Objective:To compare the differences between Workshop teaching and PowerPoint teaching being used in resident doctor/advanced doctor training,and to investigate effectiveness of Workshop teaching.Method:Over the limit of teacher on the stage and students off the stage,teacher demonstrated to students hand by hand during Workshop teaching;Over the limit of the students being accepted knowledge passively,teacher encouraged them to take part in mutually;Over the limit of theories lesson separating with practical one,teacher supply more opportunity to operate for students practically.Results:The effectiveness of Workshop teaching mode in practicability and performance ability was better than PowerPoint teaching mode'(P

In order to adapting the course construction of anatomy to the needs of medical education in the new situation,we analyzed and summed up the effect of the course construction of anatomy,and put forward some measures such as working out the plan of course construction sci-entifically,perfecting teachers’training,upgrading content of course as well as the teaching methods and means,strengthening the teaching of experiment,reforming the means and contents of evalua-tion and paying attention to the cultivation of students’innovation and manipulative ability.

This paper reports the perioperative care of a patient undergoing the bilateral posterior ventral globus pallidus deep brain stimulation treatment for neuroacanthocytosis. The nursing points mainly included psychological care of the patient before surgery,preoperative preparation,postoperative care and special nursing before and after deep brain stimulation opening. The patient's dance-like involuntary movements and compulsive behavior reduced significantly after the treatment with no complications.

Objective To explore the application value of layered suture technique in laparoscopic common bile duct exploration with primary suture. Methods A total of 216 patients received laparoscopic common bile duct exploration with primary suture in our hospital from March 2007 to March 2013.Of these cases, layered suture technique was utilized in 89 patients and single-layer suture was used in 127 patients.The operation time, postoperative hospital stay, and postoperative complications were compared between the two groups. Results Two groups of patients were operated smoothly, with no conversions to laparotomy.Postoperative recovery was smooth.The operative time was not significantly different between the two groups of patients (t=-0.931, P=0.353). The postoperative hospital stay and incidence of postoperative bile leakage were significantly lower in layered suture group than those in single-layer suture group [(5.9 ±1.7) d vs.(7.7 ±1.8) d,t =7.400, P=0.000;3.4%(3/89) vs.20.5%(26/127), χ2 =13.167, P=0.000].In the single-layer suture group, the incidence of postoperative bile leakage was significantly higher in patients complicated with acute cholangitis [45.4%(10/22) vs.15.2%(16/105),χ2 =8.429, P=0.004], whereas in the layered suture group, the incidence of postoperative bile leakage was insignificantly different among patients with and without acute cholangitis [7.1%(1/14) vs.2.7%(2/75),χ2 =0.002, P=0.964]. Conclusion Application of layered suture technique in laparoscopic common bile duct exploration with primary suture is feasible and safe, with advantages of less bile leakage and shorter hospital stay.

Aim To investigate the pharmacokinetics of dipfluzine hydrochloride,a novel piperazines calcium antagonist.Methods Eighteen Beagle dogs were randomly divided into three groups,which were administered with dipfluzine hydrochloride at iv single dose of 1.5,3.0 and 6.0 mg?kg-1,respectively.The blood was collected at different time.A RP-HPLC method was developed to determine the concentration of dipfluzine hydrochloride in plasma.The pharmacokinetic parameters were calculated by 3P97 software.Results The specificity,lowest limit of detection and quantification,extraction recoveries,the precision of intra-and inter-day and stability were qualified to the pharmacokinetic study.The concentration-time courses of dipfluzine hydrochloride were best fitted to a two-compartment open model at three doses.The main pharmacokinetic parameters at three doses were 24.7,24.2 and 29.6 h for T12?,0.44,1.12 and 2.86 g?min?L-1 for AUC,1.30,1.22 and 1.28 L?kg-1 for Vc,and 3.4?10-3,2.7?10-3 and 2.1?10-3 L?kg-1?min-1 for CL,respectively.Conclusions The developed RP-HPLC method for determination of dipfluzine hydrochloride in plasma can satisfy the requirement of pharmacokinetic study after iv dipfluzine hydrochloride.Analysis of plasma concentration-time curves indicates a biphasic decrease.There was a linear relationship between AUC and dosage.

Effects of constituents from Schisandra chinensis (Wuweizi) on six liver microsomal CYP450 isozymes (CYP1A2, CYP2C6, CYP2C11, CYP2D2, CYP2E1 and CYP3A1/2) were studied in rats in vivo and in vitro. The in vitro incubation was conducted using liver microsomes of rats after multiple dosing of alcoholic/water extract from Schisandra chinensis. A HPLC-MS method was applied to determine the metabolites formation of six CYP450s probe substrates (phenacetin-CYP1A2, dextromethorphan-CYP2D2, diclofenac sodium-CYP2C6, mephenytoin-CYP2C11, chlorzoxazone-CYP2E1 and midazolam-CYP3A1/2) in rat liver microsomal incubations. The activity of CYP450 isozymes were represented by the formation of metabolites. Alcoholic extract of Schisandra chinensis (28-120 microg x mL(-1)) showed significant inhibitory effect on six CYP450 isozymes to a certain extent in vitro. Multiple dosing of Schisandra chinensis alcoholic extract (1.5 g x kg(-1), qd x 7d) had significant induction on CYP2E1 and CYP3A1/2, inhibition on CYP2D2 and CYP2C11, and no effect on CYP2C6 and CYP1A2. Water extract of Schisandra chinensis (100-500 microg x mL(-1)) also exhibited inhibition on the activity of CYP450 isozymes in vitro, whereas multiple administrations (1.5 g x kg(-1), qd x 7d) had significant induction of CYP2E1 and inhibition on CYP2D2, no effect on CYP2C6, CYP3A1/2, CYP1A2 or CYP2C11. The results suggested that the constituents from Schisandra chinensis exhibited the inhibition and induction on six rat liver microsomal CYP450 isozymes to a certain extent in vivo and in vitro. The possibility of interaction between Schisandra chinensis and coadministrative drugs will be considered base on the levels and subtype of CYP450 involved in the drug metabolism.

