Implementing of"the center of students"teaching model demands that the old conception of teachers and students and the methods of medical education should be changed,teachers’construction and teaching condition in university should be strengthened,and evaluating system should also be reformed in clinical medical education,which will be in favor of students’ clinical thinking ability and improve the clinical teaching effect.

Objective To explore the role of the sensory neuropeptide in the chronic cough induced by postnasal drip syndrome(PNDs).Methods Patients of PNDs with and without chronic cough who came to the First Affiliated Hospital of Ji Nan University between Mar.2004 and Sep.2005 were enrolled and induced sputum by hypertonic saline aerosol inhalation was performed.Twenty-three cases of PNDs with chronic cough and 16 cases of PNDs without chronic cough were collected.Substance P(SP)and calcitonin gene-related peptide(CGRP)in the supernatant of the induced sputum were measured by radioimmunoassay.Results SP and CGRP in the supernatant of the induced sputum were significantly higher in the patients with chronic cough induced by PNDs[SP(345.14?72.58)mg/L,CGRP(573.78?210.96)mg/L]as compared with those normal subjects[SP(168.14?56.97)mg/L,CGRP(227.69?70.84)mg/L,P

The treatment of systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS) is difficult in ICU. In addition to traditional methods, immunologic therapy has been used recently to treat SIRS and MODS through adjusting inflammatory responses and redressing abnormal responses. This article reviews the progress in treatment of SIRS and MODS,including blocking inflammatory activation, modifying the activation of inflammation, giving gene therapy and combination therapy of TCM and western medicine.

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Protease activated receptor-2(PAR-2)is a G-protein-coupled receptor.Recent studies indicate that PAR-2 is mainly expressed in leukocytes and activated by pancreatin and(or)tryptase,which subsequently induces inflammation through degranulation of leukocytes.Activation of PAR-2 in leukocytes is possibly involved in the pathogenesis of rheumatoid arthritis.

This article deals with the organ culture on hamster trachea under the normal condition. The result showed that the epithelium of trachea could be kept alive up to 8 th-week at most by means of rotatory method of incubation. The culture media are RPMI 1640 (Nissui) and Eagle MEM (Nissui). Each medium was with or without bovine serum added. The results of histological, ultrastructural, radioautographic observations exhibited that the tracheal epithelia of hamster before culture showed ciliated columnar form with cilia. With prolongation of culture time, the changes of tracheal epithelium took the following order, from ciliated columnar to simple columnar and to simple squamous form. These changes were observed in all 4 groups. In radioautography, there are labeling granules in nuclei of tracheal epithelial cells in all 4 groups at different culture time, indicating that the epithelial cells still maintained DNA synthetic activity. TEM observation has showed ultrastructure of tracheal epithelium remained unchanged within 4 weeks. The ciliated cells are well with intact cilia. The intercellular junction is the tight one. Occasionally in accordance with LM observation a few of ciliated cell lacked cilia and its nucleus flattened. In cytoplasm, the dilatation of cisternae of rER and the incresing amount of ribosomes and lysosomes could be seen under TEM. During 7-8 weeks only a part of epithelia of trachea was still kept well, most of them became single layer. The ciliated cells lacked cilia, and their nuclei were long and oval in shape. Some enlarged lysosomes and autophagic vacuoles could be seen in cytoplasm indicating cytoplasmic degeneration. The present study suggested that both Eagle MEM and RPMF 1640 show the same culture effect.

OBJECTIVE:To study the effects of ligustrazine on the SCGRP and on the expression of CGRP,PDGF and bFGF in the lung of CHPH rats.METHOD:A stable rat modle of CHPH was established.The serum CGRP levels were mesured by enzyme immunoassay.The expression of CGRP,PDGF and bFGF in lumg were observed by immunohistochemical method.RESULTS:①The SCGRP level of H group was significantly lower than that of N group (P＜0.01) but no difference between the H+Li group and H group (P＞0.05).②The expression of CGRP,PDGF and bFGF increased obviously in lung tissue of H group,whereas the expression of bFGF and PDGF of H+Li group reduced obviously but that of CGRP was not influenced.CONCLUSION:SCGRP reduction and expression increasion increasion of PDGF.bFGF have close relation with the formation of CHPH;Inhibiting the expression of PDGF.bFGF may be an aspect of the mechanism of preventing and treating HPH by ligustrazine.

Objective To evaluate the analytical performance of ARCHITECT-i2000SR chemiluminescence analyzer in detec-tion of HBsAg,HIV-antibody,TP-antibody and HCV-antibody.Methods Validated the precision,carryover,ference interval of alpha-fetoprotein and linearity performance of ARCHITECT-i2000SR.The same specimens were tested by both CMIA and ELISA,and the results were compared and analyzed.Results The precision,carryover and ference interval of alpha-feto-protein of HBsAg,HIV-antibody,TP-antibody and HCV-antibody were within the range provided by the manufacturer for ARCHITECT-i2000SR.The theoretical and measured values of HBsAg were:Y = 1.102X - 6.678 6 (r = 0.995 5,P <0.05),the range of linearity 1.08~208.6.The sesult was very good for the four blood index by both methods.Conclusion The basic performances of ARCHITECT-i2000SR were consistent with the data provided by the manufacturer,so it canbe used to inspect the clinical samples and the sasults were credible.

