“新型角色扮演”教学法对临生沟通能力的影响

目的研究"新型角色扮演"教学法对临生沟通能力的影响,创新和发展高等医学院校沟通能力培养的教学模式和教学方法。方法将徐州医学院临床专业按年级分层随机抽样得到的120名临生分为干预组和对照组,对干预组进行为期1个月的以"新型角色扮演"教学法为主要内容的干预,并于干预前后采用沟通能力测量表进行测评。结果干预后,不论是与对照组比较,还是干预组前后自身的对照,沟通能力测量表的得分均有统计学意义(P<0.01)。结论采用"新型角色扮演"教学法能显著提高临生的沟通能力。

强化临生沟通能力培养创新外总实验教学内涵

目的研究外科总论实验教学对临生沟通能力的影响,创新和发展高等医学院校外科总论实验教学的模式和内涵。方法在徐州医学院临床专业某年级中,随机抽样取得2个教学班共100名临生,进行为期3个月以外科总论实验教学为内容的干预,并于干预前后采用人际关系量表进行测评。结果干预后,男女临生人际关系量表得分均有显著提高(P<0.01)。结论外科总论实验教学能够显著提高临生的沟通能力。

临生沟通能力调查

目的了解多样性高等医学教育模式和办学体制下临生的沟通能力。方法对696名临生采用问卷调查并进行分析。结果男女临生沟通能力显著低于常模,综合医学院校男女临生沟通能力分别优于独立医学院校男女临生,两种类型学校各自中低年级临生之间的沟通能力比较均无显著差异性。结论临生沟通能力尚有待提高,特别是独立医学院校的临生。

Vascular Calcification:Where is the Cure?

With the progress of aging,the incidence of vascular calcification(VC)gradually increases,which is correlated with cardiovascular events and all-cause death,aggravating global clinical burden.Over the past several decades,accumulating approaches targeting the underlying pathogenesis of VC have provided some possibilities for the treatment of VC.Unfortunately,none of the current interventions have achieved clinical effectiveness on reversing or curing VC.The purpose of this review is to make a summary of novel perspectives on the interventions of VC and provide reference for clinical decision-making.

Overview of Pharmacological & Ecological Research of Scirpus tabernaemontani Gmel

On the basis of extensive literature search, the species, ingredients, pharmacology, clinical applications, ecological value and cultivation techniques of Scirpus tabemaemontani Gmel have been reviewed, to provide scientific data for further research ＆ development.

ISSUES AND MEASURES ON ASSISTED REPRODUCTION BY ACUPUNCTURE ABROAD

As the application of acupuncture has been increased year by year in the field of overseas reproduction, it has become crucial to give a scientific and objective evaluation of the safety and efficacy of acupuncture in the field of assisted reproduction, which attaches great importance to the sustainable development of acupuncture in the field of reproduction. This article aims to introduce the current situation of overseas clinical study in the field of assisted reproduction, analyze the existing issues profoundly and put forward measures to solve them, in order to enhance the level of international clinical study of acupuncture.

Advances in Pharmaceutical and Ecological Value of Sagina japonica(Sw.) Ohwi

Sagina japonica（Sw.） Ohwi is a traditional medicinal herb for the treatment of lacquer dermatitis, and its medicinal and ecological value needs to be further developed. Based on broad literature search, this paper summarized the identification, composition, pharmacology, clinical applications, ecological value, and cultivation technologies of S. japonica（Sw.） Ohwi, aiming at providing scientific information for further research and development of S. japonica（Sw.） Ohwi.

Optimization of Supercritical Carbon dioxide Extraction of Ginger Essential Oil by Response Surface Method

[Objective] Ginger essential oil （GEO） is widely used in food production and medical field in recent years due to its prominent biological functions, and this study was conducted to obtain high-quality and high-purity ginger essential oil from the fresh ginger. [Method] GEO was extracted from ginger roots by supercritical fluid extraction （SFE） method. The effects of flow rate of CO2, mesh size of ginger powder and volume of entrainer were investigated by single-factor experiments and response surface method. The content and extraction rate of 6-gingerol represented the extraction index of GEO. [Result] The conditions were optimized as follows： flow rate of CO2 at 25 L/h, mesh size of ginger power of 80 mesh, and volume of anhydrous ethanol as entrainer of 92.46 ml. The optimal extraction rate of 6-gingerol was 3.21%, which was predicted by RSM. [Conclusion] The optimal process of supercritical carbon dioxide extraction of ginger essential oil was identified by singlefactor experiments and response surface method. The present study provides a satisfactory method for purifying GEO from ginger for industrial purpose.

Overview of Pharmaceutical Research on Passiflora foetida L.

Based on extensive literature search,the composition,pharmacology,clini cal applications of Passiflora foetida L,ecological characteristics were summarized with the aim to provide scientific data for further research and exploitation.

