Virtual Reality is just emerging as an accepted scientific discipline. It has been widely used in medicine. The major applications of virtual reality for medicine are introduced from three areas :virtual humans,the fusion of virtual humans with real humans and virtual telemedicine. The advanced graphics behind medical virtual reality,such as computational demands,hardware and software environments is briefly discussed. This article also gives a summary of existing distributed VR systems.

Objective To analyze the performance of a rapid immunofluorescence assay for plasma NT-proBNP. Methods Human plasma NT-proBNP was measured by RAMP in 264 healthy cases and 78 patients with heart failure. The precision, stability, linearity and interference factors of RAMP were evaluated according to the protocold from America CLSI. Meanwhile, the results were compared with those obtained by Elecsys. Results Functional sensitivity of RAMP in 20% CV and 10% CV were 48 ng/L and 57 ng/L respectively. The linear range was 18-8 000 ng/L. NT-proBNP in plasma samples detected by RAMP were stable at room temperature for 24 hours, 4 ℃ for 3 days and - 20 ℃ for 20 days. No influences on results were observed throughout three freeze-thaw cycles. The results measured by RAMP were compared between EDTA-K2 anticoagulant plasma and heparin anticoagulant plasma, which showed that YEDTA-K2 =0. 953 9 Xheparin + 0. 365 2 ( R2 = 0. 982, P < 0. 01, n = 40 ). The results of EDTA-K2 and heparin anticoagulant plasma using RAMP and Elecsys showed no significant difference( P ＞0. 05). Slight hemolysis( Hb 2 g/L)had small effect on the results of PAMP and Elecsys assays and deviations of them were below 5%. However median and heavy hemolysis( Hb 3-4 g/L )obviously influenced the results with deviation were more than 15%. The values measured by RMAP fell from 390 ng/L to 82 ng/L, and those measured by Elecsys method fell from 390 ng/L to 178 ng/L when 3 different concentrations of triacylglycerol were added, the values measured by two methods fell from 7 777 ng/L to 7 741 ng/L when bilirubin ( 16-330 μmol/L) was added. The anti-interference ability of RAMP method was similar to Elecsys. Results detected with two methods in 45 EDTA-K2 anticoagulant plasma samples were analyzed with Passing and Bablok regression.The regression equation was YRAMP = 0. 972 8XElecsys - 0. 035 2 (R2 = 0. 994, P ＞ 0. 05, n = 45 ). When heparin anticoagulant plasma samples increased to 78 samples, Passing and Bablok regression equation showed:YRAMP= 0. 983 2XElecsys - 0. 037 6 ( R2 = 0. 991, P ＞ 0. 05, n = 78 ). NT-proBNP levels in healthy adults were elevated along with age and related to the gender. The median value of female[105(60-120) ng/L] was higher than that of male [59 ( 44-91 ) ng/L, Z = 3. 264, P < 0. 01] significantly. Conclusions RAMP method has good repeatability, outstanding stability, and broad linear range. The results detected by RAMP is consistent with results detected by Elecsys.

OBJECTIVE:To provide reference for improving the pharmacy self-taught undergraduate course system in general universities in China. METHODS:According to comparative study and researching related literatures,the situation of pharmacy self-taught undergraduate course system in general universities in China was analyzed,and reform ideas and programs were present-ed. RESULTS & CONCLUSIONS:Based onchemistry-biology-psychology-society-medicine-pharmacyin the overall framework of pharmacy undergraduate self-examination course system,it was designed with target of cultivating applied talents;related con-tents in public basic courses,humanities basic course and professional ethics course should throughout the whole teaching process;professional main course should be pharmaceutical knowledge-based,supplemented by medical related courses;the school should set vocational elective course to reform based on combining with the own teaching research direction,characteristics and career ori-entation of different self-taught students. The reform can develop applied talents with ability and political integrity,which meets the needs of social development.

