OBJECTIVE:To observe clinical efficacy and safety of Compound huanglian jiangtang powder for patients with im-paired fasting blood glucose(FBG). METHODS:122 patients with impaired FBG were selected and randomly divided into control group and trial group with 61 cases in each group. Two groups was given healthy education and diet guidance;trial group was giv-en Compound huanglian jiangtang powder 2.5 g orally,qd. Both groups were treated for 4 months. Clinical efficacy of 2 groups was observed and FBG,TC,TG,LDL-C,HbA1c,SOD,MDA and GSH-PX levels and BMI were observed before and after treat-ment. The occurrence of ADR was recorded. RESULTS:Total effective rate of trial group was 77.0%,which was significantly higher than that of control group(24.6%),with statistical significance(P<0.05). Before treatment,there was no statistical signifi-cance in FBG,TC,TG,LDL-C,HbA1c,SOD,MDA and GSH-PX levels and BMI between 2 groups (P>0.05);after treat-ment,above indexes of 2 groups were improved significantly,the trial group was significantly better than the control group,with statistical significance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Compound huanglian jiangtang pow-der is effective improvement of laboratory indexes and safe for impaired FBG.

OBJECTIVE:To isolate and identify lignans chemical constituents from Coptis chinensis,and to investigate their in-hibitory activities to protein tyrosine phosphatase-1B (PTP1B). METHODS:The acetic ether part of 95% ethanol extract from C. chinensis was isolated by HPLC and gel column chromatography,and the structure of chemical constituents were identified by UV, IR,MS and NMR. Using RK-682 as positive drug,the inhibitory activity to PTP1B was investigated(the concentrations of posi-tive drug and isolated chemical constituents were 0,15,30,50,65,80,100,120,140,170 and 200 μmol/L,respectively). In-hibitory rate and IC50 of them were calculated. RESULTS:5 lignans were isolated,including 9-acetyl lanicepside B,Lanicepside A,Woorenogenin,(+)-isolariciresinol and(+)-lariciresinol gluciside(compound 1-5),and compound 1 and 2 were isolated from C. chinensis for the first time. Compound 1-5 inhibited PTP1B to certain extent in concentration-dependent manner. IC50 of them were 57,49,71,58 and 51 μmol/L,but their effects were not as good as RK-682 (IC50=32 μmol/L). CONCLUSIONS:5 lig-nans have been isolated from C. chinensis and can inhibit PTP1B to certain extent.

Objective To study the inclusion mechanism of 14-deoxyandrographolide and ?-cyclodextrin in inclusion ratio,molecular interaction between host and guest,inclusion part and stability of inclusion compound.Methods The formation of inclusion compound was confirmed by dfferential thermal analysis(DTA);The equilibrium constants of inclusion compound were determined and the thermodynamic constants were calculated by UV;Inclusion parts were confirmed by IR and 1H-NMR.Results Ka=1 292.631 L/mol;?G=-16.854 8;?H=-25.532;?S=-0.029 12.It was clearly that all five lactone ring and decalin ring of 14-deoxyandrographolide in indusion compound changed in IR and 1H-NMR.Conclusion Inclusion host-guest ratio is 1∶1,Van der Waals forces play a major role in the process.Inclusion site is decalin ring and five lactone ring.The inclusion compound is more stable under normal temperature.

Objective To study the influence of minocycline combined with azithromycin on serum CRP, D-Dimer and lung function in the children with refractory mycoplasma. Methods From April 2015 to August 2016, 42 children with refractory mycoplasma pneumonia were enrolled in the second hospital in Tianjing. The patients were divided into the observation group and the control group according to the order of admission. The control group was treated with azithromycin sequential therapy, the observation group were given minocycline combined with azithromycin to complete the treatment. The levels of serum CRP, D-D, lung function, clinical symptoms and signs, and the adverse effects were observed. Results After treatment, the total effective rate of the observation group was significantly higher than that in the control group (P<0.05). The levels of CRP and D-D in the observation group were significantly lower than those in the control group (P<0.05). The highest expiratory flow velocity (PEE), first-second forced expiratory volume (FEV1), forced vital capacity (FVC) and forced expiratory 25% flow rate (MEF25) in the observation group were significantly higher than those in the control group (P<0.05). The time of X-ray recovery time, the time of fever, the time of cough and the disappearance of lung rales were significantly shorter than those in the control group (P<0.05). Compared with the control group, there were no significant differences in diarrhea, abdominal pain, nausea, vomiting, pleural effusion, otitis media, mild anemia and rash adverse reaction rate in the observation group. Conclusion Minocycline combined with azithromycin in the treatment of severe Mycoplasma pneumoniae pneumonia can effectively reduce serum levels of CRP and D-D, improve pulmonary function and clinical symptoms, and have good clinical efficacy.

A total of 40 patients with COPD (excluding those with correlated/relevant diseases)were measured for inflammation parameters of erythrocyte sedimentation rate (ESR) and c-reactive protein (CRP) after hospital admission and some coagulation/fibrinolysis parameters including D-dimer,thrombinantithrombin (TAT),prothrombin fragment 1 + 2,(tissue plasminogen activator) tPA,plasminogen activator inhibitor 1 (PAI-1),von Willebrand factor (von WF),endothelin receptor A,thromboxane B2,P-selectin and pulmonary arterial pressure (PAP) by ultrasonic cardiography after the settling of the symptons of acute period.All patients were then divided into 2 groups according to PAP [＜ 40 mm Hg (1 mmHg=0.133 kPa) (n=24),＞40 mm Hg (n=16)].The values of CRP and ESRin the group with PAP ＞ 40 mm Hg were significantly higher than those in another group (P =0.044 and P =0.002respectively) while tPA was lower (P =0.04).A moderate positive correlation existed between tPA and TXB2 (r =0.547).Moreover,a highly positive correlation was found between TXB2 and PAl-1 (r =0.929).The results indicated that the COPD patients with pulmonary arterial hypertension (PAH) tend to have a higher level of inflammation,and their fibrinolysis becomes impaired leading to a prothrombotic state.

