Objective:to research how to implement early diagnosis for the hepatom model when the rats are alive.Methods:40 young male Wistar rats(30～40 d)were randomly divided into two groups,20 rats in each group(the control group and the interruptedly low doses experimental group).The control group was fed with physiologic saline for 20 weeks.The interruptedly low doses experimental group was fed with 0.2%diethylnitrosamine(DENA)at a dose of 10 mg/kg every week 5 times.The experimental group was induced for 15 continuous weeks.All of them were sacrificed at the 20th week when the rats were inspected by MRI and weighed.The histological changes of liver tissue were observed under microscope.The levels of liver function and?-foetoprotein(AFP)were recorded。all the factors were put into a logistic regression model for multivariate analysis.Results:the induction achievement ratio of hepatoma model in Wistar rats was 85%.The correct rate of MRI for hepatoma was 94.1%.With multivariate analysis,only 1 of the 7 variables in the final logistic regression model was statistically significant:alanine aminotransferase(ALT).Conclusion:Through giving rats low doses of DENA interruptedly and performing MRI for inspecting pathological changes of rat livers with anomaly increased levels of plasma ALT,we can implement early diagnosis for the hepatom model to decrease the rate of death and extrahepatic metastasis when fund and time is limited.

Objective To investigate the intervening effects of Ganoderma spore on the decrease of cell proliferation and neuronal survival in the hippocampus of fetal and postnatal rats induced with gestational hypertension. Methods Fourty SD pregnant rats were divided into four groups including the control group,Nw-nitro-L-arginine methylester(L-NAME)+distilled water(DW) group,L-NAME+L-Arginine group and L-NAME+Ganoderma spore(GS) group.The hippocampal tissue of the brain was detected by immunohistochemistry,Western blotting,RT-PCR,flow cytometry and electron microscopy. Results After the application of L-NAME,the expressions of hypoxia inducing factor-1?(HIF-1?) and vascular endothelial growth factor(VEGF) were increased at the hippocampus of E21 brain and continued up to P30 brain.The microvessel density of E21 hippocampus was increased and the structural abnormalities of blood capillary at P30 hippocampus were showed.The cell proliferation was decreased at E21 hippocampus and so was the neuronal number at P30 hippocampus.With the administration of Ganoderma spore,HIF-1? and VEGF were down-regulated at E21 hippocampus and were not detected at P30 hippocampus.The microvessel density of E21 hippocampus reached a normal level and the blood capillary ultrastructure of P30 hippocampus was restored.The cell proliferation of E21 hippocampus and neuronal number of P30 hippocampus were recuperatively increased.Conclusion Ganoderma spore may prevent the decrease of cell proliferation and neuronal survival in the hippocampus of fetal and postnatal rats induced with gestational hypertension.

The author of the article makes all-around expectation of continuous medical education development in our country from the ten aspects such as its role in medical reform and medical development,perfecting its construction,intensifing the demand-orientation,making scientific and informationized management.improving the quality of education and modernization of its means,conducting theoretical and practical study to generalize new theory and methods and promoting the international communication and cooperation.

Currently,China lacks enough public health physicians and the quality of them varies much.In order to solve this problem,proving the access to public health physician is necessary.On the basis of literature research,this essay summarizes the existing problems of the access to public health physicians:improper professional education in university,curriculum setting and provision about physician registration.The essay argues that it is a feasible way to improve the access of public health physicians in China by further piloting and perfecting the unified post-graduation standardized training system,implementing curriculum reform to enhance students' practical ability and building network physician registration.

Autologous liver transplantation,a type of ex situ liver surgery along with hypothermic organ preservation,a venovenous bypass and complicated vascular reconstructions,allows better access to unresectable tumor and is considered as an effective strategy to overcome the shortage of donors.However,the high complication incidence and mortality related with the technique limit its wide application.To popularize this technique,based on our current experience,we review the key parts of the surgery and the treatment strategy for the complications.

Background Hypoxia is an important cause resulting in many retinal diseases,such as retinal edema,diabetic retinopathy,proliferative retinopathy and so on.ObjectiveThis study is to investigate the effects of hypoxia on the expression of AQP-4 in Müller cells in vitro.MethodsMüller cells were isolated from New Zealand white rabbits and primarily cultured in DMEM containing 20% fetal bovine serum by the explant culture method.The cells were identified by immunostaining for the glial fibrillary acidic protein(GFAP).Generation 2 of cells was cultivated with the chemical hypoxia inducer,CoCl_2,for 24 hours in the hypoxic group and only with DMEM in the control group.The expression of the AQP-4 protein in Müller cells was detected by immunocytochemistry.The expression of AQP-4 mRNA was determined by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR).ResultsAbout 90% of Müller cells(generation 2) presented a positive immunoreactivity for GFAP,showing a brown staining in the cytoplasm.Cultured cells displayed the presence of intermediate filaments,microvillus and various cellular organs.The Integralabsorbance of the AQP-4 protein in Müller cells was markedly increased 24 hours after incubation with CoCl_2 in comparison with the control group (t=6.74,P＜0.05).The expression level of AQP-4 mRNA in Müller cells was significantly enhanced 24 hours after incubation with CoCl_2 in comparison with the control group (t=21.79,P＜0.05). ConclusionHypoxia enchances the expression of AQP-4 in Müller cells and further increases fluid accumulation in the retina.These results suggest that Müller cells play an important role in the formation of retinal edema in diabetic retinopathy or proliferative retinopathy.

