Trauma and infection may cause a stress reaction to the body,which leads to the metabolic imbalance of organs and tissues,but some treatment methods can effectively reduce the negative effects of undesirable stress on body metabolism.This article focuses on the effects of trauma and infection stress on the protein metabolism,furthermore,introduces some related treatment methods.

In the undergraduate teaching assessment,"eaching quality control" is the core content of their inspection.This paper explained the quality control of the content,analyzed the challenge of improving the teaching quality and put forward the idea of constructing the perfect teaching quality control system from five aspects such as raising awareness and unifying thinking,establishing a sound teaching system,strengthening the organizational functions and responsibilities,grasping the key points and implementing the whole process of the quality control.

This report indroduces the characterization of tetrodotoxin (TTX),and its pharmacological and clinical actions.

Heart failure is a serious and terminal stage of various cardiovascular diseases,is one of the most important heart diseases,and it also the most common reason for hospitalization.In recent years,studies on new markers in the diagnosis,treatment and prognosis of heart failure have made great progress,such as B-type brain natriuretic peptide can partially reflect hemodynamic imbalance,troponin can indicate cardiomyocyte injury,soluble ST2 and galectin-3 indicate myocardium remodeling and fibrosis,C-reactive protein,cystatin C and procalcitonin,and copeptin have significant prognostic value for outcomes,microRNA in the regulation of gene expression influence heart failure.

OBJECTIVE:To provide reference for clinical rational use and management of anti-HIV drugs,and to provide ref-erence basis for occupational exposure to develop free drug policy. METHODS:Using retrospective study method,according to DDD calculation method recommended by WHO,consumption sum,DDDs,DDC and B/A of anti-HIV drugs in our center during 2011-2014 were analyzed and evaluated. RESULTS:The consumption sum of anti-HIV drugs increased firstly and decreased later, increasing from 512112 yuan in 2011 to 650854 yuan in 2012,decreasing to 496473 yuan in 2014. DDDs of anti-HIV drugs in our center during 2011-2014 decreased from 35932 in 2011,to 16363 in 2014,showing decreasing tendency. The consumption sum of nucleotide reverse transcriptase inhibitors during 2012-2014 took up the first place,and DDDs of nucleotide reverse tran-scriptase inhibitors took up the first place in 2011,2013,2014. DDDs of Zidovudine tablets took up the first place in 2013,2014, and that of Tangcao tablets took up top 3 places during 2011-2014. DDC of Tenofour disoproxil fumarate tablets,Zidovudine and la-mivudine tablets,Emtricitabine and tenofovir tablets,Lopinavir and ritonavir tablets were in high level,being more than 46 yuan. DDC of Zidovudine tablets,Stavadine tablets and Nevirapine tablets were in low level,being lower than 6 yuan. B/A of Tenofovir disoproxil fumarate tablets,Stavudine tablets and Efavirenz tablets ranged 0.5-1.5 in 4 years and B/A of Tangcao tablets was equal to 1,showing good synchronism of social and economical benefits. CONCLUSIONS:Clinical application of anti-HIV drugs in our center is rational basically,and the use of drug is basically consistent with the occupational exposure prevention. The use of TCM preparation is basically in line with the requirements of drug use in the clinic.

Objective To analyze the influence of total thyroidectomy (TT) on quality of life of patients with nodular goiter with iodine deficiency.Methods 70 patients who received TT in the hospital from June 2014 to July 2015 were randomly divided into two groups, 35 cases in each.Control group received subtotal thyroidectomy and observation group received total thyroidectomy.The situation of operation, thyroid function, therapeutic effects and quality of life in two groups were compared.Results Operation time and hospital stays of observation group were significantly longer than that of control group (P<0.05);There was no significant difference in intraoperative bleeding volume and curative effective rate between the two groups;Before surgery, there was no significant difference in thyroid function between the two groups;After surgery, thyroid function of both two groups decreased compared with pre-operation, but there was no significant difference;There was significant difference in VAS and health description system scores between the two groups.Conclusion TT in treatment of patients with nodular goiter with iodine deficiency has significant clinical efficacy with high cure rate and less complication, and it can improve quality of life of patients, which is beneficial to postoperative recovery and worthy of generalization in clinical application.

Carcinoma of pancreas is the most common primar y pancreatic malignancy. Symptoms usually are nonspecific and include abdominal pain, jaundice, loss of appetite, weight loss, nausea, and vomiting. CT usually demonstrates a mass with ill-defined margins but also solid components and dil atation of the main pancreatic duct. This tumor is usually smaller and virtuall y never contains calcification. Following contrast material administration,all masses were enhanced less than the surrounding pancreas. Tumors were oval, rou nd or lobular,and is almost always locally invasive. These features can be used to differentiate carcinoma of pancreas from other pancreatic tumors.