Objective To investigate the effect of baseline Left-ventricular ejection fraction (LVEF) on the cardiac resynchronization therapy (CRT). Methods A retrospective analysis of patients with heart failure was performed. Fifty-four patients [aged (59.73 ± 11.61)years, 31 males, 23 females] who underwent CRT/CRTD were divided into 2 groups according to LVEF ( group A, LVEF≤ 35%; group B, LVEF > 35% ). NYHA class, LVEF,CRT respond rates and medical adverse event (MAE) due to worsening heart failure were detected at 3 and 12 months post-surgery. Results The score of NYHA class changing wasn′t different between these two group. Compared to group B, LVEF was markedly increased (5.08 ± 2.81)% vs (2.45 ± 1.80)%, P < 0.05;(5.38 ± 2.92)% vs (2.39 ± 3.53)%, P < 0.05)at 3 and 12 months post-surgery. Similarly, group A owned high CRT response rates(66.1% vs 33.9%, P < 0.05; 81.25% vs 47.83%, P < 0.05) at the both two time points. At 12 months post-surgery , LVED decreased and the MAE was similar in all groups. Conclusion Patients with EF≤ 35% have more increases in LVEF and own high CRT response rates post-CRT.

A simple, rapid and sensitive method was developed for the quantification of tenofovir in plasma of Beagle dogs using HPLC-MS/MS analysis. The analytes tenofovir and internal standard (IS) adefovir were separated on a Zorbax SB-C18 column (3.5 microm, 100 mm x 2.1 mm, Agilent, USA) with mobile phase of methanol/water containing 0.3% formic acid using a gradient elution mode at a flow rate of 0.2 mL x min(-1). The plasma sample preparation was a simple deproteinization by the addition of 20% trichloroacetic acid followed by centrifugation. The detection was performed in positive selected reaction monitoring (SRM) mode with an electrospray ionization (ESI) source. The reactions monitored were m/z 288.1-176.2 for tenofovir and m/z 274.1-162.2 for adefovir (IS). Linear detection responses were obtained for tenofovir ranging from 10 to 5 000 ng x mL(-1). The intra- and inter-day precisions (RSD%) was no more than 6.3% with high recovery and good stability for the quantification, indicating the present method was specific, fast, accurate and reliable. The method was successfully applied to the pharmacokinetic study of two tenofovir agents. Tenofovir dipivoxil fumarate (BP0018, test agent) and tenofovir disoproxil fumarate (reference agent) were orally administrated to 8 Beagle dogs according to the 2 x 2 crossover design. Comparing with the reference agent, the longer MRT and t1/2 were obtained in the group of BP0018, while no significant difference was observed in AUC(0-t), AUC(0-infinity), C(max) and t(max) between them, suggesting that tenofovir dipivoxil fumarate was bioequivalent to the tenofovir disoproxil fumarate in Beagle dogs.

It is valuable to establish a chemical-pharmacokinetic (PK)-pharmacodynamics (PD) fingerprint of traditional Chinese medicine (TCM) for comprehensively understanding the TCM integrated conception and revealing the material foundation. The chemical, metabolic in vitro, and PK/PD in vivo fingerprints of Schisandra chinensis (SC) alcoholic extract were established and comparatively analyzed using HPLC-UV-MS method, rat liver microsomes in vitro and CCl4 intoxicated rats in vivo. Four known effective lignans, schisandrin, schisantherin A, deoxyschizandrin and gamma-schisandrin, were detected as the standard references in SC alcoholic extract with high concentration. SC alcoholic extract and four lignans when incubated with rat liver microsomes produced several metabolites in NAPDH-dependent manner. Chemical fingerprint of some components with bioactivities were also identified in PK and PD fingerprints in normal and ALI rats that explained the material foundation of SC alcoholic extract for multiple pharmacological effects. Schisandrin, schisantherin A, deoxyschizandrin and gamma-schisandrin could be considered as the "PK marker" of SC alcoholic extract or its relevant preparations, while two metabolites of the four lignans, 7, 8-dihydroxy-schizandrin and another one (M(W) 432), could be recognized as drug-metabolism (DM) Marker. This work provides experimental data for the further studies of metabolism or material foundation of SC components.

Objective To investigate influencing factors of perioperative myocardial injury in patients undergone percutaneous coronary intervention (PCI). Methods Ninty one patients with coronary heart disease (including stable angina and unstable angina) underwent PCI, the perioperative myocardial injury incidence were observed prospectively by monitoring the preoperative and postoperative high sensitivity troponin protein levels to investigate the influencing factors of perioperative myocardial injury by Logistic regression analysis. Results There were no statistically significance in perioperative myocardial injury incidence (62.5%vs 68.7%, P=0.618) and perioperative myocardial infarction incidence (29.2%vs 20.9%, P=0.411) between stable angina and unstable angina groups . These factors of perioperative myocardial injury in patients undergone PCI by Logistic regression analysis were analysed, and we found that the influencing factors were the application loading dose rosuvastatin before PCI, preoperative statin therapy more than one month, apolipoprotein A levels and total stent length. Conclusion Application loading dose of rosuvastatin before PCI, preoperative statin therapy more than one month, apolipoprotein A levels are related to perioperative myocardial injury reduction, whereas the total length of the stent is associated with an increased occurrence of perioperative myocardial injury.