This article defined a set of communication skills that are expected of second-year medical students conducting history and physical examinations on hospitalized patients.In order to teach the skills,an educational strategy was devised that included training sessions for medical teachers and the development of an innovative videotape tool used to train the teachers and their students.The majority of teachers and students felt that the educational design stimulated discussion and improved their understanding of communication skills.This useful teaching technique is transferable to other institutions.

Moyamoya disease is a tare intracranial angiopathy resulting in symptoms and prognosis similar with the stroke,if not diagnosed and treated early.The article reviews the characteristics,pathogenesis,treatment and prognosis of Moyamoya disease.Clinicians should be aware of this disease in routine work,so that the patients with Moyamoya disease can be early diagnosed and treated to avoid disability or death.

Objective To study the efficacy of hypo responsiveness of allogenic T cells induced by curcumin (Cur)-treated dendritic cells (DCs) and influence on survival time of renal allografts in rats.Methods DCs were generated from Wistar rat bone marrow and treated with Cur. The costimulatory molecules (CDl1c, CD80, CD86 and major histocompability complex Ⅱ ) were determined by using flow cytometry,and the production of IL-12 in DCs culture supernatant was examined by using ELISA.The probability of Cur treated DCs to stimulate the proliferation of Lewis rat T cells was detected by using mixed leukocyte reaction (MLR),and the antigen specific T cell hypo responsiveness was analyzed by using secondary MLR. Allograft renal transplantation animal models were established by using Wistar rats as donors,and Lewis rats as recipients.At 7th day before allograft renal transplantation,Cur-treated DCs from donors were injected into recipients through tail vein, meanwhile the non-treated control group and immature DCs control group (immature DCs from donors were injected into recipients through tail vein) were set up.The allograft survival time and allograft pathology after transplantation were assayed.Reaction of T cells from the recipients to mature DCs of donors was analyzed at 14th day.Results Cur restrained the expression of DCs phcnotypc and production of IL-12 (P＜0.05). Cur treated DCs displayed poor ability to stimulate T cells proliferation,and potential to induce antigen specific T cell hypo-responsiveness.The survival time of the renal allograft in Cur-treatcd CDs group [(31.5 ± 6.9) days] was significantly longer (P＜0.05) than in control group [(8.6± 2.1) days] and immature DCs control group [(22.4± 7.4) days],and the pathological lesions in the renal allografts in Cur treated CDs group were milder than in the control group and immature DCs control group.T cells from the recipients injected with Cur-treated DCs showed significant hypo-responsiveness to mature DCs from donors (P＜0.05),but higher proliferation ability to the stimulation of third party independent antigen.Conclusion Cur can suppress the maturation and function of DCs,and induce immune suppression of allogeneic T cells,while infusion of Cur-treated immature DCs can prolong the survival of renal allograft remarkably.

The compound excipient containing sodium stearyl fumarate and plasdone S-630 was prepared by applying spray drying method. The basic physical properties of compound excipient were studied by solubility test, scanning electron microscope, differential scanning calorimeter, X-ray diffraction and Fourier transform infra-red spectroscopy. The effect of compound excipient on moisture absorption and ferulic acid in vitro dissolution of spray drying power of angelica were investigated. The results showed that the chemical constituents of compound excipient did not change before and after spray drying. The water soluble compound excipient can improve significantly moisture absorption and has application prospect.

There are some problems in the course of evaluating teaching quality in colleges and universities, such as theunclear aim of evaluation, few teachers taking part in evaluating, and problems existing in participants which affect thequality of evaluation. Some related measures are made here to solve the problems.[

