It is a request of social development for medical service to provide patients with high-quality and humanistic medical care.The medical science reform should be strengthened in order to disassociate medical care and medicine marketing.Medical service reform is to be furthered and medical curriculum be properly set up.The medical specialities,public subjects and humanistic care curricula should be compatible with each other,in order to coordinate with the development of modern medical skills and the cultivation of humanistic spirit,and cultivate medical talents with both exquisite medical skills and noble medical professionalism.

Objective To evaluate the predictive value of serum macrophage migration inhibitory factor (MIF) for myocardial depression in severe sepsis patients.Methods Taken prospective study method,42 cases of severe sepsis patients were enrolled from December 2011 to June 2013.The patients were monitored by PICCO system after informing consent into ICU day,and given the corresponding treatment.According to the hemodynamic parameters were divided into two groups,myocardial depression group:cardiac index ＜ 3 L/(min· m2) and global end diastolic volume index ＞ 800 ml/m2,the remaining were in non myocardial depression group,and the patients were divided into survival group and death group according to 28-d mortality.Hemodynamic parameters and serum MIF,B-type natriuretic peptide (BNP),cardiac troponin Ⅰ (cTnI) level at the 1st,3rd,Sth day after admission.Results Fortty-two severe sepsis patients,non myocardial depression in 22 cases (non myocardial depression group),myocardial suppression in 20 cases (myocardial depression group).At 28 d,20 patients of survival (survival group),22 patients of death (death group).The serum MIF in death group was higher than that in survival group at the 1st,3rd,5th day (P ＜ 0.01) ; BNP and cTnI at the 1st day in two groups had no statistical significance (P ＞0.05),BNP and cTnI at the 3rd,5th day in death group was higher than that in survival group(P ＜ 0.01).The serum MIF at each time point in myocardial depression group was higher than that in non myocardial depression group [survival:8.70(3.53,16.80) μ g/L vs.1.20(0.80,1.77) μ g/L,2.30(1.33,8.40) μ g/L vs.0.60 (0.60,0.99) μg/L,0.50 (0.31,2.50) μg/Lvs.0.16 (0.15,0.20) μg/L;death:11.43(8.10,17.16) μ g/L vs.2.30(1.96,3.69) μ g/L,9.70(6.55,14.65) μ g/L vs.1.90(1.88,5.27) μ g/L,7.50(5.15,14.20)μ g/L vs.2.40(0.80,8.46) μ g/L] (P ＜ 0.05).The serum MIF of death patients in two groups was higher than that of survival patients (P ＜ 0.05).MIF at the 5th day had biggest prediction value,AUC was 0.952,when the cut-off point of 0.65 μg/L,the sensitivity was 100％ (22/22) and specificity was 85％ (17/20).Multivariable Logistic regression analysis results showed that only APACHE Ⅱ scores was the independent risk factor for 28-d mortality (P ＜ 0.01),while MIF couldn' t independent forecast 28-d mortality (P ＞ 0.05).Conclusions Elevation of serum MIF prompts severe sepsis patient with poor outcome,and dynamic changes of MIF is helpful to evaluate the prognosis and severity of severe sepsis patients with myocardial depression,but MIF is not an independent risk factor for predicting 28-d mortality.

Objective To investigate the effects of bortezomib on cellular migration and invasion ability in cuhured human prostatic cancer cells DU145 and its mechanism.Methods Transwell method was used to detect cell migration.Invasion was assayed by Matrigel-coated invasion chambers.Expressions of FAK and Tyr397 proteins were analyzed by Western blot.Results After treated by bortezomib at the concentration of 10,20 nmol/L for 24 h,the invasion index of DU145 cells were (69.05±10.56) and (52.55±6.98),they were gradually reduced compared with untreated group (81.55±10.56) (P ＜ 0.05).The migration index were (39.35±6.45),(32.05±4.22),they were also reduced compared with untreated group (58.75±5.41) (P ＜ 0.05).The group of treated by bortezomib showed Tyr397 protein expression had been suppressed.However FAK protein had not marked change.Conclusions FAK is involved in the regulation of cellular migration and invasion function.Bortezomib might inhibit cells migration and invasion function by down regulation of Tyr397 expression.

