The author reviewed the development of general practice education in our country,deliberated and summarized the problems about the construction of curriculum system,the ranks of teachers and practice base in general practice education in higher medicine colleges.

Objective To investigate effect of tacrolimus on renal function, blood lipids, cytokines and peripheral HMGB-1 and NF-κB in nephrotic syndrome patients.Methods From January 2012 to January 2014 in the Fifth Affiliated Hospital of Zhengzhou University, 127 cases of patients with nephrotic syndrome were included based on random number table, and divided into two groups (n=65) and control group (n=62).Control group with conventional symptomatic treatment, observation group in combination with tacrolimus treatment on the basis of control group, which were treated for a total of two courses, eight weeks for a course of treatment.Serum creatinine and blood urea nitrogen levels, TG, TC, HDL-C, LDL-C levels, serum IL-1, TNF-αlevels and serum HMGB-1 and NF-κB levels were evaluated.Results The serum creatinine and blood urea nitrogen levels after treatment was significantly lower than that of control group, respectively ( P<0.05 ) .TG, TC and LDL-C levels after treatment in observation group was significantly lower than that of control group respectively (P<0.05).Serum IL-1 and TNF-αlevels after treatment in observation group was significantly lower than that of control group respectively (P<0.05).Serum HMGB-1 and NF-κB levels after treatment in observation group was significantly lower than that of control group respectively (P<0.05).Conclusion Tacrolimus can reduce blood lipid levels, inflammatory reaction and serum HMGB-1, NF-κB levels in nephrotic syndrome patients, and significantly improve renal function.

Objective To investigate effect of alprostadil on serum levels of inflammatory cytokines and nutritional biochemical indexes in patients with chronic renal failure.Methods According to the random number table, 129 patients with chronic renal failure patients were included in this group and randomly divided into observation groups (n=67) and control group (n=62).Control group were given conventional symptomatic treatment, and the observation group were given alprostadil treatment on the basis of control group with a course of four weeks of both groups.The Scr, BUN, IL-6, TNF-α, CRP, Ca2 +, ALB, P3 +, Hb, RBC, hemorheology changes were compared before and after treatment.Results The Scr, BUN levels after treatment was significantly lower than before treatment (P<0.05), and Scr, BUN levels in observation group after treatment was significantly lower than control group (P<0.05).Serum levels of IL-6, TNF-α, CRP after treatment significantly decreased than before treatment (P<0.05), serum IL-6, TNF-α, CRP after treatment was significantly lower than control group ( P<0.05 ).After treatment, Ca2 +, ALB levels of observation group was significantly higher than control group and P3 +was significantly lower than control group (P<0.05), while there were no significant differences of Hb, RBC.The hemorheology of observation group before treatment was significantly lower than control group ( P<0.05 ) .Conclusion Alprostadil can significantly improve renal function, and the possible mechanism may be associated with reducing serum levels of inflammatory factors and improving blood rheology, which delay progression of chronic renal failure effectively.

Objective To study the risk factors for ventilator associated pneumonia (VAP) in ICU and pathogens antimicrobial resistance.Methods 220 patients were selected and divided into observation group (88 patients) and control group(132 patients) depending on whetherhe has VAP or not.The clinical data were reviewed to explore the risk factors.And the secretions of respiratory tract were investigated by the routine bacterial culture and drag-resistance methods to analysis the distribution of pathogens.Results The risk factors associated with VAP were COPD,mechanical ventilation,the extensive use of antibiotics,age ＞ 60 years,APACHEII score ＞ 30(P ＜ 0.01).157 bacterial were cultured,68.9％ of pathogens was Gram-negative bacteria in which Pseudomonas aeruginosa was rated as the top one,and 26.1％ of pathogens was Gram-positive bacteria in which MRSA was the majority.The results of the antibiotic resistance monitoring indicated that all Gram-positive and Gram-negative bacteria showed high drugresistance to common antibiotics.Conclusion We should control these risk factors which are closely related to VAP,and select suitable antibiotics on the basis of etiological analysis and drug-resistance.

