitis, which were significantly higher than those in normal individuals (P < 0.05). Positive cell number in tissues of allergic rhinitis was similar to that in nasal polyps, but higher than in normal individuals. As for HE staining, there was no significant deviation of numbers of eosinophilic cell in tissue between allergic rhinitis and nasal polyps,while which differed from the normal ones (P < 0.05). CONCLUSIONS 1. IL-17 is a newly cytokine which expressed in mucosa of allergic rhinitis and nasal polyps tissue. It indicates the degree of immunological reaction and inflammatory reaction, and can be used as an index to research the mechanism of nasal polyps as well as allergic rhinitis. 2. The eosinophilic cells count was correlated with the amount of IL-17 positive cells in nasal polyps and with allergic rhinitis correlation coefficients were R = 0. 606 (P < 0 01)and R = 0.446 (P < 0.05) respectively. It seems that eosinophils, which are regulated by IL-17, play an important roles in the development of nasal polyps and allergic rhinitis.
Adolescent ; Adult ; Aged ; Case-Control Studies ; Eosinophils ; metabolism ; Female ; Humans ; Inflammation ; Interleukin-17 ; metabolism ; Male ; Middle Aged ; Nasal Mucosa ; metabolism ; Nasal Polyps ; metabolism ; pathology ; Rhinitis ; metabolism ; pathology ; Young Adult

Objective: To observe the effect of different doses of Shenfu injection on prognosis and quality of life for patients with vasovagal syncope (VVS). Methods: A total of 126 patients were randomly divided into 3 groups. The control group (n=38) were treated by western medicine comprehensive therapy with tilting training. The low and high dose Shenfu injection groups were treated by Shenfu injection 40 ml/d (n=44) and 120 ml/d (n=44) on the treatment basis of control group. All the groups were treated for 14 days. The patients were followed up for 1 year after discharge. The relapse rate of syncope, quality of life social support rating scale (SSRS), effective rate of treatment, time of stable blood pressure, time of stable heart rate, recovery time of autonomic nervous disorder and adverse reactions were observed in each groups. Results: The total effective rate was 47.4% (18/38) in the control group, 72.7% (32/44) in the low dose group, and 90.9% (40/44) in the high dose group. The difference between the three groups was statistically significant (χ²=18.997, P<0.01), and the total effective rate of Shenfu injection high-dose group was significantly higher than that of low-dose group (P<0.05). After treatment, there were significant differences in the recovery time of blood pressure, heart rate and autonomic nervous disorder among the three groups (F=19.165, 158.428, 33.405, P<0.01). The above indicators in the high dose group of Shenfu injection were significantly higher than the low dose group (t=-4.020, -5.180, -5.307, P<0.05). After 1 year of follow-up, the recurrence rate of the control group was 61.1% (11/18), the low-dose group was 18.8% (6/32), and the high-dose group was 5% (2/40), where there was significant difference among all the groups (χ²=20.886, P<0.01). The quality of life scores were compared for 1 year among the 3 groups, and the difference was statistically significant (F=23.025, P<0.01). Conclusions The Shenfu injection combined with Western medicine comprehensive therapy can improve the prognosis and quality of life of patients with VVS, and the improvement of each indicator of daily dosage of 120 ml is better than the daily dosage of 40 ml Shenfu injection.

This paper was reviewed the research status of health literacy of cancer caregivers, including an overview of health literacy, assessment tools for health literacy of cancer caregivers, factors affecting health literacy of cancer caregivers and measures to improve health literacy of cancer caregivers. To provide theoretical basis for the localized development of health literacy assessment tools for cancer caregivers and further research.

Objective:To explore the expression level of interleukin-1 receptor-associated kinase-1 (IRAK1) in the peripheral blood of rheumatoid arthritis (RA) patients and analyze its relevance between disease activity and CD4 + T cell subsets. Methods:① The concentration of IRAK1 in the peripheral blood of 77 RA patients and 24 healthy controls were detected by enzyme linked immunosorbent assay (ELISA). ② The demo-graphic and clinical data of the RA group including disease activity score with 28 joints (DAS28), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), CD4 + T cell subsets in peripheral blood. ③Independent sample t test or Mann-Whitney U test were used to compare the differences between the two groups. Spearman rank correlation test and multiple linear regression were used to analyze the correlation between IRAK1 expression level and clinical data. Results:① The IRAK1 level of the peripheral blood of RA patients was significantly higher than in the normal controls ( P<0.001). ② Compared to normal controls, the peripheral blood of the RA group, the absolute numbers and proportion of regulatory T (Treg) cells were decreased ( P<0.001), the absolute numbers and proportion of helper T (Th) 17 and the ratio of Th17/Treg were increased. Moreover, the ratio of Th17/Treg was also increased. ③ With the increase of disease activity in RA patients, the expression of IRAK1 also increased. The expression of IRAK1 in the peripheral blood of RA group was positively correlated with ESR, number of joints involved and DAS28, and had statistically significant difference between the two groups ( r=0.23, P<0.05; r=0.24, P<0.05; r=0.27, P<0.05). Meanwhile, it was sign-ificantly negatively correlated with the percentage of Treg ( r=-0.27, P<0.05), and was significantly positively correlated with the ratio of Th17/Treg ( r=0.23, P<0.05) . However, there was no significant correlation with the ratio of Th1/Th2( P>0.05). Furthermore, multiple stepwise regression analysis showed that the expression of IRAK1 in the peripheral blood of RA group was positively correlated with ESR and the number of joints involved ( β=0.34, P=0.019; β=0.27, P=0.004), and it was inversely correlated with percentage of Treg ( β=-0.23, P=0.047, R2=0.219). Conclusion:IRAK1 expression in the peripheral blood of RA patients is up-regulated and correlated with disease activity. The decrease of Treg and the imbalance of Th17/Treg caused by high expression of IRAK1 may be one of the main factors for the occurrence and development of RA. Interfering the expression of IRAK1 may be a potential new target for RA treatment.