The article expounds the significance of teaching foreign medical students in English to the internationalization of the higher learning in China,and discusses the problems and challenges that will be met in the teaching practice as well as the way to solve the problems

It has been confirmed that genetic factor plays an im-portant role in the pathogenesis of depression. MTHFR is one of the key enzymes in folate and homocysteine ( Hcy ) metabolism which participates in Alzheimer’ s disease, depression and other mental illnesses. MTHFR-677C/T polymorphism causes the de-crease of enzyme activity and heat resistance, which will lead to lower folate and elevated plasmal Hcy concentration. All of these results put together will cause the central neuronal damage and microvascular damage and affect the synthesis of central neuro-transmitter and methylation of biogenic amines and phospholipids in the central nervous system, which will eventually induce vari-ous mental illnesses like depression, etc. This article reviews the research advancement in the relationship between MTHFR-677C/T polymorphism and depression in recent years on the basis of MTHFR gene mutation and function, lack of folic acid, elevated plasma homocysteine levels and the MTHFR-C677T polymor-phism. Based on which we hope to bring new ideas about treat-ment of depression.

To improve the training quality of medical students,the questionnaire investigation was carried out to evaluate the effects of early clinic education course,which has provided us with the evidence to amend the teaching contents,teaching model,teaching methods.

A HPLC method was established for the determination of psoralen and isopsoralen in Psoralea corytifolia L. and its preparations. Psoralen and isopsoralen can be separated on ?－Bondapak C15 column with a mobile phase of MeOH－H2O (6:4) and detected at 245nm. The optimum conditions based on experimental results was to extract the sample by MeOH in an ultrasonator for 30 min. The method is simple and accurate.

Quantitative HPLC method was developed for the determination of flavonoids in extract preparations of leaves of Ginkgo biloba L. YWG-C13 column was used with a mobile phase of methanol-water-glacial acetic acid (40: 57.5 : 2.5, V/V ) and detected at 254nm.The flow rate was 1.0ml/min. Ten Peaks were observed. Rutin was used as external standard and the calibratiott cirve was linear over the rang of 0.5~2.5?g (r =0.9996 ). The extraction recovery was 104.2% (RSD = 3.3% ) .Compared with the res ilts of chemical colorimetric analysis, the method has a better reprod icibility and more information about the flavonoids in G. biloba can be obtained.

Objective To investigate the change of neutrophil elastase and matrix metalloproteinase-9 in sepsis and determine significance in the early diagnosis and prognosis of multiple organ dysfunction syndrome.Methods The plasma levels of neutrophil elastase and matrix metalloproteinase-9 in 28 ICU patients with sepsis were examined by immunofluorescence.Results Compared with control group,the levels of NE and MMP-9 were significantly higher on the day of the diagnosis of sepsis(P

Objective To determine the level of toll-like receptor4 (TLR4) in the kidney of rats with the Multiple Organ Dysfunction Syndrome (MODS),and to investigate the early phase of kidney damage in MODS.Methods The experiment was done at experimental center of medical college of Three Gorges University.Forty Adult male Sprague-Dawley (SD) rats were randomly (random number) divided into two groups,namely the normal control group and the MODS model group.The rats of model group were further divided into four sub-groups as per different intervals (6 h,12 h,24 h and 48 h),and there were 8 rats in each groups.The animal models of MODS were established by two hits,the left eyeball of each model rat was removed to bleed to 2 mL/100 g,and four hours later,Lipopolysaccharide ( LPS,5 mg/kg) was injected into intraperitoneal cavity of model rats.The same volume of saline was injected intraperitoneally into rats of control group.All rats were sacrificed at various intervals.The histological changes in the kidney tissue were observed by naked eye and under light microscope.The lever of TLR4 proteins in serum and kidney tissue were detected by using flow cytometry (FCM).One-way ANOVA was used for comparison among multiple groups.Results (1) There were no histopatholagical changes in kidney of rats in control group,and the kidney injury was serious in rats with MODS.(2) Compared with the rots of control group,the level of TLR4 in kidney tissue of rats with MODS increased at 6 hours and reached peak 12 hours later ( P ＜ 0.01 ),and then decreased 24 hours ( P ＜ 0.01 ).There was no significant difference in levd of TLR4 between two groups 6 and 48 hours.Compared with the rats of control group,the level of TLR4 in peripheral blood leucocyte of rats with MODS increased significantly 6 ～ 48 hours after LPS ( P ＜ 0.01 ).The concentrations of serum and kidney tissue TLR4 proteins were positively correlated with each other ( r =0.893,P ＜ 0.05 ).Conclusions The level of TLR4 markedly increased in the kidney tissue at early stage of MODS,and the TLR4 may play an important role in the pathogenesis of kidney injury in MODS.

