The integrated course centered on organ system has been implemented for several years in Huazhong university of science and technology.Basic medicine courses were divided into three modules.Medical introduction Ⅰ was the first one which integrated nine basic medicine courses.Reform on teaching methods,teaching content,teacher training and experiment teaching were conducted and initial results were achieved.

A total of 115 patients with acute chest pain under the suspicion of acute myocardial infarction (AMI) were selected.By the onset time of chest pain,they were divided into two periods of ＜3 h and 3 -6 h respectively. Heart-type fatty acid binding protein (H-FABP)and such traditional cardiac biochemical markers as cardiac troponin T (cTnT),creatine kinase isoenzyme (CK-MB) and myoglobin (MYO) were tested to compare the sensitivity and specificity in the early diagnosis of AMI.The sensitivity of H-FABP was significantly higher than those of cTnT,CK-MB and MYO (P =0.026,0.005,0.048 ) ; the specificity of H-FABP was lower than those of cTnT,CK-MB in the diagnosis of AMI ( P ＞ 0.05 ).The sensitivities of H-FABP were 81.6％ and 78.1％ in the ST-elevation myocardial infarction (STEMI) and nonST elevation myocardial infarction (NSTEMI) groups respectively ( P =0.095 ).Regardless of the onset of chest pain at ＜ 3 h or 3 -6 h,the combination of H-FABP and cTnT had a higher sensitivity than those of cTnT,CK-MB and MYO in the early diagnosis of AMI (P =0.005,0.028).In the early and rapid diagnosis of AMI patients,H-FABP has a high sensitivity and a poor specificity.And it has some reference value.

Objective To investigate the correlations of body mass index (BMI) with plasma apelin, waist-hip ratio (WHR), fasting plasma glucose (FPG), glycosylated hemoglobin (HbAlc), biochemical indicator, blood fat and ultrasonic cardiogram (UCG) figures in patients with congestive heart failure (CHF).Methods A total of 41 elderly CHF patients (20 males and 21 females, aged 66.0±12.3 years) were divided into 3 groups according to BMI: normal group (n= 16), overweight group (n=13) and obese group (n= 12).And they were also divided into 2 subgroups: grade Ⅲ heart function group (n=22) and grade Ⅳ heart function group (n= 19).Enzyme linked immunosorbent assay was used to detect the levels of plasma apelin, and BMI, WHR, C-reactive protein (CRP), FPG, creatine kinase (CK), CK-MB, blood fat, electrolyte and UCG of all patients were detected .Results There were significant differences in waist circumference, hip circumference and WHR among the 3 groups (P<0.05 or P<0.01).But there were no significant differences in high density lipoprotein (HDL), low density lipoprotein (LDL), total cholesterol (TC), triglyceride (TG), FPG, HbAlc, CK, CK-MB, potassium, sodium, CRP, left ventricular internal diameter at end-diastole (LVIDd), left ventricular internal diameter at end-diastole (LVIDs), interventricular septal thickness at end diastole (IVSd) and left ventrieular ejection fraction (LVEF) among the 3 groups (all P> 0.05).The apelin level was higher in obese group than in normal group and in overweight group ((0.48±0.15) mg/L vs.(0.18±0.15) mg/L and (0.27±0.06) mg/L, both P<0.01].And the plasma apelin level was higher in grade Ⅳ heart function group than in grade Ⅲ heart function group [(0.35±0.16) mg/L vs.(0.26±0.13)mg/L, P<0.05].The level of plasma apelin was positively correlated with BMI, white blood cell, CK, hemoglobin and TG, and was negatively correlated with cardiac function and LVEF.The influencing factors for the plasma apelin were BMI (β=0.672, P<0.01), age (β=0.244, P<0.05) and HDL (β=-1.000, P<0.01).Conclusions The plasma apelin level is closely correlated with the development of heart failure.Cardiac dysfunction is more severer when the level of plasma apelin is higher.The high level of plasma apelin may be one of factors for the higher survival rate of the obese CHF patients.Plasma apelin level may be used as an indicator of state of illness.

