Objective To establish a short-term scenario simulation training campus in senior med-ical students before graduation for the sake of a smooth transformation from medical students to residents. Methods There were 101 participants involved in the study . All the participants attended emergency medicine traditional teaching, including 51 fourth-year medical students and 50 fifth-year medical students. The 48 students who took the emergency scenario simulation training course were classified as training camp group while the other 53 students were classified as control group. The control group only participated in the emergency medicine traditional teaching, and the training camp group participated in the emergency sce-nario simulation training course on the basis of control group's routine teaching, including advanced cardiac life support and team collaboration, sepsis and doctor-patient communication, polypnea and crisis manage-ment, disorder of consciousness and interdisciplinary teamwork, multiple injuries and emergency plans, and comprehensive case evaluation. The training camp group was divided into groups and received evaluation of performance on treating emergency simulated case (clinical skills, teamwork, doctor-patient communication) before and after class. The training camp group was received questionnaire survey after class. SAS 9.2 was used to do the t test and descriptive analysis. Results There were no statistically significant differences (P>0.05) between the scores of the performance on clinical skills, teamwork, doctor-patient communication of training camp group and control group before class. The scores of training camp group after class were sig-nificantly better than those of control group (P<0.05). In addition, the course had a high recognition by students. 92% (44/48) students thought the course was contributed to improving the ability of crisis man-agement and clinical practice and were in favor of developing similar courses for senior medical students. Conclusion Scenario simulation training campus can strengthen the cultivation of medical students' com-prehensive thinking, independent clinical decision making, practice skills and communication ability in the final stage of medical education as well as enhancing their self-confidence so as to help them to adapt to the real clinical work.

Objective To study their chemical components of xianglingcao(Crotalaria ferruginea) and identify their chemical structures.Methods The compounds were isolated by chromatography and their structures were identified by spectral analysis and compared with the published data.Results Ten compounds were isolated and identified as vomifolilol(Ⅰ),genistein(Ⅱ),p-hydroxybenzoic acid(Ⅲ),5,7-dihydroxy-4-methoxy-flavone-7-O-?-D-glycopyranoside(Ⅳ),octadecoic acid(Ⅴ),octacosanol(Ⅵ),?-stitosterol(Ⅶ),?-daucosterol(Ⅷ),stigmasterol(Ⅸ),and ?5,22 stigmasterol-3-O-?-D-glycopyranoside(Ⅹ).Conclusion The ten compounds are obtained from xianglingcao for the first time.

OBJECTIVETo establish discriminant functions of diarrhea-predominant irritable bowel syndrome (IBS-D) by studying it from quantitative diagnosis angle, hoping to reduce interference of subjective factors in diagnosing and differentially diagnosing Chinese medical syndromes of IBS-D.

METHODSA Chinese medical clinical epidemiological survey was carried out in 439 IBS-D patients using Clinical Information Collection Table of IBS. Initial syndromes were obtained by cluster analysis. They were analyzed using step-by-step discrimination by taking information of four Chinese medical diagnostic methods and serum brain-gut peptides (BGP) as variables.

RESULTSClustering results were Gan stagnation Pi deficiency syndrome (GSPDS), Pi-Wei weakness syndrome (PWWS), Gan stagnation qi stasis syndrome (GSQSS), Pi-Shen yang deficiency syndrome (PSYDS), Pi-Wei damp-heat syndrome (PWDHS), cold-damp disturbing Pi syndrome (CDDPS). Of them, GSPDS was mostly often seen with effective percentage of 34. 2%, while CDDPS was the least often seen with effective percentage of 5.5%. A total of 5 discriminant functions for GSPDS, PWWS, GSQSS, PSYDS, and PWDHS were obtained by step-by-step dis- crimination method. The retrospective misjudgment rate was 4.1% (16/390), while the cross-validation misjudgment rate was 15.4% (60/390).

