Drastic changes are occurring in medical education around the world. Medicine and medical technologies are developing rapidly and expanding beyond the multidisciplinary area. The needs of medical care and medical education are different even from those of several years ago. In order to cope with these increasing social needs, the innovation of medical education in China has become an urgent and important problem. This study is an attempt to answer the question of how to develop medical education in China for the 21st century, based on a historical review of the development of medical education. This development might be divided into three periods: (1) before the Cultural Revolution; (2) the Cultural Revolution (1966-76); and (3) post-Cultural Revolution (1977-present) in modern China, and based on problem analysis of the curriculum, teaching methods, education evaluation, systems and policies and the balance between educational needs and supplies. We concentrate on the discussion of how to solve these problems, and have designed a new strategy for the further development of medical education in China. This discussion and newly developing strategy focuses on the main targets and priorities and adoption of suitable measures according to the conditions of the country. The purposes are to elevate the quality of medical education, to train qualified doctors to meet continuously increasing needs and to maintain the development of medical education for the 21st century in China.

The inhibitory effect and mechanism of action of nicotinamide to paraquat toxicity were studied in male Sprague-Dawley rats. Proteins of submitochondrial particles (SMP), especially of mol. wt. 25-30 kDa, in rat lungs were destroyed by paraquat radicals, and aggregated protein bands approximately 100 kDa were observed by polyacrylamide electrophoresis. The competitive inhibition effects were observed of nicotinamide on NADH oxidation by paraquat via SMP in rat lungs and the Ki was 9.3 mM. The inhibitory effects of nicotinamide on lipid peroxidation by paraquat with rat lung and liver SMP were verified. The times of occurrence of dyspnea and death in rats after paraquat exposure were delayed by nicotinamide administration. The activity of NADH: ubiquinone reaction of NADH:ubiquinone oxidoreductase (complex I) in rat lung was reduced 24 h after paraquat exposure, and was protected by nicotinamide. The activity of NADH:ferricyanide reaction of complex I was, however, reduced by administration not only of paraquat but also nicotinamide. These results imply that nicotinamide is inhibitory to paraquat toxicity. Nicotinamide, paraquat, and ferricyanide may react at overlapping sites on complex I.

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Changes in the fatty acid composition of phospholipid and triglyceride fractions in Spirometra erinaceieuropaei plerocercoids were investigated after 0, 0.5, 1, 3, and 6 hr incubation at 10 C and 37 C with physiological saline containing 5 mM arachidonic acid and 10 mg/ml bovine serum albumin, pH 7.0. At 37 C, arachidonic acid was absorbed and incorporated rapidly into the triglyceride fraction (over 14.4% in composition), and decreased after 2-3 hr; at 10 C, the amount of triglyceride increased slowly and continued to a maximum of 12.9% during 6 hr of incubation. We used a simplified method to extract and purify prostaglandins from the plerocercoid of S. erinaceieuropaei. Prostaglandins were quantified using gas chromatography-mass spectrometry. Prostaglandin E2, PGD2, PGF2alpha, and 6-keto-PGF1alpha were detected under different incubation conditions. In the dose-dependent experiment, PGD2 was detected in plerocercoids incubated with 0.5, 1, 2, and 5 mM arachidonic acid, pH 7.0, at 25 C; PGE2 was detected with 2 and 5 mM arachidonic acid. In the time-dependent experiment, where plerocercoids were incubated with 5 mM arachidonic acid, pH 7.0 at 25 C, PGF2alpha was first detected at 15 min; thereafter, 6-keto-PGF1alpha was detected at 30 min and PGD2 and PGE2 were detected at 1 hr. Thromboxane B2 was not detected in either the dose-dependent or time-dependent experiments, and only PGE2 was detected in the incubation medium with 5 mM arachidonic acid at 1 hr. These results reveal that when plerocercoids change from reptilian to mammalian hosts, they are able to absorb and modify arachidonic acid bound to albumin and generate prostaglandins under suitable conditions. Prostaglandins exhibit potent biological functions for immunoresponses that may be relevant to parasitism and the success of larva migrans in S. erinaceieuropaei.

Objective: To investigate the correlation among serum lipids, amino acids and diet of children in Japan where the mortality of ischemic heart disease is still very low. Design: Cross-sectional study. Setting: Two towns in Shimane prefecture, typical mountaneous agricultural communities in the western part of the mainland of Japan. Subjects: 514 children (10 ± 15 y) in the communities were recruited. Results: The mean cholesterol levels ranged from 3.9 to 4.4 mmolal for boys and from 4.3 to 4.5 mmolal for girls, and serum cholesterol level fell with age in boys. Serum cholesterol level of girls rose once between 11 and 13 y and fell gradually. Fish intake was positively correlated with serum o-3 series fatty acids. Milk intake was negatively and soybean intake was positively correlated with o-3ao-6 series fatty acids ratio. Serum branchedchain amino acids were correlated negatively with serum polyunsaturatedasaturated fatty acids ratio. Conclusions: Serum cholesterol level of children in agricultural communities in Japan has risen, and is probably affected by the change of food intake. Promoting the intake of soybean and ®sh, which are traditional Japanese foods, will be important in preventing atherosclerosis and ischemic heart disease. Attention should be paid to the relationship between branched-chain amino acids level in blood and fatty acids metabolism to verify the mechanism of the progress of atherosclerosis.