The mode of using standardized patients has been applied in cardiothoracic surgery teaching to assess students efficiency.It alleviates the conflict of the shortage of resource for clinical teaching and improves the quality of teaching and achieves good results.

This paper is to study the feasibility of app ly ing three-layers support structure(Browser/Server OR Client/Middle Tier/Serve r)to NO.1Military Project.By windows2000's terminal technology and distributed characteristics of ORACLE DBMS,C/S structure(Client/Server)can be turned into th ree-layers structure.The all subsystems of NO.1military project can work smooth ly on the terminals,and then the problems when NO.1Military project operated in C/S structure can be solved,such as the vulnerability,low operation speed and l arge maintenance workload.To set three-layers support structure with terminal te chnology windows2000-based can not only save investment and reduce maintenance workload,but also have important significance for database safety.It has a bri lliant application prospect.

'Social beings' model of standardized training program for residents in Shanghai is one of the important measures in the health care reform. According to the requirements of the standardized training of residents in thoracic surgery, the article preliminarily explored the standardized training model for residents from four aspects such as individualized treatment of different professional backgrounds, focus-ing on the training needs of residents with different starting point of social beings, developing training programs for different training time and combining the master's degree graduate education. And based on the characteristics of thoracic surgery, it also summed up the past experience and explored the clinical practice teaching.

Objective To investigate the effects of aerobic exercise on cardiorespiratory function in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS).Methods A total of 84 patients with OSAHS were randomly divided into a control group and an aerobic exercise group (42 in each group).The control group was given only training in the activities of daily living (ADL).The acrobic exercise group was given ADL training combined with aerobic exercise training.The regime was maintained for 16 weeks.Each patient's VO2max,maximum heart rate (HRmax),exercise time to exhaustion,6-minute walking distance and quality of life (QOL) were evaluated before and after treatment.Results VO2max,HRmax,VO2max/HRmax,maximum exercise time,6-min walking distance and QOL all increased significantly more in the aerobic exercise group compared with the control group.Conclusion Aerobic exercise training can significantly improve cardiorespiratory function in patients with OSAHS.

Aimed at the current plight of medical students' professionalism education,such as ignoring the top -level design and the overall plan but emphasizing practice,ignoring the permeability of professional spirit but emphasizing the impartation of professional knowledge,ignoring humanities but emphasizing professional issues in curriculum setting,Capital Medical University advocated the all-dimensional education philosophy implenented by all staff through the whole process,made top-level design scientifically for medical students' professionalism education.The university strengthened professionalism through teaching,permeated professionalism through a series of educational activities,consolidated professionalism through clinical practice,and thus to strengthen the cultivation of medical students' professionalism and realize scientific education by all staff and throughout the whole process.

Objective: To evaluate the safety and efifcacy of cutting balloon combining main branch single stent cross-over technique for treating the patients with coronary bifurcation lesions. Methods: A total of 113 patients with 121 bifurcation lesions treated in our hospital from 2012-01 to 2014-01 were enrolled. Cutting balloon pre-dilation was applied in both main and side branches followed by drug-eluting stent implantation at main branch. The procedural success rates, side branch blood lfow status and complications were observed. Follow-up studied for MACE occurrence was conducted at 9 months after the operation. Results: Quantitative coronary angiography (QCA) presented that the minimum lumen diameters at pre- and post-operation in main branches were (2.12 ± 1.07) mm and (3.24 ± 0.87) mm, in side branches were (1.44 ± 0.73) mm and (1.82 ± 0.64) mm respectively,P<0.05-0.01, the procedural success rate was 100%. There were 11 (9.1%) lesions with dissection at proximal side branch, 5 (4.1%) lesions with side branch TIMI blood lfow

The clinical features and lung CT findings of 174 heart failure patients,including 85 cases with normal left ventricular ejection fraction (LVEF) and 89 cases with reduced LVEF were reviewed.Patients with normal LVEF had a higher proportion of hypertension,diabetes and obesity than patients with normal LVEF; and cough and dyspnea were more common.The lung CT findings in patients with normal LVEF were frequently presented as interstitial lung edema,increased pulmonary texture,subpleural line,Kerley lines and diffuse ground-glass opacity.Patients with reduced LVEF had a higher proportion of coronary heart disease and clinical manifestations of acute left heart failure,and central alveolar edema presented in lung CT images.Results suggest that heart failure patients with normal LVEF usually have longer clinical history and occult symptoms,and have a different lung CT imaging features from those in heart failure patients with reduced LVEF.

