With the developmetn of the medical humanistic education,more and more problems appear.The casualness of the medical humanistic curriculum,the monotony of the method of the evaluation,the insufficiency of the content,the inadequacy of the quality of the teachers,and the poor effect of the education are the factors affecting the development of our medical humanistic education.Through comparison of the humanistic education home and abroad,we find the key to these problems are the innovation of the curriculum and evaluation.

OBJECTIVE To learn the disinfection and sterilization for dental instruments and to provide scientific basis for related regulations according to the scheme made by Beijing Center for Disease Prevention and Control.METHODS To investigate some dental medical units by adopting investigation form,inquirement,checking about the record for disinfection equipment including such items as air,the surface of used material,hands,etc.RESULTS Altogether 39 dental medical units including 9 hospitals,21 joint clinics and 9 private medical units were investigated with 96.11%,88.79%,and 70.97% qualified rates,respectively.CONCLUSIONS In private dental units the qualified rate for disfection is poor,disinfection instruments are short,and the professionals knowledge related to disfection is little.As a result,strengthening monitoring and guidance to prevent hospital infection should be carried out at once.

OBJECTIVE:To study the impact of ethanol volume fraction on the extract rate of ginsenoside monomer. METH-ODS:Water and different volume fraction of ethanol solution(20%,50%,70%,95%,V/V)were used for ginseng extract. High performance liquid chromatography-quadrupole-time of flight-mass spectrometry (Q-TOF LC/MS) was applied to identify compo-nents attributable of each peak. Especially 16 kinds of main saponins were analyzed. RESULTS:The volume fraction of ethanol had a significant impact on extract rate of ginsenoside. When the volume fraction of ethanol was 70%,extract rate of ginsenoside was the highest;however,the differences were mainly caused by protopanaxatriol saponins. The yield of protopanaxadiol ginsen-osides was similar in different volume fraction of ethanol solution. CONCLUSIONS:When the volume fraction of ethanol is differ-ent,result is not only different in the total saponin,but also different in the proportion of the monomers.

The effects of vasectomy on the reproductive organs in various species are controversial. This study investigated the morphological change and apoptosis of the testis, epididymis, and vas deferens in beagle dogs 12 months after vasectomy. The male beagles were divided into two groups: vasectomized and sham-operated groups (n=5 in each). Histopathological, ultrastructural, and TUNEL evaluation of the changes in the testis, epididymis, and ductus deferens of each animal were conducted 12 months after surgery. The mean lumen diameter, cellular thickness, mean interstitial distance, and lumen area fraction of each seminiferous tubule and ductus epididymis were measured by stereological analysis. The results showed that, compared with the sham-operated group, the seminiferous tubular epithelial cells of the testes in the vasectomized group were disorderly arranged and scattered. Significant atrophy and apoptosis were found in the endothelial cells, and a range of ultrastructural variations were observed in the cells of testes, epididymis, and vas deferens in vasectomized group. It was concluded that complete obstruction of the vas deferens as a traditional contraception method is not absolutely safe in terms of the reversal of fertility in the long run. Techniques of relieving the inner pressure in the vas deferens while maintaining the efficacy of male contraception need to be explored.

Objective To study the clinical effect, safety of stains collapse of traditional Chinese medicine (TCM) combined with tumor necrosis factor-alpha (TNF-α) antagonist-a recombinant human tumor necrosis factor receptor:Fc fusion protein (rhTNF:Fc) and sulfasalazine (SSZ) in treatment of active ankylosing spondylitis (AS). Methods A total of 98 patients of AS of Gansu Provincial Hospital were divided into two groups in random, the western medicine group (rhTNF:Fc and SSZ, n=46) and the combining group (stains collapse of TCM, rhTNF:Fc and SSZ, n=52). The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), Patient Global Assessment (PGA), Visual Analogue Scale (VAS) of night pain, VAS of total pain, time of morning stiffness, TCM symptom score, distance between occipital and wall, distance between finger and ground,
thoracic activity, Schober test, and erythrocyte sedimentation rate (ESR), C reactive protein (CRP), adverse reactions before and after treatment were observed and the clinical effect was evaluated in two groups. Results A total of 86 patients achieved the study finally, 45 patients in the combining group and 41 patients in the western medicine group. The effective rate of ASAS20 was better in the combining group than that in the western medicine group(χ2=4.814,P=0.028), the Bath ankylosing spondylitis disease activity index (BASDAI) 50 showed no significant difference between the two group (χ2=0.100,P=0.752). The total effective rate in the combining group than that in the western medicine group(χ2=3.873,P=0.049). In comparison with the same group before treatment, the above indicators were improved after treatment (P<0.05). In comparison with the western medicine group after treatment, BASFI, PGA, VAS of night pain, VAS of total pain, time of morning stiffness, TCM symptom score, distance between occipital and wall, distance between finger and ground and Schober test were getting better in the combining group (P<0.05), but BASDAI, thoracic activity, ESR, CRP were not improved in the combining group (P>0.05). The adverse reactions showed no significant difference (P>0.05). Conclusions Stains collapse of TCM combined with rhTNF:Fc was more effective than single method in treatment of AS, it can alleviated the symptoms, body signs and body function, decrease indexes of inflammation, which has dramatic effect and good safety in clinic.

