Electives,as an important component of medical education,are useful for students in expanding knowledge scope,improving knowledge structure and increasing overall capacity.Adjusting course resources,strengthening education administration and conducting course evaluation can achieve the establishment of electives system in medical colleges and universities.As a result,the electives system will contribute to the formation of inter-disciplinary medical talents.

Objective To investigate behavioral and endocrinal changes following the conflict-related stress. Method Male SpragueDawley rats were exposed to stressors using Vogel conflict test. Body weight and behavioral responses in open field test were investigated during the whole procedure. Serum corticosterone level was analyzed using immunoassay. Results Compared with the control, the rats of the 1-week, 2-week and 4-week stressed group showed significantly decreased body weight. There was increasing tendency or significant difference in locomotion between the 1 -week, 2-week and 4-week stressed group and their control. And the hormone levels for the stressed animal were reliably high. Conclusions The increased locomotion, and high corticosterone level and reduced body weight in stress animal,was consistent with the features of anxiety-like disorders. Furthermore, the behavioral and endocrine changes produced by conflict-related stress could maintain a long time. The conflictrelated stress paradigm may be used as psychological stress animal mode in the future.

OBJECTIVE To master the pathogenic conditions,clinical characteristic,and diagnostic clues about AIDS combinated with penicilliosis marneffei and malignant lymphoma.METHODS The clinical data about AIDS combinated with penicilliosis marneffei and malignant lymphoma were summarized in order to learn by experience.RESULTS The clinical symptoms of AIDS combinated with penicilliosis marneffei and malignant lymphoma could be unique,but most were various,the primary symptoms were always fever and enlargement of liver and spleen.CONCLUSIONS AIDS combinated with penicilliosis marneffei is common to be seen,but with penicilliosis marneffei and malignant lymphoma are rarely seen in the clinics,which should be taken high attention.

OBJECTIVE To explore the drug-resistant situation of clinical isolated Escherichia coli in our hospital from Jun to Dec in 2007,the aim is to offer evidence for drug-resistant monitoring and clinical antibiotics usage in our hospital. METHODS All clinical specimens isolated and cultured from patients were identified by using the automatic microorganism analyzer VITEK-2 as well as bacteria's drug susceptibility tests were performed using counterparts panel. RESULTS A total of 352 strains E. coli were isolated. The isolated ratio of extended spectram-?-lactamases (ESBLs) producing E. coli was 66.2% (233/352),no ESBLs producing E. coli was 33.8% (119/352). From them 111 strains E. coli were isolated in sputum and 89 strains were ESBLs producing and 22 strains were no ESBLs producing; 111 strains E. coli were isolated in urine and 62 strains were ESBLs producing and 49 strains were no ESBLs producing. The drug-resistance difference was obvious between them as well as between strains isolated from different sites. Better to select piperacillin/tazobactam,cefotetan,ertapenem,imipenem,amikacin,and nitrofurantoin to cure all isolated E. coli infection.CONCLUSIONS The drug-resistance of ESBLs producing E. coli is severe (66.2%) so that hospital administers should strengthen antibiotics usage management and improve antibiotics rational usage,inorder to decrease occurrance of bacterial resistance.

ObjectiveTo know about the correlation analysis of the physical and mental status of organ transplanted patients' family members during the patients' rehabilitation period and the long term survival of the transplanted organs.MethodsA total of 600 organ transplanted patients' family members were investigated by Zung self-rating anxiety scale (SAS) and simple coping style questionnaire.The results underwent subsequent analysis.ResultsAnxious state of organ transplanted patients' family members was more severe than that of domestic norm (P<0.01).There were some differences in terms of anxious state of family members with different genders,education backgrounds,income and the resource of medical expenditure (P<0.05).Family members most took positive coping styles,whereas fewer adopted negative coping styles (P<0.01).Positive coping styles were negatively correlated with the anxiety of family members (P<0.01) and positively correlated with long term survival of transplanted organ(P<0.05).However,negative coping styles of family members were significantly positively correlated with their anxiety (P<0.05) and were negatively correlated with long term survival of transplanted organ.ConclusionsThe anxiety generally exists in organ transplanted patients' family members.There are differences in terms of anxious state among family members of different genders,different education backgrounds,income or with the resource of medical expenditure.The more they adopt positive coping styles,the lower anxiety level they show and the longer the transplanted organ survive.Conversely,the more they adopt negative coping styles,the higher anxious level they show and the shorter the transplanted organ survive.

Determining the approach to spread the knowledge and technology for preventing birth defects using the diffusion of innovations theory.Identifying the target group,orientation messages and promotion guidelines based on related literature,laws and clinical epidemiology studies.Pathways integrating both inter-personal communication and IT have pushed the adoption percentage of innovative knowledge for preventing birth defects up from 0％ to 97 ％ in almost no time,helping the region ranking the first in China.The innovation diffusion model has caught attention of both the government and all the community.Prevention measures against birth defects are accepted community wide,while medical workers are regulated by law in their behaviors of mothers and children healthcare services to set a model for prevention of other diseases.

