A series of reforms on the teaching of analytical chemistry experiment has been carried out in accordance with the characteristics of medicine examination and the actuality,which includes the content of course,the teaching method,and the inspection method.Good results have been achieved in the aspect of development of students' comprehensive quality and practical ability.

Objective To evaluate the effects of treatment with different fluids on systemic inflammatory response in newborn rabbits with septic shock. Methods One hundred New Zealand white rabbits (3-5 days, 45-70 kg) were randomly divided into 5 groups (n = 20 each):group Ⅰ sham operation (group S); group Ⅱ sepsis (group CLP); group Ⅲ lactated Ringer's solution (group R); group Ⅳ 6% HES (group HES) and group V (group R+ HES). The animals were anesthetized with intraperitoneal ketamine and midazolam. Sepsis was induced by cecal ligation and puncture (CLP). The animals in group R and HES received lactated Ringer's solution and 6% hydroxyethyl starch (HES) 30 ml/kg infused iv over 1 h respectively immediately after CLP,while group R+ HES received Ringer's solution 20 ml/kg and 6% HES 10 ml/kg. Nio fluid was infused in groups S and CLP. Carotid artery and jugular vein were cannulated for MAP monitoring, blood sampling and drug and fluid administration. MAP was recorded immediately (T1) and at 0.5, 1, 2, 4, 8 h (T2-6) after CLP. Arterial blood samples were collected at T6 for determination of plasma IL-6 and IL-10 concentrations. Results Compared with those at T1, MAP decreased significantly after CLP at T4-6 in group CLP and at T5.6 in group R but hypotension did not develop after CLP in group HES and R + HES. Plasma IL-6 concentration was significantly higher in group CLP and R than in group S. There was no significant difference in plasma IL-6 concentration between group S and group HES and R + HES. Plasma IL-10 concentration was significantly lower in group CLP and higher in group HES than in group S. There was no significant difference in plasma IL-10 concentration between group S and group R and R + HES. Plasma IL-6 concentration was significantly lower, while plasma IL-10 concentration was significantly higher in group R + HES and HES,and plasma IL-10 concentration was significantly higher in group R or6% HES infused iv alone in maintaining the balance between pro-and anti-inflammatory cytolines in newborn rabbits with septic shock.

Objective To investigate the long-term programming effects on pubertal reproductive function by immunological challenge in early life. Methods Female Sprague-Dawley rats were administered by endotoxin (lipopolysaccharide, LPS) at a dosage of 50 μg/kg and saline intraperitoneally on postnatal day 3 and 5. Body weight was measured weekly. Puberty onset ( vaginal opening) and oestrous cyclicity were monitored from postnatal day 30. At the age of 6 weeks, bilateral ovariectomy was performed. The histological and morphological change of the ovaries (the thickness of the theca interna and the number of different kinds of follicles) were observed and the immunoreactivity of the ovarian sympathetic nerve markers (low affinity receptor of nerve growth factor, p75NGFR) was evaluated by immune staining. Results Immunological challenge (exposed to LPS) in early life delayed vaginal opening significantly [LPS-treated (40.6 ±0.7) days versus controls ( 38. 6 ± 0. 5 ) days, P ＜ 0. 05], decreased the percentage of normal oestrous cyclicity ( LPS-treated 26. 1% versus controls 66. 8% , P＜ 0. 05 ) , decreased the total number of different types of follicles (primordial follicles: LPS-treated 610 ±47 versus controls 1181 ±57, P ＜ 0. 05; primary follicles: LPS-treated 624 ±41 versus controls 960 ± 30, P ＜ 0. 05 ; preantral follicles: LPS-treated 183 ± 16 versus controls 260 ± 14, P ＜ 0. 05; antral follicles: LPS-treated 32 ± 4 versus controls 79 ± 7, P ＜ 0. 05) and increased the thickness of the theca interna [LPS-treated ( 15. 8 ±0. 4) μm versus controls (11.4 ±0. 3) μm, P ＜ 0. 05]. The immunostaining of p75NGFR was obviously enhanced in the LPS-treated ovaries when compared with that of controls ( P ＜ 0. 05 ) . Conclusions Immunological stress during early critical developmental windows could have long dysfunctional effects on the pubertal reproductive function. It delayed puberty onset, reduced the percentage of the normal oestrous cycles, decreased follicles reserve and increased the thickness of the theca interna which might involve the up-regulation of the local ovarian sympathetic nerve activity.

