Objective To study needs of training of trainers(ToT)in mini-clinical evaluation exercise(mini-CEX)and its effectiveness.Methods One hundred and fourteen doctors involved in TOT for mini-CEX were interviewed with questionnaire before and after training for their satisfaction of training and fifty of them scored the training videos.Results Before the training.39%(44/114)of doctors involved in TOT knew mini-CEX and 97%(111/114)of them hoped to know how to carry out mini-CEX thronsh training.When the training finished,30%(34/114)tO 55%(63/114)of them could completely understand seven items of examinations of mini-CEX.Fifty doctors involved in TOT scored the training videos after the training.There was signifieant difference in scores between TOT and standard scoring on training video 1 for teaching of coronary heart disease and video 2 for teaching of hematochezia(P<0.05).No significant difference Was found in scores between TOT and standard scoring on the video 3 for teaching of abdomihal pain(P>0.05).as well as those between TOT with five or less years experience and those with more than five years experience(P>0.05).Conclusions Currently,doctors involved in TOT have more demands on mini-CEX.However,effectiveness of short-course training for mini-CEX is not satisfactory,and pattern of its training should be improved further.

Thirty four residents of general practice and 11 students of junior college to undergraduate program were evaluated with the mini-clinical evaluation exercise (mini-CEX) when they were rotated to community clinics or the ward of general practice in Zhongshan Hospital from September 2009 to February 2010. The reliability and validity of mini-CEX for rotation examination in general practice training was assessed. Forty five trainees and 9 clinical faculty members completed 81 mini-CEX evaluations. The Cronbach's alpha coefficient was 0. 932. Criterion-related validity for mini-CEX overall competence with the end examination of rotation was O.53 ( P ＜ 0.001 ). The results indicate that mini-CEX may be an appropriate evaluation tool for rotation examination in general practice training.

The authors designed to separate, purify and determine the monosaccharide composition of the polysaccharide from Cordyceps militaris, and study its effect on reverse cholesterol transport in vivo by isotope tracing assay. Polysaccharides were separate and purify by ion exchange column Q-sepharose Fast Flow and size exclusion column Sephacryl S200HR; the molecular weight and monosaccharide composition of the polysaccharides were determined by high performance gel permeation chromatography and high performance liquid chromatography coming with pre-column derivation, respectively. Finally, three purified polysaccharides CMBW1, CMBW2 and CMYW1 were obtained, their total carbohydrate contents were 87%, 89%, 95%, respectively; their protein contents were 6.5%, 1.3%, 2.8%, respectively; their molecular weights were 772.1, 20.9, 13.2 kDa, respectively; CMBW1 was composed of mannose, glucosamine, rhamnose, glucuronic acid, glucose, galactose and arabinose with a molar ratio of 7.25: 0.17: 1.29: 0.23: 6.30: 11.08: 0.79; CMBW2 was composed of mannose, glucosamine, galactose and arabinose with a molar ratio of 2.40: 0.16: 2.92: 0.24; CMYW1 was composed of mannose, glucosamine, glucuronic acid and glucose with a molar ratio of 0.59: 0.57: 0.45: 25.61. Polysaccharide at 50 mg x kg(-1) could significantly improve the transport of 3H- cholesterol to blood and excretion from feces. All of the three purified polysaccharides CMBW1, CMBW2 and CMYW1 were heteropolysaccharide; and they could improve reverse cholesterol transport in vivo, the underlying mechanisms are being studied.
Animals ; Biological Transport ; drug effects ; Cholesterol ; metabolism ; Chromatography, High Pressure Liquid ; instrumentation ; methods ; Cordyceps ; chemistry ; Mice ; Monosaccharides ; analysis ; isolation & purification ; Polysaccharides ; chemistry ; isolation & purification ; pharmacology ; Tritium

Objective To summarize the domestic design for placebo acupuncture and the placebo effect and explore an ideal design for placebo acupuncture.Method Three large Chinese databases CNKI, Wan Fang and Vip were searched to systematically review the application of placebo acupuncture in randomized controlled trials published at home in recent 5 years (2011.01—2016.11).Results and conclusions A total of 48 articles were included according the inclusion and exclusion criteria. An analysis was made of the kinds of diseases for acupuncture study, the methods of designing placebo acupuncture, the effects of placebo acupuncture and comparisons with foreign placebo acupuncture. Pain syndrome and insomnia were the main kinds of diseases for acupuncture study, accounting for 10 and 8 articles respectively. Acupuncture needles were the main kind of needles for placebo acupuncture, accounting for 66.6%. Sites beside acupoints were the main positions selected for placebo acupuncture, accounting for 58.3%. Not penetrating the skin predominated in the depth of needle insertion, accounting for 37.5%. The kinds of needles for placebo acupuncture were fewer than abroad. The effects of placebo acupuncture were not superior to those of acupuncture.

