American medical education is one of the most characteristic and successful education models in the western country. There are significant differences between American and Chinese medical education. American successful experiences are precious for China to build the first-class medical universities in the new century

Primary central nervous system lymphoma (PCNSL) is a rare type of malignant lymphoma which originates in the central nervous system without spreading to other systems. It is more predisposable to immunodeficient individuals. However, an increase in the incidence of PCNSL has been also observed in the healthy population in recent years. PCNSL has short phase of clincal release, and easy to relapse with poor prognosis. Some studies have shown that relative prognostic factors were associated with age, performance status, the radiotherapy and chemotherapy modalities, the response to early adminstration of the glucocorticoid,tissue pathologic type and the molecular biologic marks.

Objective: To investigate the influence of astragalosides (AST) and Panax notoginseng saponins (PNS) combination on oxidative stress of brain tissues in C57BL/6 mice with cerebral ischemia-reperfusion injury. Methods: Eighty C57BL/6 mice were randomly divided into sham-operated group, untreated group, high-dose combination group (AST at a dose of 220 mg/kg plus PNS at a dose of 230 mg/kg), medium-dose combination group (AST at a dose of 110 mg/kg plus PNS at a dose of 115 mg/kg), low-dose combination group (AST at a dose of 55 mg/kg plus PNS at a dose of 57.5 mg/kg), AST (110 mg/kg) group, PNS (115 mg/kg) group and edaravone (4 mg/kg) group. AST and PNS were administered by gavage once daily for 4 days and edaravone was administered by intraperitoneal injection twice daily for 4 days. On the fourth day, bilateral common carotid arteries were ligated for 20 minutes to induce cerebral ischemia, followed by 60 minutes of reperfusion. Ischemic brain tissue was used to prepare tissue homogenate, then contents of malonaldehyde (MDA), glutathione (GSH) and nitric oxide (NO), and activities of superoxide dismutase (SOD) and nitric oxide synthase (NOS) in the homogenate were detected. Twoxtwo analysis of variance of factorial design was used to analyze whether there was an interaction between AST at 110 mg/kg and PNS at 115 mg/kg. Results: Compared with sham-operated group, contents of MDA and NO, and activity of NOS in the untreated group were remarkably increased (P<0.01), activity of SOD and content of GSH were decreased (P<0.01). Compared with the untreated group, content of MDA in the AST group was decreased (P<0.01) and activity of SOD was increased (P<0.01), however, contents of GSH and NO and activity of NOS had no obvious changes (P>0.05). Contents of MDA and NO in the PNS group was decreased as compared with the untreated group (P<0.01), but activities of SOD and NOS and content of GSH had no changes (P>0.05). Contents of MDA and NO and activity of NOS in brain tissues in the edaravone group were decreased (P<0.01, P<0.05), and activity of SOD was increased (P<0.05), while content of GSH had no changes (P>0.05). Contents of MDA and NO and activity of NOS in brain tissue in the AST and PNS combination groups were decreased (P<0.01, P<0.05), the activity of SOD increased (P<0.01, P<0.05), the content of GSH increased (P<0.01, P<0.05), and activity of SOD and content of GSH were increased (P<0.01, P<0.05). The results of analysis of variance of factorial design showed that there were interactions between AST (110 mg/kg) and PNS (115 mg/kg) (P<0.01). Conclusion: Combination of AST (110 mg/kg) and PNS (115 mg/kg) has a restraint effect on the early oxidative stress injury in the brain after ischemia-reperfusion, and the combination has a synergistic or additive effect.

Objective To study the effect of acupuncturing at Jiaji points plus cervical traction in treating unsteady lower cervical vertebrae.Methods The 90 outpatients willing to accept our treatment were randomized into 3 groups with 30 in each.Acupuncture group:acupuncture at the cervical Jiaji points.Traction group:traction at the cervical vertebrae.Acupuncture + traction group:acupuncture at the cervical Jiaji points plus cervical traction.Total effect,symptom scoring and X-ray examination were evaluated after 3 course of treatment.Results The total effective rate of acupuncture group,traction group and acupuncture + traction group was 47.67%,73.33% and 90.00% respectively.In total effect,symptoms of unsteady lower cervical vertebrae and the changes of X-ray examination,acupuncture + traction group was better than that of acupuncture group(P

