Objective] Aiming at the problem of a slower growth in overseas TCM students in China, to find out the causes of the problem and put forward countermeasure to promote the further development of TCM overseas education in China. [Method] The article, from the aspects of nearby schooling, the financial crisis and tuition costs, analyzed the causes for the slower growth in overseas TCM students in China, and put forward the corresponding countermeasures.[Results] Through the analysis about the present situation of TCM overseas education in China, it points out that the scale growth delay is the bottleneck problem of current TCM overseas education in China, and needs a series measures to cope with such as collaborating with overseas TCM schools, promoting teaching quality, and setting up the TCM overseas education brand in China, etc. [Conclusion] TCM overseas education in China should conform to the trend, turn the emphasis to the connotation construction from enlarging the scale and promote its the further development.

Objective To compare the lymph node dissection of left chest single incision and neck-right chest-abdomen incision in esophageal cancer surgery,and to explore the reasonable range of lymph node dissection in esophageal cancer surgery.Methods We retrospectively analyzed the clinical data of 72 patients with esophageal cancer radical surgery.According to the surgical approach,the patients were divided into left chest single-incision group (32 cases) and three-incision group (40 cases).The surgery time,number of lymph node resected,drainage tube time,length of hospital stay,lymph node dissection status and incidence of postoperative complications were analyzed.Results In left chest single-incision group and three-incision group,the operative time [(225.44 ± 11.98) min vs (265.42 + 13.15) min],lymph node dissection number[(8.031 ± 1.153) vs (11.821 ± 1.138)],length of stay [(13.212 ± 1.294) d vs(15.691 ± 1.404) d] and other aspects had statistically significant differences (t =24.201,25.302,14.010,all P ＜ 0.05).There were no significant differences between two groups in the chest tube indwelling time and the incidence of postoperative complications (P ＞ 0.05).Conclusion Both surgical radical resection of esophageal cancer have their own characteristics in terms of surgical difficulty,risks,efficacy and complications.In clinical,these must be carefully evaluated in patients with lesions and body affordability flexibility to choose the surgical approach in order to achieve the best therapeutic effect.

OBJECTIVE:To establish the HS-GC method for the content determination of menthol in Qiangli Pipa syrup,and the content of menthol in 56 batches of Qiangli Pipa syrup commercially available was determined. METHODS:HS-GC was per-formed on the column of Agilent HP-INNOWAX,column temperature was 130 ℃(maintaining 7 min),FID was used as detector, inlet temperature was 200 ℃,detector temperature was 250 ℃,carrier gas was high-purity nitrogen,flow rate was 3 ml/min,split ratio was 10∶1 and the injection volume was 1 000 μl. RESULTS:The linear range of menthol was 0.007 07-0.141 40 mg/ml(r=0.999 1);RSDs of precision,reproducibility and stability tests were no more than 3.37%;average recovery was 94.3%-99.6%(RSD=1.86%,n=6). There was significant difference in the contents of menthol in 56 batches Qiangli Pipa syrup. CONCLU-SIONS:The method is simple,sensitive,accurate and reliable,and can be used for content determination of menthol in Qiangli Pi-pa syrup. The sampling results show it is necessary to update the detecting items for the content of Qiangli pipa loquat and strength-en the quality control of it.

Objective To explore the effect of self efficacy combined with mobile health information service applied in pulmonary rehabilitation in residence in elderly patients with chronic obstructive pulmonary disease. Methods Sixty-eight elderly patients in stable situation were divided into the control group and the intervention group with 34 cases in each group accoridng to the random digit table. In the control group, the nursing intervention included health education and telephone follow-up. The intervention group adopted self efficacy theory combined with mobile health information service. The items such as persistence in pulmonary rehabilitation, Exercise Self-Regulatory Efficacy Scale (Ex-SRES) and health condition were assessed. Results After intervention for 12 weeks, the scores of persistence in pulmonary rehabilitation in residence in the intervention group scored 5.35 ±1.42, which was higher than that in the control group (2.03±1.40), the difference was significant (t=160.43, P<0.01). Ex-SRES of the intervention group scored 62.06±13.10,91.21±11.12, which were higher than those of the control group, 50.38±18.03,42.56±18.23, the difference was significant (t=9.32,176.88, P<0.01) . The interaction between treatment effects and time effect was significant in COPD Assessment of Tool (CAT) and Ex-SRES respectively(F=489.95,P=0.00;F=134.80, P=0.00). Comparing value of CAT in baseline (24.97±4.74,24.62±5.39) and at the end of the twelfth week(24.94±4.74,24.65±5.35), the difference was not significant in two groups respectively(P>0.05). The improvement of CAT was significant at the end of the twenty-forth week (21.90±4.67) in the intervention group (t=-12.09, P<0.01). Conclusions Self efficacy theory and the application of mobile health information services can help patients persist in long-term rehabilitation exercise training.

