This paper discusses the meaning of the tutorial system on clinical practice;the qualifications,tasks and a responsibility of the tutors,expounds the role of tutors,and discusses the main problems of tutorial system of the undergraduate.

Objective To research a pure capacitance sensor for acquisition of cardiac phonocardiogram. Methods Under the phantom power supply (48V), the faint vibration signal of the heart was processed into electric signal by larger pre - treatment circuit module, shielded cable and the sensor pre-amplifier of circuit module. Results With some experiments, it can be proved that the sensor won't have affect on the sound field which frequency band under 1 000Hz and can detect the level of sound field like 20dB:30dB and 150dB or higher. Conclusion So with the sensor, the precise signal which can exactly reflect the status of patients' hearts can be detected, and it suits to work in complex condition for its high sensitivity, wide frequency band and low distortion.

Objective To investigate the effect of tacrolimus on the expression of nuclear factor-κB (NF-κB) in HaCaT cells stimulated by tumor necrosis factor-α(TNF-α),and on the expression of glucocorticoid receptor (GR)α and β in untreated HaCaT cells in vitro.Methods Cultured Ha CaT cells were treated with TNF-α(10μg/L) only,combination of TNF-α(10μg/L) and various concentrations (10-8mol/L, 10-7mol/L,10-6moL/L) of tacrolimus or tacrolimus of different concentrations only.After additional 12-,24-, 36- or 48-hour cnlture, Westem blot and immunofluorescenee-confocal laser scanning microscopy were used to detect the expressions of NF-κB,GRα and GRβ in HaCaT cells.Those untreated HaCaT cells served as the control.Results The relative protein expression level of NF-κB was increased in HaCaT cells after treatment with TNF-α for 24 and 48 hours zompared with untreated ceils (0.73±0.0316 and 0.8925±0.0171 vs 0.4988±0.03506,both P<0.05);however,the increase in NF-κB expression was inhibited by the combination treatment with tacrolimus,and the relative expression level of NF-κB protein was 0.6825±0.0263.0.6200±0.0163 and 0.5575±0.0299 in HaCaT cells treated with TNF-α plus tacrolimus of 10-8mol/L 10-7mol/L and 10-6mol/L,respectively;the difference was significant etween TNF-α-treated cells and those dealt with the combination of NF-α and tacrolimus of 10-7 or 10-6 mol/L (both P<0.05).No significant difference was observed in the expression of NF-κB by HaCaT cells between different time oints treated with tacrolimus of 10-8,10-7 or 10-6 mol/L.Also,there was no zignificant difference in the expression of GRα or GRβ between untreated HaCaT cells and those treated with tacrolimus of 10-8, 10-7 or 10-6 mol/L at any time point.Conclusions Tacrolimus ould inhibit the expression of NF-κB by TNF-α-stimulated HaCaT cells,but does not affect the expression of GRα or GRβ,in untreated HaCaT cells.

Objective To evaluate the curative effect of potassium magnesium aspartate on arrhythmia and heart function in valve replacement postoperative patients of rheumatic heart disease. Methods Two hundred and eighty patients with rheumatic heart disease were divided into 2 groups in random,with no statistical significance. Treatment group (n=155) were received i.v. potassium magnesium aspartate 40 ml every day and control group (n=125) were only given conventional therapy. At the same time they were given same treatment. Blood magnesium level,blood potassium levels,arrhythmia incidences and heart function were also observed. Results Blood magnesium and potassium levels of the treatment group were higher than those of the control group (P

This paper designs a heart sound processing analog circuit, in which the amplification circuit, the filter circuit and the lifting of electrical level circuit are involved. It also gives a safety design problem analysis using an electret capacitor microphone to pick-up the heart sound signals. It is proved that the circuit is reliable and effective.

