According to teaching outline and clinical training characteristic of psychophy-laxis speciality(including Psychiatry and Medicopsychology),we explored how to strengthen the clinical thinking ability and clinical skill training for clinical medicine students based on cultiva-tion of elementary knowledge and theory,and we also established a set of more appropriate item system of clinical skills assessment so as to improve the practice quality in psychiatry and medical psychology departments.

Objective To establish a determining method for the content of berberine hydrochloride in Coptis chinensis Franch.and Xianglian pills.Method The sample was extracted and developed,the berberine hydrochloride was determined by thin layer chromatograph-fluorescence of spectrophotometry with Benzen-ethylaceate-isopropanol-methanol-ammonia water(6:3:1.5:1.5:0.5) as the developing system and Ex=365 nm,Em=409 nm.Result The calibration curve was linear in the range of 0.473～ 3.784 ?g,r=0.999 3.The recovery rate in Coptis chinensis Franch.was 99.03%,RSD=1.86%,and in Xianglian pills was 97.10%,RSD=1.09%.Conclusion The method is simple and accurate.

Objective To construct Hepatitis B Virus (HBV) Chinese-strain wild type and Lamivudine-resistant variant recombinant baculovirus. Methods 1.2-unit length HBV construct (adr serotype, C genotype) was cloned into the multiple cloning region of the pFastBac Ⅰ vector and then transformed into DH10Bac, in which homologous recombination occurred between the pFastBac vector and the inside bacmid with the help of helper plasmid. So HBV recombinant bacmid was produced and transfected into sf9 cells to generate a Recombinant HBV baculovirus called vAcHBVc. The viral titers were detected by immune plaque assay and TCID 50. Lamivudine resistance mutation (YVDD) was introduced by site-directed mutagenesis using continuous PCR. HBV YVDD recombinant baculovirus (vAcHBVcYVDD) was generated and titered as above. Meanwhile, the recombinant HBV baculovirus containing GFP reporter was constructed for evaluating the efficacy of transfection and titration of virus. Results Recombinant wild and YMDD variant HBV baculovirus were successfully developed and the titer was between 10~6～10~8pfu/ml through plaque assay. Conclusion Different kinds of recombinant HBV baculovirus could be generated rapidly and efficiently with Bac to Bac expression system. The developed recombinant HBV baculovirus could be further used in the study of anti-viral resistances.

Objective To investigate the Shenmai injection for the inhibition of hepatic and renal toxicity and leukocyte disorder during chemoradiotherapy in the women with advanced breast cancer. Methods 58 cases of female breast cancer patients with stage Ⅳ were selected and randomly divided into 2 groups, 29 cases of each group, and patients were treated with 5-hydroxytryptamine (5-HT3) receptor antagonists and white blood cell growth hormone and other conventional therapy, the control group received gemcitabine plus cisplatin chemotherapy, 28d for 1 cycles, the treatment group received more with Shenmai injection, interval was 15d, 2 groups were treated for 3 cycles. Levels of peripheral blood T lymphocyte subsets, cytokine levels and liver and kidney function, quality of life and clinical efficacy were compared. Results Compared with before treatment, levels of CD3+, CD4+ and CD4+/CD8+ in control group decreased (P<0.05), levels of CD3+, CD4+ and CD4+/CD8+ in treatment group increased (P<0.05), levels of CD8+ decreased(P<0.05), levels of IFN-γ, IL-2 and TNF-α increased(P<0.05), levels of IL-6 decreased(P<0.05), scores of KPS increased(P<0.05), scores of FACT-B decreased(P<0.05), levels of ALT, AST, BUN increased(P<0.05), and levels of CCr, WBC counts decreased(P<0.05), and compared with the control group, levels of CD3+ , CD4+ and CD4+/CD8+ in the treatment group were higher(P<0.05), levels of CD8+ were lower(P<0.05), levels of IFN-γ, IL-2 and TNF-α were higher(P<0.05), levels of IL-6 were lower(P<0.05), and the total efficiency was higher(P<0.05), levels of ALT, AST, BUN were lower (P<0.05), and levels of CCr, WBC counts were higher (P<0.05). After treatment, the efficacy of treatment group was higher than that of control group(Z=-2.142,P=0.032<0.05). Conclusion Shenmai injection can improve the efficacy of radiotherapy and chemotherapy in patients with advanced breast cancer, and it can effectively inhibit the liver and kidney damage and leukocyte disorder.

Objective To observe the clinical efficacy of acupuncture plus Chinese medicine iontophoresis in treating dry eye syndrome.Method Sixty-two patients with dry eye syndrome were randomized into a treatment group and a control group, 31 cases in each group. The treatment group was intervened by acupuncture plus Chinese medicine iontophoresis, while the control group was intervened by artificial tears. After 4-week treatment, the changes of tear secretion, tear film break-up time (BUT) and symptoms score were observed, and the clinical efficacies were compared.Result The total effective rate was 87.1% in the treatment group versus 61.3% in the control group, and the between-group difference was statistically significant (P<0.05). The total symptoms score, tear secretion and BUT were significantly changed after the treatment in both groups (P<0.05). After the treatment, the total symptoms score, tear secretion and BUT in the treatment group were significantly different from those in the control group (P<0.05).Conclusion Acupuncture plus Chinese medicine iontophoresis is an effective method in treating dry eye syndrome.

