The manuscript introduced the overview, training objectives, policy advantages, training process,curriculum, examination of the Australian College in Rural and Remote Medicine and further contrasted that with China's domestics.The authors held that Australia's training is better targeted due to its colleges tailored to this end;the training duration for general practitioners of rural and remote areas is longer,and the training schedule is reasonable;the curriculum design and training content are more targeted;and the homogeneous training is better achieved as its examination is run by the college in a standardized manner.The authors therefore hold that China should develop detailed regulations for general practitioners from rural and remote areas and explore the feasibility of setting up second-level disciplines institutes for internal medicine, surgery, gynecology and obstetrics, pediatrics and general at national and provincial level.

Objective To investigate the impact of relevant factors in mechanical ventilation on intraabdominal pressure in patients with ALI/ARDS by continuous monitoring of intra-abdominal pressure.Methods A total of 116 ALI/ARDS patients treated with mechanical ventilation in ICU were enrolled in this study.Intra-abdominal pressure (IAP) was recorded continuously.Meanwhile ventilator parameters, arterial blood gas analysis, hemodynamic variables, and as well as the levels of IL-4, IL-8 and TNF-α in blood and bronchial alveolar lavage fluid (BALF) were determined and recorded.The detection of risk factors for intra-abdomen hypertension (IAH) were carried out using multivariate stepwise logistic regression.ROC curve analysis used to estimate the diagnostic performance of these parameters for IAH.Results The oxygenation index (PaO2/FiO2) in patients with IAH after 2 hours' mechanical ventilation was significantly lower than that in patients with normal intra-abdomen pressure (IAP) (P ＜ 0.01);PEEP and RR in mechanical ventilation were higher in IAH group (P ＜ 0.01 or P =0.001);Mean artery pressure (MAP), ejection time percent (ET), stroke volume (SV), cardiac index (CI) were lower in IAH group than those in normal IAP group (P ＜ 0.01);the levels of IL-4, IL-8 and TNF-α in blood and bronchial alveolar lavage fluid were higher in IAH group than those in normal IAP group (P ＜ 0.01);IAH patients have a higher mortality on 28 d (Log rank test, P =0.023).Poor oxygenation index (PaO2/ FiO2) after 2 hours' ventilation, high PEEP setting, low MAP, ET, SV, CI and elevated IL-4 in the BALF were resulted in increasing risk of IAH for ARDS patients under mechanical ventilation support.Conclusions The monitoring of intra-abdominal pressure should be emphasized for ALI/ARDS patients when mechanical ventilation was employed.PaO2/FiO2, SV and IL-4 in BALF might be the independent risk factors of IAH.

ObjectiveTo investigate the effects of photodynamic therapy(PDT) on the activity and structure of the dental plaque biofilm formed by the main cariogenic bacteria.MethodsS.mutans,S.sangius,L.acidophilus and A.viscosus were chosen as the experimental bacteria to establish dental plaque biofilm model.They were separated into three groups:group of PDT、group of chlorhexidine and group of normal saline.The influence of the dental plaque biofilms was observed according to plate counting of bacteria method.The changes in the structure of biofilms after PDT were analyzed by means of confocal laser scanning microscopy.Results Compared to normal saline group,chlorhexidine cariogenic bacteria (CFU/ml) in plaque biofilms significantly reduced (P＜0.05),with the bactericidal rate 57.84％.After PDT treatment against artificial caries model,the number of cariogenic bacteria (CFU/ml) in plaque biofilms reduced more significantly (P＜0.05),the bactericidal rate up to 94.92％,and the structure of dental plaque biofilns changed evidently.ConclusionPDT is an effective method in eliminate cariogenic bacteria of dental plaque biofilms and to destroy the integrity of dental plaque biofilms,and it is a promising method for elimination of dental plaque and prevention of caries.

