Current undergraduate education in traditional Chinese Medicine combines classroom teaching with a small number of practical courses, which has showed its limitations of increasingly bad medical environment and employment situation. Nanjing University of Chinese Medicine explored new ways and means of medical education in recent years. Therefore, reforming based on the integration of clinical teaching pattern for TCM Bachelor has been carried out step by step. It meant that classroom teaching and clinical practice were fully integrated by moving classroom in the affiliated hospitals. It has been proved to work. With the experiences of the development, we have successfully explored a mature mean for the integration clinical teaching pattern. Here, we discussed the codes of such practice in order to strive to maximize the effectiveness of such practice.

ObjectiveTo investigate the expression characteristics of Caspase-8 in gastric carcinoma tissues and its correlation with clinical pathological features.Methods The mRNA and protein of Caspase-8 in gastric carcinoma and its surrounding tissues were detected by reverse transcription polymerase chain reaction (RT-PCR) and immunohistochemistry,respectively.ResultsThe Caspase-8 mRNA in gastric carcinoma tissues was obviously lower than that in its surrounding ones (0.154±0.065 vs 0.394±0.107,t =14.04,P ＜0.01),which was correlated with lymph node metastasis,tumor stage,differentiation grade (P＜0.01).The Caspase-8 protein in gastric carcinoma tissues was also significantly lower than that in its surrounding ones (31.48％ vs 85.19％,x2 =32.04,P ＜ 0.01),which was correlated with tumor stage,differentiation grade (P＜0.05).ConclusionsCaspase-8 is low-expressed in gastric carcinoma,which may play an important role in the occurrence and progression of gastric carcinoma.

Objective To investigate the efficacy of integrated traditional Chinese medicine (TCM) with Western medicine in treatment of diarrhea type irritable bowel syndrome (IBS-D) and its effect on serum inflammatory cytokine levels.Methods One hundred and sixty four IBS-D patients treated in Guangfu Hospital from July 2013 to August 2015 were randomly divided into study group and control group with 82 cases in each group.All patients received oral Saccharomyces boulardii 1.0 b.i.d, while patients in study group received additional Shuganjianpi decoction b.i.d for 4 weeks.The clinical efficacy was observed, serum IL-10, IFN-γ and TNF-α levels were measured in 2 groups.Results After treatment, the total score of clinical symptoms in study group was lower than that of control group [(5.71±1.41) vs.(11.70±2.88) points,t=16.707, P<0.01].Serum levels of IFN-γ, TNF-α in study group decreased significantly after treatment [IFN-γ (2.88±1.38) ng/L vs.(1.00±0.44) ng/L, t=11.609, P<0.01;TNF-α (41.26±5.29) ng/L vs.(24.13±3.27) ng/L,t=24.636, P<0.01], IL-10 significantly increased [(142.23±21.58) ng/L vs.(170.23±33.45) ng/L,t=6.291,P<0.01].The overall effective rate of study group was higher than that of control group, [87.50% (70/80) vs.68.75% (55/80), x2=8.228, P<0.01].After treatment, the quality of life scores in both groups were improved;but the improvement of diet, spirit, mood and sleep scores in study group were better than those in control group [(240±69) vs.(193±60), t=4.579, (316±74) vs.(230 ± 69), t=7.603, (297±62) vs.(228±59), t=7.211;(284±62) vs.(230±54), t=5.874, all P<0.01].Conclusion The efficacy of integrated traditional Chinese medicine with Western medicine in treatment of IBS-D is significantly better than that of Western medicine alone, which may be associated with its regulatory effect on the serum inflammatory cytokine levels.

The study used questionnaires to investigate clinical TCM master degree students who enrolled in the year of 2011 and 2012 about the implementation effect of training plan before and after standardization of resident training. The results showed that a lot of students in the year 2011 and 2012 were satisfied with their training plan and training mode. However, the ability of clinical skills and academic research improved much higher after standardization of resident training among the students in 2012. The study showed that our education training plan met the training goal and reflected achievements in the cultivation of medical master degree of TCM. The training plan and training mode were higher satisfied for the students in the year 2011 and 2012. The conception of tutor, training target, the relationship between clinical skills and scientific research should be improved in future.

Objective To investigate the role of sulfydral redox agent in the modulation of insulin secretion and the potential mechanism. Methods Insulin secretion was evaluated in INS-1 cells after treatment with different concentrations of glucose and sulfydral redox agents by a standard insulin radio immunoassay. Results Glucose concentration-dependently potentiates insulin secretion was observed in INS-1 cells. DTBNP and DTDP could not only significantly increase glucose-stimulated insulin secretion (GSIS), but also increase insulin secretion in nifedipine-pretreated cells, which could be abrogated by DTT. Importantly, pharmacological ablation of L-type calcium channels by nifedipine and/or ablation of K ATP channelby diazoxide both could potentiate glucose-induced insulin secretory. Conclusions Sulfydral redox agent could regulates GSIS. DTBNP and DTDP may increase insulin secretion via regulating the activities of KATP, L-type CaV channel and IP3 receptor.