CONCLUSIONThe establishment of discriminant functions is of value in objectively diagnosing and differentially diagnosing Chinese medical syndromes of IBS-D.

Alarmins ; Brain ; Cluster Analysis ; Diarrhea ; classification ; diagnosis ; Hot Temperature ; Humans ; Irritable Bowel Syndrome ; classification ; diagnosis ; Medicine, Chinese Traditional ; Qi ; Retrospective Studies ; Surveys and Questionnaires ; Yang Deficiency

To investigate the chemical constituents of the whole plants of Bidens bipinnata, the separation and purification of constituents were performed by chromatography on macroporous resin, silica gel, MCI and Sephadex LH-20. Their structures were elucidated by spectroscopic data as quercetin (1), quercetin-3-0-alpha-L-rhamnoside (2), keampferol-3-O-beta-D-glucopyranoside (3), keampferol-3-O-alpha-L-rhamnoside (4), 3', 5-dyhydroxy-3, 6, 4'-trimethoxyl -7-O-beta-D-glucopyranoside flavonoid (5), 7, 8, 3', 4'-tetraflavanone(6), (2S)- and (2R)-isookanin-7-O-beta-D- glucopyranoside (7a/7b), (2S)- and (2R)-3'-methoxy-isookanin-8-O-beta-D-glucopyranoside (8a/8b), 6, 7, 3', 4'-tetrahydroxyaurone(9), maritimetin (10), esculetin (11), 3-O-caffeoyl-2-methyl-d-erythrono-1, 4-lactone (12), (7S, 8R) balanophonin-4-O-beta-D-glucopyranoside (13), eugenyl-O-beta-apiofuranosyl-( 1"-6') -O-beta-glucopyranoside (14), and (+)-syringaresinol-4'-O-beta-D-glucopyranoside (15). Compounds 8, 13, 14, and 15 were isolated from this genus for the first time. Compounds 1 and 6 were potent inhibitors against HSC-T6 cells in vitro and compounds 1, 2, 6, and 7 were capable of decreasing the inflammatory cytokine production of macrophage cells in vitro.
Bidens ; chemistry ; Drugs, Chinese Herbal ; chemistry ; Molecular Structure ; Spectrometry, Mass, Electrospray Ionization

OBJECTIVETo study a new method for the evaluation of the stability of production process of Traditional Chinese Medicines (TCM) based on chromatographic fingerprinting.

METHODTaking the extraction process of Red Ginseng for example, the fingerprints of extracts produced with fluctuating processing factors, i.e. ratio of solvent to liquid, solvent concentration, extraction durations and extraction times, were acquired. Meanwhile, the similarity of fingerprinting based on Euclidean distance was calculated and each fingerprint was fitwith cubic spline.

RESULTSimilarities of fingerprints of the extracts responded to the fluctuation of processing factors, and it showed that taking similarity as index, quantitative relation between chromatographic fingerprints and processing factors could be established.

CONCLUSIONThe method proposed in the paper was able to describe the quality of products resulting from fluctuating conditions in extracting process, and therefore, can be developed as a practicable strategy to evaluate the stability Traditional Chinese Medicines in production process.

Chromatography, High Pressure Liquid ; methods ; Drug Stability ; Drugs, Chinese Herbal ; isolation & purification ; Evaluation Studies as Topic ; Ginsenosides ; isolation & purification ; Panax ; chemistry ; Plants, Medicinal ; chemistry ; Quality Control ; Solvents ; Technology, Pharmaceutical ; methods

Objective: To identify and analyze the components of Moutan Cortex from different origins by UPLC-Q-TOF-MS technology. Methods: UPLC-Q-TOF-MS technology combined with chemical composition database was used to identify and analyze the components of Moutan Cortex. The results were analyzed and verified by multivariate statistical analysis and the biomarkers were identified. Results: The 37 components were identified in Moutan Cortex, the major components were galloyl glucoses, benzoic acids, paeonols, peoniflorins, and flavonoids. There were certain differences in the composition and content of Moutan Cortex from different origins. The medicinal materials from different origins were clustered into different groups respectively by principal component analysis (PCA). Five biomarkers were collected by partial least squares-discriminant analysis (PLS-DA) model and orthogonal partial least squares-discriminant analysis (OPLS-DA). Conclusion: The experimental results provide a theoretical basis for understanding chemical material basis and quality evaluation of Moutan Cortex, also provide the basis for the development of Chinese medicinal materials specifications and grades.