AIM: To investigate the effect of purifried L-amino acid oxidase (LAO) from bungarus fasciatus snake venom on apoptosis and growth of HUVCE cell line. METHODS: The L-amino acid oxidase was purified by SP-sepharose HP column followed by Heperin-Sepharose (FF) column. The homogeneity of the preparation was examined by SDS-PAGE and the molecular weight of LAO was determined by SDS-PAGE and high performance liquid chromatography (HPLC) gel-filtration. The MTT assay was used to detect the viability of cells. Flow cytometry and laser confocal microscopy were used to identiyfy the cell cycle and apoptotic morphology after cells treated with LAO. RESULTS: An L-amino acid oxidase (BF-LAO) was successfully purified from the venom of bungarus fasciatus. It showed a single band in SDS-PAGE under both reduced and non-reduced conditions. The apparent molecular weight was determined to be 60 kD by SDS-PAGE and 70 kD by HPLC gel filtration. LAO inhibited growth and induced apoptosis of HUVCE cell line in a dose-dependent manner after 12 h incubation, with the 50% inhibitory concentration (IC_ 50 ) being of 2.8 mg/L. Flow cytometry and laser confocal microscope showed a typical apoptotic peak and morphological changes of these cells. CONCLUSION: The L-amino acid oxidase from bungarus fasciatus snake venom could inhibit the HUEVC cell growth and induce the cell apoptosis.

Objective To study the effects of recombinant human growth hormone(rhGH) on the treatment for valve replacement postoperative in rheumatic heart disease associated cardiac eaehex.Methods Fortytwo patients with rheumatic heart disease associated cardiac eachexia were divided into two groups.Group one(n=20,rhGH group) received standard enteral nutrition (15 kal·kg-1 · d-1)with rhGH 10U injection subeutaneously from postoperation day 7 to day 14 and group two(n = 22,eontrol group) received standard enteral nutrition (15 kal·kg-1· d-1) for the same period.Haemoglobin, serum total protein, serum albumin, blood glucose, handgrip exercise and triceps skin_fold thickness were determined.Meehanieal ventilation, hypostatie pneumonia incidence rate, and length of stay were observed.Results The levels of serum total protein, serum albumin and blood glucose eoneentration in the rhGH group at the 14th day were inereased significantly compared to that in the control group(P <0.01).Haemoglobin, triceps skinfold thiekness and handgrip exercise in rhGH group were significantly different from those in the control group(P <0.05).Postoperative meehanieal ventilation time, intensive care unit time, hospital stay time were signifieantly shorter than those in the eontrol group (P < 0.05), and hypostatie pneumonia was significantly lower than that in the eontroi group(P < 0.01).Conclusions The rhGH can obviously improve anabolie effects of patients with rheumatic heart disease associated cardiac eachexia whieh can reduce hypostatie pneumonia and shorten postoperative hospital stay time.

Objective To observe the effect of Sox9 gene overexpressian on chondrogenesis of esenchymal stem ceils (MSCs) in vitro. Methods Rabbit MSCs were obtained and purified by gradient centrifuge and adhesion culture in vitro. MSCs were transfected by recombinant Sox9 plasmid. RT-PCR and Western blot analysis were used for transfection confirmation. Chondrogenic molecules such as type I1 collagen,aggrecan and Sox9 were detected by immunohistology, RT-PCR and western blot. Cell proliferation was tested by MTT assay. Results MSCs were successfully transfected with Sox9 gene and verified by RT-PCR and Western blot analysis. The overexpression of Sox9 had no effect on the proliferation of MSCs. Transfeeted cells expressed more chondrogenic markers than the control groups. Conclusion Sox9 gene overexpression can enhance chondrogenic differentiation of MSCs.

Objective To analyze and summarize the skills and complications of extracorporeal membrane oxygenation( ECMO) cannu-lation and vein intubation. Methods The clinical data of 21 patients of V-A or V-V ECMO in our hospital from January 2009 to July 2014 were analyzed retrospectively. And the techniques of different catheter sites were summarized. Results Three cases were successfully insert-ed catheter by jugular vein puncture with one time. Four patients with ascending aorta intubation died from uncontrolled severe hemorrhage. Eight peripheral catheter site had a small amount of bleeding,with no more bleeding after pressurized bandage. There were no complications like bleeding, hematoma, hemothorax and pneumothorax in the period of ECMO. Conclusion In the process of the ECMO catheter, the standardized operation could reduce the incidence of serious complicaions including bleeding.