Compareing domestic and foreign medical humanistic quality education,this paper analyzed the reason for the lack of medical humanistic quality and put forward countermeasures aiming at the reform of medical humanistic quality education in medical colleges and universities through learning from the practice and experience of foreign medical humanistic quality education.There countermeasure include:reforming the concept of medical humanistic Character education,innovateing the model of medical humanistic quality education,increaseing the construction of humanities quality curriculum system,training the professional skill of medical humanistic quality,establishing the evaluation-oriented effect system,exploreing the new model of modern medical professional education and medical humanistic quality education actively,and reconstructing the systematic system of medical humanisticing quality education.

Objective　To analyze the influence of multiple variable factors on the occurance rate of pneumothorax associated with transthoracic needle aspiration biopsy of the lung. Methods　Fluoroscopically guided lung biopsies were performed in 46 patients. Variable factors were analyzed including lesion size, location, number of puncture, presence of emphysema and patients position after needle biopsy of the lung. Results　Pneumothorax occurred at 9 (19.6%) of 46 patients and that occurred at 4 (44.4%) of 9 emphysematous patients. Among them 2 necessitated chest drainage tube placement. The pneumothorax occurance rate was 30% (3/10) for lesions of diameter 3cm or less in size. In the dependent group, pneumothorax occurred in 4 of 20 patients (20%). In the nondependent group, pneumothorax occurred in 5 of 26 patients (19.2%). Conclusion　The correlation showed that increasing frequency of pneumothorax with decreasing size of lesions. An increased rate of pneumothorax was correlated with presence of emphysema. Patients with emphysema are more likely to have a symptomatic pneumothorax. No significant differences were found in the incidence of pneumothorax between patients placed with the puncture site dependent after biopsy and those placed with the puncture site nondependent.

OBJECTIVE:To optimize the formulation of Asiaticoside cationic liposomes,and to investigate the characteristics of drug release in vitro. METHODS:The thin film dispersion method was used to prepare liposome;using encapsulation efficiency and drug-loading amount as index,the formulation of Asiaticoside liposomes was optimized by central composite design-response surface method with the ratio of drug to lipid(X1),the ratio of cholesterol to lipid(X2)and the concentration of D-mannose(X3) as factors. Using sodium lauryl sulfate as medium,in vitro release characteristics of cationic liposomes prepared with 1%octadecyl-amine was investigated by bag filter method,and compared with those of Asiaticoside solution and common liposome. RESULTS:The optimal formulation was X1 0.07,X2 0.17 and X3 0.03 g/ml. The encapsulation efficiency was (75.529 ± 1.071)%,and drug-loading amount was(2.539±0.029)%(n=3);the deviation from the predicted values were -0.217% and 0.205%;1% oc-tadecylamine was add into formulation to obtain cationic liposomes,and the Zeta potential had changed from -5.6 mV to 20.8 mV. in vitro accumulative release rates of Asiaticoside solution,common liposomes and cationic liposomes were 89.13%(12 h), 87.58%(72 h) and 94.46%(72 h),and the latter was in line with Weibull model. CONCLUSIONS:Asiaticoside cationic lipo-somes have high encapsulation efficiency,and can releases for 72 h.

OBJECTIVETo modify biomacromolecules, such as chitosan and collagen, to synthesize a mineralized template that will induce self-growing remineralization of tooth enamel.

METHODSNatural polycation polysaccharide chitosan was modified through phosphorylation to synthesize the polyanion derivative ofphosphorylated chitosan. Parent hydrogels com- bined with chitosan and collagen I were built through peptide binding reaction using genipin as a crosslinker. The gels self- assembled on the tooth's inert surface, which was stimulated by ultraviolet radiation. The bionic saliva provided mineralized ion, and then the hydroxyapatite assembled and grew in situ on the tooth.

RESULTSThe functional group P04(3-) (3,446 cm(-1)) was grafted on chitosan as confirmed by the Fourier transform infrared spectroscopy. The porous polyelectrolyte complex hydrogel formed by the interaction between the polycation chitosan and the polyanion phosphorylated chitosan could induce hydroxyapatite crystal nucleation and growth on the hydrogel fiber surfaces. The neonatal crystal was hydroxyapatite as confirmed by X-ray diffraction and was tightly connected to the tooth. A continuous structure of column crystals with sizes ranging from 30 nm to 60 nm was observed. The structure was in parallel direction similar to the direction of the enamel rod, and its hardness was close to dentin.

CONCLUSIONThe parent hydrogels that were easily obtained and controlled could mimic the template of the enamel mineralization and induce a self-growing hydroxyapatite, which is an important step in the structural bionics of enamel.

