Objective To explore advantages of simulation-based medical education for overseas students on training of anesthcsia emergency skills.Methods twenty eight oversea students accepting anesthesia practice course were divided into two groups,each group fourteen.The students of simulation group (group S) were lectured with simulation-based medical education method,while the students of control group (group C) were lectured with tradition education method.Results the practice examination record and satisfaction degree for teaching in group S were both higher than that in group C (P＜0.05).Conclusion The simulation-based medical education was better than tradition education method on training of anesthesia emergency skills for oversea students.The simulation-based medical education may raise the learning interest of oversea students obviously,and it is beneficial to students' mastery of practice skills.

Objective To evaluate the application valve of intraoperative device closure secundum atrial sepetal defect (ASD) associated with deficient rims inducted by transoesophageal echocardiography (TEE). Methods Twenty-three patients with ASD were diagnosed by transthoracic echocardiography (TTE) ,and underwent an attempted intraoperative device closure through a right antierior minithoraetomy. The positon, type and size and rim of ASD were defined by TEE in preoperation, the placement of the device inducted and evaluated by TEE intraoperation,and followed by TTE after one week. Results Twenty-three patients with ASD were closed excellently. There were not shunt of atrial level in 20 patients, trivial shunt in 3 patients. However,follow-up after one week TTE indicated that all patients had no shunt,and the diameter of right atrium and right ventricle was decrease significantly (P <0.05), and pulmonary artery pressure was less than before (P <0.05). Conclusions It is very important that TEE induct the closure of ASD associated with deficient rims in micro-operative room.

ObjectiveThe expression and significance of interleukin(IL)-17 in a murine model of experimental systemic sclerosis(SSc) was studied and its correlation with transforming growth factor-beta 1 (TGF-β1) was explored.Methods Thirty female BALB/c mice were randomly divided into 3 groups,including a control group, bleomycin(BLM) injection for 4 weeks group(model 1 group) and a termination injection of BLM 4 weeks group(model 2 group).The pathological changes of skin and lung were detected.The mRNA expressions of IL-17A,RORγt,TGF-β1 mRNA were evaluated by real-time PCR.Enzyme linked immunosorbent assay was used to measure the levels of IL-17 and TGF-β1 in the serum and bronchoalveolar lavage fluid(BALF).Comparisons among groups were performed by variance analysis.ResultsSkin and lung of the model groups showed evident inflammatory cell infiltration and increased deposition of collagen fibers.The score of dermal inflammation and lung fibrosis was significantly higher in the model 1 and model 2 groups (2.5±0.8,3.0±1.8), (2.4±0.8,3.1±1.2) as compared to that of the control group (0.9±0.7,0.9±1.0),(F=12.19,8.367,25.11,4.641; all P＜0.05).The amount of hydroxyproline was markedly increased in the model groups than in the control group.Compared with those of the control group,the mRNA levels of IL-17A,RORγt,TGF- 31 in the skin and lung of the model 1 group were higher.The levels of IL-17 in serum and BALF of the model 1 group was significantly increased and the levels of TGF- β1 were increased in BALF and decreased in the serum (all P＜0.05).The mRNA levels of IL-17A in skin and lung had a positive correlation with the mRNA levels of TGF- β1,score of dermal inflammation and lung fibrosis.The levels of IL-17 in serum had a positive correlation with hydroxyproline of the skin and lung.ConclusionIL-17 may participate in systemic immune-mediated inflammation and changes of skin and lung in SSc and when combined with TGF-β1 togetter will cause damage to skin and lung in SSc.

