Medicine is a practical application subject,so medical students should conduct numerous clinical practice to improve operation skills and clinical diagnosis ability The ability of clinical practice is one of most important indicators to evaluate medical education quality.In recent years,medical students have been affected by many kinds of adverse factors,such as new doctor-patient relationship,the medical reform and employment pressure and so on.All these adverse factors will bring a great challenge to the dental clinical teaching.In the new medical situation we need urgently to solve the problems to guide students to improve clinical practice ability and cultivate qualified dental professionals

Objective To observe the effect of Jiakang formula on thyroid hormone and thyroid pathological changes of experimental hyperthyroid rats. Methods Forty rats were given Euthyrox daily at 75 ?g/100 g ig and randomly divided into hyperthyroidism model group, control group, middle dose Jiakang formula group, high dose Jiakang formula group, each with 10 rats, as well as 10 rats as normal group. Three weeks later, the rats were killed for observing the effect of Jiakang formula on thyroid hormone and thyroid pathological changes of experimental hyperthyroid rats. Result Jiakang formula could lower the level of FT3, FT4, T3, T4 and promote the level of TSH, also improve thyroid pathological changes, especially in high dose Jiakang formula group. Conclusions Jiakang formula had the effect of improving the function and pathology of thyroid on experimental hyperthyroid rats.

Objective To investigate the influence of miR-203 on the proliferation and invasion of human esophageal squamous cell carcinoma cell line Eca109.Methods Double-stranded mimics of miR-203 were designed and transfected into Eca109 cells with Lipofectamine 2000;Eca109 cells transfected with nonsense microRNA mimics were taken as control.The proliferation ability of Eca109 cells was determined by calculating the cell population doubling time and the percentage of apoptotic cells;the invasion ability of Eca109 cells was determined by Transwell assay.Results In vitro experiment showed that,compared with the control group,Eca109 cells transfected with miR-203 mimics had a significantly longer cell population doubling time([26.1?0.5]h vs [24.2?0.6]h,P

ObjectiveTo compare the therapeutic effect, adverse effects and safety of leflunomide (LEF)and cyclophosphamide(CTX) on lupus nephritis(LN). Methods43 patients with reactive LN were randomly divided into two groups. Based on hormone application,22 cases in LEF group were given LEF orally and 21 cases in CTX group were given CTX intravenous drip discontinuously. They were followed up for six months. The related indexes and possible concomitant adverse effects were detected. ResultsThe total effective rate in LEF group was 81.8％ and that in CTX group was 85.7％. The tolerance in LEF group was better and 3 cases had adverse effects. 13 cases in CTX group had adverse effects. ConclusionLEF had the same efficacy as CTX in the LN therapy, but the tolerance is better and the side effects are minor than CTX.

Objective To explore the neuroimmunomedulation mechanism of ICAM-1 and LFA-1 in children with febrile seizures (FS).Methods 40 children with FS were dividedinto simple FS(SFs)groupin20 cases and complex FS(CFS)groupin20 cases,and 30 health children matched with regard to age and sex were enrolled into control group.The real-time fluorescence quantitative PCR wag used to detect the expression of PBMC ICAM-1 mRNA.At the same time,the PBMC LFA-1 mRNA expression wfs studied with Send-QuantitativeRT-PCR analysis.Results The levels of PBMC ICAM-1 mRNA in SFS group were significantly higher than those in control group and CF$group(P<0.05).The levels ofPBMC ICAM-1 mRNA showed downtrend between CFS group and control group.but there was no statistical difference between the two groups(P>0.05).The levels of PBMC LFA-1 mRNA grey-scales in SFS group were significantly higher than those in control group and CFS group(P<0.05).In addition,the levels of PBMC LFA-1 mRNA in CFS group showed downtrend than those in control group,but there wti8 no statistical difference between the two groups(P>0.05).Conclusions The gene expression levels of PBMC ICAM-I/LFA-I in SFS group were different from those in CFS group.Inflammable immunopathology damage induced by ICAM-1/LFA-1 may play an important role in the pathogenesis of SFS.On the contrary,ICAM-1/LFA-1 may have seme neuroprotective effects on the pathogenesis of CFS.

Objective To validate the value of Simplified Renal Index Score(SRI) in predicting acute renal injury requiring renal replacement therapy(RRT-AKI) after cardiac valve surgery in Chinese adult patients.Methods An analysis was conducted for all the adult patients who underwent cardiac valve surgery from January 2010 to December 2014 in Changhai Hospital,Shanghai.A total of 3 183 adult patients were included.Based on SRI Score,the patients were divided into 3 risk stages:0 to 1 point,2 to 3 point,and 4 to 8 point.The incidence of RRT-AKI was compared between different stages.And the prediction value of the SRI model was assessed by area under the receiver operating characteristic curve (AU-ROC) and the model calibration was assessed with the Hosmer-Lemeshow (H-L) test.Results After surgery 52 (1.6％) patients developed acute kidney impairment and subsequently underwent renal replacement therapy.Patients with low values of simplified renal index (0-1),medium(2-3) and high values (4 and more) were found to have increasingly higher risk for renal replacement therapy of 0.8％ (95％ CI:0.005-0.012) 、3.8％ (95％ CI:0.026-0.052) 、20％ (95％ CI:0.010-0.720),respectively.TheAU-ROCwas0.68(95％ CI:0.610-0.760,P＜0.01).The H-L test was x2 =2.45,P=0.29.Conclusion SRI model gives a certain clinical significance,suggesting that high-values patients may occur RRT-AKI with a significantly higher risk than low-values patients.However,SRI model cannot give an accurate prediction value for RRT-AKI in Chinese adult patients after cardiac valve surgery.Direct clinical use of the model should be considered cautiously.

