Aiming at the problems in the post competency training of eight year clinical medical students such as the deficiency of humanistic spirit and communication ability,insufficient capacity of clinical skills training and clinical problem-solving,the lacl of academic research ability and innovative spirit,and according to the practical requirements for clinical personnel,we elaborated the required post competence for eight-year medical students on the basis of its basic concept and intention.We proposed strengthening the cultivation of eight-year medical students by improved course plan and cultivation process,perfected assessment system,enhanced construction of teachers in order to make the students competent to their posts,and we also made some beneficial attempts in formulating and implementing the talent training scheme based on post competency.

To investigate the expression of vaginal Th1 and Th2 cytokines in rats with experimental vaginal candidiasis under different immune conditions, ICR murine vaginal candidiasis model was established and immno-suppressed murine models of vaginal cadidiasis were established in estrogen-treated mice. Non-estrogen-treated mice were used as controls. The mRNA level of Th1 (IL-2)/Th2 (IL-4, IL-10, TGF-beta1) cytokines in murine vaginal tissues was determined by RT-PCR. The cykotine in local tissues was increased to different extent under normal immune condition. IL-2 mRNA was increased during early stage of infection, while IL-10 was increased transiently during late stage of infection. TGF-beta1 production was found to be increased persistently. At same time, the expression of IL-2 mRNA was suppressed in immno-suppressed group, and the level of IL-4, IL-10, and TGF-beta1 were higher than the normal immunity group to different degree during infection. The high level of IL-2 mRNA during early stage of infection was associated with clearance of mucosal Candidia albicans (C. albicans), and its expression suppressed leading to decreased clearance of mucosal C. albican in immuno-suppression. The over-expression of IL-4 and IL-10 could significantly enhance the susceptibility to C. albicans infection in mice.

Objective To observe the curative effect of Xianlinggubao capsules combined with mecobalamin tablets,manipulation and cervical traction in treatment of cervicalspondylotic radiculopathy(CSR).Methods Forty-eight cases CSR patients who were treated in Affiliated Hospital of North China University of Science and Technology from February 2013 to May 2015 were randomly divided into treatment group and control group,each group with 24 cases.All patients were treated with manipulation,cervical traction and mecobalamin tablets(0.5 mg,3 times/d),treatment group received Xianlinggubao capsule(1.5 g,2 times/d)for 21 d.Nervous pain was valued with short-form of McGill questionnaire(SF-MPQ),the difference between the two groups before and after treatment was compared with that before treatment,the pain rating index(PRI),the fuzzy pain rating scale(VAS)and the current degree of pain(PPI).Table 20 quantitative analysis of symptoms of cervical spondylosis of nerve root type was applied to assess the comprehensive evaluation of symptoms and signs,the curative effect was calculate(before and after treatment,and the ratio of the integral before treatment)of the omnibus symptoms and signs.The curative ratio and the healing time were calculated.Results The treatment group McGill in PRI,VAS and PPI score difference were significantly higher than the control group((6.16±1.94)points vs(4.87±2.12)points,(5.23±2.22)points vs.(3.63±1.74)points,(2.76±0.87)points vs.(1.26±1.01)points),the differences were statistically significant(P=0.02,0.03,0.04).Table 20 quantitative analysis index of treatment was significant higher than control group(0.72±0.15 vs.0.37±0.07),the differences were statistically significant(t=1.31,P＜0.05).The curative ratio of treatment group was much higher in control group(70.83％(17/24)vs.45.83％(11/24)),the differences were statistically significant(x2=8.15,P=0.02).The treatment group gained shorter healing time((8.31±3.11)d vs.(11.24±4.52)d,t=3.36,P=0.01).Conclusion Assured curative effect was found in Xianlinggubao capsules combined with mecobalamin tablets,manipulation and cervical traction for cervicalspondylotic radiculopathy.

