Virtual Reality is just emerging as an accepted scientific discipline. It has been widely used in medicine. The major applications of virtual reality for medicine are introduced from three areas :virtual humans,the fusion of virtual humans with real humans and virtual telemedicine. The advanced graphics behind medical virtual reality,such as computational demands,hardware and software environments is briefly discussed. This article also gives a summary of existing distributed VR systems.

Objective To assess the risk of emergent endotracheal intubations in pediatric intensive care unite (PICU ) and to de-termine the risk factors of complications .Methods A prospective study was conducted with unified tables to collected data of all e-mergent intubations occurring in PICU between November 2011 and May 2012 .All the children were divided into group of any com-plication and group of no complication .Results (1)69 .1% children of emergent intubations had complications including desatura-tion(67 .9% ) ,bradycardia(29 .8% ) ,vomiting (16 .7% ) .(2)Emergent endotracheal intubations were 1 .7 times more likely to occur off-hours .Off-hours intubations were associated with 2 .7 times the risk of complications as on-hours intubations .(3)In a multivari-ate logistic regression analysis ,the nasal tracheal intubation ,two or more attempts at intubation ,and off-hours intubation were asso-ciated with complications .Conclusion Emergent endotracheal intubation are 1 .7 times more likely to occur off-hours .off-hours in-tubations ,the nasal tracheal intubation ,two or more attempts at intubation ,are associated with complications .

Objective To investigate the effect of nuclear factor-?B (NF-?B), NF-?B-inducing kinase (NIK) and I-?B in basic fibroblast growth factor (bFGF) promoting gene expression and signal transduction of tenocyte NF-?B. Methods Tenocytes isolated from rabbits were divided into 3 groups with 8 dishes: no bFGF (Group A), 2 ng/ml bFGF (Group B) and 10 ng/ml bFGF (Group C). Cells in all dishes were cultured for 5 days. The effect of bFGF on tenocytes proliferation was examined by means of growth curve analysis. The mRNA was isolated after 5 days and the gene expressions of NIK,IKK? and IKK? induced by NF-?B investigated by reverse transcription-polymerase chain reaction (RT-PCR). Results The growth curve moved forward with the dosage increase of bFGF. Gene expressions of NF-?B,NIK, I?B kinase (IKK)? and IKK? were 0.4? 0.2 , 0.4 ? 0.1 , 0.3 ?0.1 and 0.2?0.1 respectively in the Group B and 1.8?0.5,1.0?0.3, 0.8 ? 0.2 and 1.5 ? 0.4 in the Group C. Gene expressions were all up-regulated in the Groups B and C posterior to adding of bFGF. Conclusions bFGF stimulates tenocyte proliferation and up-regulates gene expression of NF-?B,NIK,IKK? and IKK?, as indicates that the signal transduction of promoting tenocyte proliferation by bFGF may be through NF-?B pathway.

OBJECTIVE:To provide reference for improving the pharmacy self-taught undergraduate course system in general universities in China. METHODS:According to comparative study and researching related literatures,the situation of pharmacy self-taught undergraduate course system in general universities in China was analyzed,and reform ideas and programs were present-ed. RESULTS & CONCLUSIONS:Based onchemistry-biology-psychology-society-medicine-pharmacyin the overall framework of pharmacy undergraduate self-examination course system,it was designed with target of cultivating applied talents;related con-tents in public basic courses,humanities basic course and professional ethics course should throughout the whole teaching process;professional main course should be pharmaceutical knowledge-based,supplemented by medical related courses;the school should set vocational elective course to reform based on combining with the own teaching research direction,characteristics and career ori-entation of different self-taught students. The reform can develop applied talents with ability and political integrity,which meets the needs of social development.

AIM:The homologous recombination takes place in E.coli BJ5183 between shuttle vector and adenoviral backbone vector.Recombinants are selected for kanamycin resistance,and the linearized recombinant plasmid is transfected into 293 cells.In this study,AdEasy system was used to generate recombinant adenovirus vector carrying rat interleukin-10(IL-10) gene.METHODS:The experiment was conducted in Department of Microbiology,Qingdao University Medical College from August 2006 to May 2007.①The materials included five clean-grade SD rat,a shuttle vector pAdTrack-CMV,an adenoviral backbone plasmid pAdEasy-1,E.coli.BJ5183 and DH10B,and human embryo kidney 293 cells,which were given as a present by professor Luo.All animal treatment was accorded with the ethical standards.②Total RNA was extracted from spleen cells of rat stimulating by lipopolysaccharide.IL-10 cDNA was amplified by using RT-PCR.The gene of interest was firstly cloned into a shuttle vector pAdTrack-CMV.The resultant plasmid was linearized by digesting with restriction endonuclease Pme Ⅰ,and subsequently transformed into E.coli.BJ5183 cells with an adenoviral backbone plasmid pAdEasy-1.Finally,the linearized recombinant plasmid was transfected into adenovirus packaging cell lines 293 cells.Recombinant adenovirus vAd-IL-10 was obtained.The expression of green fluorescent protein(GFP) was observed under fluorescent microscope.293 cells were cultured in 96-well culture plate with 1 ?104 cells per well.Condensed virus stock solution was added into the plate at different ratios.Recombinant adenoviruses titer was determined.Three days later,total RNA was extracted from 293 cells by TRIzol one-step method,and contaminant DNA was digested by DNaseⅠ.Electrophoresis detected the expression of IL-10 mRNA.RESULTS:①GFP expression was observed 16 hours after packing of the linearized recombinant adenoviruses in 293 cells.The amplification product of replicationdeficient Ad-IL-10 virus was transfected into adenovirus packaging cell lines 293 cells.When the fourth and fifth generations were seeded in virus for 24-48 hours,fluorescence was found in almost cells,and 5.5?108 pfu/mL titer of Ad-IL-10 was obtained.Titer of vAd-GFP was 9.0?108 pfu/mL.②Total RNA was extracted from transfected 293 cells.Electrophoresis showed that 580bp amplification product was expressed obviously and recombinant adenovirus was duplicated in 293 cells.CONCLUSION:The recombinant adenoviral vector carrying IL-10 gene is successfully constructed using AdEasy system.Moreover,vAd-IL-10 recombinant adenovirus with high titer is prepared and transcribed in 293 cells.

