Lung distension belongs to chronic obstructive pulmonary disease (COPD) in modern medicine.In recent years,its disease incidence and mortality have increased year by year.Supported by the traditional Chinese medicine (TCM) standardization of the State Administration of TCM project-TCM preventive treatment practice guidelines-prevention of lung distension recrudescence,the first draft of the TCM Preventive Treatment Practice Guideline on Prevention of Lung Distension Recrudescence was formulated on the basis of preventive treatment theory,evidences from both ancient and modern literatures,and through the Delphi method as well as expert consensus conference.And then,peer review comments were collected,which laid the foundation for the further improvement of this guideline.This guideline was aimed to achieve the industry consensus,to improve the quality of life (QoL) in patients of the stable period,to reduce the economic burden of patients,as well as to improve both the theoretical connotation and practical value of preventive treatment in TCM.

OBJECTIVE:To provide reference for cultivating high-level comprehensive medical talents with high quality. METHODS:Based on the market and social needs,the teaching reform was conducted from the concepts of educational ideas, modes,curriculum system,contents,management and other aspects. RESULTS:In order to adapt to the needs of society and era, it should establish large education educational ideas to cultivate student's independent ability to obtain knowledge and self-develop-ment to make people change into community basic services and service and dedicate society with modes of cultivating inter-disci-plinary talents,including combination of prduction and study,foundation strengthening,professional expanding,penetration of sci-ence and technology and combination of arts and science;generally optimize curriculum system with theprinciple of precise defini-tion,clear classification,and optimized combination based on market and social needs;and update contents timely and teaching materials;the teaching management should be changed from closed off management of the past to the external management which dominated by the market assessment. CONCLUSIONS:Reform of medical higher education based on the market and social needs can cultivate the talents with high quality and comprehensive medical knowledge for the social needs,which is conductive to the de-velopment of medical industry.

OBJECTIVE:To study the resistance physiological responses of seedling of Scrophularia ningpoensis to the stress caused by saline and alkali at different concentrations. METHODS:The seedling of S. ningpoensis was placed in the illumination in-cubator,in which the temperature was maintained at(20±2)℃,light-dark cycle at 13 h/11 h and illumination intensity at 2 000 lx. The alkali (NaHCO3) of 50,100,150,200 and 250 mmol/L and the saline (NaCl) of 50,100,150,200 and 250 mmol/L were poured once every 4 days for 16 consecutive days. The growth indexes(plant height,fresh weight,dry weight),chlorophyll (Chl) content,antioxidative indexes [superoxide dismutase (SOD),catalase (CAT),peroxidase (POD),hydrogen peroxide (H2O2),malonaldehyde (MDA),membrane penetration (RMP)],and osmotic regulation physiological indexes [soluble sugar (SS),soluble protein(SP)and proline(Pro)] of the seedling were determined. There set a blank control group(distilled water). RESULTS:For saline concentration higher than 50 mmol/L and alkali concentration higher than 150 mmol/L,the seedling height, fresh weight and Chl content were lower;for saline concentration higher than 100 mmol/L and alkali concentration higher than 150 mmol/L,the dry weight of the seedling was lower. For saline concentration of 50 mmol/L and alkali concentration of 150 mmol/L, the activities of SOD and POD were the strongest;for saline concentration of 150 mmol/L and alkali concentration of 50 mmol/L, the activity of CAT was the strongest. The contents of H2O2 and MDA increased and the content of SP decreased with the increase in saline-alkali concentration. The level of RMP increased therewith,that is to say,membrane stability decreased. For saline concen-tration higher than 100 mmol/L and alkali concentration higher than 150 mmol/L,the accumulation of SS terminated;for saline and alkali concentrations higher than 100 mmol/L,the accumulation of Pro terminated,however,the content of Pro was markedly high-er in the above-said alkali concentration than in that saline concentration. CONCLUSIONS:Saline-alkali stress causes the tissues of S. ningpoensis to produce active oxygen and its cytoplasmic membrane system to be damaged. Chl,enzymatic antioxidants such as SOD,CAT and POD,and osmoprotectants such as Pro and SS can buffer saline-alkali stress to some degree. The maximum concen-trations of NaCl and NaHCO3 that seedling of S. ningpoensis can tolerate are 50 mmol/L and 150 mmol/L respectively.