Objective To compare the effects of ephedrine and dopamine in the prevention of hypotension during combined spinal and epidural anesthesia (CSEA)for cesarean delivery.Methods Fifty ASAⅠorⅡ patients undergoing elective cesarean delivery were randomly divided into the two groups,Ephedrine group (n=5 1 ):intrave-nous injection of 10mg ephedrine before anesthesia;Dopamine group(n=52):continuous intravenous infusion at the speed of 5μg·kg-1 ·min-1 .During the whole process,we investigated the incidence rate of adverse effects,com-pared the Apgar score of neonate and analyzed blood gas of umbilical artery and vein.Results Compare to the dopa-mine group,the incidence rate of hypotension was lower in the ephedrine group (43.1% vs 69.2%,χ2 =7.06,P=0.00).The pH value of umbilical artery and 1 min Apgar score of neonate in the ephedrine group was lower compare with that in the dopamine group[(7.22 ±0.03)vs (7.27 ±0.06),t=0.62,P=0.02],there are no significant difference of 5 min Apgar score in the two groups.Conclusion Compared with dopamine,ephedrine is a useful drug in the prevention of hypotension during combined spinal and epidural anesthesia (CSEA)for cesarean delivery and there are no significant differences of adverse effects of dopamine and ephedrine.Ephedrine has transient effect on the neonate,while the effect of dopamine is minor.

A serocpidemiologic study was conducted to approach the relation between HBV infection and PLC. In PLC patients, the positivity rates of HBsAg and anti-HBc are higher than that in the tumor and donors groups, but that of anti-HBs is lower. No significant difference between the HBV infections rates for PLA patients and donors was found. HBV infections pattern of patients with liver cirrhosis is very close to that of those with PLC.The outcome prompts that there is a relation between HBV infection and PLC, but it is not only one.

Objective To explore the effects of self-management strategies on self-efficacy and selfmanagement behavior in female college students with primary dysmenorrhea.Methods Implementing the plan that the interventional group (n=195) received self-management strategies,while the control group (n =196) did not received any intervention.Followed up six months,the self-efficacy and self-management behaviors and Visual Analogue Scale/Score (VAS) of dysmenorrhea pain were compared between two groups before and after the intervention.Results At the 6th month of observation period,the scores of self-efficacy in the intervention group (2.61 ±0.48) were significantly improved compared with the baseline (2.37 ± 0.36) and the control group(2.43±0.46) (both P＜0.05).Besides taking medicine to alleviate dysmenorrhea,other items in the self-management behaviors were significantly higher than baseline and control group (both P＜ 0.05).The mean of dysmenorrhea pain VAS of 6th menstrual period in the intervention group was lower than baseline and the control group (P＜0.05).Conclusion The self-management strategies can effectively improve the self-efficacy and self-management behaviors among female college students,and alleviate the degree of dysmenorrhea pain.

Objective To investigate the relevance of liver function and neurobehavior of offspring of SD rats ex-posed to sodium valproate in the second trimester. Methods 30 SD rats at 12. 5 d of pregnance were randomly di-vided into three groups: low-dose group (300 mg/kg VPA was injected into abdominal cavity), high-dose group (600 mg/kg VPA);control group (normal saline). The offspring of low-dose groupe were grouped as VPA-low-dose;the offspring of high-dose groupe were grouped as VPA-high-dose; and the offspring of control group were grouped as control group. Then, we tested the liver and neurological function of each group of offspring, respective-ly, and analyzed their relevance. Results The levels of serum total protein and albumin of the high-dose group were considerably lower than these of the low-dose group which were significantly lower than these of control group ( P<0. 01 for both total protein and albumin);the levels of ALT, AST and blood ammonia of the high dose group were drastically higher than these of the low dose group, which were dramatically higher than these of control group ( P<0. 01 ) . The duration and of stereotyped movement disorder in experimental group was markedly longer than this of the control group, while this of the high-dose group was notably longer than this of the low-dose group ( P<0. 01 );the frequency of the stereotyped movement disorder of experimental group was significantly more than this of the control group, while this of high-dose group was obviously more than this of the control group (P<0. 01). In the Morris water maze, the escape latency of the high-dose group was remarkably longer than this of low-dose group, which was observably longer than this of control group (P<0. 01);the swimming distance of the high-dose group was tremendously shorter than this of low-dose group, which was considerably shorter than this of control group ( P<0. 05 , P<0. 01 ) . Correlation analysis of liver function and neural behavior showed that the neurobe-havioral abnormalities were negatively correlated with level of total protein and albumin, and were positively related with the level of blood ammonia, ALT and AST ( P<0. 01 ) . Conclusion The VPA exposure in the second tri-mester leads to the decrement of serum albumin and total protein and to the increment of AIL, AST and blood am-monia;and it also causes the neurobehavioral abnormalities of offspring. The reduction of synthesis of liver albumin and the rise of ALT, AST and blood ammonia can influence the neurobehavioral abnormalities. And there were both of the factors which result in the neurobehavioral abnormalities of offspring exposured to VPA in the second trimes-ter.