Objective To study the employment of noninvasive ventilation with nasopharyngeai airway in coma patients with cerebral stroke.Methods One hundred and fifty-five stroke patients treated with noninvasive ventilation admitted from May 2011 to May 2013 were studied.There were 88 male and 67 female,aged 30-95 years with mean age 73 years,The patients suffered from stroke with APACHE Ⅱ score 5-13 and Glasgow coma score 7-13.There were 78 cases in the nasopharyngeal airway group,and 77 cases in oropharyngeal airway group as control.SBP,DBP,HR,SpO2 and PCO2 were observed in the two groups at the time of beginning of noninvasive ventilation with neither airway (T0),and after placement of either airway and noninvasive ventilation for 10 min (T10),20min (T20),and 30 min (T30),respectively.The differences in rate of endotracheal intubation and the incidence of pulmonary infection were compared between the two groups.Results PaO2,SBP,PCO2 were improved after 30 minutes of noninvasive ventilation in the oropharyngeal airway group,and SBP DBP,HR decreased which were associated with improved respiration,less stress response,and then good blood circulation system.The better improvement of respiration was observed in nasopharyngeal airway group after 30 minutes of noninvasive ventilation.More improvements in PaO2,PCO2,SBP,DBP,HR were observed 30 minutes after noninvasive ventilation with nasopharyngeal airway compared with control group (P ＜ 0.05).The endotracheal intubation was used in 31 cases (40.3％) in the oropharyngeal airway group,and among them,19 cases (24.7％) suffered pulmonary infection.But there were 15 cases (19.2％) with endotracheal intubation in the nasopharyngeal airway group and 11 cases (14.1％) with pulmonary infection.The length of ICU stay,incidence of endotracheal intubation,and rate of pulmonary infection were lower in nasopharyngeal airway group (P ＜ 0.05).Conclusions The nasopharyngeal airway used in noninvasive ventilation can effectively ameliorate ventilation dysfunction in stroke patients,correct hypoxia and lessen accumulation of carbon dioxide,also reduce the pulmonary infection and the rate of endotracheal intubation.Nasopharyngeal airway used in noninvasive ventilation is a effective modality to solve upper airway obstruction and offer effective ventilation in stroke patients.

BACKGROUND:Compared with traditional autogenous bone graft, composite, as the carrier of seed cells, possesses advantages of fewer traumas and no limitation of donor site in repairing bone defect.OBJECTIVE: To observe the ability of the composite of β-tricalcium phosphate artificial bone-hyaluronic acid-type I collagen (β-TCP/HA/COL-I), as induced bone marrow stromal cell (MSC) carrier, to repair rabbit radial defect, and the feasibility with the composite as bone substitute material.DESIGN: A randomized and controlled trial.SETTING: Department of Orthopaedics, Renmin HospitaL, Wuhan University.MATERIALS; The study was conducted in the Department of Orthopaedics Renmin Hospital, Wuhan University between September 2003 and July 2004. Thirty-one New Zealand big white rabbits, aged 6 months, with body mass of 1.5 to 2.0 kg were enrolled in this study. The rabbits were randomized into control group (n =4) and experimental group (n =27).METHODS : ①In vitro induction and culture of MSCs was performed on 31 white rabbits, and the alkaline phosphatase (ALP) positive ratio of induced MSCs was observed. The structure of β-TCP/HA/COL-I was observed under scanning electron microscope. ② A 2 cm radial defect was created through operation. Eight weeks later, composites of β-TCP/HA/COL-I/MSCs were implanted into one side of rabbits in the experimental group, and autogenous bone was implanted into the other side. Rabbits in the control group were untouched. ③All the animals in the experimental group were randomly sacrificed at postoperative 4,8 and 12 weeks, 6 rabbits at 4 and 8 weeks, 15 at 12 weeks; Animals in the control group were sacrificed at 12 weeks. Gross observation, X-ray photographing, haematoxylin-eosin (HE) dyeing, and assessment of inorganic ingredient were performed. Osteogenic area and biomechanical tests were performed at 12weeks. Repairing effects on bone defect in each group were compared.MAIN OUTCOME MEASURES: The ALP positive ratio of induced MSCs; The structure of composite ofβ-TCP/HA/COL-I;Gross observation; X-ray photographing; HE dyeing and assessment of inorganic ingredient; Osteogenic area and biomechanical tests.RESULTS: All the 31 rabbits entered the stage of result analysis. ① The ALP positive ratio of cells reached 75% after induction and culture. ② Scanning electron microscope observation showed that 3 kinds of materials with abundant cellular structure distributed evenly. ③ The osteogenic area at 12 weeks was (72.5±3.6)% and (76.7±6.2)% in the experimental group and autogenous group, respectively (P ＞ 0.05). ④The maximum bending moment was (521.0±61.1) and (554.3±53.3)N·mm in the experimental group and control group, respectively; The maximum displacement at point of application of force was (0.816±0.071)and (0.870±0.103)respectively, without significant difference (P ＞ 0.05). ⑤Inorganic ingredient in the composite was 75%, 57% and 42% at 4,8 and 12 weeks respectively, suggesting that the inorganic component in the material was gradually decomposed with the elongation of time. ⑥Results of gross observation,X-ray photographing, histopathological examination, biomechanical test showed that with the elongation of time, composite of β-TCP/HA/COL-I/MSCs could repair bone defect in the experimental group, while bone defect in the control group had not been repaired.CONCLUSTON: Composite of β-TCP/HA/COL-I /MSCs possesses the same effect on repairing bone defect as autogenous bone, so it may be used as autogenous bone graft substitute.

