Chinese medicine is one of the most famous traditional medicines in the world with a glorious and long written history of at least 2000 years. Recently, acupuncture and the use of other herbal medicine are being gradually accepted globally. In 2011, the International Medical University (IMU) started the Chinese Medicine programme which is the first of its kind in a western medicine university in Malaysia. The author introduced the background of Chinese medicine and the curriculum of the Chinese Medicine programme established in IMU, analyzed the situation regarding the quality of lectures given by internal and external lecturers in this programme and also discussed on ways to integrate western and traditional medicine in IMU or in Malaysia. The launching of Chinese medicine in IMU is a great step in the development of IMU and also an important step in the development of medical education in Malaysia or even in South-east Asia.

Literature review to build optional indexes pool,Delphi method to screen indexes,fuzzy model used to calculate the weight,for building such a system.An index system centering on public wellbeing is thus constructed,comprising three level 1 indicators,six level 2 indicators,40 level-3 indicators.The system can satisfactorily reflect the vision of county-level public hospitals reform,and showcase outcomes of such a reform.

Objective To determine the likelihood of G-protein coupled receptor 56 (GPR56 ) induces axonal development and myelination in the corpus callosum of mouse brain.Methods A total of 64 Gpr56 +/-and Gpr56 -/-mice were selected and randomly divided into two groups:Gpr56 +/-group (n=32)and Gpr56 -/-group (n=32).According to number of days after birth,each group was further divided into 4 subgroups including P7d,P14d,P21d and P28d subgroups.Levels of neurofilament-200 (NF -200)and proteolipid protein (PLP ) of myelin basic protein in corpus callosum were measured with immunohistochemistry staining and Western blot in P7d、P14d、P21d、P28d Gpr56 +/- and Gpr56 -/-mice.Gpr56 +/-and Gpr56 -/-neurons were cultured using P1 d Gpr56 +/-and Gpr56 -/-mouse brain.The lengths of Gpr56 +/- and Gpr56 -/-neuronal axon were measured and compared with Image J software. Axonal myelination in the corpus callosum of mouse brain in each group was observed under electronic microscopy and the axonal diameters between subgroups were compared.Results The levels of NF-200 and PLP in the corpus callosum in P7d、P14d、P21d、P28d Gpr56 -/-mice decreased significantly compared with Gpr56 +/- mice.The length of Gpr56 -/-neuronal axon was shortened compared with Gpr56 +/-neuronal axon.The number of myelinated axons was obviously reduced in the corpus callosum in P28d Gpr56 -/-mice.The diameter of axon in the corpus callosum of P28d Gpr56 +/-mouse is longer than that of P28d Gpr56 -/-mouse. Conclusions GPR56 may be involved in axonal development and myelination in the corpus callosum of mouse brain.

Aim To observe the effects of activation of aldehyde dehydrogenase 2 ( ALDH2 ) by ethanol on testis injury of type 2 diabetic rats. Methods Type 2 diabetic rats model were established by high-fat diet combined with low-dose streptozotocin ( STZ ) injec-tions. After the success of modeling, the rats were ran-domly divided into 3 groups ( n =6 ): normal control group (NC), type 2 diabetes group (T2DM) and eth-anol+type 2 diabetes group (EtOH+T2DM). Rats of EtOH + T2DM were treated with low-dose ethanol, then rats of NC and T2 DM were given normal diet for 8 weeks. After 8 weeks, the levels of the fasting blood glucose ( FBG ) , glycosylated hemoglobin ( HbA1 c ) and testosterone were tested, and the ratio of testis weight to body weight ( TW/BW ) was calculated. Morphological changes of testis tissue were observed by optical microscope. The levels of ALDH2 mRNA and transforming growth factorβ1 ( TGF-β1 ) mRNA in tes-tis tissue were measured. The expression of TGF-β1 in testis tissue was observed by immunohistochemical stai-ning, then the positive rate of TGF-β1 was calculated. Results Compared with NC, the levels of FBG, HbA1 c and TW/BW increased significantly and the level of testosterone decreased significantly in T2DM. The morphological observation showed that some semi-niferous tubules atrophied, spermatogenic cells de-creased and arrangemented loosely, Leydig cells de-creased in testicular interstitial. The level of ALDH2 mRNA in testis tissue decreased significantly, and the level of TGF-β1 mRNA and the positive rate of TGF-β1 in testis tissue increased significantly. However, compared with T2DM, the levels of FBG, HbA1c and TW/BW decreased, and the level of testosterone in-creased and the damage of testis tissue was attenuated in EtOH+T2DM. The level of ALDH2 mRNA in testis tissue increased significantly, and the level TGF-β1 mRNA and the positive rate of TGF-β1 in testis tissue decreased significantly. Conclusion Activating AL-DH2 can protect testis in type 2 diabetic rats, which may be related to the downregulation of TGF-β1 ex-pression.