Effect of Allelochemicals of Chinese-fir root extracted by supercritical CO2 extraction on Chinese fir

Allelochemicals of Chinese-fir root was extracted by technology of supercritical CO2 extraction under orthogonal experiment design, and it was used to analyze allelopathic activity of Chinese-fir through bioassay of seed germination. The results showed that as to the available rate of allelochemicals, the pressure and temperature of extraction were the most important factors. The allelochemicals of Chinese-fir root extracted by pure CO2 and ethanol mixed with CO2 have different allelopathic activities to seed germination, and the allelochemicals extracted by ethanol mixed with CO2 had stronger inhibitory effects on seed germination than that extracted by pure CO2.

Impact of material and energy flow variation-based iron /steel ratio on production cost

This paper establishes a model for the production cost of iron and steel enterprise.The variation rule of the production cost versus the iron/steel ratio for two cases, namely,fixed steel production and a fixed amount of molten iron,is analyzed,and the concept of a steel scrap threshold price is proposed.According to the analysis results,when the steel scrap unit price exceeds the steel scrap threshold price, an increase in the iron/steel ratio can reduce the production cost,and vice versa.When the gap between the steel scrap unit price and the steel scrap threshold price is relatively large, the impact of the iron/steel ratio on the production cost is more prominent.According to the calculation example,when steel production is fixed （284 358 t/month）and the steel scrap unit price is 263.2 yuan/t more than the steel scrap threshold price,an increase of 0.01 in the iron/steel ratio causes a monthly production cost reduction of approximately 750 000 yuan （2.63 yuan/t）.When the amount of molten iron is fixed （270 425 t/month）and the steel scrap unit price is 140.7 yuan/t more than the threshold price,an increase of 0.01 in the iron/steel ratio causes a monthly production cost reduction of approximately 430 000 yuan （1.5 yuan/t）.The results indicate that iron and steel enterprise should adjust the production strategy in time when the scrap price fluctuates, and then the production cost will be reduced.

Application of a biochemical and clinical model to predict individual survival in patients with end-stage liver disease

AIM:To investigate the capability of a biochemical and clinical model,BioCliM,in predicting the survival of cirrhotic patients.METHODS:We prospectively evaluated the survival of 172 cirrhotic patients.The model was constructed using clinical(ascites,encephalopathy and variceal bleeding) and biochemical(serum creatinine and serum total bilirubin) variables that were selected from a Cox proportional hazards model.It was applied to estimate 12-,52-and 104-wk survival.The model's calibration using the Hosmer-Lemeshow statistic was computed at 104 wk in a validation dataset.Finally,the model's validity was tested among an independent set of 85 patients who were stratified into 2 risk groups(low risk≤8 and high risk>8).RESULTS:In the validation cohort,all measures of fi t,discrimination and calibration were improved when the biochemical and clinical model was used.The proposed model had better predictive values(c-statistic:0.90,0.91,0.91) than the Model for End-stage Liver Disease(MELD) and Child-Pugh(CP) scores for 12-,52-and 104-wk mortality,respectively.In addition,the Hosmer-Lemeshow(H-L) statistic revealed that the biochemical and clinical model(H-L,4.69) is better calibrated than MELD(H-L,17.06) and CP(H-L,14.23).There were no significant differences between the observed and expected survival curves in the stratified risk groups(low risk,P=0.61;high risk,P=0.77).CONCLUSION:Our data suggest that the proposed model is able to accurately predict survival in cirrhotic patients.

Effects on coagulation factor production following primary hepatomitogen-induced direct hyperplasia

