ObjectiveThis paper aims to probe into the effect of working and studying combined teaching reform of chnical medicine major.MethodsTwo classes containing 46 students respectively were selected at random as observation group and control group,from the six classes of Grade Two majoring in clinical medicine.The two groups of students were trained by adopting working and studying combined teaching model and traditional teaching model respectively,after which they were evaluated in terms of clinical theory,practical skills and operations,and exercitation achievement.ResultsThe observation group does better in practical skills and exercitation achievement than the control group,while they have no difference in clinical theory.ConclusionWorking and studying combined teaching model can improve students' clinical analytical ability,strengthen their awareness of medical morals,and help them achieve more in exercitation.

Chlorella pyrenoidosa No.2 was screened from five species of microalga Chlorella sp. for its higher lipid yield. Effects of medium components and culture conditions on cell growth as well as lipid ac-cumulation of C. pyrenoidosa No.2 were investigated and the results showed that the optimum medium rec-ipe was 20.0 g/L glucose,0.08 g/L glycine,1.0 g/L K2HPO4?3H2O,0.4 g/L MgSO4?7H2O and 0.004 g/L FeSO4?7H2O. The optimum culture temperature,initial pH,shaking rate and light intensity were 28℃,6.0,130 r/min and 650 Lux,respectively. Biomass and lipid content increased from 3.73 g/L and 40.15% to 6.56 g/L and 59.90% when Chlorella pyrenoidosa No.2 was cultivated under the above optimal conditions for 7 days,with lipid yield raised by 162%. Chlorella pyrenoidosa No.2 could produce lipid with xylose as carbon source,and so is potential for lipid production from renewable materials such as lignocellulose. GC analysis demonstrated that the fatty acid composition of the lipid was similar to that of vegetable oil and its unsaturated fatty acid content reached around 71%,thus it is a promising material for biodiesel production.

A complete aniline dioxygenase gene cluster cloned from an Acinetobacter sp. strain, which could utilize aniline as the sole carbon, nitrogen and energy, was sequenced. Sequence analysis showed that the gene cluster had six intact ORFs, and the whole sequence had high similarity with that of Acinetobacter sp. YAA at amino acid level. A recombinant strain was formed with the gene cluster ligated to vector pLAFR6 and transferred to E.coli. After optimizing the fermentation conditions of this strain for producing catechol, LB was confirmed as the final medium, pH7.0, aniline concentration 0.5mg/ml, E.coli DH5?as the host, incubation temperature 37℃, amount of inoculum 3%. Under above conditions, the yield of catechol could get to 0.546mg/ml, and the converting rate of substrate at molecule level could get to 92.4%.

Objective: To observe the alteration of type-　 Ⅰ collagen protein gene expression after arterial injury and investigate its effect on the development of restenosis. Methods: Firstly, thee xperimental carotid arterial injury rabbit model was constructed. Then, Norther n blot, in situ hybridization and histomorphometric analysis were used to de tect the expression of procollagen mRNA and the accumulation of collagen protein 1,2,4 weeks after injury. Results: Type-　Ⅰ collag en mRNA increased 1 week after injury, peaked 2 weeks later and decreased 4 week s later. The deposition of the collagen protein account for a high percentage o f space in neointima on histomorphometric analysis. Conclusion: Collagen protein may play an important role in the development of neointima and restenosis.

ObjectiveTo evaluate magnesium sulfate and compound polyethylene glycol electrolyte in bowel preparation before capsule endoscopy.MethodsA total of 81 patients were randomly divided into two groups.Group A (n =41 ) received compound polyethylene glycol electrolyte,and group B (n =40) received magnesium sulfate combined with compound polyethylene glycol electrolyte. Positive detection rate,intestinal preparation score,the incidence of capsule retention and solution quality,liver and kidney function were compared between those two groups.ResultsThe positive detection rates of capsule endoscopy were 65.9％ (27/41) in group A and 62.5％ (25/40) in group B,which were nonsignificantly different (x2 =0.099,P ＞ 0.05).The intestinal preparation scores of 19 patients in group A were ≤4 and those of 22 patients were ≥6,while those of 28 patients in group B were ≤4 and of 12 patients were ≥6,which were significantly different (x2 =4.653,P ＜ 0.05). The rates of capsule retention of group A and B were 2.4％( 1/41 ) and 5.0％ (2/40) respectively,which were not significantly different (x2 =0.372,P ＞ 0.05 ).Obvious abdominal pain,nausea or vomitting occurred in no patients of the two groups.There was no difference in electrolyte level or liver and kidney function between those two groups (P ＞ 0.05 ).ConclusionMagnesium sulfate combined with compound polyethylene glycol electrolyte is applicable for the bowel preparation before capsule endoscopy.