Objective To study the differential expression of apoptosis related genes in GJB2 gene conditional knockout mice (cCx26Pax2Cre ) cochlea membranous labyrinth ,and to explore the mechanism of GJB2 gene mutations causing deafness .Methods Two developmental stages of P10 and P18 were selected from the knock out mice and the wild type ones (BALB/C) .The total RNA was isolated from cochlear membranous labyrinth and PCR array was performed using mouse apoptosis PCR arrays .Results Compared with wild -type mice ,significant up or down -regulation in gene expression was detected in 16 genes in cCx26Pax2Cre ones at P10 .Of the 16 genes ,14 ones were down-regulated .Among the 14 genes ,9 ones can be classified as anti -apoptosis or pro -proliferation genes ,5 ones can be classified as pro -apoptosis or pro -inflammation genes .The other 2 genes expression was up-regula-ted ,and their main role was to promote apoptosis .Compared with time -matched controls ,significant up or down-regulation in gene expression was detected in 4 genes in cCx26Pax2Cre mice at P18 .Of the 4 genes ,3 ones expression was down-regulated ,were anti-apoptosis ones .The expression of the other one gene among the 4 ones was up-regulated ,which acted as pro -apoptosis genes .Bcl2l10 and Tnfrsf10b expression showed significant down or up -regulation at both stages . Compared with P10 , the expression of caspase - 8 was up - ragulated at P18 in cCx26Pax2Cre mice .Conclusion It is suggested that GJB2 mutation may up -regulate the expression of DR5 ,which can trigger the death receptor pathway to cause apoptosis in cCx 26Pax2Cre mice cochlea directly .At the same time , caspase-8 in death receptor pathway may activate the mitochondria pathway indirectly and amplify the apoptosis further in cCx26Pax2Cre mice cochlea .The final result of the above activated pathways is the wide range of cochlear cells apoptosis and the profound hearing loss in cCx 26Pax2Cre mice .

Objective To evaluate the application value with low-dose CT scan and quantitative analysis in airway disease of chronic obstructive pulmonary disease(COPD).Methods All subjects(34 control cases,88 cases of stable COPD patients)underwent low-dose CT chest scans,and 88 COPD patients underwent pulmonary function tests.Measuring the airway dimensions of 3th generation in apical bronchus of the right upper lobe,the posterior basal bronchus of the right lower lobe and left lower lobe.Results COPD patients with moderate to extremely severe airflow limitation demonstrated higher WA% and Pi10 in comparison with normal volunteers(all P<0.05),meanwhile patients with extremely severe airflow limitation demonstrated higher WA % and Pi10 in comparison with patients with mild airflow limitation(both P <0.05).COPD patients with severe airflow limitation demonstrated higher T/BSA and WA/BSA in comparison with normal volunteers and patients with moderate airflow limitation (all P<0.05).The WA % and Pi10 of COPD patients group were negatively correlated with ventilation indices and small airway indices(all P <0.01).Pi10 were positively correlated with lung volume indices (all P < 0.05 ).Conclusion Low-dose CT scan and quantitative analysis can provide an objective and quantitative method to evaluate the information about airway disease of COPD,inwich both WA % and Pi10 are objective indices.With the increase of air flow limitation,the bronchial wall thickness gradually increased.

Domestic generic drug registration has a large proportion in chemical drugs with outstanding repeated registration phe-nomenon and low level innovation of enterprises. Under the above background, chemical drug registration reform kicked off. The imple-mentation of new drug registration classification, marketing authorization holder and the changes of listed drug registration documents have a huge impact on China' s pharmaceutical industry, which can promote the reformulation of domestic pharmaceutical market, en-courage R&D and innovation in enterprises and accelerate the pace towards the international market.

Objective To establish the optimal extracted method for content dete rmination of naringin in Citrus grandis. Methods RP-HPLC was used to determinat e the content of naringin extracted with the above two methods from different ye ar samples of Citrus grandis. Results The average content extracted with ultraso nic extraction was 13.53 %,and the average content extracted with soxhlet extr action was 11.98 %,there being insignificant difference between the two method s. Conclusion The content of naringin extracted with ultrasonic extraction is mo re than that with the soxhlet extraction,which be receipted in Chinese pharmeco pia. And ultrasonic extraction method is more convenient and can save time.

