Objective To know about the research status of clinical teaching management and provide guidance for establishing and perfecting the clinical teaching management system.Methods We summarized the research progress on clinical teaching management at home and abroad,including clinical training mode,qualification requirement,core competence,assessment criterion and training for clinical adviser of Master of Nursing Specialist students.Results Our country has not formed a standard and unified system on clinical teaching management so far.Conclusions We should actively learn from foreign advanced management experience,combined with China's national conditions to establish clinical adviser management mechanism.

Objective:To evaluate the effects of different nutritional supports in gastric cancer patients undergoing radical resection.Methods:Sixty patients with gastric cancer were randomly divided into three groups: parenteral nutrition(PN)group,enteral nutrition(EN) group and parenteral nutrition combined with enteral nutrition(PN-EN) group.The rate of complication, recovery time of the gut function,average post-operative hospital stay,changes of liver function,levels of blood glucose,serum albumin,prealbumin and transferrin,levels of nitrogen balance and change of body weight were observed in the three groups.The therapeutic effects of post-operational nutritional support were studied.Results:There are no significant difference in the rate of complication,average post-operative hospital stay,changes of liver function and level of blood glucose.The recovery time of the gut function in EN group was shorter than that in PN and PN-EN groups(P

Thymosin ?1 is a multiple peptide of hormone and protein isolated from thymus gland,and it has many biological functions.It has been reported that it plays an important role in immune response,neuroendocrine modulation and gene expression.The article is to review the progress of thymosin ?1 and its mechanisms.

The etiology of Crohn's disease is not clear as yet,many evidences has shown that the dysfunction of the immune system is the internal cause of inflammation and tissue damage.It is identified that many immune diseases can be anticipated,monitored and therapeutic through detecting some specified serological markers.To identify some high specific sensitive and predictable markers and groups,the research of searching an ideal and non-incursive method for differentiating inflammatory bowel diseases from other disease is still undergoing.The current research of five serum immune markers that are usefulness in the diagnosis and management of Crohn's disease are summarized.

OBJECTIVE:The pathophysiology of myocardial fibrosis during hypertension is complicated.Recently,it has been shown that inflammatory response plays an important role in the pathophysiology of myocardial fibrosis.This review describes the relationships among hemodynamic stress,hormonal factors and inflammatory factors,and emphasizes the important position of inflammation during the progress of myocardial fibrosis.DATA SOURCES:Using the terms of "hypertension,myocardial fibrosis,inflammatory response,angiotensin,cytokines" in English and Chinese respectively,we searched Medline database,Chinese Biological Medicine Database (CBM) and CNKI to identify English and Chinese articles of clinical researches and experiments related to the effects of inflammatory response on myocardial fibrosis during hypertension published from January 1991 to May 2007.STUDY SELECTION:The articles were primarily checked.Only articles that reported inflammatory response and myocardial fibrosis were included.The repeated researches and experiments and Meta analysis were deleted.DATA EXTRACTION:A total of 641 articles have been selected.The titles of all the articles and most of the abstracts have been read,and 162 articles met the inclusive criteria whereas the other 479 articles were deleted.42 articles have been analyzed.DATA SYNTHESIS:During hypertension,the extracellular matrix expands because of reactive and reparative fibrosis,which at last results in myocardial fibrosis.Previous clinical and experimental studies showed that hemodynamic stress and hormonal factors affected the progress of myocardial fibrosis.While recently,there are growing evidences indicating that the immune system.related with hemodynamic stress and hormonal factors is activated during hypertension in the progress of myocardial fibrosis.Then the recruitment of inflammatory cells and factors,including chemoattractant proteins,adhesion molecules and cytokines,informing cytokines cascade response,in turn accelerate the progress of myocardial fibrosis.CONCLUSION:Inflammatory response may play an important role in the pathophysiology of myocardial fibrosis during hypertension and then accelerate the progress of heart failure.