Objective To apply short message service (SMS) for pulmonary rehabilitation in residence. Methods A total of 102 old pa-tients with chronic obstructive pulmonary disease (COPD) in stable situation were equally divided into three groups randomly. They all ac-cepted a two-week lesson of exercise project, and then took in the project for 22 weeks. Meanwhile, group A phoned to their experts once a week, group B was phoned by their experts once a week, and group C accepted SMS once a day and sent back to the experts. They were in-vestigated with Exercise Self Regulatory Efficacy Scale (Ex-SERS), modified British Medical Research Council Scale (mMRC) and COPD Assessment Test (CAT) before and after intervention. Results The score of Ex-SERS was the most in group C (F=179.53, P<0.001), with the interaction of time (F=387.09, P<0.001). While the scores of mMRC (F=8.754, P<0.001) and CAT (F=11.32, P<0.001) were the least in group C. Conclusion Application of SMS in the integrated management for pulmonary rehabilitation in residence may improve the self regu-latory efficacy of exercise, release the dyspnea and the influence on living in patients with COPD.

BACKGROUND: How to obtain human-derived hepatocyte of high quality is the key problem for both bioartificial liver and hepatocyte transplantation. Bone marrow stem cells (BMSCs) can differentiate hepatocyte under proper condition, which provides a new think for obtaining hepatocyte.OBJECTIVE: To investigate the methods of the trans-differentiation of human BMSCs into hepatocyte in rats so as to provide a new think for clinical transplantation of liver and source of bioartificial liver.DESIGN: Randomized controlled study.SETTING: General Surgery of Zhujiang Hospital of Southern Medical University.MATERIALS: The experiment was conducted at Central Laboratory of Zhujia ng Hospital of Southern Medical University from May 2004 to February 2005. Totally 40 male SD rats of clean grade were divided randomly into five groups: model group, modeling + 14-day transplantation group of human BMSCs, modeling + 28-day transplantation group of human BMSCs, modeling + 14-day transplantation group of CL-1 cell (human hepatocyte family), and modeling + 28-day transplantation group of CL-1 cell (human hepatocyte family) with 8 in each group.acetaminofIuorene + carbon tetrachloride + cyclophosphamide were esand differentiated into hepatocyte with remedial liver regeneration. Human BMSCs were observed for 14 days in modeling + 14-day transplantation group of human BMSCs, for 28 days in modeling + 28-day transplantation group of human BMSCs, for 14 days in modeling + 14-day transplantation group of CL-1 cell and for 28 days in modeling + 28-day transplantation group of CL-1 cell. However, cells in model group function of rats was measured at normal state, before and after transplantation. The expressions of human albumin mRNA in liver were detected by immunohistochemistry staining, polymerase chain reaction (PCR) and real time reverse transcription polymerase chain reaction (RT-PCR) respectively.of human albumin mRNA in liver.transplantation of human BMSCs on hepatic function and content of total bilirubin: Hepatic function and content of total bilirubin in each transplantation group were similar to those in model group at normal state and before transplantation (P ＞ 0.05); values in each group were obviously increased before transplantation as compared with those at normal state (P ＜ 0.01) and were obviously decreased after transplantation as compared with those before transplantation (P ＜ 0.01) but were higher ical section of hepatic cells: At normal state, pathological section of hepatic cells showed that hepatic cells lined in strip-chorda shape and radian shape around central vein; and inflammatory cells were not infiltrated in crossed-channel area. Necrosis was observed in model group. Proliferated changes were observed in transplantation groups of human BMSCs after a few of necrosis, and ovale-round cells and small bile duct proliferation main histocompatibility antigen-I in liver: Positive rate was 0 in model group; (13.03±0.18)% in modeling + 14-day transplantation group of human BMSCs; (9.47±0.46)% modeling + 28-day transplantation group of human BMSCs; (10.27±0.50)% in modeling + 14-day transplantation group of CL-1 cell; and (9.84±0.23)% in modeling + 28-day transplanwas detected in model group, but Sox11 and Alu-sx were detected in both transplantation groups of human BMSCs and CL-1 cells at various RT-PCR: Expression of human albumin mRNA was not observed in model group, but expression of that was observed in transplantation groups of human BMSCs and CL-1 cell as well as positive controls at various time points respectively.CONCLUSION: Human BMSCs can promote recovery of hepatic function.Replaceable rate of human-derived cells is 10% in liver of rats, which suggests that human BMSCs can converse into hepatocyte in xenoma and replace partly.