number of goblet cells, mucus secretion and mucin MUC5AC content in lung tissues. Results S100A9 in BALF of group B was (11.89±0.77) ng/mL, S100A9 integrated optical density (IOD) value in airway epithelial cells was 13.96±1.62, PAS stain area /epithelial cell area was (12.53±1.21)%, relative value of MUC5AC / NADPH was 173.91±4.29, all of the above were higher than those of group A [(6.19±0.61) ng/mL, 4.97±0.30, (1.94±0.18)%, 1];S100A9 levels, IOD of S100A9 in airway epithelial cells, PAS stain area / epithelial cell area (%), relative value of MUC5AC / NADPH in group C [(10.69±0.79) ng / ml, 11.80±0.72, (10.61±0.61)%, 94.65±1.59], group D[(9.49±0.99) ng/mL, 10.39±0.59, (8.63±0.62)%, 82.08±1.12], group E [(7.54± 0.42) ng/mL, 5.63±0.84, (4.59±0.87)%, 26.30±1.94] were lower than group B, which showed a dose-dependent reduction and the difference was statistically significant (P<0.05 or P<0.01). Conclusion DB downregulates the expression level of Ca2+-binding protein S100A9 and the mucus secretion amount of the airway goblet cells in rats.

BACKGROUND: Autogenous bone has been used in cervical vertebra graft bone fusion in earliest stage and at most. However, its source is limited, simultaneously, induced many complications such as infection, hemorrhage and postoperative pain in the donor bone region. Recently, above-mentioned complications were avoided or reduced with the usage of new graft bone fusion material. OBJECTIVE: To compare clinical efficacy using MC+~R combination of autogenous bone or calcium sulfate artificial bone in antador cervical fusion.METHODS: A total of 26 patients (34 levels) with cervical spondylotic myelopathy underwent anterior cervical discectomy and cervical intervertebral fusion from January to December 2008. Anterior cervical oblique cut was 3.0-4.0 cm. The endplate were preserved after the cervical intervertebral disc and the posterior longitudinal ligament were removed. Autogenous bone group was filled with autogenous bone. Calcium sulfate artificial bone group was filled with Wdght's Osteoset artificial bone. Anchoring clip was implanted between the cervical vertebrae. Every patient had a short neck incision was assessed with X-ray, JOA grade and Odom's evaluation scale.RESULTS AND CONCLUSION: The two groups of 26 patients (34 segments)were followed up. The JOA score of postoperation was no significant difference between the two groups. According to the Odom's evaluation scale, the excellent and good rate of calcium sulfate group was higher than autogenous bone group, but there was not statistical significance (P>0.05). The fusion rate of autogenous bone group was higher than calcium sulfate group at 3 and 6 months, but the fusion rate of two groups were 100% at 12 months. Although the calcium sulfate group at 6 months, lordosis angle lost more than 0.4°than the autogenous bone group,but no significant statistically between the two groups (P>0.05). MC+ combination of autogenous bone or Calcium sulfate had the same clinical efficacy in the treatment of cervical spondylotic myelopathy, but the calcium sulfate artificial bone could be effectively avoided the complications of donor site.

Objective: To investigate the different efficacy of Yinchenhao Decoction (YCHD), a compound traditional Chinese herbal medicine, for liver cirrhosis induced by dimethylnitrosamine (DMN) or carbon tetrachloride (CCl(4)) in rats. Methods: To induce liver fibrosis, 0.5% DMN solution (2mL/kg body weight, i.p.) was given three consecutive days a week to male Wistar rats for 4 weeks. Cirrhotic rats were randomly divided into DMN group, YCHD group, Xiaochaihu decoction group by the end of the fourth week to accomplish a 2-week recipe treatment course. In CCl(4)-induced liver fibrosis model, 50% CCl(4)-olive solution was injected subcutaneously to rats at a dose of 2 mL/kg body weight twice a week to duplicate rat cirrhosis model. After 8 weeks, rats were divided into CCl(4) group, CCl(4) plus YCHD group and Xiaochaihu decoction group. For the YCHD group, YCHD was administered intragastrically once a day for 4 weeks. For DMN or CCl(4) model, by the end of 6 or 12 weeks respectively, rats were sacrificed for sampling to detect liver function, hepatic histological changes, hydroxyproline (Hyp) content and apoptosis-related gene expressions. Results: In DMN liver fibrosis model, hepatic fibrosis was obvious at week 2 and cirrhosis was evident at week 4 in DMN-treated rats. Compared to 6-week DMN group, hepatic pathological changes and liver function were improved significantly and content of Hyp decreased remarkably in YCHD group. In CCl(4)-induced liver fibrosis model, hepatic fibrosis was obvious at 8 weeks and cirrhosis was evident at 12 weeks in CCl(4)-treated rats. Compared to 12-week CCl(4) group, hepatic pathological changes and liver function were not obviously improvement in YCHD group. The results of gene chip showed that YCHD significantly decreased Fas, Bax and caspase-3 gene expressions, and increased Bcl-xL gene expression in the liver of DMN model. However, in the model induced by CCl(4), YCHD did not inhibit hepatocyte apoptosis induced by CCl(4), but increased tyrosine kinase receptor gene expression by 4.8 times. Conclusion: YCHD exerts more significant therapeutic effects on DMN-induced than CCl(4)-induced cirrhosis in rats in Hyp content and pathological change in liver tissue.