Objective To investigate the clinical value of virtual touch tissues quantification in the evaluation of kidney stiffness in patients of diabetic nephropathy .Methods A total of 90 cases of diabetic nephropathy were divided into 3 groups:infinitesimal albuminuria ,microalbuminuria and massive proteinuria groups.And other 30 health subjects were taken as control group.The shears wave velocity ( Vs) which reflected the tissue elasticity was measured.The Vs values were compared among different groups.Results In all groups,the highest Vs was present in renal cortex .And compared with the renal cortex ,the Vs of the renal medulla and renal sinus have statistically significant differences [ the normal control group:( 3.65 ± 0.26)m/s,(2.72 ±0.35) m/s,(1.83 ±0.54) m/s,t =9.30,18.20,both P <0.05;Infinitesimal albuminuria group:(2.98 ±0.28)m/s,(2.47 ±0.33)m/s,(1.65 ±0.31)m/s,t=5.97,15.57,both P<0.05;microalbuminuria group:(2.55 ±0.22) m/s,(2.22 ±0.28) m/s,(1.54 ±0.21) m/s,t =3.86, 11.83,both P<0.05;massive proteinuria group:(1.99 ±0.28)m/s,(1.49 ±0.30)m/s,(1.01 ±0.39)m/s, t=5.85,11.48,both P<0.05].The renal cortex Vs of Infinitesimal albumonuria group ,microalbuminuria group and massive proteinuria group show a gradually decreasing trend .And the renal cortex Vs of microalbuminuria group and massive proteinuria group have statistically significant differences compared with the normal control group(t=11.79,17.79,both P<0.05).Conclusions Virtual touch tissues quantification technique can reflect the renal tissue elasticity .It will contribute to the assessment of renal function in patients with early diabetic nephropathy .

To establish a UPLC-MS/MS method for the simultaneous determination of geniposide, genipin 1-O-beta-D-gentiobioside and geniposidic acid in rat brains and study the brain pharmacokinetics of the three iridoid glycosides in stroke rat after the oral administration of Xingnaojing. In this experiment, brain samples were precipitated with protein for twice. Acquity BEH C18 column was adopted, with acetonitrile-0.1% formic acid-water as the mobile phase for gradient elution. ESI source was adopted for mass spectra; multiple reaction monitoring (MRM) was conducted to detect negative ions. The time for sample analysis was 3.5 min. the results showed good linear relations among the three iridoid glycosides, with the extraction recovery between 99.6% and 114.3%, good intra- and inter-day precisions and accuracies and stability in line with the requirements. The t1/2 and MRT in the three components were similar in brains of stroke rats. Geniposide and genipin 1-O-beta-D-gentiobioside showed double peaks; where as geniposidic acid showed a single peak. In conclusion, the method is so specific, sensitive, accurate and reliable that it can be used to study the brain pharmacokinetics of Xingnaojing oral preparation.
Animals ; Brain ; metabolism ; Brain Chemistry ; Chromatography, High Pressure Liquid ; methods ; Drug Stability ; Drugs, Chinese Herbal ; chemistry ; pharmacokinetics ; Iridoids ; chemistry ; pharmacokinetics ; Male ; Rats ; Rats, Sprague-Dawley ; Tandem Mass Spectrometry ; methods

OBJECTIVETo investigate the potential molecular mechanism underlying down-regulation of albumin expression induced by lipopolysaccharide (LPS) in rat hepatocytes.

METHODSThe albumin mRNA expression and albumin protein levels in the supernatant were observed at 0, 2, 8, 12 and 24 hours after 1 micro g/ml LPS treatment. The albumin mRNA expression was determined by RT-PCR, and albumin protein levels were assayed with EIA in the supernatant of hepatocytes pretreated with specific inhibitors of extracellular signal-regulated kinase (PD98059) and p38 kinase (SB203580).

RESULTSThe albumin mRNA expression was reduced to 70% of baseline value, meanwhile, the albumin protein concentration in the supernatant was reduced by 50% compared with the controls after 24 hours of LPS treatment. Pretreatment with PD98059 and SB203580 did significantly inhibit the reduction of albumin by LPS at the given dose.

CONCLUSIONThe results indicate that LPS can induce the reduction of albumin synthesis by down-regulation of albumin mRNA expression at transcription level, and the process may be related to the signal transducation of extracellular signal-regulated kinase and p38 kinase.