Biocompatible Materials ; Chitosan ; Collagen ; Dental Enamel ; Durapatite ; Microscopy, Electron, Scanning ; Polymers ; Spectroscopy, Fourier Transform Infrared ; Tooth ; Tooth Remineralization ; Ultraviolet Rays ; X-Ray Diffraction

Objective To identify the related factors of PICC malposition.Methods The domestic published literature about the related factors of PICC malposition were collected from 2001 to 2014.Analysis of heterogeneity was performed and cumulative effects were calculated using either fixed or random effects models by RevMan 5.0.Results The incidence of PICC malposition in patients with median cubital vein or cephalic vein was obviously higher than that in patients with basilic vein,the incidence of PICC malposition in patients with cephalic vein was significantly higher than that in patients with median cubital vein; the incidence of PICC malposition in patients with recumbent position was significantly higher than that in patients with seat position; the incidence of PICC malposition in the older than sixty years patients was significantly higher than that in younger than sixty years patients; the incidence of PICC malposition in male and female patients was not discrepant.Conclusions The vein,position and age of patient are the related factors of PICC malposition,while sex factor has nothing to do with the occurrence of PICC malposition.

Objective To observe the changes in proliferative activity of and autophagosome formation in human HaCaT keratinocytes and primary keratinocytes after different doses of ultraviolet B (UVB) radiation,and to assess the potential relationship between proliferation impairment and autophagosome formation.Methods Both cultured HaCaT cells and primary keratinocytes from human foreskin were irradiated with different doses (5,10,20and 40 mJ/cm2) of UVB.Those receiving no irradiation served as the control.After additional 12-hour culture,methyl thiazolyl tetrazolium (MTT) assay was performed to evaluate the proliferative activity of cells,monodansylcadaverin (MDC) staining to detect autophagosomes in cells.The number of autophagosome-positive or negative cells was counted using inverted fluorescence microscopy.Results UVB radiation induced a significant decrease in the proliferation of keratinocytes,especially in that of HaCaT cells.The proliferative activity expressed as the absorbance value at 490 nm was significantly lower in HaCaT cells (1.367 ± 0.035,1.173 ± 0.034 and 0.873 ±0.025 vs.1.519 ± 0.022,all P＜ 0.01) and primary keratinocytes (0.782 ± 0.012,0.773 ± 0.021 and 0.725 ± 0.031 vs.0.887 ± 0.035,all P ＜ 0.05) irradiated with UVB of 10,20 and 40 mJ/cm2 than in the unirradiated control cells.Significant differences were also observed in the proliferative activity among HaCaT cells irradiated with UVB of 10,20 and 40 mJ/cm2.The proportion of autophagosome-positive cells was increased after irradiation with UVB of 5,10 and 20 mJ/cm2,but decreased after irradiation with UVB of 40 mJ/cm2 in keratinocytes,especially in the primary keratinocytes.In detail,the proportion of autophagosome-positive cells was 22.69％ ± 2.15％,28.10％ ± 2.92％ and 22.92％ ± 2.61％ in HaCaT cells irradiated with UVB of 10,20 and 40 mJ/cm2 respectively,significantly higher than that in the unirradiated cells (10.18％ ± 1.50％,chi-square test for trends:x2 =27.48,P ＜ 0.01).No significant changes were observed in the proportion of autophagosome-positive cells in primary keratinocytes after irradiation with UVB of 5,10 and 20 mJ/cm2,but a marked decrease was found after irradiation with UVB of 40 mJ/cm2 compared with unirradiated keratinocytes (chi-square test for trends:x2 =6.86,P ＜ 0.01).Conclusions UVB radiation (10-40 mJ/cm2) decelerates the proliferation of HaCaT cells and primary keratinocytes in a dosedependent manner,and primary keratinocytes seem to be more resistant to UVB damage than HaCaT cells.Low to moderate doses (5-20 mJ/cm2) of UVB promote autophagosome formation in HaCaT cells in a dose-dependent manner,and exert no significant influence on that in primary keratinocytes; however,UVB of 40 mJ/cm2 suppresses autophagosome formation in keratinocytes,especially in primary keratinocytes.