Objective To explore the clinical values of applying contact-mode argon plasma coagulation (APC) for retroflex colonoscopic treatment of ultra-lower rectal polyps. Methods 46 wide outsole and applanate polyps smaller than 1.0 cm located at ultra-lower rectum in 17 cases of patients were treated by contact-mode APC under U-type retroflex colonoscopy after failure in regular colonoscopic treatment. Then observe the contacting rate of APC probe with polyps, success rate of curing polyps, rate of probe being adhered and blocked by the solidification structures, incidence of submucosal emphysemas, and incidence of colonoscope ambustion. Results Under U-type retroflex colonoscopy, the probe could contact with polyps in 17 patients. The polyps in every patient were cured by APC in the first time of colonoscopic treatment, whereas all 46 polyps were cured by 97 times of APC spurt. Mild adhesions occurred between the probe and solidification structures at 5 times (5.15 %) among 97 times of APC spurt, without injuries to the coagulation surface from which when the probe separated. The solidification structures blocked the probe only twice (2.06 %). When the solidification structures were cleared, efficiency of the probe restored. No sub-mucosal emphysemas and colonoscope ambustion happened. Conclusion Applying contact-mode APC for retroflex colonoscopic treatment of ultra-lower rectal polyps is safe and effective, it can prevent the damage of colonoscope from the argon knife.

To clear the kinds of trace elements which is closely related with the active ingredient, proclaim the effects of trace elements on the quality of the Glycyrrhizae Radix et Rhizoma, provide the theoretical foundation to the further quality control of cultivation, take the advantage of the HPLC to determine the contents of glycyrrhizic acid and the liquiritin according to Chinese pharmacopoeia, use the inductively coupled plasma mass spectrometry to test the contents of Cu, Zn, Mn, Pb, Se, Cd, Ni, La, Na, Cr, M, Fe, Ca, Al, K, Sr, then, use SPSS statistical software for active ingredient and trace elements Correlation Analysis. The result of correlation analysis showed that Liquiritin contents of Glycyrrhizae Radix et Rhizoma have strong a positive correlation with the Mn, Pb contents, well, have a negative correlation with the Cu, Na contents; Glycyrrhizic acid contents showed a positive correlation with Mg, Cd, La contents, however, it showed a negative correlation with K, Fe contents. Comprehensive analysis of the results of the study, a preliminary thought that the active ingredient of Glycyrrhizae Radix et Rhizoma closely related with the trace elements, but the exact conclusion still need further study concentration-response relationship analysis.
Chromatography, High Pressure Liquid ; Flavanones ; analysis ; Glucosides ; analysis ; Glycyrrhiza ; chemistry ; Glycyrrhizic Acid ; analysis ; Mass Spectrometry ; methods ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Rhizome ; chemistry ; Trace Elements ; analysis

Powder X-ray diffraction (PXRD) technology combined with cluster analysis method was used to classify 75 batches of crystalline ceftriaxone sodium into subtypes, the crystalline characteristics of each subtype were measured with scanning electron microscope (SEM). By comparing some parameters of these subtypes correlated to crystallization process of ceftriaxone sodium, such as salification rate, water content in different subtypes, as well as by studying different lattice stabilities, different compatibilities with rubber closures during accelerated stability tests, the key point to improve the quality of domestic ceftriaxone sodium was disclosed. The results of this paper indicated that the fine structure of the products could be controlled well by improving the salification and crystallization process. As a result, the subtype II of ceftriaxone sodium with high stability can be produced.
Ceftriaxone ; chemistry ; classification ; Crystallization ; Microscopy, Electron, Scanning ; Powders ; Water ; X-Ray Diffraction