Objective:To investigate the protective effect of pine pollen on lipopolysaccharide (LPS)-induced learning and memory impairments in mice and the underlying mechanism.Methods:Sixty mice were randomly divided into four groups ( n = 15/group): normal control, model, low-dose pine pollen (500 mg/kg) and high-dose pine pollen (1 000 mg/kg). Mouse models of learning and memory impairment were established by lateral ventricle injection of LPS. The learning and memory abilities of mice were determined by the Morris water maze test. Superoxide dismutase (SOD) activity and glutathione (GSH) and malondialdehyde (MDA) levels in the hippocampus of mice were measured. Interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), dopamine (DA), and norepinephrine (NE) levels in the hippocampus were also determined. Results:The latency in the passive avoidance test in the model group was significantly shorter than that in the normal control group [(134.80 ± 33.89) s vs. (282.20 ± 17.43) s, t = 4.23, P < 0.01]. The number of errors in the model group was significantly higher than that in the normal control group [(4.00 ± 1.58) vs. (1.20 ± 1.30) times, t = 2.85, P < 0.01]. The latency in the passive avoidance test in the low-dose pine pollen (500 mg/kg) and high-dose pine pollen (1000 mg/kg) groups was significantly longer than that in the normal control group [(189.40 ± 27.21) s or (213.40 ± 21.26) s vs. (134.80 ± 33.89) s, t = 3.21, 4.38, all P < 0.05]. The number of errors in the low-dose pine pollen (500 mg/kg) and high-dose pine pollen (1 000 mg/kg) groups was significantly lower than that in the normal control group [(1.60 ± 1.44) times or (1.40 ± 1.44) times vs. (4.00 ± 1.58) times, t = 5.12, 6.42, both P < 0.05]. SOD activity and GSH, DA and NE levels in the hippocampus in the model group were significantly decreased compared with the normal control group [SOD: (7.59 ± 1.77) kU/g vs. (39.90 ± 6.37) kU/g; GSH: (3.49 ± 0.13) mmol/g vs. (6.37 ± 0.14) mmol/g; DA: (418.42 ± 2.57) ng/L vs. (586.37 ± 3.64) ng/L; NE: (187.20 ± 5.41) ng/L vs. (298.42 ± 2.32) ng/L, t = 3.67, 8.23, 2.23, 3.65, all P < 0.05]. MDA, IL-6 and TNF-α levels in the hippocampus in the normal control group were significantly higher than those in the model group [MDA: (8.79 ± 0.82) mmol/g vs. (2.62 ± 0.16) mmol/g, IL-6: (48.07 ± 5.56) ng/L vs. (18.76 ± 1.42) ng/L, TNF-α: (87.20 ± 4.31) ng/L vs. (22.42 ± 3.39) ng/L, t = 7.45, 2.67, 4.35, P < 0.05 or P < 0.01]. SOD activity, GSH, DA and NE levels in the hippocampus in the low-dose pine pollen (500 mg/kg) and high-dose pine pollen (1 000 mg/kg) groups were significantly higher than those in the model group [SOD: (18.80 ± 2.39) kU/g, (28.70 ± 2.36) kU/g vs. (7.59 ± 1.77) kU/g, GSH: (5.04 ± 0.36) mmol/g, (5.45 ± 0.17) mmol/g vs. (3.49 ± 0.13) mmol/g, DA: (488.37 ± 3.46) ng/L, (506.29 ± 5.72) ng/L vs. (418.42 ± 2.57) ng/L, NE: (225.65 ± 3.72) ng/L, (239.76 ± 5.58) ng/L vs. (187.20 ± 5.41) ng/L, t = 4.56 or 6.71, t = 4.65 or 5.32, t = 4.73 or 6.72, t = 3.84 or 5.63, P < 0.05 or P < 0.01]. MDA, IL-6 and TNF-α levels in the hippocampus in the low-dose pine pollen (500 mg/kg) and high-dose pine pollen (1 000 mg/kg) groups were significantly lower than those in the model group [MDA: (5.72 ± 0.47) mmol/g, (3.77 ± 0.23) mmol /g vs. (8.79 ± 0.82) mmol/g, IL-6: (28.42 ± 3.54) ng/L, (23.43 ± 5.62) ng/L vs. (48.07 ± 5.56) ng/L, TNF-α: (48.87 ± 4.82) ng/L, (39.65 ± 6.69) ng/L vs. (87.20 ± 4.31) ng/L, t = 6.31 or 7.28, t = 3.46 or 6.31, t = 4.28 or 3.57, P < 0.05 or P < 0.01]. Conclusion:Pine pollen can improve LPS-induced learning and memory impairments possibly through up-regulating the levels of monoamine neurotransmitters DA and NE and inhibiting the levels of oxidative stress and inflammatory reaction in the hippocampus of mice.