Based on the anatomic data and fractal theory, the vascular tree model of forearms similar to actual vessel was established, and then the 3D heat transfer model of forearms based on the actual vessel anatomic structure was created. The model was analyzed and investigated with finite element method to explore the influential factors such as dimensional distribution of vessel, blood perfusion rate and external heat source for the 3D temperature field. The simulation results were consistent with the experimental data derived from Pennes. The model well reflects the regional difference of tissue temperature caused by the irregular distribution of vessel, and provides temperature guidance for tumor thermotherapy.

Objective To detect the antibiotic resistance of four kinds of gram-negative bacilli strains against seven antibiotics and to analyze the differences in antibiotic resistance between the strains isolated in intensive care unit (ICU) and common wards.Methods This study involved 3 238 gram-negative bacilli strains isolated in Beijing Tongren Hospital from January to December 2016.Of all strains, 46.6% were isolated in ICU (severe group) and 53.4% were isolated in common wards (general group).Resistance of these strains to seven kinds of antibiotics was detected and the differences between the two groups were analyzed.Results Antibiotic resistance rates of Pseudomonas aeruginosa strains to ceftriaxone, cefepime and imipenem were 41.7%, 41.2% and 39.5% in severe group and 20.9%, 21.7% and 17.1% in general group.Moreover, the differences between the two groups were all statistically significant (χ2Cefatriaxone=56.72, P<0.01;χ2Cefepime=49.12, P<0.01;χ2Imipenem=69.81, P<0.01).Antibiotic resistance rates of Klebsiella pneumoniae strains to imipenem was 17.2% in severe group and 8.8% in general group, and the difference between the two groups was statistically significant (χ2Imipenem=11.48, P<0.01).Resistance rates of Escherichia coli strains to ceftriaxone and cefepime were 72.9% and 35.8% in severe group and 44.7% and 13.3% in general group, and the differences between the two groups were statistically significant (χ2Ceftriaxone=40.13, P<0.01;χ2Cefepime=41.61, P<0.01).More than 60% of Acinetobacter baumanii strains whether they were isolated in ICU or in common wards were resistant to all the seven antibiotics, and there were no significant differences between the two groups.Conclusion Gram-negative bacilli strains isolated in ICU have higher resistance rates than those isolated in common wards and therefore antibiotics should be used differently.Regular monitoring of drug resistance should be strengthened to provide references for empirical clinical medication.

Objective: To develop a healthy personality scale for undergraduates.Methods: A healthy personality scale was developed based on interviews,open questionnaires and theory hypothesis.The test-retest reliability,split-half reliability,internal consistency reliability,construct validity were examined.Results: Exploratory principle factor analysis of the items indicated that the scale had three factors: self consistency and congruence,self-social harmony,practical ability,which explained 54.8% of the total variance.The Cronbach's ? coefficient ranged from 0.82 to 0.94,split-half reliability ranged from 0.70 to 0.85,and retest reliability ranged from 0.73 to 0.84.In the confirmatory factor analysis of the three factor model,fit statistics(RMSEA=0.07,NFI=0.95,NNFI=0.96,CFI=0.94,GFI=0.95) for the model best explained the observed relationship.The three dimensions and the total scale had significant positive correlations with self-esteem and subjective well-being and significant negative correlations with SCL-90.Conclusion: The results suggest the healthy personality scale with eligible psychometric quality,can be applicable to Chinese undergraduates.

ObjectiveDiabetes is an independent risk factor for coronary artery bypasss grafting(CABG). Off pump coronary artery bypasss (OPCAB) experience in 251 cases was reviewed to determine whether diabetes wou ld be applicable in OPCAB procedures.MethodsConsecutive 251 patients underwent OPCAB over 12 month period. This study included 71 diebetic patients (DM group) and 180 nondiabetic patients (NDM group). Preoperative v ariables were compared between the two groups by univariate analysis.R esultsNo differences were found regarding the length of stay in cardio intensive care unit [DM group(2.4?0.3)d; NDM group (2.4?0.3) d;P=0. 386], and sternal complication (DM group: 5.7%;NDM group: 3.9%;P=0.511) . In hospital complications were as follows: death rate(DM group: 2.8%; NDM gr oup: 1.1%; P=0.680); stroke (DM group: 2 8%; NDM group: 1 7%; P=0 623 ); hemofiltratioin renal failure (DM group: 2.8%; NDM group: 0.5%; P=0.194); myocardial infarction(DM group: 0%; NDM group: 0.5%;P=1.000); blood using were more frequent in DM group comparied with NDM group (P=0.111). ConclusionOPCAB in diabetic patients is as safe as in non diabetic patients.

Early diagnosis and early intervention for cognitive impairment after ischemic stroke can delay disease progression and prevent the occurrence of dementia.This article reviews the advances in research on ischemic stroke caused each risk factor for cognitive impairment.