Objective:To understand the current situation of medical students' professional attitude,find out the exiting problems and put forward some corresponding suggestions.Methods:The medical students' professional attitude was investigated using questionnaire in Shanghai.FResults:Some medical students lacked of professional confidence;the students expected highly towards compensation benefit;the professional satisfaction was low.There existed a correlation between professional values,expect and satisfaction.Conclusions:Perfecting pre-service training is a necessary prerequisite to improve medical students' professional confidence;compensation benefit is one of the referred factors for medical students to choose an occupation;improving medical students' professional view is the foundation of long-term development of medical enterprise;the professional counterpart is the key to ensure medical students' professional satisfaction.

Objective To investigate the effect of dexmedetomidine pretreatment on the expression of caspase-12 in lung tissues undergoing one-lung ventilation (OLV) in rats.Methods Thirty male Sprague-Dawley rats, aged 6-8 weeks, weighing 180-220 g, were randomly allocated into 3 groups (n=10 each) using a random number table: two-lung ventilation (TLV) group, OLV group and dexmedetomidine group (Dex group).Bilateral lungs were ventilated for 2 h in group TLV.In OLV and Dex groups, unilateral lung was ventilated for 1.5 h followed by 0.5 h TLV.In group Dex, dexmedetomidine was infused intravenously at a rate of 3.0 μ g · kg-1 · h-1 over 60 min starting from 60 min prior to OLV.The equal volume of normal saline was given instead of dexmedetomidine in OLV and TLV groups.Peak airway pressure (Ppeak) and mean airway pressure (Paw) were recorded at 45 min of OLV and 15 min of TLV in OLV and Dex groups, and at 15 min of TLV in group TLV.The rats were then sacrificed, and left lungs were removed for microscopic examination of the pathologic changes (using HE staining) and the ultrastructure of lung tissues (with transmission electron microscope) and for determination of wet to dry lung weight ratio (W/D ratio), cell apoptosis in lung tissues (by TUNEL), caspase-12 mRNA expression (using real-time reverse transcriptase-polymerase chain reaction), and caspase-12 expression (by Western blot).Results Ppeak and Paw were significantly lower at 15 min of TLV than at 45 min of OLV in OLV and Dex groups (P＜0.05).Compared to group TLV, W/D ratio and AI were significantly increased, and the expression of caspase-12 protein and mRNA was up-regulated in OLV and Dex groups (P＜0.01).Compared to group OLV, W/D ratio and AI were significantly decreased, and the expression of caspase-12 protein and mRNA was down-regulated in group Dex (P ＜ 0.01).The pathologic changes of lung tissues were significantly alleviated in group Dex as compared with group OLV.Conclusion The mechanism by which dexmedetomidine pretreatment alleviates acute lung injury caused by OLV is associated with down-regulated expression of caspase-12 and inhibited cell apoptosis in rats.

Objective To investigate the effect of Calcium Dobesilate Capsules in the treatment of diabetic retinopathy ( DR ) and its effect on hemorheology, vascular endothelial function and thrombin.Methods According to the random number table the 80 cases of DR patients admitted in our hospital from September 2014 to August 2016 were divided into observation group and control group, 40 cases in each group, two groups of patients were treated with conventional therapy, the observation group was treated with Calcium Dobesilate capsules.Two groups of treatment were three months.Compared of the therapeutic effects, the before and after treatment changes of visual acuity, hemorheology, vascular endothelial function and thrombin index.Results The total efficiency of the observation group 92.50% was higher than the control group 72.50% (P<0.05);After treatment, two groups visual acuity increased, and the observation group after treatment higher than the control group (P<0.05); Plasma viscosity, whole blood viscosity at high shear and low shear whole blood viscosity, erythrocyte aggregation index in two groups were decreased, and observation group lower than the control group (P<0.05);Plasma NO and ET-1 levels in two groups were reduce, and observation lower than the control group after treatment (P<0.05); After treatment, two groups PT, TT and APTT increased, and observation group PT, TT and APTT higher than the control group (P<0.05) .There were no obvious adverse reactions in the two groups during the treatment period.Conclusion The effect of calcium dobesilate capsules in the treatment of patients with DR is obvious, and it can improve hemorheology.

