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This paper expounds that the construction of a clinical teacher's teaching ability model is an urgent problem to be solved in medical colleges and universities, and analyzes that the current clinical teaching concepts and methods are constantly improving, and the clinical teaching environment is more informatized and intelligent. This paper summarizes the clinical teachers' teaching ability models at home and abroad, such as the ability and quality iceberg model, teacher growth model, inquiry-based teaching model, Molenaar three-dimensional teaching ability model, etc., and discusses the practice research progress of current clinical teacher teaching ability models such as student-centered guided teaching, bedside teaching, micro-teaching and BOPPPS (bridge-in, objective, pre-assessment, participatory-learning, post-assessment, and summary) method, medical simulation teaching, etc., hoping to provide guidance for further constructing models of teacher's teaching ability suitable for Chinese medical colleges and universities.
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Objective To analyze the changes of CD4+ T cell numbers at different periods of antiviral therapy in HIV-infected and AIDS patients (HIV/AIDS) in Yichang City. Methods The relevant information was retrieved from the National AIDS Comprehensive Prevention Information System-Antiretroviral Treatment Management Database. Changes in the number of CD4+ T cells were analyzed in HIV/AIDS patients who started receiving highly active antiretroviral therapy (HAART) and continued the treatment for 3 years from January 1, 2003 to December 31, 2017 in Yichang. Results The number of CD4+T lymphocytes in 550 HIV/AIDS cases increased significantly at various time points within 3 years after treatment, and increased with the increase of treatment time（F=100.20，P<0.001）. The CD4+T cell counts of different baseline level groups were statistically different before and after treatment（F=8.57，P<0.01）. The CD4+ T cell counts of patients who started treatment at age of 15-30 years old increased faster than those who started treatment at age of over 30 years old（F=1.27，P<0.05）. Conclusion HAART has a significant effect on the increase of CD4+T cells, and the early treatment is more effective. Early detection, diagnosis and treatment should be promoted, and anti-viral treatment should be actively carried out.
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OBJECTIVE： To establish the method for the content determination of chlorogenic acid， ligustrazine， ferulic acid， senkyunolide I， senkyunolide H， coniferly ferulate， senkyunolide A， n-butylphtalide， Z-ligustilide and n-butylidenephthalide in Ligusticum chuanxiong under different storage conditions. METHODS： HPLC method was adopted. The determination was performed on Boston C18 column with mobile phase consisted of acetonitrile-0.5％ acetic acid solution （gradient elution） at the flow rate of 1.0 mL/min. The detection wavelength was set at 285 nm， and the column temperature was 30 ℃. The sample size was 5 μL. RESULTS： The linear range of chlorogenic acid， ligustrazine， ferulic acid， senkyunolide I， senkyunolide H， coniferly ferulate， senkyunolide A， n-butylphtalide， Z-ligustilide n-butylidenephthalide were 0.030 53-0.519 01 μg （r＝0.999 5）， 0.001 02-0.017 34 μg （r＝0.999 9）， 0.012 83-0.218 11 μg （r＝0.999 5）， 0.007 63- 0.129 71 μg （r＝0.999 7）， 0.001 76-0.029 92 μg （r＝0.999 5）， 0.054 74-0.930 58 μg （r＝0.999 9）， 0.215 80-3.668 60 μg （r＝0.999 9）， 0.018 02-0.306 34 μg （r＝0.999 7）， 0.232 50- 3.952 50 μg （r＝0.999 9）， 0.002 40-0.040 80 μg （r＝0.999 5）.The limits of quantitation were 2.073 7， 0.556 6， 0.753 8， 0.231 5， 0.306 9， 0.925 2， 2.295 3， 4.624 0， 3.215 3， 0.910 5 ng， respectively. The detection limits were 0.622 1， 0.167 0， 0.226 1， 0.069 4， 0.092 1， 0.277 6， 0.688 6， 1.387 2， 0.964 6， 0.273 1 ng， respectively. RSD of precision， stability and repeatability tests were all less than 5％ （n＝6）. The recovery rates were 95.90％-103.28％ （RSD＝2.99％， n＝6）， 88.24％-107.84％ （RSD＝4.89％， n＝6）， 95.06％-102.08％ （RSD＝3.97％， n＝6）， 93.67％-101.05％ （RSD＝1.02％， n＝6）， 94.81％-104.33％ （RSD＝2.34％，n＝6）， 