The medical education of China and the United States was compared by analyzing the differences about educational system, teaching mode and teaching content in this paper. Standard-ization of the Chinese medical education system, improving clinical practice, teaching students by initi-ating questions and advanced medical education technology were recommended in China. This paper will inspirit and provide experience for the innovation of Chinese medical education.

Objective To study the relationship between soluble CD147 (sCD147) level in peripheral blood and serum lipid level and explore the effect of sCD147 on atherosclerosis in rheumatoid arthritis (RA). Methods The level of sCD147 in 36 patients with RA,36 patients with coronary artery disease (CAHD) and 30 healthy volunteers was detected by enzyme linked immunosorbent assay (ELISA) .The disease activity score (DAS28) in RA patients was evaluated and the correlation between sCD147 level and DAS28 score was analyzed.The serum lipid level of RA patients was detected by an automatic biochemical analyzer and the cor relation between sCD147 level and serum lipid level was analyzed.Results The level of sCD147 in serum of RA patients was significantly higher than that in patients with CAHD and healthy volunteers,sCDI47 level in the RA group with high DAS28 score was significantly higher than that with low or medium DAS28 score.In RA patients,elevated total cholesterol (TC) and triglyceride (TG) level was positively correlated with serum sCDI47 level (r=0.84,P＜0.05;r=0.87,P＜0.05;while slightly elevated,normal TC and normal TG had no correlation with serum sCDI47 level (r=0.41,P=0.21;r=0.14,P=0.57;r=0.49,P=0.87).Elevated or slight ly elevated LDL-C was positively correlated with serum sCD147 level (r=0.86,P＜0.05;r=0.81,P＜0.05), while no correlation could be found in the group with normal LDL-C level (r=0.78,P=0.22).The high density lipoprotein-cholesterol (HDL-C) level decrease in RA patients had no correlation with serum sCD147 level (r--0.04,P=0.96;r=0.13,P--0.87).Conclusion sCD147 may be involved in the pathogenesis of RA and associate with disease activity.Elevated sCD147 level may be associated with abnormal serum lipid in RA.

Objective To investigate the effects of penehyclldine hydrochloride postconditioning on hind limb ischemia-reperfusion (I/R) injury in rats. Methods One hundred and forty-four male Wistar rats weighing 220-250 g were randomly divided into 4 groups (n = 36 each): control group (group C), I/R group, ischemic postconditioning group (group IPO) and penehyclidine hydrochloride postconditioning group (group PHPO). Limb ischemia was induced by occlusion of bilateral hind limb for 3 h followed by 24 h reperfusion. In group IPO, the animals were subjected to three cycles of 30 s reperfusion and 30 s ischemia on the proximal part of the hind limb,while in group PHPO, the animals received iv injection of penehyclidine hydrochloride 0.15 mg/kg (in normal saline 1 wl) via the caudal vein immediately after reperfusion. Blood samples from the inferior vena cava were taken for determination of activities of serum LDH and CK and concentrations of TNF-α and IL-10 at O, 1, 3, 6, 12 and 24 h of reperfusion. Then 6 rats were sacrificed at each time point respectively and the quadriceps femoris tissues of the hind limb were removed for determination of MDA content, activities of SOD, MPO, Na+ -K+-ATPase and Ca2 + - Mg2+ -ATPase, and HIF- 1 α expression and microscropic examination. Results Compared with group C, the activities of serum LDH and CK and concentrations of TNF-α and IL-10 were significantly increased, the activities of SOD, Na+-K+-ATPase and Ca2+-Mg2+-ATPase were decreased, MPO activities and MDA content were increased, HIF-1α expression was up-regulated in group I/R, IPO and PHPO (P ＜0.05 or 0.01). Compared with group I/R, the serum activities of serum LDH and CK and TNF-α concentration were significantly decreased, IL- 10concentration was increased, activities of SOD, Na+ -K+ -ATPase and Ca2+ -Mg2+ -ATPase were increased, and MPO activity and MDA content were decreased, HIF-1α expression was down-regulated (P ＜ 0.01), and the pathologic changes was reduced in group IPO and PHPO. Compared with group IPO, the serum LDH activity and TNF-α concentration were significantly decreased, CK activity and IL-10 concentration were increased, activities of SOD and MPO and MDA content were decreased and HIF-1α expression was down-regulated (P ＜ 0.05 or 0.01).Conclusion Penehyclidine hydrochloride postconditioning can reduce hind limb I/R injury in rats, and the mechanism is related to inhibiting inflammatory response and lipid peroxidation, reducing calcium overload and improving cellular energy metabolism.

