In order to accelerate the pace of teaching reform,our school explores the tutorial system of undergraduate course this year,this article emphasize the necessity and beneficial effects of this system in clinical practice.

Nitric oxide (NO) played an important role in the pathogenesis of many diseases. It selectively dilates the pulmonary vasculare, combats pulmonary hypertension associated with hypoxemia, improves oxygen. At the same time, it could relaxe bronchial smooth muscle, kill pathogens and have anti-inflammatory effect,etc. Inhaled nitric oxide has important significance in the treatment of respiratory diseases.

This paper introduces interns shoule know the importance of interpersonal relationship in clinic practice thoroughly and good interpersonal relationship requires the teacher and medical students to make efforts together.

With the progress and development of science and technology, biomedical technology has been widely used in traditional Chinese medicine (TCM) research. However, TCM and Western medicine developed and came into being at different times and from different cultural backgrounds. Their targets are to study and explore the objective laws of human life activities from different angles and by different means. To study and evaluate TCM simply by the diagnosis and treatment standards of Western medicine cannot truly reflect the characteristics of TCM. Lots of clinical phenomena in the diagnosis and treatment in TCM cannot be revealed scientifically. It might be a significant pattern to combine the study of TCM with Western medicine, based on double-screening model of combining disease with syndrome types, following up evidence-based medical research steps, and making use of systematic review and data mining to analyze the inherent laws of TCM symptoms.

Objective To observe the efficacy and safety of albumin-bound paclitaxel on the patients with advanced malignance in more than the third-lines (including the third-lines).Methods 34 patients with advanced malignance diagnosed by pathological evidence accepted more than the third-lines (including the third-lines) chemotherapy containing albumin-bound paclitaxel after failure of chemotherapy.The efficacy and safety were observed.Results Totally 110 cycles chemotherapy were completed,with a mean of 3.24 cycles in each of the 34 patients.No CR patients,12 cases of PR,9 cases of SD and 13 cases of PD were found.The response rate (RR) was 35.29 ％ (12/34) and the disease control rate (DCR) was 61.76 ％ (21/34).The main toxicity was hematologic toxicity,including neutropenia in 26 cases (76.47 ％),anemia in 14 cases (41.18 ％) and thrombocytopenia in 3 cases (8.82 ％).Other common adverse reactions included alopecia in 27 patients (79.41％) and muscle and joint pain in 15 cases (44.18 ％).Conclusions The albumin-bound paclitaxel is effective and tolerable in patients with advanced malignance in more than the third-lines (include the thirdlines) chemotherapy.

Objective To explore the effectiveness and safety of high frequency oscillatory ventilation(HFOV) in children with measles complicated with severe pneumonia and the acute respiratory distress syndrome(ARDS).Methods A total of 63 children with measles complicated with severe pneumonia and the ARDS were divided into conventional mechanical ventilation(CMV) group and HFOV group.The PaO2/ FiO2,oxygenation index (OI),HR and mean arterial pressure (MAP) before treatment and 12 h,24 h,48 h after treatment were detected.The rate of air leak and the motality in two groups were compared.The efficacy and safety of HFOV treatment were evaluated in children with measles complicated with pneumonia and severe ARDS.Results In HFOV group,the PaO2/FiO2 ratio was elevated and OI was decreased significantly after 12 h and maintained for at least 48 h.Compared with CMV group,OI of HFOV group improved more significantly,and the difference was statistically significant.The ventilation time in HFOV group was shorten than that in CMV group[(7.97 ±3.06) d vs.(11.03 ±3.60) d],but there was no statistical difference between two groups (P ＞ 0.05).The heart rate after treatment 48 h was gradually returned to normal,and there was no statistical difference between the two groups.There were no significant changes in the MAP of two groups after treatment.There were no significant differences in the incidence of air leak between the CMV group and the HFOV group(24.2％ vs.16.7％).The mortality rate of CMV group and HFOV group was respectively 45.5 ％ and 33.3 ％,and there was no statistically significant difference.Conclusion HFOV was effective in oxygenation and seems to be safe for pediatric patients with measles complicated with severe pneumonia and the ARDS.Also it didn't influence the occurrence of complications.It has no adverse influence on hemodynamic parameters.Early intervention of HFOV is safe and effective for the children with measles complicated with severe pneumonia and ARDS.

