Based on the Miller Pyramid for assessing clinical competence, this article analyzed the existing problems in the practice of teaching physical examination and provided suggestions for possible reforms.

AIM:Targeting of focal adhesion kinase (FAK) gene,we aim to construct FAK shRNA lentiviral vector and to identify its function on the growth of leukemic cells.METHODS:FAK shRNA was chemically synthesized,and inserted into a GFP-lentiviral plasmid through molecular biology methods.After packaged and concentrated,the lentiviral-FAK-shRNA-vector was transduced into a human leukemic cell line.FAK gene expression was detected by reverse transcriptional PCR and Western blotting.Cell apoptosis was measured by Annexin V labeling.RESULTS:The results showed that FAK shRNA was successfully inserted into the lentival vector,and the infection efficiency varied from 10% to 25%.Compared to the control vector (lentival vector without FAK shRNA),FAK shRNA inhibited the expression of FAK mRNA and protein by 40% and 70%,respectively.Moreover,the results of apoptosis experiment showed that the percentages of Annexin V+ cells in control vector group and FAK shRNA group were (4.19 ? 0.36) % and (8.48 ? 0.58) % respectively,the difference was statistically significant (P

OBJECTIVE To explore the correlation between hands pollution and nosocomial infection,and to raise measures to keep hand hygiene.METHODS To evaluate the condition of hand pollution and hand washing,the relationship between hands pollution and nosocomial infection,and measures to improve hand hygiene.RESULTS Most nosocomial infections were transmitted by the hands pollution,bacteria of which were thought to be the main microbial population of nosocomial infection.Handwashing was considered to be the most important intervention to prevent nosocomial infections.However,the present studies indicated that there was not enough handwashing practice among the medical personnel,lacking the consciousness of the importance of hand cleaning,misunderstanding the standard hand cleaning steps,like the length of washing time and the choose of hand disinfectant,and inadequately providing the hospital condition for cleaning work,all these played an important role in declining the efficiency of hand disinfection in hospital.Medical workers could achieve their goal through the improving of the above aspects of work.CONCLUSIONS Hands pollution is closely related to nosocomial infection.Handwashing can reduce nosocomial infections.

OBJECTIVE To observe the preventive effect on nosocomial infection by the herbal medicine Atractylodes chinensis disinfectant for air sterilization in cardiothoracic surgery.METHODS A.chinensis disinfectant and ultraviolet irradiation were used to disinfect the patients′ rooms of our cardiothoracic surgery department.The total number of germ and fungus in the indoor air before and after using the two methods were collected.The nosocomial infection rates of the same period were also studied.RESULTS A.chinensis disinfectant had strong effect on sterilization of indoor germs and fungi,and the sterilization rate was 92.7%.The comparison between A.chinensis disinfectant and ultraviolet irradiation showed significant difference in their disinfection effects,while no significant difference in their nosocomial infection rates.CONCLUSIONS The herbal medicine A.chinensis disinfectant can achieve good sterilization effect and prevent nosocomial infection.

OBJECTIVETo examine UVB-induced responses in normal human keratinocytes (HaCaT) and epidermoid carcinoma cells (A431) at the cellular and molecular level, and investigated the protective effect of salidroside.

METHODSCells irradiated by UVB at various dosage and their viability was assessed by MTT assays, cell cycle was analysed by flow cytometry. The expression of NF-κB, BCL-2, and CDK6 after 50 J/m(2) UVB irradiation were detected by RT-PCR and western blotting.

RESULTSOur results confirmed greater tolerance of A341 cells to UVB-induced damage such as cell viability and cell cycle arrest, which was accompanied by differential expression changes in NF-κB, BCL-2, and CDK6. UVB exposure resulted in HaCaT cells undergoing G(1)-S phase arrest. When treated with salidroside, HaCaT survival was significantly enhanced following exposure to UVB, suggesting great therapeutic potential for this compound.

CONCLUSIONTaken together, our study suggests that A431 respond differently to UVB than normal HaCaT cells, and supports a role for NF-κB, CDK6, and BCL-2 in UVB-induced cell G(1)-S phase arrest. Furthermore, salidroside can effectively protect HaCaT from UVB irradiation.