A molecularly imprinted electrochemiluminescence sensor for detection of cinchonine based on surface self-assembly of molecularly imprinted membrane on magnetic nanoparticles was developed. Cinchonine was used as template and lauryl mercaptan was used as assembling monomer. The morphology and particle size distribution of the magnetic nanoparticles were characterized by TEM, and the infrared spectroscopy was used to study the structure and composition of cinchonine, molecularly imprinted membrane before and after elution. The results showed that, cinchonine could be specifically assayed with a linear relationship between the signal intensity and the logarithm of concentrations of cinchonine in the range of 1×10-10 mol/L to 9×10-8 mol/L. The detection limit for cinchonine was 3. 5×10-11mol/L. The sensor was used for the determination of cinchonine in serum samples, with the recoveries of 98. 8% to 104. 7%.

Objective To study the occurring regulation of antibody of Urbani sever acute respiratory syndrome (SARS)-associated coronavirus after onset of illness in patients with SARS and investigate the co-infection status of Chlamydiae pneumoniae (Chlamydiae P.) , Mycoplasma pneumoniae (Mycoplasma P.), Adenovirus, Respiratory Syncytia virus (RSV). Methods Serum Antibody IgM and IgG of Urbani SARS-associated coronavirus of 43 patients with SARS and 10 patients with other diseases except SARS at the two different phases of illnesses were detected with immune fluorescent technique. Antibody IgM and IgG of Chlamydiae P., Mycoplasma P., Adenovirus and RSV in the above samples were detected with enzyme-linked immunosorbent assay (ELISA). Results 40 cases' infection of were Urbani SARS-associated coronavirus were determined (93.02%) and 3 cases were negative (6.98%). 10 patients with other diseases except SARS have negative serum Antibody IgM and IgG of Urbani SARS-associated coronavirus. Recent infection rates of Chlamydiae P., Mycoplasma P., Adenovirus and RSV were 25.58%, 16.28%, 6.98% and 4.65% , respectively, and former infection rates of these pathogens were 39.53%, 34.88%, 27.91% and 0, respectively. Antibody IgM of Urbani SARS-associated coronavirus occurred at the same time of onset of fever. Positive rates of IgM were respectively 69.57% and 62.96% in 8～14 days and 15～33 days after onset of fever, and there were no remarkable difference between them, but they were re-markably higher than that in 1～7 days after onset of fever (16.67%). Antibody IgG of Urbani SARS-as-sociated coronavirus occurred at the 6th day after onset of fever. Positive rates of IgG were respectively 19.44%, 65.22% and 92.59% in 1～7 days, 8～14 days and 15～33 days after onset of fever, and there were remarkable difference among them. Conclusions Antibody IgM and IgG of Urbani SARS-associated coronavirus may occur at the early stage of illness in patientswith SARS, which positive cases may increase remarkably 2 weeks later after onset of fever. There may be recent infection and/or former infection of Chlamydiae P., Mycoplasma P., Adenovirus and RSV in some patients with infectious atypical pneumonia. Detection of Antibody IgM and IgG of Urbani SARS-associated coronavirus in sera with immune fluorescent technique can be used on the early diagnosis of SARS.

ObjectiveTo immunoscreen the mimic peptides of Mycobacterium tuberculosis antigen from phage displayed 12-mer peptide library.MethodsSpecific IgG was purified from sera of patients with TB and used as the target to immunoscreen a phage random peptide library of 12 amino acids.Positive clones which were obtained after three rounds of biopanning were detected by ELISA and sequenced.The diagnostic value of the high frequent positive clones were observed by ELISA.Results After 3 rounds of immunoscreening,the eluted phages were enriched effectively.Six kinds of animo acid sequence were obtained from twelve positive phage clones.Sensitivity of the two high frequent positive clones were 71.4％ (A2)and 55.4％ (A7) respectively.ConclusionThe antigen-mimic peptide was successfully screened from 12 random phage peptide library and the peptides can be recognized by tuberculosis patients' polyclonal antibodies.