Objective To assess the influence of timing of tracheostomy performed on ICU patientswith mechanical ventilation support for long-term.Methods A retrospective study was carried out in 94 patients under mechanical ventilation support with tracheostomy from January 2012 to October 2014.The patients were divided into early stage group (group A) in which the tracheostomy was done within 7 days after endotracheal intubation and late stage group (group B) in which the tracheostomy was performed at above 7 days after endotracheal intubation.The differences in lengths of mechanical ventilation support (MVS),ICU stay,and hospital stay,incidence of ventilator-associated pneumonia (VAP) and mortality were compared between two groups using nonparametric statistics.Results Compared with group B,there were statistically significant reduction in duration of mechanical ventilation (7d vs.17 d;P ＜ 0.05),shorter length of ICU stay (10 d vs.19 d;P ＜ 0.05),and lower incidence of VAP (21.05％ vs.36.84％;P ＜ 0.05) in group A.There were no significant differences in hospital stay and mortality between two groups (P ＞0.05).There was a correlation between the duration of mechanical ventilation and timing of tracheostomy (R2 =0.680) and a correlation between the length of ICU stay and the timing of tracheostomy (R2 =0.662) was found.Conclusions Early tracheostomy has a significant positive impact on critically ill patients hospitalized in this ICU.These results support the tendency to balance the risk-benefit analysis in favor of early tracheostomy.

Objective To develop a new type of Raman-enhanced substrate for rapid detection of E.coli based on label-free surface-enhanced Raman scattering( SERS) technology.Methods Stober’ s improved method was used to prepare 360 nm silica ( SiO2 ) nanospheres.Prepared gold core-silver shell nanoparticles( Au@Ag) of different size were attached to 360 nm SiO2 to fabricate the nanocomposites ( SiO2-Au@Ag ) that were characterized by transmission electron microscopy (TEM) and UV-visucl light adsorption spectra (UV-Vis).PATP was detected to select SiO2-Au@Ag with optimal SERS effect.This optimal SiO2-Au@Ag was used to obtain the sensitivity of PATP and E.coli detection after a simple mixed culti-vation.Results TEM images showed that Au@Ag aggregated with the size of Au@Ag attached to 360 nm SiO2 .UV-Vis spectra indicated that the maximum absorption of Au@Ag and SiO2-Au@Ag had a red shift with the invrease of Au@Ag size.The experiment results suggested that detection sensitivity of PATP by SiO2-100 nm Au@Ag 10 -10 mol/L, while the lowest detectable E.coli concentration was 105 CFU/ml.Conclusion The 360 nm SiO2 binding with 100nm Au@Ag exhibits great potential for SERS applications.

OBJECTIVE:To prepare nanostructured lipid carrier of adefovir dipivoxil(ADV-NLC),and optimize the formula-tion. METHODS:Using stearic acid and glycerin monostearate as solid lipid,oleic acid as liquid lipid,Gemini surfactant and poly-sorbate 80 as emulsifier,sodium dodecyl sulfate (SDS) as stabilizer,solvent dispersion ultrasonic method was used to prepare ADV-NLC. And using particle size,polydispersity index,Zeta potential,encapsulation efficiency as indexes,single factor test was conducted to screen Gemini surfactant-polysorbate 80 ratio,emulsifier dosage(ratio of emulsifier to water phase),drug-lipid ratio, solid-liquid lipid ratio. RESULTS:The formula was as follow as 3% emulsifier (Gemini surfactant-polysorbate 80 ratio of 1:2), 4.5% drug-lipid ratio,solid-liquid lipid ratio of 6:5. The average particle size of the prepared ADV-NLC was(48.83±2.65)nm, polydispersity index<0.3,Zeta potential was(-28.7±1.8)mV,encapsulation efficiency was(77.65±0.03)%(n=3). CONCLU-SIONS:ADV-NLC is successfully prepared,and the formulation is reasonable and feasible.

To develop a safe and efficient recombinant subunit vaccine to foot-and-mouth disease virus(FMDV)type Asia 1 in sheep,a tandem repeated multiple-epitope gene consisting of residues 137-160 and 197-211 of the VP1 gene of FMDV was designed and artificially synthesized.The biologically functional molecule,the ovine IgG heavy constant region(oIgG)as a protein carrier was introduced for design of the multiple-epitope recombinant vaccine and recombinant expression plasmids pET-30a-RE and pET-30a-RE-oIgG were successfully constructed.The recombinant proteins,RE and RE-oIgG,were expressed as a formation of inclusion bodies in E.coli.The immune potential of this vaccine regime in guinea pigs and sheep was evaluated.The results showed that IgG could significantly enhance the immune potential of antigenic epitopes.The recombinant protein RE-oIgG could not only elicit the high levels of neutralizing antibodies and lymphocytes proliferation responses in the vaccinated guinea pigs,but confer complete protection in guinea pigs against virus challenge.Although the recombinant protein RE could not confer protection in the vaccinated animals,it could delay the appearance of the clinical signs and reduce the severity of disease.Inspiringly,the titers of anti-FMDV neutralizing antibodies elicited in sheep vaccinated with RE-oIgG was significantly higher than that for the RE vaccination.Therefore,we speculated that this vaccine formulation may be a promising strategy for designing a novel vaccine against FMDV in the future.

