Effect of rehabilitation training combined with bailing capsule on the efficacy and pulmonary function of patients with chronic obstructive pulmonary disease via RhoA/Rho-kinase signaling pathway / 中国医师进修杂志

Objective:To investigate the effect of respiratory rehabilitation training combined with bailing capsule on the efficacy and lung function of patients with chronic obstructive pulmonary disease (COPD) through RhoA/Rho-kinase signaling pathway.Methods:One hundred patients with COPD from February 2016 to September 2017 in the Eighty-Eleventh Army Hospital of Hebei Army were randomly divided into control group (50 cases) and bailing capsule + respiratory rehabilitation training group (50 cases). At the same time, 50 healthy people were selected as blank group. The patients in the control group were treated with bailing capsule, and patients in the combined treatment group were treated with respiratory rehabilitation training combined with bailing capsule. The pulmonary function (FEV 1, FVC, FEV 1/FVC%) and clinical efficacy were analyzed. The expression of RhoA, Rock Ⅰ/Ⅱ protein and mRNA were detected by immunoblotting and qRT-PCR. Results:After treatment, the indexes of pulmonary function in the combined group were significantly higher than those in the control group: (2.34 ± 0.91) L vs. (1.91 ± 0.83) L, (2.98 ± 0.83) L vs. (2.34 ± 0.86) L, (79.63 ± 9.95)% vs. (76.13 ± 6.97)% ( P < 0.05). Compared with the blank group, RhoA mRNA and Rock Ⅰ/Ⅱ mRNA in the combined treatment groups were significantly higher than those in the control group ( P < 0.05), and RhoA mRNA and Rock Ⅰ/Ⅱ mRNA in the combined group were significantly lower than those in the control group ( P < 0.05). Compared with the blank group, the RhoA mRNA and Rock Ⅰ/Ⅱ proteins combined treatment groups were significantly higher than those in the control group ( P < 0.05), and the RhoA mRNA and Rock Ⅰ/Ⅱ proteins in the combined group were significantly lower than those in the control group (2.46 ± 0.18 vs. 4.38 ± 0.21, 1.72 ± 0.11 vs. 2.36 ± 0.24, 1.79 ± 0.24 vs. 3.34 ± 0.21) ( P < 0.05). After treatment, the 6MWD and the total clinical effective rate in the combined group were significantly better than those in the control group: 92.00% (46/50) vs. 78.00% (39/50) ( P < 0.05). Conclusions:Respiratory rehabilitation training combined with bailing capsule can significantly improve the pulmonary function of COPD patients, improve the clinical efficacy, and can down-regulate the expression of RhoA, Rock Ⅰ/Ⅱ protein and mRNA through RhoA/Rho-kinase signaling pathway.

A Comparative Analysis of Medical Education Models and Curriculums of A Medical University and A Medical Education Center.

INTRODUCTION: In order to solve the shortage of competent healthcare manpower at the village level of Yunnan Province, We compared the training mode of Kunming Medical University and The Medical Educational Center, Hat Yai of PSU. The aim of this study is to compare the difference of the two institutions and learn from each other's advantages. METHODS: The review covered relevant policy areas and stipulations governing general practitioner training for both countries. Qualitative research was done by using a questionnaire developed in house by the project team, students from the inaugural cohort at KMU and students from the MECH. In Qualitative research, in-depth interviews were carried out with the teaching administration and students from both schools. RESULTS: In Kunming Medical University, besides the conventional lectures, teaching methods such as case based learning and problem based learning have been worked into the basic science, laboratory, and clerkship/internship sessions. The desired end product is a general practitioner. The curriculum emphasizes general practice and clinical exposure during the course being guided and informed by the "Undergraduate Medical Education Standard-Clinical Medicine" and the "General Practitioner Training Guidelines" about teaching methods. In Prince of Songkla University, the first and second phases consist of basic science and preclinical integrated topics taught at PSU. For the third and final phase, the students have core clinical modules and selective at MECH where the methods are learner centered, problem based, integrated and set in the context of community primary healthcare practice. CONCLUSIONS: We should start with the integration of the medical disciplines and the humanities, so as to restore the lost "art of doctoring". We need to integrate the various foundational and clinical disciplines into an organ system based curriculum, not just in form, but also in function and purpose.

