This article defined a set of communication skills that are expected of second-year medical students conducting history and physical examinations on hospitalized patients.In order to teach the skills,an educational strategy was devised that included training sessions for medical teachers and the development of an innovative videotape tool used to train the teachers and their students.The majority of teachers and students felt that the educational design stimulated discussion and improved their understanding of communication skills.This useful teaching technique is transferable to other institutions.

Moyamoya disease is a tare intracranial angiopathy resulting in symptoms and prognosis similar with the stroke,if not diagnosed and treated early.The article reviews the characteristics,pathogenesis,treatment and prognosis of Moyamoya disease.Clinicians should be aware of this disease in routine work,so that the patients with Moyamoya disease can be early diagnosed and treated to avoid disability or death.

Objective To study the efficacy of hypo responsiveness of allogenic T cells induced by curcumin (Cur)-treated dendritic cells (DCs) and influence on survival time of renal allografts in rats.Methods DCs were generated from Wistar rat bone marrow and treated with Cur. The costimulatory molecules (CDl1c, CD80, CD86 and major histocompability complex Ⅱ ) were determined by using flow cytometry,and the production of IL-12 in DCs culture supernatant was examined by using ELISA.The probability of Cur treated DCs to stimulate the proliferation of Lewis rat T cells was detected by using mixed leukocyte reaction (MLR),and the antigen specific T cell hypo responsiveness was analyzed by using secondary MLR. Allograft renal transplantation animal models were established by using Wistar rats as donors,and Lewis rats as recipients.At 7th day before allograft renal transplantation,Cur-treated DCs from donors were injected into recipients through tail vein, meanwhile the non-treated control group and immature DCs control group (immature DCs from donors were injected into recipients through tail vein) were set up.The allograft survival time and allograft pathology after transplantation were assayed.Reaction of T cells from the recipients to mature DCs of donors was analyzed at 14th day.Results Cur restrained the expression of DCs phcnotypc and production of IL-12 (P＜0.05). Cur treated DCs displayed poor ability to stimulate T cells proliferation,and potential to induce antigen specific T cell hypo-responsiveness.The survival time of the renal allograft in Cur-treatcd CDs group [(31.5 ± 6.9) days] was significantly longer (P＜0.05) than in control group [(8.6± 2.1) days] and immature DCs control group [(22.4± 7.4) days],and the pathological lesions in the renal allografts in Cur treated CDs group were milder than in the control group and immature DCs control group.T cells from the recipients injected with Cur-treated DCs showed significant hypo-responsiveness to mature DCs from donors (P＜0.05),but higher proliferation ability to the stimulation of third party independent antigen.Conclusion Cur can suppress the maturation and function of DCs,and induce immune suppression of allogeneic T cells,while infusion of Cur-treated immature DCs can prolong the survival of renal allograft remarkably.

The compound excipient containing sodium stearyl fumarate and plasdone S-630 was prepared by applying spray drying method. The basic physical properties of compound excipient were studied by solubility test, scanning electron microscope, differential scanning calorimeter, X-ray diffraction and Fourier transform infra-red spectroscopy. The effect of compound excipient on moisture absorption and ferulic acid in vitro dissolution of spray drying power of angelica were investigated. The results showed that the chemical constituents of compound excipient did not change before and after spray drying. The water soluble compound excipient can improve significantly moisture absorption and has application prospect.

There are some problems in the course of evaluating teaching quality in colleges and universities, such as theunclear aim of evaluation, few teachers taking part in evaluating, and problems existing in participants which affect thequality of evaluation. Some related measures are made here to solve the problems.[