Antioxidants ; pharmacology ; Apoptosis ; radiation effects ; Carcinoma, Squamous Cell ; Cell Cycle Checkpoints ; Cell Line, Tumor ; Cell Survival ; drug effects ; radiation effects ; Gene Expression Regulation, Neoplastic ; Glucosides ; pharmacology ; Humans ; Keratinocytes ; radiation effects ; Phenols ; pharmacology ; Ultraviolet Rays

OBJECTIVETo discuss the impact of number of retrieved lymph nodes and lymph node ratio(LNR) on the prognosis in patients with stage II and III colorectal cancer.

METHODSClinicopathological data of 507 patients with stage II and III colorectal cancer were analyzed retrospectively. Follow-up was available in all the patients.

RESULTSThe total number of retrieved lymph nodes was 5801, of which 1122 had metastasis. There was a positive correlation between metastatic lymph nodes and retrieved lymph nodes(r=0.171, P<0.01). In stage II colorectal cancer there was a significant difference in 5-year survival rate between patients with more than 12 lymph nodes retrieved and those with less than 12 lymph nodes retrieved(P<0.01). LNR also affected the 5-year survival rate of patients with stage II and III colorectal cancer(P<0.05). In patients with similar LNR, the 5-year survival rate differed significantly among different regions of lymph node metastasis(P<0.05). LNR influenced the prognosis independent of the number of lymph nodes retrieved.

CONCLUSIONSThe number of retrieved lymph nodes is a prognostic factor for stage II and III colorectal cancer. More than 12 lymph nodes should be retrieved for better staging and prognosis. LNR is also a prognostic factor in stage II and III colorectal cancer. Regions of lymph nodes metastasis should be considered when evaluating the prognosis of patients using LNR.

Colorectal Neoplasms ; diagnosis ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; diagnosis ; pathology ; Male ; Neoplasm Staging ; Prognosis ; Retrospective Studies

OBJECTIVETo discuss the anti-tumor activity of ginsenoside Rh2, we observed the expressions of the junction adhesion molecul (JAM) in transplanted-tumor in mice.

METHODThe models of 40 transplanted-tumor mice that were established by subsequently injecting cancer ascite of mice (S180) with 0.2 mL per mouse into the preepipodite skin were divided into two groups. Experiment group was drenched with 2 mL ginsenoside Rh2 per mouse, equating to a dose 20 mg x kg(-1). Control group was drenched with 2 mL normal saline per mouse. The expression of JAM-1, JAM-2 in the lymphatics, blood vessels and tumours were observed by immunohistochemical staining.

RESULTThe expression of JAM-1 on the cancer cells was significantly decreased in experiment group (IA 340.55) as compared with control group (IA 549.90, P<0.05). However, JAM-2 weakly expressed in both two groups. The density of blood vessels in which JAM-1, JAM-2 expressed showed 2.33 and 1.34 in control group, and 1.09 and 0.9 in experiment group respectively. Moreove, the density of lymph vessels were respectively 2.23 and 1.88 in control group compared with 0.99 and 0.79 in experiment group. The expression in blood vessels and lymph vessels in control group were significantly higher than those in experiment group, respectively (P<0.05).

CONCLUSIONGinsenoside Rh2 can affect the tumor growth, further angiogenesis and lymphangiogenesis by down-regulating JAM expression in tumor.

Animals ; Cell Adhesion Molecules ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Female ; Gene Expression Regulation ; drug effects ; Ginsenosides ; pharmacology ; Immunoglobulins ; metabolism ; Immunohistochemistry ; Male ; Mice ; Neoplasm Transplantation ; Neoplasms ; metabolism ; pathology ; Receptors, Cell Surface ; metabolism

Objective To observe the effects of Shuangdan Mingmu Capsules on the expressions of HIF-1α and NF-κB; To explore its possible mechanism of treatment. Methods SD rats were injected with STZ (50 mg/kg) into the tail vein to induce diabetes mellitus. After the DR model was confirmed by fundus fluorescein angiography, the rats were randomly divided into model group, Shuangdan Mingmu Capsules group and positive medicine group, and normal rats were set as control group. After the last administration, the blood glucose level and retinopathy in rats were measured. The protein and gene expression of HIF-1α and NF-κB in the retina were detected by Western blot and RT-PCR respectively. Results Compared with control group, the blood glucose in the model group was significantly increased; the retinal capillaries increased; the leakage of fluorescein was obvious; the protein and gene expressions of HIF-1α,NF-κB were significantly increased.After administration of Shuangdan Mingmu Capsules,the model rats decreased blood glucose; retinal microvascular volume decreased; fluorescein leakage area was significantly reduced; protein and gene expressions of HIF-1α and NF-κB were decreased. Conclusion Shuangdan Mingmu Capsules can effectively inhibit the neovascularization of DR rats and protect the retina, which may be related to the down-regulation of the expressions of HIF-1α and NF-κB.