The effect of exercise combined with bailing capsules on chronic stationary obstructive pulmonary disease / 中华物理医学与康复杂志

Objective To observe and compare the effect of Cordyceps sinensis ( bailing ) capsules com-bined with weight-bearing breathing exercises, and weight-bearing breathing exercises combined with tiotropium bro-mide and seretide, on patients with stable but moderate-to-severe chronic obstructive pulmonary disease (COPD). Methods Sixty-three patients with moderate-to-severe COPD were randomly divided into an observation group and a control group. Both groups performed weight-bearing breathing exercises, supplemented in the observation group with the oral administration of bailing capsules. The control group instead inhaled tiotropium bromide and seretide. Six-mi-nute walking distance, the COPD assessment test ( CAT scores) and concentrations of interleukin-6 ( IL-6) , interleu-kin-8 ( IL-8) and tumor necrosis factor-α ( TNF-α) were observed after 1 ( T1) , 30 ( T2) and 58 ( T3) days of the treatments. Results At T1 there were no significant differences between the two groups in any of the measurements ( P≤0.05) . At T2, there were still no significant differences except that a significant decrease in IL-8 and TNF-αlevels was observed in the control group. At T3 the average CAT scores had decreased significantly in both groups compared to before the treatment but there was no significant difference between the two groups. In the observation group, the average 6MWT distance had increased significantly compared to before the treatment and compared to the control group, where there was no significant improvement. The average IL-6, IL-8 and TNF-αreadings of the control group were significantly lower than those of the observation group at T3 and compared to before the treatment. No sig-nificant changes in those indicators were observed in the observation group at T3. Conclusions Bailing capsules combined with weight-breathing exercises are more effective for relieving dyspnea symptoms and improving exercise capacity than weight-breathing exercises combined with tiotropium bromide and seretide. However, in controlling air-way inflammation and airway hyper-responsiveness, the triple inhalation combined with weight-bearing breathing exer-cises is more effective.

Effect of 1, 25(OH)2D3 on the proliferative ability of and methylation levels of genomic DNA and proliferation-associated gene promoter in human HaCaT keratinocytes / 中华皮肤科杂志

Objective To estimate the influence of 1,25(OH)2D3 on the proliferative ability of and methylation levels of genomic DNA and proliferation-associated gene promoter in human HaCaT keratinocytes.Methods Some cultured HaCaT cells were treated with 1,25 (OH)2D3 of 10-6,10-7 and 10-8 mol/L for 24 hours,then,methyl thiazolyl tetrazolium (MTT) assay was carried out to evaluate the proliferative activity of cells,and a global DNA methylation quantification kit was used to determine the global DNA methylation level.Real-time PCR was conducted to quantify the mRNA expression of DNA methyl transferases (DNMTs) and methyl-DNA binding domain (MBD) proteins,and methylation-specific PCR (MS-PCR) to evaluate the methylation status of promoter region in the programmed cell death 5 (PDCD5) and tissue inhibitor of metalloproteinase 2 (TIMP2) genes,in HaCaT cells after 24-hour treatment with 1,25 (OH)2D3 of 10-6 mol/L.The HaCaT cells receiving no treatment served as the control.Results Compared with the untreated HaCaT cells,those treated with 1,25(OH)2D3 of 10-6 mol/L showed significantly down-regulated proliferative activity (0.152 ± 0.027 vs.0.290 ± 0.017,P ＜ 0.01),global DNA methylation level (0.187 ± 0.071 vs.0.316 ± 0.049,P ＜ 0.05),DNMT3a and DNMT3b mRNA expression levels (P ＜ 0.01 or 0.05),but markedly upregulated mRNA expression levels of MECP2,MBD2,PDCD5 and TIMP2 (P ＜ 0.01 or 0.05).Moreover,the DNA methylation levels within the promoter region of PDCD5 and TIMP2 genes were significantly lower in HaCaT cells treated with 1,25 (OH)2D3 of 10-6 mol/L than in the control cells (0.38 ± 0.135 vs.0.72 ± 0.121,0.46 ± 0.172 vs.0.68 ± 0.133,both P＜ 0.05).Conclusions 1,25(OH)2D3 may down-regulate the global genomic DNA methylation level of,and modulate the expression of DNA methylationmodifying genes in,HaCaT cells.Furthermore,1,25 (OH)2D3 can decrease the promoter methylation levels but induce the overexpression of PDCD5 and TIMP2 genes,and decelerate the proliferation of HaCaT cells.