The application of Standardized patient(SP) in Chinese clinical teaching is still in its infancy.The experience of SP in respiratory medicine teaching is also very limited.This article discusses the experience in applying SP in respiratory medicine teaching and several issues of SP training that should he paid attention to,and hrings forward our expectation in SP training in China.

OBJECTIVE:To provide suggestions for the government decision of payment price of medicare drugs. METHODS:Investigation was conducted for the beginning of payment price policy of medicare drugs,effect of the implementation of policy in other countries and the encountered problems. The payment pricing mechanism was explored based on the combination of new medi-cal reform with theoretical analysis and empirical research. RESULTS:The reform of payment pricing mechanism of medicare drugs will have effect on current drug price,especially for R&D oriented pharmaceutical industries. The policy can decrease drug expendi-ture in medicare expenditure,and it is not sure whether it can decrease total medicare expenditure. CONCLUSIONS:It is suggest-ed to notice the related measures and government should keep balance between drug availability and encouraging R&D innovation.

Objective:To investigate YKL-40-mediated inflammation in human bronchial epithelial cells and analyzed the soluble factors secreted by bronchial epithelial cells exposed to YKL-40 that were responsible for increasing proliferation and migration of primary normal human bronchial smooth muscle cells (BSMCs).Methods:YKL-40-induced inflammation was assayed in two human bronchial epithelial cells (BEAS-2B cell line and primary human bronchial epithelial cells ,namely HBECs).In addition,we treated BEAS-2B cells and HBECs with YKL-40,and added the conditioned culture media ( YKL-40-BEAS-2B-CM) and ( YKL-40-HBECs-CM) to BSMCs.The proliferation and migration of BSMCs were determined by premixed WST-1 cell proliferation reagent and QCM chemotaxis migration assay ,respectively.Results: Bronchial epithelial cells treated with YKL-40 resulted in a significant increase of IL-8 production,but have no effect about RANTES ,Eotaxin and TNF-α.YKL-40-BEAS-2B-CM and YKL-40-HBECs-CM induced IL-8 was found to further stimulate proliferation and migration of BSMCs ,and the effects were inhibited after neutralizing IL-8.Conclusion:Through investigating the interaction of airway epithelium and smooth muscle ,our findings implicate that YKL-40 may be involved in the inflammation of asthma by induction of IL-8 from epithelium,subsequently contributing to BSMCs proliferation and migration.Moreover, inhibition of IL-8 signaling is a potential therapeutic target for YKL-40-induced inflammation and remodeling of asthma.

With the rapid development of medical technology,burn treatment level is also rising.However,large area bum injury with inhalation injury treatment has not yet made a breakthrough,and become the main cause of death in burn patients.Severe shock,infection,multiple organs failure and acute respiratory system injury caused by inhalation injury are the main factors threatening the life of patients.The treatment of large area burn combined with inhalation injury has been the focus of bum and clinical research.Domestic and foreign scholars on large area bum associated with inhalation injury treatment for a large number of studies.In recent years,with the deepening of research,some new treatment concepts have been proposed.The advanced treatment progress of large area burn combined with inhalation injury were reviewed.

