The application of analogue associative thinking in literature classification and the application of ana-logue reasoning in CBM and PubMed teaching were elaborated according to their abstractive , obscure , dry and dull contents , which showed that analogue thinking can achieve good results in medical literature retrieval teaching and improve the ability of students to analyze and solve their problems , and their innovative thinking .

Based on the brief introduction of the concept of evidence - based medicine and the importance of its education, the paper analyzes the advantages of launching this kind of education in medical library. Contents and modes are described in detail. It proposes va-rious forms of education should be carried out according to different user groups, so as to further promote the development of evidence-based medicine education.

Objective To discuss the indication and safety of vaginal birth after cesarean .Methods Prospective analysis was clone the 63 cases of successful vaginal delivery from scarred uterus during Jan 2009 to Dec 2012 in this hospital .Results Intensive observation revealed 21 successful cases of vaginal delivery without occurrence of uterus rupture or neonatal suffocation .Postpartum hemorrhage occurred only once .Conclusion Vaginal birth after cesarean is safe as long as its indication is strictly controlled .

[ ABSTRACT] AIM:To construct a prokaryotic expression plasmid to produce recombinant human tumor necrosis factor-related apoptosis-inducing ligand ( TRAIL) and to verify the biological activity of TRAIL.METHODS: The pro-karyotic expression plasmid pET-28a (+)-TRAIL114-281 was constructed.Human soluble TRAIL was obtained through opti-mized inducing protein expression and purification conditions.The biological activity of TRAIL was verified by CCK-8 as-say.The apoptosis-inducing effect of TRAIL alone and/or in combination with proteasome inhibitor bortezomib ( Velcade, PS-341) on the tumor cell lines H460 ( TRAIL-sensitive) and K562 ( TRAIL-resistance) for 24 h was determined.The ap-optotic rates of the cells were analyzed by flow cytometry with Annexin V-FITC/PI staining.The activities of caspase-8,-9 and -3 in the cells were detected by colorimetric method.The protein expression of Bax, Bcl-2 and cFLIP was measured by Western blot.The expression of DR4 and DR5 in the H460 cells and K562 cells after treated with bortezomib for 24 h was detected by flow cytometry.RESULTS:The recombinant human soluble TRAIL protein with stable bioactivity was success-fully acquired, which induced apoptosis in H460 cells and K562 cells.After treatment with different concentrations of TRAIL, the apoptotic rate of H460 cells was significantly increased with the increase in the concentration of TRAIL ( P<0.05), but the apoptotic rate of K562 cells was not affected by the increasing TRAIL concentration.Apoptotic rate in com-bination group was obviously higher than that in single group ( P<0.05 ) .In the process of apoptosis, the activities of caspase-8,-9 and -3 in H460 cells and K562 cells were both increased.The expression of Bcl-2 and cFLIP in treatment groups ( especially the combination group) was decreased compared with control group.No significant change of the Bax expression level was observed.The expression of DR4 and DR5 in the H460 cells and K562 cells was significantly up-regu-lated after treated with bortezomib ( P<0.05 ) .CONCLUSION: Bortezomib combined with recombinant human soluble TRAIL synergistically induces apoptosis in tumor cell lines H460 and K562 through initiating intrinsic apoptotic pathways by up-regulating death receptors DR4 and DR5, and reducing the expression of antiapoptotic proteins Bcl-2 and cFLIP.

AIMTo establish a collagen sandwich system (CSS) wit h self-prepared collagen for rat hepatocytes culture[FQ(14*2。46,X-WZ]in vitro, and study the effect of CYP3A substrates on cyt o chrome P450 activities of hepatocyte cultured by CSS. METHODSS terilized type Ⅰ collagen was prepared from rat tail tendons. The morphology of hepatocyte cultured by collagen coated (CC) and CSS method was investigated and compared. Activities of ALT, AST, and LDH in aliquots of extracellular medium w ere measured by biochemical assay. CYP1A, CYP2E1 and CYP3A activities of hepatoc ytes were also determined. RESULTSBy CSS method, the shape of hepatocytes was maintained, and the structure of cells was integrated after cult ivated for 6 d. However, in CC method after 3 d, hepatocytes dropped from the co llagen matrix, and the activities of ALT, AST and LDH in aliquots were increased . As compared with control group, in CSS cultivated hepatocytes, the activities of CYP3A increased 33%, and CYP2E1 decreased 45% by nimodipine, and CYP3A was in duced 1 94-fold (P

AIM To explore a long-term Kupffer cell culture method, which can best maintain the function and activity of cell and decrease the cellular damage. METHODS Lactic dehydrogenase (LDH) in the supernatants were measured to observe the severity of cellular damage ,the function of Kupffer cell was reflected with the nitrogen monoxide(NO) content and the intracellular acid phosphatases(ACP) activity. In the conditions of common culture(CC),single collagen culture(SCC) and double collagen culture(DCC), with or without serum, study the maintenance of cellular function and the severity of cellular damage. RESULTS Compared with the other two methods, the LDH contents were significantly lower( P

To cultivate nursing students with international professional ability for higher vocational education is the key to promote the internationalization of Chinese nursing field. Through analyzing the de-veloping trends and problems of international nursing education in China, based on the international nurses' ability, and study from the nurses training model of Philippines, the international nursing training model was constructed. The paper discussed the selection and retention of students, emphasizing the cultivation of students' international nursing concept and professional English, focusing on the ISPN curriculum and the integration of theory and practice, encouraging the cooperation of international school and faculties sharing, adapting the students-centered teaching methods, and establishing a corresponding sound evaluation system.