Objective To investigate the effects of hyperbaric oxygen (HBO) on the systemic inflammation response in patients with severe traumatic brain injury (TBI), and to explore HBO therapy mechanisms. Methods Seventy patients with severe TBI were randomly divided into a routine treatment group ( RT group, n = 35 ) and an HBO group (n=35). All patients received conventional treatment, but the HBO group received additional early HBO therapy. Twenty age-and sex-matched normal subjects were recruited and served as normal controls. Serum interleukin-6 (IL-6) was measured by ELISA, and C reactive protein (CRP) was also measured on days 1, 7, 14 and 21 after injury. Sequential organ failure assessments (SOFAs) and Glasgow coma scale (GCS) scores were evaluated at the same time points. Systemic inflammatory response syndrome (SIRS) was assessed daily. Results The concentrations of serum IL-6 and CRP increased obviously following TBI, but patients in the HBO group exhibited significantly lower levels at each time point than those in the RT group. In the HBO group fewer cases of SIRS developed,and they had a significantly shorter average duration than those in the RT group. The average SOFA score in the HBO group was significantly lower than that of the RT group at days 14 and 21 after injury, and the GCS scores had improved significantly more by day 21. Compared with the patients who were free of SIRS, the patients with SIRS showed higher levels of IL-6 and CRP, higher SOFA scores as well as lower GCS scores ( all differences statistically significant). Conclusions HBO therapy can attenuate systemic inflammation after TBI, protect the functions of important organs and improve clinical outcomes. Decreasing the level of IL-6 may contribute to the effectiveness of HBO.

Objective To study the relationship among HLA-A alleles,supertype,HPV infection and cervical cancer in Tu Nationality of Hubei province.Methods As a case-control surevy. The comparisons included the comparison between HPV positive cases and HPV positive women in control group,and the comparison between HPV positive cases and HPV negative women in control group. Number of cases was 100(HPV positive in 86),and control was 187 (HPV positive in 95 and HPV negative in 92). The most polymorphism of 2 and 3 exons of the HLA-A alleles were analyzed by the high-resolution typing method-sequence-based typing(SBT).Results Comparison between HPV positive cases and HPV positive control women. Supertype HLA-A3(Pcorrected=0.005,OR=2.36,95% CI=1.45～3.85) was risk factors. Comparison between HPV positive cases and HPV negative control women,HLA-A*0206 alleles (Pcorrected=0.025,OR=0.20,95% CI=0.07～0.58)supertype HLA-A2 (Pcorrected=0.005,OR=0.57,95% CI=0.37～0.88)was protective factor. Supertype HLA-A3 (Pcorrected=0.005,OR=2.36,95% CI=1.45～3.85) was also related to the susceptibility of cervical carcinoma.Conclusion Supertype HLA-A3 is a risk factor of cervical cancer.

[Objective]To investigate the pharmacological mechanism of montelukast in the inhibition of inflammation.[Meth-ods]Respiratory syncytial virus-infected human bronchial epithelial cell(16HBEC)inflammatory cell model was established,and mRNA and protein expressions of Nuclear factor NF-E2 related factor(Nrf2),heme oxygenase(HO-1),quinone oxidoreductase (NQO-1),and glutathione transferase (GST) were determined by qPCR and Western-blot ,and production of cellular reactive oxygen species(ROS)was measured by DCFH-DA fluorescent probe method. Nrf2 siRNA was further synthesized to reduce the expression of Nrf2 ,to investigate the chang of inflammatory index.[Results]Montelukast significantly reduced the expressions of inflammatory cytokines IL-6,TNF-α,and IL-1β(P<0.05)on respiratory syncytial virus-infected 16HBEC,and the ROS level in inflammatory cell model was decreased(P<0.05),increased the mRNA and protein expressions of Nrf2,HO-1,NQO-1 and GST (P < 0.05),with a more significant effect at higher dose. After the down-regulation of Nrf2,the expressions of inflammatory cyto-kines IL-6,TNF-α,and IL-1βwere increased(P<0.05),and ROS level was significantly increased(P<0.05),mRNA and pro-tein expressions of Nrf2,HO-1,NQO-1 and GST were decreased(P<0.05).[Conclusion]Montelukast inhibits the inflammation of human bronchial epithelial cells infected by respiratory syncytial virus (RSV),and the potential mechanism may involve its ef-fect on the Nrf2/ARE signaling pathway.