It is important to explore the fundamental medical concepts which can enhance the overall quality of medical students in the department of geriatrics during clinical practice. These funda-mental medical concepts include medical humanistic spirit,holistic medicine,health management and patient-physician communication. Specific measures include improving emotional communication of clini-cal interns in department of geriatrics with elderly patients,training student's thinking as a whole towards multiple system disease in the elderly,training students to assess and manage elderly patients from a vari-ety of perspectives and improving doctor-patient communication skills by routine clinical teaching and teaching ward round. All these concepts will help improve the working ability and medical ethics of clini-cal interns and enable them to adapt to the clinical work quickly. So they can become qualified doctors.

China ; Humans ; Pulmonary Medicine

Adolescent ; Adult ; Asian Continental Ancestry Group ; Child ; Child, Preschool ; Cystic Fibrosis ; Female ; Humans ; Infant ; Male ; Retrospective Studies ; Young Adult

OBJECTIVE: To establish the method to analyze γ-hydroxybutyric acid (GHB) and its precursors 1,4-butanediol (1,4-BD) and gamma-butyrolactone (GBL) in urine through LC-MS/MS and provide evidence for related cases. METHODS: GHB-d6 and MOR-d3 were used as the internal standard. The urine sample was separated by LC after protein precipitation with methanol. The electrospray ion source was for ionization. Each compound was detected through multiple-reaction monitoring (MRM) mode. RESULTS: The limits of detection of GHB and its precursors 1,4-BD and GBL were 0.1, 0.1 and 2 μg/mL. The accuracy was 87.6%-98.1%. The intra-day and inter-day precisions were less than 15% and matrix effects were higher than 80%. CONCLUSION The method is high sensitive, simple, rapid, specific and with high reliability. This study has provided technical support and basic data for forensic cases involving GHB.
4-Butyrolactone/urine* ; Butylene Glycols/urine* ; Chromatography, Liquid ; Forensic Sciences ; Humans ; Hydroxybutyrates/urine* ; Mass Spectrometry ; Reproducibility of Results ; Tandem Mass Spectrometry

Objective To investigate the dynamic changes of regulatory T cells (Treg ) and the surface expression of programmed death (PD)‐1 and the level of transforming growth factor (TGF )‐βduring antiviral treatment in patients with chronic hepatitis C (CHC) .Methods Eighty‐six CHC patients referred to the First Affiliated Hospital of Zhengzhou University from October 2012 to October 2013 were included ,and all of them were administered with pegylated interferon α‐2a and ribavirin .Thirty healthy controls were enrolled .The percentage of Treg cells ,PD‐1 expression and TGF‐β level were analyzed by flow cytometry at baseline and at time of achieving rapid virological response (RVR ) , early viral virological (EVR ) , end‐of‐treatment virological response (ETVR ) and sustained virological response (SVR) ,or not achieving SVR .Comparison between two groups was analyzed by t test .Results Among 86 CHC patients ,the proportions of RVR ,EVR ,ETVR ,and SVR at week 24 of follow‐up were 29 cases ,67 cases ,79 cases and 67 cases ,respectively .Percentage of Treg cells in CHC patients was much higher than that in healthy controls (10 .31 ± 5 .61 vs 2 .18 ± 0 .65 ,t = 2 .28 , P< 0 .05) .During antiviral therapy ,percentages of Treg cells declined ,not only in CHC patients with HCV genotype 1b (at baseline , RVR ,EVR ,and ETVR :14 .44 ± 3 .78 ,11 .01 ± 1 .79 ,8 .24 ± 2 .98 ,and 5 .36 ± 1 .47 ,respectively ) ,but also in those infected with HCV genotype 2a (at baseline ,RVR ,EVR ,and ETVR :12 .34 ± 2 .82 ,8 .99 ± 1 .68 ,7 .53 ± 2 .96 ,and 4 .79 ± 1 .23 ,respectively ) .Expressions of PD‐1 and TGF‐β also decreased .At baseline ,the expressions of PD‐1 in patients with SVR and without SVR were 29 .11 ± 14 .65 and 37 .73 ± 11 .65 ,respectively (t = 2 .15 , P = 0 .04) ,and the levels of TGF‐β were 41 .20 ± 18 .96 and 56 .75 ± 14 .42 ,respectively (t= 2 .66 ,P< 0 .01) .At week 24 ,the expressions of PD‐1 in patients with SVR and without SVR were 10 .36 ± 4 .81 and 36 .46 ± 10 .52 ,respectively (t= 13 .95 ,P< 0 .01) ,and the levels of TGF‐β were 10 .06 ± 4 .64 and 45 .23 ± 17 .85 , respectively ( t = 11 .85 , P < 0 .01 ) . Conclusions Percentages of Treg cells and expressions of PD‐1 and TGF‐β decrease during antiviral treatment in CHC patients .Thus ,it could be of assist to predict the treatment response by monitoring these parameters .

