After summing up the experience of recent years' clinic teaching, ICU department in Fangcun Branch of Second Clinical Medical College of Guangzhou University of TCM comes to a conclusion that, the clinical teaching of ICU should pay attention to and ensure effective implementation of beginning educationg. And following the PDCA method (Plan, Do, Check & Act) will make the work orderly, normative and controllable and meanwhile raise the students' observing and analysis ability as well as their operation and doctor-patient communication ability. In this way we can mostly enhance the effect of teaching.

AIM: To establish the methods for determining ephedrina hydrochloridum,pseudoephedrine hydrochloride,puerarin,baicalin in Ganmao Soft Capsule (Herba Ephedrae,Radix Puerariae lobatae,Radix Scutellariae,Ramulus Cinnamomi,Radix Angelicae sinensis,Radix Angelicae dahuricae,etc.) METHODS: Part 1(determination of ephedrina hydrochloridum and pseudoephedrine hydrochloride):The HPLC was carried out on kromasilTMC18 column(4.6 mm ? 250 mm,5 ?m) with acetonitrile-0.02 mol/L phosphoric acid solution(pH2.7)-triethylamine(2 ∶ 98 ∶ 0.1)as mobile phase,gradient elution.The detection wavelength was set at 207 nm.Part 2(determination of pueranin and baicalin):The HPLC was carried out on kromasilTMC18 column(4.6 mm ? 150 mm,5 ?m)with acetonitrile-water(11 ∶ 89)as mobile phase,gradient elution.The detection wavelength was set at 250 nm.RESULTS: The average recoveries were 99.96% with RSD 1.25% ,98.41% with RSD 1.46% ,98.67% with RSD 0.91% ,99.30% with RSD 0.88% ,respectively.CONCLUSION: The assay results demonstrate that the methods are simple,accurate and reproducible for quantification of four active components in Ganmao Soft Capsule.

Objective:To improve the knowledge on propythiouracil(PTU)-induced antineutrophil cytoplasmic antibody(ANCA)-associated vasculitis.Methods:6 cases of PTU-induced ANCA-associated vasculitis were analyzed on clinical manifestation,laboratory and biopsy findings,therapy and prognosis.Results:All patients with Grave's disease had been treated with PTU from 2 months to 7 years suffered from ANCA-associated vasculitis, which can also appear after withdrawal of PTU. Clinical manifestations are different with only skin, joint, muscle involvements on mild cases or lung, renal and hematological involvement on severe cases. Sera from all patients were anti MPO-ANCA positive. All patients responded to withdrawal of PTU and administration of prednisone and immuno-suppressants well with ANCA declined or turned to negative.Conclusion:PTU can induce ANCA-associated vasculitis in the part of which lung and kidney can be seriously involved. Early withdrawal of PTU and administration of immunosuppressive agents might improve the prognosis.

Objective To study the expressions of the tumor suppressor gene TSH receptor( TSHR),P16, and RAS in papillary thyroid carcinoma ( PTC ) , and the correlation between the occurrence of tumor and the aberrant promoter hypermethylation of three tumor suppressor genes. Methods RT-PCR was used to detect the mRNA expression of three tumor suppressor genes in tissues of 50 cases of PTC ,20 cases of nodular goiter,and 12 cases of thyroid adenoma. The promoter methylation status of three tumor suppressor genes was examined by methylation-specific PCR technique( MSP). Gene sequencing was used to test if the hypermethylation existed in the promoter of three tumor suppressor genes. Results In 68.0% (34/50) TSHR gene, 54.0% (27/50) P16 gene, and 60.0% ( 30/50 ) RAS gene in PTCs, hypermethylation in promoter region was detected, the respective results 21.9% (7/32) , 15. 6% (5/32) ,and 31. 3% (10/32) were found in control tissues. The rates of the three genes with promoter hypermethylation in PTC were significantly higher than those in control tissues ( all P<0. 05). The mRNA expressions of TSHR,P16,and RAS were significantly lower in PTC than those in control tissues (0. 41 ± 0.11 vs 0.63±0. 08,0. 51±0. 17 vs 0. 72±0. 22,0. 56±0. 10 vs 0. 67±0. 16, all P<0. 05). The sequencing confirmed that there was CC to TC transmission in the promoters of three tumor suppressor genes. Conclusions The methylation of three tumor suppressor genes in promoter region is a common molecule event and may be involved in the genesis and development of human PTC.

