By participating in the national medical colleges and universities students' clinical skill competition and summarizing the experiences after the competition,we reflected on problems and weakness in the past clinical teaching including weak sterile concept and lack of clinical thinking,humanities,communication skills,teamwork awareness,etc.We should take methods to future improve medical students' clinical training capabilities including strengthening the concept of sterile and clinical skills,promoting training of comprehensive clinical thinking ability and problem-solving ability,emphasizing on humane care and communication between doctors and patients; cultivating teamwork awareness thus to comprehensively enhance the overall quality of medical students.

Objective To explore the changes and clinical significance of prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen time(FGB)and platelet(PLT)on Kawasaki disease(KD)in children with acute and convalescent 10 d,which aimed at early diagnosis,prediction and prognosis of coronary artery lesions.Methods Thirty-eight cases who were diagnosed KD were selected as KD group,30 cases age-matched acute respiratory infections in children with fever as fever group,moreover,30 cases of a class of elective surgery preoperative children admitted to surgical departments were put as control group.The plasma PT,APTT,TT,FGB,PLT of all cases and plasma APTT,FGB,PLT in recovery 10 d in children with KD disease were detected,and then the results were compared between the 3 groups;and the results of APTT,FGB,PLT in KD children with acute and convalescent 10 d to coronary artery dilatation groups or not were compared.Results 1.APTT prolonged and FGB,PLT increased in KD children with acute stage,which had a significant difference compared with other groups(Pa0.05).2.When comparing the results of APTT,FGB,PLT in KD children with acute and convalescent 10 d,the difference was significant(Pa

In order to improve the scientific research capability of medical graduates,help them cultivate scientific statistical mind and the ability to resolve actual medical scientific research issues,we made a teaching reform on the teaching objectives,curriculum system,teaching material and informational teaching of Medical Statistics teaching,established a diversified teaching pattern and improved the teaching quality.

Objective To explore the manipulation,feasibility and safety of laparoscopy assisted natural orifice translumenal endoscopic surgery(NOTES).Methods The technique was performed in 4 female porcine models.Diagnostic laparoscopy was performed first,and followed by transgastric access through the anterior gastric wall under the monitor of laparoscopy.The stoma was extended with the dilation ballon and the endoscope was sent to the abodominal cavity.Such procedures as endoscopic peritoneoseopy,fallopian tube ligation,oophorectomy,eholeeysteetomy and closure of gastrostomy were performed.The drainage tube and antibiotics of 3 days were used after operation according to the bleeding and potential risk of fistula and peritonitis.The animals were feeded on a semiliquid diet.Two weeks later,routine gastroseopy was pedbrmed to examine the healing of luminal incision.Subsequently,all models were sacrificed for the evaluation of the validity of NOTES.Results With the assistance of the laparoscope,endoscopic peritoneoseopy and,fallopian tube ligation,oophorectomy and cholecystectomy,twice for each,were successfully performed in all models.Abdominal drainage were used in two animals'after eholecystectomy.All porcines survived for 2 weeks postoperatively with no weight loss.Autopsic examination showed good healing of transgastric incisions,with little adhesion,no massive heinan'hage,abcesses,or injury to adjacent organs.Conclusion Combined laparoscopy and endoscopy for NOTES is feasible with relative safety.Laparoscopic assistance could facilitate the NOTES procedures at the present stage.