BACKGROUND:As a traditional treatment for multilevel cervical myelopathy,nterior long-segmental decompression has the shortcomings of great operative trauma,high difficulty,low fusion rate,etc.,which can affect the postoperative efficacy.OBJ ECTIVE:To evaluate the clinical effects of three different anterior surgeries on multilevel cervical myelopathy.DESIGN:A comparative observation.SETTING:Department of Orthopaedics,Changzheog Hospital,the Second Military Medical University of Chinese PLA.PARTICIPANTS:Thirty-six patients with multilevel cervical myelopathy of 3 consecutive segments,who were surgically treated,were selected from the Department of Orthopaedics,Changzheng Hospital,the Second Military Medical University of Chinese PLA from June 1999 to June 2003,including 25 males and 11 females,35-62 years of age,the disease course ranged from 3 to 26 months. According to the clinical manifestations and imaging esults,they were diagnosed as multilevel cervical myelopathy,and they were not suffering from consecutive ossification of posterior longitudinal ligament and ossification of ligamenta flava. Informed contents were obtained from all the patients and their relatives.METHODS:All the patients were grafted with utologous bone. Autologous ilium or cancellous bone excluding vertebral body was filled into titan net or Cage,which were made of titan and characterized by high intensity,tolerance to decay,good biocompatibility,etc. According to the operative manner,the patients were divided into 3 groups:① two-level corpectomy with fusion group(long-segmental decompression group,n =11):There were 4 cases grafted with long-titan net,and 7 cases grafted with autologous iliac bone. Sub-total two-level corpectomy with fusion was performed. ②segmental decompression group(n =16):including 12 cases of titan net+cage graft,4 cases of autologous bone+cage graft. One-level decompression and sub-total single corpectomy with fusion were performed. ③three-level decompression group(n =9):Only discectomy without corpectomy was performed. After complete decompression,3cages were used to fill artificial bone or grafted with autologous bone.MAIN OUTCOME MEASURES:Cervical anteroposterior and lateral radiographies,flexion and extension radiograph were reexamined within 1 week and at 3,6 and 12 months postoperatively. The neurological function was assessed using the Japanese Orthopaedic Association(JOA) scoring method preoperatively and 3 months postoperatively. The total score was 17 points,the higher the score,the better the neurological function. The duration of operation,perioperative bleeding amount,length of stay,cost of hospitalization,graft fusion at 3 months postoperatively,improved JOA score at 3 months postoperatively were recorded in the three groups. The occurrence of postoperative complications was observed by means of return visit.RESULTS:All the 36 patients with multilevel cervical myelopathy were involved in the analysis of results. The mean duration of operation,mean perioperative bleeding amount and mean length of stay in the segmental-decompression group and three-level decompression group were obviously fewer or shorter than those in the long-segmental decompression group(P ＜ 0.05),and the average cost of hospitalization was obviously higher than that in the long-segmental decompression group(P ＜ 0.05). The postoperative improved JOA score and graft fusion rate were close among the groups(P ＞ 0.05).CONCLUSION:Segmental anterior cervical decompression is a recommendable technique for multilevel cervical myelopathy by comprehensively considering the fusion rate,recovery of neurological function,duration of operation,perioperative bleeding and length of stay.

Objective To investigate the association between CHI3L1 polymorphism and asthma in the Han population of Guangdong,and to explore the clinical values of chitinase-like protein YKL-40 in evaluating disease severity and monitoring the progression of the disease.Methods Total 251 objects were divided into asthma group (n=150)and control group(n=101).The single nucleotide polymorphism (SNP)at CHI3L1 gene was detected with Massarray method. The serum YKL-40 levels, total IgE levels, peripheral blood eosinophil percentage (Eos%)of the obj ects in asthma and control groups were detected. The asthma patients were divied into asthma exacergation group and stable group,and the serum YKL-40 levels were compared.Results The distribution of A/G at rs3806448 of CHI3L1 had significant difference between asthma and control groups (P<0.01 ), and the frequency of A allele at rs3806448 of the patients in asthma group was significantly higher than that in control group (OR= 1.93,95% CI=1.30-2.62,χ2=11.6,P<0.01).The serum YKL-40 levels,total IgE and Eos% of the patients with AA at rs3806448 were higher than those of the patients with GG or AG at rs3806448 (P<0.05);the FEV1% of the patients with AA was lower than those of the patients with GG or AG at rs3806448(P<0.01). The serum YKL-40 level of the patients in asthma group was significantly higher than that in normal control group (P<0.01),and the serum YKL-40 level of the patients in asthma exacergation group was higher than those in asthma stable group and normal control group(P<0.01).The serum YKL-40 level of the patients in asthma group was positively correlated with the peripheral blood Eos% and total IgE level(rEos=0.348,rIgE=0.437,P<0.01), and was negatively correlated with the lung function(r=-0.745,P<0.01). Conclusion The polymorphism of CHI3L1-rs3806448 may correlate with asthma of Han population in Guangdong area.The serum YKL-40 may be a new biomarker to evaluate asthma disease severity and helpful for monitoring illness stage.