The seven-year system in medical education is a new teaching model of cultivating the high-level medical talents to meet the need of construction of socialist health modernization of our country.As a student having had medical study for two years,I realize some advantages and shortcomings existing in the class education.So I have made analysis of the current conditions of its basic medical education and put forward some proposals,hoping to provide help for the seven-year teachings in the undergraduate courses.

Objective To investigate the modulation of affective pictures on experimental tonic cold and heat pain in a behavioral study. Methods Fifteen healthy female subjects went through the tonic cold and tonic heat stimulation when watching the affective pictures in a counter-balanced order after the pictures were grouped into the pleasant, the unpleasant and the neutral picture sets. The pain tolerance time ( PTT ) was recorded.Results The tolerance time was prolonged when watching the pleasant and unpleasant pictures contrast to thatwhen watching the neutral ( Unpleasant ( 146.20 ± 13.68 ) s, Neutral ( 86. 73 ± 12.93 ) s, Pleasant ( 145.27 ±15.99 ) s, F(2,42) = 5.718, P ＜ 0.01 ) ). However, no significant difference was observed in the heat pain test under the different experimental conditions ( Unpleasant ( 74.73 ± 15.78 ) s, Neutral ( 68.80 ± 15.85 ) s, Pleasant ( 78.80± 14.81 )s, F(2.42) =0. 109, P＞0.05) ). A correlation between the residual difference of arousal in pleasant and neutral picture sets and the residual difference of heat PTT in pleasant and neutral picture sets was investigated (r = 0.546, P = 0.035 ). Conclusion Besides the emotional valence,the arousal may be one of the key elements that modulate the tonic pain.

To develop a RP-HPLC method for the determination of catechin (C),epicatechin (EC),gallic acid (GA)and procyanidin B2 (PCB2 )in procyanidins and compare the contents of C,EC,GA and PCB2 in procyani-dins purchased from different manufacturers.A RP-HPLC method was developed and the determination was car-ried out on a Hypersil ODS2 column (4.0 mm ×200 mm,5 μm).The mobile phase consisted of methanol and 2% acetic acid with gradient elution and the detection wave-length was at 280 nm.There was a good linear rela-tionship between concentration and the peak area in the range of 0.1-50 μg/mL (r =0.998 6)for catechin,0.1-50 μg/mL (r =0.994 5)for epicatechin,0.05-50 μg/mL (r =0.999 9)for gallic acid and 0.1-50 μg/mL (r =0.992 2)for procyanidin B2 ,respectively.The average recoveries of catechin,epicatechin,gallic acid and PCB2 were 98.36%,98.21%,89.60% and 98.47%,respectively and the RSDs were 1.39%,0.84%,2.12% and 2.46%,respectively.The method is simple,accurate,reproducible and can be used for assay of C,EC,GA,PCB2 in procyanidins.There was a great difference in the content of four substance in procyanidins purchased from dif-ferent manufacturers.

Objective To investigate the relationship of glycosylated hemoglobin A1C(HBA1c) and 2 hour postprandial blood glucose(2hPBG) with 12-hour urinary albumin excretion rate(UAE).Methods One hundred and thirteen patients with type 2 diabetes mellitus(T2DM),whose fast blood glucose(FBG) levels after treatment were less than 7.0 mmol/L,and 54 healthy subjects were the control group in this study.The level of HBA1c was detected by high performance liquid chromatography(HPLC).The level of 2hPBG was measured by glucose oxidase assay and the level of UAE was detected by radioimmunoassay.According to the level of HBA1c and 2hPBG,the patients were divided into 4 groups: group A(HBA1c7% and PBG

