By analyzing the present condition of communication courses in some medical colleges and universi -ties and the clinical practice situation , this paper emphasized the significance of the clinical professional courses :it is beneficial to promote the reform of medical education , is advantageous to the medical students′humanistic spirit , to improve clinical teachers′humanistic quality , is helpful to reduce medical disputes .And on the future develop-ment of clinical communication course put forward the following suggestions: extended content , the integration of related courses , reform teaching methods , intensify communication course value .

Objective To compare the effect of inhaled corticosteroids and montelukast in children with asthma .Methods Data were obtained from Pubmed ,Embase and Central databases ,CNKI and VIP .Only randomized controlled trials (RCT ) that evalua-ting inhaled corticosteroids and montelukast for children were included .The Cochrane collaboration risk bias tools was used to eval-uated the quality of literature .Results The patients with inhaled corticosteroids had a better effect in FEV 1% and PEF than pa-tients with montelukast ,the incidences of adverse drug reactions had no statistically significant difference .The patients with inhaled corticosteroids combined with montelukast had a better effect in FEV 1% or PEF than patients with inhaled corticosteroids only . Conclusion The effect of inhaled corticosteroids is better than montelukast ,the effect of inhaled corticosteroids combined with montelukast is better than inhaled corticosteroids only ,and has drug safety .

Objective To investigate the effects of Kidney nourishing decoction in the treatment of reproduce patients in serum hormone .Methods 120 cases with reproduce patients from June 2014 to June 2016 in hangzhou traditional chinese medical hospital were selected,and divided into control group and experiment group, 60 cases in each group.The control group was given artificial cycle treatment, the experiment group was treated with Kidney nourishing decoction, two groups were treated for three months.Serum sex hormone and AMH content, clinical effect and pregnancy rate were compared before and after treatment.Results Compared with before treatment, levels of FSH, LH, E2 and FSH/LH in two groups decreased, AMH content increased after treatment,the thickness of endometrium and ovarian antral follicle number increased,symptom scores decreased after treatment (P <0.05);Compared with the control group, levels of FSH, LH, E2 and FSH/LH in the experiment group were lower, AMH content were higher, the thickness of endometrium and ovarian antral follicle number in the experiment group were higher,and the symptom scores were lower (P<0.05).The total effective rate of the study group was 90.00% higher than the total effective rate of the control group 73.33% (P<0.05).There was no significant difference in adverse reaction rate between the two groups, the pregnancy rate in the experiment group 30.00% was higher than the control group 11.67% ( P <0.05 ) .Conclusion Kidney nourishing decoction can reduce the sex hormone and increase the content of AMH , and increase the pregnancy rate in the treatment of reproduce patients.

Objective To investigate the role of interleukin-6(IL-6), interleukin-8(IL-8) and tumor necrosis factor-?(TNF-?) in the pathogenesis of secondary syphilis, and their relationship with RPR titers and clinical manifestations in secondary syphilis. Methods The serum IL-6, IL-8 and TNF-? were tested by ELISA. RPR titers of the patients were determined simultaneously. Histopathology was performed if skin lesions were present. Results Thirty three cases of secondary syphilis were studied. The average levels of serum IL-6, IL-8 and TNF-? were 78.7?82.5 pg/mL, 171.9?117.9 pg/mL and 115.7?67.9 pg/mL, respectively, in syphilis group, which were significantly higher in comparison with those in controls (P

Objective To study of cellular immune function change of elderly patients with non-small car-cinoma after chemotherapy.Methods 62 patients with non-small carcinoma by age was divided into elderly group (≥60 years old)and youth group (<60 years old).The lymphocytes and their subsets CD3,CD4,CD8 levels were detected respectively in 2 weeks after chemotherapy and chemotherapy before compared with 20 cases of healthy vol-unteers.Results The immune condition of CD3[(51.87 ±2.56)%,(58.98 ±3.87)%]and CD4[(35.01 ± 5.12)%,(42.12 ±3.54)%],CD4/CD8[(0.89 ±0.49)%,(1.08 ±0.86)%]levels were significantly lower than those of healthy controls.Two groups of patients compared with healthy group CD3(69.38 ±8.54)%,CD4(48.21 ± 3.45)%,CD4/CD8(1.87 ±0.85)%(t=10.586,5.998,10.087,6.093,5.170,3.236,all P<0.05),and CD8 [(32.68 ±3.64)%,(30.24 ±2.45)%]levels were higher than those of healthy controls (26.10 ±2.89%)(t=6.777,5.531,all P<0.05);The CD3 and CD4,CD4/CD8 of elderly group patients were markedly lower than that of young patients (t=8.472,6.394,3.059,all P<0.05).The CD8 levels of the elderly group was higher than young patients (t=3.114 2,P<0.05);The Elderly group and young patients after 2 cycles of chemotherapy CD3 signifi-cantly was lower than before treatment (t=10.233,16.847,all P<0.05),but the two groups of patients with CD4, CD8 and CD4/CD8 levels before and after treatment (P>0.05);There was no significant difference with CD3 level of the two groups of patients after chemotherapy (P>0.05);The CD3 level of the two groups of patients after chemo-therapy was no significant difference (P>0.05),the elderly group patients after chemotherapy with CD4 levels was lower than young patients (t=7.130,P<0.05).The CD8 and CD4/CD8 level of the two groups after chemotherapy were no significant difference (P>0.05);The CD3 levels of patient withⅠ-Ⅱ stage were significantly better than patients withⅢ-Ⅳstage (t=1.584,1.721,all P<0.05),the CD4,CD8 and CD4/CD8 level of the two groups had no significant difference(P>0.05).Conclusion The senile non-small carcinoma patients need assistance targeted immunotherapy,also need to adjust according to the patient's age and clinical staging in patients with chemotherapy drug doses.

