OBJECTIVE:To provide reference for improving the quality of clinical pharmacy undergraduates in our university. METHODS:Considering about the practice problems of clinical pharmacy undergraduates in our university,pilot reform was con-ducted in the First Affiliated Hospital of our university in respects of teacher arrangement,department rotation assignment,assess-ment method. RESULTS:For new practice mode,in term of teacher arrangement,when the students were practicing in clinical pharmacy department,they were taught by clinical doctors and pharmacists;teacher training should be strengthened,and a variety of teaching methods was carried out. In term of department rotation assignment,to shorten the practice time of basic pharmacy de-partment,and increase the clinical pharmacy practice department and practice time;to integrate the content of clinical medicine and clinical pharmacy practice,and select clinical medical departments equipped with clinical pharmacists to practice. In term of assess-ment method,there were 3 aspects including clinical pharmacy practice skills assessment,drug-related theory examination and ba-sic situation assessment during internship. CONCLUSIONS:The new practice mode focuses on clinical pharmacy application skills training and students practical skills assessment,contributes to cultivate students'thinking of rational drug use and improves clini-cal practice skill of students. It is suitable for clinical pharmacy undergraduate internship of our university.

The primary causative factors of liver failure include direct damage and immune -mediated liver injury.Increasing evidence sug-gests that immune -mediated injury plays a pivotal role in the pathogenesis of liver failure.The new concepts concerning the mechanisms of immune -mediated liver injury in liver failure are reviewed with relevant basic and clinical studies in both humans and animals.The innate and adaptive immunity,particularly the interaction of various immune cells and molecules,as well as apoptosis -related molecules,are dis-cussed in detail.

Objective To produce a comprehensive transcript dataset of Oncomelania hupensis before and after Schistosoma japonicum infection,so as to provide experimental data for perfecting genetic structural information and excavating related mo-lecular markers of O. hupensis infected by S. japonicum. Methods O. hupensis snails were divided into the following 3 groups:one week after S. japonicum miracidium infection,4 weeks after S. japonicum miracidium infection,and normal condition. Mil-lion high-quality reads were obtained from the normalized cDNA of the pooled samples,which were assembled into transcripts. Results A total of 63686 unigenes were identified and were classified into 4 main categories,including general functional pre-diction(15.36%),signal transduction mechanism(11.75%),posttranslational modification(8.89%),and functional unknown (12.20%). Conclusions The transcriptome information of O. hupensis snail after the invasion of S. japonicum shows that sever-al genes are significantly up-regulated or down regulated expression,and that the availability of transcriptome information might provide a strong foundation for further understanding the schistosome-snail interaction at the molecular level.

Objective To investigate the present situation of elective course,find out the problems,explain the causes and offer some suggestions.Methods Using the information collected from self-made questionnaires,and analysis data.Results The survey shows that there are the problems of elective courses in the installation,time,management,contents,teachers,exam,and so on.Conclusion The system of elective course should be made perfect in construction,management and operation.

OBJECTIVE:To study the targeting of folic acid(FA)-modified docetaxel(DOC)nano-liposome(L-DOC-FA)to hepatocellular carcinoma Bel-7402 cells in vivo and in vitro. METHODS:The cell viability and survival rate of Bel-7402 cells was tested by CCK-8 kit after treated with 0,1,2,5,10 and 20 μg/ml DOC,L-DOC and L-DOC-FA for 24 h. And then,the fluores-cein isothiocyanate was used to label L-DOC and L-DOC-FA nano-liposome,and the rate of L-DOC and L-DOC-FA absorbed by hepatocellular carcinoma Bel-7402 cells were detected. 125I was used to label L-DOC and L-DOC-FA nano-liposome,and then the contents of them in the subcutaneous tumor tissues were detected. 28 Balb/c naked mice were selected and given liver cell suspen-sion via back ih to induce tumor model. After modeling,naked mice were divided into blank control group(normal saline),DOC group(3 mg/kg),L-DOC(3 mg/kg,by DOC)and L-DOC-FA(3 mg/kg,by DOC). They were given relevant medicine intrave-nously once a day for consecutive 30 d. The relative tumor volume in naked mice was detected. RESULTS:DOC,L-DOC and L-DOC-FA all inhibited the cell viability of Bel-7402 cells,the survival rate of cells decreased in concentration-dependant manner;compared with DOC and L-DOC,the cell viability decreased after treated with L-DOC-FA,the survival rate of cells decreased (P<0.01). The rate of L-DOC and L-DOC-FA absorbed by Bel-7402 cells in descending order as L-DOC-FA(69.5%)>L-DOC (31.2%),with statistical significance (P<0.01). The content of L-DOC-FA in tumor was significantly more than that of L-DOC (P<0.01). In addition,3 mg/kg L-DOC-FA showed better inhibitory effect than 3 mg/kg L-DOC and DOC on tumor,and the rela-tive tumor volume was smaller(P<0.01). CONCLUSIONS:L-DOC-FA has obvious targeting to Bel-7402 cells in vivo and in vi-tro,and shows good inhibitory effect on tumor in vivo and in vitro.