Estrogen is involved in the process of postmenopausal osteoporosis, and the main functional cells are osteoclasts. However, the mechanism of estrogen on the osteoclasts is not yet fully understood. Here we demonstrate the effects of estrogen on osteoclasts in three aspects: morphology and structure, apoptosis of osteoclasts and differentiation of preosteoclasts, which give an overall explanation for effects of estrogen on osteoclasts.

Objective To summarize the experiences in treating 30 cases of skin soft tissue defects in head and neck by applying repeated expansion, and to explore an effective and satisfactory method of massive defect repair in head and neck. Methods Skin soft tissues were repeatedly expanded for 1 to 3 times after the first expansion. Massive skin defects in head and neck were repaired several times by useing repeated expansion of flap. The size of the skin defects ranged from 29cm?24cm to 10cm?8cm. The indications, complications and experiences in the treatment were discussed. Results A total of 30 cases were treated. Complication incidences of every expansive procedure were 27%, 15%, 14% and 0% respectively . After 6～12 months postoperative follow-up, the appearance and functional restoration was satisfactory. Conclusion Repeated expansion is an excellent method of repairing massive defects in head and neck.

There are some existing problems in controlling the quality of oxygen. In order to improve quality, efficiency and safety in the use of oxygen, we presented some factors which may give rise to variations in concentration of oxygen and proposed some suggestions based on the investigation and analysis of such problems.
Equipment and Supplies ; Oxygen

Objective To compare the expression changes of neuropeptide Y (NPY) receptor Y1 in different stages of osteoblast differentiation of rat bone marrow mesenchymal stem cells (BMSCs).Methods The rBMSCs were isolated in vitro from Sprague-Dawley (SD) rats using whole bone marrow adherence method and cultured. Then, the rBMSCs were divided into osteoblast-induced group and noninduced group. In different periods of culture at 1, 2 and 3 weeks, identification of the osteoblasts was performed by using immunocytochemistry and Western blot. Expressions of mRNA and protein of Y1 receptor were detected by real time reserve transcriptase-polymerase chain reaction (RT-PCR) and Western blot. Results RT-PCR demonstrated that osteoblast-induced group had a lower expression of Y1 receptor than non-induced group at the same time point and the expression of Y1 receptor was increased in a time-dependent manner in both groups. Western blot demonstrated higher expression of Y1 receptor in osteoblast-induced group compared with non-induced group at the same time point and a decreased expression of Y1 receptor in a time-dependent manner in both groups. Conclusions During the process of osteoblastic differentiation of rat BMSCs, the expressions of mRNA and protein of NPY Y1 receptor show different trends, when NPY may mediate the inhibition of osteoblastic differentiation of BMSCs through Y1 receptor pathway.

Objective To investigate the effects and mechanism of calcitonin gene-related peptide (CGRP) and substance P (SP) on proliferation of rat bone marrow mesenchymal stem cells. Methods The rBMSCs were isolated using whole bone marrow adherence method. In the different periods of culturing (1, 2,and 3 weeks), expressions of the neuropeptide receptors were detected by Western Blot and reserve transcriptase-polymerase chain reaction (RT-PCR). The BMSCs were treated with CGRP and SP at concentration 10-8 mol/L at different time (1,3,5,7,9 days), cell proliferation was detected with MTT assay, the protein expressions of cyclin D1 ,cyclin E and p53 were examined using Western Blot. Results The CGRP receptor and SP receptor were expressed in BMSCs. The expression of CGRP receptor was statistically higher than that of SP receptorat the same time point. The growth curves of BMSCs cultured by both neuropeptides had similar appearance. CGRP and SP stimulated the proliferation of BMSCs significantly at 9 days and 7 and 9 days. In this process, the expressions of cyclinDl and cyclinE were up-regulated by CGRP, SP only enhanced the expression of cyclinE; these effects all reached a peak at 5 days. The expression of p53 was down-regulated by both neuropeptides. Conclusion CGRP and SP had direct effects on the proliferation of BMSCs, the regulation of cell cycle proteins is one of the mechanisms.