94.41％-105.59％ （RSD＝4.32％， n＝6）， 92.76％-104.83％ （RSD＝1.95％， n＝6）， 87.22％-102.56％ （RSD＝2.89％， n＝6）， 94.04％-99.52％ （RSD＝0.92％， n＝6）， 88.51％-103.83％ （RSD＝4.89％， n＝6）， respectively. At 5 ℃ and 15 ℃， no obvious deterioration was observed in medicinal materials. At room temperature， some samples were moth-eaten and mildewed. The content ranges of 6 batches of samples were 0.047 7％-0.160 8％， 0.006 1％- 0.022 7％， 0.048 2％-0.172 2％， 0.023 3％-0.145 2％， 0.004 6％-0.030 7％， 0.085 2％-0.835 4％， 0.182 6％-2.112 7％， 0.009 9％- 0.098 3％， 0.614 9％-3.176 2％ and 0.005 7％-0.036 9％， showing decreasing trend； the decrease rate was in descending order 5 ℃＜15 ℃＜room temperature； at the same storage temperature， the decrease rate of polyethylene plastic bag was lower than that of polypropylene woven bag. CONCLUSIONS： This method is accurate and feasible， and can be used for simultaneous determination of 10 kinds of components in L. chuanxiong. It is suggested that L. chuanxiong medicinal materials should be sealed and packed in dry and cool places and should not be stored for a long time.
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Objective To analyze the characteristics and changes in the disease spectrum of Air Force(AF) servicemen in order to provide reference for the determinatron of the overall level of health of AF and priorities of disease prevention and control.Methods The data of outpatient and inpatient diseases between 2009 and 2013 in AF was collected and analyzed statistically according to the International Classification of Diseases-9(ICD-9),and statistical description was performed with SPSS18.0.Results Between 2009 and 2013,unit B had the highest number of outpatients and inpatients,accounting for 47.74% and 39.64% respectively.The upper respiratory tract infections,gastroenteritis/gastritis,chronic low back pain,skin diseases,nasal sinusitis,training injury,trauma,hemorrhoids,varicocele and stone diseases were the common and frequently occurring diseases in AF,which were the top ten in the disease spectrum.Among them,the incidence and admission rate of skin diseases kept declining.However,the incidence of gastroenteritis/gastritis in unit A,the incidence and admission rate of chronic low back pain in unit B and D,the incidence of injury in unit D,as well as the incidence of neurological headache and hypertension in unit C and D were higher than in other units.Conclusion Respiratory system disease,and occupation-related diseases such as low back pain,training injuries,trauma,skin disease and digestive system disease are the focus of health care in AF.Health education and health promotion for these diseases should be improved,and health intervention for key populations should be enhanced.
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An efficient method for the analysis of multiclass plant growth regulators and pesticide (imidacloprid, acetamiprid) residues in tea was developed based on ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). The samples were extracted with acetonitrile/formic acid (99∶1, V/V) solution, cleaned up with four sorbents including C18, strong anion exchanger (SAX), primary secondary amine (PSA) and anhydrous MgSO4. The compounds were separated on a HSS T3 column under positive/negative electrospray ionization mode, detected by scheduled multiple reaction monitoring (SMRM), and quantified by matrix-matched external standard curves. All pesticide residues showed good linearity in the concentration range of 1-200 μg/L (6-benzylaminopurine, paclobutrazol, uniconazole, forchlorfenuron, mepiquat chloride, imidacloprid, acetamiprid) or 5-1000 μg/L (2,4-dichlor-ophenoxyacetic acid, 4-chlorophenoxyacetic acid, indole-3-acetic acid, gibberellic acid, 1-naphthaleneacetic acid, indole-3-butyric acid) , with correlation coefficient (R2≥0.99). Limits of detection (LOD, S/N=3) and limits of quantitation (LOQ, S/N=10) were 0.18-9.68 μg/kg and 0.61-32.26 μg/kg, respectively. In addition, the spiked recoveries of tea samples were 73.1％-108.9％, and RSDs were 0.6％-8.0％. This method was applied to commercial samples, and all the detections were confirmed by acquiring transitions for each pesticide in the samples.