Objective In children with neurogenic bladder and secondary vesicoureteral reflux , we ex-plore the differences of urodynamics between the children with and without detrusor overactivity (DO). The study is in order to provide theoretical support for clinical practice. Method From January 2013 to March 2016, 110 children with NB vesicoureteral reflux diagnosed by videourodynamics were recruited. There are 63 boys and 47 girls aged 4-12 years with mean of 7.5 years. According to presence of DO during the filling phase, the patients were divided into DO (n=32) and non-DO groups (n=78). The time of bladder ureter reflux perfusion and detru-sor pressure were recorded for calculation of bladder compliance when the reflux occurs in the two groups. Maximum cystometry capacity and maximum detrusor pressure were recorded for calculation of the bladder compliance at the end of filling in the two groups. According to the reflux flow level, patients were divided into mild reflux (Ⅰ-Ⅱdegrees), severe reflux (Ⅲ-Ⅴdegrees). The difference of reflux side of the two groups and reflux degree were an-alyzed. Result In DO group, bladder capacity and compliance were (107.5 ± 21.3) mL and (5.6 ± 1.8) mL/cmH2O, respectively, when bladder ureter reflux occurs. In non-DO group, the bladder ureter reflux bladder capac-ity and compliance were (124.7 ± 35.6) mL, (6.7 ± 2.3) mL/cmH2O. The two parameters were significantly differ-ent in both groups. In DO and non-DO groups, the detrusor pressure were (21.7 ± 8.3) cmH2O and (19.6 ± 9.2) cmH2O, respectively, which does not have any significant statistical difference. At the end of filling, bladder capac-ity and compliance in DO group were (198.7 ± 36.5) mL, (5.8 ± 1.9) mL/cmH2O. In non-DO group, bladder ca-pacity and compliance were (223.8 ± 40.2) mL and (6.5 ± 1.4)mL/cmH2O. In both group, there are difference. In DO group, there are 20 cases of unilateral reflux (63%) and 12 cases of bilateral reflux (37%). In non-DO group, there are 31 cases of unilateral reflux (40%) and 47 cases of bilateral reflux (60%). The reflux of the two groups are also serious. Conclusion Small bladder capacity and poor bladder compliance are the urodynamic characteris-tics of children with NB and secondary vesicoureteral reflux when DO occurs.

Objective To observe the change of profilin-1 during the aging of rats' aorta and the anti-aging effect of grape procyanidins (GPC).Methods Young male Wistar rats (9 weeks) and middle rats (12 months) were randomly divided into GPC treatment and control groups respectively.We quantified arterial aging changes through morphological methods.Thoracic aortas were stained with hematoxylin eosin.Serum levels of 3-nitrotyrosine (3-NT),malondialdehyde (MDA),superoxide dismutase (SOD) and nitric oxide (NO) were tested using enzyme-linked immunosorbent assay (ELISA).Western blotting was performed to measure the protein expression of inducible nitric oxide synthase (iNOS) and profilin-1.Results Compared with the young male Wistar rats group,aging change in the aortic morphology of middle rat group were shown by hematoxylin-eosin staining (HE) staining:media thickness (MT) increased [(98.3±0.5)μm vs.(83.1±1.0)μm,P＜0.05],luminal internal diameter (LD) decreased [(15.5 ±0.2) μm vs.(18.2±0.5,P＜0.05)μm,P＜ 0.05],(MT/LD)％ increased [(6.4±0.1) ％ vs.(4.6±0.1)％,P＜0.05],the protein expressions of profilin-1 and iNOS both increased [profilin-1:(1.58 ± 0.09) vs.(1.29 ± 0.04),iNOS:(1.02±0.12) vs.(0.75±0.02),both P＜0.05],levels of NO and SOD in serum decreased [NO:(6.3±0.2)μmol/L vs.(8.4±0.2) μmol/L,SOD:(172.3±1.6) U/ml vs.(189.1±1.5) U/ml,both P＜0.05],the levels of MDA and 3-NT increased[MDA:(11.3±0.3) μmol/L vs.(9.4 ±0.1) μmol/L,3 NT:(40.2±0.3) nmol/L vs.(35.6±0.5) nmol/L,both P＜0.05)].After treatment with GPC,compared with the control group,MT decreased,LD increased and MT/LD (％)decreased in the middle GPC treatment group.The protein expressions of profilin-1 had no changes before and after treatment with GPC both in young and middle groups.After the GPC treatment in middle group,compared with the middle control group,iNOS expression decreased,serum levels of NO and SOD increased,and the levels of MDA and 3-NT decreased significantly (all P ＜0.05).Conclusions Profilin-1 is related with age-related changes in rat aorta.Profilin-1 participates in vascular aging through iNOS induced oxidative stress.GPC may defer vascular aging by inhibiting vascular oxidative stress.