Diabetic cognitive dysfunction,a glucose metabolic disorder,is caused by metabolic,neurochemistrical,morphological,electrical physiological and behavioral changes featuring the disability of reasoning and learning,memory loss,inattention and hypophrenia.In recent years,more attention has been attached to the field of medicine.In this review,a progress of cognitive disorder was systematically explored over the pathogenesis and treatment of both TCM and western medicine,and investigated multi-targets and multiple methods of Chinese herbal researches at multiple stages for expanding the range of clinical application of TCM,enriching and developing the theory of TCM compatibility,and promoting the advantages of TCM syndrome differentiation.

Objective To prepare a recombinant pneumococcal surface protein A clade 4 ( PspA4) and to analyze its immunogenicity.Methods The gene encoding PspA4 protein was synthesized and inserted into pET-20b to construct the recombinant expression plasmid.The transformed E.coli strains carrying expression plasmid were induced to express PspA4 protein.ELISA was performed to analyze the ti-ters of PspA4-specific IgG in a mouse model.Results The recombinant PspA4 protein of high purity ( 90%) was successfully prepared.The titers of PspA4-specific antibody in mice received PspA4 immuniza-tion were 106 times higher than those of the blank control group, suggesting that the expressed PspA4 protein had the advantage of high immunogenicity.Conclusion This study suggested that the PspA4 protein might be used as one of the candidate protein for the development of pneumovax and laid a foundation for further in-vestigation on pneumococcal protein based vaccine.

This study was aimed to investigate the action mechanism ofHypoxis Hemerocallidea (African Potato, AP) on the AMPK signal pathway of skeletal muscles in diabetic rats. Among 40 male SD rats, 10 rats were used as the normal group, and the other 30 rats were fed with high-fat food for one month, and then injected with STZ for the model establishment. After the successful model establishment, rats were divided into the model group, pioglitazone hydrochloride group and the AP group. Intragastric administration was given for 5 weeks in each group. Then, the skeletal muscle tissues were embedded and sliced for immunohistochemistry test. The protein expression of p-AMPKα, p-AS16 and GLUT4 in skeletal muscles was detected by western blot. The 100 mmol·L-1 glucose was used in the establishment of C2C12 skeletal muscle cells insulin resistance model. AP drug-containing serum was used in the establishment of the treatment group. The control group was the normal cells. Glucose consumption, cell proliferation, SOD content, and MDA content were detected. And the protein expressions of p-AMPKα, p-AS160, GLUT4 were detected with the western blot and RT-PCR. The results showed that compared with the normal group, AP can up-regulate p-AMPKa protein express (P < 0.01), increase skeletal AS160 phosphorylation level (P < 0.01), and up-regulate the GLUT4 level (P < 0.01). Compared with the normal group, the high glucose caused the decrease of C2C12 skeletal muscle cell activity and the decrease of glucose consumption (P < 0.05), decrease of SOD, increase of MDA (P < 0.01), and the decrease of p-AMPKα, p-AS160, GLUT4 protein expression (P < 0.01). After 48 h intervention, the SOD of C2C12 skeletal muscle cells in the AP drug-containing serum group was significantly increased (P < 0.01), the MDA content was decreased (P < 0.05), the AMPKa and AS160 phosphorylation levels were increased (P < 0.01), the GLUT protein expression was increased (P < 0.01). It was concluded that the induced AMPKa and AS160 phosphorylation promoted GLUT 4 expression may be one of the action mechanism of insulin resistance of skeletal muscles in diabetes.