ObjectiveTo discuss the features and laws of online learning of graduate studnets in Beijing University of Chinese Medicine (BUCM); To provide references for the directions of guidance and improvement. Methods Graduate students from the grade 2014 in BUCM were set as the investigation objects. Questionnaire was used to investigate students’ online learning experience, learning channels, time frequency, main contents for online learning, learning achievements and shortcomings, and cognitive degree of MOOCs. Students were invited to write down their understanding of online learning and their opinions and suggestions for the new learning mode of combining MOOCs and classroom learning.Results In this survey, 92.16% of graduate students had the experience in online learning; 41.18% of the students did online learning through the campus network; 47.06% of students kept“once a week” frequency of online learning; 54.90% of students learnt through the network mainly used to develop extracurricular knowledge; 66.27% of students thought online learning had a certain learning harvest; 49.41% of students thought complicated network information brought certain problems. In the MOOCs cognitive survey, 43.92% of students did not understand MOOCs completely; 66.27% of students wanted to try MOOCs as a new study mode; 30.98% of students thought the hours of MOOCs should accounts for a quarter of the total class hours.Conclusion Most graduate students have experience in online learning, have certain learning achievements and have expectations for MOOCs teaching.

Objective To investigate the effects of low temperature adjustable sodium dialysis combined Astragalus injection in patients with chronic cardiac insufficiency uremia combined the clinical curative effect of dialysis related hypotension .Methods Fourty‐nine patients with uremia combined chronic cardiac insufficiency and suffered repeated dialysis hypotension were involved in this study ,and they were divided into treatment group(n=25) and control group(n=24) .Patients in the control group were treated with hemodialysis for low temperature (35 .5 ℃) ,and sodium curve dialysis ;patients in the treatment group were treated with the same method in that of control group ,and they were treated with astragalus injection 40 mL continuous intravenous drip .Then ob‐serve the blood pressure changes and treatment effect of the two groups of before and after treatment .Results Systolic pressure of the treatment group and the control group was (92 .6 ± 8 .4) and (89 .5 ± 9 .0) mm Hg ,and that of after treatment was (99 .9 ± 8 .0) and (94 .9 ± 9 .3) mm Hg respectively ,the difference before and after treatment in each group was significant (t=3 .147 , 2 .044 ,P<0 .05) ,and the difference of systolic pressure before and after treatment in each group was significant (t=2 .020 ,P<0 .05) .Before the treatment ,the left ventricular ejection fraction score of treatment group and control group was (45 .80 ± 3 .62)%and (46 .01 ± 3 .59)% ,and that of after treatment was (59 .05 ± 3 .15)% and (53 .85 ± 1 .60)% ,respectively ,and the difference be‐fore and after treatment was significant (t=13 .906 ,9 .847 ,P<0 .05) ,and the difference of the left ventricular ejection fraction score after treatment in the two groups was significant (t=7 .328 ,P<0 .05) .Conclusion For patients with uremia combined chronic car‐diac insufficiency and suffered repeated dialysis hypotension ,low temperature adjustable sodium dialysis can significantly reduce the incidence of hypotension in the process of dialysis .But combined huangqi injection in the treatment group could significantly in‐creased the left ventricular ejection fraction ,thus improve the left ventricular function in patients with dialysis .

Objective To explore the best mode of diabetic dietary education in the nursing specialist outpatient service,which is suit for China's national situation.Methods A total of 100 diabetic patients consulting diabetes diet in the nursing specialist outpatient service were divided into observation group and control group with 50 cases each by random digits table method.The routine sermonic education mode was used in control group,while the error-correction education mode was used in observation group.The question-real-time evaluation was performed at the end of the education and a follow-up evaluation after 6 months of intervention was evaluated.Results Grasp of the knowledge of diabetes diet in observation group immediately after education and 6 months after education were better than those in control group,t=3.07,3.06,P＜0.01.In the follow-up evaluation after 6 months of intervention,fasting blood glucose and glycosylated hemoglobin were (6.84±0.79) mmol/L,(6.83±0.36) ％ in observation group and (7.56±0.93) mmol/L,(7.67±0.87) ％ in control group.The indices in observation group were significantly better than those in control group,t=-4.17,-6.32,P＜0.01.Conclusions Using the error-correction education mode can correct the false dietary behavior of patients and improve the effect of the diabetic dietary education more effectively.

