The enrollment of foreign medical students has expanded year after year.The education of foreign students becomes an important part of college education.In order to explore an effective method of medical education,the difference between Chinese students and foreign ones has been analyzed and the experience has been concluded according to the practice in teaching clinical diagnostics in recent years.

Objective To establish a rapid, accurate and low-cost screening method for the detection of calreticulin (CALR) mutations in myeloproliferative neoplasms (MPN).Methods Seventy cases diagnosed with MPN were collected from 2012 to 2016. PCR combined with high resolution melting (HRM) analysis were used to screen the CALR mutations, and Sanger sequencing and T-A sequencing were applied to verify the HRM positive samples. CALR wild type DNA, type 1 and type 2 mutant DNA samples were selected and analyzed 4 times/day for 5 days to detected the CVs of Tm (melting temperature) respectively. JAK2 mutations were also analyzed in MPN patients to compare the association between JAK2 and CALR mutations.Results PCR-HRM analysis showed 7 cases (26.9%) and 5 cases (20.8%) patients with CALR mutations were screened out from 26 essential thrombocythaemia (ET) cases and 24 primary myelofibrosis (PMF) cases, but no CALR mutations were found in cases with polycythaemia vera (PV). All mutations were confirmed by direct sequencing or cloning sequencing. The CVs for HRM analysis of CALR wild type DNA, type 1 and type 2 mutant DNA samples were 1.91%,1.59% and 1.43%, respectively.There were 47 cases with JAK2 V617F and 1 case with exon12 mutation. No coexistence of JAK2 mutation and CALR mutations were found in a single sample.Conclusion PCR-HRM can be used for rapid screening of CALR mutation. Subsequent sequencing can be applied for rapid diagnosis of MPN patients in clinical practice.

BACKGROUND: Pancreatic stem cells can be differentiated into endocrine functioning cells under a suitable cultivation condition, suggesting that pancreatic stem cells can be used as a new source of islet in treating diabetes mellitus.OBJECTIVE: To discuss the expression of stem cell in different purities of pancreatic islets.DESING: A controlled observation based on cells.SETTING: Third People's Hospital of Mianyang City.MATERIALS: The experiment was conducted in the Center Laboratory (Key Laboratory of Chongqing City), the First Affiliated Hospital of Chongqing Medical University from March 2005 to March 2006. Thirty healthy male SD rats, of clean grade, aged 50 days were used in this study. During the experiment, the disposal of animals corresponded to Animal Ethical Standard. Cytokeratin (CK)-19 and β-actin were designed by Shanghai Invitrogen Biological Co., Ltd.Brdu reagent, mouse anti-rat Brdu monoclonal antibody, rabbit anti-mouse (RAM) CK-19 polyclonal antibody and Brdu immunohistochemical kit were from Boster Co., Ltd. (Wuhan); HistostainTM -DS double immunohistochemical staining kit was purchased from Beijing Zhongshan Company.METHODS: Rats were intraperitoneally injected with Brdu for labeling, and subjected to perfusion with Ⅴ-type collagenase via pancreatic ducts, with pancreas being excised, ripped, beaten up, digested and centrifuged to obtain pancreatic islet sediments. After being precipitated, the sediments were divided into 3 groups. Group A: The isolated sediments of islets were not purified; Group B: The sediments were added slowly with 25% Ficoll-400 and Hanks solution for purification; Group C: The sediments were slowly added with 25% Ficoll-400, 11% Ficoll-400 for purification in order.MAIN OUTCOME MEASURES: Expressions of Brdu and CK-19-positive cells in the islet samples were detected by immunohistochemical method, and mRNA expression of CK-19 in the different purities of islets was detected by reverse transcription-polymerase chain reaction.RESULTS: ① The purity of islets in the group A was the lowest. The purity of islets obtained by different purification techniques showed significances among the three groups (F =89.42, P ＜ 0.05). ②Positive expressions of Brdu and CK-19 in the group A were significantly higher than those in the group B and group C (F =18.64, 22.12, 38.61. P ＜0.01). ③Expression of CK-19 mRNA in the group A was significantly higher than that in other groups, with group C showing the lowest.CONCLUSION: Expressions of Brdu and CK-19-positive cells exist in different purities of islets, suggesting the existence of more stem cells in the low purify of islets.