Objective To analyze the coverage of iodized salt and the focus population iodine nutrition after implementing new standard of iodized salt in Hainan Province.Methods Eighteen cities (counties,districts) were divided into eastern coastal,western coastal and inland areas according to coastline and terrain of Hainan Province in 2013.One township (town,street) was sampled from each city (county,district) in the east,the west,the south,the north and the center of these areas.Four villages (committees) and 15 households in each village (committee),and 40 children aged 8-10 in one primary school,20 pregnant women and lactating women were sampled from each township (town,street).Iodized salt samples collected from household were monitored by the method of direct titration;random urine samples of children aged 8-10,pregnant woman and lactating woman were tested by arsenic cerium catalytic spectrophotometry.Results Totally 6 310 edible salt samples were tested,and the median of salt iodine was 25.9 mg/kg.The coverage of iodized salt was 97.92％ (6 179/6 310).Residents consumption rate of qualified iodized salt reached 95.47％ (6 024/6 310),and the rate of non-iodized salt was 2.08％ (131/6 310).About 4 444 urine samples of children aged 8-10 were examined,and the median of urinary iodine was 165.4 μg/L,in which suitable urinary iodine (100-199 μg/L) accounted 49.3％ (2 194/4 444);about 1 286 urine samples of lactating woman were examined,the median of urinary iodine was 122.3 μg/L,≥ 100 μg/L was 60.6％ (779/1 286);about 813 urine samples of pregnant woman were examined,the median of urinary iodine was 126.6 μg/L,59.6％ (485/ 813) of this group were urinary iodine deficiency (＜ 150 μg/L).There were significant differences between the three groups in the east,the middle and the west areas of Hainan Province (children:176.7,147.7,158.0 μg/L,lactating women:148.7,108.7,106.7 μg/L,pregnant women:146.7,108.0,147.1 μg/L,H =34.70,26.76,35.95,all P ＜ 0.01).Conclusion The results have showed that pregnant woman are iodine deficiency,they should be given more iodine.

Medical Solace Words are a kind of working language used by medical staff who tend to offer solace and encouragement to patients on purpose of medical treatment,and it is a kind of oral language frequently applied by medical staff in the new medical mode.Medical solace aims at decreasing and eliminating patients' negative emotions and improving their mood so as to establish a harmonious relationship between doctors and patients,and make the treatment smooth as well.This article analyzes medical solace words from the perspective of linguistic pragmatics,revealing that for the concealment and complexity of the expressing context for medical words,and the unique programmatic rules of medical language,medical staff should pay much attention to the language hierarchy and grasp the explanatory principle and the guiding principle of medical solace language to achieve the targeted effects of medical solace.

Objective To investigate the relationship between plasminogen activator inhibitor(PAI) activity and coronary artery disease(CAD) in elderly patients. Methods Plasma samples from 93 patients with CAD were analyzed for the PAI activity, plasminogen activator(t-PA) activity, serum levels of cholesterol and triglyceride. The values of these parameters were compared between the CAD and the control groups. Results Higher plasma PAI activity 〔(810?360) AU/L vs. (640?300) AU/L,P

OBJECTIVE:To study the antithrombotic effect of orientoside.METHODS:The effects of prophylactic oriento_side on the clotting time in vitro and the systemic clots dissolution of mice,the plasma prothrombin time(PT),the kaolin partial thromboplastin time(KPTT),the thrombin time(TT),and the platelet aggregation induced by ADP and the euglobulin lysis time (ELT)in rabbits were studied.RESULTS:As compared with the normal saline group,orientoside(1,2,and 4mg/kg)signi_ficantly prolonged the clotting time of mice in vitro,yet which had no significant influence on the systemic clots dissolution of mice;while orientoside(0.625,1.25 and 2.5 mg/kg)significantly prolonged the PT,KPTT and TT of rabbits,and significantly inhibited platelet aggregation of rabbits induced by ADP,yet which had no significant influence on the ELT of the rabbits.CONCLUSION:Orientoside can significantly inhibit the formation of thrombus.

Stereotactic radiotherapy is a rapidly growing treatment strategy for tumor due to the advances in target definition,radiation dose delivery,and image guidance of radiation.We reviewed the clinical application of stereotactic radiotherapy in the management of early stage non-small cell lung cancer including the technique,the workflow of the technique established,the outcome and relative radiation toxicity.

