The introduction of problem-based learning techniques into the teaching of anatomy has been subject to great contro- versies.This paper debates the rationale behind this concept using the example of the curriculum of Harvard Medical School.The anatomy curriculum is covered during the eight first weeks of the medical studies,and is an original combination of discussions of clinical cases in small groups,and work in gross anatomy,histology and radiology laboratories.The lectures are reduced to the minimum and emphasize general concepts.

Objective To investigate T-bet mRNA expression on peripheral blood mononuclear cells (PBMCs) and its relations with allergen specific IgE (SIgE), eosinophile cationic protein (ECP) levels, and allergic symptom in patients with allergic rhinitis (AR). Methods The allergen, SIgE, and ECP in serum of patients with AR were detected by Unicap CAP system. Blood samples were taken from 15 healthy controls and 35 house dust mite allergic patients. PBMC was isolated by density gradient centrifugation and one part of them was cultured with mite allergen at a concentration of 50 μg/mL. PBMC was subjected to analysis of T-bet mRNA expression using semiquantitative reverse transcriptase-polymerase chain reaction (RT-PCR). Results The ratio of T-bet to β-actin mRNA levels was 0.418 ± 0. 101 in patients of AR and 0.706 ± 0.091 in healthy controls and the difference was significant (P ＜ 0.01). The expression intensity of T-bet mRNA was not related to varying severity of allergic symptom and ECP levels ( r = - 0.227, - 0.033, P ＞ 0.05). However, there was an inverse correlation between expression intensity of T-bet mRNA and SIgE concentration (r = -0.375, P ＜ 0.05). There was a positive correlation between SIgE and allergic symptom scores ( r = 0.426, P ＜ 0.05). After that PBMC was stimulated by mite allergen, the expression intensity of T-bet mRNA, ECP, and SIgE changed very little ( P ＞ 0.05). Conclusion Down-regulated expression of T-bet mRNA in mite-AR patients is not related to serum ECP and symptom scores but one of important links in the mechanism of imbalance of Th1/Th2 in the occurrence of AR. Specific allergen has no effect on T-bet mRNA, ECP, and SIgE of children and adults with AR in vitro. The level of SIgE objectively and directly indicates the severity of allergic symptom, but T-bet did not. T-bet may be one of indirect factors which affect the level of IgE.

OBJECTIVETo explore the effect of puerarin in improving the insulin resistance (IR) and its closely related abnormal lipid and fibrinolytic activity in patients with coronary heart disease (CHD).

METHODSSeventy-six patients with CHD were randomly divided into two groups, 40 in the puerarin group and 36 in the routine treated group. Puerarin 500 mg was given to the former in addition to routine therapy by adding to 250 ml of normal saline for intravenous dripping once a day with a therapeutic course of 3 weeks. The changes of fasting blood glucose (FBG), fasting plasma insulin (FINS), plasma total cholesterol (TC), triglyceride (TG), low and high density lipoprotein cholesterol (LDL-C & HDL-C) and plasminogen activator inhibitor-1 (PAI-1) activity were measured before and after treatment, and the insulin sensitivity index (ISI) calculated. At the same time, tissue plasminogen activator (tPA) activity before and during venous occlusion test (VOT) was tested. Besides, 30 healthy subjects were taken as control.

RESULTSIn CHD patients, FINS, TC, TG, LDL-C and PAI-1 levels were higher and ISI, HDL-C and tPA before and during VOT were lower than those in the healthy controls. FINS and ISI correlated well with lipids and fibrinolytic abnormality. After puerarin treatment, FINS level lowered and ISI increased significantly (P < 0.01), while comparing with the routine group, TC, TG, LDL-C and PAI-1 were lower but HDL-C and tPA activity before and during VOT were higher in the puerarin group (P < 0.05, P < 0.01). Correlation analysis showed that FINS was positively correlated with TC, TG, LDL-C and PAI-1 and negatively correlated with HDL-C, tPA before and during VOT; ISI was negatively correlated with TC, TG, LDL-C and PAI-1 and positively correlated with HDL-C and tPA before and during VOT in the puerarin group.

CONCLUSIONPuerarin could improve the IR, IR related lipid and fibrinolytic activity abnormality in CHD patients.

Aged ; Cholesterol ; blood ; Coronary Disease ; blood ; drug therapy ; Female ; Humans ; Insulin ; blood ; Insulin Resistance ; Isoflavones ; therapeutic use ; Male ; Middle Aged ; Tissue Plasminogen Activator ; blood ; Vasodilator Agents ; therapeutic use

ObjectiveTo investigate the state of rehabilitation professionals in knowledge about chronic obstructive pulmonary disease(COPD).Methods60 rehabilitation professionals had received a 3-hour education delivered by four pulmonary rehabilitation experts. The trainees were assessed by Bristol COPD Knowledge Questionnaire (BCKQ) after the course.ResultsThe score of BCKQ was from 42 to 80 while the average score was (60.00±9.33).ConclusionThe rehabilitation professionals' knowledge about COPD was poor.