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This paper studied the influence ofsurface preponderantfungi on main effective substances of CitriReticulatae Pericarpium (CRP).Spreading plate method was used to isolatepredominant strains from the surface of CRP.Besides,the method combining microscopic and molecular identification was also adopted.HPLC and UVspectrophotometric methods were used to determine the main effective substances in CRP.From thesurface of CRP,the advantage strain fungi were Aspergillusniger and A.Flavus.After the inoculation of A.Niger and A.flavus against CRP,the effective compositionwas changed.And different A.niger strains had differenceeffectiveness oneffective chemical components,especially one strain of A.niger.Compared withthe control group,contents of total flavonoids and hesperidin were significantly increased (P＜0.01);and five types of obvious new chemical compositions were produced.It was concluded that the metabolic transformation of fungi was related tochanges ofeffective substances of CRP,which played a significant role in the aging process of CRP.The growth and metabolism of fungi consumeeffeetive substances and producechanges of composition.From the perspective of microorganisms,"the older,the better" of CRP hasa better explanation.
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Chinese medicinal materials are likely to be polluted by various kinds of fungal toxins during the plantation,collection,transportation and storage,which results in the possibility that quality,safety and treatment effect fails to meet the requirement of safe medicine.This paper reviewed the domestic and overseas studies on the pollution of fungus and fungal toxins in herbs,and made an introduction to the limit standard of fungus and fungal toxins.This paper discussed the importance to establish the inspection standard of various fungal toxins in Chinese medicinal materials and their limit standards to provide references to medication safety and improvement of quality control standard system of Chinese medicinal materials.
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An efficient technique for the determination of multiclass pesticide residues ( glyphosate, aminomethyl phosphonic acid ( AMPA) and glufosinate) in four kinds of tea ( green tea, black tea, Oolong tea and Puer tea) was developed based on ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). Samples were extracted with 0. 05 mol/L NaOH solution, regulated pH value with HCl, followed by purification by Oasis HLB column, and then precolumn-derived with 9-fluorenylmethyl chloroformate ( FMOC-CL ) in borate buffer. All pesticide residues studied showed good linearity with correlation coefficient ( R2 ) greater than 0. 99 in the concentration range of 5-1000 μg/L. Limits of quantitation (LOQs) of three pesticide compounds ranged from 0. 03 to 0. 08 mg/kg (S/N=10). Tea samples spiked with 0 . 1 , 0 . 4 and 4 mg/kg showed the recovery ranging from 72 . 1% to 109 . 9%, and RSDs from 0. 5% to 9. 8% (n=6). In addition, the validated method was applied to commercial samples, and all the detections were confirmed by acquiring transitions for each pesticide in samples.
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Objective To investigate the mortality and cause of death in inpatients with cerebral infarction. Methods The clinical data of 515 patients with cerebral infarction as the underlying cause of death from January 2005 to December 2009 were analyzed retrospectively. The hospital mortality, direct cause of death,and constituent ratio of the cause of death were calculated. The clinical features,such as classification of the Trial of Org 10 172 in acute stroke treatment( TOAST),age and duration of hospital-ization were analyzed. Results ( 1 )The hospital mortalities in patients with cerebral infarction from 2005 to 2009 were 2. 0%(91/4 659),2. 1%(110/5 264),1. 9%(95/5 035),1. 2%(100/8 656),and 1. 0%(119/11 640),respectively. The overall mortality rate was 1. 5%(515/35 254),basically had a declining trend year by year(χ2 =42. 39;P74 years)groups were 1. 1%( 22/2 009 ),1. 0%( 112/11 158 ),1. 5%( 221/14 311 ),and 2. 1%(160/7 776),respectively. They increased with increasing age(P<0. 01).(3)The TOAST classification in 515 died patients were as follows:57. 3%(n=295)for large-artery atherosclerosis,19. 4%(n=100) for cardioembolism,14. 4%(n=74)for cryptogenic stroke,7. 0%(n=36)for small-artery occlusion and 1. 9%(n=10)for other reasons. The five leading direct cause of death were cerebral hernia 49. 3%(n=254),primary central respiratory and circulatory failure 25.0%(n=129),pneumonia 8. 9%(n =46), cerebral-cardiac syndrome 5. 8%( n =30 ),and multiple organ failure 5. 6%( n =29 ).( 4 ) The mean age of death was 67 ± 12 years old. The patients who died of cerebral hernia and primary central respiratory and circulatory failure were younger than those who died of pneumonia(65 ± 13,68 ± 11,and 75 ± 10,respectively;all P<0. 01). The median length of hospital stay was 3 days. The length of hospital stay in patients who died of hernia,primary central respiratory and circulatory failure,and cerebral-cardiac syndrome were significantly shorter than those who died of pneumonia and multiple organ failure( the median length of hospital stay was 3. 0,3. 0,3. 0,12. 5,and 9. 0 days,respectively;all P <0. 05). Conclusions The mortality of hospitalized patients with cerebral infarction have a declining trend year by year. Brain disease itself is the most important reason of early death for patients with cerebral infarction, indicating that it is the important point of prevention and treatment in clinical work.
