Objective To investigate the distribution and effect of class Ⅰ integron in 40 strains of clinical multi-resistant Enterobacter cloacae. Methods Kirby-Bauer method was used to analyze the drug resistance of 40 strains of multi-resistant Enterobacter cloacae and the drug resistance gene was analyzed by polymerase chain reaction (PCR). Results 28 strains (70.0%) of 40 clinical isolates were observed to contain class Ⅰ integron. Drug resistance test showed their resistance rate to 10 kind of an-tibaeterials as follow: 7.5% to imipenem, 5.0% to meropenem, 75.0% to piperacillin-tazobactam,55.0% to amikacin, 12.5% to cefepime, 52.5% to ceftazidime, 55.0% to cefotaxime, 90.0% to ceftriaxone;81.8% to ticarcillin-clavutanic acid, and 85.0% to ciprofloxacin. Conclusion This study shows that the resistance situation of Enterobacter cloacae isolates is very serious, and class Ⅰ integron may play an important role in the muhidrug resistant mechanism.

Objective To evaluate the efficacy and safety of radioactive 125 I seed implantation combined with paclitaxel (PTX) for treating senile non‐small cell lung cancer(NSCLC) .Methods The clinical data in 35 patients with NSCLC in our hospi‐tal from June 2013 to August 2014 were retrospectively analyzed ,including 12 cases receiving the lung tumor radioactive 125 I seed implantation therapy(group A) ,10 cases treated with PTX combined with cisplatin (TP scheme)after receiving radioactive 125I seed implantation therapy(group B) and 13 cases only conducted TP scheme(group C) .The 21 d chemotherapy was a evaluation cycle . The adverse reactions were evaluated after 1 cycle and the curative efficacy was evaluated after 2 cycles .Results Thirty‐five cases were followed up for 6 months .The adverse reactions could be evaluated in all the cases .The short‐term efficacy could be evaluated in 34 cases .The group A had no obvious adverse reactions ,the main adverse reactions in the group B and C were bone marrow sup‐pression and digestive tract reactions without statistically significant differences (P> 0 .05) .The effective rates after 4 cycles of chemotherapy in the group A and B were 66 .7% and 80 .0% ,the clinical benefit rates were 83 .3% and 90 .0% respectively ,which were higher than 23 .1% and 53 .8% in the group C respectively ,the differences were statistically significant ( P< 0 .05 ) . Conclusion Radioactive125 I seed implantation therapy and PTX combined with radioactive 125 I seed implantation for treating senile early NSCLC are superior to the simple PTX chemotherapy ,which have high effective rate and benefit rate ,safety ,mini‐invasion and mild adverse reactions ,and can increase the patient′s living quality .

BACKGROUND:Previous studies have found that human platelet-derived growth factor-B (PDGF-B)-transfected gingival fibroblasts are capable of rapid proliferationin vitro, which can secrete platelet-derived growth factor BB proteins. OBJECTIVE:To explore the ability of PDGF-B-modified gingival fibroblasts in the acelular dermal matrixin vivo to form periodontal tissue engineering compound. METHODS: Gingival fibroblasts from Beagle dogs transfected with or without PDGF-B gene were implanted into the acelular dermal matrix. Cel growth on the acelular dermal matrix was observed. PDGF-B gene-transfected gingival fibroblasts/acelular dermal matrix composite (experimental group), gingival fibrobalsts/acelular dermal matrix composite (control group) and acelular dermal matrix (blank group) were implanted subcutaneously into the nude mice, respectively. At 2, 4, 8 weeks after implantation, skin tissues were taken and observed histologicaly. RESULTS AND CONCLUSION: PDGF-B gene-modified gingival fibroblasts and non-transfected gingival fibroblasts both grew and proliferated wel in the acelular dermal matrix. At 8 weeks after implantation, in the blank group, the surrounding cels largely entered into the acelular dermal matrix, but produce less new colagen fibers, and the cels only grew on the original colagen scaffold; in the control group, a great amount of colagen fibers formed, the original colagen fibers in the acelular dermal matrix were replaced by newly formed colagens, but the original colagen structure was reserved; in the experimental group, a large scale of permineralization formed, and mineralized nodes were arranged along the original colagen scaffold. These findings indicate that PDGF-B gene modified gingival fibroblasts can acquire osteoplastic abilities in the acelular dermal matrix in vivo.

Computed tomography (CT) has become a very important method for preoperative examination for hilar cholangiocarcinoma.In this article,the multidetector helical CT findings of 20 patients with hilar cholangiocarcinoma who were confirmed by surgical pathological examination or biopsy in the Ruijin Hospital of Shanghai Jiaotong University from September 2010 to September 2012 were retrospectively analyzed to investigate the value of muhidetector helical CT in the diagnosis and resectability evaluation of hilar cholangiocarcinoma.All the 20 patients received dynamic contrast enhanced CT scanning after abdominal plain scanning,including arterial phase and portal venous phase scanning.Six patients received additional delayed phase scanning for 3-4 minutes.Muhi-phase reconstruction (MPR) and CT angiography were performed after the scanning.The location and sizes of lesious,the range of invasion of adjacent vessels,swelling of lymph nodes of hilar and retroperitoneum,and hepatic metastasis were recorded.The results showed that only 8 lesions were found on CT plain scanning,and they were presented as hypodense nodules.All lesions were showed on contrast enhanced images.Five cases with infiltrating type were showed as focal wall thickness of hilar bile duct,ringlike enhancement appeared on arterial phase scanning,and the enhancement was more apparent in portal venous and delayed phasc scanning.Eight cases with intraductal growing type demonstrated as intraductal nodules,obvious enhancement was detected on delayed phase scanning,and the dilation of intrahepatic bile duct was also found.Seven cases of tumoral type showed as mass located in hilar region and involved adjacent vessels and partial hepatic parenchyma.Diffused or local dilation of bile duct could be seen on CT images.Combination of 2and 3-dimensional reconstruction images can show more clearly of hilar cholangiocarcinoma lesions,invasion of hepatic arery or portal vein,segmental atrophy and metastasis of lymph nodes and liver.One-stop CT examination combined with axial multiphase dynamic contrast enhanced scanning with MPR and CT angiography of multidetector helical CT can clearly show the lesions of hilar cholangiocarcinoma,improve the preoperative tumor staging and help to design the surgical treatment.

