Symbiotic modern scienee and technology with convergence of disciplines are accelerating professional doctor cultivation.In addition,market pressure is also calling for high quality talents for practice.Professional doctors with high degree should possess specified research skills,comprehensive knowledge,occupational quality and professional ability,and the integration of all these so that they can provide extraordinary service for the society.This paper,fiom perspective of knowledge production model Ⅱ,discusses occupational features of professional doctors,the value and cultural identification of professional doctors,and higher education unable to place oneself outside the market competition.It is necessary to make clear the educational target,establish the efficiently educational system and regulations of professional doctor education.

Cultures of traditional Chinese and Western medicine are the different ones of a same kind (medicine) but from the different sources. Their respective advantages, complement and unity are rooted in the differences of the two distinctive cultures. Preventive- biomedical - psychological -social behavior patterns of medicine is a unity of contradictions. Integration of what is different can generate the new while what is exactly the same can hardly be developed. A unity of contradictions of cognitive power is tending to a higher realm beyond both medicines.

Brief descriptions were made on the paper format of articles and letters in Nature magazine including title,author, affiliation, text, references, author information and contributions. It was important for authors to have an overview of principles and standards for paper adopted by Nature, that is, to follow characteristics of the originality, intersection,readability, novelty and ingenuity. At the same time, attention must be paid to the format and manuscript details. As the essence of the details and specification were rigorous, rigorous details would ensure the perfectly unified content and form.

Objective To analyse the pregnancy rate after treatment of tubal pregnancy with the systemic methotrexate (MTX) injection Methods From March 1985 to August 1999, 129 women with confirmed unruptured tubal pregnancy,and desiring to conceive were selected Among them 60 women were successfully treated with systemic MTX, and 69 with unilateral salpingectomy All cases were followed up for 1～15 years Results The rates of subsequent intrauterine pregnancies (IUP) in the MTX group was 73% (44 cases) and of recurrent extrauterine pregnancies (EP) was 8% (5 cases) Among 69 patients treated by salpingectomy, the rates of IUP and EP was 70% (48 cases) and 4% (3 cases) respectively The differences between the two groups were not statistically significant Conclusions The effect of conservative management with MTX was similar to those of salpingectomy The rate of subsequent pregnancy did not increased

Objective To establish a novel Monte Carlo simulation method for reconstruction of medical accelerator model and X?ray energy spectrum based on IAEA Varian 6 MV X?ray phase?space file and photon energy spectrum of the target accelerator. Methods The verified 6 MV X?ray phase?space files were preprocessed to elevate the energy of each particle. Particles were saved in different Phase?Space?Let ( PSL) files according to their position and energy, yielding an initial photon energy spectrum for Monte Carlo simulation of accelerator under an initial target energy. The initial photon energy spectrum was fit to a photon energy spectrum of an accelerator ( Elekta Precise 10 MV X?ray accelerator) under an unknown target energy to yield a fitting coefficient, which was the weight of each PSL. Finally, an accelerator model under an unknown target energy was reconstructed using the initial PSL files and the weight information. The percentage depth dose ( PDD) distribution was calculated in different square open fields. The effectiveness of this method was verified using one dimensional gamma passing rate. Results The peak position and overall distribution of the reconstructed 10 MV photon energy spectrum were in accordance with those of the verified 10 MV photon energy spectrum. The PDD calculated from the reconstructed 10 MV accelerator model agreed well with the measured PDD. The one?dimensional gamma passing rate was above 96%( 1%/1 mm, threshold=0%) . Conclusion The Monte Carlo reconstruction method proposed in this study is reliable, accurate, and effective.

ObjectiveTo investigate the effect of urinary kallidinogenase on the expression of Bcl-2 and Bax in cerebral ischemia-reperfusion injury of rats.Methods Forty eight male adult Sprague-Dawley rats were randomly assigned into four groups: sham operation group, model group,normal saline group andurinary kallidinogenase group.The middle cerebral artery occlusion reperfusion model was made by the suture method. After focal cerebral ischemia-reperfusion, the animals were neurologically assessed on a 5 point scale. The levels of Bcl-2 and Bax expression were measured by immunohistochemical and RT-PCR.Results In model and normal saline group, the expressions of positive Bcl-2 neurocytes and mRNA [(14.28±2.54)/HP, 0.551±0.068 and (16.54± 1.84)/HP, 0.585 ± 0.084] were significantly increased compared with the sham operation group [ (7.58 ± 0.97 )/HP、 0.324 ± 0.042] ( P ＜ 0.05 ) ; The expressions of Bax positive neurocytes and mRNA[( 24.38 ± 3.58 )/HP, 0.540±0.076 and (26.74 ±4.04) /HP, 0.527 ± 0.065] were significantly increased than the sham operation group [ (8.24±1.95 )个/HP, 0.309 ± 0.037] (P ＜0.05). After treatment with urinary kallidinogenase, the expressions of Bcl-2 positive neurocytes and mRNA [(25.61±3.41)/HP, 0.791 ±0.096] were upregulated ( P＜0.05), and the expressions of Bax positive neurocytes and mRNA [( 18.54 ± 2.38)/HP, 0.359±0.053] were down regulated (P＜0.05), compared with model group and normal saline group.ConclusionsUrinary kallidinogenase is significantly related to the upregulation of Bcl-2 expression and the downregulation of Bax expression, which suggest that urinary kallidinogenase could be related with the inhibitory effects on ischemic neurocyte apoptosis.

