Virtual Reality is just emerging as an accepted scientific discipline. It has been widely used in medicine. The major applications of virtual reality for medicine are introduced from three areas :virtual humans,the fusion of virtual humans with real humans and virtual telemedicine. The advanced graphics behind medical virtual reality,such as computational demands,hardware and software environments is briefly discussed. This article also gives a summary of existing distributed VR systems.

The virtual reality teaching system of human skeletal anatomy developed in this paper is based on the advanced personal computer and uses the stereo glasses of ELSA 3D REVELATOR, mouse and keyboard to make up the human-computer interface. Using this system, students can take apart and assemble the skeleton, grasp single bone to rotate and zoom, learn the human skeletal anatomy in a vivid environment, and thus know more about motion physiology.

Targeted cancer therapy is one of the modalities to increase efficiency and decrease adverse effects of chemotherapy,and the selection of drug vector system is of importance for targeted therapy.An ideal adriamycin targeted vector system should have maximal efficacy and minimal adverse effects in inhibiting cancer cells through different mechanisms.This article reviews the recent progress in adriamycin targeted therapy,including the modes of adriamycin administration,the selection of drug vectors,as well as other chemotherapeutic drugs in targeted therapy of liver carcinoma.

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 a better reference for the quality control of Nujin Pian by establishing the method for the determination of paeonol in Nujin Pian by HPLC. Methods HPLC was used Agilent XDB C18 column (4.6 mm×150 mm, 4.6 μm), mobile phase was composed of methanol-water (45∶55). The flow rate was 1.0 mL/min with detection wavelength at 274 nm and column temperature at 40 ℃. Results The regression equation of paeonol was Y=7×107X-16 965, r 2=0.999 8 (n=6). The linear range of paeonol was 0.003 8-0.38 μg. The average recovery rate was 99.7%, and RSD was 1.56% (n=6). Conclusion The method is simple, fast and accurate with good reproducibility. It can provide reference for the quality control of Nujin Pian.

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.

Objective To prospectively evaluate the mid-term results of mitral annuloplasty using autologous pericardium for mitral valve insufficiency.Methods From April 2004 to December 2011,48 patients underwent mitral annuloplasty using autologous pericardium,the average length of pericardial strips was (51.9 ±2.8)cm.Carpentier classification was class Ⅰ in 5 cases,class Ⅱ in 41 cases,and class Ⅲ in 2 cases.The mitral valve repair techniques included quadrangular resection in 30 cases,valve repair in 7 cases,chordae transposition in 4 cases,edge to edge technique in 2cases,and artificial chordae tendineae in 3 cases.Concomitant procedures included one case arotic valve replacement,11 cases tricuspid valve repair,9 cases coronary artery bypass grafting,1 case coronary artery muscle bridge resection,and 1 case permanent pacemaker implant.Datum on long-term outcomes were obtained by questionnaires and by phone interview [average follow-up time (62.2 ± 21.3) months].Results Compared with preoperative datum,the diameters of left ventricular end diastolic diameter (LVDD) and left atrial diameter (LAD) examined by echocardiography show significant reduction in postoperative [(58.6 ± 1.7) mm vs (45.1 ± 1.3) ram,t =12.85,P ＜0.01 ; (50.6 ± 1.6)mm vs (38.0 ± 1.4)ram,t =9.58,P ＜0.01].There was early postoperative death in one case,cerebral infarction in one case,but none of patients died in late postoperative period.One patient had moderate mitral valve regurgitation in long-term follow-up.None of patients had redo operation and hemolytic complications.Conclusions Mitral annuloplasty using an autologous pericardium was an acceptable technique with low anticoagulation complications,permanent,well left ventricular function maintenance,and an economic method.

Objective To study the value of transesophageal echocardiography(TEE) in the operation of Ebstein's anomaly(EA).Methods The TEE characteristics of 69 patients with Ebstein's anomaly were retrospectivly analized.Results TEE could display the anatomic features of tricusipid valves(TV) clearly in all patients.Six cases were found having downward displacement of anterior leaflet before cardiopulmonary bypass,6 were found having hypoplasia of posterior leaflet, and posterior leaflets were absent in 3 cases.Ten cases were found middle regurgitation of TV by TEE after surgical correction during the operation, which had been improved satisfatorily by second time TV plasty.Conclusions TEE is useful in accurate diagnosis of the EA,and evaluation of operative effects during the operation, thus could help increase success rate of operation.

Objective To study the diagnosis accuracy and features of echocardiography on aortic coarctation combined with hypoplastic aortic arch. Methods The echocardiographic characteristics of seven patients who were diagnosed as aortic coarctation combined with hypoplastic aortic arch were analyzed and compared with results of cardiac catheterization, CT scan and operation. The diagnostic features of echocardiography were summarized. Results Besides the echocardiographic characteristics of aortic coarctation,other specific echocardiographic characteristics of hypoplastic aortic arch were:distinct stenoses of transverse and decsending part of aortic arch were visualized in supra-sternal long-axis view; the range of hypoplastic part started from innominate artery beginning or left common carotid artery beginning; the ratio of diameter of hypoplastic aortic arch over that of descending aorta at diaphragm was less than 0. 5; the blood flow speed detected by Doppler at the site of aortic coarctation was in the normal range. The echocardiographic characteristics of the aortic coarctation combined with hypoplastic aortic arch were correspondent to the results of cardiac catheterization, CT scan and operation results. Conclusions There is high accuracy of echocardiography in diagnosis of aortic coarctation combined with hypoplastic aortic arch. Hypoplastic aortic arch should be paid more attention in diagnosis of aortic coarctation.

malities should be alerted in TOF.