Background Cyclosporine A (CsA) is an effective drug to prevent rejection response after penetrating keratoplasty (PKP).Appropriate dosage forms and right administrating route is very important for improving the bioavailability of CsA.Objective This study was to investigate the preventing effect of CsA microspheres via subconjunctive and anterior chamber injection and CsA eye drops on immune rejection after PKP.Methods Sixty eyes of 60 clean adult New Zealand white rabbits served as receipts,and 60 eyes of 30 clean adult pigmented rabbits were used as the donors.The receipts were randomized into the blank control group (only PKP group),subconjunctival CsA injection group,subconjunctival vector injection group,anterior chamber CsA injection group,anterior chamber vector injection group,and 1％ CsA eye drops group.PKP was performed on the all rabbits,and then the CsA microsphere (0.1 ml,12 g/L) or blank microsphere (0.1 ml) were respectively administered in the corresponding groups.The corneal grafts were examined by slit lamp microscope regularly,and rejection index (RI)was calculated based on the corneal opacity,edema and neovascularization.The intraocular pressure (IOP) of operative eyes was measured by Tono-pen tonometer before operation,3 days,1 week,2 weeks,3 weeks,1 month,2 months and 3 months after operation,respectively.Histopathological examination on corneal grafts was performed 1month and 3 months after operation.Results The IOP of all the rabbits lowed after operation,but there was no statistical difference in different time points and various groups (Ftime =29.210,P =0.000; Fgroup =0.254,P =0.938).The grafts of the blank control group,subconjunctival vector injection group and the anterior chamber vector injection group showed varied degrees of corneal opacity and neovascularization 2-3 weeks after operation,and the degree of graft opacity was aggravated obviously in the fourth week,with the RI 8.60±1.52,8.60±0.55 and 8.80±0.84 individually.Neovascularization of the grafts in the subconjunctival CsA injection group,anterior chamber CsA injection group,and 1％ CsA eye drops group was found 3 weeks after operation,and the RI were 4.40±0.89,3.20±0.84 and 3.00±0.71,showing a significantly lower than that of the control groups (P＜0.05).Mild inflammatory response of the grafts was seen in the anterior chamber CsA injection group,but it was lightened over time.The histopathological examination revealed obvious thickening of corneal grafts,neovascularization and infiltration of lots of inflammatory cells in the blank control group,subconjunctival vector injection group and the anterior chamber vector injection group.However,only slight new blood vessels and inflammatory response were seen on the subconjunctival CsA injection group,anterior chamber CsA injection group,and 1％ CsA eye drops group.Conclusions Administration of CsA in different methods can prevent the immune rejection after PKP in rabbit eyes,the effect of giving drugs via anterior chamber injection is better than that via subconjunctive pathyway.

Animals ; Cell Differentiation ; Cytokines ; metabolism ; Disease Progression ; Epithelial-Mesenchymal Transition ; Extracellular Matrix ; metabolism ; Fibroblasts ; metabolism ; pathology ; Hepatic Stellate Cells ; metabolism ; pathology ; Humans ; Liver ; metabolism ; pathology ; Liver Cirrhosis ; etiology ; metabolism ; pathology ; Stem Cells ; metabolism ; pathology

OBJECTIVETo investigate the relationship between chronic pyelonephritis (CPN) and immune function, and the therapeutic mechanism of Yishenkang granule (YSKG).

METHODSOne hundred and twenty patients of CPN were divided into 3 groups randomly, the YSKG group (treated with YSKG), the control A group (treated with Sanjin tablet) and the control B group (treated with western medicine). Serum levels of immunoglobulin (Ig), complement 3 (C3), interleukin-2 (IL-2), peripheral T-lymphocyte subsets, and urinary secretory immunoglobulin A (sIgA) were determined before and after treatment with monoclonal antibody assay, agar diffusion method, radioimmunoassay (RIA), and radioimmuno-equilibrium method, and compared with normal control.

RESULTSThere were disorders of T-lymphocyte subsets in CPN, lowering of serum Ig, C3 and urinary sIgA, and increase of blood IL-2 (P < 0.05 or P < 0.01). These abnormalities could be normalized after YSKG treatment.

CONCLUSIONFunctional disorders of cellular and humoral immunity exist in CPN patients of chronic stage, YSKG could correct the immune functional disorder, control the recurrence of CPN effectively and alleviate the immunopathological damage.

Adult ; Chronic Disease ; Complement C3 ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Immunoglobulin G ; blood ; Interleukin-2 ; blood ; Male ; Middle Aged ; Pyelonephritis ; drug therapy ; immunology ; prevention & control ; T-Lymphocyte Subsets ; drug effects