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Objective To analyze the change in the concentration of IL-17 and IL-10 inflammatory factors among the deadaptation personnel who returned from the plateau.Methods A total 21 healthy males were investigated who averaged 25 years in age, lived permanently in the plains (200 m), and once stayed to the plateau (Lasha) for 6 months.Their venous blood was collected at three time points:the day before ascending to the plateau(control), the second day after return to the plains(d2) and the 30th day(d30), respectively.Their serum was seperated from the whole blood and the level of IL-17A and IL-10 was detected by ELISA method.Results The concentration of IL-17A and the IL-17A/IL-10 ratio were significant increased at d2 and d30, respectively, compared with control (P<0.05).Compared with d2, IL-17A and the IL-17A/IL-10 ratio were decreased obviously at d30(P <0.05).The level of IL-10 at d2 and d30 was significantly reduced compared with control ( P <0.05), but increased at d30 compared with d2.Correlative analysis showed that there was a negative correlation in the levels of IL-10 and IL-17A between control, d2 and d30, respectively (r1=0.948, P<0.05;r2=0.969, P<0.05;r3=0.972, P<0.05).A significant negative correlation was observed in the alteration levels of IL-10 and IL-17A between the three groups(r4=-0.793, P<0.05; r5=-0.756, P<0.05). Conclusion The concentration of inflammatory factors among the plateau deadaptation patients is imbalanced, but it is gradually reduced with time.The mechanism is still not clear.
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As a famous-region Dao-di Herbs, Ligusticum chuanxiong which mainly grows in the west of the upper reaches of Jinma River in Dujiangyan for a long time. In recent years, the history, species and origin of L. chuanxiong were researched by many scholars. However, the forming pattern of Dao-di herbs of L. chuanxiong has not been reported systematically. Basing on the general principles of the formation of Dao-di herbs, it can be concluded that the forming pattern of L. chuanxiong is the type of two determinants, which are combined both unique ecological environment of genuine regions and advanced cultivation techniques.
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China , Ecology , LigusticumABSTRACT
<p><b>OBJECTIVE</b>To establish the fingerprint chromatograms of the extract of Cimicifugae Rhizoma firstly.</p><p><b>METHOD</b>Phenolic acids and triterpenoid saponins were analyzed by HPLC. Hypersil BDS C18 (4.6 mm x 250 mm, 5 microm) column was used, the mobile phase was composed of acetonitrile -0.1% H3PO4 with gradient elution, flow rate was 1.0 mL x min(-1), column temprature was 30 degrees C, and the detection wavelength was set at 316 nm and 210 nm.</p><p><b>RESULT</b>In the fingerprint of phenolic acids, thirteen feature peaks were found and the RSD of relative retention time and relative peak area were all less than 3% in the precision and repeation experiments. The similarity of ten batches of samples were all more than 0.90. In the fingerprint of triterpenoid saponins, fourteen feature peaks were found and the RSD of relative retention time and relative peak area were all less than 4% in the precision and repeation experiments. The similarity of ten batches of samples were all more than 0.90.</p><p><b>CONCLUSION</b>This method is comprehensive, stable, reliable and can be used to evaluate the quality of the extract of Cimicifugae Rhizoma. It has provided a reference to the analysis on pharmacodynamic deferences of Cimicifuga extracts and also laid the foundation for its further development.</p>