The acceptance assessment is an important part of research project management.By analyzing the content,methods,process and model of the current acceptance assessment of medical research projects in China,we summarized and elaborated the main problems in the medical research management.By referring to the mature practices of some other countries,we proposed the solutions to improve the quality of acceptance assessment in China,i.e.,balancing the qualitative and quantitative assessment,improving the quality of peer-review,constructing information platform,introducing independent third party assessment and construing the overall process evaluation system.Our study may provide important reference for constructing the high-quality evaluation system of medical research projects in China.

Objective To investigate the correlation of postoperative platelet counts with liver function recovery after partial hepatectomy in patients with hepatocellular carcinoma.Methods 212 patients with hepatocellular carcinoma were enrolled in this study.The relation between postoperative platelet counts and serum levels of ALT,AST,TB and PT after operation was analyzed.Results There were 78 patients with a low (＜ 100 × 109/L) immediate postoperative platelet count in this series of 212 patients who underwent partial liver resection for hepatocellular carcinoma,and 134 patients with a normal platelet count (≥ 100 × 109/L).Based on the criteria,27 patients were categorized as having delayed postoperative liver function recovery.There was no perioperative mortality in this study.Postoperative peak levels of ALT,AST and TB were significantly higher in patients with low postoperative platelet counts than those with normal platelet counts (P ＜ 0.05).Statistical analysis showed that low postoperative platelet counts after partial liver resection for hepatocellular carcinoma correlated with increased risk of delayed postoperative recovery (x2 =9.112,P =0.003).Conclusions Low postoperative platelet counts were associated with delayed liver function recovery after partial hepatectomy in patients with hepatocellular carcinoma.

Professor Shi Qi is a famous traditional Chinese medicine doctor specializing in orthopaedics and traumatology, who has formatted a set of systematic protocols for the diagnosis and treatment of chronic musculoskeletal conditions. When it is time for using tonics in winter, he advocates applying herbal paste for treating chronic musculoskeletal diseases. This paper introduces Professor Shi Qi's commonly used prescription for treating chronic musculoskeletal conditions and puts forward demands and understandings in concocting herbal paste, experience in herbal paste for treating chronic musculoskeletal diseases such as cervical spondylosis, lumbar disc herniation, lumbar spinal stenosis, lumbar muscle strain, ankylosing spondylitis, osteoporosis, knee osteoarthritis and avascular necrosis of femoral head, and the advantages of herbal paste for treating chronic musculoskeletal conditions as opposed to alternative treatments.

Objective To improve the early diagnosis and differential diagnosis of adrenal incidentalomas to guide clinical management of this disease. Methods One hundred and twenty-eight cases were diagnosed as adrenal incidentalomas due to health examination or treatment of other than adrenal disease,including 60 males and 68 females,whose ages were between 20 and 75 years,with a mean age of 50 years.Tumor diamer:＜3 cm 63 cases,3-6 cm 6 cases,＞6 cm 10 cases.128 patients all had biochemical and electrolyte examination,adrenal cortex and medulla biochemical testing,abdominal ultrasound and CT examination,6 cases with MRI examination.Surgery and post operative pathological examination were performed in all patients. Results Post operative pathology finally diagnosed adrenocortical adenoma in 85 cases,pheochromocytoma in 13 cases,adrenal cyst in 8 cases,paraganglioma and myeiolipoma in 7 eases respectively,adrenal nodular hyperplasia in 4 cases,adrenocortical carcinoma in 2 cases,adrenoconical oncocytoma,cellular Schwannoma and adrenal liposarcoma in 1 case,respectively.One case of pheochromocytoma patients died of intraoperative hypotension,which is not included in the total number. Conclusions The preperative diagnosis of adrenal incidentalomas is difficult.For adrenal incidentalomas with diameter more than 6 cm and those with endocrine function,early surgicM treatment is recommended.

ObjectiveTo compare the clinical effects of extracorporeal shock wave lithotripsy (ESWL) and ureteroscope holmium laser lithotripey(URL) in emergency patients with ureteral calculi.MethodsTwo hundred and forty emergency patients with ureteral calculi were retrospectively analyzed,including 110 patients undergoing ESWL (ESWL group) and 130 patients undergoing URL (URL group).Results The success rate of fragmentation and calculi-free rate were 90.0％ (117/130) and 80.8％(105/130) in URL group,of which were 88.2％(97/110) and 75.5％(83/110) in ESWL group with no significant difference between two groups (P ＞ 0.05 ).The success rate of fragmentation and calculi-free rate of upper ureter in ESWL group were much better than those in URL group[93.1％(54/58) vs.84.3％(59/70),77.6％ (45/58) vs.70.0％ (49/70),P ＜ 0.05 ],those of middle-lower ureter in URL group were much better than those in ESWL group[96.7％(58/60) vs.82.7％(43/52),93.3％(56/60) vs.73.1％(38/52),P＜0.05].ConclusionESWL and URL both have good curative effects in emergency patients with ureteral calculi,and ESWL has better effects for upper ureter while URL for middle-lower ureter.