Human rotavirus (RV) is one of the main pathogens that cause non-bacterial acute gastroenteritis diseases globally. Live attenuated vaccine is an effective method to prevent RV infection. In order to improve the safety of RV vaccines, it is a good choice to develop other forms of vaccines other than live virus vaccines to avoid attenuated vaccine strains to restore virulence through back mutation or cause environmental contamination. This article reviews the research of RV virus like particle(VLP) vaccines.

Polymeric micelles as effective drug carriers have been paid wide attention. They have many considerable advantages in cancer therapy, such as high efficiency, long acting and high drug loading etc. The paper reviewed the type, preparation materials and drug lording methods of polymeric micelles, especially discussed the targeting strategy of tumor-targeting drug delivery systems and the ap-plication examples of polymeric micelles in targeting drug delivery systems.

Objectives: To investigate the effect of the addition of glutamine to WMO solution on the small bowel preservation. Methods:According to preservation solutions, the rats were divided randomly into three groups: University of Wisconsin solution(UW group), WMO solution (WMO group) and WMO solution with the addition of glutamine(WMO G group). And each group was redivided into two subgroups in terms of preservation time of 8 h or 12 h. The intestine was perfused by intubation via abdomial aorta, then the gut was flushed with metronidazole solution(4℃,5%). The proliferation of small intestine was observed through tissue culture. The histology, immunohistochemistry (TUNEL, PCNA) of intestinal mucosa and determination of ATP were used to evaluate the results. Results: Compared with UW group and WMO group, ATP contents of WMO G group were significantly higher, particularly in 12 h subgroup. Apoptosis in WMO G group was slighter than those in UW group and in WMO group. The difference in the two latter was not obviously, although pathological change in UW group was slighter than that in WMO group. The number of positive PCNA cells in WMO G group was more than that in other groups. Conclusions: The addition of glutamine to WMO solution could decrease injury of small bowel induced by cold ischemia, provide energy for the small bowel,and promote the proliferation of small bowel mocosal cell.

College students' employment viewpoint has transferred ultimately from traditional"government-planning assignment" to modern job-seeking mechanism of "two way choice and independent option".Recently,medical college has reformed clinical teaching in 5-years program.But some problems still exist in clinical teaching reflected from the employment situation of medical graduates and the evaluation of recruiting employers.Some work can be done to solve problems existing in medical students' employment.It is an important issue in adapting social requirement through reforming the model of clinical teaching and arranging the period of clinical training reasonably.

With the development of social education,the examination system becomes standardized.The fairness of test paper evaluation,which is a last procedure,becomes more and more important.Aiming at the shortcomings of the existing test paper evaluation,educator should pay more attention and take many effective measures to form good response mechanism in order to embody the fairness about test paper evaluation and give play to the initiative.

Objective To compare the efficacy and complications of early transabdominal preperitoneal patch (TAPP) implantation and open tension-free repair in the treatment of adult inguinal hernia .Methods 84 adult patients with inguinal hernia were divided into two groups by random number table ,and 42 cases in each group .The control group was given Lichtenstein technique ,while the observation group underwent TAPP .The surgery situation, postoperative visual analogue scale (VAS) scores,postoperative morbidity and recurrence rate were compared between the two groups.Results The operative time,ambulation time,average length staying hospital and postoperative VAS scores of the observation group were (42.21 ±3.13) min,(1.13 ±0.21) d,(4.28 ±0.62) d and (2.28 ±0.22) points,which were significantly less than (65.72 ±3.62)min,(2.03 ±0.30)d,(7.87 ±0.83)d and (4.56 ±0.31) points of the control group(t=7.29,8.02,8.32,9.29,all P<0.05).The incidence rate of postoperative complica-tions and recurrence rate of the observation group were 11.90% and 2.38%,which were significantly lower than 26.19%and 16.66%of the control group(χ2 =12.52,14.39,all P<0.05).Conclusion The effect of TAPP in the treatment of adult inguinal hernia is remarkable ,and it is safe and minimally invasive ,which is easy to operate ,it has low recurrence rate ,rapid postoperative recovery and has better clinical value .

