In light of the unfulfilled docking of the previous curriculum system of clinical medicine science specialty in higher vocational colleges and with the requirement of being a first-line physician,we put forward our reform sketch for Clinical Medicine Transboundary Curriculum System targeting at fostering technical and skilled genius that will be qualified for the post of clinical physician in primary heahh-care institution,following the principle of quality-first,capability-centered and knowledge-based and attempting to establish a unified system combining quality,capability and knowledge,and analyze the difficulty during the implementation of the reform ideas and measures that could be taken.In this way,it will be possible for us to comprehensively dock curriculum initiatives with the capability of the post,curriculum content with professional criteria,professional teaching with clinical applications,vocational education and lifelong study,and hence,it will be helpful for us to foster qualified genius for first-line medical institution.

[Objective]To investigate the ability of repairing bone defect with the combination of recombinant human insulin-like growth factor-1(rhIGF-1),coralline hydrolyapatite(CHA) and autogeneous red bone marrow(ARBM) by way of imaginology.[Method]Bilateral middle radius periosteum-bone defects (11mm in length) were created in 54 Chinese rabbits,and were ramdonly devided into 6 groups(each group containning 18 radial defects of one forearm): group A, defects transplanted with rhIGF-1/CHA/ARBM,group B,with CHA/ARBM,group C,with rhIGF-1/CHA,group D,with CHA,group E,with autograft,group F,no implant.At 2,4,8,and 12 weeks postoperation,the repair effects of defects were evaluated by observation of gross appearance,roengenodiagnosis and radionuclide bone image assay.[Result]In group A,radiological and bone density image analysis showed that the defects were bridged well at 12 weeks postoperatively and was significantly superior to those of any other groups(P0.05).[Conclusion]The recombinant compound rhIGF-1/CHA/ARBM,which possesses the potential ability of osteogenesis,osteocondution and osteoinduction for bone defect repairing,can enhance bone healing and serve as a new type of bone substitute.

Objective To illustrate the evaluation effect of bivariate analysis of sensitivity and specificity meta-analysis model in diagnosis test to provide basis for selecting better evaluation method of diagnostic test.Methods Bivariate model was presented by reanalyzing the data from a published meta-analysis of two diagnostic techniques in diagnosis of schistosomiasis japonica.Results The bivariate model could directly provide summary estimates of(logit)sensitivity,specificity and DOR with corresponding 95% CI for two diagnostic tests(IHA and ELISA).Also,it could elicit any significant difference that existed among sensitivity,specificity and DOR between the two diagnostic methods,and incorporate any correlation that existed between sensitivity;specificity.Conclusion The bivariate model preserves the two dimensional nature of the original data,and separates effects of sensitivity and specificity,which is more rational than a net effect on diagnostic odds ratio scale as in SROC approach.The bivariate model is appropriate and agile,and can be used as an extension and improvement of the traditional SROC method.

Sirt3 is a kind of nicotinamide adenine dinucleotide (NAD+)-dependent deacetylases.Sirt3 is localized in mitochondria and has been involved in a wide range of mitochondrial biological functions, such as nutrient oxidation、ATP generation, reactive oxygen species (ROS) detoxification and mitochondrial homeostasis.Sirt3 plays an important role in the occurrence and development of cardiovascular diseases.Increased expression of Sirt3 gene has been associated with extended lifespan of humans.

Objective:To determine the effect of IL-12 on the cellular immune response of PBMC from patients with chronic hepatitis B virus infection, and provide basic scientific information for clinic therapy of this disease.Methods:PBMCS were prepared from peripheral blood of individuals with chronic HBV infection and cultured in the presence or absence of HBsAg and HBcAg with or without IL-12.The level of IFN-?in culture supernatants, the frequency of IFN-?-producing cells, and the subpopulation of IFN-?-producing cells were detected by either ELISA,ELISPOT or FACS.Results:Less than 30% patients and very low level of IFN-? were observed when PBMCs were stimulated with HBsAg or HBcAg alone. Addition of IL-12 to the cultures resulted in significant increase in IFN-?production and IFN-?-producing cells. In addition, IL-12 induced expression of IFN-? not only by CD8~+T cells, but also by non-T cell populations.Conclusion:IL-12 can promote the cellular immune response to the chronic hepatitis B virus by the enhancement of IFN-?production.

[Summary] SIRT3 is a member of the silent information regulator 2 ( Sir2) family, located in the inner mitochondrial membrane, with a strong effect of deacetylation. SIRT3 not only modulates energy metabolism, cell apoptosis, tumor growth, anti-aging etc. , but also plays an important role in the field of cardiovascular diseases. In this review, we summarize recent findings related to SIRT3 with metabolic syndrome and cardiac hypertrophy, to provide a theoretical basis for the further study on the potential role of SIRT3 in cardiovascular diseases.