This article explained the character of dental disease and effective facts for dental health utilization, and current situation of basic medical insurance for oral diseases through checking up relative articles. Dental insurance had a positive effect on utilization of dental medical service and public oral health. The PEST tool was used to analyze the environment of dental insurance developing direction and feasibility in this article, and then raise some suggestions and core strategies for developing dental insurance. We believe that the dental insurance can increase the oral health service utilizations and enhance the oral health for Chinese people. Only oral insurance will be developed, Chinese oral health could be geared to international practice.
China ; Humans ; Insurance, Dental ; Oral Health

OBJECTIVETo observe the anti-tumor recurrent and metastatic efficacy of Ru'ai Shuhou Recipe (RSR) on HER2 positive breast cancer, to evaluate the effects of RSR on the expressions of matrix metalloproteinases (MMPs) and the tissue inhibitor of metalloproteinases (TIMPs) in the recurrence and metastasis of HER2 positive breast cancer, thus revealing its anti-tumor recurrent and metastatic mechanisms.

METHODSSelected were 30-week-old HER2/neu transgenic spontaneous breast cancer mice FVB/neu. The primary tumor resection was carried out. After surgery they were randomly divided into the blank control group, the RSR group, the Herceptin group, and the combination group (RSR + Herceptin group). The treatment lasted for 4 months. The inhibition rate of the recurrent tumor volume and the inhibition rate of the lung metastasis were evaluated. The expressions of matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9), tissue inhibitor of metalloproteinase (TIMP-1), and TIMP-2 in the recurrent tumor tissue were detected using Western blot.

RESULTSBy the end of the treatment the average recurrent tumor volume was 11.11 +/- 8.71 cm3 in the blank control group and 5.56 +/- 5.55 cm3 of the RSR group, showing statistical difference between the two groups (P = 0.037). The average lung metastatic nodule was 16 in the blank control group and 10 in the RSR group. The inhibition rate of lung metastasis was 37. 85% in the RSR group, but with no statistical significance. The expression level of activated MMP-2 in the RSR group was down-regulated when compared with the blank control group, the Herceptin group, and the combination group (P < 0.05). The expression of MMP-9 of the RSR group, the Herceptin group, and the combination group was significantly down-regulated when compared with the blank control group (P < 0.05). The expression of MMP-9 of the RSR group and the combination group was further down-regulated when compared with the Herceptin group (P < 0.05). The expressions of both TIMP-1 and TIMP-2 of the RSR group, the Herceptin group, and the combination group were all up-regulated when compared with the blank control group (P < 0.05). The increased expression of TIMP-1 was more significantly in the RSR group and the combination group when compared with the Herceptin group (P < 0.05). It was higher in the combination group than in the RSR group (P < 0.05).

CONCLUSIONSRSR could inhibit the tumor recurrence of FVB/neu mice. It could reduce the degradation of extracellular matrix and increase the protective effects of extracellular matrix. It might achieve its anti-tumor effect through effecting the invasive and metastatic capabilities of breast tumor cells.

Animals ; Breast Neoplasms ; drug therapy ; metabolism ; pathology ; Drugs, Chinese Herbal ; pharmacology ; Female ; Matrix Metalloproteinase 2 ; metabolism ; Matrix Metalloproteinase 9 ; metabolism ; Mice ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Phytotherapy ; Postoperative Period ; Receptor, ErbB-2 ; metabolism ; Tissue Inhibitor of Metalloproteinase-1 ; metabolism ; Tissue Inhibitor of Metalloproteinase-2 ; metabolism

OBJECTIVETo establish fluorescent quantitative PCR method for detecting human herpes virus type 6 (HHV6).

METHODSAccording to the specific sequence of human herpes virus type 6 genes, the primers and the fluorescent probe (TaqMan) were designed and synthesized. The fragment generated from HHV 6 gene as template was cloned into the pMD18-T vector which was constructed from the pUC 18. And the positive recombinant plasmid was 1:10 diluted and used as standard quantitative template to make the standard curve for sample detection.

RESULTSThe standard curve indicated the linear relationship between Ct (cycle threshold) and template concentration. The clinical samples from 135 cases were detected by this system, 16 cases among 135 were positive.