Adult ; Aneurysm, Dissecting ; Humans ; Male ; Pulmonary Artery

Objective To explore the changes of serum IL‐6 ,IL‐10 ,PLA2 on intracranial infection and its prognosis .Methods Totallly 100 patients with intracranial infection during February 2011 to December 2013 were selected as the research object .In 100 cases of intracranial infection patients ,30 cases were cured (group A) and 52 cases improved (group B) ,18 cases of illness or death as poor prognosis group (group C) .Serum IL‐6 ,IL‐10 ,PLA2 content of the subjects in different time point were detected .Results One day After infection ,serum IL‐6 ,IL‐10 ,PLA2 levels in intracranial infection group were obviously higher than that of healthy control group (P< 0 .01) ;7 d after infection ,IL‐6 ,IL‐10 average level among 3 groups had obvious changed(P< 0 .05) ,7 d after in‐fection ,IL‐6 ,IL‐10 level of group B and group C was significantly higher than group A (P< 0 .05) ;and in group C ,IL‐6 ,IL‐10 was higher than group B (P< 0 .05) .7 d after infection ,the IL‐6 IL‐ 10 level of group A declined ,the IL‐6 ,IL‐ 10 levels of group B be‐gan decreasing 14 d after infection ,and the IL‐6 ,IL‐10 levels of group C had been in a rising trend .3 d after infection ,the PLA2 leves among 3 groups had obvious changed(P< 0 .05) ,7 d after infection ,the change rate increased ,7 d after infection ,PLA2 level of group B and group C was significantly higher than group A (P< 0 .05) ,and in group C ,PLA2 was higher than group B (P< 0 . 05) .7 d after infection ,the PLA2 level of group A declined ,in group B and group C ,PLA2 level began to decline significantly 14 d after infection .Conclusion IL‐6 ,IL‐10 ,PLA2 are closely related to the occurrence and prognosis of intracranial infection .

Objective: Investigate the curative effect of acupuncture on dysphasia in hypophrenia children. Methods: One hundred and sixty children with hypophrenia and dysphasia were randomly divided into an acupuncture group of 80 cases, a language training group of 40 cases and a composite group of 40 cases for clinical observation. Total intelligence quotient (TIQ), vocal intelligence quotient (VIQ) and practical intelligence quotient (PIQ) were compared between pretreatment and posttreatment in the children themselves and between the groups before and after treatment. Results: The total efficacy rate was 77.5% in the acupuncture group, 82.5% in the composite group and 52.5% in the language training group. Conclusion: Acupuncture significantly raises TIQ, VIQ and PIQ in the sick children. Language training only raises VIQ to some degree.Acupuncture in cooperation with language training is an effective way to treat this disease.

Embryonic Stem Cells ; Humans ; Myocardial Infarction ; therapy ; Stem Cell Transplantation

OBJECTIVE:To investigate therapeutic efficacy,safety and economics of budesonide for infant bronchiolitis based on salbutamot. METHODS:In prospective study,160 inpatient children with bronchiolitis during Oct. 2014-Apr. 2016 were divid-ed into observation group and control group according to admission order,with 80 cases in each group. Both groups received conventional treatments. Control group was given Salbutamol solution for inhalation 0.25 mL added into 0.9% Sodium chloride injection 3 mL,q8 h. Observation group was given Budesonide suspension for inhalation 2 mL added into 0.9% Sodium chlo-ride injection 1 mL+Salbutamol solution for inhalation 0.25 mL,q8 h. Both groups received oxygen driven inhalation,and treat-ed for 5-7 d. Clinical symptom disappearance time,hospitalization time and clinical efficacy were compared between 2 groups as well as therapy drug cost(aerosol inhalation,other therapy drugs). The occurrence of ADR was recorded. RESULTS:There was no statistical significance in cough disappearance time,wheezing disappearance time,lung rale disappearance time,tri-re-traction sign disappearance time and hospitalization time between 2 groups(P>0.05). There was no statistical significance in to-tal response rate between observation group (95.00%) and control group (92.50%)(P>0.05). The cost of inhalation drugs in observation group [(355.77±10.98)yuan] was significantly higher than control group [(26.83±2.86)yuan],with statistical signif-icance (P<0.05). There was no statistical significance in the cost of routine therapy drugs between 2 groups (P>0.05). There was no significant ADR between 2 groups during treatment. CONCLUSIONS:For infant bronchiolitis,aerosol inhalation of budesonide based on salbutamol sulfate can not significantly shorten disease,shorten hospitalization time and improve clinical ef-ficacy,but increase therapy cost.

0.05).After exposure of U937 macrophages to 11.1 mmol/L,16.7 mmol/L and 33.3mmol/L glucose,the expression of LOX-1 protein was 1.56-,2.26-and 2.96-fold,as compared with that of 5.6 mmol/L glucose group(P