AIM:To investigate the role of B cells in CD45RB antibody-induced transplantation immune toler-ance.METHODS:Single cell suspension was made from the spleen of BALB/c nude mice disposed by CD45RB antibod-y, then mixed cultured with T cells of BALB/c mice and spleen cells of C57BL/6 mice.The Th1, Th2, Treg and Tm cells were monitored by flow cytometry during the culture process .The skin graft model was set up with B 6.μMT-/-mice as re-ceptors and BALB/c mice as donors.CD45RB antibody was intraperitoneally injected into the receptors after transplantation and then CD3+CD45RBhi cells were detected by flow cytometry .In another mixed lymphocyte culture , CD45RB antibody was added, and then B cells were isolated and injected into B6.μMT-/-mice through the tail vein.The heart transplanta-tion model was established with B 6.μMT-/-mice as receptors and BALB/c mice as donors, and then the survival and the migration of B cells to the thymus were observed .RESULTS:When T lymphocytes were co-cultured with B lymphocytes treated with anti-CD45RB monoclonal antibody (mAb) in vivo, the percentages of Th2 and Treg cells were up-regulated and Th1 cells were down-regulated, but Tm cells were not altered as compared with the control .In vivo without B lympho-cytes, anti-CD45RB mAb also down-regulated the expression of CD45RB in T lymphocytes.The reduction was faster and the percentage of CD3 +CD45RBhi T cells was not altered as compared with the control .The B lymphocytes treated with an-ti-CD45RB mAb in vitro prolonged the lifetime of receptor in heart transplantation model but failed to induce complete toler -ance.After recieving B cells treated with anti-CD45RB mAb and allogeneic heart transplantation , B cells migrated to the thymus in B6.μMT-/-mice.CONCLUSION:B lymphocytes play a definite role in the transplantation immune tolerance induced by anti-CD45RB mAb through their affection on T-cell subgroups and also in the central tolerance .However, the induction of immune tolerance can not only rely on B cells .

Through feedback from questionnaire,relevant problems are summed up,further understanding of the status of medical students' clinical practice is found.then some problems,such as low positivity of students,week didactical consciousness of teachers and inflexibility of practice system,are researched to table some proposals for reformation of clinical practice.

BACKGROUND:A variety of factors contribute to biliary injury that is difficult to be repaired. Stent implantation is extensively used for bile duct injury, but either scaffolds made by metal or plastics can lead to certain adverse reactions. OBJECTIVE:To explore the biological characteristics of a novel biodegradable scaffold and its repair effects on bile duct injury. METHODS:The biological characteristics of the novel biodegradable scaffold were detected by fresh bile, and its degradation was observed at different time points. Thirty Bama mini pigs were included and were randomly divided into observation group (n=15) and control group (n=15). After bile duct injury models were prepared, the control group was subjected to the bile duct interrupted suture, while the observation group was subjected to the novel biodegradable scaffold combined with omentum majus. The biological properties of the scaffolds were observed. Hepatic enzymes and serum total bilirubin levels were detected, as wel as hematoxylin-eosin staining, Masson staining and immunohistochemistry detection ofα-smooth muscle actin were performed. RESULTS AND CONCLUSION:Before and 1, 3 and 6 months after surgery, hepatic enzymes and total bilirubin of two groups were detected, and neither intra-group nor intergroup comparisons had significant differences (P>0.05). Hematoxylin-eosin staining and Masson staining revealed that inflammatory reactions and fiber hyperplasia at the anastomotic site in the observation group were lighter than those in the control group at different time points after surgery. Theα-smooth muscle actin-positive scores in both two groups were in a rise at 1 and 3 months after surgery, and peaked at the 3rd month, and then began to decline. Moreover, theα-smooth muscle actin-positive scores in the observation group were significantly lower than those in the control group at 3 and 6 months after surgery (P<0.05). These results show that the novel biodegradable scaffold has good biological characteristics and can obtain ideal repair effects in the bile duct injury.

Precision medicine for cancer patients aims to adopt the most suitable treatment options during diagnosis and treatment of individuals.Detecting circulating tumor cell (CTC) or circulating tumor DNA (ctDNA) in plasma or serum could serve as liquid biopsy,which would be useful for numerous diagnostic applications.Liquid biopsies can help clinicians screen and detect cancer early,stratify patients to the most suitable treatment and real-time monitoring of treatment response and resistance mechanisms in the tumor,evaluate the risk for metastatic relapse,and estimate prognosis.We summarized the advantages and disadvantages of tissue and liquid biopsies.We also further compared and analyzed the advantages and limitations of detecting CTCs,ctDNAs,and exosomes.Furthermore,we reviewed the literature related with the application of serum or plasma CTCs,ctDNAs,and exosomes for diagnosis and prognosis of cancer.We also analyzed their opportunities and challenges as future biomarkers.In the future,liquid biopsies could be used to guide cancer treatment.They could also provide the ideal scheme to personalize treatment in precision medicine.

Under the guidance of strengthening medical undergraduates' practical ability and their competence in future jobs, Dalian Medical University has established a clinical medical talents practical ability training mode. This model has implementedThree Turnsclinical skills training pattern to strengthen the three stage (before, during and after practice) clinical skills training and concentrated on humanistic quality education through overall evaluations and set up clinical skill examination system to evaluate teach-ing effectiveness comprehensively and truly , which has effectively improved the quality of education by perfecting safeguard mechanisms and guaranteeing teaching quality.