Objective To investigate the effect of flow management of cerebral perfusion during aortic arch surgery on the neurological complication.Methods From March 2007 to November 2011,189 patients underwent aortic arch surgery with hypothermic circulatory arrest plus antegrade cerebral perfusion in our department.The clinical data were analyzed retrospectively.According to the different methods of cerebral perfusion flow nanagement,patients were divided into two groups.Single pump with double limb (to the lower body and brain) perfusion was used in group A (96 patients),based on natural distribution of petfusion flow without control.Modified flow management was used in group B (93 patients).A magnetic flow sensor probes was installed on the brain perfusion limb to monitor and control the cerebral perfusion flow precisely (10 ml · kg-1 · min-1).Postoperative neurological complications were compared between two groups.Results There was no significant difference between the two groups in CPB time,aortic clamping time and circulatory arreating time.However,the morbidity of postoperative neurological complications in group B was much lower than that in group A (1.1％ vs 5.2％,P ＜0.05).Conclusion When performing antegrade cerebral perfusion during aortic arch surgery,precisely control of cerebral perfusion flow can reduce the morbidity of postoperative neurological complications effectively.

Objective To describe the CSP genotypic profile in clinical isolates of Aspergillus fumigates from different regions of China,and to investigate if there is a difference in antifungal susceptibility among A.fumigates of different CSP genotypes and from different regions.Methods Totally,112 A.fumigates strains clinically isolated from Fujian,Shanghai,Hebei and Beijing were included in this study,and identified according to macro-and micro-morphological characters,growth temperature and β-tubulin sequence.Classic A.fumigatus strains were typed according to CSP gene sequence.The minimal inhibitory concentrations (MICs) of voriconazole,itraconazole and amphotericin B to A.fumigates were determined in accordance with the National Committee for Clinical Laboratory Standards (NCCLS) M38-A protocol.Results All the strains were identified as classic A.fumigates,and fall into 11 CSP genotypes.The most common genotypes were t04A (n =32),t03 (n =17) and t01 (n =24) in all the strains,tl0,t04A and t01 in Fujian,t04A and t01 in Shanghai,t01,t03 and t04A in Hebei,t02,t04A,t01and t03 in Beijing.One A.fumigatus strain was identified as a new CSP type t25 in Fujian,which showed no obvious difference in morphology,growth rate or appropriate growth temperature from the other CSP genotypes of A.fumigatus strains.No statistical difference was found in the susceptibility to amphotericin B,itraconazole or fluconazole among different genotypes of A.fumigates,whereas the MICs of itraconazole were significantly lower in A.fumigates isolates from Fujian than in those from the other three regions.Conclusions The CSP genotypic profile of A.fumigates varies in clinical isolates from different regions.No significant difference is observed in the susceptibility to amphotericin B,itraconazole or fluconazole among different CSP genotypes of A.fumigates,but the susceptibility to itraconazole is somewhat different between A.fumigates strains from different regions.

Objective: To investigate the relationship between blood pressure variability and ambulatory arterial stiffness index (AASI) in both normal subjects and hypertensive patients.
Methods: A total of 280 consecutive subjects without antihypertensive medication were studied. All subjects received ambulatory blood pressure monitoring (ABPM) and AASI was calculated as 1 minus the regression slope of diastolic blood pressure value vs systolic blood pressure value according to ABPM recording.
Results: ① There were 161 subjects with male gender, 138 patients with hypertension, and the average age was (50.4 ± 13.3) years.②Pearson analysis indicated that AASI was related to age (r=0.272, P<0.001), 24-hour mean pulse pressure (r=0.504, P<0.001) , nocturnal diastolic blood pressure dipping (r=-0.334, P<0.001) and standard deviation of 24-hour diastolic blood pressure (r=-0.520, P<0.001).③AASI in anti-dipper hypertensive patients was higher than that in dipper patients, P<0.05;while AASI between dipper and non-dipper patients, dipper and extreme-dipper patients were similar, P>0.05 respectively.④Multiple linear regression analysis demonstrated that with adjusted age, gender, BMI and blood pressure, AASI was independently related to 24-hour mean pulse pressure (β=0.003, P<0.001), nocturnal diastolic blood pressure dipping (β=-0.001, P<0.05), standard deviations of 24-hour systolic blood pressure (β=0.032, P<0.001) and 24-hour diastolic blood pressure (β=-0.064, P<0.001), standard deviation of 24-hour heart rate (β=0.006, P<0.001).
Conclusion:AASI is closely related to blood pressure variability, it’s a comprehensive index for arterial stiffness and blood pressure variability.

Liver transplantation is the best treatment for end-stage liver disease.Because of the severe shortage of donor sources,most of the patients died while waiting for liver grafts.Artificial liver support system can improve the liver function in a short time,and help patients to pass the waiting periods.Artificial liver support system takes place of composition,detoxification and metabolism function of liver,stabilizes the physiological and biochemical index of liver,relieves the burden of liver and helps patients to prepare for the liver transplantation.With the wide application of artificial liver support system,new types of the artificial liver support systems gradually conquered the defects of the old types,but they still have their own defects.This review concludes the merits and demerits of artificial liver systems,its clinical application and the problems so as to help the treatment of end-stage liver disease.