Objective To investigate influence of amlodipine /atorvastatin on atherosclerosis in the elderly with hypertension and hyperlipidemia.Methods Totally 108 cases with hypertension and hyperlipidemia in our hospital were randomly divided into control group and observation group (n =54 each).The control group received conventional antihypertensive treatment such as diuretics,angiotensin-converting enzyme inhibitors,calcium antagonists; the observation group received amlodipine and atorvastatin combination tablet as add-on therapy to the above drugs for 6 months.The blood lipid level and carotid artery ultrasound detection results were observed and compared between the two groups after treatment.Results The levels of TC[(4.23 ± 0.79)mmol/L vs.( 5.32 ±1.23)mmol/L],TG[(1.53±0.35) mmol/L vs.(5.32± 1.23) mmol/L],LDL-C [(3.19 ± 0.59)mmol/L vs.(4.07±0.79)mmo1/L]were decreased,while HDL-C [(1.53±0.95)mmol/L vs.(1.32±0.83)mmol/L]were increased in observation group after treatment as compared to control group (all P ＜0.05).After carotid artery ultrasonography,the LN[( 1.61± 0.76) scores vs.( 2.24 ± 0.89) scores ] and IMT [(0.76 ± 0.22)mm vs.(0.98 ± 0.28)mm] levels were lower in observation group after treatment than in control group (P＜0.05).Conclusions Amlodipine/atorvastatin combination can reduce blood lipids and alleviate atherosclerosis.It is suitable for elderly patients with hypertension and hyperlipidemia.

Many kinds of medical education standards came out at home and abroad in the new era to lead and evaluate the development of medicinal education.The Forth Militay Medical University,after analyzing the characteristics and the insufficiency of these standards,believe that health view,medical model and the other five aspects will be the key factors for the research of military surgeon educational standard for undergraduates majoring in clinical medicine.

OBJECTIVE:To optimize the extraction technology of Yigu granule. METHODS:L9(34)orthogonal test was used, using comprehensive scores of transfer rate of icariin,gentiopicroside,loganic acid and yield rate as evaluation indexes,alcohol volume fraction,the amount of solvent,extraction times and extraction time as investigation factors,extraction technology of Yigu granule was optimized,and the verification test was conducted. RESULTS:The optimized extraction technology was 10-fold 60%ethanol reflux extraction for twice,1 h once. Results of verification test showed,average transfer rates of icariin,gentiopicroside and loganic acid were 81.28%(RSD=1.54%,n=3),48.71%(RSD=2.37%,n=3)and 59.82%(RSD=2.52%,n=3);aver-age yield rate was 31.48%(RSD=1.97%,n=3). CONCLUSIONS:The optimized extraction technology for Yigu granule is sta-ble and feasible with good reproducibility,which can provide basis for the follow-up study of production process.

[Absrtact] Objective To investigate the effect of anatomic quantitative target evaluation of class-room teaching on students' professional knowledge learning ability. Methods Twenty-five international students of 6-year program of grade 2013 were chosen as the experimental group, while twenty-seven Chinese students coming from the same class of grade 2013 and fifteen international students of 6-year program of grade 2012 were chosen as two control groups; quantitative and non-quantitative evaluation were imple-mented respectively by classroom questions and answers; teaching effects were evaluated by scales in the separation of teaching and examination, by records of answers for in-class questions and by questionnaire survey; SPSS 20.0 was used to make statistical analysis, one-way ANOVA and Kruskal Wallis test to com-pare the scores of three groups of students, P<0.05 indicates statistic significance. Results Compared with control groups, the accuracy of answers for class questions were improved greatly in the experimental group (2/3~3/4) vs. (1/2) and (2/3~3/4) vs. (1/2) and the average test scores (80.62±5.93) vs. (79.62±5.93) and (80.62 ±5.93) vs. (70.16 ±6.36) of the experimental group students were higher than control groups, the difference was statistically significant between the control group and the control group (P=0.045). Conclusions
Quantitative evaluation of teaching objectives in anatomy class can improve the learning attitude of foreign students and enhance their academic ability.

OBJECTIVETo investigate the effects of lung protective ventilation strategy combined with lung recruitment maneuver on ARDS complicating patients with severe burn.

