In order to accelerate the comprehensive reform of clinical education,the Ministry of Education and the Ministry of Health decided to implement the program of excellent doctor education training plan in 2012.On the basis of the plan,taking a certain medical college as an example,on the problems such as lack of teachers,unreasonable age structure,the lack of advanced experimental technology and comprehensive talents and the lack of innovation and enterprising spirit and so on,the author puts forward some proposals from the development of experimental teaching,the teachers' personal and professional growth and the institutional and policy level,such as strengthening the foreign exchange,making learning training plan and personal development planning,establishing the evaluation system of the experiment teaching quality and opening up a variety of learning methods to improve the teachers' comprehensive ability.

Objective To investigate and analyze the researches and guarantee mechanisms of Chinese undergraduate students' social practice, to understand the current situation of college students' social practice and research quality and to provide the reference for the development of college students' social practice guarantee mechanism in China. Methods With the “University” “college students”“social practice” as key words , we retrieved published documents about long-term mechanism of CUSSP dating to March 2014, from Chinese journal full text database(CNKI), China outstanding master's degree thesis database, Chinese Excellent Doctor Degree Dissertation Full-text Database, Wanfang, CMFD, CDFD,VIP, Google and Baidu, etc. We classified the including documents based on evidence-based scientific evidence grading standards, analyzed Grade C and above documents only. Results A total of 22 relevant studies were included; 4 of them are policy studies with Grade B, 18 of them are cross-sectional studies with grade C. The studies showed: ①The policy studies give important sugges-tions on the content, form, effect, construction and evaluation system of long-term mechanism of CUSSP.②18 cross-sectional studies surveyed over 14 504 students' social practice conditions show the method-ology of most of the studies is described unclearly or non-standard however. ③12 studies have inves-tigated the Chinese college students' attitude towards social practice and actual participation, with 5 studies about the time of participation and 5 about the condition of combination with specialty. The undergraduate students can recognize the importance of social practice, however, the range, duration and times of their actual participation are limited, and the combination with their major is not close enough. ④7 studies have investigated the main problems of college students' social practice and 5 studies have investigated the students' satisfaction. At present, there exist many problems in CUSSP, of which the most difficult things are: hard-to-contacting practice units, lack of funds, lack of teacher guidance, hard-to-determining the practical projects etc. The students' overall satisfaction is“general”. Conclusions ①There is lack of high-quality studies about CUSSP, and the methodology of studies should be improved and standardized. ②Strengthening the long-term mechanism and evaluation system construction is urgently needed to ensure that students can conduct long-term, effective and stable social practice.

AIM:To investigate the effects of antioxidant N-acetylcysteine(NAC)on the lipopolysaccharide(LPS)-induced MAPK phosphorylation in mouse liver.METHODS:54 male mice were divided into three groups:control(n=6),0.9% sodium chloride 0.2 mL ip;LPS group(n=24):LPS 5 mg ip;NAC+LPS group(n=24):NAC 150 mg?kg-1?d-1 ip,for 3 d;LPS 5 mg ip after 1 h of NAC administration at 3rd day.The liver was excised with carbrital anesthesia after LPS or 0.9 % sodium chloride injection at 0.5 h,1 h,2 h and 6 h for GSH and MDA assays.The protein extracted from liver was assayed for the phosphorylation of MEK1/2,ERK1/2,p38 MAPK by Western blotting.TNF-? in liver was assayed by radioimmunoassay.RESULTS:MDA in the liver was decreased remarkably and the GSH in the liver was increased significantly by NAC pretreatment.The phosphorylation of MEK1/2,ERK1/2 and p38 MAPK in liver were inhibited significantly by NAC pretreatment after LPS challenge.Meanwhile,TNF-? in liver was decreased markedly.CONCLUSION:Reactive oxygen species plays a critical role in MAPK signaling during the LPS induced acute liver injury.NAC partially inhibits LPS-induced MAPK signaling by antioxidant effect and decreases TNF-? production.