ObjectiveTo introduction of perforator flaps,muscle flaps pedicled by descending branch of lateral circumflex femoral artery,method and their clinical application that multiple soft tissue defects of hand are repaire by muliplefoliated tissue flap only branch lateral circumflex femoral artery.MethodsFifteen patients with multiple soft tissue defects of hand were repaired muliplefoliated tissue flap only pedicled bydescending branch lateral circumflex femoral artery.At first,the anterolateral thigh perforator flap was designed and harvested according to the soft tissue defects of hand, then the descending branch lateral circumflex femoral artery was dissected at the same time the segmented perforator flap,fascia lata flap,rectus femoris muscle flap, vastus lateralis muscle flap, vastus intermedius muscle flap and distal spatium intermusculare flap were harvested in need according to distance among soft tissue defects.The muliplefoliated tissue flap was harvested only pedicled by descending branch lateral circumflex femoral artery, at last muscle flaps and fascia lata flaps were covered by skin graft, so the multiple soft tissue defects of hand were repaired in one time.ResultsNo vascular crisis happened. All skin grafts survived well, the contour of all repaired soft tissue defects was good and protective feeling was recovered by skin grafts of all flaps. All cases were got follow-up and the range was from 6 to 20 months(the average was 8.7 months).Wound of donor site healed well, muscle strength of quadriceps and motion of knee were normal. Three cases were excellent,nine cases were well and 3 cases were good, according to upper extremity function evaluation criteria of Chinese Medical Society for the Surgery of the Hand, the rate of good was 80 percent.ConclusionMultiple soft tissue defects of hand can be repaired by muliplefoliated flap only pedicled by descending branch of lateral circumflex femoral artery. Its advantages included reduction of operation time and treatment, good recovery of hand contour and function. It is a good method to repair multiple soft tissue defects of hand.

OBJECTIVETo investigate the curative effect and histocompatibility of reconstruction of traumatic urethral defect of rabbit using urethral extracellular matrix (ECM).

METHODSUrethral ECM was obtained by excision of the urethra in 20 donor rabbits. In experimental group, 20 rabbits were resected a 1.0 cm-1.5 cm segment of the urethra and artificially made a model of traumatic urethral defect, then reconstructed by the urethral extracellular matrix of the same length. The rabbit immunity response was assessed by lymphocyte transformation test and serum TNF-alpha level. The reconstructed urethral segments were stained with hematoxylin-eosin and Van Gieson stain and observed by histological examination postoperatively. The urethrography, urethroscopy and urodynamic examinations were performed.

RESULTSThere was no significant difference in stimulative index of lymphocyte transformation between ECM group and control group. The serum TNF-alpha levels of ECM group slightly rose, but the increase was not significant as compared with control group. On postoperative day 10, epithelial cell had migrated from each side and small vessels were found in the extracellular matrix. In the 3rd week, several layers of urothelium covered the whole surface of the matrix tube. In the 6th week, the disorganized arrangements of smooth muscle fibers were firstly observed by Van Gieson staining. In the 24th week, the smooth muscle cells increased and the matrix tube appeared fairly similar to normal urethral wall components. The urethroscopy and urodynamic evaluation revealed that the surface of reconstructed urethra was smooth and emiction was unobstructed.

CONCLUSIONThe urethral extracellular matrix might be an ideal and safe biomaterial for the reconstruction of urethral traumatic defect.