Objective To explore the effect of multi-disciplinary team (MDT) combined with bundle management on prevention and control of multidrug-resistant organism (MDRO) infection in the intensive care unit(ICU).Methods Patients who were admitted to the ICU in a tertiary first-class hospital from January 2013 to December 2015 were studied,MDT combined with bundle management has been applied in the prevention and control of MDRO infection in ICU since January 2014,continuous quality improvement program was performed one year later,isolation of MDROs from specimens of ICU patients before implementation(in the year of 2013),after implementation(in the year of 2014),and after continuous quality improvement(in the year of 2015) was compared.Results The infection rates of MDROs in ICU patients before implementation,after implementation,and after continuous quality improvement were 26.55％ (154/580),17.13％ (117/683),and 12.01％ (77/641) respectively,showing a downward trend,with a significant difference (x2 =44.030,P＜0.001);the total isolation rates of MDROs in ICU patients were 64.44％(154/239),63.59％(117/184),and 43.26％ (77/178) respectively,showing a downward trend,with a significant difference (x2 =22.284,P＜0.001).The main MDROs in ICU were multidrug-resistant (MDR) and pandrug resistant(PDR) Acinetobacterbaumannii (44.54％).Conclusion MDT combined with bundle management can decrease MDRO infection rate and isolation rate in ICU.

OBJECTIVEThe present study was designed to test whether transplantation of human bone marrow-derived mesenchymal stem cells (hMSCs) in New Zealand rabbits with myocardial infarction can improve heart function; and whether engrafted donor cells can survive and transdifferentiated into cardiomyocytes.

METHODSTwenty milliliters bone marrow was obtained from healthy men by bone biopsy. A gradient centrifugation method was used to separate bone marrow cells (BMCs) and red blood cells. BMCs were incubated for 48 h and then washed with phosphate-buffered saline (PBS). The culture medium was changed twice a week for 28 d. Finally, hematopoietic cells were washed away to leave only MSCs. Human MSCs (hMSCs) were premarked by BrdU 72 h before the transplantation. Thirty-four New Zealand rabbits were randomly divided into myocardial infarction (MI) control group and cell treated group, which received hMSCs (MI+MSCs) through intramyocardial injection, while the control group received the same volume of PBS. Myocardial infarction was induced by ligation of the left coronary artery. Cell treated rabbits were treated with 5 x 10(6) MSCs transplanted into the infarcted region after ligation of the coronary artery for 1 h, and the control group received the same volume of PBS. Cyclosporin A (oral solution; 10 mg/kg) was provided alone, 24 h before surgery and once a day after MI for 4 weeks. Echocardiography was measured in each group before the surgery and 4 weeks after the surgery to test heart function change. The hearts were harvested for HE staining and immunohistochemical studies after MI and cell transplantation for 4 weeks.

RESULTSOur data showed that cardiac function was significantly improved by hMSC transplantation in rabbit infarcted hearts 4 weeks after MI (ejection fraction: 0.695+/-0.038 in the cell treated group (n=12) versus 0.554+/-0.065 in the control group (n=13) (P<0.05). Surviving hMSCs were identified by BrdU positive spots in infarcted region and transdifferentiated into cardiomyocytes characterized with a positive cardiac phenotype: troponin I.

CONCLUSIONTransplantation of hMSCs could transdifferentiate into cardiomyocytes and regenerate vascular structures, contributing to functional improvement.

Animals ; Biomarkers ; analysis ; Bone Marrow Cells ; cytology ; Bone Marrow Transplantation ; Cells, Cultured ; Humans ; Immunohistochemistry ; Male ; Mesenchymal Stem Cell Transplantation ; Myocardial Infarction ; physiopathology ; surgery ; Rabbits ; Survival Rate ; Time Factors