Background Lead exposure induces microglial cell death, of which the mechanism is unclear. Ferroptosis is a new death form and its role in microglia death has not been reported. Objective To investigate the role of ferroptosis in microglia following lead exposure in order to provide a theoretical basis for the mechanism of lead neurotoxicity. Methods Microglial cell line BV-2 cells were co-cultured with 0, 10, 20 and 40 μmol·L⁻¹ lead acetate for 24 h. The 40 μmol·L⁻¹ lead acetate group with iron chelator (DFO) was named the 40+DFO group. Changes in BV-2 cell morphology after lead exposure were observed under an inverted microscope; tissue iron kit and glutathione kit were used to detect intracellular iron and glutathione (GSH) respectively; flow cytometry was applied to detect lipid reactive oxygen species (lipid ROS) immunofluorescence intensity. Western blotting and qPCR were adopted to detect the expressions of glutathione peroxidase 4 (GPX4), solute carrier family 7 member 11 (SLC7A11), transferrin receptor 1 (TFR-1), divalent metal transporter 1 (DMT1), ferroportin 1 (FPN1) protein and mRNA. Results Compared with the control group, the number of BV-2 cells decreased with increasing doses of lead and the cells showed a large, round amoeboid shape. The intracellular levels of iron of BV-2 cells were (1.08±0.04), (1.29±0.03), and (1.72±0.10) mg·g⁻¹ (calculated by protein, thereafter) in the 10, 20, and 40 μmol·L⁻¹ lead acetate groups, respectively, significantly higher than that in the control group (P<0.05), and the intracellular level of iron in the 40+DFO group, (1.34±0.10) mg·g⁻¹, was lower than that in the 40 μmol·L⁻¹ lead acetate group, (1.72±0.03) mg·g⁻¹ (P<0.05). Compared with the control group, the TFR-1 and DMT1 protein and mRNA expressions were increased in BV-2 cells in the 10, 20, 40 μmol·L⁻¹ lead acetate groups (P<0.05), especially in the 40 μmol·L⁻¹ lead acetate group; the FPN1 protein expression did not change significantly, but the FPN1 mRNA expressions in BV-2 cells in the 10, 20, 40 μmol·L⁻¹ lead acetate groups were significantly decreased (P<0.05). Compared with the control group, the intracellular GSH level decreased and the lipid ROS content increased in all three lead acetate groups; compared with the 40 μmol·L⁻¹ lead acetate group, the GSH level increased by 12.30% and the lipid ROS content decreased by 13.00% in the 40+DFO group (P<0.05). The expressions of GPX4 protein were reduced to 50.00%, 35.00%, and 17.00% of that of the control group in the 10, 20, and 40 μmol·L⁻¹ lead acetate groups respectively, while the expressions of GPX4 mRNA were also significantly reduced; the expressions of SLC7A11 protein and mRNA in the 20 and 40 μmol·L⁻¹ lead acetate groups were lower than that in the control group, with the most significant decrease in the 40 μmol·L⁻¹ lead acetate group (P<0.05). Conclusion Lead exposure could induce ferroptosis in BV-2 cells, in which iron transport imbalance and oxidative damage might be involved.

Medical education of PhD candidates is of great importance to medical personnel training in our country. With the development of society, the progress of science and technology and renewal of knowledge, cultivation of innovative talents and improvement of graduate education quality is priority nowadays. This paper reflects on the progress we’ve made on medical education of PhD candidates. Though efforts have been made to improve the innovative ability of talents in our country gradually, we still need to be more innovative, more consistent and more scientific in the future. According to the state Degree Requirements and our goal of talent training, we should combine courses with scientific research systematically, pay more attention to scientific methodology and academic training, finally form a better training mode of PhD candidates majoring in medical science.

OBJECTIVETo investigate the effects of lead exposure on the copper concentration in the brain and serum and the expression of copper transporters in the choroid plexus among rats.

