We implemented tutorial system by relying on young teachers in hospitals and taking undergraduates in Capital Medical University as the main body aiming at cultivating students' clinical and scientific research abilities.Practice has proved that tutor system method is of great value to cultivate students' comprehensive clinical ability,scientific research ability and innovation ability.Meanwhile,this method is effective in improving clinical teaching effect.

Objective: To examine the relationship between traditional Chinese medicine (TCM) constitutional types and health status among groups of different age or gender in the general population of China. Methods: Data of 8 448 cases were randomly sampled from a database of 21 948 cases of a cross-sectional survey on the TCM constitutional types and health status which was carried out in 9 provinces or municipalities of China (Jiangsu, Anhui, Gansu, Qinghai, Fujian, Beijing, Jilin, Jiangxi and Henan) according to gender and age structure of the Chinese population in 2005. Scores of health-related quality of life scale--the Medical Outcomes Study 36-Item Short-Form Health Survey (MOS SF-36)--were analyzed by Nemenyi test to compare the health status of individuals with different constitutional types. Results: Compared with the gentleness type, the MOS SF-36 scores of the 8 types of pathological constitution were significantly low (P<0.05) among groups of different age or gender. The MOS SF-36 score was the lowest in men of the qi-deficiency, qi-depression and blood-stasis types, while it was the lowest in women of the phlegm-dampness, qi-depression and qi-deficiency types. For the age group of 15 to 34, the special diathesis, qi-depression and blood-stasis types had the lowest MOS SF-36 scores; for the age group of 35 to 59, the qi-deficiency, qi-depression and blood-stasis types had the lowest MOS SF-36 scores; for the age group of over 60, the qi-deficiency, qi-depression and phlegm-dampness types had the lowest MOS SF-36 scores. Conclusion: In groups of different gender or age, the MOS SF-36 scores of the 8 types of pathological constitution were significantly lower than that of the gentleness type, indicating a deficient health status. The health status of different types of constitution showed different characteristics in groups of different gender or age.

Aim To study the mechanism of DSF-Cu induced apoptosis of human nasopharyngeal carcinoma CNE-2 Z cells by affecting the function of mitochondria and cytoskeleton. Methods The cell cycle,the rate of apotosis,the levels of intracellular ROS and MMP in CNE-2 Z cells were tested by flow cytometry after trea-ted with different concentration of DSF-Cu. The chan-ges of the cell surface morphology, ultrastructure, cell height, width and roughness were detected by AFM. The distribution and reorganization of cytoskeleton F-actin were observed by Laser scanning confocal micro-scope. Results Cells were incubated with different concentration of DSF-Cu ( 0 ~200 nmol · L-1 ) for 24 h, the apoptotic ratio increased significantly and the treatment of DSF-Cu resulted in a concentration-de-pendent accumulation of CNE-2Z cells in G2/M phase. Furthermore,the treatment of DSF-Cu was able to in-crease the production of intracellular ROS and decrease the MMP in CNE-2Z cells. In addition,AFM imaging showed that compared to the control group,with the in-crease of DSF-Cu concentration,the CNE-2Z cells be-came smaller, cytoplasm condensed, the height in-creased,and the surface roughness reduced. Moreover, the filopodia became shorter, shrinked and even com-pletely destroyed after treated with different concentra-tion of DSF-Cu. At last,the LSCM image showed that the fluorescence intensity of F-actin networks was de-creased, then the structure was rearranged and de-stroyed obviously by treated with DSF-Cu. Conclusion DSF-Cu can induce apoptosis and arrest cell cycle at G2/M phase in CNE-2Z cell through a mitochondria-dependent pathway. Above findings highlight the appli-cations of AFM at the single cell level for the investiga-tion of antineoplastic drug in nasopharyngeal carcinoma therapy.

