Biochemistry is one of the important basic courses for medical speciality.This article discussed the four aspects of how to improve the quality of biochemistry instruction,such as strengthening young teachers'sense of responsibility in teaching,and building up their professional knowledge training and so on.To young teachers,this paper may be useful for improving the quality of medical biochemistry teaching.

Objective:This study aimed to investigate the role of mitochondrial fusion protein 2 (Mfn2) in chronic renal injury caused by cyclosporine A (CSA) and the possible mechanism.Methods:The model of chronic CSA nephropathy was established in rats. The rats were divided into solvent control group, CSA model group and normal control group. Serum creatinine and urinary protein levels were detected. The tubulointerstitial injury was observed by light microscopy. The changes of mitochondrial structure were observed by electron microscope, and the expression of Mfn2 was detected by Western blot.Results:The levels of serum creatinine and urinary protein in CSA model group at 2 and 4 weeks were significantly higher than those in control group and solvent group ( P<0.05). In CSA model group, tubulointerstitial injury was obvious, mitochondria swelling and deformation were found in tubular epithelial cells, and ridge disappeared. Compared with normal control group and solvent control group, the expression of Mfn2 in CSA model group was significantly decreased at 2 and 4 weeks ( P<0.05), and the expression of Mfn2 in CSA model group at 4 weeks was further decreased compared with 2 weeks ( P<0.05). Conclusions:Mfn2 may play an important role in the injury of tubular epithelial cells caused by cyclosporine.

Climacteric ; Depression ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Middle Aged ; Phytotherapy ; Sleep Initiation and Maintenance Disorders ; Syndrome

Disorders of sex development(DSD) include anomalies of sex chromosomes,gonads,reproductive ducts,and genitalia.Here,the term "intersex" is avoided because of its imprecision.The purpose of this review is to assist health care professionals in the provision of treatment,education,and support to children born with DSD and to their families.The goal of DSD treatment is to achieve the long-term physical,psychological,and sexual well-being of the patients.In the case of DSD it involves several principles.Providing medical and surgical care to deal with a complication that threatens to the patient's physical well-being;minimizing the potential for the patient and family to feel ashamed,stigmatized,or overly obsessed with genital appearance;delaying elective surgical and hormonal treatments until the patient can actively participate in decision-making;telling the truth to the family and the child and addressing psychosocial distress of the children and their parents.This approach is termed as "patient-centered".

BACKGROUND: Because the continuity and integrity of the trachea are likely damaged to some extent after tracheostomy, the implementation of sequential ventilation has certain difficulties, and sequential invasive-noninvasive ventilation on patients after tracheostomy is less common in practice. The present study aimed to investigate the feasibility of invasive-noninvasive sequential weaning strategy in patients after tracheostomy. METHODS: Fifty patients including 24 patients with withdrawal of mechanical ventilation (conventional group) and 26 patients with sequential invasive-noninvasive weaning by directly plugging of tracheostomy (sequential group) were analyzed retrospectively after appearance of pulmonary infection control (PIC) window. The analysis of arterial blood gases, ventilator-associated pneumonia (VAP) incidence, the total duration of mechanical ventilation, the success rate of weaning and total cost of hospitalization were compared between the two groups. RESULTS: Arterial blood gas analysis showed that the sequential weaning group was better than the conventional weaning group 1 and 24 hours after invasive ventilation. The VAP incidence was lowered, the duration of mechanical ventilation shortened, the success rate of weaning increased, and the total cost of hospitalization decreased. CONCLUSION: Sequential invasive-noninvasive ventilator weaning is feasible in patients after tracheostomy.

ObjectiveThe purpose of this study was to evaluate the effect of prostaglandin E1 (PGE1) on blocking the development of acute respiratory distress syndrome (ARDS) induced by acid aspiration. MethodsTwenty new Zealand rabbits were used. Dilute HCl was instilled into right bronchus of the rabbits. The rabbits were then divided randomly into two groups: injury group and treatment group. In injury group ( n = 10) rabbits received no treatment except mechanical ventilation. In treatment group ( n = 10) immediately after acid instillation the rabbits received an intravenous bolus of PGE1 followed by a continuous infusion. Blood gas, airway pressure and dynamic and static compliance were measured before and after acid instillation. Blood samples were taken from artery for determination of 6-k-PGF1α, TXB2, NO2-/NO3- and ET-1. The animals were killed and the wet/dry lung weight (W/D) ratio and total protein of bronchoalveolar lavage fluid(BALF) of right lung were measured. Microscopic examination of the lung was done. ResultsIn treatment group PaO2 was significantly higher than that in injury group after acid instillation. Plasma 6-k-PGF1α and NO2-/NO3- levels were significantly higher in treatment group while plasma TXB2 and ET-1 levels were significantly lower. W/D ratio and TP of BALF of right lung were significantly lower in treatment group. The inflammatory changes were diffuse in injury group while in treatment group they were localized and less severe. Conclusions PGE1 can lessen severity of ARDS induced by acid aspiration. It may protect pulmonary vascular endothelial cells through maintaining the balance between PGI2 and TXA2 and that between NO and ET-1 .

