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.

OBJECTIVE:To provide reference and evidence for rational use of clinical nutrition. METHODS:The types of en-teral and parenteral nutrition and the cost of prescription were analyzed statistically in 17 third grade class A general hospitals,3 third grade class A special hospitals and 14 secondary general hospitals from Shanghai area during 2011 to 2013. RESULTS:Nutri-tion preparations were mainly used by hospitalized patients. Total cost of nutrition preparations in outpatient and emergency depart-ment respectively occupied 8.14%,8.77% and 8.89% of total cost of nutrition preparations in the hospital during 2011-2013. The parenteral nutrition was the main form of nutritional support. There were only three kinds of enteral nutrition in top ten nutrition preparations in the list of prescription cost. Although seven out of ten kinds of nutrition preparations were given enterally which was the main mode for outpatients and emergency patients,the cost of prescriptions of parenteral nutrition increased faster compared to enteral nutrition,especially alanyl-glutamine. CONCLUSIONS:Parenteral nutrition is the main mode of nutrition support,especial-ly for inpatients;great attention should be paid to the increase of the cost of prescriptions about parenteral nutrition in outpatients and emergency patients.

Adolescent ; Athletes ; Cortisone ; blood ; Diagnosis, Differential ; Drugs, Chinese Herbal ; therapeutic use ; Hemoglobins ; analysis ; Humans ; Male ; Medicine, Chinese Traditional ; Phytotherapy ; Testosterone ; blood

Objective To investigate the effect of selenium on proliferation and apoptosis of chondrocytes of articular cartilage cultured in vitro in Kaschin-Beck disease(KBD) patients and normal person, to explore the role of selenium in control of KBD, and to provide evidence for selenium's effect on the growth of normal cartilage cells. Methods The articular cartilage samples of grade Ⅱ and Ⅲ KBD patients were selected according to the national "Clinical Diagnosis of KBD" (GB 16003-1995). Chondrocytes of 5 KBD and 5 non-endemic normal accidentswere separated and cultured in vitro. KBD group and control group were given different doses of selenium (0,0.0125,0.0250,0.0500,0.1000,0.2500,0.5000,1.0000 mg/L, respectively). Methyl thiazolyl tetrazolium (MTT),flow cytometric analysis, and immunocytochemical staining were used to observe the effect of selenium on cell growth and apoptosis in KBD and normal persons. Results MTT results showed that the cell proliferation rate in each dosage group of the control group at the 6th day(0.086 ± 0.025,0.077 ± 0.012,0.073 ± 0.027,0.071 ± 0.017,0.058 ± 0.028,0.052 ± 0.028 and 0.046 ± 0.037) was significantly lower than that of 0 mg/L group(0.138 ± 0.026,all P ＜ 0.05);the average cell proliferation rate was negative( - 0.001 ± 0.001, - 0.003 ± 0.000, - 0.003 ± 0.001and - 0.004 ± 0.001 ) in 0.1000 - 1.0000 mg/L dose group, which was significantly lower than that of the 0 mg/L group(0.025 ± 0.003, all P ＜ 0.05);compared with 0 mg/L group(0. 115 ± 0.011), the KBD 0.2500 mg/L dose group promoted cell proliferation(0.128 ± 0.037, P ＜ 0.05), the KBD 1.0000 mg/L dose group inhibited cell growth (0.071 ± 0.019, P ＜ 0.05). The apoptotic rate of 0.0500 - 1.0000 mg/L dose control group [ (18.88 ± 0.02)%,(17.58 ± 0.01)%, (17.09 ± 0.04)%, (56.00 ± 0.02)%, (57.85 ± 0.03)% ] were higher than that of the 0 mg/L group[(13.51 ± 0.01)%, all P ＜ 0.05];compared with 0 mg/L group[(25.84 ± 0.02)%], the apoptotic rate in KBD 0.0250 - 0.2500 mg/L dose group [ ( 13.69 ± 0.02) %, ( 15.96 ± 0.03 ) %, ( 16.68 ± 0.03 ) %, ( 16.67 ± 0.02) % ]were lower, and the apoptotic rate in 0.5000, 1.0000 mg/L dose group [ (59.58 ± 0.03)%, (73.48 ± 0.04)% ] were significantly higher(all P ＜ 0.05). The Fas expression in KBD 0.0500 - 0.2500 mg/L dose groups[ (41.2 ± 1.5)%,(40.3 ± 2.0)%, (50.2 ± 2.5)%] were lower than those of the same dose control group with selenium intervention [(52.4 ± 1.0)%, (67.2 ± 4.0)%, (75.1 ± 5.0)%, all P ＜ 0.05], the caspase-3 expression in KBD 0.0500,0.1000 mg/L dose groups[ (40.8 ± 1.1 )%, (45.1 ± 2.1 )%] were lower than those of the same dose control group with selenium intervention[ (68.0 ± 3.0)%, (70.6 ± 3.5)%, all P ＜ 0.05 ]. Conclusions Appropriate dose of selenium supplementation (0.1000 - 0.2500 mg/L) could promote the growth of KBD chondrocyte, decrease cell apoptosis,but have a damage when the dose of selenium ＞ 0.5000 mg/L;doses of selenium that could promote the growth of KBD chondrocyte does not mean to promote the growth of normal cartilage cells in vivo.

