The institute of higher medical education has witnessed an apparent development along with the context of mass education.However,new problems and contradictions have meanwhile limited its normal development.After an analysis of a series of structural contradictions,the writer of the present paper has put forward several measures centering around the innovative education so as to completely promote the education quality and the healthy development of the higher medical education.

This paper expatiates on the concept of higher-order thinking skills. From the necessity of cultivating students with higher-order thinking skills,the paper analyzes how to cul-tivate students'higher-order thinking skills according to the constructivism and provides an im-portant reference for the educational case teaching.

The current mental health of college students can not be optimistic.This paper summarized college students' psychological crisis from the perspectives of psychological crisis and crisis intervention,came up with updated research outcomes and deficiencies,and pointed out the direction of its future research and development.

Objective To explore the strategies of prevention and treatment of MRSA infection in ICU patients. Methods The clinical data of 6 patients with MRSA infection occurring at the same time in ICU were reviewed retrospectively. Results Vancomycin was given in 4 cases, 250mg twice daily, and teicoplanin was given in one case, 400mg once daily. MRSA cultures were negative in 5 cases after antibiotic treatment. Conclusions MRSA infection occurs frequently in ICU patients, and it spreads readily. Antibiotic treatment, isolation and bacteriological monitoring are very important measures for control of MRSA infection in ICU patients. [HS(1*2/3]

[Summary] Dyslipidemia after organ transplantation is one of the important risk factors of postoperative cardiovascular disease and graft dysfunction. There are many factors that result in postoperative dyslipidemia. However, the factors influencing serum lipid levels are changing with the development of organ transplantation. In this article the effects of different anti-rejection drugs such as cyclosporine, azathioprine, mycophenolate mofetil, tacrolimus, rapamycin ( sirolimus ) , corticosteroids, and monoclonal antibody on dyslipidemia after organ transplantation were summarized in different eras.

Objective To evaluate the clinical diagnostic significance of clinical laboratory indexes of anti-CCP,rheumatoid factor (RF),C reactive protein(CRP)and erythrocyte sedimentation rate(SR)in rheumatoid arthritis.Methods Anti-CCP,RF and CRP were quantitatively tested in 90 patients confirmed as rheumatoid arthritis(RA)and 93 patients with non-rheumatoid arthritis(non-RA)diseases by the electrochemiluminescence immunoassay(ECLIA),immunization rate scattering turbidimetry,etc.T test results were performed the statistical and comprehensive analysis by using the ROC curves.Results The levels of anti-CCP and RF had statistical differences between the RA group and the non-RA group(P <0.05 ),while there was no statistically significant differ-ences in the levels of CRP and SR(P >0.05 ).The areas under ROC curves(AUC)of anti-CCP,RF,CRP and SR were 94.0%, 84.0%,51.7% and 56.5% respectively;the sensitivity of anti-CCP and RF was 90.0% and 74.4% respectively,while the specifici-ty was 94.6% and 86% respectively;the Youden indexes were 84.6%and 60.4% respectively;the diagnostic sensitivity of CRP was only 52.2% and the diagnostic specificity of SR was only 50.5%.Conclusion Anti-CCP and RF have the good diagnostic value for RA,moreover the diagnostic performance of anti-CCP is better than RF;CRP and SR have the poor diagnostic preformance,the combination of above indexes has more clinical significance for diagnosing RA.

OBJECTIVETo comparatively observe the curative effect, adverse reaction and compliance of Modified Xiaoyao Pill combining amitriptyline (MXP-At) in treating patients with depression.

METHODSSixty-four patients with diagnosis of depression matched to the Chinese Classification of Mental Disorders (CCMD-3) were randomly assigned to 2 groups, the treatment group treated with MXP-At and the control group with fluoxeline, 32 cases in each group. The curative effect was evaluated by Hamilton depression (HAMD) scale and the adverse reaction was recorded before treatment and at the 2nd, 4th and 12th week of the treatment. Patients were regularly followed up from the 12th week to the 24 th week. The curative effect and compliance in the two groups were compared.

RESULTSThe HAMD score dropped in both groups from the 2nd week of the treatment, and at that time, it was lower in the control group than that in the treatment group (P < 0.05); but at the 4th week, no significant difference was found in the therapeutic effect and the HAMD score between the two groups. However, 3 and 14 cases in the treatment and the control group were relapsed during the 12 weeks of follow-up respectively.

CONCLUSIONMXP-At shows a curative effect similar to fluoxetine on depression but with less adverse reaction, and is not expensive.