METHODSSixty specific pathogen-free Sprague-Dawley rats were randomly divided into a control group and three lead-exposed groups, with 8 mice in each group. The lead-exposed groups were orally administrated with 500 (low-dose group)), 1 000 (middle-dose group), and 2 000 mg/L (high-dose group) lead acetate in drinking water for eight weeks. And the rats in control group were given 2 000 mg/L sodium acetate in drinking water. The content of lead and copper in the serum, hippocampus, cortex, choroid plexus, bones, and cerebrospinal fluid (CSF) was determined by inductively coupled plasma-mass spectrometry (ICP-MS). Confocal and real-time PCR methods were applied to measure the expression of copper transporters including copper transporter 1 (Ctr1), antioxidant protein 1 (ATX1), and Cu ATPase (ATP7A).

RESULTSCompared with the control group, the lead-exposed groups showed significantly higher lead concentrations in the serum, cortex, hippocampus, choroid plexus, CSF, and bones (P < 0.05) and significantly higher copper concentrations in the CSF, choroid plexus, serum, and hippocampus (P < 0.05). Confocal images showed that Ctr1 protein was expressed in the cytoplasm and cell membrane of choroid plexus in control group. However, Ctr1 migrated to CSF surface microvilli after lead exposure. Ctr1 fluorescence intensity gradually increased with increasing dose of lead, except that the middle-dose group had a higher Ctr1 fluorescence intensity than the high-dose group. In addition, the middle- and high-dose groups showed a lower ATX1 fluorescence intensity compared with the control group. Real-time PCR data indicated that the three lead-exposed groups showed significantly higher mRNA levels of Ctr1 and ATP7A compared with the control group (P < 0.05).

CONCLUSIONCopper homeostasis in the choroid plexus is affected by lead exposure to induce copper homeostasis disorders in brain tissue, which may be one of the mechanisms of lead neurotoxicity.

Adenosine Triphosphatases ; Animals ; Brain ; Cation Transport Proteins ; drug effects ; Choroid Plexus ; drug effects ; metabolism ; Copper ; metabolism ; Homeostasis ; Organometallic Compounds ; toxicity ; RNA, Messenger ; Rats ; Rats, Sprague-Dawley

Fluorosis is widely prevalent worldwide, and China is one of the countries with a high incidence of endemic fluorosis. In recent years, study on non skeletal damage caused by fluorosis, especially cardiovascular system damage, has gradually increased. Fluoride can cause cardio vascular arteriosclerosis, hypertension and other diseases, while cardiovascular disease have hidden and acute onset, and the mortality rate has increased year by year in recent years. At present, the mechanism of cardiovascular diseases caused by fluoride is not yet clear, and further clarification is needed. This article provides an overview of the effects of fluoride on cardiovascular diseases from three aspect: epidemiological investigation, animals experiment, and in vitro cell experiment. It categorizes and analyzes the pathogenesis, providing new ideas for the study of cardiovascular system damage caused by fluorosis.

Objective Discrete potentials (DPs) have been recorded and targeted as the site of ablation of the outflow tract arrhythmias.The aim of the present study was to investigate the significance of DPs with respect to mapping and ablation for idiopathic outflow tract premature ventricular contractions (PVCs) or ventricular tachycardias (VTs).Methods Seventeen out of 24 consecutive patients with idiopathic right or left ventricular outflow tract PVCs/VTs who underwent radiofrequency catheter ablation between September 2012 and December 2013 in our department were included.Intracardiac electrograms during the mapping and ablation were analyzed.Results During sinus rhythm,sharp high-frequency DPs that displayed double or multiple components were recorded following or buried in the local ventricular elec0trograms in all of the 17 patients,peak amplitude was (0.51 ± 0.21) mV.The same potential was recorded prior to the local ventricular potential of the PVCs/VTs.Spontaneous reversal of the relationship of the DPs to the local ventricular electrogram was noted during the arrhythmias.The DPs were related to a region of low voltage showed by intracardiac high-density contact mapping.At the sites with DPs,unipolar and bipolar ventricular voltage of sinus beats were lower compared with the adjacent regions without DPs (unipolar:(6.1 ± 1.8)mV vs.(8.3 ±2.3)mV,P ＜0.05;bipolar:(0.62 ±0.45)mY vs.(1.03 ±0.60) mV,P ＜ 0.05).The targeted DPs were still present in 12 patients after successful elimination of the ectopies.Discrete potentials were not present in seven controls.Conclusions Discrete potentials and related low-voltage regions were common in idiopathic outflow tract ventricular arrhythmias.Discrete potential-and substrate-guided ablation strategy could help to reduce the recurrence of idiopathic outflow tract arrhythmias.