Objective To stuay the serum levels of sCD40L,hsCRP,ICAM-1 and VCAM-1,and the expression of CD40L of the CD4+T cells in patients withacute coronary syndrome(ACS),and to explore the relationship between CD40L and inflammatory factors and the effects of CD40/CD40L on ACS.Method Thirty-two coronary heart disease patients without history of other discernible systemic disease and medicine of steroids or immunosuppressants taken were divided into acute myocardial infarction group(AMI,n=11),unstable angina pectoris group(USP,n=14)and stable angina pectoris group(SAP,n=7).The control group was composed of eight healthy volunteers(CON group).Theexpression of CD40L Was determined by flow cytometry(FCM).Serum sCD40L.ICAM-1 and VCAM-1 were determined by using ELISA.The serum hsCRP was assayed by using immunoturbidimetry.Data were analyzed with SPSS 11.0 software for windows.Results The expression percentage(%)of CD40L of the CD4+T cells,and the serum levels of sCD40L,hsCRP,ICAM-1 and VCAM-1were sifnificantly higher in patients of AMI group than those in patients of other groups(P＜0.05 or P＜0.01).Similarly,those biomarkers in patients of UAP group were usually higher than those in patients of CON or SAP groups(P＜0.05).There Was a positive correlation between the expression of CD40L and the serum level of VCAM-1 in paients of AMI group(P＜0.05),and likewise,a positive correlation also existed between the serum level of sCD40L and other factors,hsCRP,ICAM-1 as well as VCAM-1,in patients of AMI group(P＜0.05).Conclusions The enhanced expression of CD40L of the CD4+T cells and high serum level of sCD40L are present in patients with acute coronary syndrome.The hsCRP,ICAM-1 and VCAM-1 play roles in the pathogenesis of ACS,and they have correlation with enhanced expression of CD40L and high serum level of sCD40L.Therefore,CD40L and sCD40L may be used as indicators of risk in coronary heart disease.

Thunder-fire wonder moxibustion is one of pressing moxibustion therapies and has a very good therapeutic effect on limb pains, furuncle-carbuncle and cold syndrome. To reveal the mechanism of clinical action of ancestors’ thunder-fire wonder moxibustion and seek the physical basis of its therapeutic advantage, this study, by a series of experiments, compared heat transfer regularities of thunder-fire wonder moxibustion versus pure moxa stick in simulated biological tissues under different conditions, preliminarily revealed heat radiation and heat transfer regularities of thunder-fire wonder moxibustion, tried to find pressing strength suitable for clinical operation of pressing moxibustion and had thoughts about changes in the clinical operation of past dynasties.

OBJECTIVE:To study the quality standards of Compound kuqin ointment.METHODS:TLC method was used for the identification of alion,baicalin,menthol.The content of tetrahydropalmatine and baicalin were determined by HPLC.RESULTS:The identification method was specific.The linear range of tetrahydropalmatine was 0.131～3.275 ?g(r=0.999 9) with an average recovery of 102.40%(RSD=0.77%,n=6).The linear range of baicalin was 0.050 35～2.014 ?g (r=0.999 9)with an average recovery of 100.97%(RSD=1.42%,n=6).CONCLUSION:The method is simple,accurate and reproducible for the quality control of Compound kuqin ointment.

OBJECTIVETo identify genes associated with metastasis suppression and to investigate the molecular mechanism of osteosarcoma metastasis.

METHODSThe subtracted cDNA library of low metastatic human osteosarcoma cell line SOSP-9607 was constructed using suppression subtractive hybridization. Partial clones were sequenced. The acquired sequence data were aligned against the GenBank nucleotide database using Blastn to search for sequence matches. The interested clone was used to perform Northern blot and reverse transcriptase-PCR (RT-PCR) analysis on mRNA isolated from low metastatic cell line SOSP-9607 and OS-9901, high metastatic cell line SOSP-M and three pulmonic metastatic nodules of nude mice.

RESULTSA cDNA clone from low metastatic cell line SOSP-9607 subtracted cDNA library was identified as telomeric repeat binding factor 2 (TERF2) by sequence analysis and Blastn search. Northern blot and RT-PCR analysis demonstrated that TERF2 expressed highly in low metastatic cell line SOSP-9607 and OS-9901, but not in high metastatic cell line SOSP-M and three pulmonic metastatic nodules.

CONCLUSIONTERF2 may be important for suppressing metastasis of osteosarcoma.