Objective To investigate the protective effect of methylene blue (MB) on blood-brain barrier (BBB) injury after focal cere-bral ischemia-reperfusion in rats. Methods 18 male Sprague-Dawley rats were randomly divided into sham-operated group (n=6), model group (n=6) and MB treatment group (n=6). The left middle cerebral arteries were occluded for 1 hour and reperfused. MB was infused intra-venously immediately after reperfusion (3 mg/kg) and again 2 hours post-reperfusion (1.5 mg/kg), while normal saline was administered in the model group. The sham-operated group was treated as same as the model group without occlusion and infusion. HE staining was used to observe the histological injury in the cortex around the infarcted region 47 hours after reperfusion, while albumin immunohistochemistry was used to evaluate the permeability of the BBB, and immunohistochemistry and double immunofluorescence staining were used to exam-ine the expressions of glial fibrillary acidic protein (GFAP) and aquaporin-4 (AQP-4). Results HE staining showed that cells and blood ves-sels were not intact in the cortex around the infarcted region in the model group and they were better in the MB treatment group. The expres-sions of the albumin, GFAP and AQP-4 were higher in the model group than in the sham-operated group (P<0.01), and were lower in MB treatment group than in the model group (P<0.05). The double immunofluorescence staining showed the colocalization of GFAP and AQP-4 in the astrocytes. Conclusion MB may ameliorate the BBB disruption induced by focal cerebral ischemia-reperfusion through reducing glio-cyte proliferation and down-regulation of AQP-4 expression in rats.

Objective To investigate the effect of voice training therapy on the voice improvement in patients with vocal nodules .Methods Twenty one patients with vocal nodules were recruited and were evaluated by the GRBAS perpetual evaluation ,voice handicap index (VHI)-30 subjective assessment ,vocal laryngostroboscopy , maximum phonation time (MPT) and acoustic analysis pre- and post-therapy .These patients completed 5 cour‐ses of voice training .Results The VHI value(29 .48 ± 21 .21) of post-therapy was less than the value (52 .95 ± 24 . 30)of pre -therapy (P< 0 .01) .There were significantly differences in voice perpetual evaluation between pre -training and post-training ,especially for G (grade) (P<0 .01) and R (roughness) (P<0 .01) .The post-training laryngostrobescopy vocal vibration improved comparing with pre-therapy in the closure of vocal cords ,symmetry of vibration ,the mucosal wave and vibration regularity of the vocal cords .After therapy ,three patient nodules dis‐appeared ,thirteen patient nodules became smaller ,and five patient nodules remained the same .The maximum pho‐nation time (MPT) (12 .54 ± 3 .68)of post-therapy was longer than MPT(8 .87 ± 3 .75) of pre-therapy MPT(P<0 .01) .The jitter value (0 .18% ± 0 .08% ) of post -therapy was less than that of pre-therapy(0 .43% ± 0 .31% ) (P<0 .01) .The shimmer of post -therapy (2 .10% ± 0 .98% ) was less than that of pre -therapy (4 .55% ± 1 .80% )(P<0 .01) ,The ratio of noise to harmonic(NHR)(0 .0034 ± 0 .0022 dB) of post-therapy was significantly less than NHR(0 .0184 ± 0 .028 dB)(P<0 .05) of pre-therapy .Conclusion The voice therapy could significantlyimprove voice of patients with vocal nodules .

BACKGROUND: Skin defect is commonly repaired by autologous skin graft, but in which, it is required healthy skin provider and it probably results in scarring deformity to various extents. The successful construction and clinical application of tissue-engineered skin (TE skin) mark the major breakthrough in treatment of skin defect.OBJECTIVE: To analyze the relationship between operation method and healing rate, through repair of skin defect with TE skin, to provide experimental evidence on clinical application of TE skin.DESIGN: Randomized controlled observation was designed.SETTING: Department of Oral and Maxillofacial Surgery, Teaching-Research Room of Histology and Pathology and Experimental Center of Tissue Engineering, School of Stomatology, Fourth Military Medical University of Chinese PLAMATERIALS: The experiment was performed in Experimental Center of Tissue Engineering, School of Stomatology, Fourth Military Medical University, in which 6 healthy York pigs were employed, of clean grade,aged varied from 2.5 to 3 months. 3 groups were randomized, named TE whole-layer group, TE dermal and auto-epidermal group and auto-graft group, 2 pigs in each group. 8 wounds were prepared in each pig, round in shape and 50 mm in diameter, 16 wounds in each group, totally 48wounds.METHODS: ①Preparation of TE whole layer and TE true skin. ② In TE whole-layer group: The whole layer of skin was cut off from fat layeralong the drawn line. When bleeding stopped thoroughly and the wound was covered with wet physiological saline gauze, TE whole-layer skin was collected and windowing was done on the skin for drainage. Physiological saline was used to rinsed away the culture solution on the surface of TE skin, and then, the cuticular layer was upward-covered the wound, avoiding gas vacuole between cuticular layer and wound. Single-layer oleic gauze, physiological saline gauze, aseptic dry gauze and elastic sponge cushion were covered successively, about 3-5 mm in thickness each layer. After routine dressing, elastic bandage was wrapped with compression terminally. ③ TE dermal and auto-epidermal group: The whole- layer skin was cut off with same method. Thin split-thickness skin (TIS) 0.1-0.2 mm was collected with drum dermanuring machine and soaked in physiological saline. The same method was used to collect the managed TE true skin and cover it on the wound, covering immediately on autoTTS. The rest management was same as TE whole-layer group. ④ Autograft group: The whole-layer skin was cut off and the fat tissue was removed, afterwards, it was re-grafted on the auto-wound, covered with various layers of dressing and bandaged with compression. ⑤ The survival case was determined if it was discovered no infection, necrosis and scaling of grafted skin, less than 3 mm in diameter when the wound was opened for changing fresh dressing each time, otherwise, the failed case was recorded. The survival rate in each group was analyzed statistically in 4 weeks after operation.MAIN OUTCOME MEASURES: Survival situation of grafted skin in 4weeks after operation in each group.RESULTS: In 4 weeks after operation, the survival rate of grafted skin was 75% in TE whole-layer group was 87% in TE dermal and auto-epidermal group and was 94% in auto-graft group. The results were similar basically in comparison among 3 groups (x2=-2.34, P ＞ 0.05).CONCLUSION: The effect of TE skin graft on repair of skin defect is near to that of auto-epidermal graft, testifying that the repair of skin defect with TE skin is feasible.