Objective To validate the value of Cleveland Clinical Score in predicting acute renal injury requiring renal replacement therapy(RRT-AKI) after cardiac valve surgery in Chinese adult patients.Methods An analysis was conducted for all the adult patients who underwent cardiac valve surgery from January 2010 to December 2014 in Changhai Hospital,Shanghai.A total of 3 230 adult patients were included.Based on Cleveland Clinical Score,the patients were divided into 3 risk stages:0 to 2 point,3 to 5 point,and 6 to 8 point.The incidence of RRT-AKI were compared between different stages.And the predictive value of the Cleveland Clinical Score model was assessed by area under the receiver operating characteristic curve(AUC-ROC) and the model calibration was assessed using the Hosmer-Lemeshow test.The patients were also divided into two groups:Non-RRT group and RRT-AKI group.The mortality were compared between these two groups.Results The incidence of RRT-AKI was 1.67％ vs the predicted ratio of RRT-AKI 1.70％ (x2 =0.018,P =0.892).Among the stage 1,2,and 3,the actual incidence of RRT-AKI,was 1.23％,2.66％,and 16.7％ vs the predicted incidence 0.40％,1.80％,and 9.50％,respectively.The AUC-ROC for Cleveland Clinical Score predicting RRT-AKI was 0.64 [95 ％ CI(0.57,0.71),P ＜0.01].Compared with Non-RRT group,the RRT-AKI group got a higher mortality(87.00％ vs 1.50％,x2 =1 330,P ＜0.01).Conclusion The Cleveland Clinical score had no real predictive value for RRT-AKI in Chinese adult patients after cardiac valve surgery.The incidence of RRT-AKI of the whole population and the stage 3 patients could be predicted by the model.And the patients with a high Cleveland score got a higher mortality than that of patients with a low Cleveland score.

Objective To investigate the difference of gene expression in the visceral adipose tissue of the lean type 2 diabetic rats. Methods The difference bands were generated by the representational difference analysis ( cDNA RDA) ; the final difference products was ligated into the pUC-18 vector, subcloned and sequenced, and the obtained expressed sequence tags ( ESTs) were given bioinformatics analysis, and then the expression level of known gene was verified by semi-quantitative RT-PCR preliminarily. Results Six novel ESTs and 1 known gene [ rat lipoprotein lipase ( LPL) gene) were obtained in visceral adipose tissue of rat. One of the ESTs was partially similar to mouse musculus ERA-like GTPase (Era) gene. LPL gene was up-regulated in the visceral adipose tissue of the lean type 2 diabetic rats and those fed with fat-enriched food. Conclusion Six novel ESTs and 1 known gene in high expression are obtained from visceral adipose tissue of rat. LPL gene among them is up-regulated and may be related to the high fat and high calorie diet, hyperlipidemia, insulin resistance and molecular pathogenesis of the lean type 2 diabetic rat.

OBJECTIVETo purify recombinant nuclear protein of Hantaan virus.

METHODSThe recombinant plasmid was transformed into E.coli and induced by IPTG. The expressed protein is a fusion protein with GST and existed in inclusion bodies. The inclusion bodies were processed through denaturation and renaturation and were purified with Glutathione Sepharose 4B affinity chromatography column. Then the purified fusion protein and nuclear protein were examined by sandwich ELISA and Western blot.

RESULTSThe expressed fusion protein was separated from the mixture proteins by the first affinity chromatography. GST was cut from the purified fusion protein with thrombin. The nuclear protein was separated from GST by the second affinity chromatography. The crossed peak represents nuclear protein and the elute peak represents GST. The purified fusion protein and nuclear protein were single band by SDS-PAGE. Both of them had available antigen activity.

CONCLUSIONSPurification of nuclear protein of Hantaan virus with Glutathione Sepharose 4B affinity chromatography is an effective method.

Blotting, Western ; Chromatography, Affinity ; Enzyme-Linked Immunosorbent Assay ; Hantaan virus ; Nuclear Proteins ; analysis ; isolation & purification ; Plasmids ; Recombinant Fusion Proteins ; analysis ; isolation & purification ; Viral Proteins ; analysis ; isolation & purification

Objective:To evaluate the application effect of the vertical and horizontal step-by-step teaching mode in clinical nursing students.Methods:Using the convenient sampling method, the nursing students who were internship in the nursing college of Dalian Medical University were selected as the research objects. 27 nurses from July 9, 2016 to April 12, 2017 were the control group, and 29 nursing students from July 2017 to April 2018 were experimental groups. The control group adopts the traditional teaching mode, and the experimental group adopts the vertical and horizontal ladder teaching mode to complete the 40-week internship, and each round (four weeks) conducts theoretical and skill assessment.Results:The experimental group of nursing students in the experimental group had a score of (91.52 ± 1.75) points on the theoretical theory, a score of (90.99 ± 1.44) points on the staged skills examination, and a score of (699.34 ± 8.85) points on the national nursing qualification examination. The comprehensive quality evaluation score of the phased internship nursing students was (92.58 ± 1.17) points, which were higher than the control group's (88.89 ± 2.82), (88.27 ± 2.04), (694.26 ± 7.61), (89.44 ± 0.62) points, and the difference was statistically significant ( t values were -4.21,-5.79, -2.30, -7.50, P <0.05). Conclusion:The vertical and horizontal step-by-step teaching mode is conducive to improving the efficiency of clinical teaching, improving the learning effect of students, and playing a positive guiding role in the development of internship plans with teaching departments, and improving the overall level of nursing teaching.