CONCLUSIONThe fluorescent quantitative PCR method for the detection of human herpes virus type 6 is simple and accurate, and this method may be helpful to clinical diagnosis.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; DNA Primers ; DNA Probes ; DNA, Viral ; genetics ; Female ; Herpesvirus 6, Human ; genetics ; Humans ; Male ; Middle Aged ; Polymerase Chain Reaction ; methods ; Purpura, Thrombocytopenic, Idiopathic ; diagnosis ; virology ; Reproducibility of Results ; Roseolovirus Infections ; diagnosis ; virology ; Sensitivity and Specificity ; Young Adult

Objective To establish the HPLC fingerprints of Tangbikang Granules; To scientifically evaluate and effectively control the quality of Tangbikang Granules; To ensure its production stability. Methods HPLC was performed on the column of Germany Merck RP-18 endcapped (250 mm × 4.6 mm, 5 μm) with mobile phase of acetonitrile-0.1% formic acid water; column temperature was 40 ℃; flow rate was 1.0 mL/min; detection wavelength was 240 nm; volume injection was 20 μL. Fingerprint Similarity Evaluation Software (edition 2004A) of Chinese Pharmacopoeia Commission was used to evaluate the similarity of the 10 batches of Tangbikang Granules, and to analyze the correlations of 9 ingredients in Tangbikang Granules. Results Wogonoside was used as the reference peak, and the common mode for the HPLC fingerprints was set up. The similarities of the 10 batches of Tangbikang Granules were above 0.930, and altogether 25 common peaks in the chromatograms were found, of which 18 peaks were assigned to Chinese materia medica in Tangbikang Granules. Conclusion The method has good separability and is accurate and simple, which can provide references for the quality control of Tangbikang Granules.

OBJECTIVE: To investigate the pattern and value of the expression of T-bet in nasopharyngeal-associated lymphatic tissue (NALT) of patients with or without allergic rhinitis (AR). METHOD: T-bet and CD4/T-bet expression in adenoids, tonsils and nasal mucosa was respectively detected with single stain and double stain of immunohistochemistry. RESULT: The positive ratio of T-bet expression in tonsils, adenoids and nasal mucosa between AR group and the control group had statistically different (P < 0.05). There was statistical difference of T-bet expression in tonsils from AR group in three different age groups (P < 0.05). The difference was that T-bet expression in adults group was significantly lower than that in children group and adolescent group. There was no difference of T-bet expression among different age groups in non-AR group. There were some positive expression of CD4 and T-bet in tonsils, adenoids and nasal mucosa from two groups and most positive expression of T-bet on CD4 positive cell. CONCLUSION T-bet expression was down-regulated in NALT of patients with AR. T-bet expression of NALT is associated with allergic mucosal inflammation and functional status of NALT, as well as the weak Th1 response at the level of transfer factor in local mucosa of respiratory tract in AR patients.
Adolescent ; Adult ; Child ; Humans ; Lymphoid Tissue ; metabolism ; Palatine Tonsil ; metabolism ; Rhinitis, Allergic, Perennial ; metabolism ; T-Box Domain Proteins ; metabolism ; Young Adult

OBJECTIVETo investigate the genetic mode of nasal polyp and the effect of genetic factor on occurrence of the disease.

METHODSA genetic epidemiological case-control study including 280 pedigrees (120 nasal polyp cases and 160 controls) was conducted. The segregation ratio and the heritability of nasal polyp were respectively estimated by the Li-Mantel-Gart method and the Falconer method.

RESULTSThe segregation ratio was 0.124 (95% CI 0.081-0.167), significantly lower than 0.25, which showed that nasal polyp did not possess the characteristics of monogenetic model. The prevalence rate of first-degree and second-degree relatives in cases were 8.571% and 3.086% respectively, which were significantly different (X2 = 24.851, P < 0.01) and were higher than that noticed 1.376% and 1.141% in controls (X2 = 33.547 and 14.274, all P < 0.01). The heritability of the first-degree and second-degree relatives of nasal polyp was 64.488% and 61.947%. Among the first-degree relatives of nasal polyp probands, the heritability of the adult group and the children group were respectively 60.735% and 74.598% (the difference was significant, X2 = 4.504, P < 0.05). The heritability of the first-occurred group was 62.839% and the recurred group was 74.304% (the difference was significant, X2 = 4.105, P < 0.05).

CONCLUSIONSThis study indicated that the genetic model of nasal polyp belonged to polygenetic and the genetic factors played an important role in the occurrence of nasal polyp, especially for young or recurred patients.

Adolescent ; Adult ; Aged ; Case-Control Studies ; Child ; China ; epidemiology ; Female ; Humans ; Inheritance Patterns ; Male ; Middle Aged ; Nasal Polyps ; epidemiology ; genetics ; Pedigree ; Young Adult