The potency of an improved recombinant multi-epitope vaccine against FMDV type Asia1 was evaluated in this study .A multi-epitope gene based on FMDV type Asia1 was designed and a recombinant expression plasmid (pRE-oIgG) was constructed .The proteins ,RE-oIgG and 3D were expressed in E .coli cells and purified with Ni-NTA agarose resin by affinity chromatography .The proteins ,RE-oIgG ,3D and RE-oIgG plus 3D ,were emulsified in an oil adjuvant ISA 206 .Twenty-five female guinea pigs were randomly divided into five groups and intramuscularly vaccinated for with RE-oIgG ,3D ,RE-oIgG plus 3D ,an inactivated FMDV vaccine (type Asia1) ,and PBS .All animals were vaccinated for two times .Anti-FMDV specific an-tibodies ,neutralization antibodies ,protection potency ,and lymphoproliferation assay were detected by ELISA ,virus neutrali-zation assay ,challenge test ,and flow cytometry ,respectively .Results showed that RE-oIgG plus 3D elicited significant high-level anti-FMDV specific antibodies compared to RE-oIgG alone (P<0 .05) .All the vaccinated animals induced higher level lymphoproliferation responses in vitro except PBS .Both 3D alone and PBS produced the negligible neutralizing antibodies and anti-FMDV specific antibodies .RE-oIgG plus FMDV 3D not only elicited high levels of anti-FMDV neutralizing antibodies ,but also induced significant lymphoproliferation responses .More importantly ,RE-oIgG plus 3D conferred complete protection to guinea pigs against challenge with 1 000 GPID50 .Interestingly ,two of five vaccinated animals with 3D alone were full protected against challenge ,and other three animals significantly showed a delay of 2-3 days in the onset of clinical signs .Therefore ,we considered that RE-oIgG plus 3D induces strong humoral and cellular immune responses ,which may be used for control and prevention of FMD in the future .

Objective:To discuss the structure of medical humanistic curriculum system based on the research of quality features of excellent doctors .Methods:The goal , content and form of humanistic curriculum were based the factor of famous doctors'competencies which was build on the basis of literature review and experts'interview. Results:Ability and attitude or values accounted for high proportion of overall quality features .Humanities con-tained in most factors of excellent doctors'quality features;guiding significance of the structure of medical humanis-tic curriculum system is provided with excellent doctors'quality features .Conclusion:We should focus on the inte-gration of humanistic knowledge and practice , push humanities course into every stage of the medical education , further enrich category and quantity of medical humanities course and teaching form of medical humanities course , perfect the examination mode of medical humanities course in order to cultivate more excellent doctors .

Editor's Notes: The basic theory of traditional Chinese medicine is the theoretical foundation of Chinese medicine , modernization of Chinese medicine needs of the modern theory of Chinese medicine urgently . However , it is always the important issues about how modern Chinese medicine theory should be created , and what kind of theory should have been established concerned and explored by domestic and foreign counterparts in tradi-tional Chinese medicine . To lead the development of modern Chinese medicine theory , Modern Basic Theory of Traditional Chinese Medicine series of symposiums are set up specially in the current Review column, and discussed thoroughly and systematically using three consecutive pats respectively. Among them, part I contains 3 articles about new concepts, new theories, new disciplines; part II contains 5 articles about new ideas, new norms, how to clear concept, how to verify hypotheses, why to evaluate theory; part III contains 12 articles about concept of wholism updating, treatment based on syndrome differentiation development, viscera-state doc-trine innovation, pathogeny, etiology, pathogenesis, prevention, principle of treatment, knowledge structure, cogni-tion structure , monographic study , 5-year outlook . Published article on this issue is the first one belong to new concept of part I. In this paper, we want to describe the denotation and connotation of the new concept of the modern basic theory of traditional Chinese medicine from three aspects of a concept: a label , a theoretical definition , and an operational definition learning from the international academic understanding of scientific concepts, demonstrate the necessity of theoretical premise to the research and establishment of the modern basic theory of traditional Chinese medicine and the need to build on , illustrate the inevitable trend toward modern science . The whole article contains profound meaning and a certain breakthrough and innovation. We are expected to cause concerns and discusses of experts and scholars through this article .