Objective To investigate the results of follow-up visits of pregnancy course, delivery and infants of women who got clinically pregnant by assisted reproductive technique after gonadotropin-releasing hormone agonist (GnRH-a) added for luteal support, and to analyse the influence of adding GnRH-a in luteal support on the safety of mother and infant. Methods A retrospective analysis was carried out on the medical record from 215 patients who got clinically pregnant after luteal phase long regimen fresh-cycle transfer was operated. According to the differences in luteal support methods, the patients were assigned to Group A (124 patients, progesterone+dydrogesterone group), Group B (91 patients, GnRH-a added group). The patients′ pregnancy course, delivery time, and the growth and development of infants within 1-2 years were followed up. Results (1)There was no obvious difference between Group A and Group B in terms of the abortion ratio during the early pregnancy (8.1%, 12.1%), the rate of abortion villous deformity (50.0%, 9.1%), the rate of heterotopic pregnancy (10.5%, 5.5%) and rate of twin pregnancy (19.4%, 28.6%;all P>0.05).(2)Compared to group A, during the middle and late pregnancy of single or twin pregnancy in Group B , there was no obvious difference in the rate of fetal chromosomal abnormality, organ malformation incidence, late abortion rate and stillbirth rate (all P>0.05).(3)As to childbirth, in the case of twin pregnancy, there was a higher rate of premature delivery (60.0%, 39.1%;P=0.041), as well as rate of lower birth weight of newborn (56.0%, 34.8%; P=0.037) in group B.(4)The statistics on general growth and development as well as infantile common diseases within 2 years after birth indicated that there was no obvious difference between the two groups in single birth and twin birth subgroup (all P>0.05). Conclusion On the basis of controlling of implanted embryos and reducing the occurrence of twins, GnRH-a luteal support maybe relatively safe and effective.

The basic course of medical specialty is an important part of medical education. There are few studies on effective teaching of basic courses of medical specialty. Based on the course of Pharmacology, this paper discusses the connotation, influencing factors and strategies of effective teaching of basic courses of medical specialty. The factors influencing the effective teaching of basic courses of medical specialty are multiple, that mainly includes four dimensions: students, teachers, course resources and teaching environment. Strategies to improve teaching effect include strengthening the idea of education, positioning goals hierarchically, optimizing curriculum structure, and innovating education platform.

Applying the effective teaching theory to the small-class teaching of pharmacology can improve the flexibility of small-class teaching mode under the guidance of the concept of effective teaching and high efficiency. The course chapters were randomly selected for traditional teaching mode or small-class teaching mode based on effective teaching theory in the same class. Practice has proved that the small-class teaching based on AO-AMFM can enhance student analysis and make careful smart objective and teaching frame work before class, and can also reach prompt activation, multi-learning, effective feedback and multi-summary, which can significantly improve students' learning enthusiasm and learning efficiency.

Under the background of dual-track training mode, the current clinical program of professional master's graduate education lacks complete and unified content and requirements. We set out a unified teaching scheme of subspecialty, in the main subject acupuncture. We identified the teaching management and innovated the teaching and examination methods in the scheme. Our research gradually formed a multidisciplinary talents training system, as the foundation of developing the standardization training. This method could help to cultivate qualified graduates as the high quality talents for the national medicine development.

ObjectiveTo analyze the clinical distribution and antimicrobial resistance profile of Serratia marcescens(S. marcescens), and to provide the scientific evidence supporting clinical diagnosis and treatment.MethodsThe antimicrobial susceptibility test was performed in 104 strains of S. marcescens by agar dilution method. The results were judged according to the criteria recommended by Clinical and Laboratory Standards Institute (CLSI) 2010.The data were analyzed by chi square test. Results The majority of S. marcescens were isolated from sputum specimens,accounting for 59.6％ (62/104). The bacteria were most frequently isolated from department of respiratory (33.7％,35/104),followed by intensive care unit (23.1％,24/104),department of gerontology (16.3％, 17/104). The results of antimicrobial susceptibility test showed that the resistance rates of S.marcescens against ampicillin,gentamicin and cephazolin were high,which were 90.4％,86.5％ and 79.8％,respectively; those against the 3rd generation of cephalosporins were 24.0％-43.3％. No imipenem and meropenem resistant strains were identified. Compared with cefoxitin-resistant strains,the resistance rates of non-cefoxitin resistant strains against piperacillin (82.9％ vs 28.6％),ceftazidime (63.4％ vs 9.5％),aztreonam (68.3％ vs 9.5％),amikacin (68.3％ vs 20.6％),ciprofloxacin (48.8％ vs 19.1％) and chloramphenicol (90.3％ vs 58.7％) were all lower (all P ＜ 0.05 ). Conclusions S. marcescens is one of the most common conditional pathogenic bacteria leading to nosocomial infections,which is resistant to many kinds of antimicrobial agents.The surveillance of antimicrobial resistance in S. marcescens should be strengthened for purpose of preventing the transmission of multidrug resistant strains.