METHODSClinical data of 15 severely burned patients with ARDS admitted to our burn ICU from September 2011 to September 2013 and conforming to the study criteria were analyzed. Right after the diagnosis of acute lung injury/ARDS, patients received mechanical ventilation with lung protective ventilation strategy. When the oxygenation index (OI) was below or equal to 200 mmHg (1 mmHg = 0. 133 kPa), lung recruitment maneuver was performed combining incremental positive end-expiratory pressure. When OI was above 200 mmHg, lung recruitment maneuver was stopped and ventilation with lung protective ventilation strategy was continued. When OI was above 300 mmHg, mechanical ventilation was stopped. Before combining lung recruitment maneuver, 24 h after combining lung recruitment maneuver, and at the end of combining lung recruitment maneuver, variables of blood gas analysis (pH, PaO2, and PaCO2) were obtained by blood gas analyzer, and the OI values were calculated; hemodynamic parameters including heart rate, mean arterial pressure (MAP), central venous pressure (CVP) of all patients and the cardiac output (CO), extravascular lung water index (EVLWI) of 4 patients who received pulse contour cardiac output (PiCCO) monitoring were monitored. Treatment measures and outcome of patients were recorded. Data were processed with analysis of variance of repeated measurement of a single group and LSD test.

RESULTS(1) Before combining lung recruitment maneuver, 24 h after combining lung recruitment maneuver, and at the end of combining lung recruitment maneuver, the levels of PaO2 and OI of patients were respectively (77 ± 8), (113 ± 5), (142 ± 6) mmHg, and (128 ± 12), (188 ± 8), (237 ± 10) mmHg. As a whole, levels of PaO2 and OI changed significantly at different time points (with F values respectively 860. 96 and 842. 09, P values below 0. 01); levels of pH and PaCO2 showed no obvious changes (with F values respectively 0.35 and 3.13, P values above 0.05). (2) Levels of heart rate, MAP, CVP of all patients and CO of 4 patients who received PiCCO monitoring showed no significant changes at different time points (with F values from 0. 13 to 4. 26, P values above 0.05). Before combining lung recruitment maneuver, 24 h after combining lung recruitment maneuver, and at the end of combining lung recruitment maneuver, the EVLWI values of 4 patients who received PiCCO monitoring were respectively (13.5 ± 1.3), (10.2 ± 1.0), (7.0 ± 0.8) mL/kg ( F =117.00, P <0.01). (3) The patients received mechanical ventilation at 2 to 72 h after burn, lasting for 14-32 (21 ± 13) d. At post injury day 3-14 (7 ± 5) d, lung recruitment maneuver was applied for 2-5 (3.0 ± 2.0) d. All 15 patients recovered without other complications.

CONCLUSIONSLung protective ventilation strategy combining lung recruitment maneuver can significantly improve the oxygenation in patients with severe burn complicated with ARDS and may therefore improve the prognosis.

Acute Lung Injury ; physiopathology ; therapy ; Blood Gas Analysis ; Burns ; complications ; Extravascular Lung Water ; Hemodynamics ; Humans ; Positive-Pressure Respiration ; Respiration, Artificial ; methods ; Respiratory Distress Syndrome, Adult ; complications ; physiopathology ; therapy ; Treatment Outcome

Implanted brain-computer interface (iBCI) is a system that establishes a direct communication channel between human brain and computer or an external devices by implanted neural electrode. Because of the good functional extensibility, iBCI devices as a platform technology have the potential to bring benefit to people with nervous system disease and progress rapidly from fundamental neuroscience discoveries to translational applications and market access. In this report, the industrialization process of implanted neural regulation medical devices is reviewed, and the translational pathway of iBCI in clinical application is proposed. However, the Food and Drug Administration (FDA) regulations and guidances for iBCI were expounded as a breakthrough medical device. Furthermore, several iBCI products in the process of applying for medical device registration certificate were briefly introduced and compared recently. Due to the complexity of iBCI in clinical application, the translational applications and industrialization of iBCI as a medical device need the closely cooperation between regulatory departments, companies, universities, institutes and hospitals in the future.
Humans ; Brain-Computer Interfaces ; Brain/physiology* ; Electrodes, Implanted

