With the changes in medical model and the enhancement of ethical standard as well as the patients' awareness of right protection,clinical teaching resource shortages have been increasingly prominent.This article analyzes the characteristics and status of clinical medical education and points out that the development of medical simulation education has great significance for building a harmonious clinical training environment centering on the content classification,functional positioning and outstanding advantage of medical simulation education.

Objective:To explore the lipid-regulating effect and safety of atorvastatin combined fenofibrate therapy in patients with coronary heart disease (CHD)complicated diabetes mellitus (DM).Methods:A total of 100 pa-tients with CHD complicated DM were enrolled.Based on routine treatment,patients were randomly and equally di-vided into statin group (n=50,received 20mg atorvastatin,once/night)and combined treatment group (n=50,re-ceived 20mg atrovastatin once/night,combined fenofibrate 200mg once/d).Serum levels of total cholesterol (TC), triglyceride (TG),low density lipoprotein cholesterol (LDL-C)and high density lipoprotein cholesterol (HDL-C) were measured before,six and 12 weeks after treatment,levels and standard-reaching rates of above blood lipid were observed before and after treatment;adverse reactions and clinical events were recorded.Results:Compared with before treatment after six-week treatment,there were significant reductions in serum levels of TC,TG and LDL-C in both groups,and they further decreased after 12-week treatment (P <0.05~ <0.01),compared with statin group after 12-week treatment,there were significant reductions in levels of TC [(4.35±0.71)mmol/L vs. (4.09±0.56)mmol/L],TG [(2.35±0.62)mmol/L vs.(1.65±0.49)mmol/L]and LDL-C [(2.01 ±0.39) mmol/L vs.(1.85±0.22)mmol/L]in combined treatment group,P <0.05 or <0.01;HDL-C level significantly rose in both groups after treatment,and it′s more significant after 12 weeks,but there was no significant difference between statin group and combined treatment group (P >0.05).After 12-week treatment,standard-reaching rates of LDL-C,TG,HDL-C,all standard-reaching of above three indexes and non HDL-C (70%,68%,80%,58% and 70%)in combined treatment group were significantly higher than those of statin group (50%,46%,48%,10% and 48%)respectively,P <0.05 or <0.01. No severe adverse reactions were observed in two groups during treatment. Conclusion:Atorvastatin combined fenofibrate treatment is more effective than atorvastatin monotherapy in patients with coronary heart disease complicated diabetes mellitus.It can improve blood lipid level more comprehensively, contribute to comprehensive standard-reaching of blood lipids,and possess better safety and tolerance.

Objective To explore the influence of polyamine-cholesterol cationic liposome (PCL)-mediated CpGODN aerosol on eosinophiles in the lung tissue of mouse asthma model. Methods Mouse asthma model was replicated by challenging with 1% ovalbumin aerosol. Mice were categonied into four groups, namely normal control, asthma control, CpGODN/PCL treatment group and CpGODN treatment group (6 each). The left lungs of mice were harvested, serially sectioned, hematoxylin and eosin (HE)-stained, and the infiltration of eosinophiles (EOS) was examined under microscope. Meanwhile, the bronchoalveolar lavage fluid (BALF) was collected for total and eosinophil cells count. Results An ovalbumin challenged mouse asthma model was successfully replicated. Pathological observation of the lung of asthma control showed increase in mucous secretion in alveolar space and peribronchial infiltration of large amount of inflammatory cells, primarily EOS and lymphocytes. The total cell number, EOS number and the ratio in BALF were significantly higher in asthma control group compared with that in both normal control group and CpGODN treatment group (P

32 cases of children small cerebral abscess di-agnosed with CT scaning are reported. The maxi-mum diameter of the enhancement area was 2. 2cm. 29 cases did not give a history of infection. In30 cases, Epileptic seizures were usually the Initialand main symptoms, but local neurological signswere usually absent. All of the cases were treatedby antibiotic therapy. The duration of the therapyin most childhood patients was 2～3 months exceptthree who were over 3 months.

[ ABSTRACT] AIM: To explore the role of chemokine receptor CXCR 4 in the pathogenesis of protein C system (PCS) in ulcerative colitis (UC).METHODS:In vivo, the mice were divided into control group and UC group .The mac-roscopic score, microscopic score and ulcer index were assessed .The mRNA levels and activity of myeloperoxidase ( MPO) , cyclooxygenase-2 ( COX-2 ) , stromal cell-derived factor-1α( SDF-1α) and monocyte chemotactic protein 1 (MCP-1) both in colonic tissue and plasma were determined .The expression and location of CXCR4,β-arrestin, p-JNK, endothelial cell protein C receptor (EPCR) and thrombomodulin (TM) were detected.The activity of protein C (PC) and protein S ( PS) was measured in each group .In vitro, mouse colonic microvascular endothelial cells were isolated , cultured and identified.Both CXCR4-overexpressing and CXCR4-silencing colonic mucosa microvascular endothelial cells were con-structed.The effects of SDF-1αon the protein levels of EPCR , TM,β-arrestin and p-JNK, and on the activity of PC , PS and activated protein C ( APC) were observed .RESULTS:Compared with control group , UC mice showed increased gross score, histopathological score and ulcer index (P<0.05).The mRNA levels and activity of MPO, COX-2, SDF-1αand MCP-1 in colon and plasma were increased (P<0.01).The protein levels of CXCR4,β-arrestin and p-JNK were up-regu-lated, EPCR expression was down-regulated in colon, and the activity of PC and PS in plasma was decreased (P<0.05 or P<0.01).CXCR4 overexpression further aggravated SDF-1α-induced PCS inhibition in colonic mucosa microvascular en-dothelial cells, and further up-regulated the protein levels of β-arrestin and p-JNK (P<0.05).CONCLUSION:PCS is inhibited in UC.CXCR4 is involved in the regulation of PCS inhibition by mediating chemokines and acting on colonic mu -cosa microvascular endothelial cells through β-arrestin-JNK pathway .