Objective:To investigate the protective effect of pine pollen on lipopolysaccharide (LPS)-induced learning and memory impairments in mice and the underlying mechanism.Methods:Sixty mice were randomly divided into four groups ( n = 15/group): normal control, model, low-dose pine pollen (500 mg/kg) and high-dose pine pollen (1 000 mg/kg). Mouse models of learning and memory impairment were established by lateral ventricle injection of LPS. The learning and memory abilities of mice were determined by the Morris water maze test. Superoxide dismutase (SOD) activity and glutathione (GSH) and malondialdehyde (MDA) levels in the hippocampus of mice were measured. Interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), dopamine (DA), and norepinephrine (NE) levels in the hippocampus were also determined. Results:The latency in the passive avoidance test in the model group was significantly shorter than that in the normal control group [(134.80 ± 33.89) s vs. (282.20 ± 17.43) s, t = 4.23, P < 0.01]. The number of errors in the model group was significantly higher than that in the normal control group [(4.00 ± 1.58) vs. (1.20 ± 1.30) times, t = 2.85, P < 0.01]. The latency in the passive avoidance test in the low-dose pine pollen (500 mg/kg) and high-dose pine pollen (1000 mg/kg) groups was significantly longer than that in the normal control group [(189.40 ± 27.21) s or (213.40 ± 21.26) s vs. (134.80 ± 33.89) s, t = 3.21, 4.38, all P < 0.05]. The number of errors in the low-dose pine pollen (500 mg/kg) and high-dose pine pollen (1 000 mg/kg) groups was significantly lower than that in the normal control group [(1.60 ± 1.44) times or (1.40 ± 1.44) times vs. (4.00 ± 1.58) times, t = 5.12, 6.42, both P < 0.05]. SOD activity and GSH, DA and NE levels in the hippocampus in the model group were significantly decreased compared with the normal control group [SOD: (7.59 ± 1.77) kU/g vs. (39.90 ± 6.37) kU/g; GSH: (3.49 ± 0.13) mmol/g vs. (6.37 ± 0.14) mmol/g; DA: (418.42 ± 2.57) ng/L vs. (586.37 ± 3.64) ng/L; NE: (187.20 ± 5.41) ng/L vs. (298.42 ± 2.32) ng/L, t = 3.67, 8.23, 2.23, 3.65, all P < 0.05]. MDA, IL-6 and TNF-α levels in the hippocampus in the normal control group were significantly higher than those in the model group [MDA: (8.79 ± 0.82) mmol/g vs. (2.62 ± 0.16) mmol/g, IL-6: (48.07 ± 5.56) ng/L vs. (18.76 ± 1.42) ng/L, TNF-α: (87.20 ± 4.31) ng/L vs. (22.42 ± 3.39) ng/L, t = 7.45, 2.67, 4.35, P < 0.05 or P < 0.01]. SOD activity, GSH, DA and NE levels in the hippocampus in the low-dose pine pollen (500 mg/kg) and high-dose pine pollen (1 000 mg/kg) groups were significantly higher than those in the model group [SOD: (18.80 ± 2.39) kU/g, (28.70 ± 2.36) kU/g vs. (7.59 ± 1.77) kU/g, GSH: (5.04 ± 0.36) mmol/g, (5.45 ± 0.17) mmol/g vs. (3.49 ± 0.13) mmol/g, DA: (488.37 ± 3.46) ng/L, (506.29 ± 5.72) ng/L vs. (418.42 ± 2.57) ng/L, NE: (225.65 ± 3.72) ng/L, (239.76 ± 5.58) ng/L vs. (187.20 ± 5.41) ng/L, t = 4.56 or 6.71, t = 4.65 or 5.32, t = 4.73 or 6.72, t = 3.84 or 5.63, P < 0.05 or P < 0.01]. MDA, IL-6 and TNF-α levels in the hippocampus in the low-dose pine pollen (500 mg/kg) and high-dose pine pollen (1 000 mg/kg) groups were significantly lower than those in the model group [MDA: (5.72 ± 0.47) mmol/g, (3.77 ± 0.23) mmol /g vs. (8.79 ± 0.82) mmol/g, IL-6: (28.42 ± 3.54) ng/L, (23.43 ± 5.62) ng/L vs. (48.07 ± 5.56) ng/L, TNF-α: (48.87 ± 4.82) ng/L, (39.65 ± 6.69) ng/L vs. (87.20 ± 4.31) ng/L, t = 6.31 or 7.28, t = 3.46 or 6.31, t = 4.28 or 3.57, P < 0.05 or P < 0.01]. Conclusion:Pine pollen can improve LPS-induced learning and memory impairments possibly through up-regulating the levels of monoamine neurotransmitters DA and NE and inhibiting the levels of oxidative stress and inflammatory reaction in the hippocampus of mice.

Objective To investigate the effects of celastrol on the cell growth and apoptosis of human gallbladder cancer NOZ cells,and explore its potential molecular mechanism.Methods NOZ cell were cultured in vitro.And CCK-8 assay,Annexin V-FITC/PI staining method,cell cycle analysis were conducted to investigate the effects of celastrol on the growth and apoptosis of NOZ cells after being treated with drugs.The mitochondrial membrane potential and Bax and Bcl-2 protein expression level were determined by Rhodamine 123 and Western blot,respectively.Results Celastrol could inhibit NOZ cell growth,and the IC50 value was 5.3 μmol/L.Annexin-V/PI staining showed that cell apoptosis of NOZ cells were induced as the celastrol concentration increased,and the apoptosis ratio of control group was 4.4％,while the apoptosis rates of the test groups (2,5,10 p mol/L) were 7.4％,27.1％ and 43.4％,respectively.In addition,cell cycle analysis revealed that celastrol could induce G1-phase arrest.The G1-phase rate of control group was 25.6％,while the G1-phase rates of the test groups (2,5,10 μmol/L) were 36.5％,45.7％ and 92.5％,respectively.The mitochondrial membrane potential was measured after treatment with celastrol and the results indicated that the mitochondrial membrane potential was significantly decreased.Western Blot showed that the protein expression of Bax increased and Bcl-2 decreased in a time-dependent manner after treatment with celastrol.Conclusions Celastrol may inhibit cell proliferation of human gallbladder cancer NOZ cells and induce cell apoptosis partly by inducing the loss of mitochondrial membrane potential.