Objective:To explore the effect of tectorigenin on myocardial fibrosis(MF) in the rats and clarify the related mechanism,and to provide reference for its clinical application. Methods:Sixty Wistar rats were randomly divided into normal control group,model group,positive drug (capropril) control group, and low,middle,high doses of tectorigenin groups(n=10).Except normal control group, the rats in other groups were used to construct MF models by subcutaneous injection of 5 mg·kg -1·d -1 isoproterenol (Iso) for 7 d.The rats in tectorigenin groups and captopril group were intragastricly administrated with different doses of tectorigenin (25,50,100 mg·kg-1·d-1)and captopril(10 mg·kg -1·d -1) from the second day after modeling for consecutive 28 d.Bl-420E+ biological function experiment system was used to detect the heart function;Heart mass index (HMI) and left ventricular mass index (LVMI) were measured after experiment.UV detection was used to measure the levels of malondialdehyde (MDA) and the activities of superoxide dismutase (SOD) in myocardial tissue.Microplate reader was used to measure the activities of lactic dehydrogenase(LDH) and creatine kinase(CK) and the levels of nitric oxide (NO)in serum.ELISA were used to detect the levels of collagen typeⅠ(ColⅠ) and collagen type Ⅲ (Col Ⅲ) in myocardium tissue of the rats.The pathological changes of myocardium tissue of the rats in various groups were observed by HE staining.Results:Compared with normal control group,the HR of rats in model groups was increased,and the left ventricular systolic pressure (LVSP) was decreased(P<0.01);the HMI and LVMI were increased(P<0.05),the levels of MDA in left ventricular myocardial tissue was increased(P<0.01),and the activity of SOD was decreased,the levels of serum ColⅠ,Col Ⅲ and the activities of LDH , CK were also increased(P<0.01);the level of NO in serum was decreased(P<0.01).Compared with model groups, the HR were decreased,LVSP were increased, and HMI and LVMI of the rats in different doses of tectorigenin groups were decreased in a dose-dependent manner;the levels of MDA were reduced;the activities of SOD were increased in myocardium tissue,and the CK activities and the ColⅠ and ColⅢ levels were decreased(P<0.05 or P<0.01);the LDH activities in middle and high doses of tectorgenin groups were decreased(P<0.01);and the levels of NO in serum in different doses of tectorigenin groups were significantly increased(P<0.05 or P<0.01) .Conclusion:Tectorigenin could inhibit the MF induced by Iso in the rats, and its mechanism may be related to antioxidation,scavenging free radical and inhibition of collagen synthesis.

To reveal the scientific research situation of general hospitals in recent years in　china,the authors retrieved papers included in CBM、CCD and ISI Web of Knowledge,and compared　the production of papers from the general hospital in 15 sub-provincial cities during the period of 2000　-2009.Also the citation frequency of all papers and the average citation frequency were compared.

This article was aimed to study the relevance between traditional Chinese medicine ( TCM ) syndromes and the treatment of chemotherapy and targeted therapy , in order to provide theoretical support for TCM syndromes of lung cancer in the clinical application . Uniform TCM syndromes questionnaire was used in the TCM syndrome differentiation among lung cancer patients from the Oncology Department of Longhua Hospital, Shanghai University of Traditional Chinese Medicine and TCM Department of Shanghai Pulmonary Hospital. The analysis was made on correlation between distribution rules of TCM syndromes and chemotherapy and targeted therapy . The results showed that among primary lung cancer patients , the most TCM syndromes were syndrome of lung-yin deficiency , lung-q i deficiency , blood stasis in lung collaterals , spleen-q i deficiency , lung-yin deficiency with fire excess . There were certain correlation in TCM syndromes and different TCM therapeutic methods , in which targeted therapy had great significant effect on syndrome of lung-yin deficiency ( P < 0 . 05 ) , after targeted therapy syndrome of lung-yin deficiency increased obviously . It was concluded that there were some regulations in TCM syndromes of lung cancer which take syndrome of lung-yin deficiency, lung-qi deficiency, blood stasis in lung collaterals, spleen-qi deficiency, lung-yin deficiency with fire excess. There were certain correlation in TCM syndromes and different TCM therapeutic methods , after targeted therapy syndrome of lung-yin deficiency increased obviously .

Objective To investigate the effects of ultrasound radiation force(USRF) on adhering of targeted microbubbles in vivo.Methods A rat model of cremaster muscle Inflammation was developed,and microbubble(MB) or targeted microbubble of intercellular adhesion molecule-1 (MBICAM) was injected through the caudal vein.Immediately after intravenous MB or MBICAM injection,the cremaster was insonated for 5 minutes and the control group was in sham ultrasound exposure.All mice were divided into four groups randomly:① MB + false USRF; ② MB + USRF; ③ MBICAM + false USRF; ④ MBICAM + USRF.Fluorescence microscope was performed in twenty mice to evaluate microbubbles adhesion and video recordings were made with a high-resolution camera.Results The adhesion number of MBICAM was significantly greater in USRF group than that of MBICAM in false USRF group [(43.4 ± 2.1)/view vs (14.8± 1.8)/view,P =0.000].The adhesion number of MB in USRF group was greater than in false USRF group [(6.2 ± 1.3)/view vs (4.6 ± 0.9)/view].But there is no statistical significance (P =0.129).The adhesion number of MBICAM in both USRF group and false USRF group was significantly greater than the adhesion number of MB.Conclusions The ultrasound radiation force can significantly improve the adhesion of targeted microbubbles in vivo.