OBJECTIVE:To investigate outpatients' cognition(including knowledge,attitude and behavior)on adverse drug reactions(ADR),and to analyze the influential factors of ADR cognition.METHODS:An on-the-spot questionnaire survey was conducted in which a total of 488 outpatients sampled from our hospital from May to December in 2007 were investigated and the data analyzed statistically.RESULTS:The correct rate was 36.6% for the questions related to cognition on ADR.70.5% of the patients investigated had a poor cognition on ADR.The factors influencing patients' cognition on ADR included educational background,ADR experience,pharmacists' guidance on medication,source of medicine knowledge,occupation,doctors' guidance on medication,community ADR lecture,and gender.CONCLUSION:The outpatients have a poor cognition on ADR.Both doctors and pharmacists should offer guidance on medication and give lecture in community to inform patients the knowledge about rational administration and ADR.

Objective To compare the manipulation of two different methods of percutaneous dilatational tracheostomy (PDT),the guidewire dilating forceps (Portex method) and the modified onestep dilation technique (Ciaglia Blue Rhino method,CBR method).Methods From March 2013 to February 2014,48 patients eligible to meet the criteria of tracheostomy in ICU were collected and were divided into two groups at random.The length of time consumed for operation,amount of blood lost during operation and the operation complications were compared between two groups.The participant surgeons were asked which method they preferred,Portex or CBR.Results Of them,the mean age was 76.7 ± 11.6 years old,and 25 patients (52.1％) were male.The reasons for tracheotomy were the length of time needed for mechanical ventilation support expected to be longer than 2 weeks (n =30),severe disturbance of consciousness (n =17),and upper airway obstruction (n =1).The patients enrolled in the study were randomly divided into Portex and CBR groups.There were no significant differences in age,gender,APACHE Ⅱ score,the reason of tracheotomy,the length of time for mechanical ventilation support before tracheotomy,and the preoperative coagulation function between two groups.CBR method can easily be done with less operation time required than Portex [(5.9 ±4.3) min vs.(9.9 ± 1.5) min,P ＜0.01],and had obviously fewer operation complications and less amount of blood lost than Portex method (P ＜ 0.05).The male surgeons with a slew of surgical practice were in preference to Portex,whereas female doctors with less work experience and without surgical practice preferred CBR.Conclusions The CBR method can easier be done and was better than the Portex method in minimizing operative trauma and reducing the complications,especially it can easily be accepted by female doctors with less work experience and without surgical practice and it is worth using widely in clinic.

There is a long history of Toad venom in the treatment of cancer in China.Bufalin,extracted from Toad venom,is one of the biologically active compounds of anticancer.We elaborate the molecular mechanism of bufalin on anticancer activity from several aspects such as inducing cell apoptosis and differentiation,inhibitting cell proliferation and angiogenesis,enhancing the sensitivity of chemotherapeutics,which can provide the basis for in-depth study of Toad venom and its development and clinical medication.

Since the laparoscopic thyroidectomy carried out in China for ten years,this technique has become more and more mature,indications gradually broadened,and playing a vital role in the field of thyroid surgery.This article will explain this technique in the aspects of approaches,the establishment and maintenance of the surgical space,indications,antiindications and complications.

OBJECTIVE:To explore the antidepressant effects of bioactive compounds from paecilomyces tenuipes(BCPT)on expression of hippocampus and cortex mineralocorticoid receptor(MR),glucocorticoid receptor(GR)mRNA in CUS(chronic unpredictable stress)rats.METHODS:The depression model rat was produced by CUS,the therapy effect of BCPT was observed in CUS rats.It detected expression of hippocampus and cortex MR,GR mRNA with RT-PCR in CUS rats.RESULTS:BCPT could enhance the expression of hippocampus and cortex MR,GR mRNA or decrease the ratio of MR/GR mRNA in CUS rats.CONCLUSION:BCPT could obviously enhance the expression of hippocampus and cortex MR,GR mRNA or decrease the ratio of MR/GR mRNA in CUS rats,the result of this study suggested that BCPT possess certain antidepressant effect.