Objective To compare the appfication of rapid sequence induce nasotracheal intobation with awake nasotracheal intubation with fiberoptic bronchoscope (FOB) in patients with cervical vertebra injury.Methods Forty patients with cervical vertebra injury were randomly divided into group (rapid sequence induce nasotracheal intubation with FOB) and group II (awake nasotracheal intubation with FOB),20 patients in each group.Bp,HR,SpO2 before and during intubation,intubafion time and cases of re-intubation were observed.Results SpO2 maintained normal during intubation.Between group I and group II,there was no significance in intubation lime [(3.12±0.52)min and (3.34±0.65)mini and cases of re-intubafion (2 cases and 1 case) (P ＞ 0.05 ).During intubation,MAP and HR inceased significantly in group II than those in group I (P ＜ 0.05 ).Conclusion The application of rapid sequence induce nasotracheal intubation with FOB is better than awake nasotracheal intubation with FOB in patients with cervical vertebra injury,it is safe and valid.

Objective To evaluate the surgical technique of titanium miniplates in reconstruction of laminar roof after a posterior approach in intraspinal tumor surgery. Methods From August, 2007 to March, 2009, 11patients underwent intraspinal tumor surgery with osteotomy and reconstruction of laminar roof, titanium miniplates were used for fixing in the re-implantation. There were 2 intramedullary tumors,9 extramedullary tumors. The target of surgery was the cervical spine in 2 cases, the cervicothoracic spine in 4 cases, the thoracic spine in 2 cases, the thoracolumbar spine in 2 cases, and the lumbar spine in 1 cases. The patitens were followed up for 6 months to 2years. Local pain,bony healing and spinal malformation were assessed. Results In the 11 patients, there was no case of dural, nerve root, or spinal cord injury due to laminar roof reconstruction. One patient complained of moderate to severe local pain during follow-up and 2 patients complained of occasional slight pain at the surgical site. No limitation of activity occurred. Bony healing was confirmed radiologically or CT scan in 9 patients. There were no patients demonstrated a new spinal malalignment, and no patients developed stenosis of the spinal canal. Conclusions The reconstruction of the laminar roof using titanium miniplates will benefit the recovery of normal structure of spine,and maintain the stability of spine,and avoid the occurrence of stenosis of the spinal canal.

Objective To investigate the effect of health literacy on stroke education in patients with ischemic cerebrovascular disease and their family members.Methods Health literacy questionnaire was used to conduct the health literacy questionnaire survey for patients with ischemic cerebrovascular disease and their family members.The respondents received stroke education randomly through neurologists' explanation or self-reading.The corresponding questionnaire was used to evaluate the mastering of the content of stroke education for the respondents.Results The complete data of 42 patients with ischemic cerebrovascular disease (34 ischemic stroke and 8 transient ischemic attack) and 57 family members of the patients with ischemic cerebrovascular disease were collected and enrolled in the analysis.The good health literacy score group (＜ 10) and the poor health literacy score group (≥ 10) were 61 and 38 subjects respectively.The proportions of younger age (x2 =16.410,P ＜0.001) and high school or above (68.85％ vs.23.68％ ;x2 =19.25,P ＜ 0.001) of the former were higher than those of the latter,and the proportion of patients (32.79％vs.57.89％;x2 =6.043,P=0.014) was significantly lower than that of the latter,but there was no significant difference in the proportion of the males between the two groups (55.74％ vs.44.74％ ;x2 =1.134,P =0.287).Multivariate logistic regression analysis showed that health literacy was independently associated with the age of respondents (≤40 years:odds ratio [OR] 7.753,95％ confidence interval [CI]1.208-49.740; P=0.031) and the level of education (high school and above:OR,3.993,95％ CI 1.305-12.218; P=0.015),and it was not correlated with gender and role.Those with good stroke education score (≥7)and poor stroke education score (＜7) were 57 and 42,respectively.The proportions of younger age (x2 =17.095,P ＜0.001),high school and above (70.00％ vs.23.08％ ;x2 =20.836,P ＜ 0.001),and good health literacy score (88.33％ vs.20.51％;x2 =45.968,P＜0.001) were significantly higher than those of the latter,while there were no significant differences in the proportions of gender,role,and stroke education.Multivariatelogistic regression analysis showed that only the good health literacy was independently associated with the stroke education score (OR 20.147,95％ CI6.089-66.655; P＜0.001).Conclusions Health literacy can significantly affected the effect of the stroke education in patients with ischemic cerebrovascular disease and their family members.In the development of individualized stroke education program,it should be considered.