With the rapid growth of foreign student education in China,specific development goals have been put forward. Although size of bachelor of medicine and bachelor of surgery students(referred to as MBBS students) is ranked the first place among foreign students with other majors in China,it faces difficulties,including decline in the quality of students,chaotic curricula,weak faculty team and a lack of managerial personnel. Seven colleges and universities in Jiangsu province which enroll MBBS students must strengthen cooperation and collaborative development,to increase contribution to the overall size and quality of foreign students education in the province and to jointly build the MBBS student education brand of‘study in Jiangsu’.

Objective To investigate the pathogenesis of hepatorenal syndrome(HRS),especially the role of the vasoconstrictor that and vasodilator that played in the process.Methods The patients were divided into two groups for observation:The patients of chronic hepatitis with HRS were observational group,the patients of chronic hepatitis without hepatorenal syndrome were control group.Immunoenzyme technique was used for detecting the quantity of renin、atrial natruretic polypeptide、nitric oxide and endothelin in blood and ascites of all patients in two groups respectively.Then we compared the data of the two groups.Results Compared with those of the control group,rennin and endothelin in blood and ascites of the observational group increased significantly(P

OBJECTIVE: To establish a simple and rapid HPLC method for the determination of serum concentration of isofosfamide.METHODS: With cyclophosphamide as internal standard,the serum sample was extracted on C18 solid phase extraction column and determined on Zorbox-ODS C18 at room temperature.The mobile phase consisted of acetonitrile-water(25∶75) at a flow rate of 1 mL?min-1 and a detection wavelength of 200 nm.RESULTS: The linear range of ifosfamide was 2.5～200 ?g?mL-1(r=0.999 9),with the lowest detectable limit at 0.5 ?g?mL-1(S/N=3).Both the intraday and interday RSD were less than 5%.The extraction recoveries of ifosfamide at high,middle and low concentrations were ranged between 89.3% and 93.6% versus 77.6%～82.3% in chloroform-treated serum samples.CONCLUSION: The method which uses the C18 solid phase extraction column is of high recovery,and the sample treatment by which is simple,rapid,accurate,and pollution-free,and it is applicable for the monitoring of serum concentration and pharmacokinetic study of isofosfamide.

ObjectiveTo investigate the efficacy and toxicity of docetaxel combined with compound tegafur capsule(S-1)on anthracycline-refractory recurrent metastatic breast cancer (ARMBC).Methods Thirty-eight ARMBC patients were given intravenous 70 mg/m2 docetaxel at day 1,and oral 60 mg/m2 S-1twice every day at day 1 to 14.Every 3 weeks was one cycle and each patient received at least two cycles.ResultsAfter treatment,among these 38 patients,there was 2 complete response (CR) (5.3 ％),20 partial response (PR) (52.6 ％),10 stable disease (SD) (26.3 ％),and 6 progressive disease (PD) (15.8 ％).Overall objective response rate was 57.9 ％ (95 ％ confidence intervaal: 42.6 ％-74.2 ％) while clinical benefit response rate was 73.7 ％ (95％ confidence interval: 58.4 ％-89.1％).The median time to progression (TTP) was 7.8 months(95 ％ confidence interval:6.7-8.9 months),and median overall survival time(OS)was 15.7 months (95 ％ confidence interval: 12.9-18.8 months).The main toxic reaction was myelosuppression,and grade Ⅲ and Ⅳ adverse events including leucopenia occurred in 21.1％ of all cases.Most common grade Ⅰ and Ⅱ adverse events,such as hand-foot syndrome,nausea,vomiting,diarrhea,liver dysfunction,and oral mucositis,were tolerable.ConclusionGood clinical efficacy is achieved in the therapy of metastatic breast cancer with docetaxel and S-1 combination regimen and toxic reaction is tolerable.