Problem-based Learning (PBL) is a teaching model originating from the construc-tivism theory, which stressed the meaning construction in problem situation by collaborative learning, conversation and completing knowledge. Based on the times background, development of learning theory, teaching situation, cognitive strategies, ideological connotation about constructivism, PBL's practical significance, its teaching forms, teaching resources, internal motivation, and the teaching evaluation were analyzed deeply, which was beneficial to carrying out PBL normatively in medical education, so as to provide the theoretical support for further exploration and innovation of PBL.

AIM: To study the acute toxicity of bioactive compounds from paecilomyces tenuipes (BCPT) and the effect of BCPT on lipid peroxidation of brain in chronic stress model (CMS) of depression in rats. METHODS: The depression animal model was induced by chronic unforeseeable stress (CUS). The maximally tolerated dose (MTD) was used to detect the acute toxicity of BCPT. UV spectrophotometer analysis technique was used to detect the activity of SOD, GSH-PX and CAT, and content of MDA and NO in rat's brain. RESULTS: The MTD of BCPT was 9 g?kg -1 . BCPT could obviously enhance the activities of SOD, GSH-PX and CAT, and also significantly inhibit the increase of MDA and NO content in brain in CMS rats. CONCLUSION: BCPT has little toxicity and produces an antidespressant-like effect in antioxidation in CMS rats.

Aim Exploration of the effects of bioactive compound from paecilomyces tenuipes (BCPT) on the behavior, ultrastructure of hippocampus, and expressions of BDNF and Bax of cerebral cortex in CUS rats. Methods The depression model rat was induced by chronic unpredictable stress(CUS). The Open field test was used to observe the behavior of CUS rats. The expressions of BDNF and Bax of cerebral cortex were studied using immunohistochemical method, and average optical density of cortical neuron was calculated by image analysis. Morphology of hippocampus was observed by transmission electron microscope. Results Compared with model group, BCPT could obviously increase the activity of ambulation and rearing and the number of positive neuron of BDNF, decrease the number of positive neuron of Bax, and effectively prevent pathological damage induced by chronic unpredictable stress. Conclusion BCPT may exhibit the effects of antidepression, up-regulate the expression of BDNF, down-regulate the expression of Bax, and improve of the ultrastructure of hippocampus.

Aim To study the effect of bioactive compounds from paecilomyces tenuipes(BCPT) on AVP content of hypothalamus,pituitary and expression of AVP mRNA of hypothalamus and behaviour in chronic unpredictable stress model of depression in rats.Methods The depression animal model was induced by chronic unpredictable stress.The behaviour of rats was tested in the open field.The effect of BCPT on AVP content in hypothalamus and pituitary was tested by radioimmunoassay.RT-PCR was used to test the expression of AVP mRNA in hypothalamus.Results BCPT could decrease the expression of AVP mRNA of hypothalamus and decrease AVP content of hypothalamus and pituitary in chronic stressed rats obviously.BCPT could increase ambulation and rearing score of chronic stressed rats in the open-field test.Conclusion BCPT exhibited an antidepressant-like effect may in part be associated with the decreasing AVP content of hypothalamus and pituitary,and the expression of AVPmRNA of hypothalamus in chronic unpredictable stress model of depression in rats

Aim To study the effect of bioactive compounds from paecilomyces tenuipes(BCPT) on antioxidization and lymphocyte proliferation in chronic unpredictable mild stress(CUMS) model of depression in rats.Methods Depression animal model was reproducted in CUMS,UV spectrophotometer analysis technique was used to detect the activity of SOD、GSH-PX and CAT,and content of MDA and NO in rat serum;lymphocyte proliferation was tested with MTT method.Results BCPT could obviously enhance the activities of SOD、GSH-PX and CAT,and also significantly inhibit the increase of MDA and NO content in serum in CUMS rats;BCPT decreased the serum from depressive rat inhibited ConA-induced lymphocyte proliferation.Conclusion BCPT produces an antidespressant-like effect in antioxidation and cellular immunological function in CUMS rats.