Objective To evaluate protective effects of recombinant human thioredoxin(TRX) in myocardial injury of mice with viral myocarditis. Methods We established viral myocarditis models by intraperitoneal injection with 0.1 ml 100TCID50 Coxsackie virus 3m(CVB3m), along with tail vein injection of recombinant human TRX (2 mg/kg) for protection. The control group was given equivalent volume of normal saline. The mice were killed 7 days following the injections. Serum lactate dehydrogenase (LDH) activity was determined and myocardial injury was examined with light microscopy. Results The somm LDH activity in Coxsackie virns-infected mice [(3130.50±390.57)U/L] was higher than that of animals in the control group[ (1617.86±155.42)U/L] and that of TRX protection group[ (1959.43±540.75)U/L], the difference being statistically significant (P<0.05); there was no significant difference between TRX protection group and the control group(P 0.05). Light microscopy showed that five of the eight Coxsackie rims-infected mice had myocardial lesions, including focal myocardial necrosis and inflammatory infiltration. There was no myocardial injury in the TRX protection group. Conclusions Recombinant human TRX can lessen myocardial injuries induced by infection with CVB3m, and so can protect myocardium.

Objective To observe the protective function of recombinant human thioredoxin(TRX) on HeLa cell injury induced by Coxsackie virus 3m(CVB3m) and to study the inhibiting effect of TRX on viral replication. Methods We infected HeLa cells with 10TCID50 CVB3m and then protected these cells with TRX (2,5,10 mg/L). The protective group of TRX, viral group, control group of TRX, and normal control group were included. Six parallel wells were set up in each group. The cell growth was observed by methyl thiazolyl tetrazolium(MTT) and contrast phase microscope. Results The results of contrast phase microscope revealed that HeLa cells were arranged tightly and polygon in normal control group; untightly, became circle and abscission in viral group; HeLa cells morphous improved by increasing TRX concentration in TRX protective group(2,5,10mg/L). MTT results of the inhibitory ratio on cell growth of TRX(2,5,10 mg/L) control group(1.2%,2.9%,6.3%) were compared with normal control group(0), there was no significant difference(all P > 0.05); and while the inhibitory ratio on cell growth of TRX(2,5,10 mg/L) protective group(32.0%,28.0%,27.0%) was compared with virus infective group(51.7%), there was a significant difference (all P < 0.05). The inhibition study of viral replication showed that compared the inhibitory ratio on cell growth of TRX(2,5,10 mg/L) protective group(26.0%,27.0%, 10.9%) with virus infective group(60.0%), there was a significant difference(all P < 0.05). In the protective groups, there was a significant difference (all P < 0.05) between low dose groups(2,5 mg/L) and high dose groups( 10 mg/L). Conclusions The recombinant TRX(2,5,10 mg/L) may alleviate HeLa cell's injury induced by virus and the construct has no significant toxicity. TRX(2,5,10 mg/L) is effective in inhibiting virus CVB3m replication.

Objective To observe curative effects of augmentation fixation technique injected with PMMA through lateral holes of dynamical hip screw (DHS) in treatment of unstable intertrochanteric fracture of senile osteoporotic patients. Methods From January 2006 to December 2007,15 senile osteoporotic inpatients with unstable femoral intertrochanteric fracture were treated with augmentation technique injected with PMMA to the femoral head through central channel and lateral holes of DHS. Clinical data about function of hip joint and complications early after operation were observed. All patients were followed up till fractures were healed, when the hip joint function was evaluated according to Harris standarch. Results Surgical trauma indices such as operation time and bleeding volume of augmentation technique were the same as those of merely DHS fixation. All the patients could safely do hip flexion and extension exercises in the bed and completely sit up by bedside 2-3 days after operation. Six patients could do walking exercise with aid one week after operation, with no complications relating to staying in bed or to PMMA during per-operation period. All fractures were healed 3-6 months after operation, without complications like fixation loosening, cut or destruction of femoral head during postoperative follow-up period. Six months after operation, 14 patients recovered viability to normal. According to Harris standards, the results were excellent in four patients, good in 10 and fair in one, with average Harris score of 83 points. Conclusions The augmentation fixation technique injected with PMMA through lateral holes of DHS has advantages of better DHS anchoring ability in femoral heads, less surgical trauma, reliable fixation and early functional exercise and is suitable for senile osteoporotic patients with unstable intertrochanteric fractures.