Objective To investigate the effects of attentional bias training on mood and disease uncertainty in anxious patients with coronary artery intervention treatment during transition period. Methods A total of 82 anxious patients with coronary artery intervention treatment during transition period were assigned into control group (28 cases), escape-negative-training group(27 cases) and positive-direction-training group (27 cases) by random digits table method. Patients in control group only received routine psychological counseling, while patients in escape-negative-training group and positive-direction-training group also received spot-type attentional bias training(200 trails/time,10-15 minutes/time,2 times/week, all 4 weeks in the two groups;the negative and neutral words between the probe points were 20%and 80%in escape-negative-training group,and positive and neutral words between the probe points were 100%and 0 in positive-direction-training group). All the patients were evaluated by Stroop test, Self-evaluation of Anxiety Scale (SAS), Attention to Positive and Negative Information Scale (APNIS), Profile Of Mood States (POMS) and Illness Uncertainty Scale (IUS). Results After intervention, 21.4%(6/28) was alleviated in the control group, while respective 70.4%(19/27) and 44.4%(12/27) in escape-negative-training group and positive-direction-training group (χ2=8.15, P=0.003). There were no significant differences in SAS, POMS, Stroop test, APNIS and IUS among three groups (P>0.05). After intervention, the SAS, negative emotion scores in POMS (tension-anxiety, depression-dejection, fatigue-inertia, baffling-confusion) and IUS were lower in escape-negative-training group than those in control group(Q=3.79-7.58, all P<0.01);and the SAS and IUS were lower in positive-direction-training group than those in control group, while positive emotion scores in POMS (vigor-activity) higher than those in control group (Q respective was 3.11, 4.34, 6.12, all P<0.05). The SAS, POMS (tension-anxiety, depression-dejection, fatigue-inertia, baffling-confusion, vigor-activity) were more improved in escape-negative-training group than those in positive-direction-training group (Q = 3.09-4.04, all P<0.05), while no difference in IUS (P>0.05). Conclusions Attentional bias training could improve the anxiety symptoms and reduce illness uncertainty in anxious patients with coronary artery intervention treatment during transition period. Escape-negative-training is more effective in reducing patients′ negative mood and alleviating anxiety symptoms than the positive-direction-training.

This article was aimed to study the action of antigout effects of compoundWeifu. Through the acute gouty arthritis models of rabbits and rats induced by micro-crystal sodium urate (MSU). The histopathological changes of synovial tissues among rabbits were observed. And the contents of TNF-α, IL-1β, IL-6 in rabbit serum were determined. The swelling degree of the rats’ feet and the content of prostaglandin E2 (PGE2) from the inflammatory exudate foot induced by MSU were also determined. The antigout effects of compoundWeifu were observed. The results showed that the grade of the vascular congestion, swelling and inflammatory cell infiltration in synovial tissues in the high-dose and medium-dose CompoundWeifu group had significantly improved (P <0.05). And the levels of TNF-α, IL-1β, IL-6 in serum were significantly decreased (P< 0.05, orP < 0.01). It can obviously reduce the swelling degree induced by MSU, and the level of PGE2 in the inflammatory exudate foot (P< 0.05, orP < 0.01). It was concluded that CompoundWeifu had obvious antigout effects in the study.

Hepatic ischemia/reperfusion injury is an important restricting factor of clinical liver resection and liver transplantation.When the liver is transiently deprived of blood followed by repeffusion,a large number of various mediators are released that can lead to cellular and,eventually,organ dysfunction.This review summarizes the pathogenesis and the protection mechanisms of hepatic ischemia/reperfusion injury.

Objective To discuss the diagnostic value of multi-slice spiral CT (MSCT) in distinguishing the severe acute respiratory syndrome (SARS) from community acquired pneumonia (CAP), and to evaluate the prognosis in these two groups. Methods A retrospective study was performed on 64 cases with SARS (28 men, 36 women, aged 18-93 yrs, mean age 42.3 yrs) and 46 inpatients with CAP (29 men,17 women, aged 28-88 yrs, mean age 70.1 yrs). Pathogens of respiratory tract were found in 23 patients of CAP. All of patients underwent MSCT scanning of the chest. Results The sensitivity, specificity, and accuracy for diagnosis of SARS using a combination of 3 factors, including ground-glass opacities of lung parenchyma in chest CT, age, and WBC counts were 93.8%, 60.9% and 80.0%, respectively. The sensitivity, specificity, and accuracy for excluding SARS using a combination of consolidation of lung lesions, fiber stripe components and thicken bronchus wall of lung CT in CAP patients were 91.3%, 82.8%, and 86.4%, respectively. The death in SARS and CAP was 7 (10.9%) and 4 (8.7%), respectively. The late follow-up results indicated that 48.8% (21/43 cases) of SARS cases left abnormal manifestations in the lung. The lung sequela of the patients over 50 yrs tended to be severe with the age. Conclusion In outbreak region of SARS, MSCT plays an important role in early diagnosis, but we need to closely combine the density features of lung lesions and other manifestations of lung with clinical condition of patients to increase the accuracy for the differential diagnosis of SARS from CAP. The prognosis of patients over 50 yrs with SARS is relatively poor.