[Objective To explore the effect of problem-based learning(PBL) in biochemistry teaching in medical college. Methods Totally 128 students(2011 grade) of medical laboratory major were derived into experiment group(n=64)and control group(n=64). Lecture-based learning(LBL) was used in control group and PBL was used in experiment group.In control group,teachers did teaching design according to the needs of curriculum standards,employed multimedia courseware,explained the basic content of each chapter,class exercises and homework after class. In experimental group,PBL was conducted through establishing biochemistry teaching website based on school's teaching platform. Teach-ing process in experiment group included:grouping-selecting appropriate cases-consulting data-group discussing-summarizing by teachers. Theory test was carried out after the course and questionnaire was conducted for students in experiment group . Data were analyzed using the independent sample t test . Results Average test scores were higher in PBL group than in traditional group,with statistically signif-icant differences[(83.15±11.87)vs. (76.15±12.48)]. Questionnaire survey showed that more than 90.0%students in experiment group were interested in the PBL teaching method and thought that the PBL teach-ing method can enhance the enthu-siasm of learning, independent learning ability and comprehensive analysis ability. Conclusions PBL teaching method can improve the quality and the effect of biochemi-stry teaching and culture students' comprehensive ability. It is worthy of further study and popularization.

Exosomes, small vesicles of endocytic origin, have attracted attention in bone regeneration field. The vesicles travel between cells and deliver functional cargoes like proteins and RNAs, thereby regulating targeted cells dif-ferentiation, commitment, function, and proliferation. Exosomes directly regulate MSCs into the osteoblastic lineage, stimulate bone regeneration by directly regulating osteoblast proliferation and activity, regulate osteoclast maturation and activity and stimulate bone growth and regeneration by increasing vessel formation. Meantime, exosomes resolves toxicity and immunogenicity problems caused by biomaterial treatment. Furthermore, compared with living cell trans-plantation, exosomes present a lower risk for severe complication(such as tumors, emboli formation).

Animals ; Animals, Newborn ; Brain ; drug effects ; metabolism ; pathology ; Disease Models, Animal ; Excitatory Amino Acid Antagonists ; pharmacology ; therapeutic use ; Female ; Hypoxia-Ischemia, Brain ; drug therapy ; metabolism ; Ketamine ; pharmacology ; therapeutic use ; Male ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Treatment Outcome

BACKGROUND:C2 transpedicle screw fixation for Hangman fractures has been paid more attention due to reliability and no loss of physiological function.However,there are lacks of biomechanical evidences for indication treatment because the fixation is single segmental.OBJECTIVE:To investigate the biomechanical stability of C2 transpedicle screw fixation for Hangman fractures.DESIGN,TIME and SEITING:This was a contrast study which was performed at the General Key Laboratory of Biomechanics,First Military Medical University of Chinese PLA from May to August 2004.MATERIALS:AO-universal titanium alloy transpedicle screw of 18 25 mm in length and 3.5 mm in diameter was adopted in this study.Six fresh C1-C4 cervical vetebrae samples were ordiually made into type Ⅰ,ⅡA,and Ⅱ Hangman fracture models.METHODS:After transpedicle screw fixation.Hangman fracture models were measured by non-destroyed style with spinal anterior flexion/posterior extension,left/right lateral curvature,and left/right axial direction.Loading/unlonding circulation was performed three times during each testing.Kinematics indicators were measured on the 3rd circulation.MAIN OUTCOME MEASURES:Spinal motor images at zero load and maximal load were obtained with laser photoscanning(0.1% in precision),and the corresponding systematic software was adopted to calculate 3D range of movement.RESULTS:The relative stability of type Ⅰ Hangman fracture models after C2 transpedicle screw fixation was 100.62%(inflexion),96.91%(posterior extension),99.19%(lateral curvature),and 97.12%(rotation)as compared to control group (P＞0.05).The relative stability of type Ⅱ Hangman fracture models after C2 transpedicle screw fixation was 47.84%(inflexion),21.29%(posterior extension),65.98%(lateral curvature),and 41.69%(rotation)as compared to control group (P＜0.05).CONCLUSION:Biochemical evaluation suggests that type Ⅰ and Ⅱ A Hangman fractures do fit for C2 transpedicle screw fixation,and the fixation may generate well physiological fixation or stability.However,stability of type Ⅱ Hangman fracture is poor,so it is not suitably adopted single transpedicle screw fixation.