Animals ; Base Sequence ; Blotting, Northern ; DNA-Binding Proteins ; genetics ; Gene Expression Regulation, Neoplastic ; Humans ; Mice ; Mice, Nude ; Molecular Sequence Data ; Neoplasm Metastasis ; genetics ; Neoplasm Transplantation ; Nucleic Acid Hybridization ; methods ; Osteosarcoma ; genetics ; pathology ; RNA, Messenger ; genetics ; metabolism ; Telomeric Repeat Binding Protein 2 ; Transplantation, Heterologous ; Tumor Cells, Cultured

A mini pig model for study of human obstructive sleep apnea syndrome (OSAS) was established by altitude hypoxia. Eight mini pigs were randomly assigned to 3 groups, named A, B, and C. They were placed in a double-roomed altitude chamber. As control, Groups A lived in Room 2 and there was an altitude of sea level in it. Groups B and C were in Room 1 and the pressure in it was 53.9 KPa with an oxygen concentration of 10.0%-11.2%. All of these mini pigs were in their rooms for 6 hours per day. Pigs in Groups B were in the room for 12 consecutive days and sacrificed on the 13th day. Pigs in Groups A and C were executed on the 23rd day. The pharyngeal CT scanning and the defermination of respiratory pressure in pharynx oralis and saturation of arterial blood oxygen were conducted in all exprimental mini pigs before they were put in chamber and before they were put to death. The pharyngeal tissues of the executed pigs were pathologically examined. CT scanning revealed there was significant (P < 0.05) increase in mini pigs' posterior pharyngeal wall (8.8 +/- 1.1 vs 6.5 +/- 0.6) and lateral pharyngeal wall (8.1 +/- 0.2 vs 6.3 +/- 0.6) on the 13th day as compared with that before they were put in chamber, and there was also significant (P < 0.05) increase (9.2 +/- 1.2 vs 6.3 +/- 0.7; 8.9 +/- 0.7 vs 6.4 +/- 0.5) on the 23rd day. There was significant (P < 0.05) reduction in diameter from left to right at the hyoid bone level (7.6 +/- 1.4 vs 9.7 +/- 1.4) and in the anteroposterior diameter at the soft palace level (3.8+/-1.1 vs 6.5 +/- 1.3) on the 13th day as compared with that before the mini pigs were put in chamber, and there was also sinificant (P < 0.05) reduction (6.4 +/- 1.6 vs 9.3 +/- 1.5; 4.3 +/- 0.9 vs 5.9 +/- 0.8) on the 23rd day. There was significant reduction (P < 0.05) in anteroposterior diameter on the posterior area of hyoid bone (3.7 +/- 0.9 vs 6.4 +/- 0.6) on the 23rd day. A significant change (P < 0.05) was observed in respiratory pressure of pharynx oralis on the 23rd day (0.0755 Mv) when compared with that before the first day (0.0658 Mv) in chamber and no significant change was seen on the 13th day. The saturation of blood oxygen decreased from 96.3% to 87.0% on the 13th day (P < 0.05) and further descended to 88.5% on the 23rd day (P < 0.05), compared with that before the first day in chamber. Pathological examination showed. In Group A, the mucosa of pharynx is covered by nonkeratinized-stratified squamous epithelium, and the layer of submucosa is thin; the muscular layer has clear striations and less fat cells among muscular fibers. In Group B, the pharyngeal epithelium is cornified and proliferated. Edema and proliferation of connective tissue occur in submucosa, and the muscular layer is thick with unclear striations; local infiltration of fat cells can be observed among muscular fibers. The pathological changes were more serious in Group C than in Group B. The results suggest that the method of intermittent altitude hypoxia could make the pharyngeal tissue of mini pig remodel and change its muscular biomechanical properties into those similar to the performance of OSAS in human. Living in altitude hypoxia for 22 days, the mini pigs became ill with OSAS, thus the expected animal model has been established in this study and could be used in further researches on OSAS in patients.
Altitude ; Animals ; Disease Models, Animal ; Hypoxia ; physiopathology ; Male ; Oxygen ; chemistry ; Pharynx ; pathology ; Sleep Apnea, Obstructive ; physiopathology ; Swine ; Swine, Miniature ; Tomography, X-Ray Computed

Brain ; Cholesterol ; chemistry ; Cytoskeleton ; drug effects ; Endothelial Cells ; cytology ; metabolism ; Hemolysin Proteins ; chemistry ; pharmacology ; Humans ; Phalloidine ; pharmacology ; Pseudopodia ; drug effects ; Stress Fibers ; drug effects ; rac1 GTP-Binding Protein ; metabolism ; rhoA GTP-Binding Protein ; metabolism