Objective To investigate the effect to the blood supply of the gastrocnemius if ligating the medial or lateral artery, and provide theory base for the sural artery flap repairing the soft tissue defects of legs injuries.Methods The anatomical study involved 16 fresh adult cadaver lower legs ligating the medial or lateral gastrocnemius vessel, the arteries of which were perfused with the Meglumine Diatrizoatis Mucilage,and then carried out the cross-sectional analysis of the CTA, the bifurcation, location length, diameter and perforator of the sural artery were recorded by dissection.To observe the anastomosis with gastrocnemius vessel in artery pipeline foundry made by 1 specimen.Results The consistent with the result of the angiography was the gastrocnemius can completely get enough blood supply from some anastomotic arteriole when ligating one side of the sural vessel.Under normal circumstances, the blood supply of gastrocnemius muscle mainly supplied by sural artery.In the case of the sural vessel was cut off, the blood supply of gastrocnemius come from the anastomotic arteriole between medial and lateral artery and the soleus.The anastomotic arteriole from soleus has larger diameter, but less quantity, and was invariably deteced in the lower third of the gastrocnemius muscle constantly.A lot of anastomotic arteriole were found between the muscle heads, and it was also invariably deteced in the lower third of the gastrocnemius muscle, communicating with the surai neurovascular axis, the average external diameter was less than 0.5 mm.Conclusion The blood supply of the gastrocnemius are enough when ligating the medial or lateral artery.

Objective To evaluate the vancomycin trough concentration and nephrotoxicity in ICU patients with scale method.Methods The patients in ICU were evaluated from September 2011 to December 2013 in the hospital by prospective randomized controlled study.Experience using drug was applied in control group (n=116).Scale method was applied in test group (n=117), vancomycin concentration and renal toxicity were compared between two groups.Results The percentage of patients with an initial vancomycin trough concentration 15.0μg/mL or higher increased in the test group as compared with control group (73%vs 38%, P=0.004).The test group also demonstrated that an increase in the percentage of patients with initial trough concentration from 15.0 to 20.0μg/mL (41% vs.19%, P=0.008), and no statistical difference in the percentage of patients with an initial vancomycin trough concentration above 20μg/mL (31% vs.17%, P=0.340).There was no difference in nephrotoxicity in test group compared with control group (17% vs.16%, P=0.953).Conclusion Use of scale method increases the percentage of initial vancomycin trough concentrations 15.0μg/mL or higher in ICU patients and is not associated with an increased occurrence of nephrotoxicity.

Objective To study the antitumor activity of extract from Salvia plebeia and investigate whether the extract induce apoptosis of K562 cells. Methods The aqueous, petroleum ether, dichloromethane (CH2Cl2), ethyl acetate, and butanol extracts were prepared from the aerial parts of 5. plebeia. Taking fluorouracil as reference, the cytotoxic activities of these extracts on HeLa, A549, SGC-7901, HCT-116, K562, LoVo, DU-145, and HepG2 cells were evaluated. To clarify the apoptosis of K562 cells induced by CH2Cl2 extract, the methods of Hoechst 33258 staining, flow cytometry assay, and DNA ladder assay were investigated. Results The CH2Cl2 extract showed the most potent cytotoxic effect against K562 cells, with an IC50 < 15 μg/mL for 3 d treatment. The characteristic apoptotic symptoms such as DNA fragmentation and chromatin condensation were also observed in the K562 cells. Conclusion The CH2Cl2 extract from S. plebeia may inhibit the cancer cell proliferation by inducing cell apoptosis.

OBJECTIVE:To observe clinical efficacy and safety of sitagliptin combined with metformin in the treatment of type 2 diabetes complicating with metabolic syndrome. METHODS:Totally 80 patients with type 2 diabetes complicating with meta-bolic syndrome were divided into the observation group and control group with 40 cases in each group according to simple random sampling method. Both groups were given same diet and exercise plan;control group was additionally given metformin orally,0.5 g each time,tid;observation group was additionally given sitagliptin,100 mg each time,qd,on the basis of control group. Treat-ment course of 2 groups lasted for 12 weeks. The waist circumference(WC),body mass index(BMI),blood glucose,blood lip-id,fasting insulin (FINS) and serum adiponectin were detected in 2 groups,and steady-state model insulin resistance index (HOMA-IR)and whole body insulin sensitivity index(WBISI)were calculated. The occurrence of ADR was observed. RESULTS:Before treatment,there were no statistically significant differences between 2 groups in WC,BMI,systolic blood pressure,diastol-ic blood pressure,triglycerides,cholesterol,high-density lipoprotein cholester,low-density lipoprotein cholesterol,fasting plasma glucose,2 h postprandial blood glucose,FINS,HOMA-IR,WBISI and serum adiponectin(P>0.05). After treatment,the above indexes of 2 groups were obviously improved,and the improvement of observation group was significantly better than that of con-trol group,with statistical significance(P<0.05). 2 cases and 3 cases were withdraw from the study in control group and observa-tion group because of ADR,respectively.There was no statistically significant difference in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS:Sitagliptin combined with metformin shows significant clinical efficacy in the treatment of type 2 di-abetes complicating with metabolic syndrome. Its mechanism may be related to reducing insulin resistance,enhancing insulin sensi-tivity,decreasing patients’body weight and up-regulating serum adiponectin level.