Background and Objective Large randomized controlled trials have demonstrated that percutaneous coronary intervention (PCI) with the routine use ofdrug-eluting stents is safe and effective, however, the patients older than 75 years undergoing PCI are at increased risk for major adverse cardiac events, so that the patients are usually excluded from this trial. The aim of the present study was to assess the early clinical outcome and risk factors in old patients with acute ST elevation myocardial infarction (STEMI) following primary PCI. Methods We analyzed the outcome after stenting in 136 patients older than 60 years in our coronary care unit with acute STEMI, and the patients were further classified in 2 age groups: patients≥75 years and <75 years. Results Though the older group had a higher prevalence of adverse baseline characteristics and lower final TIMI flow than those of the younger, the procedural success had no difference between two groups. The main adverse clinical events (MACE) for the old group was a little higher comparing with the younger in 12-month following up. Conclusions Our study suggest that drug-eluting stent implantation in elderly patients with acute ST elevation myocardial infarction has high initial procedural success rates despite having more severe baseline risk characteristics, and to shorten the time form symptom onset to PC1 and improve final TIMI flow strategy may decrease MACE among old patients following PCI.

Objective To investigate the left atrium (LA) function and structure changes in the paroxysmal atrial fibrillation (AF) patients after catheter ablation using tissue Doppler imaging. Methods After complete pul-monary vein, radiofrequency ablation guided by Ensite NavX System, LA systolic function and LA diameter, volume, mean mitral gradient and mitral annulus early and advanced diastolic peak velocity were assessed in 32 cases of par-oxysmal AF patients,which were compared with age-matched controls before and after 24 hours, 1 week, 1 month) AF ablation. Results AF did not occur again in 32 AF paroxysmal patients after isolation. LA diameter and volume in AF groups before ablation were larger than controls(P<0.01), which were also larger 24 hours after ablation than before (P>0.05 ), but LA volume was larger than before (P<0.05), and decreased in I week after ablation (P< 0.05), but had no significant difference compared with controls in 1 month(P>0.05 ) ;mitral annulus advanced di-astolic peak velocity decreased in AF groups before ablation (P<0.01 )and was lower than that 24 hours after cathe-ter ablation (P<0.05 ), but increased after 1 week (P<0.05 or P <0.01 ), and had no significance after 1 month. Conclusion Catheter ablation is the effective way to manage AF because LA is distended and atrial systolic func-tion is reduced within 24 hours after procedure, then gradually increased in a week and will nearly recover to that be-fore procedure in a month, which may be correlated with LA repair, implicating that postprocedural thromboembollc risk and procedure injury should be taken into consideration.

Internet-based practice of stomatology hospitals plays an important role in promoting hierarchical medical system and overcoming the social problems of " high costs and difficulties of medical services" . The authors introduced the practice of free online consultations at a tertiary stomatology hospital during this period. They also analyzed such characteristics of the practice as the doctors′ response rate, doctors′ response timeliness, as well as the specialties and timeframe distribution of patient consultations. The hospital provides online consultations on Guangdong cloud-based hospital platform in two modes. For example, the normal consultation mode operates in a many-many manner, with services provided by attendings and associate chief physicians appointed less than three years. In off hours, patients can also raise questions online. The expert consultation mode offers consultations during business hours in a one-to-one manner, with services provided by associate chief physicians appointed over three years and chief physicians. From February 10 to March 22 2020, 2 156 persons/times of consultations were served in the normal mode, and 1 043 persons/times received in the expert mode. The response timelines of the latter (16.19 min) was much better than the former (27.10 min). In terms of consultation workload of sub-specialties, oral medicine ranked the top (69.30%), while the consultations of the normal mode in work hours accounted for only 73.47% of total consultation workload. It is recommended to optimize resources deployment, introduce artificial intelligent inquiry service, explore an online-offline combined stomatological service, and improve performance management. These measures, when in place, can promote sustainable development of Internet-based stomatology hospitals.