Objective To assess the risk of emergent endotracheal intubations in pediatric intensive care unite (PICU ) and to de-termine the risk factors of complications .Methods A prospective study was conducted with unified tables to collected data of all e-mergent intubations occurring in PICU between November 2011 and May 2012 .All the children were divided into group of any com-plication and group of no complication .Results (1)69 .1% children of emergent intubations had complications including desatura-tion(67 .9% ) ,bradycardia(29 .8% ) ,vomiting (16 .7% ) .(2)Emergent endotracheal intubations were 1 .7 times more likely to occur off-hours .Off-hours intubations were associated with 2 .7 times the risk of complications as on-hours intubations .(3)In a multivari-ate logistic regression analysis ,the nasal tracheal intubation ,two or more attempts at intubation ,and off-hours intubation were asso-ciated with complications .Conclusion Emergent endotracheal intubation are 1 .7 times more likely to occur off-hours .off-hours in-tubations ,the nasal tracheal intubation ,two or more attempts at intubation ,are associated with complications .

The virtual reality teaching system of human skeletal anatomy developed in this paper is based on the advanced personal computer and uses the stereo glasses of ELSA 3D REVELATOR, mouse and keyboard to make up the human-computer interface. Using this system, students can take apart and assemble the skeleton, grasp single bone to rotate and zoom, learn the human skeletal anatomy in a vivid environment, and thus know more about motion physiology.

Objective To investigate the effect of nuclear factor-?B (NF-?B), NF-?B-inducing kinase (NIK) and I-?B in basic fibroblast growth factor (bFGF) promoting gene expression and signal transduction of tenocyte NF-?B. Methods Tenocytes isolated from rabbits were divided into 3 groups with 8 dishes: no bFGF (Group A), 2 ng/ml bFGF (Group B) and 10 ng/ml bFGF (Group C). Cells in all dishes were cultured for 5 days. The effect of bFGF on tenocytes proliferation was examined by means of growth curve analysis. The mRNA was isolated after 5 days and the gene expressions of NIK,IKK? and IKK? induced by NF-?B investigated by reverse transcription-polymerase chain reaction (RT-PCR). Results The growth curve moved forward with the dosage increase of bFGF. Gene expressions of NF-?B,NIK, I?B kinase (IKK)? and IKK? were 0.4? 0.2 , 0.4 ? 0.1 , 0.3 ?0.1 and 0.2?0.1 respectively in the Group B and 1.8?0.5,1.0?0.3, 0.8 ? 0.2 and 1.5 ? 0.4 in the Group C. Gene expressions were all up-regulated in the Groups B and C posterior to adding of bFGF. Conclusions bFGF stimulates tenocyte proliferation and up-regulates gene expression of NF-?B,NIK,IKK? and IKK?, as indicates that the signal transduction of promoting tenocyte proliferation by bFGF may be through NF-?B pathway.