OBJECTIVE To prevent and control the incidence of nosocomial infection,and improve the inner quality of nosocomial infection management.METHODS A total of 49 363 cases of inpatients in the recent four years were retrospectively analyzed.RESULTS Of them 2 409 cases were infected,the incidence was 4.88%.The lower(respiratory) tract ranked the first place (34.16%) and the highest infected rate was in medicine(department)((8.29%).) Totally 505 isolates of bacteria were found,of which Gram-negative ones accounted for 45.15%,(Gram-)positives 25.15%,fungi were for 29.70%.CONCLUSIONS The incidence of nosocomial infection is(connected) with following factors such as age,inpatient factor,invasive diagnosis and treatment manipulation,the misusage of(antibiotics),and the environment quality.

Background and purpose:The morbidity and mortality of lung cancer are currently the highest malignant tumor in China and the world. Most onset age of the illness is after 60 years old. Therefore, surgical resection of lung cancer in the elderly is very worthy of concern. This study aimed to investigate the clinical features, epidemic characteristics and conditions in perioperative period between the elderly and middle-aged patients with lung cancer, and provide the reference for clinical treatment.Methods:Totally 1 019 patients with lung cancer who were admitted to the hospital and accepted the operations in department of thoracic surgery in Shanghai Pulmonary Hospital from Jan. 2007 to Dec. 2012 were analysed retrospectively. The clinical data including gender, pathological type, TNM stage, intraoperative amount of bleeding and post-operative length of hospitalization were compared.Results:There was a signiifcant difference in sexual factors between these two groups (P?0.05), and compared with the middle-aged group, the proportion of male was more higher in the elderly group (76.91%vs 52.81%). Adenocarcinoma was the most common and squamous carcinoma was the next in both two groups. The constituent ratio of the pathlogical type between the elderly group and the middle-aged group was statistically signiifcant (P?0.05). The squamous carcinoma in the elderly group was higher than that in the middle-aged group (37.5%vs 15.6%). On the contrary, adenocarcinoma was more common in the middle-aged group (72.8%vs 50.7%). StagesⅡa,Ⅱb, andⅢa were more common in the elderly group and stagesⅠa, andⅠb were the most clinical stage in the middle-aged group. The clinical stage between two groups was statistically significant (P?0.05).The intraoperative amount of bleeding was higher and the post-operative length of hospitalization was longer in the elderly group, with a signiifcant difference as compared with that in the middle-aged group(P?0.05). And there was a signiifcant difference in incidence of accompanying diseases between the two groups, compared with the middle-aged group, the proportion of accompanying diseases was more higher in the elderly group(58.6%vs42.3%).Conclusion:Elderly patients with lung cancer are more common in males, with adenocarcinoma being the most common. The cancer mostly belongs to a medium or advanced stage. Elderly patients have the trend with more amount of bleeding in operation and lengh of stay.