Objectives To analyze the clinical features and gene types of Apert syndrome (AS). Methods The clinical data of one boy with AS were retrospectively revisited and FGFR 2 of the boy and his father were analyzed with PCR amplification and gene sequencing. The relevant literatures were reviewed. Results The boy was one year and one month old, with brachycephaly, exophthalmos, hypertelorism, low set ears, micrognathia, high-vaulted arch, without cleft palate, and with syndactyly of both ifngersⅠ-Ⅴ and toesⅠ-Ⅴ. A heterozygous mutation (c. 758 C?>?G,p.P 253 R) in exon 7 of FGFR 2 was detected in the boy, supporting the diagnosis of AS. The relevant gene mutation was not detected in his father. Among the 24 cases of AS retrieved from literature, 22 cases were with obvious craniofacial malformations, one with mild craniofacial malformations and one without craniofacial malformations. All cases were with syndactyly of both ifngers and toes. Thirteen cases of FGFR 2 were with S 252 W mutation, 3 cases with P 253 R , 3 cases with Alu insertion, one with 1 . 93-kb deletion, removing exon IIIc and substantial portions of the lfanking introns, one case with a heterozygous 1372 bp deletion between FGFR 2 exons IIIb and IIIc, 2 cases with (c.756_758delGCCinsCTT) in the IgIIe-IgIIIa linker region and one case with sequence variant T78.501A in intron 8. Conclusions Apert syndrome present with craniofacial malformations and syndactyly of hands and feet, S 252 W and P 253 R are main mutations of AS.

Objective To investigate the role of antisense RNA of plasminogen activator inhibitor 1 (PAI 1) in regulating the expression of PAI 1 and vascular endothelial growth factor (VEGF) in aorta endothelial cells (EC) cultured in vitro. Methods The second extron of PAI 1 was amplified by polymerase chain reaction(PCR) and the product was inserted into eukaryotic cell expression vector pcDNA3.1(-) to construct PAI 1 antisence RNA recombinant plasmid. The recombinant plasmid was transfected into EC and the PAI 1 expression was detected by immunohistochemistry, Westernblot and ELISA. The effects of PAI 1 variation on VEGF were examined by immunofluorescence method. Results PAI 1 antigen was the lowest (0 017 ng/ml) in cells and the immunofluorescence representing the expression of VEGF in the cytoplasm showed the weakest at the third day after transfection. At the fifth day, PAI 1 antigen increased to 0 093 ng/ml with VEGF expression increased correspondingly. At the seventh day, PAI 1 antigen(0 143 ng/ml) and VEGF increased closed to normal level. Conclusions PAI 1 antisense RNA blocked the translation of PAI 1 proteins effectively and inhibited the expression of VEGF in aorta endothelial cells.

Objective To study the protective effect of FGP on liver damage in mice caused by carbon tetrachloride(CCl4).Methods Carbon tetrachloride was used to make the model of chemical liver damage.The mice were randomly divided into 5 groups,10 in each:FGP(10.0 ml/kg)+CCl4,FGP(5.0 ml/kg)+CCl4,FGP(2.5 ml/kg)+CCl4,CCl4(0.12%,10 ml/kg)and the control group.The mice were treated with FGP and CCl4 by gavage and intraperitoneal injection.The biochemical and pathological examinations were conducted to observe the liver damage.Results Compared with CCl4 group,treated with FGP at 5.0 ml/kg could reduce the serum ALT activity significantly,the histopathological findings showed an obvious improvement.Conclusion FGP may have some protective effects on acute live damage caused by CCl4 in the mice.

OBJECTIVE:To optimize the extraction technology for Huangshen electuary.METHODS:In this experiment the optimum extraction technology for Huangshen electuary was investigated by the L9(34) orthogonal test with the content of Astragaloside Ⅳ as technology index.The effects of three factors including the extraction times,time length of extraction and solvent ratio were investigated.RESULTS:The best extraction technology for Huangshen electuary was as follows:the solid-liquid ratio was 1∶10 and the decoction was carried out for 3 times(2 hours/time).CONCLUSION:The optimum extraction technology for Huangshen electuary is stable and feasible.