Objective To explore the exposure condition of DDR, screen -film radiography and the radiation dose to patients, and evaluate value of the DDR system. Methods Five thousand images of DDR and screen-film radiography were selected and then analyzed by three junior radiologists and two senior radiologists. Results 1.The quality of the images was classified into grades A ,B ,C: grade A in 92.8 % , grade B in 7.2 % , grade C in 0% ,waste in 0 % for DDR group and grade A in 40.8% , grade B in 41.7 %,grade C in 15.5 % ,waste in 2% for screen-film radiography group. 2. The required voltage of DDR system raises 3-24kV than screen-film radiography and radiation exposure was increased about 25 % . Conclusions The imaging quality of DDR was obviously higher than the screen -film radiography, but the disadvantage of DDR system was the higher exposure condition required, which increase X-ray radiation dose for patients.

Objective To explore the effects of bioactive parts of Xiongma Decoction (parts of ethyl acetate and n-butanol extract) on the CGRP-CRLR/RAMP1 signal pathway so as to clarify its therapeutic mechanism on migraine.Methods We randomly divided 36 male SD rats into 6 groups with 6 in each:blank group,model group,groups of low-,medium-and high-dose Xiongma Decoction bioactive parts,and Sumatriptan group.By giving hypodermic injection of 10 mg/kg nitroglycerin,the migraine rat model was copied;Only 18 rats were found to have positive expressions of CGRP,CRLR,and RAMP1 in TCC with immunohistochemistry staining after heart perfusion.For the remaining 18 rats,TCC was stripped directly from the whole brain and divided into two parts,one part used to detect CGRP,CRLR,RAMP1 mRNA expressions by qPCR,and the other part to detect CGRP,CRLR,RAMP1 protein expressions by Western blot.Results The number of CGRP,CRLR and RAMP1 immunoreactive cells,the mRNA and protein expressions on TCC in model group were effectively increased,compared with those in the blank group (P＜0.05),indicating that the model copying was successful.Compared with those in the model group,the number of CGRP,CRLR and RAMP1 immunoreactive cells in Xiongma Decoction bioactive parts was significantlv decreased,and the expressions of CGRP,CRLR and RAMP1 mRNA and protein were reduced (P＜0.05).Conclusion The bioactive parts of Xiongma Decoction can reduce the activity of CGRP-CRLR/RAMP1 signal pathway in TCC of migraine rats.

Objective: To evaluate the post-operative mortality of left ventricular end-diastolic pressure (LVEDP) during primary percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods: We retrospectively analyzed 255 patients with new onset of STEMI who received primary PCI in our hospital and all patients received LVEDP measurement before coronary artery opening. According to LVEDP value, the patients were divided into 2 groups: LVEDP≤14 mmHg group,n=155 and LVEDP>14 mmHg group,n=100. The post-operative mortality up to 6 months was observed, and the effect of LVEDP on death rate was studied by Cox regression analysis. Results: Compared with LVEDP≤14 mmHg group, the patients in LVEDP>14 mmHg group had the 6 months mortality at HR=4.26, 95% CI (1.13-16.08),P=0.03. Relevant study presented that LVEDP was slightly related to LVEF (r=-0.267, P=0.001) and BNP (r=-0.154,P=0.041). Multi-regression analysis indicated that with adjusted LVEF and BNP, LVEDP was the independent predictor for post-operative mortality up to 6 months in acute STEMI patients after PCI. Conclusion: The LVEDP value measured during PCI procedure is the independent predictor for mortality after PCI in patients with new onset of STEMI.