Objective To investigate the toxicity of lidocaine solid lipid nanoparticles (SLNs) in human neurons.Methods Lidocaine-loaded SLNs were prepared using high pressure homogenization.SHSY5Y cells were cultured in vitro and inoculated on 96-well plates (100 μl/well) at a density of 5× 105 cells/ml.SH-SY5Y cells were randomized into 10 groups (n =30 each) using a random number table:control group (group C), different concentrations of lidocaine groups (L1-4 groups), different concentrations of lidocaine SLN groups (L-SLN1-4 groups), and blank SLN group (group SLN).The cells were cultured routinely in group C.The cells were incubated with the culture medium containing lidocaine with the final concentrations of 1.000％, 0.500％, 0.250％ and 0.125％ in L1-4 groups, respectively.In LSLN1-4 groups, the cells were incubated with the culture medium containing lidocaine SLNs with the final concentrations of 1.000％, 0.500％, 0.250％ and 0.125％ in L1-4 groups, respectively.Before incubation (at the corresponding time points in group C), and at 1, 12 and 24 h of culture or incubation (T0-3) , 6 wells in each group were selected for measurement of the cell survival rate (using methyl thiazolyl tetrazolium assay).The cell morphology was examined with optical microscope at T3.Results Compared with that at T0, the cell survival rate was significantly decreased at each time point in L1-4 and L-SLN1,2 groups, at T2,3 in L-SLN3 group, and at T3 in L-SLN4 group (P＜0.05) , and no significant change was found in SLN and C groups (P＞0.05).The cell survival rate was significantly lower at T2,3 in L1-4 and L-SLN1-3 groups, and at T3 in group L-SLN4 than that at T1, and at T3 in L1-4 and L-SLN1-4 groups than that at T2 (P＜0.05).Compared with group C, the cell survival rate was significantly decreased at each time point in L1-4 and L-SLN1,2 groups, at T2,3 in group L-SLN3, and at T3 in group L-SLN4 (P＜0.05) , and no significant change was found in group SLN (P＞0.05).Compared with group L-SLN at the corresponding concentration, the cell survival rate was significantly decreased at each time point in group L1-4 (P＜0.05).Conclusion Lidocaine SLNs have toxic effect on human neurons, but the effect is weaker than that caused by Iidocaine solution.

Objective:To investigate effects of viola on macrophage TOLL-like receptor expression ,and tentatively explore the partial mechanism of viola intervention on macrophage function.Methods: Using viola water decoction lavage intervention in clean grade SD rats of conventional preparation containing serum ,In a certain concentration coculture with mouse peritoneal macrophages in 96-well plates.After 24 hours,cell phagocytosis activity was determined by neutral red uptake assay ,changes in expression levels of TLR-1,TLR-2,TLR-3,TLR-4,TLR-5 mRNAs were determined by RT-PCR.Results:Compared with the same concentration of normal serum group :(1 ) viola-containing serum group macrophage activity was significantly increased ( P<0.01 );( 2 ) Within certain concentration,viola containing serum group with increased or decreased expression levels of TLR -1,TLR-2,TLR-3 mRNA(P<0.05 or P<0.01 ) ,the expression level of TLR-4 was not significantly altered in each group ( P>0.05 ) ,and the expression level of TLR-5 was significantly increased in each group ( P<0.01 ).Conclusion:Viola-containing serum has obvious promoting effect on macrophage phag-ocytosis,the mechanism of which may be related to that this drug regulates and controls part of macrophage TOLL -like receptor expres-sion.

This study was aimed to objectively evaluate the validity and safety of normalized Tuina massage thera-py on the treatment of 240 infants with acute diarrhea, thus disseminate and promote the application of infantile Tuina massage therapy. This study is a multicenter, randomized, controlled trial of 240 cases with acute infantile diarrhea. The experimental group (180 cases) was treated with Tuina massage therapy. The main acupoints are Pi-jing, Da-chang, Lan-men. And the combining acupoint is San-guan. In the control group (60 cases), the pa-tients were orally administered with Smecta. The statistical analysis was conducted with SPSS 15.0. The compre-hensive curative effect, time point effect, safety and technical stability of infantile Tuina massage were evaluated in the treatment of acute diarrhea. The results showed that the comprehensive effect of cure rate in the experi-mental group was 75.6% (136/180), and that of the control group was 21.7% (13/60). It showed that the effect in the experimental group was significantly better than the control group (P < 0.001). Time point effect showed that the TCM Syndrome Total Score was significantly improved in experimental group compared with control group ( P < 0 . 001 ) . Tuina massage techniques were stable in each research center ( P > 0 . 05 ) . Furthermore , there was no side effect in both groups. It was concluded that the infantile massage technique is an effective therapy for the treatment of acute diarrhea . Meanwhile , it is a safe and stable therapy and is worth popularizing .

OBJECTIVETo explore the preventive effect of Qingyi Decoction (QYD) on post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis and hyperamylasemia.

METHODSOne hundred and twenty-five patients scheduled to receive ERCP were randomized by the digital table into three groups, two were medicated respectively with QYD (39 cases) and octreotide (42 cases), the other one was untreated for control (44 cases). Changes of blood levels of amylase, C-reactive protein (CRP), and interleukin-10 (IL-10), as well as the incidence of pancreatitis and hyperamylasemia was observed and compared.

