In the basic skill teaching of "Diagnostics Foundation"in Chinese medicine colleges and universities, the standardized patients are used to strengthen students’ clinical basic skill,let them consolidate their theoretical knowledge and change it into their skills,which is an effective way to guarantee the students to enhance their"double-base"ability,namely the elementary theory and clinical basic skill,and their self-confidence and shorten the time from the classroom to the clinical practice running-in period.

Objective To investigate the safety and efficacy of long-term low doses of Azithromycin combined with Budesonide/Fomoterol in the treatment of stable Ⅲ to Ⅳ COPD patients. Methods Collect the confirmed COPD patients of our hospital, they were randomly divided into two groups: the control group (160μg/ 4.5 μg, Bid), the joint group (160 μg/ 4.5 μg/ Bid + azithromycin 250 mg qd). Then Observe the PEF, FEV1, FEV1/FVC, mMRC, 6 MWT, AECOPD of the two groups after treatment for 3 months and 6 months. Results the index of PEF, FEV1, FEV1/FVC of joint group improved more significantly (P < 0.05) than control group after 6 months; the mMRC, 6 MWT, AECOPD, of the two groups improve the similar degree in terms of 3 months (P > 0.05), joint group improved more significantly than control group after 6 months (P < 0.05). Conclusion the therapy of Long-term low doses of azithromycin combined with Budesonide/Fomoterol can more significantly improve lung function index , as the treatment time extended , it can significantly improve clinical symptoms ,reduce the number of exacerbations than single inhaled Budesonide/Fomoterol .

Aim: To establish a method for the determination of pantoprazole sodium and its related substances. Methods: A column packed with octadecylsiance bonded silica gel (250 mm × 4. 6 mm, 5 pjn) was used. The 0. 01 mol/L monopotassium phosphate solution( adjusted with phosphoric acid to pH 7. 0) -acetonitrile were adopted as the mobile phase, a gradient elution was programmed as follows: 0→30 min(90:10-60:40), 30→45 min(60: 40→15: 85); the detection wavelength was 289 nm; the column temperature was 40 ℃; the flow rate was 1. 0 mL/min. Results: Pantoprazole sodium, the intermediates and its related substances could be well separated. A good linear relationship was obtained over the range of 6. 96-48. 72 μg/mL( r =0. 999 9). The limit detection and quantisation of pantoprazole sodium were 8.51 ng and 17.0 ng, respectively. Conclusion: This method can be applied to control the related substances of pantoprazole sodium and determine pantoprazole sodi-um.

Objective To explore the value of 18F-fluorodeoxyglucose（18F-FDG）PET-CT and CT in diagnosing bronchioloalveolar carcinoma （BAC）.Methods The PET-CT and CT findings of 15 patients with BAC pathologically confirmed were retrospectively analyzed.Results According to 18F-FDG PET-CT,there was definite diagnosis of malignant in 8 cases（53.3 %）,no exclusion of malignancies in 2 cases （13.3%）,definite diagnosis of benign tumors in 5 cases（33.3%）.The misdiagnosis rate of 18F-FDG PET-CT is higher.According to CT,there was definite diagnosis of malignant tumors in 11 cases（73.3 %）,no exclusion of malignancies in 2 cases（13.3%）,definite diagnosis of benign tumors in 2 cases（13.3%）.Conclusion The false negative rate and the misdiagnosis rate are high when SUVmax as 2.5 was employed as criteria in the diagnosis of BAC.To improve diagnosis accuracy and decrease misdiagnosis of BAC,we should be familiar with the CT images of different BACs and adjust the SUVmax as a diagnosis value.

0.05).Both HMGB1 mRNA expression and HMGB1 protein level were remarkably higher in LPS treatment group than that in control group(P0.05).CONCLUSION:RPM inhibits HMGB1 expression not only by directly suppressing STAT3 activation,but also by indirectly reducing TNF-? level.

Adult ; Aged ; Cartilage Diseases ; diagnosis ; therapy ; Humans ; Laryngeal Cartilages ; Laryngeal Diseases ; diagnosis ; therapy ; Male ; Middle Aged

Objective:To investigate the expression and function of CD226 on NK s ubsets and its coexpression with other activation receptor and inhibition recept or on NK cells. Methods:The expression of CD226 on CD56 bright and CD56 dim NK subsets and coe xpress ion with CD16 and NKG2A in PBMC and MLC in the presence or absence of IL-2 or IL-15 were detected by double fluorescent staining and flow cytometry analysis. The level of IFN-? in the supernatants of PBMC culture and MLC treated with o r without IL-2 or IL-15 were evaluated by ELISA. 51Cr release assay w as employed to measure the specific lysis of NK cells killing target K562 cells. Results:CD226 was mainly expressed on CD56 dim NK subsets in PBMC. When s imulated by IL-2, CD226 expression was shifted to CD56 bright NK subsets, while IL-15 increased the subpopulation of NKG2A+CD226+double positive cell s. In MLC-generated NK cells, CD226 was mainly expressed on CD56 dim NK su bsets, and also shifted to CD56 bright NK subsets in the addition of IL-15 . Furt hermore, the percentage of CD16+CD226+和NKG2A+CD226+ subsets were increa sed when stimulated by IL-2 or IL-15. There was great increase in IFN-? lev el in the supernatants of PBMC culture in the presence of IL-2 or IL-15, but no difference in the supernatants of MLC treated with or without two cytokine s. Moreover, the cytotoxicity of NK cells in PBMC and MLC were greatly enhanced by IL-2 or IL-15. Conclusion:CD226 is mainly expressed on CD56 bright NK subsets in IL-2 or IL-1 5 activated NK cells, and is coexpressed with CD16 and NKG2A preferentiatly, whi ch maybe involve in the modulation of cytotoxicity of NK cells based on the balance of coexpressed activation and inhibition receptors. [