Objective To detect the level of visfatin in the peripheral blood ofpafients with coronary atherosclerotic heart disease (coronary heart disease),and investigate the conelation between the level of visfatin and the lesion degree of coronary heart disease.Methods Two hundred and twenty patients who were diagnosed as coronary heart disease by coronary artery angiography from January to June 2011 (coronary heart disease group) were enrolled in this study,including 74 cases with stable angina pectoris(stable angina pectoris group),60 cases with unstable angina pectoris (unstable angina pectoris group),and 86 cases with acute myocardial infarction (myocardial infarction group).And 20 healthy persons with normal coronary artery angiography were selected as control group.The biochemical parameters of triglyceride (TG),total cholesterol (TC),high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were detected by biochemistry autoanalyzer.The level of serum visfatin was detected by ELISA analysis.The serum biochemical parameters and serum visfatin among all the groups were compared and the correlation between them was analyzed.ResuIts The level of serum visfatin of coronary heart disease group [(34.07 ±5.51) μg/L] was significantly higher than that of control group [(13.22 ±3.17) μg/L](P＜0.05).TC and LDL-C of different coronary heart disease groups had no significant differences compared with that of control group (P ＞ 0.05).TG,H DL-C and serum visfatin of stable angina pectoris group,unstable angina pectoris group and myocardial infarction group [(1.44 ±0.27) mmol/L,(1.16 ±0.12) mmol/L,(21.36 ± 3.35) μg/L; ( 1.84 ±0.32) mmol/L,(1.01 ± 0.08) mmol/L,(27.78 ±4.47) μg/L; (2.31 ±0.34)mmol/L,(0.93 ± 0.06) mmol/L,(33.14 ± 5.66) μ g/L] had statistical significance compared with those of control group [(0.93 ±0.25) mmol/L,(1.48 ± 0.24) mmol/L,(13.22 ±3.17) μg/L](P＜0.05 or ＜0.01).TG,C,ensini score and serum visfatin of unstable angina pectoris group were significantly higher than those of stable angina pectoris group and HDL-C was obviously lower than that of stable angina pectoris group (P ＜0.05).Gensini score and serum visfatin of myocardial infarction group were significantly higher than those of unstable angina pectoris group and HDL-C was obviously lower than that of unstable angina pectoris group (P ＜ 0.05).Spearman correlation analysis showed that the level of serum visfatin of coronary heart disease group was positively correlated with TG and Gensini score (P ＜0.05 or ＜0.01 ) and negatively correlatedwith HDL-C (P ＜ 0.01 ),and had no correlation with TC and LDL-C (P ＞ 0.05).Conclusions The highlevel expression of visfatin in the peripheral blood may be a risk factor of coronary heart disease.The changes of serum visfatin can reflect the lesion severity degree of coronary artery.

The relationship between hyperlactatemia and metabolic acidosis, which may involve shock resuscitation,homoiostasis, and nutritional support, remains a hot topic. On one hand, increased production of lac-tate due to anaerobic glycolysis during tissue hypoperfusion can aggravate metabolic acidosis; on the other hand,the utilization of lactate at organ and cell levels may lower blood lactate level, and thus alleviate metabolic acidosis.The ultimate blood lactate level depends on the balance of these two action mechanisms.

Objective: In order to provide references for drawing up related health policy reasonably, the current status of medical insurance payment in third level hospital. Methods: Through analyzing the payment situation of medical insurance in third level hospital from 2010 to 2012, to understand the related situation of gross prepayment system in large publich hospital since this year. Results: In recent years, the coverage rate of health insurance in the whole city is increasing continuously, while the rising extend of annual gross prepayment limit is not obvious, refusal in medical insurance fund is serious and the accounting method of prepay limit is not scientific. Conclusion: While satisfying the quality of patients’ visiting, it needs to implement gross prepay accounting method, enhance medical management and reduce the economic burden of the hospital.

Exogenous surfactant replacement has been successfully achieved and become standard therapy in neonatal respiratory distress syndrome,but clinical trials in acute respiratory distress syndrome (ARDS) had mixed results.Early studies show that pulmonary surfactant(PS) administration in ARDS can significantly improve oxygenation and decrease mortality,but in recent years,some clinical trials haven't achieve the most substantial benefits to long-term patient outcomes.The inconsistent results of clinical trials may have related to aspects of drug composition,dosing,delivery,and timing.At this time,surfactant therapy cannot be recommended as routine therapy in pediatric ARDS.