RESULTSThe 4 h and 24 h post-operational blood amylase (U/L) was 132.03 +/- 75.29 and 153.15 +/- 78.69 in the QYD group, and 134.74 +/- 22.24 and 148.50 +/- 79.37 in the octreotide group, all were significantly lower than those in the control group (241.27 +/- 137.04 and 286.89 +/- 133.77), respectively. The 24 h CRP (mg/L) in both QYD and octreotide group (11.05 +/- 3.57 and 12.48 +/- 3.80) was also lower than that in the control group (17.70 +/- 4.93, P < 0.05), while the 24 h IL-10 (ng/L) in the QYD group (105.00 +/- 31.85) was higher than that in the octreotide group (77.98 +/- 33.13) and the control group (75.98 +/- 30.99) respectively. The incidence of pancreatitis in the QYD, octreotide, and the control group was 2.6%, 0 and 11.4%, that of hyperamylasemia in them 28.2%, 21.4%, and 56.8%, respectively. The occurrence rate of hyperamylasemia was lower in the QYD group and the octreotide group than in the control group (P < 0.05).

CONCLUSIONQYD could lower CRP and up-regulate IL-10 level, restrain the inflammation reaction and reduce the blood amylase level in the post-ERCP period, thus reducing the incidence of hyperamylasemia.

Adolescent ; Adult ; Amylases ; blood ; C-Reactive Protein ; analysis ; Cholangiopancreatography, Endoscopic Retrograde ; adverse effects ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Hyperamylasemia ; etiology ; prevention & control ; Interleukin-10 ; blood ; Male ; Middle Aged ; Octreotide ; therapeutic use ; Pancreatitis ; etiology ; prevention & control ; Young Adult

PURPOSEFor penetrating thoracic trauma, there is no consensus on whether operative exploration or conservative treatment is better. In this study, we compared the clinical effect of video-assisted thoracoscopic surgery (VATS) and thoracotomy on the patients with penetrating thoracic trauma.

METHODSFrom January 2000 to December 2010, 123 patients with penetrating thoracic trauma were treated in Affiliated Hospital of Chengdu University. Based on the inclusion criteria, 80 patients were enrolled and randomly assigned into VATS and thoracotomy group.

RESULTSThe operation time, amount of bleeding and drainage in VATS group were all lower than traditional operation (p < 0.05).

CONCLUSIONThe results indicate that VATS has the merits of shorter operation time, non-blind area, exact surgical path and less bleeding comparing with traditional operation.

Adult ; Female ; Humans ; Male ; Middle Aged ; Operative Time ; Thoracic Injuries ; surgery ; Thoracic Surgery, Video-Assisted ; methods ; Thoracotomy ; methods ; Wounds, Penetrating ; surgery

Antibiotics are the cornerstone to cure infectious diseases, however, it also destroys the intestinal inherent microflora, and may cause serious gastrointestinal dysfunction, such as abdominal distension, diarrhea, mucosal barrier damage etc. In severe conditions, it may induce intestinal sepsis. With the development of the human microbiology group program and the popularity of microbial sequencing technology, people can comprehend the effects of antibiotics on intestinal flora deeply, meanwhile the traditional biomedical model (the basis of bacterial disease) is questioned. It presents the effects and mechanisms of antibiotics on intestinal microflora and intestinal mucosal barrier function in detail and demonstrates the feasibility by the treatment of probiotics and fecal transplantation to construct "health-promoting microbes" to adjust gastrointestinal function, in addition, it can promote the rational use of antibiotics.

OBJECTIVETo evaluate the feasibility and stability of chemically conjugating IgM on collagen films.

METHODSIgM was labeled with 125I using the chloramine-T method. Six collagen films were randomly divided into two groups. In chemical coupling group 125I-labeled IgM was chemically coupled with the films through N-succinmiclyl-3- (2-pyridyl-dithio) propionate reaction. In control group 125I-labeled IgM was absorbed onto collagen films. The amount of IgM on the collagen films and the amount of IgM remained on the films after extensive rinsing with phosphate buffered saline were monitored by counting the radioactivity of 125I.

RESULTSThe amount of antibodies loaded onto collagen films in the chemical coupling group was 15 times higher than that on the control films, showing significant statistical difference (P < 0.01). And the stability of conjugation antibodies on collagen films was significantly better than the control films.

CONCLUSIONChemical coupling is an effective approach to immobilize antibodies on collagen for further plasmid DNA tethering.

Angioplasty, Balloon, Coronary ; instrumentation ; Animals ; Antibodies, Antinuclear ; metabolism ; Cattle ; Coated Materials, Biocompatible ; chemistry ; metabolism ; Collagen ; chemistry ; metabolism ; Genetic Vectors ; Immunoglobulin M ; metabolism ; In Vitro Techniques ; Mice ; Protein Binding ; Stents ; Surface Properties