Objective To optimize the preparation technology of transcription activator (TAT) and polyethylene glycols (PEG) co-modified tilianin-loaded composite phospholipid liposome (TAT & PEG tilianin CPL, T&PTCPL) and investigate its protective effect on cardiomyocytes. Methods The composite phospholipid liposome was prepared by thin film-ultrasonic method. A three- factor, three-level Box-Behnken experimental design was employed. The weight ratio of total phospholipid to tilianin (X1), the concentration of DSPE-PEG2000-TAT (X2), and hydration volume (X3) were observed. The encapsulation efficiency (Y1), particle size (Y2), and polydispersion coefficient (Y3) were evaluated to optimize optimal formula. In addition, hypoxia/reoxygenation model was established with Na2S2O4 in H9C2 cells. Superoxide dismutase (SOD) activity, malonaldehyde (MDA) level and release of lactate dehydrogenase (LDH) and creatine kinase-MB (CK-MB) were assessed to evaluate the effect of T&PTCPL, meanwhile, the in vitro release rate (dynamic dialysis method) and absorption rate of tilianin and T&PTCPL in Caco-2 cell were examined. Results The optimal formula was as following: X1 = 20, X2 = 1.7%, and X3 = 3.2 mL; The encapsulation efficiency was (86.62 ± 2.51)%, particle size was (149.7 ± 8.2) nm and PDI was 0.15 ± 0.05. Compared with model group, T&PTCPL and tilianin groups increased SOD activity, inhibited level of MDA, LDH and CK-MB leakage (P < 0.05), and the effect of T&PTCPL group was better than tilianin group, meanwhile, T&PTCPL was completely released at 48 h, with a cumulative release of 88.65%, and Caco-2 cells had better absorption of T&PTCPL. Conclusion The Box-Behnken design is suitable for optimizing the formulation of T&PTCPL, and the observed responses are in close agreement with the predicted values of the mathematic models; Moreover, T&PTCPL shows a better sustained release effect in vitro release, which promots the absorption of tilianin in Caco-2 cells and suggests that T&PTCPL may have protective effect on myocardial ischemia reperfusion injury.

In order to investigate the effects of TGF-beta1 on the expression of MMP-2, -9 and TIMP-1 in human retinal pigment epithelial (RPE) cells, the third-sixth passage cultured RPE cells were treated with TGF-beta1 at different concentrations (0.01, 0.1, 1.0, 10 ng/mL), the expression of MMP-2, -9 and TIMP-1 mRNA was detected by semi-quantitative RT-PCR assays. MMP-2, -9 and TIMP-1 mRNA were expressed in the cultured RPE cells. The values of MMP-2/beta-actin in the cells treated with 0.1, 1.0, 10 ng/mL TGF-beta1 were 1.04 +/- 0.04, 1.07 +/- 0.02 and 1.11 +/- 0.03, respectively, significantly higher than in the control group (0.96 +/- 0.03, P < 0.05-0.01). The expression of MMP-2 mRNA could be up-regulated by TGF-beta1, in a dose-dependent manner. The expression of MMP-9 mRNA in the cultured RPE cells was slightly up-regulated by various TGF-beta1 concentrations treatment. The values of TIMP-1/beta-actin in the cells treated with 0.01 and 0.1 ng/ mL TGF-beta1 were 0.85 +/- 0.01 and 0.97 +/- 0.02 respectively, significantly lower than in the control group (1.07 +/- 0.04, P < 0.01), indicating that the expression of TIMP-1 mRNA was down-regulated by TGF-beta1 at low concentrations. But along with the increase of TGF-beta1 concentrations (1.0 and 10 ng/mL), the expression of TIMP-1 mRNA was slightly up-regulated, not significantly different from that in the control group (P > 0.05). It was concluded that TGF-beta1 might play an important role in the up-regulation of the expression of MMP-2 in RPE cells and result in a directional shift in the balance between MMP and TIMP. This may be facilitated for RPE cells to migrate in the pathogenesis of vitreoretinopathy.

Objective To evaluate the method, clinical effects and influential factors of using three dimensional external fixators in the treatment of severe open comminuted tibiofibular fractures 5 cm near the knee or ankle joints. Methods We retrospectively analyzed 32 cases of open comminuted tibiofibular fracture 5 cm near the knee (11 cases) or ankle joints (21 cases). They were treated with three dimensional external fixators from October 2000 to May 2005. The patients with small wounds were treated with manipulative reduction or leverage reduction through the wound under the guidance of C-arm radiography. In case of malreduction or soft tissue being tangled by the fracture ends, visible reduction was carried out after the wound was lengthened or a small incision was added. Limited internal fixation was used in case of necessity. The results were evaluated in terms of shortening of the fractured limbs, X-ray manifestation, bilateral flexion differences and postoperative walking complaints. Results Follow-ups from 5 to 18 months (nine months on average) showed that all the cases achieved osseous union. The mean union time was 5.6 months. The total excellent and good rates of fracture healing and functional recovery were 81.3% and 87.5% respectively. Conclusion Application of the three dimensional external fixator is appropriate for the treatment of severe open comminuted tibiofibular fracture 5 cm near the knee or ankle joints, because its operative procedure is simple, the injury it causes is minimal, its fixation is reliable and its complications are quite limited.

Aromatase inhibitors(AIs) are standard therpy for postmenopausal women with estrogen responsive breast cancers.By inhibiting the aromatase enzyme,causing decreases in endogenous estrogens,the treatment of Als is responsible for lower bone mineral density(BMD) and increased fractures.Therefore,early recognition, prevention,and/or treatment of AI-induced bone loss is needed.Zoledronic acid is specific inhibitors of osteoclasts and extensively used in bone metastasis patients.Recently, there are several trials evaluating the use of in- travenous zoledronic acid as prevention and treatment of AI-induced bone loss in postmenopausal women with breast cancer.In this article, we aim to review the use of zoledronic acid in this population including the response and safety.