Objective To evaluate the surgical technique of titanium miniplates in reconstruction of laminar roof after a posterior approach in intraspinal tumor surgery. Methods From August, 2007 to March, 2009, 11patients underwent intraspinal tumor surgery with osteotomy and reconstruction of laminar roof, titanium miniplates were used for fixing in the re-implantation. There were 2 intramedullary tumors,9 extramedullary tumors. The target of surgery was the cervical spine in 2 cases, the cervicothoracic spine in 4 cases, the thoracic spine in 2 cases, the thoracolumbar spine in 2 cases, and the lumbar spine in 1 cases. The patitens were followed up for 6 months to 2years. Local pain,bony healing and spinal malformation were assessed. Results In the 11 patients, there was no case of dural, nerve root, or spinal cord injury due to laminar roof reconstruction. One patient complained of moderate to severe local pain during follow-up and 2 patients complained of occasional slight pain at the surgical site. No limitation of activity occurred. Bony healing was confirmed radiologically or CT scan in 9 patients. There were no patients demonstrated a new spinal malalignment, and no patients developed stenosis of the spinal canal. Conclusions The reconstruction of the laminar roof using titanium miniplates will benefit the recovery of normal structure of spine,and maintain the stability of spine,and avoid the occurrence of stenosis of the spinal canal.

Objective To compare the appfication of rapid sequence induce nasotracheal intobation with awake nasotracheal intubation with fiberoptic bronchoscope (FOB) in patients with cervical vertebra injury.Methods Forty patients with cervical vertebra injury were randomly divided into group (rapid sequence induce nasotracheal intubation with FOB) and group II (awake nasotracheal intubation with FOB),20 patients in each group.Bp,HR,SpO2 before and during intubation,intubafion time and cases of re-intubation were observed.Results SpO2 maintained normal during intubation.Between group I and group II,there was no significance in intubation lime [(3.12±0.52)min and (3.34±0.65)mini and cases of re-intubafion (2 cases and 1 case) (P ＞ 0.05 ).During intubation,MAP and HR inceased significantly in group II than those in group I (P ＜ 0.05 ).Conclusion The application of rapid sequence induce nasotracheal intubation with FOB is better than awake nasotracheal intubation with FOB in patients with cervical vertebra injury,it is safe and valid.

Objective To introduce a puncture-drainage system for intracranial hematoma, which can be used in both peacetime and wartime. Methods The inserting-style connections were taken to design the catheter needle and driller. In the design of the combined T-piece, silica membrane was used to be the main sealing end. The fixed division between the main sealing end and the catheter needle took thread connections. The angle between the side-tube of the T-piece and the catheter needle was 120 degree; the side-tube of the T-piece and the Y-tube also took thread connections. The another two sides of Y-tube linked to different drainage bag and syringe, and all of the hoses got the individual and portable switches. Results This system was more efficient, rapid, safe and convenient. What's more, the injury was minimal when doctor performed an intracranial hematoma puncture surgery by using the puncture-drainage system. Conclusion It is very easy to operate and suitable to puncture drainage for intracranial hematoma surgery in both peacetime and wartime.

Objective To analyze the clinical application value of serum homocysteine(Hcy) detection in diagnosing acute myo-cardial infarction .Methods 78 cases of acute myocardial infarction in the hospital from January to December 2013 were selected as the acute myocardial infarction group ,69 cases of unstable angina as the unstable angina group and contemporaneous 78 healthy per-sons undergoing the physical examination as the control group .The serum Hcy ,myoglobin and creatine kinase isoenzyme were de-tected and the detection results were performed the statistical analysis .Results The serum Hcy levels and the positive rate in the a-cute myocardial infarction group were significantly higher than those in the unstable angina group (P<0 .05) ,but serum myoglobin and creatine kinase isoenzyme had no statistical differences in the concentration and positive rate between these two groups (P>0 .05) .The serum Hcy concentration and the positive rate in the acute myocardial infarction group and the unstable angina group were higher than those in the control group(P<0 .05) .The ROC curve analysis showed that the efficiency for diagnosing acute my-ocardial infarction from high to low in turn was MYO ,Hcy and CK-MB .Conclusion Serum Hcy may be used as a routine index for diagnosing acute myocardial infarction ,which has certain clinical value for the condition monitoring and prognosis of the disease ,and also has certain clinical significance for the differential diagnosis between acute myocardial infarction and unstable angina .