In the clinical skill evaluation,SP and the new technology OSCE for medical educational evaluation brought by SP can offer a vivid and complete exam atmosphere for the medical students,which have been widely applied by medical colleges and schools at home and abroad,with real,effective,reliable characteristics and broader development prospect. To induce the technology into TCM clinical evaluation is in accordance with the requirements of TCM educational development,which can make students better grasp clinical various basic skills within limited studying periods.

Npu DnaE intein was used to produce some large proteins,which were difficult to obtain through conventional expression systems.A T7 expression system was described,by which the gene of T7 RNA polymerase is split into two pieces,and each piece fuses with Npu DnaE N-and C-terminal sequences respectively.Functional T7 RNA polymerase is created by mixing the two kinds of fusion constructs in vitro.The approach of split intein-mediated production of large proteins,in theory,readily generalizable to the purification of other large,cytotoxic or membrane proteins.

Objective To investigate the alteration of NKT cells number in patients with systemic lupus erythematosus (SLE) and its correlation with SLE disease activity.Methods Blood samples were obtained from 30 patients with SLE and 30 healthy control subiects.The number of NKT cells from peripherial blood mononuclear cells (PBMC) were detect by flow cytometry (FCM).Two independent samples t-test and Pearson correlation was used to evaluated the relationship between SLE disease activity and NKT cells.Results Compared with healthy controls [(4.16±0.22)%],lower number of NKT cells were found in SLE group[(2.53±0.33)%](P<0.05).An inverse correlation was observed between the frequency of NKT cells and IgG,anti-dsDNA,SLE disease activity index.Conclusion Reduced proportions of NKT cells observed in patients with SLE and is associated with high SLE disease activity.

Objective To observe the preventive and therapeutic effects of L-carnitine on the metabolic disorder and cardiac remodeling in alcoholic cardiomyopathy. Methods Experimental animals were divided into three groups: alcohol-fed group(A), an alcohol/L-carnitine fed group(B) and a control group(C). Free fatty acid(FFA) and earnitine were detected in the blood serum at different time. mRNA and protein expressions of peroxisome proliferator-activated receptors (PPARα and PPARγ), retinoic acid receptor retinoid X receptor alpha (RXRα), earnitine palmitoyl transferase isoform and medium-chain acyl-CoA dehydrogenase (MCAD) were observed with RT-PCR and Western blotting methods. Results (1) When group A and B were compared with group C, FFA was increased and carnitine was decreased;mRNA and protein expressions of PPARα, RXRα, CPT-Ⅰ and MCAD were decreased with the development of alcoholic cardiomyopathy (ACM), being more significantly in group A than group B (P < 0.05). (2) mRNA and protein expressions of PPARγ had no statistical significance between these three groups at the end of 2 and 4 months(P>0.05), but after 6 months, they were increased in group B and decreased in group A (A vs. C,P<0.01;B vs. C,P<0.05). Conclusion Metabolic disorder and cardiac remodeling occur in the development process of ACM; they are partly prevented by L-carnitine through downregulating mRNA and protein expressions of PPARct, RXRα, CPT-Ⅰ, MCAD and PPARγ.

Objective To summarize the clinical manifestation ,the main pathogenic bacteria distribution and drug resistance of neonatal community acquired sepsis late onset in our hospital .Methods Retrospectively analyse the clinical material of 122 cases (41 premature cases and 81 cases of full term) with neonatal community acquired sepsis late onset ,which were clinically diagnosed , from January 2009 to December 2012 in our hospital .Results The main clinical manifestation of neonatal community acquired sep-sis late onset was poor response(64 .7% ) ,repellent milk(57 .4% ) ,temperature changes(61 .5% ) ,and the respiratory tract and um-bilical region were the main infection ways .42 cases were checked out with pathogen in the 122 cases ,blood culture positive rate was 34 .4% ,and there was no statistically differences between the premature and the full term infant group ,In the 42 cases ,there were 29 cases with staphylococcus ,including 10 cases of staphylococcus aureus ,14 cases of coagulase negative staphylococcus and 5 cases of enterococcus ;and there were 10 cases are checked out with e .coli .All of the coccus detected were resistant to penicillin and erythromycin ,but sensitive to vancomycin ,teicoplanin ,linezolid .The e .coli was sensitive to amikacin ,imipenem ,meropenem ,and al-so had a higher sensitivity to cefazolin ,ceftriaxone ,cefepime ,cefoperazone and nitrofurantoin .Conclusion Blood culture positive rate is not high in neonatal community acquired sepsis late onset ,and its′clinical manifestations are nonspecific .The main pathogenic bacteria is coagulase negative staphylococcus ,staphylococcus aureus ,followed by escherichia coli .

Strong inhibition of Bacillus subtilis strain NJ-18 on mycelia growth of Alternaria solani was observed in the antagonistic tests by cylinder plate methods, and the inhibition width was 21.5 mm. Observation under microscope found that the supernatant of fermentation from NJ-18 could make the pathogen hyphae cells malformed and swelled, and consequently the growth of the pathogen was inhibited. Determining of the colonization in potato plants by the signed rifampicin-resistance in NJ-18 showed that it could colonize well in the plants, the colonization quantity of NJ-18 in the root and stem of the potato detected 30 days after fermentation irrigation was 103 CFU/g plant’s fresh weight. In pot experiment, we inoculated the tomato plants with the spore suspensions of Alternaria solani after spraying the fermentation of NJ-18, the results were investigated in 14 days and the efficacy in controlling the disease was 72.9%, which was significantly higher than 45.7%, the efficacy resulted from spray treatment of 2000 fold dilution of 50% iprodione wetable powder.