AIM： To investigate the molecular mechanisms involved in coagulation factor expression and/or function during direct hyperplasia （DH）-mediated liver regeneration. METHODS： Direct hyperplasia-mediated liver regeneration was induced in female C57BL/6 mice by administering 1,4-bisr2-（3,5-dichloropyridyloxy）] benzene （TCPOBOP）, a representative hepatomitogen. Mice were weighed and sacrificed at various time points [Day 0 （D0： prior to injection）, 3 h, D1, D2, D3, and D10] after TCPOBOP administration to obtain liver and blood samples. Using the RNA samples extracted from the liver, a comprehensive analysis was performed on the hepatic gene expression profiling of coagulation-related factors by real-time RT-PCR （fibrinogen, prothrombin, factors Ⅴ, Ⅶ, Ⅷ, Ⅸ, Ⅹ, Ⅺ, Ⅻ, ⅩⅢβ , plasminogen, antithrombin, protein C, protein S, ADAMTS13, and VWF）. The corresponding plasma levels of coagulation factors （fibrinogen, prothrombin, factors Ⅴ, Ⅶ, Ⅷ, Ⅸ, Ⅹ, Ⅺ, Ⅻ, ⅩⅢ, and VWF） were also analyzed and compared with their mRNA levels. RESULTS： Gavage administration of TCPOBOP （3 mg/kg body weight） resulted in a marked and gradual increase in the weight of the mouse livers relative to the total body weight to 220% by D10 relative to the DO （control） ratios. At the peak of liver regeneration （D1 and D2）, the gene expression levels for most of the coagulationrelated factors （fibrinogen, prothrombin, factors Ⅴ, Ⅶ, Ⅷ, Ⅸ,Ⅺ, Ⅻ, ⅩⅢβ, plasminogen, antithrombin, protein C, ADAMTS13, VWF） were found to be downregulated in a time-dependent manner, and gradually recovered by D10 to the basal levels. Only mRNA levels of factor X and protein S failed to show any decrease during the regenerative phase. As for the plasma levels, 5 clotting factors （prothrombin, factors Ⅷ, Ⅸ, Ⅺ, and Ⅻ） demonstrated a significant decrease （P 〈 0.05） during the regeneration phase compared with DO. Among these 5 factors, factor Ⅸ and factor Ⅺ showed the most dramatic decline in their activities by about 50% at D2 compared to the basal levels, and these reductions in plasma activity for both factors were consistent with our RT-PCR findings. In contrast, the plasma activities of the other coagulation factors （fibrinogen, factors Ⅴ, Ⅶ, ⅩⅢ, and VWF） were not significantly reduced, despite the reduction in the liver mRNA levels. Unlike the other factors, FX showed a temporal increase in its plasma activity, with significant increases （P 〈 0.05） detected at DI. CONCLUSION： Investigating the coagulation cascade protein profiles during liver regeneration by DH may help to better understand the basic biology of the liver under normal and pathological conditions.

Possible involvement of leptin and leptin receptor in developing gastric adenocarcinoma

AIM： To investigate the expression of leptin and leptin receptor （ob-R） in intestinal-type gastric cancer and precancerous lesions, and to explore the possible mechanism and role of the leptin system in developing intestinal-type gastric adenocarcinoma.METHODS： Immunohistochemistry was performed to examine the expression of leptin and leptin receptor in archival samples of gastric adenocarcinoma and preneoplastic lesions, including intestinal metaplasia and mild to severe gastric epithelial dysplasia. Positive staining was identified and percentage of positive staining was graded.RESULTS： Dual expression of leptin and leptin receptor were detected in 80% （16/20） intestinal metaplasia, 86.3% （25/30） mild gastric epithelial dysplasia, 86.7% （26/30） moderate gastric epithelial dysplasia, 93.3% （28/30） severe gastric epithelial dysplasia, 91.3% （55/60） intestinal-type gastric adenocarcinoma and 30.0% （9/30） diffuse-type gastric carcinoma. The percentage of dual expression of leptin and leptin receptor in intestinal-type gastric adenocarcinoma was significantly higher than that in diffuse-type gastric adenocarcinoma （χ^2 = 37.022, P〈0.01）.CONCLUSION： Our results indicate the presence of an autocrine loop of leptin system in the development of intestinal-type gastric adenocarcinoma.

The Establishment and Characterization of a Continuous Cell Line of Mouse Cervical Carcinoma

OBJECTIVE To establish a murine uterine cervical cancer cell line and to define its biological characters. METHODS Transplanted tumor tissue was used for in vitro primary culture of U14 cervical carcinoma cells. After 20 passages, we examined its morphology, chromosomes, tumorigenicity and produced a growth curve. CK was detected by immunohistochemistry, the cell cycle determined by flow cytometry and the metastatic potential assessed in 615 and C57BL/c mice. We also transfected the cells with the pEGFP-N1 plasmid. RESULTS A newly established murine cell line was passaged 50 times over a period of 10 months. The cells grow as a partially suspended culture, and are immunohistochemically CK（＋）. The cell line is characterized by a hypotetraploid karyotype, a chromosomal number of 64-68 and a doubling time of 21.8 h. Exponential growth occurs by the third and forth day of culture. Cell cycle analysis showed G1 34%, G2 26%, and 40% in the S phase. The tumorigenicity was 100% upon implantation. No mycoplasma contamination was detected. A monoclonal continuous U14-GFP cell strain which was 100% GFP （＋） was also produced. CONCLUSION We successfully established a new murine cervical U14 carcinoma cell line and an U14-GFP monoclonal strain. These cell lines are ideal for combined in vivo and in vitro tumor research.

Increasing the use of biocompatible,glucose-free peritoneal dialysis solutions

A major concern inhibiting some clinicians from embracing peritoneal dialysis(PD) as the preferred first modality of dialysis is the effects of PD solutions on the peritoneal membrane. These anatomical and functional changes predispose to complications like peritonitis,encapsulating peritoneal sclerosis and ultrafiltration failure. In recent years, "biocompatible" and glucosesparing PD regimens have been developed to minimize damage to the peritoneal membrane. Can the use of these more expensive solutions be justified on current evidence? In this review of the literature, we explore how we may individualize the prescription of biocompatible PD fluid.