AIM: To observe the effect of receptor-interacting protein 2 (Rip2) overexpression on human pan-creatic cancer cell line Panc-1.METHODS: pEGFP-C2 and pEGFP-Rip2 plasmids were respectively transfected into the Panc-1 cells using JetPRIME reagent.The cells were divided into control group, pEGFP-C2 group and pEGFP-Rip2 group. The apoptosis in the cells was detected 48 h after transfection by flow cytometry.Rip2 level and the expression of apoptosis-related proteins, Bax, cytoplasmic cytochrome c ( Cyt-c) and Bcl-2, were analyzed by Western blot.The activity of caspase-3 was measured by colorimetric method.RESULTS: Rip2 protein expression significantly increased in the cells transfected with control and pEGFP-C2 plasmids.The apoptotic rate in pEGFP-Rip2 group was higher than that in control group and pEGFP-C2 group, whereas no significant difference of apoptotic rate was observed between control group and pEGFP-C2 group.The protein expression of Bax and cytoplasmic Cyt-c was remarkably increased and the protein expression of Bcl-2 was obviously decreased in pEGFP-Rip2 group as compared with control group and pEGFP-C2 group.The activity of caspase-3 in pEGFP-Rip2 group was obviously increased as compared with control group and pEGFP-C2 group.CON-CLUSION: Overexpression of Rip2 is able to induce apoptosis in the Panc-1 cells, and the mechanism may be related to the up-regulation of Bax and cytoplasmic Cyt-c protein expression, down-regulation of Bcl-2 protein expression and en-hancement of caspase-3 activity, thus activating intrinsic apoptotic pathway.

Objective To analyze the complications ofventriculoperitoneal shunt in the treatment of pediatric hydrocephalus,and improve operative method,in order to reduce postoperative complications and improve the clinical curative effect.Methods A total of 39 infants with hydrocephalus who underwent adjustable shunt were retrospectively analyzed,including surgical methods,results,and complications,and put forward counter measures.Results Thirty cases of postoperative clinical symptoms obviously improved compared with preoperative,head CT review were clearly seen with ventricle retraction.Nine cases suffered with complications after operation.Obstruction of shunt tube was found in 4 cases,shunt exposed in 3 cases,and postoperative infection in 2 cases.Conclusions Ventriculoperitoneal shunt complications related to surgery itself.Improved surgical techniques,and taking appropriate treatment measures can effectively reduce the incidence of complications.

Objective To investigate the clinical value of new transnasal Fujifilm EG-530-NW electronic gastroscope.Methods A total of 295 patients who underwent gastroscopy were randomly divided into 2 groups to receive examination by routine endoscope (n =172) or Fujifilm EG-530-NW transnasal endoscope (n =123).The fluctuation of heart rate,blood pressure and compliance during the examination were recorded and compared between the two groups.Results The new Fujifilm EG-530-NW could obtain clear images with same quality of routine gastroscope.The heart rate change and visual analog pain score in patients from EG-530-NW gastroscope group were significantly lower than those of routine gastroscope group (P ＜ 0.05).No significant difference in blood pressure fluctuation was observed between the two groups.In patients older than 50 years,the fluctuations of heart rate and blood pressure in EG-530-NW group were significantly less than those of routine gastroscope group.Conclusion Fujifilm EG-530-NW gastroscope can get high quality image with less influence on heart rate and blood pressure fluctuation,which is more significant in older patients.

Objective To report the experience of using rectus abdominis musculocutaneous flap after open-window thoracosto- my in managing refractory chronic pleural empyema.Methods From Nov.2004 to Mar.2006,intrathoracic transplantation of the musculocutaneous flap was performed successfully in 4 patients with empyema and fistula after upper lobectomy.The myocutaneous flap was designed in such a way that epigastrica vessels were incorporated.Results The rectus abdominis myocutaneous flap has provided sufficient bulk for tract obliteration.Over a mean follow-up period of 10 months,patients are free from recurrent infections and skin nacrosis.Conclusion Vaseularized museulocutaneous flap may help in healing refractory empyema.