The process of tumorigenesis,local invasion and distant metastasis will produce a series of molecular changes,these genetic mutation or abnormal expression of molecules play a promoting role in hypercoagulation.At the same time,hypercoagulation also increases the risk of tumor progression.It is important to understand their specific processes and the molecular role,and it can provide theoretical basis for better management of patients,and has significance for developing more effective and security new anti-clotting drugs.

Objective:To analyse the coronary lesion of patients with rheumatic heart disease.Methods:Selective coronary arteriography in comparison with ECG,ECT and ultrasonography were performed on 66 cases with rheumatic heart disease from Aprll,1995 to April 1999.Results:Single or multiple stenosises of coronary artery were found in 10 cases (15.2%).Unsmooth lumen and multipl atherosclerosis plaques were found in 12 cases (18.2%),58 cases had atrial fibrillation.44 cases had ST-T changed or abnormal Q wave(66.7%).Mitral valve was demaged in all cases with ultrasonography.Conclusion:It is essential that patients with rheumatic heart disease to have valve replacement should have coronary arteriography. [

Objective To analyze the risk factors associated with postoperative respiratory failure (PRF) in elderly patients undergoing noncardiac surgery. Methods In a prospective randomized joint study, 582 patients conforming to the criteria established by the four medical centers were enrolled for analysis. Univariate analysis and multivariate logistic regression analysis were used to examine the relations between perioperative risk factors and PRF. PRF was defined as mechanical ventilation after operation lasting for more than 48h or reintubation and mechanical ventilation within 6h after extubation.Results Fifty-one patients developed PRF (8.8%) . Multivariate logistic regression analysis identified that the type of surgery, ASA physical status classification, history of COPD and plasma albumin upper abdominal surgery and peripheral vascular surgery. The reason that neurosurgery topped the list was that most neurosurgical patients suffered from severe head injury and postoperative mechanical ventilation was prolonged because of coma. Our study showed that physical status was also a significant predictor of PRF. According to ASA classification, one class higher increased the risk by 6.325 time s. Conclusion Based on these predictors of PRF, in high risk elderly patients necessary measures can be taken to decrease the development of PRF.

Objective Neutrophils (PMNs) play an important role in the myocardial injury-induced by ischemia/reperfusion. The purpose of the study was to assess the role of PMN in anoxia/reoxygenation (A/R) injury to primary cultured myocytes and the protective effects of desflurane preconditioning (DPC) .Methods Myocytes obtained from ventricle were cultured in MEM medium for 3 days. The cultured myocytes were then randomly divided into 4 groups : group Ⅰ A/R; group Ⅱ PMNs + A/R; group Ⅲ DPC + A/R and group Ⅳ DPC + PMNs + A/ R. In all four groups the cultured myocytes were subjected to anoxia by being incubated in a tightly closed incubator filled with 95 % N2 + 5 % CO, for 2 h, followed by one hour reoxygenation (95 % O2 + 5 % CO2). In group Ⅱ and Ⅳ 5.0 ? 106 ml -1 PMNs isolated from peripheral blood or bone marrow were added to the medium during the one hour reoxygenation. In group Ⅲ and Ⅳ the myocytes were exposed to 9 % desflurane for 1 h before A/R. The activities of lactic dehydrogenase (LDH) and creatine kinase (CK) and the concentration of cardiac troponin (cTnT) in the supernatant were measured before and at the end of the experiment. Cell survival rate, beating rate and arrhythmia rate of the cultured myocytes were also calculated under phase-contrast microscope before and at the end of the experiment.Results A/R caused significant increase in LDH and CK-MB activities, cTnT concentration and arrhythmia rates and decrease in beating rates except in group Ⅲ . The differences in LDH, CK-MB activities and arrhythmia rates between the baseline value and the value obtained at the end of the experiment were significantly lower in group Ⅳ than those in group D but still higher than those in group Ⅰ . The cell survival rate was significantly higher in group Ⅳ than that in grorp Ⅱ . Conclusion Neutrophil accentuates A/R injury while desflurane preconditioning attenuates neutrophil-mediated A/R injury to primary cultured myocytes.