Objective To develop the bipolar depression index scale (BDIS) and test the validity and reliability of BDIS.Methods The original bipolar depression index scale (BDIS) was developed by the clinical features of bipolar depression reported by the studies focused on comparing the bipolar depression (BP) and unipolar depressive disorder (UP).46 patients with bipolar depression and 44 patients with unipolar depression were rated the original BDIS and enrolled consecutively by DSM-IV.Results There were eleven items in the BDIS.The interrater reliability between eleven items and BDIS score ranged from 0.61 to 0.87.The correlation coefficients between eleven items and BDIS score ranged from 0.53 to 0.73.The Cronbach's alpha of BDIS was 0.68.The mean BDIS score of BP(7.26 ± 3.12 ) was significantly higher than that of UP( (4.80 ± 3.08 ), (P ＜ 0.01 ).The BDIS scores were significantly correlated with the scores of Mood Disorder Questionnaire ( coefficient 0.56) and 32-item hypomania checklist ( coefficient 0.45).The BDIS score could discriminate between BP patients and UP patients by the ROG curve analysis and 5 was the best cutoff score ( sensitivity 0.80, specificity 0.64).Conclusions The validity and reliability of BDIS are fit for the requirements of psychometrics.BDIS may use to differentiate between bipolar depression and unipolar depression in the practice.

ObjectiveTo investigate the relation of obesity parameters,including body mass index (BMI),waist-to-height ratio(WHR),waist circumference,and waist-to-hip ratio(WHR),with hypertension in adolescents.MethodsA cross-section study was conducted among 3953 adolescents aged 12 to 18 years old,who were assigned to the normal blood pressure group (3724) or hypertension group(229).Measurements were height,weight,waist circumference,systolic blood pressure (SBP),and diastolic blood pressure (DBP).ResultsThe data showed that mean BMI,WHR,waist circumference,WHR,SBP,and DBP in the hypertension group Was significantly higher than those in the normal blood pressure group(all P<0.05).In partial correlation analysis,BMI,WHR,waist circumference,and WHR were positively correlated with both SBP and DBP after gender or age were adjusted(r'=0.3228 and 0.2358,both P<0.05).For alias under the receiver operating curve(ROC),the BMI was obserred to strongly predict hypertension in male (0.715;95%CI0.659-0.771)and female (0.702;95%CI0.646-0.757).BMI was also entered into the multiple linear regression modeL ConclusionBMI could be an effective predictive factor of hypertension in adolescents.

We amplified genes encoding UDP-glucose dehydrogenase, ecohasB from Escherichia coli and spyhasB from Streptococcus pyogenes. Both ecohasB and spyhasB were inserted into T7 expression vector pRX2 to construct recombinant plasmids pRXEB and pRXSB, and to express in E. coli BL21(DE3). After nickel column purification of UDP-glucose dehydrogenases, the enzymes were characterized. The optimum reaction condition of spyHasB was at 30 °C and pH 10. The specific activity reached 12.2 U/mg under optimum condition. The optimum reaction condition of ecoHasB was at 30 °C and pH 9. Its specific activity reached 5.55 U/mg under optimum condition. The pmuhasA gene encoding hyaluronic acid synthase was amplified from Pasteurella multocida and ligated with ecohasB and spyhasB to construct the coexpression vectors pBPAEB and pBPASB, respectively. The co-expression vectors were transformed into E. coli BW25113. Hyaluronic acid (HA) was produced by biotransformation and the conditions were optimized. When recombinant strains were used to produce hyaluronic acid, the higher the activity of UDP-glucose dehydrogenase was, the better its stability was, and the higher the HA production could reach. Under the optimal conditions, the yields of HA produced by pBPAEB/BW25113 and pBPASB/BW25113 in shake flasks were 1.52 and 1.70 g/L, respectively, and the production increased more than 2-3 folds as previously reported.
Biotransformation ; Escherichia coli ; enzymology ; Genetic Vectors ; Glucuronosyltransferase ; genetics ; Hyaluronan Synthases ; Hyaluronic Acid ; metabolism ; Pasteurella multocida ; enzymology ; Streptococcus pyogenes ; enzymology ; Uridine Diphosphate Glucose Dehydrogenase ; metabolism

accumulation and endothelial dysfunction are associated with insulin resistance.