Objective To investigate the possible contribution of PPAR-? coupled signaling pathways to rat liver regeneration (LR) at transcription level.Methods The above signaling pathways-related genes were obtained by collecting database data and retrieving pertinent literatures. The gene expression during LR was checked by Rat Genome 230 2.0 array, and LR-associated genes were identified by comparing difference between partial hepatectomy (PH) and operation control (OC) groups.Results Sixty four genes were found to be LR-associated. The number of initially and totally expressed genes occurring in initiation phase of LR, G0/G1 transition, cell proliferation, cell differentiation and structure-function reconstruction was 28, 4, 34, 2 and 72, 41, 247, 90 respectively. Classification of their expression patterns into 11 groups reflected diversity and complexity of gene expression alteration in LR. Conclusion PPAR-? coupled signaling pathways may promote glycogen synthesis in forepart, prophase and anaphase of LR, cell proliferation and migration in the whole LR, while inhibits inflammation during LR.

OBJECTIVE:To discuss the solution of therapeutic contradictions of bleeding and hemostasis in pulmonary embo-lism patients receiving warfarin anticoagulation. METHODS:The risk evaluation and dissolution of bleeding and embolism induced by warfarin anticoagulation were summarized by analyzing therapeutic duration of INR abnormal elevation in a pulmonary embo-lism patient receiving warfarin anticoagulation. Case analysis was based on foreign and domestic guideline and information. RE-SULTS:Referring to INR value,based on HAS-BLE,Caprini scale,China Expert Consensus on Anticoagulant Therapy of Warfa-rin,China Expert Suggestions on Prevention of Venous Thrombosis in Internal Inpatients and Guidelines of Prevention of VTE in Nonsurgical Patients of American College of Chest Physicians,clinical pharmacists and physicians adjusted the dose of Warfarin tablet timely. The patient was recovered after symptomatic treatment of anticoagulation,relieving cough and asthma,reducing phlegm,etc.,and then disagreed from hospital with drugs. CONCLUSIONS:The risk of bleeding and embolism for this type pa-tients can be evaluated and resolved on the basis of HAS-BLED,Caprini scale and relevant guidelines. At present,there still are some problems as deficient evaluation method,lack of large-scale high-level evidence and quantitative study. It is needed to carry out multiple center clinical study and drug interaction quantitative study actively,and develop suitable risk evaluation method so as to provide high-quality and valuable decision-making evidence.

12 gestational-week uterus) were treated in our hospital by LAVH. The operation time,intraoperative blood loss,and postoperative recovery of the patients were compared to another 110 cases that underwent TAH. Results The operation time in the TAH group was significantly shorter than that in the LAVH group [(109?27) min vs (130?22) min,t=-6.441,P=0.000]. During the operation,the LAVH group had a mean of (121?70) ml blood loss,which was significantly lower than that in the TAH group [(141?73) ml,t=-0.903,P=0.368]. After the operation,the patients in the TAH group had longer recovery time for gastrointestinal function and longer hospital stay than those in the LAVH group [(45?13) h vs (24?6) h,t=15.778,P=0.000;and (7?2) d vs (5?2) d,t=7.530,P=0.000]. Conclusions Compared to TAH,LAVH results in shorter hospital stay and fewer postoperative complications. It is a feasible and safe treatment for large uterus.

Objective To explore the effects of self-management strategies on self-efficacy and selfmanagement behavior in female college students with primary dysmenorrhea.Methods Implementing the plan that the interventional group (n=195) received self-management strategies,while the control group (n =196) did not received any intervention.Followed up six months,the self-efficacy and self-management behaviors and Visual Analogue Scale/Score (VAS) of dysmenorrhea pain were compared between two groups before and after the intervention.Results At the 6th month of observation period,the scores of self-efficacy in the intervention group (2.61 ±0.48) were significantly improved compared with the baseline (2.37 ± 0.36) and the control group(2.43±0.46) (both P＜0.05).Besides taking medicine to alleviate dysmenorrhea,other items in the self-management behaviors were significantly higher than baseline and control group (both P＜ 0.05).The mean of dysmenorrhea pain VAS of 6th menstrual period in the intervention group was lower than baseline and the control group (P＜0.05).Conclusion The self-management strategies can effectively improve the self-efficacy and self-management behaviors among female college students,and alleviate the degree of dysmenorrhea pain.

A serocpidemiologic study was conducted to approach the relation between HBV infection and PLC. In PLC patients, the positivity rates of HBsAg and anti-HBc are higher than that in the tumor and donors groups, but that of anti-HBs is lower. No significant difference between the HBV infections rates for PLA patients and donors was found. HBV infections pattern of patients with liver cirrhosis is very close to that of those with PLC.The outcome prompts that there is a relation between HBV infection and PLC, but it is not only one.