Objective:To observe the relationship between inducible carbon monoxide synthase (iNOS) and delayed encephalopathy after acute carbon monoxide poisoning (DEACMP), and explore its mechanism of action in DEACMP.Methods:This study was designed as prospective cohort study. Patients with acute carbon monoxide poisoning who met the diagnostic criteria and were admitted to Emergency Intensive Care Unit(EICU) of our hospital from June 2019 to June 2021 were selected as subjects. Patients were divided into the DEACMP group and non-DEACMP group according to the occurrence of DEACMP. Serum samples were collected on the first 24 h after admission and on day 7 and 14 after admission, and the serum nitric oxide (NO), neuronal nitric oxide synthase (nNOS), inducible carbon monoxide synthase (iNOS), and endothelial nitric oxide synthase (eNOS) level were measured by enzyme-linked immunosorbent assay. The generalized estimating equation was used to estimate the difference of NO, nNOS, iNOS and eNOS between DEACMP and non-DEACMP patients.Results:A total of 78 patients with carbon monoxide poisoning were included in our study finally, including 49 (62.82%) males and 29 (37.18%) females, with an average age of (53.96±14.95) years, 20 (25.64%) patients with DEACMP, and 1 (1.28%) death. Univariate analysis showed that patients with DEACMP had an average increase of 3 h (95% CI: 1.00, 5.00) in carbon monoxide exposure time and a 5-point decrease in GCS score (95% CI: 1.00, 6.00) than the patients without DEACMP, and the proportion of patients with severe carbon monoxide poisoning in the DEACMP group was higher than that of the non-DEACMP group (90.00% vs. 32.76%). According to the analysis of generalized estimation equation, on day 7 and 14 after admission, Compared with non-DEACMP patients, neither by performing unadjusted nor adjusted analysis with the iNOS of DEACMP patients was significantly higher than that in non-DEACMP patients regardless of whether exposure time, GCS score, coma time or severity of carbon monoxide poisoning were adjusted or not ( P <0.01 or P <0.05). Except for the level of nNOS in the GEE model adjusted with carbon monoxide exposure time, the levels of NO, nNOS and eNOS showed no significant difference between DEACMP and non-DEACMP patients ( P >0.05). Conclusions:The expression of iNOS level is increased in DEACMP patients, and its continuous expression may be involved in the pathogenesis of DEACMP.

Objective This study investigated whether gut microbiota and its metabolites are altered in myasthenia gravis(MG)patients.Methods We collected fresh stool specimens from MG patients and healthy controls.16S rRNA gene sequencing and gas chromatography-mass spectrometry were used to measure abundance of gut microbiota and metabolite levels in two groups,respectively.Clinical data of the subjects were also collected including quantitative MG score(QMGS),MG-activities of daily living(MG-ADL),MG-specific quality-of-life 15(MG-QOL15),manual muscle testing(MMT),and the acetylcholine receptor antibody(AchR-Ab)titers.The correlation between the differential microbiota and the clinical characteristics was investigated.Results A total of 50 MG patients and 15 healthy controls were recruited.Simpson's index was significantly higher in the MG group(0.936±0.041)than in the control group(0.888±0.123).Alpha diversity was significantly decreased in the MG group(t=2.349,P=0.022).There was a significant difference in microbial phenotype between the two groups(R=0.966,P=0.001,Adonis).The results of LEfSe showed that the abundance of Esherichia-Shigella,Succinivibrio,Fusobacterium,and Ruminococcus-gnavus-group were up-regulated while the abundance of Lachnospira,Roseburia,Desulfovibrio,and Coprococcus were down-regulated.The results showed that the metabolites of the MG group were significantly different from those of the control group.There were 28 metabolites up-regulated and 71 metabolites down-regulated in the MG patient group.Kyoto Encyclopedia of Genes and Genomes analyses demonstrated that the majority of metabolic pathways in which differential metabolites were involved were related to amino acid metabolism and nucleotide metabolism.61.2% (30/49)of bacterial amplicon sequence variant(ASV)were significantly associated with multiple metabolites(P<0.001).The relative abundance of Lachnospiraceae in the group with MG was negatively correlated with the QMGS(r=-0.496,P<0.001),MG-ADL(r=-0.542,P<0.001),MG-QOL15(r=-0.464,P=0.007),and the AchR-Ab(r=-0.315,P=0.026).The relative abundance of Lachnospiraceae in the group with MG was positively correlated with the MMT(r=0.374,P=0.008).Conclusion The intestinal flora of MG patients is down-regulated in the abundance of beneficial bacteria and up-regulated in the abundances of harmful bacteria.Disturbance of metabolites are also present in MG patients.Regulating gut microbiota in MG patients may be a new target for treating the disease.