Objective To explore the expression of aquaporin 4 (AQP4) in primary and secondary cultured rat astrocytes. Methods Rat cortical astrocytes from a newborn (one day) Wistar rat were cultured. Astrocytes were identified with immunofluorescence staining of glial fibrilillary acidic protein (GFAP). The expression of AQP4 was determined with real-time quantitative polymerase chain reaction and immu-nofluorescence staining three, five, seven and nine days of primary culture, and nine days of secondary culture. Results The purity of GFAP-positive cells was more than 95％. The expression of AQP4 mRNA was found three days of primary culture, remained unchanged five days of primary culture (P>0.05), and increased seven and nine days of primary culture (P<0.05). The expression of AQP4 mRNA was not different between nine days of primary culture and nine days of secondary culture (P>0.05). AQP4 immunofluorescence staining showed the same trend of AQP4 mRNA. Conclusion AQP4 may express since three days of primary culture in rat astrocytes in vitro, and increase slowly until nine days of primary culture.

Objective To study the proteins related to aging in aortic of old rats for laying the foundation of further study of aging mechanism.Methods The rat model of aging was built,and all model rats were divided into 4 groups:the adult group(9 weeks),the old group(12 months)of WistarKyoto (WKY) rats,and the age-matched spontaneously hypertensive rats (SHR).Blood pressure of 4 groups was observed.Morphological change of aorta was observed by HE staining.Differential proteins were identified by isobaric tags for relative and absolute quantitation,(iTRAQ)-coupled liquid chromatography and tandem mass spectrometry technology.Part of differential proteins was subsequently detected by real time PCR and Western blot.Results The mean SBP of the old group SHR was higher than WKY of 97.1％ (t=39.00,P＜0.05),and the adult group of SHR was also higher than WKY of 5.4％(t=3.64,P＜0.05).Compared with the adult group,aging change in the aortic morphology of old SHR and WKY were shown in HE staining,and the change in SHR rats was more marked.7 proteins related to aging were identified by Mass spectrum analysis,and they were Profilin-1,Prelamin A,HSP70,creatine kinase-M,Fibulin-5,eIF5A and Prohibitin.Part of differential proteins was subsequently confirmed by real time PCR and Western blot.Prelamin-A was up-regulated in the old group of WKY and SHR (0.15±0.01 vs.0.45±0.04,0.34±0.02 vs.0.78±0.06) (t=12.67,12.06,all P＜0.01),Prohibitin was down-regulated in the old group of WKY and SHR(1.34±0.05 vs.1.01± 0.06,1.24±0.05 vs.0.88±0.08) (t=7.41,7.09,all P＜0.01).Profilin-1 was up-regulated in the old group of WKY and SHR (9.12±0.4 vs.20.76±0.8,16.84±0.5 vs.55.16±0.9) (t=22.55,64.46,both P＜0.01),and Profilin-1 expression in the old group of SHR was higher thanWKY (55.16±0.90 vs.20.76±0.8,t=49.49,P＜0.01).Conclusions Differential proteins of the old rat aorta are identified through the comparative proteomics method.These differential proteins will provide new targets for the prevention and control of vascular aging.