Objective To investigate the effects of dexmedetomidine on global cerebral ischemia-reperfusion (I/R) injury in rats.Methods Fifty-four adult male SD rats weighing 200-250 g were randomly divided into 3 groups (n =18 each): shame operation group (group S),global cerebral I/R group (group I/R) and dexmedetomidine group (group D).Global cerebral I/R was produced by occlusion of bilateral common carotid arteries combined with hypotension (MAP maintained at 35-45 mm Hg).In group D dexmedetomidine 3 μg/kg was injected iv immediately after I/R,followed by infusion of dexmedetomidine at a rate of 3 μg· kg- 1 · h- 1 until 2 h of reperfusion.The neurological deficit score (NDS) was assessed (0 =normal,100 =brain death) at 6 h (T1),24 h (T2)and 72 h (T3) of reperfusion.Then six rats were sacrificed in each group and brain tissues were removed for microscopic examination of hippocampus CA1 region and determination of activity of myeloperoxidase (MPO),contents of TNF-α and IL-1β and expression of glial fibrillary acidic protein ( GFAP).Results Compared with group S,NDS,MPO activity and the contents of TNF-α and IL-1β at T1-3 were significantly increased,the expression of GFAP was up-regulated at T2,3 in groups I/R and D ( P ＜ 0.05 or 0.01).Compared with group I/R,NDS,MPO activity and TNF-α concent were significantly decreased at T1-3,IL-1β concent was decreased at T1,2,the expression of GFAP was down-regulated at T2,3 in group D (P ＜ 0.05 or 0.01 ).The pathologic changes were significantly attenuated in group D as compared with group I/R.Conclusion Dexmedetomidine can attenuate global cerebral I/R injury in rats,and the inhibition of inflammatory response may be involved in the mechanism.

Objective The purpose of this study is to define the pollution level of CO2 pneumoperitoneum in operation room and its influence on the health of medical personnel,and put forward certain countermeasures.Methods This research consisted of four groups of experiments,and gradually proved that the use of pneumoperitoneum machine would lead to air pollution in the operation room,and the health of medical staff were influenced too.The four experiments were:the maximum CO2 gas leakage experiment;laparotomy and pneumoperitoneum surgery in the operating room CO2 gas concentration control experiment;CO2 gas concentration increase on the influence of the medical staff experiment; long-time pneumoperitoneum surgery operating room CO2 gas concentration change experiment.Results The maximum CO2gas leakage situation could cause the operation room CO2 gas concentration to increase(＞ l 000× 104); pneumoperitoneum machine in actual use process,could cause the increase of CO2 gas concentration in operation room; increase of CO2 gas concentration had an impact on the vital signs of the medical staff,the heart rate and blood pressure were statistically different before and after the operation; during pneumoperitoneum surgery for a long time,indoor CO2 gas concentration increased (＞1000× 10-6)and reduced quickly postoperation.Conclusions The use of C02 pneumoperitoneum machine in operation room influence the health of medical personnel.Effective protective measures dealing with gas pollution should be taken to reduce the chronic injury to medical staff.

Objective To evaluate the effects of dexmedetomidine on the permeability of blood-brain barrier in rats subjected to global cerebral ischemia-reperfusion (I/R).Methods Thirty-six male Sprague-Dawley rats,weighing 250-300 g,were randomly divided into 3 groups (n =12 each):sham operation group (group S),global cerebral I/R group (group I/R) and dexmedetomidine group (group D).Global cerebral I/R was induced by occlusion of bilateral common carotid arteries combined with hypotension (MAP was maintained at 35-45 mm Hg) in anesthetized rats.In group D,dexmedetomidine was infused at a rate of 3μg· kg-1 · h-1 until 2 h of reperfusion after a loading dose of dexmedetomidine 3 μg/kg was injected intravenously immediately after onset of I/R.The rats were sacrificed at 24 h of reperfusion and their brains were immediately removed for microscopic examination of hippocampal CA1 region and for determination of the cell apoptosis,brain water content,Evans blue content and aquaporin 4 (AQP4) expression.Results The number of apoptotic cells was significantly larger,and brain water content,Evans blue content and AQP4 expression were higher in groups I/R and D than in group S (P ＜ 0.05 or 0.01).The number of apoptotic cells was significantly smaller,and brain water content,and Evans blue content and AQP4 expression were lower in group D than in group I/R (P ＜ 0.05 or 0.01).Global cerebral I/R-induced pathological changes were significantly attenuated in group D.Conclusion Dexmedetomidine can decrease the permeability of blood-brain barrier and attenuate global cerebral I/R injury in rats,and down-regulation of AQP4 expression may be involved in the mechanism.