Low gradient ascites: A seven-year course review

AIM: To study the patients with low gradient ascites in hospitals of Guilan Province (northern Iran).METHODS: Patients admitted in hospitals of Guilan Province with low gradient ascites from 1993 to 2000 were enrolled in the study. Serum and ascitic fluid albumin levels were determined by biochemical reactions. The serum-ascitic albumin gradient (SAAG) less than 1.1 g/dL was considered low. Statistical analysis was performed with SPSS 9.0software and P＜0.05 was considered statistically significant.RESULTS: Of the 148 patients enrolled in the study, 72(48.6%) were males and 76 (51.4%) were females with a mean age of 59.03±13.54 years. Tuberculous peritonitis was the most frequent cause of low gradient ascites in 68 (45.9%). Other most frequent causes were cancer in 62 (41.9%), nephrotic syndrome in 9 (6%), pancreatitis in 6 (4%). Peritoneal cancer was found in 22 (35%),ovarian and gastric cancers were found in 14 (22.5%)and 12 (19.3%), respectively. All of which were the causes of ascites. The mean SAAG was 0.68±0.19 g/dL. The mean serum and ascitic fluid albumin concentrations were higher in tuberculous patients (P＜0.006), but lactate dehydrogenase (LDH) level was higher in cancer patients (P＜0.0001). In peritoneal tuberculosis, mean ascitic glucose concentration was significantly lower than other patients (P＜0.0001).CONCLUSION: Tuberculosis should be considered in all patients with low gradient ascites especially in developing countries (like Iran), as the first cause of ascites. In the approach to patients with low gradient ascites, ascitic fluid glucose, and LDH level are useful indicators for decision making.

Quality of life in gastric cancer

AIM: To summarize the empirical research on assessing quality of life (QOL) in patients with gastric carcinoma. METHODS: Literature searches were conducted in MedLine from 1966 to February 2004. RESULTS: Twenty-six studies were identified. QOL was used as an outcome measure in virtually all identified studies, such as those examining the effects of gastric cancer and various medical or surgical treatments in the patients. QOL was assessed mainly with generic measures; the social dimensions of QOL were largely neglected. The lack of gastric cancer-specific QOL measures hampers QOL research up to now. The gastric cancer-specific EORTCQLQ-STO22 and the FACT-Ga are important additions to the arsenal of disease-specific QOL measures. In most of the studies, the label QOL is used for questionnaires, which only assess symptoms or performance status, or are physician-reported rather than patient-reported outcomes. CONCLUSION: QOL in patients with gastric cancer deserves more systematic studies, especially as one of the outcome measures in randomized clinical trials. Results of studies that include QOL in patients with gastric cancer should be applied in clinical care, which aims at improving QOL of these patients.

Cancer gene therapy targeting angiogenesis:An updated review

Since the relationship between angiogenesis and tumor growth was established by Folkman in 1971, scientists have made efforts exploring the possibilities in treating cancer by targeting angiogenesis. Inhibition of angiogenesis growth factors and administration of angiogenesis inhibitors are the basics of anti- angiogenesis therapy. Transfer of anti-angiogenesis genes has received attention recently not only because of the advancement of recombinant vectors, but also because of the localized and sustained expression of therapeutic gene product inside the tumor after gene transfer. This review provides the up-to-date information about the strategies and the vectors studied in the field of anti-angiogenesis cancer gene therapy.

Hepatitis B virus-induced oncogenesis

Hepatocellular carcinoma (HCC) is one of the most com- mon cancers in the world with an annual incidence of more than 500 000 in the year 2000. Its incidence is rising in many countries. Recently, it has been estimated that about 53% of HCC cases in the world are related to hepatitis B virus (HBV). The epidemiological association of HBV with HCC is well established. In recent studies, it was revealed that HBsAg carriers have a 25-37 times increased risk of developing HCC as compared to non-infected people. At present, HBV-associated carcinogenesis can be seen as a multi-factorial process that includes both direct and indirect mechanisms that might act synergistically. The integration of HBV DNA into the host genome occurs at early steps of clonal tumor expansion. The integration has been shown in a number of cases to affect a variety of cancer- related genes and to exert insertional mutagenesis. The permanent liver inflammation, induced by the immune response, resulting in a degeneration and regeneration process confers to the accumulation of critical mutations in the host genome. In addition to this, the regulatory proteins HBx and the PreS2 activators that can be encoded by the integrate exert a tumor promoter-like function resulting in positive selection of cells producing a functional regulatory protein. Gene expression profiling and proteomic techniques may help to characterize the molecular mechanisms driving HBV-associated carcino- genesis, and thus potentially identify new strategies in diagnosis and therapy.