Objective To investigate the clinical effects of gastrointestinal decompression with enteral feeding tube in elderly patients with gastric cancer.Methods 78 cases of gastric cancer patients undergoing postoperative gastric decompression with enteral feeding tube were selected as the treatment group,and 66 patients with gastric cancer undergoing postoperative intravenous nutrition and gastric decompression with routine nasogastric tube as the control group in our hospital from January 2015 to December 2015.The incidence rate of gastric tube patency,faster postoperative recovery,nutritional immune improvement,adverse reaction and complication were compared between the two groups.Results The incidence rate of adverse reactions and complications in treatment group were significant lower than in control group (3.0 ％ vs.12.8 ％,x2 =4.4857,P =0.0342;1.5 ％ vs.10.2％,x2 =4.6620,P =0.0308,respectively).Following parameters were significant better in treatment group versus in control group:the time of evacuating [(3.1 ± 0.3) d vs.(4.0 ± 0.1) d,t =24.9227,P =0.0000],defecation[(4.3 ± 0.6) d vs.(5.5 ± 1.1) d,t =7.9189,P =0.0000],extubation [(5.3±1.3)d vs.(10.1±2.2)d,t=15.5690,P=0.0000],hospitalization[(12.3±2.5)d vs.(18.6± 3.2)d,t=12.9864,P=0.0000],postoperative body weight[(57.2±4.9)kg vs(49.0±7.2)kg,t=-7.8408,P=0.0000],plasma protein[(133.2± 11.2)g/L vs(104.5± 10.3)g/L,t=-16.0055,P=0.0000],hemoglobin[(4.7 ± 1.0) g/L vs (3.2 ± 0.6) g/L,t =-11.0991,P =0.0000] and peripheral blood lymphocyte count[(3.5 ± 0.7) × 109/L vs (2.1 ± 0.4) × 109/L,t =-15.0088,P =0.0000].Conclusions Effects of postoperative gastrointestinal decompression in elderly patients with gastric cancer are similar between with routine gastric tube and with enteral feeding tube.However,the enteral feeding tube-induced enteral nutrition shows fewer side effects and complications,better nutritional and immune effects,and faster postoperative recovery,which is worthy of a generalization and application.

Objective To investigate the incidence of healthcare-associated infection (HAI)in patients in a respiratory in-tensive care unit (RICU)of a teaching hospital,and provide reference for HAI prevention and control.Methods All pa-tients admitted to this RICU from January to December 2014 were surveyed with prospective targeted monitoring method, surveyed data were analyzed statistically.Results A total of 561 patients were surveyed,43 patients developed 44 times HAI,HAI rate and HAI case rate were 7.66% and 7.84% respectively,incidence of HAI and adjusted incidence of HAI per 1 000 patient-days were 6.26‰ and 1.79‰ respectively.The main infection site was urinary tract (45.46%,n=20). Incidence of ventilator-associated pneumonia (VAP ),catheter-related bloodstream infection (CRBSI),and catheter-associat-ed urinary tract infection (CAUTI)per 1 000 catheter-days were 2.73‰(n=13),1.57‰(n=2),and 3.78‰(n=18)re-spectively.Incidence of HAI per 1 000 patient-days between the first and second half year of 2014 was significantly differ-ent(4.59‰ vs 7.89‰;u=-1.75,P =0.04).A total of 47 pathogenic strains were isolated,the main pathogens were gram-negative bacteria(n=26,55.32%).Conclusion The major HAI in RICU is device-associated infection,it is necessary to strengthen the management of invasive procedures;targeted monitoring can find the weak links of infection control prac-tice and helpful for taking effective prevention and control measures to reduce the incidence of HAI in ICU.