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 investigate moisture content and hygroscopicity of spray dry powder of Gubi compound's water extract obtained at different spray drying conditions and laying a foundation for spray drying process of Chinese herbal compound preparation.

METHODIn the paper, on the basis of single-factor experiments, the author choose inlet temperature, liquid density, feed rate, air flow rate as investigated factors.

RESULTThe experimental absorption rate-time curve and scanning electron microscopy results showed that under different spray drying conditions the spray-dried powders have different morphology and different adsorption process.

CONCLUSIONAt different spray-dried conditions, the morphology and water content of the powder is different, these differences lead to differences in the adsorption process, at the appropriate inlet temperature and feed rate with a higher sample density and lower air flow rate, in the experimental system the optimum conditions is inlet temperature of 150 degrees C, feed density of 1.05 g x mL(-1), feed rate of 20 mL x min(-1) air flow rate of 30 m3 x h(-1).

Desiccation ; methods ; Drugs, Chinese Herbal ; chemistry ; Hydrophobic and Hydrophilic Interactions ; Particle Size ; Powders ; chemistry ; Temperature ; Water ; analysis ; Wettability

Objective To carry out a comparative study between the Chinese 2008 and'92 staging system of nasopharyngeal carcinoma (NPC). Methods A total of 777 patients presented with untreated nondisseminated NPC who had received MRI scan of nasopharynx and neck were studied retrospectively. The clinical materials and information of imaging were collected. All patients were restaged according to the Chinese 2008 and 92 staging system of nasopharyngeal carcinoma. Distribution of T, N stage, survival and prognostic value were compared. 513 patients of the 777 cases were treated with conventional radiotherapy,264 cases with intensity modulated radiation therapy. Results The 3-year follow-up rate was 97.6%. The consistency of T stages was 95.0%. T, N and clinical stage distributions in two systems were similar ( Kappa = 0. 93, P = 0. 000; Kappa = 0. 58, P = 0. 000; Kappa = 0. 74, P = 0. 000). Local failure-free survival and disease specific survival were also similar. There was no difference of distant metastasis between N0 and N1(x2 = 1.94,P=0. 164), and a marginal difference between N1 and N2(x2 =3.83,P=0.051) in the Chinese'92 staging system. However, although there was also no difference of distant metastasis-free survival between No and N1a(x2 =0. 07,P =0. 797), ) the difference of overall survival among N1b, N2, and N3 were significant ( x2 = 4. 95, P = 0. 026; x2 = 6. 74, P = 0. 009) in the Chinese 2008 staging system. Conventional radiotherapy or intensity modulated radiation therapy was not a prognostic factor for survival ( x2 = 3.60,P =0. 058). It is reasonable for the Chinese 2008 staging system integrated lymph node characteristics such as laterality, level and extranodal neoplastic spread into the N staging criteria ( x2 = 6. 59, P = 0. 010; x2 =4.78,P=0. 029;x2=9.32,P=0. 002). Conclusions For the Chinese 2008 staging system, it was reasonable to simplify the previous T stage. The N stage showed a better predictive role of distant failure.The role of retropharyngeal lymph node in stage system needs further investigation.