Objective To discuss the demands of replacement care service for family caregivers of the aged in Zhengzhou City,so as to provide the reference for replacement care service of the aged.Methods A total of 145 family caregivers of the aged were collected in Zhengzhou city and were investigated with a self-designed questionnaire.Results In the 145 questionnaires,106 were valid.81 (76.4％) of them expressed needing to be replaced in the process of care,and 68 (64.1％) were willing to accept replacement care service.Order of demands of replacement service content was daily life nursing (77,72.6％),disease (66,62.3％) and psychological care (60,56.6％),etc.Influencing factors of selecting replacement care service for family caregivers included quality of service (63,59.4％),service price (38,35.8％) and professional skill (37,34.9％).The degree of demand of different ages,different careers,as well as different duration of daily care of family caregivers was statistically significant for replacement care service.Conclusions The degree of demand of family caregivers of the aged for replacement care service was higher.The government needs to establish replacement care service mechanism which is suitable for China's national conditions through policy guidance and support.

Objective To compare the effectiveness,safety and related clinical indicators between simple drainage treatment and drainage treatment combined with intrathoracic urokinase for children with parapneumonic pleural effusion(PPE).Methods Twenty-nine in patients with PPE given pleural effusion drainage in the First Affiliated Hospital of Zhengzhou University from January 2013 to December 2015 were selected as research subjects,who were divided into a simple group and an urokinase group based on whether intrathoracic urokinase was injected or not.The total number of hospital stay,the total drainage volume,the total number of catheter days,the total cost,the days with fever,efficient rate,operation rate and security of the patients were retrospectively analyzed between two groups.Results The intrathoracic days of hospital stay [M(P25,P75)] of urokinase group[19(11,30) days]were less than those of simple group[30(21,38) days],and the difference was significant (Z =-2.545,P =0.011);the total drainage volume[M(P25,P75)] of the urokinase group [430 (175,1 308) mL] was more than that of the simple group [110 (10,325)mL],and the difference was significant (Z =-2.811,P =0.005);the total number of catheter days [M (P25,P75)] of urokinase group [9 (7,19) days] was less than that of the simple group [20 (10,30) days],and the difference was significant (Z =-2.020,P =0.043);the total cost [M(P25,P75)] of the urokinase group [20 000(10 000,30 000)RMB] was less than that of the simple group [40 000 (30 000,50 000) RMB],and the difference was significant (Z =-2.631,P =0.009);the days with fever between urokinase group and the simple group was not significant (Z =-0.820,P =0.412).The urokinase group had a higher cure rate[76.9％ (10/13 cases)] and a lower surgical rate [23.1％ (3/13 cases)] compared with those of the simple group[18.7％ (3/16 cases),81.3％ (3/16 cases)],and the difference was significant (x2 =9.814,P =0.003).Conclusions Intrapleural urokinase therapy as an adjuvant treatment of PPE is simple and convenient,economic,higher efficiency,lower risk,which can be used as an effective clinical solution such disease.

Objective To evaluate clinical features, therapeutic regimen and prognosis of unexplained rhabdomyolysis. Method Clinical manifestations, therapeutic regimen and prognosis were recorded in 23 patients,who were admitted to The First Affiliated Hospital of Nanjing Medical University 13 to 27 August,2010.The 23 patients were diagnozed as unexplained rhabdomyolysis. Results The patients all presented myalgia of upper body,like neck,waist and back,maybe with asthenia, nausea,dyspnea,abdominal pain, red urine or changed color of urine. Laboratory examination: obviously step-up of creatine kinase [CK: (4655 ± 2556) U/L( normal: 25 ～ 190U/L) AST:(141 ±78) U/L(normal:10～45 U/L),LDH:(348± 127) U/L(normal: 110～ 250 U/L)]and myoglobin[( Mb ＞ 1000 μg/L (normal: 0 ～ 50 μg/L)]. Therapeutic regimen included treatment of the underlying diseases, volume repletion, alkalization and dealing with the complications. No patients developed acute renal failure.All the patients recovered. Conclusions Rhabdomyolysis is a syndrome with different clinical manifestations.However, early diagnosis, proper treatment could prevent serious complications,and prognosis is good.