Tetrandrine, a bis-benzy 1-i soqui noline alkaloid isolated from Radix Stephania tetrandra S. Moor, was proved to be a calcium antagonist. Its effects upon the heart conduction system were investigated in anesthetized rabbits.Tetrandrine 8 mg/kg iv could prolong the sino-atrial conduction time & the sinus node recovery time from 50 ? 13 ms & 286? 36 ms to 75?19 ms ( n= 8 , P

Neferine, an alkaloid, isolated form Nelumbo nucifera Gaertn,has antiarrhytbmic effect. The present report deals with its action on the ECG in rat & the surface potential of toad sciatic nerve.Neferine could prolong ECG, P-R & Q-T intervals, and widen QRS in a dose-dependent manner, The effects are similar to quini-dine, and dissimilar to tetrandrine. The inhibitory effects of neferine & quinidine on the surface potential of toad sciatic nerve are similar in potency.

Objective To evaluate the training quality of junior college graduates of clinical medicine based on the feedback from the graduates and their employers.Methods Totally 112 junior college graduates tailored to rural areas among all the three years' graduates were selected.These graduates and their employers were asked to do the questionnaire and discussion.Results The overall evaluation from the graduates on the school curriculum and teachers was good,with satisfactory rate being above 95％.The employers had nice impression on the graduates and spoke highly of them,with satisfactory rate reaching 97.4％.Of all the three years' graduates,one-time passing rate in the qualification examination for assistant practitioners came to 41.0％,much higher than the average passing rate of 20.12％ in the same area and at the same time.Conclusion The teaching effect for junior college graduates of clinical medicine tailored to rural areas is satisfactory and the reform on teaching is worka ble and effective,however,it needs further practice.

Objective To assess the levels of glucose-6-phosphate isomerase(GPI) mRNA in peripheral blood monocytes and serum GPI levels in patients with rheumatoid arthritis, and analyze the association of serum GPI with MCV antibody, CCP antibody and RF of RA. Methods Fluorogenic quantitative real-time polymerase chain reaction (FQ-RT-PCR) was used to examine mRNA expression on peripheral blood monocytes in 60 RA patients (28 case in active stage,32 cases in stable stage) ,30 patients with other rheumatic diseases, and 30 healthy controls. ELISA was used to detect the levels of serum GPI, anti-MCV antibodies, anti-CCP antibodies and RF in each group. Results The levels of GPI mRNA in RA group [△Ct=4.21 (3.04-7.23)] were significantly higher than those in patients with other rheumatic diseases [△Ct=8.42 (5.16-9.98),P<0.01] and healthy controls [△Ct=8.66 (4.90-10.01), P<0.01]. There were statistically significant differences of GPI mRNA levels between active RA [△Ct=3.78 (1.28-6.09)] and inactive RA[△Ct =5.88(3.23-8.94),H=11.760,P<0.01)]. The RA group serum GPI levels [3.02 (2.02-8.39) mg/L] were higher than those of other rheumatic diseases [0.20 (0.11-0.32) mg/L] and healthy controls [0.18(0.08-0.30) mg/L]. There were significant differences of serum GPI levels between active RA group [4.84(2.81-10.38) mg/L] and inactive RA group[2.12 (1.26-4.34) mg/L] (H=9.830, P<0.01). The sensitivities of GPI, anti-MCV and anti-CCP were 68% (41/60) ,57% (34/60),58% (35/60), respectively and specificities were 95% (57/60), 92% (55/60) and 93% (56/60), respectively. Conclusions The high expression of GPI mRNA in RA patients shows that it may play a pathological role in the development of RA, and it may be correlated with the activity of RA. It may be a valuable diagnostic parameter for RA, because of its high sensitivity and specificity.

Human resources development in medical and health is of vital importance to medical and health sector reform and development as well as to medical and health existence and service improvement.Medical and health sector in China has made remarkable progress;however,facing the new requirements from economic and social development and people's new needs for medical health service because of their upaating health concepts and the new promotion by the development of biomedical science and technology,we still have some critical problems in medical and health personnel education.Therefore,the task of conducting careful analysis and exploring the solutions to these problems should be given sufficient attention and completed as soon as possible in the field of medical education.

Tetraspanins belongs to the transmembrane 4 superfamily(TM4SF). They can be as a bridge to connect the proteins outside or inside the cell membrane. A tetraspanins web is formed by the tetraspnins-proteins complex, and the web is believed to involve in fundamental functions of immunity system, and consequnently, signaling between cells and inside cells, regulating cell activation and adhesion, participating in the identification and infection of some virus. As a family of conservative transmembrane proteins, tetraspanins play multiplex roles in invertebrate. It was described how tetraspanin microdomains might have functions in the immune system, and how they contact with virus. In addition, the important role of tetraspanins in the innate immune system of invertebrate were discussed.