This study examined whether 1-methyl-tryptophan [1-MT, an indoleamine 2, 3-dioxygenase (IDO) inhibitor] could reduce CD4(+)CD25(+) regulatory T cells (Tregs) proliferation and improve the anti-tumor efficacy of dendritic cells (DCs) pulsed with tumor cell lysate in the mice bearing pancreatic adenocarcinoma. The models of pancreatic adenocarcinoma were established in C57BL/6 mice by subcutaneous injection of Pan02 cells. Eight mice which were subcutaneously injected with PBS served as control. The expression of IDO was determined in tumor draining lymph nodes (TDLNs) and spleens of the murine pancreatic adenocarcinoma models. The prevalence of Tregs was measured in the TDLNs and spleens before and after 1-MT administration. The dendritic cells were pulsed with tumor cell lysate for preparing DC vaccine. The DC vaccine, as a single agent or in combination with 1-MT, was administered to pancreatic adenocarcinoma mice. The anti-tumor efficacy was determined after different treatments by regular observation of tumor size. The results showed that the levels of IDO mRNA and protein in tumor-bearing mice were significantly higher than those in the normal control mice. The percentage of Tregs in the spleen and TDLNs was also higer in tumor-bearing mice than in normal control mice (P<0.05). Foxp3 expression was significantly lower in the TDLNs and spleens of tumor-bearing mice administrated with 1-MT than that in normal control mice. Furthemore, in the mice that were administered 1-MT plus DC vaccine, the tumor was increased more slowly than in mice treated with DC vaccine or 1-MT alone, or PBS on day 36 (P<0.01). Our results indicated that 1-MT may enhance anti-tumor efficacy of dendritic cells pulsed with tumor cell lysate by downregulating the percentage of Tregs.

Objective To investigate epidemic status and explore the influential factors of pulmonary tuberculosis (PTB) in the servicemen of armed forces and to provide reference basis for control and prevention. Methods According to the questionnaire, the test of PPD (purified protein derivative), X-ray checking and sputum bacteria culture method had been used. A 1∶1 matched case-control study was carried out in the servicemen with 162 cases and 162 controls. Odds ratios (ORs) were calculated for the relevant factors. Results The prevalence rate of activated tuberculosis, the bacteriological positive prevalence rate, the smear positive prevalence rate and PPD positive reaction rate respectively were 176.66/105, 33.12/105, 22.08/105 and 34.31%. The prevalence rate of officers was obviously higher than that of soldiers, and the army resident in the countryside was higher than that in the city. The prevalence rate of high training intensity was higher than that of low training intensity. With the increasing of the age and time duration in army, the prevalence rate of pulmonary tuberculosis and the positive rate of PPD reaction presented a ascending tendency. Single factor conditional logistic regression analysis showed that the occurrence of PTB was closely associated with training intensity, body mass index, the number of scar, housing condition, the contact history of infection source, area of enrollment and character, their ORs value were 5.12, 0.37, 0.42, 0.51, 1.82, 0.57 and 1.63 respectively (P

Objective To investigate the changes in metabolic indexes and anesthesia administration during perioperation in patients undergoing orthotopic liver transplantation. Methods Eleven patients who underwent orthotopic liver transplantation were selected. Their pH, BE, HCO 3 -, K +, Ca 2+, blood glucose, PT, APTT and FIB were assessed at 60 min of pretransplantation, 20 min and 40 min of liver transplantation, 20 min and 40 min of new liver reperfusion. Results The pH, BE, HCO 3 -, K +, Ca 2+ during 20 min and 40 min of liver transplantation decreased more significantly than those during pretransplantation 60 min, PT and APTT extended markedly, the level of blood glucose did not change markedly; pH, BE, HCO 3-, K +, Ca 2+ and the level of blood glucose during new liver reperfusion 20 min and 40 min increased significantly compared to those during liver transplantation 20 min and 40 min; PT, APTT and FIB did not change markedly. Conclusion Metabolic indexes during liver transplantation change more markedly than those during pretransplantation or new liver reperfusion.