Objective To detect the proliferation of neural stem cells (NSC) and analyze the effects of taurine on NSC proliferation in rats with fetal growth restriction (FGR).Methods For in vivo experiment,pregnant rats were randomly divided into three groups:control group (n=5),FGR group (n=7) and taurine group (n=6) [treated with taurine,300 mg/(kg · d)].Rats in the latter two groups were fed with 40％ of food intake in control group throughout pregnancy to establish the FGR model.Fatty acid binding protein-7 (FABP-7) expression in brains was detected by immunohistochemistry.For in vitro experiment,pregnant rats were divided into two groups including control group and FGR group.FGR modeling was established in the same way as above.On the 14.5 day of pregnancy,NSC were isolated and cultured for five days to form neurospheres with different concentrations of taurine (control,0,5,10,15,20,30,40 mmol/L).Immunofluorescence staining was used to detect the expression of NSC-specific marker FABP-7.CCK8 test was used to detect the cell proliferating index.Neurospheres were collected at the end of culture and disaggregated to get the total number of viable cells.One-way ANOVA,Kruskal-Wallis Test,SNK-test and Tamhane's test were used for statistical analysis.Results Compared with the control group (18 012±3 016),the number of FABP-7-positive cells in FGR model group (10 173±1 728) was decreased (P＜0.05),but increased in taurine group (19 518±3 201) (F=200.8,P＜0.05).Free-floating neurospheres could be formed in both control and FGR groups and the cells within neurospheres were mostly FABP-7-positive and were then considered as NSC.The proliferation indexes in control,FGR,FGR+5 mmol/L taurine,FGR+10 mmol/L taurine,FGR+15 mmol/L taurine,FGR+20 mmol/L taurine,FGR+30 mmol/L taurine,FGR+40 mmol/L taurine groups were 1,0.80±0.07,0.92±0.11,1.33±0.24,1.20±0.15,1.11 ±0.14,0.80±0.12 and 0.82±0.08,respectively.The proliferation indexes in FGR groups treated with 10,15 or 20 mmol/L of taurine were significantly higher than that of FGR group without taurine interference (P＜0.05).The total cell numbers in the eight groups were (24.5 ± 0.6)× 105,(20.23 ± 1.09)× 105,(22.80 ±0.86) × 105,(27.53± 1.22)× 10s,(25.30±1.05)× 105,(22.70±0.72)× 105,(21.80± 1.80)× 105 and (18.06 ± 0.90)× 105,respectively.Compared with the FGR group without taurine interference,those treated with 5,10,15 or 20 mmol/L of taurine showed higher total cell numbers (all P＜0.05 or ＜0.01),while that treated with 40 mmol/L oftaurine was lower.Conclusions The number and proliferation of NSC in FGR fetal rat brains is significantly decreased,however,these could be reversed by antenatal supplementation of taurine.The best effect is shown when l0 mmol/L of taurine is given.

Objective To observe the application effect of mind mapping in the nursing teaching of higher vocational nursing students. Methods A total of 120 nursing students from 2014 four vocational nursing classes. First class and second class were observation group (60 cases), third classes and fourth classes were control group (60 cases). Nursing students in observation group unfold nursing teaching with mind mapping teaching method. Nursing students in control group unfold nursing teaching with traditional teaching method. The test results and teacher satisfaction with nursing students at the end of the period were assessed. And the evaluation of nursing students on mind mapping teaching method was compared. Results The scores of the instruments and materials, the performance of the operation steps, the technique and the achievement scores were (9.85 ± 0.40), (64.67 ± 1.64), (17.37 ± 1.25) points in the observation group and (9.22±0.64), (58.68±2.21), (14.18±2.23) points in the control group, the differences were significant(t =-8.440,-18.539,-10.881, P<0.05). The satisfaction degree of the control group was 78.3%(47/60) and the satisfaction degree of the observation group was 95.0%(57/60), and there was significant difference (χ2=5.550, P<0.05). Nursing students in observation group of mind mapping teaching hold a higher rating (t =11.32-5.25, P<0.01). Conclusions Mind mapping teaching method allows nursing students quickly master the nursing skills, improve teaching effectiveness, improve teaching nursing students′satisfaction, enhance clinical thinking and critical thinking skills.