In the paper, the authors not only analyzed and compared the international medical educational system, but also reviewed the medical educational system flux in China. The authors put forward several advices for perfect medical educational system according to international trend.

Animals ; Calcitonin Gene-Related Peptide ; blood ; Cerebral Infarction ; blood ; Endothelins ; blood ; Humans ; Nitric Oxide ; blood ; Plasminogen Inactivators ; blood ; Thromboxane B2 ; blood

Objective To explore the learning curve of transbronchial needle aspiration by evaluating the procedure time and the positive rate for respiratory physicians who have already mastered the bronchoscopy. Methods Clinical data of 60 patients who received TBNA procedure from May 2013 to August 2014 were retrospectively analyzed. The patients were divided into four groups (A, B, C, D) according to the time sequence of receiving the TBNA procedure, 15 patients in each group were set as a learning stage. The patients were received TBNA by the same doctor. The average time in each stage of puncture, positive rate, and puncture complications were compared among each groups. Results There did not show any significant differences in gender, age, etc. (P > 0.05) among the four groups. Puncture time in group A (15.2 ± 2.0) min and in group B (14.7 ± 2.2) min were significantly longer than that in group C (8.3 ± 1.6) min and in group D (7.6 ± 1.3) min (P < 0.05). In terms of the positive rate after the puncture, group A (26.7%) and group B (33.3%) were significantly lower than group C (80.0%) and group D (80.0%) (P < 0.05). There were no significantly different between group A and group B, and group C and group D in terms of puncture time and positive rate. Complications in each group was similar to intravascular puncture, after-puncture bleeding, pneumothorax, mediastinal hematoma, mediastinal bleeding and mediastinal infection did not show significant differences. Conclusion The learning curve of transbronchial needle aspiration for respiratory physicians who havemastered the bronchoscopy is around 30 cases.

Animals ; Animals, Newborn ; Hippocampus ; metabolism ; Hypoxia, Brain ; metabolism ; Ischemic Preconditioning ; methods ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Rats ; Rats, Sprague-Dawley ; bcl-2-Associated X Protein ; metabolism

Objective To investigate the expressions of miR-16,miR-106b,miR-449a,miR-34a and let-7g in peripheral blood plasma of the residents surrounding hot springs with radon in Hebei province.Methods A total of 41 randomly selected residents surrounding hot springs with radon were considered as the radon group,and 46 residents with same living habit but without contact with hot springs were considered as control.The miRNAs in the peripheral blood plasma of these two groups were detected with qRT-PCR.Results The levels of miR-16,miR-106b,miR-449a and let-7g in the radon group were significantly higher than those in control group (Z=-2.278,-3.835,-2.719,-2.721,P＜0.05).Alterations of these miRNAs were associated with radon exposure (t =2.154,3.711,2.319,2.015,P ＜ 0.05) but had no relationship with age,sex,smoking and drinking factors.No significant difference was observed in the plasma levels of miR-34a between the two groups.Conclusions miR-16,miR-106b,miR-449a and let-7g could be applied as potential biomarkers for radon exposure.

Objective To investigate the value of Cytochrome P450 (CYP3A5) * 3 gene polymorphism in providing individualized administration for the use of tacrolimus (Tac) in renal transplantation recipients.Method Pyrophosphate sequencing method was used to determine the CYP3A5 * 3 genotype of renal transplant patients in the first day after surgery.Sixty recipients were divided into experiment group and control group.Both groups of patients were routinely given the initial dose of Tac-4.0 mg/day in the first day after surgery.The experiment group of patients were given different doses of Tac based on the different CYP3A5 * 3 genotypes at the third day after surgery [for AA:0.12 mg/(kg· day),and for GG:0.06 mg/(kg· day)],and the control group of patients were given different dosages of Tac according to drug concentration.Different parameters were compared between two groups of patients:percentage of patients reaching the target concentration (3-8 μg/L) at the fifth day after surgery,days required to reach the target concentration level,times needed to adjust the dosage of Tac within two weeks.Result The percentage of patients reaching the target concentration in experiment group and control group was 90％ and 46.67％,respectively (P＜ 0.05).Days required to reach the target concentration were (3.67 ± 1.32) and (7.57 ± 3.42) on average,respectively (P ＜ 0.05).Times of adjusting the Tac dose in experiment group was significantly less than those in the control group (P＜0.05).In the experiment group,the target concentration was obtained even without dosage adjustment (70％).Conclusion Individualized adjustment of Tac doses for patients according to recipients' different CYP3A5 * 3 genotypes is beneficial for reaching target concentration as soon as possible,which is superior to traditional dosage regimen.

Objective To study the mechanism of GuiJi cream in dispelling effects on corrupt microorganism.Methods A total of 90 full-layer skin injured rats were served as test model. The effects of Guiji cream on collagen type Ⅰ (C Ⅰ), matrix metalloproteinase-1 (MMP-1) and MMP-3 in granulation tissue of wound were observed with immunohistochemistry technique and image-analysis system at various stages of healing. Results The expression of C Ⅰ was obviously increased and the level of MMP-1 and MMP-3 increased at the early stage and kept at a high level from day 3 to day 10. Conclusion The mechanism of GuiJi cream for dispelling effects on corrupt microorganism was increasing the C Ⅰ content in granulation tissue of wound through inhibiting the secretion of MMP- 1.

Alzheimer Disease ; drug therapy ; enzymology ; Amyloid Precursor Protein Secretases ; antagonists & inhibitors ; Animals ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; methods ; Membrane Glycoproteins ; antagonists & inhibitors ; Molecular Targeted Therapy ; Phytotherapy ; methods ; Presenilins ; antagonists & inhibitors