Objective To explore the simplified method by examining the levels of luteinizing hormone(LH),follicle-stimulating hormone(FSH),estradid(E2) and stosterone(T) at different times in the stimutation test of luteinizing hormone-releasing hormone(LHRH).Methods Sixty patients with precocious puberty accepted LHRH stimutation test.The levels of E2,T,FSH,LH before injection and after 30,60,90 minutes were compaired.The levels of stimutation test of LHRH examined with ACS:180 chemiluminesence.Results There were 39 patients in the group of central precocious puberty(CPP).The levels of FSH and LH in CPP group significantly increased after LHRH 30 minutes injection.The ratio of LH/FSH was higher than 1.The peak level of LH was higher than 12 IU/L.There were 21 patients in group of peripheral precocious puberty(PPP).Compared with the results before injection,the levels of LH were similar to the results of 30,60 and 90 minutes after LHRH injection.Compared with the result before injection,the levels of E2 and T were similar to the result of 60 minutes after LHRH injection.The peak levels of LH and FSH in two groups all focused in 30,60 minutes.Conclusions LHRH stimutation test is mainly based on the peak level of LH and the ratio of LH/FSH,the test can be simplified to examine the levels the of LH and FSH before the test and 30,60 minutes after injection as a basis for the clinical diagnosis.

Objective To develop an efficient method for the determination of activity of human lymphocyte kynureninase by high performance liquid chromatography. Methods Protein containing kynureninase was extracted from lymphocytes.The reaction was made with 3-hydroxyanthranilic acid as substrate and pyridoxal-5'-phosphate as coenzyme.The product was determined by high performance liquid chromatography and fluorescence detection.(Results)Standard curve of 3-hydroxyanthranilic acid was highly linear over the range from 2 to 400 nmol/L.The intra-day coefficient of variation(CV) was less than 3.0% and the inter-day CV was less than 3.2%. Conclusion(The developed) assay is efficient and can be used to determine the activity of kynureninase from kinds of tissues.

A new method of identification and study of diversity of endophytes wa s described in this paper. The seedlings of tomato were treated using four meth o ds, sterile water, chemical reagents, ultraviolet radiation and mechanical to pe el off, respectively. Then endophytes were isolated using plates of beef- pept on e, Gaos I and PDA respectively. The optimal method of wiping off non-endophyte s was determined. We had obtained 148 isolates of endophytes with different size, shape and color. 43 strains of 148 were amplified using method of ERIC-PCR. T he results showed that 32 strains with amplified bands could fall into 28 classes. The purified bacteria were cultured confronting to leaf blight pathogen of tomat o to screen high resistant strain. Three bacteria strains with high resistance to pathogen were obtained.

The recombinant fusion protein staphylokinase-hirudin(rSFH) was purified from the high density-fermented engineered E.coli by means of ion-exchange chromatography (IEC) and gel filtration (GF). The purity of rSFH reached to more than 98% determined by RP-HPLC and SDS-PAGE, and the yield was up to 0.7g per liter of fermentation broth. The analysis of homologous dimmer of rSFH appeared during the purification and calculation of the surface hydrophobic area had been carried out by means of hydrophobic chromatography and MALD-TOF. The influence of sodium chloride and temperature on the behavior of rSFH reversible dimerization was analyzed by high performance sized- exclusive chromatography(HPSEC). It is concluded that the hydrophobic interaction played an important role in the reversible dimerization of rSFH.

Objective To investigate the feasibility and accuracy of magnetic resonance microneurog- raphy of sciatic nerve fascicles in rabbil by correlation with the gross anatomy.Methods The 3D T_2-weigh- ted imaging(3D-T_2 MI),3D T_2-weighted imaging plus spectral presaturation with inversion recovety(SPIR), T_1-weighted imaging(T_1 WI)of the sciatic nerve in 10 rabbits were performed on a 1.5 Tesla magnetic reso- nance system.The radiological ananomy and imaging features of sciaticnerve fascicles were observed and the anterior-posterior diameter was measured on 3D T_2-weighted imagingThe imaging evaluation was correlated with the gross anatomy.The T_1 and T_2 relaxation time were determined by multiple echo spin echo and mix se- quecerespectively.Results The libial nerve and peroneal nerve in the main trunk of sciaticnerve in all 10 rabbits could be clearly displayed on the 3D T_2 WI,3DT_2WI plus SPIRand T_1WI.Strikingly,the 3D T_2 WI could delineate the fine branches of the sural nerve and posterior femural cutaneous nervesThe T_1 and T_2 relaxation time were 915 ms40 msrespectivelyGrosslythe anterior-posterior diameter of sciatic nerve trunk was3.17?0.21)mmwhile was(3.15?0.19)on 3D T_2 WI.There was no statistically significant difference(t=0.768,P=0.462).Conclusion With 1.5 Telsa MR system the microneurography of the sci- atie nerve could be achievable and the individual fascicles of sciatic nerve trunk could be clearly and accurately discriminated.