Adolescent ; Adult ; Amitriptyline ; therapeutic use ; Antidepressive Agents, Tricyclic ; therapeutic use ; Depression ; drug therapy ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Patient Compliance ; statistics & numerical data ; Phytotherapy ; Treatment Outcome ; Young Adult

Objective:To study the role of protein kinase C-δin the Dectin-1-Src-Syk-mediated killing of Candida albicans by macrophages and investigate the molecular mechanism of antifungal innate immunity .Methods:Cell surface receptors were accessed by Flow Cytometry.Mouse bone marrow derived macrophages were pre-incubated with different protein kinase inhibitors and then stimulated with C.albicans.The phosphorylation of related proteins was determined by Western blot.The ROS production,phagocytosis and killing of C.albicans by macrophages were measured.Results:Either Src or Syk inhibitor reduced C.albicans induced PKC-δphos-phorylation.PKC-δinhibitor Rottlerin reduced p40phox phosphorylation,ROS production and killing of C.albicans but had no effect on the phagocytosis of C.albicans by macrophages.Conclusion:PKC-δinhibitor Rottlerin reduced the killing of Candida albicans by mac-rophages through the inhibition of NADPH complex activation and ROS production ,suggesting that PKC-δplays an important role in an-tifungal innate immunity.

Aim To determine whether pranlukast (ONO-1078), a cysteinyl leukotriene receptor antagonist, possesses therapeutic effect when administered after focal cerebral ischemia in mice. Methods Persistent focal cerebral ischemia was induced by middle cerebral artery occlusion. Pranlukast and edaravone, a positive control drug, were ip injected 1, 6 and 24 h after ischemia. The neurological deficits were evaluated by neurological scores and inclined plane test 24 and 48 h after the surgery. Forty-eight h later, the brain slices were prepared for measurements of infarct volume and the ratio of ischemic/non-ischemic hemispheres. Brain sections were cut and examined for neuron densities in different regions of the brain. The effects of pranlukast and edaravone were evaluated by the changes of these variables. Results Pranlukast (0.1 and 0.2 mg?kg -1) and edaravone (3 and 10 mg?kg -1) significantly reduced the neurological deficits, infarct volume (maximally 82.3%), ratio of ischemic/non-ischemic hemispheres, and attenuated the reduction of neuron densities in hippocampal CA1 region, cortex and striatum. Conclusion Pranlukast possesses therapeutic effect on ischemic insults when administered after ischemia as effective as edravone, indicating a therapeutic potential in the treatment of ischemic stroke.

Objective To investigate the regularity of intrapulnonary lobar and segmental lymph nodes metastasis in patients with cT1N0M0 stage lung adenocarcinoma.To provide a basis for more accurate determination of N stage and indication for pulmonary segmental resection.Methods A prospective study was performed from March 2014 to December 2015.103 cases of cT1 N0M0 stage lung adenocarcinoma received lobectomy and mediastinal lymph node dissection in the thoracic surgery department of China-Japan Friendship Hospital.Intrapulmonary lobar and segmental lymph nodes were dissected and sorted carefully then sent to the pathological department with the corresponding lung specimen and other lymph nodes.Statistical analysis was carried out considering size of the lesion,imaging features,serum CEA levels,pathological subtypes and so on.Results In total 103 cases,pN0 was confirmed in 82 cases,pN1 in 15 cases,pN1 + N2 in 5 cases,and skipping-pN2 in 1 case.14 cases(93.3％) in pN1 group were detected with station 12-14 lymph node metastasis,while only 5 cases (33.3％) were detected with station 12-14 LSNs metastasis.4 cases(66.7％) in pN2 group were detected with station 12-14 lymph node metastasis,while only 1 case(16.7％) with station 13 and station 7 lymph node metastasis.If LSNs were not detected,the false negative rate of N staging could be as high as 6.1％ (5/82),The rate of missed diagnosis of lymph node metastasis might be 30％ (6/20) to N1 stations alone.41.2％ (7/17)cases with metastasis to the adjacent LSNs had been proved with metastasis to the isolated LSNs.The metastasis rate of the isolated LSNs was significantly lower(P =0.049) in pure GGNs compared with those part-solid/solid nodules.Invasive adenocarcinoma had higher metastasis rate of isolated LSNs,compared with preinvasive lesions or minimally invasive adenocarcinomas,with no statistical difference between groups (P =0.055).No significant difference in isolated LSNs metastasis rate was found between groups with different serum CEA levels(P =0.251) or tumor size(P =0.197).Conclusion Dissection of intrapulmonary lobar and segmental lymph nodes might facilitate a more accurate N stage,reduce the false negative rate of lymph node metastasis,and provide basis for more accurate assessment of prognosis and postoperative adjuvant treatment.The sampling area of lymph nodes during segmental resection should include the adjacent LSNs of the target segment.The isolated LSNs metastasis rate of cT1N0M0 stage lung adenocarcinoma with pureGGN as imaging feature is relative low,which might be suitable for segmentectomy when meeting other criteria.