Human rhinoviruses (HRVs) are the causative pathogens in more than half of viral upper respiratory tract infections. Currently, no antiviral agents that are active against HRVs are available for clinical use. Because only higher primates are susceptible to HRVs, the screening of new drug is most commonly based on the cell line model. In this study, isolated rabbit airway smooth muscles (ASM) tissue model has been established, and the airway responsiveness with different treatment has been examined. Relative to control tissues, the maximal constrictor (Tmax) response to ACh increased significantly 150% in ASM inoculated with HRV, and relaxation to isoproterenol has been attenuated to 63%. And the abnormal responsiveness can be inhibited in presence of pretreatment with several new compounds which have been exhibited effective anti-HRV activity on cell lines. The results demonstrate that the established ASM model will be applied to screening the anti-HRVs drugs.

A series of 4-(2-acetoxybenzoylamino) butyrate derivatives were designed and synthesized. All of the novel 12 compounds (7a-7k) were synthesized from gamma-aminobutyric acid (1) as starting material, and their structures were confirmed with IR, 1H NMR, EI-MS and elemental analysis. Preliminary pharmacological test in vitro showed that most of these title compounds possessed antiepileptic activity. Compounds 7i-7k displayed strong antiepileptic activity and are worth for further development. Compounds 4, 7d-7h showed moderate antiepileptic activity. The structure-activity relationship of 4-(2-acetoxybenzoylamino) butyrate derivatives is also discussed preliminarily.

To explore new agents of gamma-aminobutyric acid (GABA) derivatives with more potent antiepileptic activity, a series of 4-(2-acetoxybenzoylamino) butyramide derivatives were designed and synthesized. All of the novel compounds (5a-51) were synthesized from GABA as starting material, and their structures were confirmed with IR, 1H NMR, EI-MS and elemental analysis. Preliminary pharmacological test in vitro showed that all target compounds displayed strong antiepileptic activities and were worth for further study. The structure-activity relationship of 4-(2-acetoxybenzoylamino) butyramide derivatives was also discussed preliminarily.

Objective To evaluate the effects and safety of uterine artery embolization for uterine leiomyoma. Methods Total of 185 patients with uterine leiomyoma were treated by UAE. They were followed for one to 6 years to observe the changes of leiomyoma size and improvement in clinical symptoms. Ovarian function was evaluated in 44 cases. Results Bilateral embolization of uterine arteries was performed in 185 patients. Follow-up of 1 ～6 years for 292 leiomyoma indicated that one to 9 months after embolization, shrinkage of leiomyoma size was the most significant factor. One year after embolization, leiomyoma sizes decreased a little. Shrinkage of submucous leiomyoma was more significant than that of intratumoral one, and the latter was more significant than subserous one. Shrinkage of leiomyoma with large size ( volume ≥ 150cm~3) was less than that of small one. Menorrhagia, anemia and pressure symptoms were all resolved. There was no significant difference between pre- and post embolization ovarian hormone level. Conclusions The significant reduction in leiomyoma volume and resolution of clinical symptoms confirmed that the treatment validity of symptomatic leiomyomas by UAE. UAE is an effective therapeutic procedure which has no adverse effect on the ovarian function.

AIMTo further elucidate the role of agmatine on the pharmacological effects of opioids. METHODSThe effect of L-arginine and L-arginine decarboxylase(L-ADC) antibodies on pain threshold, morphine ntinociception and tolerance were investigated in mouse acetic acid writhing test, mouse radiant heat tail flick test and mouse hot plate test. RESULTSIn mouse acetic acid writhing test, intracerebroventricular injection of L-arginine dose-ependently inhibited the writhing of mice compared with saline control. L-arginine did not influence the tail flick latency itself in mouse radiant heat tail flick test, but enhanced antinociceptive effect of morphine in a dose-dependent manner. The possible maximal analgesia percentage of morphine 2.5 mg*kg-1 was increased from 23% to 71%. Furthermore, L-arginine inhibited acute tolerance induced by morphine 100 mg*kg-1in mouse radiant heat tail flick test. The effect of L-arginine as mentioned above could be antagonized by idazoxan (3 mg*kg-1, ip), which is a selective antagonist of imidazoline receptors. L-ADC specific antibodies inhibited morphine antinociception and promoted the development of tolerance to morphine in mouse radiant heat tail flick test and 55℃ hot plate test. CONCLUSIONL-Arginine and L-ADC play important roles in the formation of pain threshold, morphine antinociception and tolerance.