BACKGROUND: Esophageal replacement or reconstruction should be performed after esophageal resection. There are still no suitable substitutes for esophagus if the conventional esophageal substitutes cannot be used.OBJECTIVE : To investigate the feasibility of applying a pulmonary tissue with vascular pedicle to repair the intrathoracic esophageal defect.DESIGN: A prospective animal investigation.SETTING: Department of Thoracic Surgery, Second Hospital Affiliated to China Medical University.MATERIALS: This trial was carried out in the laboratory of Department of Thoracic Surgery, Second Hospital Affiliated to China Medical University during January 2003 to June 2004. Fourteen adult mongrel dogs of either gender, with body mass of 12 to 18 kg, were provided by Animal Room, Second Hospital Affiliated to China Medical University (License No.SYXK (Liao) 2003-0019).METHODS: Of 14 anesthetized dogs, the middle lobe of right lung was dissected and its right middle lobar bronchus was ligated without damaging pulmonary and bronchial vessels in order to make pulmonary flap. A part of full-layer intrathoracic esophageal wall was resected, which was 4 cm long and 1/2 to 2/3 circled esophageal wall. The defect was patched by pulmonary tissue with vascular pedicle which was inosculated with esophageal cross section. On the 3rd day after operation, intravenous transfusion was performed to maintain nutrition. Qn the 7th day after operation, the dogs were given oral liquid soft food gradually 2 weeks after the operation. The access to the food and the survival of dogs were observed. Every 2 dogs were sacrificed respectively at the 2nd, 4th, 6th, 8th and 10th postoperative weeks. To observe the healing of esophageal defect, light microscope, transmission electron microscope, esophagography and endoscope were used in this study.MArN OUTCOME MEASURES: ①Survival situation and access to food of dogs after operation. ② The healing of esophageal defect of dogs.RESULTS: Three of fourteen dogs died within one week after operation. Eleven dogs survived. ① The survival and access to food of experimental dogs after operation: One dog was alive without problems for more than 170 weeks. The living dogs could be fed orally on the 7th day after operation. ② The healing at esophageal defect of experimental dogs:At the 2nd week after operation, the esophageal defect was covered with collagen layer and inflammatory exudation. A little epithelization was observered at free edge of the anastomosis, which was 1 to 2 layers of stratified squamous epithelium cells. At the 4th to 6th weeks after operation, the internal surface of the defect was covered with 3 to 5 layers of stratified epithelium cells. At the 8th to 10th weeks after operation, the luminal surface of the defect was covered with 6 to 8 layers of stratified epithelium cells. The pathological changs of pulmonary flap mainly included pulmonary alveoli atelectasis and pulmonary fibrosis, and some inflammatory cells without infective focus were observed. In the transmission electron microscope examination, newborn stratified squamous epithelium cells were. found on the surface of pulmonary tissue flap at esophageal defect.CONCLUSION: It is feasible to repair the partial irregular intrathoracic esophageal defect with the autologous pulmonary flap in dogs.

Objective To explore the changes of serum nitric oxide(NO) and trace element Zinc in children with pneumonia and their clinical significance.Methods The observing group contained 48 patients with pneumonia in our hospital from Oct.2005 to May 2006,who were collected 3 mL of blood sample on empty stomach on the second day.Twenty-six of them had been collected serum during their convalescence stage.The control group contained 20 children,who were healthy in the same stage.The levels of NO of 48 pneumonia,26 convalescence stage(recovery group) and 20 healthy patients were determined by UV-2100 spectrophotometer.The Zinc in serum was determined by P-E503-mode atomic absorption spectrophotometric analysis antigenic in those patients.Blood viscosity was measured and analyzed with the statistic analysis SPSS 10.0 software.Results The levels of NO in pneumonia children[(57.76?19.41) ?mol/L] were significantly higher than that in control group [(25.09?5.51) ?mol/L] and recovery group[(30.08?8.05) ?mol/L](P_a

Objective To carry out the clinical validation of a domestic HBsAg kit to evaluate its application value. Methods 543 serum samples with HBsAg ELISA values of S/CO ≥ 0. 7 were tested by HBsAg confirmatory test. Specific anti-HBs reagent and control reagent were added separately into duplicate wells of HBsAg ELISA plate, in which test sample was also added. After incubation at 37℃, HBsAg was detected by routine ELISA, and the inhibition rate was calculated using absorbanee (A) result of anti-HBs reagent well and control reagent well according to the provided formula. The sample was confirmed as HBsAg positive when the inhibition rate was≥50%. For HBsAg weakly positive samples, "prolonged confirmatory test" (conjugate reaction time was prolonged to 120 rain) was applied to increase the sensitivity. 39 samples were randomized selected for testing and comparison with Abbott Murex confirmatory test. Results 543 serum samples in total were tested by the confirmatory test. Among the 504 cases which showed positive reaction in screening HBsAg ELISA, 89 ( 17. 7% ) were confirmed as negative. According to their S/CO value of the screening HBsAg test, the ratio of negative cases / tested eases in the group were:S/CO≤<5.0, 87/143 (60. 8% ) ;5.0 < S/CO ≤ 10. 0,0/25 (0) ;10. 0 < S/CO ≤ 15.0, 1/21 (4. 8% ) ;15.0 < S/CO ≤ 20. 0, 1/23 (4. 4% ) ;S/CO 20. 0, 0/292(0). Among 39 cases with negative HBsAg (0. ≤