In this work, a new method of heart sound signal preprocessing is presented. First, the heart sound signals are decomposed by using multilayer wavelet transform. And then double parameters as thresholds are used in processing each layer after decomposition for denoising. Next, reconstruction of heart sound signals could be done after processing last layer. Four methods, i.e. wavelet transform, Hilbert-Huang transform (HHT), mathematical morphology, and normalized average Shannon energy, were used to extract the envelop of the heart sound signals respectively after reconstruction of heart sounds. All methods were improved in this study. We finally in our study chose 30 cases of raw heart sound signals, which were selected randomly from a database comed from The Clinical Medicine Institute of Montreal, and processed them by using the improved methods. The results were satisfactory. It showed that the extracted envelope with the original signal has a high degree of matching, whether it is a low frequency portion or high frequency portion. Most of all information of heart sound has been maintained in the envelope.
Algorithms ; Heart Sounds ; Humans ; Signal Processing, Computer-Assisted ; Wavelet Analysis

This study aims to investigate the current situation of the enrollment , training model and career planning of medical students in the targeted admission program .After analyzing the implementation process of this targeted admission policy in medical education , we raised some feasible strategies to increase the attraction and reten-tion of health professionals in rural China .The study covered 4 medical universities in central and western China .A cohort of 308 medical graduates from this targeted admission program were recruited in June 2015 .A baseline survey , including questionnaire survey , in-depth interviews and the focus group discussions , were conducted right before their graduation .The first follow-up online survey was done 6 months after their graduation .he findings of this investiga-tion show that 72.9%of the investigated students in the program used to live in rural areas before 15 years old.The average annual household income was 28,200 Yuan.The top three reasons of choosing this program were guaranteed job after graduation , low performance in the college entrance examination , and wavier of tuition fee .There were sig-nificant differences of implementation of this policy between different provinces , especially the contract-signing and job deployment .Income and working environment were the main influencing factors of the medical graduates 'job-see-king intention .Based on the findings of this study , it can be concluded that the targeted admission program is rather successful in attracting medical graduates for rural health services .However , extra efforts are needed to improve the implementation of the policy and to retain the medical graduates in rural area .

Objective To investigate the prevalence and risk factors of chronic kidney disease (CKD) in Chengdu urban population and the prevalence of CKD in risk population.Methods Questionnaire (anamnesis,smoking,drink) of risk factors of CKD and somatoscopy (blood pressure,body height and body weight) were caried out in railman of Chengdu urban.Their blood and urine indicators (blood sugar,blood lipid,blood uric acid,blood creatinine,uromicroprotein/creatinine ratio,routine urine examination,etc) were measured.The prevalence and risk factors of CKD in Chengdu urban population and the prevalence of CKD in risk population were elucidated.Results Eligible data of 5326 subjects were enrolled in the study.After the adjustment of age and gender component,the prevalence of albuminuria was 11.54％,reduced eGFR was 5.54％,hematuria was 3.87％,and CKD was 18.32％; the recognition was 1.93％.In addition,the prevalence of albuminuria was respectively 23.79％,28.00％,14.08％; prevalence of reduced eGFR was respectively 4.76％,4.53％,3.26％; prevalence of hematuria was respectively 2.94％,3.20％,2.37％ in 3098 people with hypertension,diabetes or hyperlipaemia.Independent risk factors of albuminuria were female,hypertension,diabetes,hyperlipemia and high BMI.Independent risk factors of reduced eGFR were female,age,hyperuricemia and hypertension.Drink was negatively correlated with reduced eGFR.Independent risk factors of hematuria were female and age.Conclusions The prevalence of CKD is quite high and the recognition rate is low in the Chengdu urban populaton.Risk factors of CKD are age,female,diabetes,hypertension,hyperlipemia,hyperuricemia and high BMI.Control of the development of metabolic disease can reduce the CKD.

BACKGROUNDWith the development of patch clamp and molecular biology technique, and the application of them in the investigation of tumor cellular membrane ion channnel, the ion channel is becoming the hot spot of the tumor base research gradually. The aim of this study is to investigate the electrophysiological properties of human lung adenocarcinoma cell line A-549 and the role of K+ channel in inhibition of cell proliferation by the recombinant mutant human tumor necrosis factor (rmhTNF).

METHODSIonic currents were recorded using the whole-cell patch clamp recording technique. The proliferation activity of A-549 cells was measured by MTT assay. The cell cycle and apoptosis rates of the carcinoma cells were measured by flow cytometric analysis (FCM).

RESULTSWhole-cell patch clamp recording revealed a voltage-gated K+ current in A-549 cells, which could be blocked by the K+ channel blocker, TEA and CsCl. The amplitude of K+ current was markedly diminished in all cells incubated with different concentration of rmhTNF (P < 0.01). Obvious inhibitive effect of rmhTNF on proliferation of the cells was found in vitro in a dose-dependent manner (P < 0.01), the maximal inhibitory rate was 38.68% when the concentration was 400U/mL. The rmhTNF inhibited the cell cycle shifting from G1 phase to S phase and promoted apoptosis as determined by FCM analysis. The proportion of G1 cells increased from 53.02% to 72.93%, and the apoptosis rate increased from 2.08% to 8.68%. The difference were significant between the control and the high concentration groups ( 200U/mL and 400U/mL) (P < 0.01).

CONCLUSIONSrmhTNF exerts its cytotoxic effects on A-549 cells through inhibiting cell cycle shifting and inducing apoptosis. The K+ channels on the A-549 cell membrane can be blocked by rmhTNF partly, and the effect of inhibiting proliferation and activating apoptosis on A-549 cells is a result of depression of the K+ channel.