Objective To analyze the expression and the role of Toll-like receptor 4 (TLR4) and the effect of N-acetylcysteine (NAC) on hepatic ischemia- reperfusion (I/R) injury.Methods The rat model of 45 min hepatic ischemia followed by 24 h reperfusion was used. Animals were divided into 3 groups: the pseudoperated control group (P), I/R group and treated group with NAC at a dose of 300 mg/kg at 5 min before reperfusion (I/R-NAC). Plasma concentrations of ALT, AST and lipopolysaccharide (LPS) at various time points were measured. The expression of TLR4 protein and mRNA was detected in liver tissue by using immunohistochemistry and RT-PCR.Results The TLR4 expression, plasma ALT, AST and LPS levels were markedly increased during 45 min hepatic ischemia and 24 h reperfusion, but they were lower in I/R-NAC group and no alteration almost in group P. The plasma concentrations showed a significant correlation between ALT, AST and LPS at different time points in I/R group and I/R-NAC group.Conclusion LPS and TLR4 play a prominent role in the pathophysiological processes of I/R and NAC can be of therapeutic potential for reducing the expression of TLR4 mRNA and alleviating endotoxemia derived from gut.

Objective To determine whether or not capsazepine(CPZ),a transient receptor po-tential vanilloid-1(TRPV1)antagonist,attenuates lidocaine-induced cytotoxicity on rat dorsal root ganglion (DRG)neurons in vitro.Methods Adequate DRG neurons from 3-day neonatal Wistar rats were obtained,cultured and purified in vitro.To achieve higher cell viability,we reduced the concen-tration of trypsin to 0.125% compared with others.The purified DRG neurons were incubated with 0,2.5,5,10,20 and 40 mmol/L lidocaine for 10 min,respectively,their viabilities were examined using Cell Counting Kit(CCK-8)assay,and the lethal concentration 50(LC50 )of lidocaine on DRG neurons was calculated.Then,the variation of lidocaine-induced cell viability at LC50 ,when 0,1,10 and 100 μmol/L CPZ were respectively added to the incubations,was examined with CCK-8 assay. Results The purified percentage of DRG neurons was as high as 91% after digesting by 0.125%trypsin and purifying in vitro.Cell viability of DRG neurons in group L1,L2,L3,L4,L5 was signifi-cantly down regulated compared with the control group,to be specific,that of L3,L4,L5 being re-markably lower than that of L1,that of L4,L5 lower than that of L2 and that of L5 lower than that L3 and L4.After lidocaine induced DRG neurons for 10 min,LC50 was 30 mmol/L;10 μmol/L and 100 μmol/L CPZ significantly reduced LC50 DRG neuron toxicity induced by lidocaine (P <0.05). The effect of 10 μmol/L CPZ had reached the maximal effect,decreasing the cell viability decrease from 50% to 35%.Conclusion The novel method in this experiment is effective to obtain good DRG neurons,the LC50 of lidocaine on rat DRG neurons is 30 mmol/L,and CPZ attenuates the cytotoxicity induced by lidocaine on rat DRG neurons.

Objective To discuss the practical application effect of the work process oriented teaching model that based on flipped classroom in the teaching of higher vocational Chinese medicines.Method We chose 97 students from Grade 2012 higher vocational Chinese traditional medicine,set them into experimental group (47 students) and comparison group (50 students).The experimental group was applied with the flipped classroom teaching,combined with the teaching mode of working process and the comparison group was applied with the traditional teaching mode from September 2014 to July 2015.At the end of the experiment,through the questionnaire survey,the differences of the experimental group students' autonomous learning ability and problem solving ability were compared between before the experiment teaching and after the teaching.The difference of post adaptation ability of the experimental group and the control group was also compared,and besides,the students' satisfaction degree to flipped classroom combined with working process teaching mode was investigated and analyzed.SPSS 16.0 software was used for statistical analysis,and t test was used to compare two groups' measurement information and count data with chi-square test.Result The score of independent learning ability after teaching in the experimental group was significantly higher than before [(77.50 ± 7.10) vs.(88.51 ± 9.30);t=6.451,P=0.000].However,there was no statistically significant difference in problem-solving capability before and after the teaching[(83.70 ± 2.32) vs.(84.30 ± 2.11);t=1.312,P=0.193].The score of five aspects of the adaptability to work in the experimental group and total score were higher than the comparison group and the difference was statistically significant [work attitude (18.72 ± 2.01) vs.(16.78 ± 3.33),t=3.447,P=0.001;service ability (17.99 ± 1.98) vs.(16.05 ± 2.15),t=4.614,P=0.000;professional ability (18.19 ± 2.46) vs.(15.37 ± 2.79),t=5.267,P=0.000;completion of work (19.01 ± 1.75) vs.(16.88 ± 1.83),t=5.851,P=0.000;strain capacity:(18.33 ± 2.09) vs.(17.01 ± 2.46),t=2.839,P=0.006;the total score of job adaptability (92.24 ± 3.89) vs.(82.09 ± 4.05),t=12.574,P=0.000].Experimental group's satisfaction showed that 91.48％ of students liked the teaching model,87.23％ thought that it improved their learning interest,82.98％ believed that it was beneficial to improving their communication skills.Conclusion Teaching mode of flipped classroom combined with working process helps to improve teaching quality.