Objective To investigate how ultraviolet B (UVB)-irradiated urocanic acid (cis-UCA) affects the immune function and possible mechanisms.Methods Skin grafts were harvested from the tails of C57B mice and placed onto full thickness beds on the flanks of BALB\C mice (across a complete MHC Class Ⅰ and Ⅱ mismatch). 0.2 ml of 24% cis-urocanic acid, 100% trans-urocanic acid, and saline was separately injected ip into recipient mice prior to skin grafting. The skin allograft survival time was observed and compared between groups.A mice model for delayed-type hypersensitivity (DTH) response to DNP6-OVA which was indicated by increasing in ear thickness was established. Each mouse in Group A and B was injected respectively with 200 μg cis-UCA and trans-UCA ip 5 hours previous to sensitization with 10 μg emulsified DNP6-OVA in the subcutaneous of hind legs. Group C was control group, in which DNP6-OVA remained at the same time. After 7 days, each ear thickness of all mice including group D was measured by micrometer. Mice in the group D were examined by increase of ear thickness caused by the physical stimulus and other factors. 2 μg DNP6-OVA were injected into each pinnae thereafter. And each ear thichness was remeasured 24 hours later.The serum IgG, C3, C4 level in the mice stimulated by E. Coli was detected by ELISA assay.The lymphocytes were cultured with 24% Cis-UCA, trans-UCA, histamine, Cis-UCA cimetidine together and histamine cimetidine together respectively. After 40 hours PHA stimulating, 200 μl lymphocytes culture mediaClinical Experiment Research Laboratory, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029 Jiangsu Province, China (Wang T, Chen HQ, Ni L and Ding XJ)This research was sponsored by National Natural Science Foundation of China, No. 39270646.supernatant were collected from each group to evaluate the IL-2 active level with IL-2 depending cells "CTLL" by MTT method. 68 hours later following PHA stimulating, lymphocytes proliferation index (SI) was detected by MTT method. Meanwhile, the total cells RNA of each group were extracted by one step extraction method and quantified, then the IL-2 mRNA was detected by RT-PCR.Results Cis-UCA could significantly prolong the allograft skin survival (11.4±0.71 / 9.3±0.22 days, P<0.05) comparing with the trans-UCA and PBS. Significant immunosuppression of DTH to DNP6-OVA was found in the Cis-UCA group, the P value <0.01 (t=9.48). No same effect was found in trans-UCA and PBS group. The 24% Cis-UCA immune suppression rate was 47.9%. Also we found that Cis-UCA could significantly inhibit the IL-2 bioactivity than trans-UCA (3.13±1.52 / 10.14±6.21, P<0.05) in the mice stimulated by E. Coli. The humoral immune response could be suppressed by Cis-UCA. The serum IgG level was decreased significantly in the Cis-UCA group (t=4.03, P<0.01). The serum complement level (C3 and C4) was also decreased after injecting Cis-UCA (C3: t=2.50, P<0.05; C4: t=4.63, P<0.01). Meanwhile, the results indicated that normal T lymphocytes proliferation could be inhibited by Cis-UCA. The stimulated index (SI) of T lymphocytes could be decreased by Cis-UCA. Same effects were found in histamine group. The inhibited effects could be blocked by cimetidine (H2R blocker). The trans-UCA did not show the stimulated index inhibiting effect on T lymphocytes.The same effects of Cis-UCA upon T lymphocyte's total RNA were found. The Cis-UCA and histamine decreasing the cell total RNA could be also blocked by cimetidine. Conclusions The ultraviolet immunosuppression may be mainly mediated by Cis-UCA which could effect on the H2 receptors on T lymphocytes.

Xi'an Jiaotong University Health Science Center introduces the concept of CDIO (conceive, design, implement and operate) into the training practice of medicine-engineering interdisciplinary talents. By optimizing the curriculum and graduate training mechanism, building academic exchanges and innovative experimental platforms, and guiding students to carry out scientific research oriented to clinical problems, Xi'an Jiaotong University Health Science Center uses medical and industrial methods to solve clinical problems and produce medical achievements. The application of the CDIO model is conducive to deepening students' understanding of interdisciplinary knowledge, forming a fused innovative thinking, and improving the ability to solve problems and cooperate with others. The CDIO model is also conducive to the growth of high-level composite innovative talents, clinical technology innovation, team construction and discipline development, which provides new ideas for exploring the training of medical and engineering interdisciplinary talents.

Since the outset of the coronavirus disease 2019(COVID-19)pandemic,the gut micro-biome in COVID-19 has garnered substantial interest,given its significant roles in human health and pathophysiology.Accumulating evidence is unveiling that the gut microbiome is broadly altered in COVID-19,including the bacterial microbiome,mycobiome,and virome.Overall,the gut microbial ecological network is significantly weakened and becomes sparse in patients with COVID-19,together with a decrease in gut microbiome diversity.Beyond the existence of severe acute respiratory syndrome coronavirus type 2(SARS-CoV-2),the gut microbiome of patients with COVID-19 is also characterized by enrichment of opportunistic bacteria,fungi,and eukaryotic viruses,which are also associated with disease severity and presentation.Meanwhile,a multitude of symbiotic bacteria and bacteriophages are decreased in abundance in patients with COVID-19.Such gut microbiome features persist in a significant subset of patients with COVID-19 even after disease resolution,coinciding with'long CO VID'(also known as post-acute sequelae of COVID-19).The broadly-altered gut microbiome is largely a consequence of SARS-CoV-2 infection and its downstream detrimental effects on the systemic host immunity and the gut milieu.The impaired host immunity and distorted gut microbial ecology,particularly loss of low-abundance beneficial bacteria and blooms of opportunistic fungi including Candida,may hinder the reassembly of the gut microbiome post COVID-19.Future investigation is necessary to fully understand the role of the gut microbiome in host immunity against SARS-CoV-2 infection,as well as the long-term effect of COVID-19 on the gut microbiome in relation to the host health after the pandemic.