BACKGROUND:Magnetic resonance diffusion tensor imaging can display the dispersion changes of peripheral nerve injury and be used to conduct quantitative research, so it has good application prospects in displaying the nerve injury and regeneration. OBJECTIVE:To investigate the possibility of magnetic resonance diffusion tensor imaging of rabbit acute sciatic nerve traction injury, and to figure out the value of diffusion tensor parameters in the diagnosis of peripheral nerve injuries and to reveal the pathologic basis. METHODS:The right hind limb sciatic nerves of 32 New Zealand white rabbits were selected to make the regeneration and repair models, the left hind limb nerves as the sham-operation side. Diffusion tensor imaging examination of sciatic nerves were performed at 1 and 3 days, 1, 2, 3, 4, 6 and 8 weeks after operation with 1.5 T MRI. Fractional anisotropy and apparent diffusion coefficient were measured through diffusion tensor tracing
reconstruction, and then the pathological examination was performed. RESULTS AND CONCLUSION:Diffusion tensor imaging revealed only the proximal nerve, injured nerve as wel as the middle of the distal nerve at 1 day after traction injury. At 1 week, the nerve of distal portion appeared thinner and shorter fiber bundle. At 2-6 weeks after operation, the fiber bundle was increased and thickened. At 8 weeks after operation, the distal nerve fibers had nearly restored to the level before injury. There was significant difference in the fractional anisotropy value of traction portion and distal portions between traction injury and sham-operation group at 1 day-8 weeks after operation (P<0.05). While there was significant difference in the fractional anisotropy value of proximal traction portion between traction injury and sham-operation group 1 day-1 week after operation (P<0.05). There were no significant differences in the apparent diffusion coefficient values between traction injury and sham-operation group at 1 day-8 weeks after operation. Fal of fractional anisotropy value in the early stage of nerve traction injury was the result of myelin sheath broke down and axonal disintegrated;recovery of fractional anisotropy value resulted from myelin sheath proliferated and myelin sheath grew slowly to mature. Diffusion tensor tracing can show the abnormal change of the sciatic nerve with traction injury in rabbit clearly and early, and the measurement of fractional anisotropy value can be used as the sensitive method to monitor the degeneration and regeneration after nerve traction injury.

Objective To investigate the effect of smoking and smoking cessation on the phosphorylation of IKK-β in type 2 diabetic rats. Methods Forty-two six-week-old Wistar rats were randomly divided into 4 groups: normal control(NC, n =7), diabetes control (DC, n =7), diabetes with smoking (DS, n = 14) and diabetes with smoking cessation(SC, n = 14). Rats in DS and SC groups were further assigned randomly into 8w and 12w subgroups. DS group was given passive smoking twice a day for 8 or 12 weeks, while SC group ceased passive smoking for 4 weeks after 8 or 12 weeks of smoking . Western blot method was used to detect the level of IKK-13 phosphorylation in skeletal muscle. Results Compared with the NC group,the phosphorylation of IKK-β protein in DC group was increased (0. 16±0. 05 vs 0. 30±0. 08, P < 0. 01). There was an increasing trend with the phosphorylation level of IKK-β in the DS (8w) subgroup, but there was no statistical difference between the DC group and SC(8w) subgroup (0. 40±0. 09 vs 0. 30±0. 08,0. 36±0. 10, P >0. 05). The phosphorylation level of IKK-β in DS(12w) group increased obviously, being significantly higher than that in the DC group and SC (12w) subgroup(0. 74 ± 0. 11 vs 0.30±0.08,0.35±0.07,P < 0.01). Conclusion With the prolongation of smoking duration, the phosphorylation of IKK-β in type 2 diabetic rats increased. After smoking cessation, the phosphorylation of IKK-β decreased. The phosphorylation of IKK-β may be involved in the mechanism by which smoking causes type 2 diabetes.

Objective To analyze the dielectrophoresis patterns of the proteome of the Rifampin-dependent and-resistant stains of Mycobacterium tuberculosis,to search and identify the differently expressed proteins,and to provide the proteomic basis for researching the mechanism of anti-tuberculosis drug dependence of M.tuberculosis.Methods The whole somatic proteins were extracted from two strains of M.tuberculosis.The first dimensional ampholine electrophoresis was performed on immobilized pH gradient(IPG) rod gels(pH 4-7).Then the proteins on IPG strips were separated using SDS-PAGE.The stained gels were scanned with image scanner and the images were analyzed by Imagemaster 2D software.The differentially expressed proteins were detected by matrix-assisted laser desorption/ionization time of flight mass spectrometry(MALDI-TOF-MS).Results Seven hundred and fifty-three spots were detected in Rifampin-dependent strain of M.tuberculosis,while 584 spots were detected in Rifampin-resistant strain,including 404 match spots(the match rate: 61.5%).As to the expression in Rifampin-dependent strain,7 spots significantly up-regulated and 35 spots down-regulated,6 spots were absent in expression,and 5 spots expressed separately,most of the spots were small molecular proteins.Ten spots were selected to run MS analysis.Nine spots were identified as representing 7 proteins.Conclusion The Rifampin-dependent strain of M.tuberculosis is characterized by a rapid and vigorous growth mainly by means of the differential expression of enzymes related to energy metabolism and fatty acid biosynthesis.