Albumins ; genetics ; metabolism ; Animals ; Calcium-Calmodulin-Dependent Protein Kinases ; antagonists & inhibitors ; Dose-Response Relationship, Drug ; Down-Regulation ; Enzyme Inhibitors ; pharmacology ; Enzyme-Linked Immunosorbent Assay ; Flavonoids ; pharmacology ; Hepatocytes ; drug effects ; metabolism ; Imidazoles ; pharmacology ; Lipopolysaccharides ; toxicity ; Male ; Mitogen-Activated Protein Kinases ; antagonists & inhibitors ; Pyridines ; pharmacology ; RNA, Messenger ; genetics ; metabolism ; Rats ; Reverse Transcriptase Polymerase Chain Reaction ; Time Factors ; p38 Mitogen-Activated Protein Kinases

ObJective To summarize the microsurgieal techniques through direct Sylvian fissure approach. Methods A retrospective analysis was conducted in 62 patients undergoing microsurgeries through direct Sylvian fissure approach, including 4 with cavernous angioma in the Sylvian fissure, 5 with insular lobe tumors, 33 with middle cerebral artery aneurysms, 15 with glioma spanning or invading the Sylvian fissure, 1 with metastatic tumor, 2 with arteriovenous malformations, and 2 with temporal lobe epilepsy. Results All the vascular lesions were exposed satisfactorily and managed appropriately. Of the 19 cases ofgliomas and metastatic tumors, total resection was achieved in 13 cases, and subtotal resection in 6 cases. Transient aphasia or hemiparesis occurred postoperatively in a few patients but all recovered within 1 or two months. Conclusions The Sylvian fissure provides a good surgical route as a subarachnoid space between the frontal, parietal, temporal and insular lobes. The Sylvian fissure should be carefully separated under the operating microscope with high-power magnification, and tension-free retaction is critical in important language areas. In the management of tumors involving the Sylvian fissure, we recommend that extended resection be performed after exposure and appropriate preservation of important blood vessels in the fissure.

Objective:To sieve molecular biomarkers associated with heart failure derived from arrhythmogenic right ventricular cardiomyopathy (ARVC).Methods:The comparative gene microarray analysis using individual left ventricular myocardial samples from 5 patients with heart failure resulting from ARVC undergoing transplantation and 5 matched samples from normal adult heart were performed.The accuracy rate of the differentially expressed genes obtained by gene microarray was further verified by quantitative real time RT-PCR.Results:83 genes (from a total of 35000) that were differentially expressed in diseased hearts versus normal hearts were identified.Among them thirty-seven genes were up-regulated and forty-eight genes were down-regulated in ARVC hearts compared with the normal hearts.Changes of gene expressions were most prominently observed in those belonging to the "metabolism" category.Eighty percent of the selected 30 differentially expressed genes from microarray analysis were confirmed by quantitative real time RT-PCR.The highly expressed level of atrial natriuratic peptide (ANP) in ARVC hearts that was confirmed by quantitative real time RT-PCR and immunohistochemistry was reported.Conclusion:For the first time to our knowledge,the altered expressed genes in ARVC hearts compared with the matched normal hearts were identified.The results are the base to further study the molecular mechanism and identify diseased-specific molecular biomarkers in heart failure derived from ARVC.

OBJECTIVETo investigate the mechanism that glutamine (Gln) downregulates the cytokine expression in lipopolysaccharide (LPS)-stimulated human peripheral blood mononuclear cells (PMBCs).

METHODSPMBCs were extracted from healthy volunteer by density gradient centrifugation, the cells were divided into two parts. The first part of PMBCs was pretreated with Gln of the concentration of 0, 8, 15 mmol/L for 0.5 h and 2.0 h respectively, then stimulated by LPS for 4.0 h. Cells and supernatants were collected. The second part of PBMCs was divided into group A, B and C. Group A and B were pretreated with HSP70 blocker (Quercetin) for 1.0 h, then were stimulated by LPS for 4.0 h. Cells and supernatants were also collected. The release of TNF-alpha and IL-10 was analyzed via enzyme-linked immunosorbent assay (ELISA) and HSP70 via Western Blot. In this experiment, the effect of Quercetin on TNF-alpha, IL-10 and HSP70 expression in human PBMCs was assessed.

RESULTSGln led to an increase in HSP70 expression, and decreased TNF-alpha, IL-10 release at 4.0 h after LPS stimulation when 8 mmol/L glutamine pretreated for 0.5 h and 2.0 h, 15 mmol/L glutamine pretreated for 0.5 h (P < 0.05). The expression level of HSP70 was significantly decreased, however, the expression of TNF-alpha and IL-10 was enhanced in Quercetin group (P < 0.05).

CONCLUSIONThe effect of glutamine attenuating cytokine release in PBMCs is related to the enhancement of HSP70 expression.

Cells, Cultured ; Cytokines ; metabolism ; Glutamine ; pharmacology ; HSP70 Heat-Shock Proteins ; metabolism ; Humans ; Interleukin-10 ; metabolism ; Leukocytes, Mononuclear ; drug effects ; metabolism ; Lipopolysaccharides ; pharmacology ; Tumor Necrosis Factor-alpha ; metabolism