Objective To investigate the understanding level of asthma related knowledge and the treatment compliance in parents of children with asthma in Tianjin. Methods Questionnaire survey was given to 93 randomly selected parents of children with asthma at our asthmatic clinic ,whose children began to receive regularly asthmatic administration for at least 6 months from June to July in 2009. Results 72.04% of the parents included into the survey knew that asthma was a chronic airway inflammatory disease; 100% of them adhered to use prescription inhaled corticosteroid (55.91%) or inhaled corticosteroid combined with an inhaled long-acting β2-agonist (44. 09% ) ;74. 68% of them believed that if the child is in a well control state, he/she could participate in exercise as healthy children. There were 93.55% and 97.85% children patients aged ＞ 5 had never used PEF meter or CACT respectively to monitor the ill conditions. 25.81% of the parents chose rapid-acting β2-agonist to deal with asthma at acute attack stage, while 19.35% chose to add antibiotics and 11.83% were unable to do anything. 43.01% of the parents worried that the long-term use of inhaled corticosteroid would have side effects on the growth and development of their children, although they chose to obey to the doctor's prescription. Conclusions The general understanding of asthma is good in the parents, whose children had received asthmatic administration regularly in Tianjin area,but there are still some weak links exist. The related education may help asthmatic children's parents to master the knowledge of asthma, give them correct recognition of the treatment and prevention of asthma,increase the treatment compliance. This work should be insisted continuously.

Objective To evaluate the correlation between ultrasonography and histopathology in acute lung injury of rats.Methods Twenty male Wistar rats were randomly divided into control group (4 rats) and experimental group (16 rats),in the experimental group acute lung injury models were step-by-step induced by oleic acid (OA) and sequentially by OA and lipopolysaccharide (LPS).After the end of each step of models,ultrasound examination was applied,and the rats were sacrificed to take the lung specimens to be observed.The ultrasonography and pathological results were analyzed,and the numbers of alveolar were counted under microscope (200 times).Results With the aggravation of acute lung injury,the sonographic findings showed unclear or disappeared pleural line,close-set of B-lines,and pulmonary consolidation with air bronchogram.For control group,the ultrasonographic score was 0.25 ± 0.50,lung injury pathological score was 0.50 ± 0.58,and the numbers of alveolar were 25 ± 3.For OA group,the ultrasonographic score was 2.86-± 1.35,lung injury pathological score was 6.28-± 0.76,and the numbers of alveolar were 10-± 2.For OA + LPS group,the ultrasonographic score was 5.83-± 2.32,lung injury pathological score was 9.83 ± 0.98,and the numbers of alveolar were 6-± 2.All 3 groups were significant different on ultrasonographic score,pathological score and alveolar counts (P ＜ 0.01).Conclusions The ultrasonography image of acute lung injury of rats were positively correlated with its histopathological alteration.The ultrasonography can effectively evaluate the degree of acute lung injury of rats.

Objective To explore the pregnancy outcomes of women with pancytopenia and the risk factors for the adverse perinatal outcomes.Methods A total of 106 pregnant women with pancytopenia were admitted to Peking University People's Hospital from Jan.2005 to Sep.2014.The clinical data and the pregnancy outcomes were reviewed retrospectively to investigate the risk factors for the adverse perinatal outcomes.Results (1)Eighty-four patients were found pancytopenia before pregnancy while 22 were found for the first time during pregnancy.Sixty-four patients were diagnosed as aplastic anemia;30 as myelodysplastic syndrome;2 as paroxysmal nocturnal hemoglobinuria;4 as hypersplenism,and 1 as anti-phospholipid syndrome.Diagnoses of the remaining 5 patients were uncertain.(2)Sixty-nine patients received at least one time blood transfusion before delivery.(3) As for the complications,nine women developed gestational diabetes;twenty-two suffered severe preeclampsia (SPE);two were diagnosed as anemic heart disease and three experienced respiratory tract infection.The postpartum blood loss ranged from 50 ml to 3 800 ml,with the median of 400 ml.And six women had the blood loss more than 1 000 ml.The gestational age at delivery ranged from 24 weeks to 40 weeks,with the median of 37.0 weeks.(4)Thirty-one patients suffered adverse perinatal outcomes,including 3 cases of intrauterine death,4 therapeutic labor induction before 28 gestational weeks,6 premature delivery before 34 weeks.There were 2 neonates complicated with intracranial hemorrhage,2 with neonatal respiratory distress syndrome,3 with hypoxic-ischemic encephalopathy,2 with severe asphyxia and death,and 14 with small for gestational age.Among the patients with adverse perinatal outcomes,26 women received blood transfusion during pregnancy and 17 developed SPE.The maximum and the minimum value of their white cell count (WBC),hemoglobin concentration (Hb) and blood platelet count (BPC) were (4.9± 1.4)× 109/L,(2.9±0.8)× 109/L,(88.6± 14.9) g/L,(57.9 ± 14.5) g/L,(47.7±27.4)× 109/L and (11.9 ± 12.3)× 109/L,respectively.For those patients without adverse perinatal outcomes,43 received blood transfusion during pregnancy and 5 developed SPE.The maximum and the minimum value of their WBC,Hb and BPC were (5.2±1.5)×109/L,(3.2±0.9)×109/L,(101.4±16.2) g/L,(71.9 ± 14.5) g/L,(52.3 ± 24.0)× 109/L and (19.0 ± 12.1)× 109/L,respectively.The multivariate regression analyses indicated that SPE,Hb less than 70 g/L and BPC less than 20× 109/L were the independent risk factors for the poor perinatal outcomes in pregnant women with pancytopenia (P＜0.05).Conclusions The incidence of adverse perinatal complications increased dramatically in pregnant women with pancytopenia.Concurrent SPE,minimum Hb less than 70 g/L and minimum BPC less than 20 × 109/L may be the independent risk factors for the adverse perinatal outcomes.