ObjectiveTo determine the levels of type Ⅳ collagen and matrix metalloproteinase-9 ( MMP-9 ) in the serum and kidney of rats with the multiple organ dysfunction syndrome ( MODS ) and investigate the mechanism of extracellular matrix damage in renal failure of MODS.MethodsForty adult male Sprague- Dawley (SD) rats were randomly (ramdom number) divided into two groups,namely the normal control group ( n =8 ) and the MODS model group ( n =32 ).The rats of model group were further divided into four sub-groups as per different intervals,6 h,12 h,24 h and 48 h,after modeling (n =8 in each).The animal models of MODS were established by two hits,the left eyeball of each model rat was removed to bleed to 2 ml bloocd/100 g body weight and lipopolysaccharide ( LPS,5 mg/kg) was injected into intraperitoneal cavity of model rats four hours later. The same volume of saline instead was injected intraperitoneally into rats of control group.All rats were sacrificed at different intervals.Creatinine (Cr)and blood urea nitrogen (BUN) were determined by using a Hitachi Automatic Biochemical Analyzer.The histological changes in renal tissue were observed under light microscope and transmission electronic microscope.The levels of serum type Ⅳ collagen and MMP - 9 protein were measured by using enzyme linked immunosorbent assay (ELISA).Type Ⅳ collagen and MMP- 9 protein levels in renal tissue were detected by western blot.One - way ANOVA was used for comparison among multiple groups.Results Compared with the control group,Cr and BUN were significantly higher in MODS group ( P ＜0.05 ).There were no histopathological changes in kidney of rats in control group,and the renal injury was serious in rats with MODS.The remarkable edema of basement membrane and defect of collagen fibers in renal tissue were observed in MODS group.Compared with the control group,the levels of MMP-9 in serum increased 6-48 hours after modeling and peaking at interval of 12 hours after modeling ( P ＜ 0.05 ).The protein levels of type Ⅳ collagen increased not significantly in 6 h group and 12 h group in comparison with control group (P ＞ 0.05 ),while those in 24 h group and 48 h group significantly increased ( P ＜ 0.01 ).The levels of MMP -9 in renal tissue of rats with MODS increased in 6 h group and 12 h group (P＜0.05),peaked in 24 h group ( P ＜ 0.05 ),and decreased in 48 hours.However,the level of Ⅳ collagen in serum of rats with MODS decreased significantly 6-48 hours after modeling (P ＜ 0.05 ) Conclusions The injury of extracellular matrix is an important factor to the kidney damage in MODS and it may he used for early diagnose and as a treatment target for kidney injury in MODS.

Objective To evaluate the clinical outcome associated with the core decompression in combination with the nano-hydroxyapatite/collagen composite rod combined with decalcified bone matrix in a consecutive series of patients with osteonecrosis of femoral head,especially the prevention of collapse of femoral head and its predisposing factors.Methods From August,2012 to May,2013,46 pationts (50 hips) who had undergone core decompression in combination with nano-hydroxyapatite/collagen composite rod insertion in corporated with decalcified bone matrix in our hospital were involved in this study.Postoperative care consisted of prophylactic intravenous antibiotic and anticoagulation therapy.Patients were instructed to be non-weight-bearing for 3 weeks,to partial weight-bear for the next 3 weeks,and to weight bear as tolerated thereafter.All patients were evaluated both clinically and radiographically.The primary clinical outcome of this study was functional improvement assessed with the Harris hip score.Serial radiograms of the pelvis were taken at 1,3,6,12 months post-operatively to analyze the process of osteonecrosis.Results All patients followed up for 12 months,no one suffer complications.The mean Harris score pre-operation was 65.6 ± 10.6,post-operation score was 87.5 ± 15.3,with a mean improvement of 21.8 ± 13.2 (P ＜ 0.05).According to Harris hip score system,excellent for 30 hips,good for 14 hips,fair for 2 hip and poor for 4 hips.Refer to the Kaplan-Meier survivorship curve,the success rate at 12 months post-operatively was 92％.Radiological changes coincided with clinical changes.Conclusion Core decompressionin combination with nano-hydroxyapatite/ collagen composite rod insertion in corporated with decalcified bone matrix provided a minimally invasive surgical treatment option to treat early stage osteonecrotic hips(stage Ⅰ and Ⅱ) and to prevent femoral heads from collapsing,with clinical outcomes and success rates priorto other commonly used surgical procedures.

Objective To evaluate results and demonstrate problems of Scandinavian total ankle replacement (STAR) in patients with ankle arthritis and clarify its role as a growing alternatives to ankle fusion.Methods Retrospectively analyzed 43 patients who had total ankle replacement from May 1999 to January 2013.All cases were evaluated with interview focusing on pain,daily activities and clinical and radiologic examinations.The average age of patients was 46 (range,35 to 56) years old.Among these cases,9 patients suffered from posttraumatic arthritis,25 osteoarthritis,5 rheumatoid arthritis and 4 avascular necrosis of the talar body.All patients complained about ankle joint pain and swelling as well as limited ROM of joint.Results Mean follow-up was 6.7 (1.5 to 12 years) years.37 cases had complete follow-up.The average preoperative ankle score was 27.0± 10.5,pain degree score was 16.5± 12.8,joint function score was 10.6±7.4,ROM score was 8.2±5.2.The average preoperative ankle score was 86.5±13.2,pain degree score was 49.5±4.5,joint function score was 19.7±9.5,ROM score was 19.2±3.2.The indicatiors compared with preoperative,postoperative differences have statistical significance.The score of postoperative Kofoed were divided into excellent 35 cases,good 1 case and poor 1 case,excellent and good rate was 97.3％.The American orthopaedic foot and ankle society (AOFAS) scoring system was improved from 40.5 preoperatively to 80.6 postoperatively.No postoperative loosening or migrating of the prosthesis was noted.Conclusion It was demonstrated that the standardized and normalized operative techniques as well as operative tools closely matched to the prosthesis could achieve favorable outcomes according to the clinical and radiographic outcomes and overall acceptable cornplication rates in the present study.STAR was a choice for the patients with advanced osteoarthritis,posttraumatic arthritis,rheumatic arthritis and avascular necrosis of the talar body.