Animals ; Extracellular Matrix ; immunology ; physiology ; Female ; Immunohistochemistry ; Lymphocyte Activation ; Rabbits ; Reconstructive Surgical Procedures ; methods ; Tumor Necrosis Factor-alpha ; blood ; Urethra ; immunology ; injuries ; surgery

OBJECTIVETo investigate the effects of overexpression of exogenous Notch1 in human tongue squamous cell carcinoma (TSCC) cells on cell growth and expression of epidermal growth factor receptor (EGFR) in vitro.

METHODSHuman TSCC cell line Tca8113 cells were transiently transfected with the eukaryotic expression plasmid pRAMIC-IRES2-EGFP encoding exogenous intracellular fragment of Notch1 and control plasmid pIRES2-EGFP by Lipofectamine 2000, respectively. Untransfected parental Tca8113 cells served as control. The cell proliferation was evaluated by methyl thiazolyl tetrazolium(MTT) assay. The apoptosis was assessed by flow cytometry. The mRNA and protein levels of Notch1 and EGFR in Tca8113 cells were detected by reverse transcriptase-polymerase chain reaction (RT-PCR) and Western blot. The expression of EGFR protein in Tca8113 cells was detected by immunocytochemistry.

RESULTSMTT assay showed that the cell proliferation of Tca8113 cells transfected with pRAMIC-IRES2-EGFP was significantly inhibited as compared with controls (P < 0.05). After transfected with pRAMIC-IRES2-EGFP for 48 h, the apoptosis rate of Tca8113 cells was significantly higher than those of Tca8113 cells transfected with pIRES2-EGFP and untransfected Tca8113 cells (P < 0.05), and Notch1 expression was significantly increased at mRNA (P < 0.05) and protein (P < 0.05) levels, while EGFR expression was significantly decreased at mRNA (P < 0.05) and protein (P < 0.05) levels.

CONCLUSIONOverexpression of exogenous Notch1 may inhibit cell growth and down-regulate EGFR expression in TSCC cells.

Apoptosis ; Carcinoma, Squamous Cell ; Cell Line, Tumor ; Cell Proliferation ; Down-Regulation ; Humans ; In Vitro Techniques ; RNA, Messenger ; Receptor, Epidermal Growth Factor ; Tongue Neoplasms ; Transfection

OBJECTIVETo investigate the expression of Notch1 in human tongue squamous carcinoma (TSCC) and precancerous lesion, and to explore the potential relation between Notch1 and epidermal growth factor receptor (EGFR).

METHODSThe expression of Notch1 and EGFR was detected in human TSCC (n = 41), tongue leukoplakia (LP) (n = 39) and normal tongue mucosa (n = 7) by immunohistochemistry.

RESULTSIn normal tongue mucosa and LP, the positive staining of Notch1 was mainly distributed in stratum corneum, partially in stratum granulosum and stratum spinosum, but not in stratum basale, while the positive staining of EGFR was mainly distributed in stratum basale, rarely in stratum spinosum, but not in stratum granulosum and stratum corneum. In TSCC, Notch1 expression was mainly distributed in locations of squamous metaplasia, but not in peripheral cells of carcinomas, while EGFR expression was detected mainly in peripheral cells of carcinomas, but not in locations of squamous metaplasia.

CONCLUSIONNotch1 promotes the differentiation of epithelial cells in tongue mucosa and acts as a tumor suppressor in TSCC. EGFR may act as a negative regulator of Notch1 expression in epithelium of tongue mucosa and TSCC, for maintaining cell proliferation and promoting the tumorigenesis and progression of TSCC.

Carcinoma, Squamous Cell ; Cell Differentiation ; Cell Proliferation ; Epithelial Cells ; Epithelium ; Humans ; Immunohistochemistry ; Leukoplakia, Oral ; Mouth Mucosa ; Receptor, Epidermal Growth Factor ; Tongue ; Tongue Neoplasms