Objective To study the relationship between expression of EGFR and E- cadherin and metastasis of esophageal cancer. Methods The expression of EGFR and E- cadherin in esophageal cancer tissues of 47 patients by LSAB immunohistochemistry method was studied. Results The positive rates of EGFR in distant metastasis group and local lymph node metastasis group were 47.62 % and 56.52 % respectively. They were higher than individual corresponding control groups(27.08 % and 26.32 %)(P

Mechanosensitive ion channels are mechanoreceptors that convert mechanical stimulation on the cell surface into intracellular electrical signal or chemical signal. In recent years, Piezo protein as a mechanically activated cation channel in eukaryotes has gradually become a research hotspot. Piezo1 and Piezo2 proteins are expressed in different organs and tissues of mammals, and tissues such as bones and joints are directly related to mechanical conduction. The intracellular effects caused by the conduction of mechanical force play a very important role in the treatment and prevention of orthopedic diseases. In this paper, the researches on Piezo protein mechanically activated cation channels in bone tissue, cartilage tissue, bone marrow tissue, intervertebral disc tissue and orthopedic diseases were reviewed.

Objective To investigate the clinical effect of nicorandil for treatment of patients with acute respiratory distress syndrome (ARDS).Methods A prospective randomized controlled trial was conducted. A total of 40 cases of patients with ARDS admitted to Department of Critical Care Medicine of Guizhou Provincial People's Hospital from October 2012 to October 2014 were enrolled, and they were randomly divided into two groups, 20 cases in each group. The two groups were treated with routine western medicine after admission. On this basis, the observation group was given nicorandil 10 mg, while the control group was given warm boiled water 10 mL, through gastric tubes 3 times a day, the therapeutic course being consecutive 5 days in both groups. The length of stay in intensive care unit (ICU), duration of mechanical ventilation after treatment, oxygenation index (OI), alveolo-arterial oxygen partial pressure difference (PA-aO2), positive end-expiratory pressure (PEEP), acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, Glasgow coma score (GCS) before and after treatment, the predicted death rate (PDR) and 28-day mortality were compared between the two groups. The predicitive factors for 28-day mortality were screened by binary logistic analysis.Results The length of stay in ICU and duration of mechanical ventilation of control group were longer than those of observation group, but the difference was not statistically significant [ICU length of stay (day): 14.55±12.71 vs. 9.15±6.00, duration of mechanical ventilation (day): 13.25±12.27 vs. 7.75±5.32, bothP > 0.05]. After treatment, the GCS was higher than that before treatment in control group and observation group (11.95±3.98 vs. 10.75±4.89, 12.95±3.67 vs. 12.20±4.56), while APACHE Ⅱ score, PDR and PEEP were all lower than those before treatment [APACHE Ⅱ: 21.05±8.58 vs. 24.90±5.63, 18.70±11.21 vs. 26.65±7.67; PDR: (47.71±29.49)% vs. (61.00±23.29)%, (36.79±18.49)% vs. (56.12±18.16)%; PEEP (cmH2O, 1 cmH2O = 0.098 kPa): 4.40±3.14 vs. 5.75±2.59, 3.80±2.55 vs. 7.55±3.32], but there were no statistically significant differences between the two groups before and after treatment (allP > 0.05). After treatment, the OI was significantly higher and the PA-aO2 was significantly lower than those before treatment in the two groups, and the degrees of improvement of the observation group were more remarkable than those of the control group [OI (mmHg, 1 mmHg = 0.133 kPa): 224.72±85.12 vs. 141.37±45.82, PA-aO2 (mmHg): 132.60±46.64 vs. 204.30±121.2, bothP < 0.05]. The 28-day mortality of observation group was lower than that of control group, but no statistically significant difference was seen [15% (3/20) vs. 25% (5/20),χ2 = 0.156,P > 0.05). Binary logistic regression analyses showed that the PA-aO2 [odds ratio (OR) = 0.958,P = 0.013, 95% confidence interval (95%CI) = 0.927 - 0.991], APACHE Ⅱ score (OR = 0.882,P = 0.010, 95CI = 0.803 - 0.970), GCS (OR = 1.399, P = 0.004, 95%CI = 1.111 - 1.761) and PDR (OR = 0.907,P = 0.002, 95%CI = 0.853 - 0.965) after treatment were the independent predictors of 28-day mortality.Conclusion Nicorandil can significantly improve oxygenation, but cannot reduce 28-day mortality in patients with ARDS.