Objective To investigate the possible effects of aspirin and indomethacin on the growth of Helicobacter pylori(H.pylori) and the effects of aspirin on the susceptibility of H.pylori to some antimicrobials. Methods Kinetic studies of H.pylori were performed by inoculating strains in Brucella broth with different concentrations of aspirin and indomethacin. Growth of bacteria in the broth was assessed spectrophotometrically and by viable colony count after incubation for 24 and 48 hours. Bacteria morphology was studied by Gram stain under light microscopy. MICs of aspirin and indomethacin were determined by standard agar dilution method. MICs of amoxicillin, clarithromycin and metronidazole were measured in the presence and in the absence of aspirin by E test method. Results Kinetic studies revealed that aspirin and indomethacin inhibited the growth of H.pylori in a dose dependent manner and the bactericidal activities of these agents were due to cell lysis. Aspirin at 400 ?g/ml produced about 2 logs decrease in CFU per milliliter at 48 hours. The assemble inhibition effects were obtained when 100 ?g/ml indomethacin tested. The MIC 90 of H.pylori for aspirin and indomethacin were 512 ?g/ml and 128 ?g/ml, respectively. Increased susceptibility to amoxicillin, clarithromycin and metronidazole of H. pylori were induced by aspirin. Conclusions Aspirin and indomethacin could significantly inhibit the growth of H.pylori when incubated in Brucella broth in vitro. A subinhibitory concentration of aspirin enhanced the susceptibility of H. pylori to antimicrobial agents.

According to interactive teaching,Problem-based Learning (PBL),visual teaching and other theories,combining with the characteristics of medical practice teaching,the paper puts forward a set of informatization methods used for medical teaching and practice,verifies that the application of informatization technology to medical teaching can obviously improve the teaching efficiency and quality,and meanwhile proposes the follow-up construction contents,in order to provide reference for further development of informatization medical teaching.

AIM: To study the expression of hepatitis B virus core gene in Pichia pastoris and to obtain high-level expressed recombinant HBcAg with good immunoreactivity and high specificity. METHODS: HBV core gene was amplified by PCR from plasmid pHBV1 which contained HBV whole DNA sequence. The PCR product was cloned into pGEM-T vector by TA cloning strategy. After confirmed by DNA sequence analysis, the gene of interest was inserted into the yeast expression vector pPIC9. The recombinant plasmid pPIC9-cAg was constructed and transformed into GS115 by electroporation. The recombinant yeast GS115 was induced by 0.5% methanol. The expressed product was analysed by SDS-PAGE,Western blot and ELISA. RESULTS: The restriction analysis and DNA sequence analysis proved that HBV core gene had already been cloned to yeast expression plasmid pPIC9. The expressed HBcAg existed in SDS-PAGE. Good immunoreactivity and high specificity of the recombinant HBcAg have been proved by ELISA and Western blot. The titre of the recombinant HBcAg in the cell lysate was 1∶ 12 800 . CONCLUSION: The recombinant plasmid pPIC9-cAg was successfully constructed. The recombinant HBcAg with good immunoreactivity and high specificity was successfully expressed in Pichia pastoris expression system and can be applied to further developing HBcAb immunoassay. [

OBJECTIVE:To provide reference for rational use of antibiotics in the clinic. METHODS:In retrospective study, the distribution,composition and drug resistance of pathogens in our hospital during Jan.-Dec. in 2015 were analyzed statistically. RESULTS:In 2015,a total of 9401 specimens were collected in microbiology laboratory of our hospital;pathogens were detect-ed in 1743 specimens with positive rate of 18.54%;1591 strains of pathogens were isolated,mainly from sputum (59.77%), urine (14.775) and blood sample (8.93%). Totally 347 strains of Gram-positive bacteria(21.81%),991 strains of Gram-negative bacteria (62.29%),253 strains of fungus (15.90%)were detected. Top 4 pathogens in the list of amount were Escherichia coli, Klebsiella pneumoniae,Pseudomonas aeruginosa and Staphylococcus aureus. S. aureus,Streptococcus pneumoniae and Staphylo-coccus haemolyticus were sensitive to vancomycin,linezolid and sodium fusidate,with resistance rate of 0;resistance rates of them to erythromycin were more than 65%. The resistance rate of S. aureus to penicillin was more than 95%,and S. haemolyticus showed high resistance rate to common antibiotics. Drug resistances of E. coli,K. pneumoniae and P. aeruginosa to carbapenems were all lower than 15%,and they were sensitive to polymyxin with resistance rate of 0. Resistance rate of E. coli to quinolones was more than 50%. CONCLUSIONS:The main pathogens are Gram-negative bacteria in our hospital,drug resistance of them are not satisfactory. Drugs most sensitive to main pathogens include vancomycin,linezolid,carbapenems,etc. The inspection of patho-gen drug resistance characteristics should be strengthened,and antibiotics should be selected rationally and normatively according to the results of drug sensitivity test.