Objective To evaluate the effect of denatonium benzoaten on α-smooth muscle actin (α-SMA),subepithelial collagen and airway inflammation in asthmu mice.Methods Forty-five BALB/c mice were divided into 3 groups,normal control group (A group),asthma model group (B group),asthma model+ denatonium benzoaten group(C group);α-SMA detected by using immunohistochemistry,lung sections were stained with Masson to detect subepithelial collagen,HE stain method was used to observe the airway inflammation the images were analyzed with semi-quantitative computer.Results The deposition of α-SMA、subepithelial collagen and inflammation degree in C group was significantly reduced compared with B group,the difference were statistically significant(P＜0.05).Conclusion Denatonium benzoaten can improve airway remodeling in asthmatic mice.

Objective To study the expression and significance of Th17 and Tc17 cells in the peripheral blood,skin and lung in a murine model of bleomycin (BLM)-induced systemic sclerosis (SSc).Methods Thirty female BALB/c mouse were randomly divided into 3 groups,including a control group ( A group),a injected with BLM 4 week without pulmonary fibrosis(PF) group( B group) and with obviously PF group(C group).Pathological changes of skin and lung were detected.The proportion of CD4+,CD8+,CD4+IL-17+(Th17),CD8+IL-17+(Tc17) cells in the peripheral blood,skin and lung of mouse was determined by flow cytometry.The mRNA expressions of RORγt,IL-17A in skin and lung of mouse were evaluated by real-time PCR.Enzyme linked immunosorbent assay(ELISA) was used to measure the levels of IL-17 in serum.Results Dermal hydroxyproline(HYP) contents and the score of PF were significantly increased in C group [ (3.07±1.26) μg/mg,4.0±1.41 ]and B group [ (2.43±0.61) μμg/mg,1.50±0.76]as compared with A group [ (1.45±0.40) μg/mg,0.60±0.70 ],and pulmonary HYP contents was obviously increased in C group than in A and B groups,all P＜0.05.Compared with the A group,the percentage of CD4+ and Th17 cells in the peripheral blood,skin and lung of B and C groups,Tc17 cells of C group was significantly increased,and CD8+ cells was significantly decreased(all P＜0.05).The ratio of Th17/CD4+CD8+ in the peripheral blood,skin and lung of B and C groups [ ( 1.41 ±0.36)％,( 1.79±0.77)％ ],[ (2.58±1.07)％,(5.23±2.34)％ ]and [ (3.50±1.20)％,(4.02±1.32) ％ ]was significantly increased compared with A group (0.71±0.25)％,(1.15±0.59)％,(0.99±0.46)％.The ratio of Tc17/CD4+CD8+ in the lung of C groups( 1.62±0.53) ％ and in the skin of B and C groups [ (1.70±0.70) ％,( 1.63±0.63 ) ％ ]was significantly increased compared with A group [ ( 1.00±0.47 ) ％,( 1.1 1 ±0.34 ) ％ ],all P＜0.05.Compared with the A group,the mRNA levels of IL-17A,RORγt in skin of B and C groups,and in lung of C group were higher and the levels of IL-17 in serum was significantly increased,all P＜0.05.Th17 cells and the levels of IL-17 in blood were positive correlation with dermal and pulmonary inflammation,fibrosis and H YP contents,all P＜0.01.The frequency of Th17 and Tc17 cells in skin and lung respectively had a positive correlation with dermal and pulmonary inflammation,the score of fibrosis,and HYP contents of skin and lung,all P＜0.01.Conclusion Th17 and Tc17 cells were significantly increased in the peripheral blood,skin and lung of a murine model of SSc,and Th17 cells is dominated.They correlated with the inflammation and fibrosis of skin and lung,and may participate in the pathogenesis of SSc through secrete IL-17.