Aortic dissection is a dangerous and critical disease with extremely high mortality and disability rate.In clinical practice,aortic dissection should be highly suspected when patients developed dying-like severe chest and back pain.CT and MRI have been the reliable tools for diagnosing aortic dissection.In recent years,endovascular therapy has become the preferred treatment for Stanford type B aortic dissection,and some patients with Stanford type A dissection who cannot receive open surgery may also be treated with endovascular therapy.In order to improve endovascular treatment,to develop new instruments and to study the pathogenesis of aortic dissection,the preparation of stable and reliable animal models is very necessary.This paper aims to make a brief review about the research status concerning the preparation of animal models of aortic dissection.

Objective To find out and clarify the causes and the pathogens of vulvovagmitis in childhood girls, to determine the clinical treatment. Methods There were 345 cases of childhood girls .ranged from 18 days to 12 years, with symptoms of vulvovagini tis, and their vaginal secretions were examined by routine smear for cleaning degree, trichomonas , Candida and clue cells, gram-stain for neisseria gonorrhoeae, culture for bacteria, mycoplasma urealytium, mycoplasma hominis and chlamydia trachomatis. Results One hundred and nine pathogens were detected(31.6% of the whole cases ), including specific pathogen 70 cases(20. 3% )and non-specif ic pathogen 32 cases(9.3%). Gardnerella was detected most frequently in specific pathogen while enteric bacilli was detected most frequently in non-specific pathogen. Conclusions Non-specific vulvovaginitis is the most frequent cause in childhood vulvovagimtis, and bacterial vaginosis is the mast frequent in specific infection. Symptomatic treatment is effective, but antibiotic treatment should be based on pathogenic findings of vaginal secretions.

Objective To evaluate the feasibility and application of histopathology diagnosis of endometrial tissues obtained by endometrial cell collector (Jingyou, SAP-1). Methods One hundred and ninety-three patients whose endometrial lesions should be excluded were selected. First, endometrial tissue were obtained from the patients by Jingyou, then they underwent comprehensive curettage under hysteroscopy. The histopathology diagnosis was performed respectively. The specimen satisfaction rate and diagnostic accuracy was analyzed and compared. Results The specimen satisfaction rate of curettage under hysteroscopy was 95.85%(185/193). The specimens of 8 cases were not satisfied because the tissues were not enough. The specimen satisfaction rate of Jingyou was 82.38% (159/193). The specimens of 34 cases were not satisfied, among whom in 10 cases scratches did not throughout the whole palace antrum, and in 24 cases tissues quality were poor. The endometrial thickness in unsatisfactory specimen by Jinyou was significantly thinner than that in satisfactory specimen:(0.64 ± 0.18) cm vs. (0.97 ± 0.43) cm, and there was statistical difference (P<0.05). The diagnostic accordance rate between Jingyou and curettage under hysteroscopy was 79.87%(127/159). The sensitivity of Jingyou from high to low was 94.19% (81/86) in normal menstrual endometrial, 7/10 in endometrial carcinoma/ atypical hyperplasia, 67.86%(38/56) in endometrial hyperplasia and 1/7 in endometrial polyps. Missed diagnosis of jingyou inluded 2 cases of endometrial carcinoma and 4 cases of endometrial atypical hyperplasia. The misdiagnosed rate of high grade endometrial lesions was 6/16, and the patients were misdiagnosed because the tissues were not enough. Four cases of endometrial atypical hyperplasia had underwent conservative treatment of repeated curettage. Conclusions Application of Jingyou can obtain micro endometrial tissues, and the accordance rate of histopathology diagnosis is high with curettage under hysteroscopy. When the collector makes a comprehensive collection to the uterine cavity specimen, it can accurately screen endometrial carcinoma and atypical hyperplasia. The patients who have endometrial atypical hyperplasia and receive conservative treatment and curettage repeatedly curettage, thin endometrium and ultrasonic highly suspected endometrial polyps, are not recommend to use Jingyou to obtain specimen. When the specimen is not satisfied using the collector, additional hysteroscopy should be performed to avoid misdiagnosis of high grade endometrial lesions.

Objective To evaluate the feasibility and efficacy of catheter-directed thrombolysis (CDT) for the treatment of non-acute (history ＞ 14 days) deep venous thrombosis (DVT) of the lower extremity.Methods Clinical data of 63 patients of non-acute DVT of lower extremities treated by CDT and adjunctive angioplasty and stenting from July 2009 to August 2013 were analyzed retrospectively.Venous recanalization was graded by a thrombus score based on pre-and post-treatment venography.Follow-up was performed by Doppler ultrasound and clinical evaluation.Results A total of 63 limbs with DVT with a mean symptom duration of (22 ± 5) days were treated by a continuous combined with pulse-spray infusion of urokinase of (1.21 ± 0.69) million IU/d for (74 ± 21) hours.Significant recanalization was achieved in 77％ (48 of 63) of the treated limbs.After thrombolysis,percutaneous angioplasty was done for 15 residual lesions and stent placement was performed in 11 iliac veins and 1 femoral vein.Minor bleeding occurred in 6 (10％) patients,no patients suffered from major bleeding or symptomatic pulmonary embolism.During follow up (mean:15 ±6 months),the veins were patent in 45 (71％) limbs.15 (24％) limbs developed mild post-thrombotic syndrome (PTS),and none had severe PTS.Conclusions CDT combined with adjunctive angioplasty and stenting is safe and effective for removal of the clot burden and for restoration of the venous flow in patients with non-acute lower extremity DVT.