Objective The aim of this study is to dynamically investigate peripheral blood lymphocyte subsets in fever with thrombocytopenia syndrome (SFTS) patients at different stages,to evaluate the influence of these changes in the infection process.Methods Case-control study was used in the research.Twelveconfirmedthrombocytopeniasyndromevirus ( SFTSV ) infectedpatientswere enrolled.According to SFTS prevention guide issued by Chinese Ministry of Health,these patients were divided into two groups,recovery group and death group.For each group,dynamic profiles of the CD3 + T cells,CD4 + helper T cells,CD8 + cytotoxic T cell and CD3 - CD16 + CD56 + natural killer cells were tested by flow cytometry.Meanwhile, the relationshipsbetween these dynamicchanges and liver function,leukocytes,and platelets were analyzed respectively.Two independent-samples t test was used to compare the difference of the peripheral blood lymphocyte subsets count between the SFTS patients and healthy control.Small sample was analyzed by Mann-Whitney U test.Results In the early stage of infection,Th cells in peripheral blood of recovery group were significantly reduced and Th/Tc ratio was reversed.On day 5,7,9 of post infection,Th cell counts in peripheral blood were (740.9 ± 6.4),(836.2 ± 272.3 ) and ( 1083.6 ± 319.7 ) cells/μl respectively,which were significantly lower than health control ( 1351.4 ± 295.1 ) cells/μl ( t value was -2.883,-4.235,-2.145 respectively,all P ＜0.05).Tc cell counts were significantly more than healthy controls (690.1 ± 194.8) cells/μl through the course,which were ( 1006.3 ±356.5),(1166.4±242.4),(1102.4±245.9),(991.3±205.1) and (886.5±154.5) cells/μl on day 7,9,11,13,15 of the course (t value was 3.312,5.661,4.574,3.874,2.382,all P＜0.05).NK cells were decreased significantly from the ninth day of the course.Associated with abnormal changes of cell subsets,WBC and PLT decreased significantly,and serum ALT,AST,LDH and CK etc.were higher than normal level.With the disease recovery,the abnormality above was gradually improved.In contrast,death cases showed significant decrease in T and Th cells compared with health control (P ＜ 0.05).On day 7,8,9 of the course,the counts of total T cell were (735.9 ± 359.9),(724.9 ± 125.9),(845.3 ± 389.3) cells/μl and the counts of Th cell were ( 533.2 ± 246.9 ),( 532.1 ± 105.7 ),( 551.7 ± 86.9 ) cells/μl,significantly lower than healthy control ( 1727.9 ± 230.2 ) cells/μl and ( 1351.4 ± 295.1 ) cells/μl,with statistically differences (z value was - 2.828, - 2.342,- 2.342 and - 2.828, - 2.342, - 2.342,all P ＜ 0.05 ).On day 7,8,9 of the course,the numbers of NK cell in death group were ( 1141.8 ± 415.5),( 1047.2 ±68.4),( 1276.3 ±545.3) cells/μl,which were significantly more than health group (470.7 ± 242.2) cells/μl,with statistically differences (z value was - 2.180,- 2.335,- 2.258,all P ＜0.05).Conclusions SFTSV infection can induce cell immunity damage.The changes of lymphocyte subsets are associated with clinical classification and prognosis.Significant reduction of T cell and CD4 +cell in peripheral blood are accompanied with significant increase of NK cell,which may be a pivotal indicator of poor prognosis and play an important role in making appropriate strategy in clinical treatment.( Chin J Lab Med,2012,35:826-831 )

Objective To evaluate the relationship between obesity and serum soluble intercellular adhesion molectde-1 (sICAM-1) in adolescents. Methods Totally, 158 adolescents aged 13-15 years were divided into three groups based on their body mass index (BMI) , 80 in control group, 44 in overweight group and 34 in obesity group. Height, weight, waist circumference (WC) and blood pressure were measured for all of them and sICAM-1 was assayed from fasting venous blood collected. Results BMI, WC and systolic blood pressure were significantly higher in overweight group than those in control group (P < 0. 01). BMI, WC, systolic blood pressure and diastolic blood pressure were significantly higher in obesity group than those in overweight group (P<0. 05). Level of sICAM-1 was significantly higher in obesity group than that in control group (P <0.05). Their sICAM-1 showed positive correlation with BMI (r = 0.168, P=0.035) and WC (r=0. 179, P =0.025). Multiple linear regression analysis using sICAM-1 as a dependent variable showed that WC (β= 0.009, 95% CI 0. 001-0.018, P=0.025) was an independent predictors for sICAM-1 adjusted for age, sex, BMI and blood pressure. Conclusions Results mentioned above suggest that endothelial dysfunction associates with obesity, particularly with abdominal obesity. sICAM-1 can be used as an early marker of atherosclerosis in adolescents.