Objective To discuss the clinical efficacy of internal fixation assisted by thoracoscope in treatment of rib fractures.Methods The study enrolled 180 patients with rib fractures associated with thoracic deformity hospitalized from July 2010 to June 2013.Ninety out of the patients were operated on by thoracoscope-assisted internal fixation (operation group),and the remaining 90 fractures were treated non-operatively (non-operation group).Clinical markers recorded were duration of pain,time of ventilator use,hospital length of stay and complications.Patient mental health was measured with self esteem scale (SES).Patient mobility was evaluated at follow-up.Results Between operation and non-operation groups differences were observed in duration of pain [(3.1 ± 1.0)d vs (8.9 ± 1.2) d],time of ventilator use [(3.0 ± 1.0) d vs (4.8 ± 1.0) d] and hospital length of stay [(10.0 ± 1.1) d vs (15.8 ± 1.0) d] (P ＜ 0.01).SES in operation group was (28.3 ± 2.1) versus (24.4 ± 3.3) points in non-operation group (P ＜ 0.01).No major complications occurred in operation group,but there were 20 pleural effusion,15 severe thoracic collapse or deformity,14 lung infection,10 refractory chest pain and 2 upper limb dysfunction in non-operation group (P ＜0.01).Two patients presented mobility limitation in operation group,but 12 had evident loss of mobility in non-operation group (P ＜0.01).Conclusions Thoracoscope-assisted internal fixation is effective to accelerate the pace of recovery,relieve pains,reduce complications and thus can be a priority method for treatment of rib fractures.

Objective To observe the effect of moxibustion on the proliferation of neural stem cells after cerebral ischemia- reperfusion in rat models.Method The middle cerebral artery occlusion (MCAO) model was developed by using modified Zea-Longa method. Seventy-two Wistar rats were randomized into group A (sham-operation group), group B (model group) and group C (moxibustion group). Each group was then further divided into 4 sub-groups according to different time points: 3 d, 7 d, 14 d, and 21 d, 6 rats in each sub-group. For each group, Baihui (GV 20) and bilateral Taiyang (EX-HN 5) were selected to study. The proliferated cells were marked by intraperitoneal injection of BrdU, and TTC staining and HE staining were adopted to detect the pathological changes of brain tissues after cerebral ischemia-reperfusion. Immunohistochemical method was used to dynamically detect the positive expressions of BrdU and Nestin cells in DG and SVZ zones at different time points, and microscope image analysis was taken to study the positive expressions.Result The neurological deficit score in group C was significantly lower than that in group B at each time point (P<0.05). The neurological deficit score in group C was significantly different from that in group B at the same time point (P<0.05). Moxibustion can up-regulate the expression of BrdU in SVZ and DG, and the increase started from the 3rd day and reached the peak on the 7th day. The increase of BrdU expression in group C was more significant than that in group B (P<0.05). Moxibustion can up-regulate the expression of Nestin in SVZ and DG, and the increase started from the 3rd day and reached the peak on the 7th day. The increase of Nestin expression in group C was more significant than that in group B (P<0.05).Conclusion Moxibustion can remarkably promote the recovery of nerve function and the proliferation of BrdU and Nestin after cerebral ischemia-reperfusion in rats.

0. 05), respectively. Conclusion: Repeated +Gz stress may disorder the ratio of ET and NO. This imbalance may be one of the causes which lead to pathology changes in masseter musscles.