OBJECTIVE To study the germicidal efficacy and germicidal mechanism of compound ortho-phthalaldehyde(OPA) against Bacillus subtilis var.niger spores.METHODS Suspension quantitative germicidal test was used to observe the germicidal efficacy of compound OPA against B.subtilis var.niger spores.The germicidal mechanism of compound OPA was studied in transudation of protein and DNA and ultra-microstructure.RESULTS The results showed that at(20?1)℃,the logarithm mean reduction was greater than 5.00,after B.subtilis var.niger spores had been exposed to compound OPA for 30min.Some protein leaked from B.subtilis var.niger spores treated with compound OPA for some time,but there wasn′t DNA.The ultrastructure showed that the shape was amorphic,the electronic density of the coat was unequal,the core leaned to one side or appeared the transmission area.CONCLUSIONS Compound OPA can effectively kill B.subtilis var.niger spores.Its mechanisms are that in accordance with benzolkonium bromide(Bromogeramine) the compound OPA can change the osmotic pressure of cell and increase cell permeability,then it can easily penetrate to their target sites within the cell.

Objective To explore the effect of spinal decompression system on lumbar disc herniation. Methods 83 patients of lumbar disc herniation were divided into observation group (n=42) and control group (n=41). Both groups received massage therapy, while the observation group was treated with spinal decompression system in addition. The effect was evaluated with Visual Analogue Scale (VAS) and Japanese Orthopedic Association (JOA) assessment of low back pain. Results The VAS score decreased and the JOA score increased in both groups after treatment (P<0.05), and it was better in the observation group than in the control group (P<0.01). Conclusion Spinal decompression system could improve the therapeutic effect on lumbar disc herniation.

Objective To describe the analgesic effect of low-flow rate oxygen inhalation with intravenous mannitol injection for patients after nasal operation and seek for effective method for allevia-tion of pain.Methods 160 patients were divided into group A,B,C and D with 40 cases in each group.Group A received intravenous injection of 125 ml of 20%mannitol and group B got low-flow rate oxygen inhalation through nasal canulas.While group C were given the combination of treatment in that of group A and group B.Group D was named the control group and only adopted routine nursing.The pain alleviation effect was observed by McGill pain evaluation method.Results The score of pain in group C was lower than those in group A and B.While the scores of pain in group A and B were lower than that in group D(P<0.01).Conclusion The nasal swelling in group C lightened compared with those of group B (P<0.01)and group A(P<0.05).The nasal swelling in group A was lighter than that of group D but no difference Was seen between group B and group D

Objective To evaluate the clearance efficacy of resin hemoperfusion(HP) on the removal of organophosphorus in the rabbits poisoned by methamidophos(MAP) and its effects on organ injury. Method Six-teen healthy Japanese white rabbits were randomly divided into HP group and non-HP group. MAP was given through gastric tube in a dosage of 20 mg/kg to rabbits of both groups. Rabbits of liP group received resin hemop-ersion plus conventional treatment including early gastric lavage, atropine and pralidoxime. Rabbits of non-HP group received only conventional treatment. The plasma concentration of MAP was determined by using gas chro-matography before and after rabbits were poisoned at different intervals. Serum choline esterase (ChE),lactic de-hydrogenase (LDH), alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase (CK) and creatine kinase isoenzyme (CK-MB) of rabbits of both groups were assayed 6 hours after rabbits poisoned. Pathological changes in lung, liver, kidney and muscle were investigated simutaneously. SPSS 10.0 software was used for statistical analysis. The comparison between groups was carried out by using t -test. Results ① The typical symptoms of organophospborus poisoning were occurred in rabbits within 5 - 10 minutes after ingestion of MAP. In HP group, the plasma levels of rabbits before,and 30 min,60 min,90 min and 120 min after hemoperfu-sion were (11.43±1.56),(7.82±1.54),(4.97±1.58),(5.66±1.75) ,(5.49±1.68) μg/mL, respectively (P <0.01). After hemoperfusion, the plasma MAP levels of rabbits in HP group were lower than those in non-HP groups (P < 0.01). The improveme, nt of clinical presentation of rabbits was observed shortly after HP. ② The blood choline esterase activity of rabbits were depressed in hoth groups without significant difference. In contrast, the blood levels of ALT, AST,LDH,CK and CK-MB of rabbits in non-HP group elevated significantly than in HP group (P < 0.01). ③ The more severe injury of muscle, liver, kidnet and lung of rabbits can could be seen in non-HP group. Conclusions ① HP can effectively eliminate the plasma MAP and has the potential to improve the clinical presentation of intoxication in rabbits. ② Early intervention of Hp exerts a protection from organ dam-age of organophosphorus pesticide.