OBJECTIVETo test whether 7 herbs stimulate human pregnane X receptor (PXR)-mediated CYP3A4 transcription.

METHODTransient cotransfection reporter gene assays were performed with human PXR expression plasmids and a reporter plasmid containing the XRES in the CYP3A4 gene promoter in HepG2 cells.

RESULTThe aqueous extracts of Chrysanthemi Flos, Lycii Fructus, and Salviae Miltiorrhizae Radix et Rhizoma, and the methanol extracts of Chrysanthemi Flos, Crataegi Fructus, Lycii Fructus, Lonicerae Japonicae Flos, Dioscoreae Rhizoma,and Salviae Miltiorrhizae Radix et Rhizoma, activated human PXR-mediated transcription.

CONCLUSIONThe aqueous extracts of Chrysanthemi Flos, Lycii Fructus, and Salviae Miltiorrhizae Radix et Rhizoma, and the methanol extracts of Chrysanthemi Flos, Crataegi Fructus, Lycii Fructus, Lonicerae Japonicae Flos, Dioscoreae Rhizoma, and Salviae Miltiorrhizae Radix et Rhizoma are inducers of CYP3A4 by activating PXR, and thus may influence the metabolism of other substrates on CYP3A4.

Cell Line ; Chrysanthemum ; Crataegus ; Cytochrome P-450 CYP3A ; drug effects ; genetics ; metabolism ; Dioscorea ; Drugs, Chinese Herbal ; pharmacology ; Gene Transfer Techniques ; Genes, Reporter ; Hep G2 Cells ; Humans ; Lonicera ; Lycium ; Medicine, Chinese Traditional ; Plant Extracts ; pharmacology ; Receptors, Steroid ; drug effects ; genetics ; metabolism ; Salvia miltiorrhiza

Objective:To investigate whether stress hyperglycemia (SH) is an independent risk factor for the occurrence and mortality of sepsis-associated encephalopathy (SAE).Methods:From August 2016 to October 2021, sepsis patients admitted to the ICU of Guangdong Provincial People's Hospital were selected as the study subjects. According to whether they developed to SH (RBG>11.1 mmol/L) within 7 days of enrollment, the pat ients were divided into the SH group and the non-SH group for analysis. Logistic regression was used to analyze whether SH was an independent risk factor for SAE occurrence, and ROC curve was used to analyze the predictive value of SH to SAE. Kaplan-Meier curve was used to compare the 90-day survival of SAE patients with or without SH. Cox regression analysis was used to analyze the risk factors of 28-day and 90-day death in SAE patients.Results:A total of 183 sepsis patients were included, including 62 patients in the SH group and 121 in the non-SH group. Logistic regression analysis demonstrated that SH was an independent risk factor for SAE ( OR=4.452, 95% CI: 2.021-9.808, P <0.001). ROC curve demonstrated that SH could accurately predict SAE (AUC=0.831; Sensitivity=78.4%; Specificity=76.8%; and Yoden index=0.553). Kaplan-Meier curve demonstrated that the 90-day survival of SAE patients with SH significantly declined (log-rank test: P<0.01). Cox regression analysis suggested that SH was a risk factor for death at day 28 and day 90 in SAE patients (28 d, HR=2.272, 95% CI: 1.212-4.260, P=0.010; 90 d, HR=2.456, 95% CI: 1.400-4.306, P<0.01). Conclusions:SH is an independent risk factor for SAE and can predict SAE occurrence. SH significantly reduces 90-day survival and increase mortality at 28 and 90 days in SAE patients.