Objective To investigate the correlation between serum lipoprotein-associated phospholipase A2 (LP-PLA2) and homocysteine (Hcy) level change with cerebral infarction,and clinical value of combined detection of serum LP-PLA2,Hcy and blood lipid level in the diagnosis and differentiation diagnosis of cerebral infarction.Methods The serum lipoprotein-associated phospholipase A2,homocysteine and blood lipid in sixty-five cases of cerebral infarction(cerebral infarction group) and contemporaneous 64 healthy persons qualified in physical examination(health control group) were selected as the research subjects.The levels of serum LP-PLA2,TG,HDL,LDL,CHO and Hcy were detected.The differences were compared among various groups.Results The TG and LDL levels had no statistically significant difference between the health control group and cerebral infarction group(P>0.05),but the LP-PLA2 and Hcy levels in the cerebral infarction group were higher than those in the health control group(P<0.01),while serum HDL and CHO levels were lower than those in the health control group(P<0.01).Serum High Hcy and LP-PLA2 levels were the independent risk factors for cerebral infarction,however,high HDL was a protective factor for cerebral infarction.In the combined detection,the combined detection of LP-PLA2 and Hcy was superior to single index detection and other combined detection mode.Conclusion Serum LP-PLA2 and Hcy levels in the patients with cerebral infarction are significantly higher than those in the health control group,indicating that it may be involved in the occurrence of cerebral infarction,and may become an early biological marker for predicting cerebral infarction occurrence.The combined detection of serum LP-PLA2 and Hcy has highly clinical value in the diagnosis of cerebral infarction.

OBJECTIVE:To provide reference for the development and improvement of pharmaceutical care in our hospital. METHODS:By questionnaire investigation,habits and understarding situation and demand of knowledge of drug use among pa-tients in our hospital were randomly collected by face-to-face interview or network platform. A statistical analysis was carried out on obtained results. RESULTS:In this questionnaire investigation,289 questionnaires were sent out face-to-face,and 282 valid ques-tionnaires were returned with effective feedback rate of 97.58%. Totally 51 valid questionnaires were returned through network plat-form. A total of 333 valid questionnaires were returned through two ways. The results of questionnaire investigation showed that 44.14% of the surveyed patients would read the drug instructions before taking drugs;41.14% of the surveyed patients would pay more attention to ADR and cautions stated in drug instructions. More than 60% of the surveyed patients had various bad habits of drug use. When getting better,66.07% of the surveyed patients would stop using drugs or reduce the dosage. When having not im-proved,26.73% of them would change drugs or increase dosage.Consulting with the medical staff was the most common source(69.07%)of drug use knowledge,and it was also the most trusted source(84.08%). Among the knowledge of drug use, surveyed patients most expected to understand theADR and side effects(65.46%),and the selectionindication and main us-er,cautions,drug interaction in multiple useandusage and dosagewere also selected frequently,and the choices of some options were significantly affected by the characteristics of people,such as age and education degree(P<0.05). The most expected way to acquire drug use knowledge wasface-to-face consultation with medical staff (72.97%),followed bytelephone consulta-tionandnetwork consultation,and the choices of some options were significantly affected by the characteristics of people,such as age and education (P<0.05). CONCLUSIONS:Patients in our hospital haven't pay enough attention to drug instructions and their content,and bad habits of drug use still exist. Sources of drug use knowledge are diverse,but confidence of other sources is not enough except for source of medical staff. The demands for the knowledge of drug use are different,however,the present form and content of pharmaceutical care in our hospital cannot fully meet the needs of patients.