OBJECTIVE:To provide reference for improving practical teaching system of biomedical specialty talents training. METHODS:Based on the present situation of practical teaching system in higher vocational education,combined with the develop-ment of biomedicine industry,referring to foreign experience about vocational education mode,using the elements of the practice teaching system as the breakthrough points,hardware and software of practical teaching were highlighted and strengthened;the practical teaching system was established fromability oriented,practical teaching as the leadingpractical ability of vocational stu-dents and vocational ability talent training mode. RESULTS:The practical teaching system of biomedical specialty talents training was established on the basis ofthree-capacity,one body two wingspractical teaching target system,three standards,hierarchi-cal and modularpractical teaching content system,system and institutions,hardware and software managementstandard man-agement system,progressive training base platform,dual-level teaching staff,practical teaching supporting system of talented teacher group. CONCLUSIONS:The practical teaching system strengthen comprehensive practice ability training, can realize win-win between college and government,and of society. It can provide reference for improving practical teaching system of bio-medical specialty talents training.

Objective To evaluate the significance of oxygen stress test in 10 minutes after fluid resuscitation in the incidence and prognosis of acute kidney injury (AKI) in septic shock patients.Methods From January 2014 to December 2017,fifty-eight patients with septic shock were enrolled.The 10 min oxygen challenge test was conducted using transcutaneous oximetry just before (T0) and 6 h (T1) after initiation of fluid resuscitation,and 10 min oxygen challenge test data(10 min OCT) at TO and T1 were then calculated,respectively.The enrolled patients were divided into L group (10 min OCT＜66 mmHg,32 cases) and H group (10 min OCT ≥66 mmHg,26 cases)according to the 10 min OCT value at T1.The hemodynamic variables and oxygen metabolism indexes,dose of vasoactive agents,10 min OCT at T0 and T1 were recorded,incidence and severity of septic shock-associated AKI,frequency of continuous renal replacement therapy,ICU mortality and 28 d mortality were compared between two groups,the risk factors associated with prognosis were analyzed using COX regression model.Results The hemodynamic variables and oxygen metabolism indexes and dose of vasoactive agents were comparable between two groups at TO and T1 (P ＜ 0.05).The incidence of septic shock-associated AKI (78.1％ (25/32) vs.50.0％ (13/26),x2 =6.365),proportion of phase 3 AKI (53.1％ (17/32) vs.26.9％ (7/26),x2 =8.016) and frequency of continuous renal replacement therapy (46.9％ (15/32) vs.23.1％ (6/26),x2 =5.764) was higher in L group than those in H group(P＜0.05),and similarly were the ICU mortality (23.1％ (6/26)vs.53.1％ (17/32),x2 =7.134,P ＜ 0.05) and 28 d mortality (30.8％ (8/26) vs.62.5％ (20/32),x2 =6.067,P ＜0.05).Therefore,the 6 h 10 min OCT≥66 mmHg was a protective factor to improve the ICU mortality(RR =0.013,95％CI:0.021-0.396,P＜0.05) and 28 d mortality(RR=0.018,95％CI:0.009-0.280,P＜0.05) in patients with septic shock-associated AKI.Conclusion 10 min OCT imposes substantial imquence on the incidence,severity and prognosis of patients with septic shock-associated AKI,oxygen challenge test could improve the treatment of septic shock-associated AKI.

Objective To investigate whether follicular helper T(Tfh) cells were involved in the development of Henoch-Sch?nlein purpura(HSP) and Henoch-Sch?nlein purpura nephritis(HSPN) in chil-dren through affecting CD40/CD40L axis. Methods Fifty-five subjects were enrolled in this study and di-vided into four groups as follows:22 children with HSP but without renal involvement(Group A),11 chil-dren with HSPN presenting with microhematuria(Group B),11 children with HSPN presenting with micro-hematuria and proteinuria (Group C) and 11 healthy children (control group). Flow cytometry was per-formed to detect the percentages of CD19+B cells and their subsets,CD19+B cells and CD19+CD38+B cells secreting different Ig classes,CD19+CD40+B cells and their subsets and Tfh cells expressing CD40 ligand (CD40L). Results Compared with the control group,the percentages of CD19+CD86+B,CD19+CD138+B and CD40L+Tfh cells significantly increased in Group C(P<0.05) and slightly increased in Groups A and B (P>0.05). No significant difference in the percentages of CD19+B cells, CD19+CD27+B cells, CD19+B cells or CD19+CD38+B cells expressing IgG, IgM, IgD, CD19+B cells or CD19+B cell subsets secreting CD40 was found between the control group and Groups A,B and C(P>0.05). Moreover,the percentages of CD19+B and CD19+CD38+B cells secreting IgA and IgE in Groups A,B and C were higher than those in the control group(P<0.05). Secretion of IgA by CD19+B and CD19+CD38+B cells were positively correla-ted with the expression of CD40L by Tfh cells(P<0.05). Conclusion Tfh cell-mediated abnormal expres-sion of CD40/CD40L might play an important role in the development of HSP and be related to the clinical severity of renal involvement in HSPN.