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.

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.

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.

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.

malities should be alerted in TOF.

Objective To study the value of echoeardiography for diagnosis of juxtaposition of atrial appendage(JAA) and to discuss its features. Methods Eehocardiographic characteristics of JAA in nine cases were compared with results of cardiac catheterization and operation. The diagnostic features of echocardiography were summarized. Results Seven cases had juxtaposition of left atrial appendage and two had juxtaposition of right atrial appendage. The nine cases were all associated with severe congenital heart disease and the most frequent malformations observed with JAA were double outlet right ventricle, transposition of great artery, single ventricle and so on. Direct visualization of the JAA in the parasternal short-axis view at the base of the heart and visualization of an unusual transverse orientation of the atrial septum were the most features of JAA. Echocardiographie characteristics of JAA cases were correspondent to the results of cardiac catheterization and operation. Conclusions There is high accuracy by echocardiography to diagnosis JAA. JAA should be alerted in severe congenital heart disease.

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.

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.