Objective To analyze the clinical and pathological characteristics of thyroid nodules.Methods A retrospective analysis of the clinical data of 2843 Han patients with thyroid nodules from January 2009 to June 2011 in Henan province was performed.Results The most high-risk of thyroid nodule resided in the group aged 45-54.The main pathological manifestation was simple nodular goiter.The rate of preoperative misdiagnosis was 2.4％.22.1％ of the patients with thyroid nodules showed abnormal thyroid function,which was mainly as subclinical thyroid dysfunction.The positive rate of thyroid peroxidase antibody (TPOAb) in patients with thyroid nodule was 19.8％ while that of thyroid globulin antibody (TgAb) was 20.0％.Among all 2843 subjects,the prevalence of differentiated thyroid carcinoma (DTC) was 28.8％,and the incidence of DTC was accompanied by raised TSH levels.The prevalence of DTC exceeded 40％ in patients aged between 25 to 34 as well as more than 74 years old.The prevalence of DTC was up to 33.8％ in TgAb positive patients.There was no difference in TPOAb levels between DTC patients and non DTC patients (P =0.406),but the TgAb level in patients with DTC was significantly higher than that of non DTC patients (P =0.033).Conclusion Thyroid nodule patients aged 25-34 or older than 74 formed high-risk groups of DTC.The serum TSH level and TgAb level were positively correlated with the risk of DTC.

Objective To investigate the clinical effect of phacoemulsification and individualized intraocular lens implantation in senile cataract patients with super high myopia.Methods Thirty-six cases of senile cataract patients with super high myopia with 49 eyes underwent phacoemulsification and individualized intraocular lens implantation,postoperative uncorrected distance visual acuity,best corrected visual acuity,diopter and surgical complications were observed.Results All surgical eyes visual acuity had improved to varying degrees,the postoperative far visual acuity in 0.05-0.30,the near visual acuity in 0.02-0.50,best corrected visual acuity 0.31-0.40 in 22 eyes (44.9％,22/49),≥ 0.5 in 14 eyes (28.6％,14/49).The postoperative diopter ＜-1.00 D in 3 eyes,-1.00 to-2.00 D in 16 eyes,-2.01 to-3.00 D in 27 eyes,and ＞-3.00 D in 3 eyes.Diopter difference with the goal ＜ ± 0.50 D in 21 eyes,± 0.50 D to ± 1.00 D in 18 eyes,＞ ± 1.00 D in 10 eyes.Postoperative corneal edema in 28 eyes,were completely disappeared within 1 week to 3 months,no retinal detachment and corneal decompensation and other serious complications.Conclusion Senile cataract patients with super high myopia are treated with phacoemulsification and individualized intraocular lens implantation,visions improve ideal and have good clinical efficacy.

CD4(+)CD25(+)CD127(dim/-) regulatory T cells (Tregs) have been implicated in suppressing T cell immune responses to hepatitis B virus (HBV), but the inhibition mechanism has not being clear yet. This study investigated the effects of soluble FGL2 (sFGL2) secreted by Tregs on immune suppression in chronic HBV-infected patients. We verified that sFGL2 protein and mRNA were highly expressed in Tregs. The separated Tregs by using magnetic beads from peripheral blood mononuclear cells (PBMCs) in 20 patients with chronic hepatitis B were co-cultured with PBMCs at a ratio of 1:3 with anti-CD3 stimulating antibody or FGL2 blocking antibody. The proliferation index of CD8(+)T cells after blocking FGL2 was higher than that in blank group (3.58±0.18 vs. 3.28±0.17, P=0.034) in 18 of 20 samples, and lower than that in CD3 stimulation group (3.82±0.19, P=0.026) in 16 of 20 samples. The IFN-γ secreted in the mixed culture in the absence of Tregs was higher than that in the culture in the presence of Tregs, but it could be abolished by FGL2 blocking antibody. These results suggest that sFGL2 protein secreted by Tregs suppresses the proliferation and function of CD8(+) T cells in chronic hepatitis B.

The noninvasive measurement of liver stiffness (LS) was evaluated by transient elastography (FibroScan) and the possible influencing factors from the patients' clinical situations including age, gender, liver inflammation represented by alanine transaminase (ALT) and total billirubin (TBIL) level, HBV replication (HBV DNA loads), portal vein pressure (portal vessel diameter, PVD), splenic thickness (SPT) and body mass index (BMI) were analyzed in patients with chronic hepatitis B (CHB). A total of 466 patients including 31 patients with acute-on-chronic liver failure (ACLF), and 435 patients with chronic hepatitis B (CHB) among which 82 patients were diagnosed with liver cirrhosis (LC) by clinical manifestations and liver B-type ultrasonic inspection were enrolled at Tongji Hospital from April to December 2009. LS was measured by a FibroScan device (EchoSens, France). Simultaneously, ALT and TBIL levels, HBV DNA loads, PVD, SPT and BMI in all patients were also tested. Forty-one healthy volunteers served as controls. The values of LS were correlated positively with ages of CHB patients and significantly higher in males than in females. In patients with BMI>28 kg/m(2) (obesity) and abnormal levels of ALT and TBIL, LS values were significantly increased as compared with those having normal levels of ALT and TBIL. The patients with ACLF had the highest LS value. Furthermore, LS values in the patients with LC were significantly higher than those in patients without LC. It is concluded that noninvasive measurement of liver fibrosis by FibroScan provides an alternative method to evaluate liver fibrosis of patients with CHB. In order to properly illustrate the stiffness value taken by transient elastography, patients' gender should be taken into consideration and it is also suggested to avoid possible influencing factors including liver inflammation (high levels of ALT and TBIL) and obesity (high BMI).

Objective To investigate the therapeutic indications,dosage and prognosis of dermato-mucous membrane heamangioma(DMMH)in infants using low-dose superficial X-ray irradiation.Methods The patients were treated with a superficial X-ray machine(DERMOPAN typeⅡ)at voltages of29kV,43kV and50kV according to the depth and position of angioma,one or two times per week,1~2Gy per time,with the average total doses of5~10Gy and the maximal dose of20Gy.Results In a total of267patients,230cured,24markedly improved,10improved,and3failed.The cure rate was86.14%,and the total improve-ment rate was95.13%.Conclusion Treatment of DMMH with low-dose superfical X-ray is simple,conve-nient,safe,painless and cheap.The method has a high cure rate and is well accepted by the chlidren and their parents.