OBJECTIVE:To investigate the characteristics and regularity of moxifloxacin-induced adverse drug reaction(ADR) and provide reference for the rational clinical use of drugs. METHODS:Retrieved from CNKI (2005-2014) about the moxifloxa-cin-induced ADR,3 445 cases and the related ADR information were statistically analyzed. RESULTS:Moxifloxacin-induced ADR had a certain relationship with gender,and the male had a high incidence,especially the elderly patients. ADR could appear within 10 min;the clinic features were allergic reaction,the nervous system and digestive system at most. CONCLUSIONS:Great impor-tance should be attached to ADR monitoring and rational use of drug to reduce or avoid the occurrences of moxifloxacin-induced ADR.

How to identify active constituents of traditional Chinese medicines (TCMs) and study their interactions are key problems in the development of TCMs. The inhibitory effect of six alkaloids from Rhizoma Coptidis (RC) on Shigella dysenteriae (S. dysenteria) growth had been investigated by microcalorimetry in this study. Main active constituents of RC were confirmed by comparing their contributions to the bacteriostatic effect, and the interactions among active constituents were further researched. According to the result, in 0.8 mg-mL-1 extract of RC, the contributions of six active alkaloids including berberine, coptisine, epiberberine, palmatine and the combination of jatrorrhizine and columbamine were 52.83%, 36.31%, 2.49%, 4.27% and 3.21%, respectively. Therefore, berberine and coptisine were the main active constituents of RC that inhibited the growth of S. dysenteria. The study of interactions among the six alkaloids indicated that, 1 there were some contstituents antagonizing the inhibitory effect of RC, 2 there was a synergy effect between berberine and coptisine, 3 there were additive effects between other four alkaloids and the main active constituents. These results may provide some useful references for the establishment of the quality standard for RC and the development of multi-component TCMs.

Objective To observe the relationship between expression of retinoic acid receptor-β (RAR-β) in esophageal squamous cell carcinoma (ESCC) and chemotherapy response. Methods Fifty-two cases advanced ESCC patients treated by DDP and 5-FU, DDP 80 mg/m2, divided into 5 days;5-FU 375 mg/m2, dl-5. Immunohistochemistry was used to exmine the expression of RAR-β in ESCC. Fifty cases normal esophageal tissue were used as controls. Results RAR-β immunoreactivity was recognizd in both cytoplasm and nucleus, RAR-β positive rate was lower in ESCC compared with normal tissue (61.5%vs 92% ,P ＜0. 05 ). The 52 cases ESCC patients were treated 228 chemotherapy cycles, the overall response rate (OR) was 71.2%. The OR in RAR-β positive patients was 84. 4% (27/32), significant higher than RAR-β negative patients 50. 0% ( 10/20 ) ( P ＜ 0. 05 ). The time-to-progression ( TTP ) for RAR-β positive patients was 5.9 months, the median survival period was 12. 1 months, 2 years survival rate was 56. 7%;whereas TTP for RAR-β negative patients was 2. 1 months, the median survival period was 5.8 months,2 years survival rate was 32. 9%. There was signifcant difference between the 2 groups ( P ＜ 0. 05 ) .Conclusion RAR-β protein expression by immunohistochemistry may be a useful indicator to predict the chemotherapy response and clinical outcome for ESCC, meanwhile it may be an avenue for target therapy.

Nine short tandem repeat (STR) markers (D3S1358, VWA, FGA, THO1, TPOX, CSFIPO, D5S818, D13S317, and D7S820) and a sex-identification marker (Amelogenin locus) were amplified with multiplex PCR and were genotyped with a four-color fluorescence method in samples from 174 unrelated Han individuals in North China. The allele frequencies, genotype frequencies, heterozygosity, probability of discrimination powers, probability of paternity exclusion and Hardy-Weinberg equilibrium expectations were determined. The results demonstrated that the genotypes at all these STR loci in Han population conform to Hardy-Weinberg equilibrium expectations. The combined discrimination power (DP) was 1.05 x 10(-10) within nine STR loci analyzed and the probability of paternity exclusion (EPP) was 0.9998. The results indicate that these nine STR loci and the Amelogenin locus are useful markers for human identification, paternity and maternity testing and sex determination in forensic sciences.
Amelogenin ; China ; Dental Enamel Proteins ; genetics ; Electrophoresis ; Ethnic Groups ; genetics ; Forensic Medicine ; methods ; Gene Frequency ; Genetics, Population ; Genotype ; Heterozygote ; Humans ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Sex Determination Analysis ; methods ; Tandem Repeat Sequences ; genetics

The study is aimed to investigate the effect of lamivudine on growth and metabolism of three intestinal characteristic bacteria (namely, Bifidobacterium adolescentis, Escherichia coli and Shigella dysenteriae). The growth condition of the three bacteria was quantitatively evaluated by microcalorimetry with four characteristic parameters of the thermal power-time curves, including the growth rate constant (k), thermal power (p), time to peak (t) and calorific value (Q). The results showed that the IC50 value of lamivudine on B. adolescentis was 200 microg x mL(-1), and the IC50 values of lamivudine on S. dysenteriae and E. coli were higher than 3 000 microg x mL(-1) and 6 000 microg x mL(1), respectively. Therefore, lamivudine made different inhibitory effects on the three bacteria, in which the B. adolescentis was most susceptible to lamivudine. This work showed that taking lamivudine chronically is likely to affect the balance of good flora in the intestinal tract, and might increase endotoxin release, leading to inflammation and disease progression in hepatopathy.