OBJECTIVE:To provide reference for rational use of antibiotics in the clinic. METHODS:Blood culture positive specimens were collected from our hospital during Jan. 2011-Dec.2016. Distribution of bloodstream infection(BSI)pathogens and drug resistance were analyzed in our hospital retrospectively. RESULTS:During 2011-2016,26 034 blood culture specimens isolat-ed from inpatients of our hospital were examined,including 1 775 positive specimens with positive rate of 6.82%. The specimens mainly came from tumor hematology department(10.65%),neurosurgery department(8.28%)and pediatric department(8.00%). A total of 1 775 strains of pathogens were detected,including 967 strains of Gram-negative bacteria(54.48%)mainly as Escherich-ia coli,Klebsiella pneumoniae,649 strains of Gram-positive bacteria(36.56%)mainly as Coagulase negative Staphylococci, Staphylococcus aureus and 159 strains of fungus(8.96%)mainly as Candida albicans. E. coli and K. pneumoniae were resistant to common antibiotics to different extents,but sensitive to piperacillin sodium and tazobactam sodium,imipenem,meropenem. Aci-netobacter baumanii was highly resistant to enzyme inhibitors,cephalosporins,aminoglycosides,quinolones. Pseudomonas aerugi-nosa was sensitive to third-generation cephalosporins,aminoglycosides and quinolones. S. aureus was highly resistant to penicil-lins,cephalosporins and aminoglycosides. Resistance rate of Coagulase negative Staphylococci to most commonly used antibiotics was higher than 40%. Above two bacteria were sensitive to linezolid and vancomycin with resistance rate of 0. A total of 205 strains of ESBLs-producing E. coli(42.01%),64 strains of ESBLs-producing K. pneumoniae(30.33%)and 31 strains of Methicil-lin-resistant S.aureus(17.61%)were detected.No vancomycin-resistant Enterococcus or vancomycin-resistant S.aureus was detect-ed. CONCLUSIONS:BSI pathogens mainly distribute in tumor hematology department of our hospital. BSI pathogens mainly in-clude Enterobacteriaceae and Staphylococcus,and also involve fungus. The situation of drug resistance and enzyme production are not optimistic.Antibiotics,which are sensitive to the major pathogens,include carbapenems,linezolid and vancomycin.

ObjectiveTo optimize and establish a multiplex polymerase chain reaction （PCR） system to simultaneously identify Ziziphi Spinosae Semen （ZSS），Hovenia acerba semen （HAS），and Ziziphi Mauritianae Semen （ZMS）， etermine their content to solve the problem of adulteration of ZSS pieces and its preparations. MethodAfter the analysis and comparison of the internal transcribed spacer （ITS） sequence differences of ZSS and its adulterants，specific single nucleotide polymorphism （SNP） sites were found，and specific primers for identification were designed. The samples of ZSS，HAS， and ZMS from different sources were specifically amplified under the conditions of optimized annealing temperature，the number of cycles， and concentration of primers，as well as different polymerases and PCR systems after evaluation. Identification was carried out according to the size of specific amplification bands，and the lower limit of detection （LOD） and adulteration LOD were studied. ResultWhen the annealing temperature was 63 ℃ and the number of cycles was 23，549，169，389 bp specific bands were amplified from ZSS，HAS， and ZMS. The lower LOD of this method was 0.24 ng and 1.2 ng for ZSS and HAS， respectively. The adulteration LOD for ZSS，HAS， and ZMS was 0.5%，2%， and 2% respectively. ConclusionThe established multiplex allele-specific PCR identification method can accurately identify ZSS，HAS， and ZMS at the same time，which can provide a basis for solving the problem of adulteration of ZSS and references for controlling the quality，security， and clinical application of ZSS.

Tuberculosis (TB) is an ancient infectious disease. Before the availability of effective drug therapy, it had high morbidity and mortality. In the past 100 years, the discovery of revolutionary anti-TB drugs such as streptomycin, isoniazid, pyrazinamide, ethambutol and rifampicin, along with drug combination treatment, has greatly improved TB control globally. As anti-TB drugs were widely used, multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains of Mycobacterium tuberculosis emerged due to acquired genetic mutations, and this now presents a major problem for effective treatment. Genes associated with drug resistance have been identified, including katG mutations in isoniazid resistance, rpoB mutations in rifampin resistance, pncA mutations in pyrazinamide resistance, and gyrA mutations in quinolone resistance. The major mechanisms of drug resistance include loss of enzyme activity in prodrug activation, drug target alteration, overexpression of drug target, and overexpression of the efflux pump. During the disease process, Mycobacterium tuberculosis may reside in different microenvironments where it is expose to acidic pH, low oxygen, reactive oxygen species and anti-TB drugs, which can facilitate the development of non-replicating persisters and promote bacterial survival. The mechanisms of persister formation may include toxin-antitoxin (TA) modules, DNA protection and repair, protein degradation such as trans-translation, efflux, and altered metabolism. In recent years, the use of new anti-TB drugs, repurposed drugs, and their drug combinations has greatly improved treatment outcomes in patients with both drug-susceptible TB and MDR/XDR-TB. The importance of developing more effective drugs targeting persisters of Mycobacterium tuberculosis is emphasized. In addition, host-directed therapeutics using both conventional drugs and herbal medicines for more effective TB treatment should also be explored. In this article, we review historical aspects of the research on anti-TB drugs and discuss the current understanding and treatments of drug resistant and persistent tuberculosis to inform future therapeutic development.
Humans ; Pyrazinamide/therapeutic use* ; Isoniazid/therapeutic use* ; Antitubercular Agents/therapeutic use* ; Tuberculosis, Multidrug-Resistant/microbiology* ; Mycobacterium tuberculosis/genetics* ; Tuberculosis/drug therapy* ; Rifampin/therapeutic use* ; Mutation ; Drug Resistance, Multiple, Bacterial/genetics*