Objective To investigate the effects of Mycobacterium vaccae vaccine on immunological function and clinical character in elderly patients with stable chronic obstructive pulmonary disease (COPD). MethodsA total of 100 elderly patients with stable COPD were randomly divided into immunotherapy group (group A, n= 50) and non-immunotherapy group (group B, n= 50), and normal control group (group C, n = 50). The levels of peripheral blood T-lymphocyte subsets (CD3+ , CD4+, CD8+ , CD4+/CD8+ ratio), natural killer cells (NK cells), immunoglobulins (IgG, IgA, IgM) and cytokines (IL-6, IL-8, TNF-a) were measured respectively before and after therapy. Group A and B were followed up for 1 year, then the times of acute outbreak and hospitalization of patients in the two groups were also compared. Results The levels of CD4 + ,CD4+/CD8+ ratio and NK cells in group A, B were significantly lower before therapy (P＜0. 05～0. 01＝, and the levels of IL-6, IL -8, TNF-a and IgA were significantly higher than in group C (P＜0. 01＝. After treatment with Mycobacterium vaccae vaccine in group A, the levels of CD4+ , CD4+/CD8+ ratio and NK cells were significantly higher (P＜0. 05-0. 01＝ and IL-6, IL-8, TNF-a and IgA were significantly lower than before treatment (all P＜0. 01＝. These levels showed no significant changes in group B after treatment (P＞0. 05). After 1-year follow-up, the times of acute outbreak and hospitalization on patients were statistically lower in group A than in group B (P＜ 0. 01 ).ConclusionsMycobacterium vaccae vaccine can improve cellular immunity function and reduce the times of acute outbreak and hospitalization in patients with stable COPD, so it has a higher clinical application value.

Objective Diabetic mice models were established.Hearts were separated from the body,reperfused after ischemia,and disposed of with the extraneous calcitonin gene-ralated peptide (CGRP),to prove if the CGRP had protective effect on the early-staged diabetic mice with cardiac ischemia.Method ICR mice were injected with Streptozocins intraperitoneally to establish diabetic model.The model mice and the normal mice were randomly divided into 4 groups:two diabetic groups,two control groups.Hearts of the experimental mice were taken out from the chest cavity alive,and hanged on the Langendorff steadily for 30min.Western blot and radioimmunoassay techniques were used to test expression of Vanilloid receptor(VR1) and CGRP in myocardic tissue;Madlab system was used to test the cardiac function,which including left ventricular end-diastolic pressure (LVEDP),left ventricular developed pressure (LVDP),heart rate (HR),and coronary artery flow (CF),in the process of ischemic reperfusion,And ELISA assay kit was used to measure the concentration of the lactate dehydrogenase (LDH) in perfusion fluid collected from the heart.Result Expressions of VR1 and CGRP in diabetic hearts were significantly lower than those in normal ones 2 weeks later(P＜0.01).By comparing with normal hearts,diabetic hearts had higher LVEDP and CF (P＜0.05),and lower LVDP and HR(P＜0.05).However,release of LDH were lower than normal ones (P＜0.05).Predisposition of normal and diabetic hearts with CGRP can improve the cardiac function after ischemie injury.And the beneficial effect was more profound in early-staged diabetic hearts than in normal ones.Conclusion The diabetes disease(DM) can impair the expression of CGRP in myocardiac tissue.The extraneous CGRP may exert more potent protective effect on cardiac function in the early-staged diabetic heart.

BACKGROUNDBoth p16(INK4) and p21(Waf1) are tumor suppressors with similar biological functions in the regulation of cellular senescence. Previous reports showed that p16(INK4) could be activated by p21(Waf1) through transcriptional factor Sp1 in HeLa cells. This study was undertaken to determine the effects of p16(INK4) on the expression and functions of p21(Waf1).

METHODSHuman diploid fibroblast 2BS cells were stably transfected with sense (2BS/p16(INK4)), antisense p16(INK4) (2BS/asp16(INK4)) or empty vector (2BS/neo). Then they were assayed by reverse-transcription polymerase chain reaction (RT-PCR), fluorescence activated cell sorting (FACS) and Western blot.

RESULTS2BS/p16(INK4) cells exhibited cell cycle arrest in both G1 and G2/M phases. Endogenous p21(Waf1) protein levels increased twofold in the 2BS/p16(INK4) cells, but not decreased in the 2BS/asp16(INK4) cells. p21(Waf1) mRNA levels were not affected in neither 2BS/p16(INK4) nor 2BS/asp16(INK4) cells.

CONCLUSIONp16(INK4) may play an important role in the regulation of cellular senescence by modulating the p21(Waf1) protein level via the posttranscriptional mechanism.

Cell Cycle ; Cells, Cultured ; Cellular Senescence ; Cyclin-Dependent Kinase Inhibitor p16 ; physiology ; Cyclin-Dependent Kinase Inhibitor p21 ; physiology ; Fibroblasts ; metabolism ; Humans ; Transcription, Genetic