Objective To test psychometric properties of the PTSD checklist-civilian version(PCL-C) among junior school students from earthquake-hit region.Methods PC L-C Chinese Version, Rosenberg self-esteem scale and SCL-90 were utilized to assess 560 junior school students from earthquake-hit region.Results Firstly,the internal consistency of the total scale and three subscales were qualified, the coefficient alphas were 0.890,0.734,0.789 and 0.722, respectively; 307 participants, from the first samples, engaged in the second test two months after the first assessment.The test-retest stability was re-experiencing 0.40(P ＜ 0.01 ) ,avoidance 0.45 (P＜ 0.01 ), hyper-arousal 0.448 (P ＜ 0.01 ), total scale 0.535 (P ＜ 0.01 ), respectively.Secondly, the results of criteria validity showed PCL-C and its three subscales had negative correlation with self-esteem (r =-0.192 ～-0.299, P ＜ 0.01 ), and had positive-related with SCL-90 and its subscales of depression, anxiety, and psychotic (r=0.563 ～0.775, P＜0.01 ).Finally,the results of empirical validity revealed that based on the score on PCL-Ccould differentiate those people who have significant different scores on SCL-90.Conclusions The PCL-C hadgood reliabilities and validities,which could be used to assess the severity of PTSD.

ObjectiveTo explore the changes of the levels of cytokines in patients with first-episode depression and the effect on the levels of cytokines after the treatment with duloxetine.MethodsThe serum levels of interleukin 1 ( IL-1 ),interleukin 6 ( IL-6 ),tumor necrosis factor-alpha ( TNF-αt ),interleukin4 ( IL-4 ),interleukin10(IL-10) were measured in 38 patients with depression before and after duloxetine treatment by enzyme linked immunosorbent assay(ELISA).HAMD score were assessed at pre- treatment and post-treatment to assess curative effect.The control group was 30 healthy individuals.All data were statisticaly analyzed by SPSS.ResultsBefore treatment,the HAMD score and the levels of serum IL-6,TNF-α,IL-1 in first-episode depressant patients were remarkablely higher than those in the control group( IL-6:( 10.66 ± 3.12 ) pg/ml vs (2.72 ± 0.91 ) pg/ml ;TNF-α:(77.49 ±3.12) pg/ml vs (37.48 ±5.87) pg/ml; IL-1:(39.09 ± 3.77 ) pg/ml vs ( 10.31 ± 1.05 ) pg/ml ),the levels of serum IL-4 and IL-10 in first-episode depressant patients were remarkablely lower than those in the control group(P＜0.05,P＜0.01 ).The HAMD score and the levels of serum IL-6,TNF-α,IL-1 in post-treatment were remarkablely lower than pre-treatment (P ＜ 0.05 ),but which were still higher than the control group(P＜ 0.05 ).The levels of serum IL-4 and IL-10 in post-treatment were remarkablely increased than pre-treatment(P＜0.05).The levels of serum IL-6,TNF-α,IL-1 were positively correlated with the HAMD score( r =0.667,0.486,0.727,P ＜0.01 ),but the levels of serum IL-4 and IL-10 were negatively correlated with the HAMD scorae ( r=-0.433,-0.269,P＜0.05,P＜ 0.01 ).ConclusionsThe first-episode depressant patients show immune disorder induced by cytokines.Anti-depressant activity of duloxetine may participate in the regulation of cytokines and Th1/Th2 unbalance.

Objective To determine the relationship between visual signal intensity and quantitative signal intensity of HCC assessed with DWI and histopathological differentiation of HCC.Methods The MR examinations including MRI plain scan,LAVA dynamic enhanced scan and DWI (1.5T,b value:0 and 600 s/mm2) of 224 patients who had surgically resected HCCs were retrospectively reviewed.Histopathological examinations revealed that there were 31 well-,169 moderately-,and 24 poorly-differentiated HCCs.The incidence of each visually evaluated signal intensity and quantitative signal intensity of HCC assessed with DWI signal intensity and the relationship between signal intensity and histopathological differentiation were assessed for each sequence.Results (1) On DWI,56.7％ of HCCs appeared as obviously hyperintense,24.1％ tumors appeared as moderate hyperintense,and 19.2％ tumors appeared as isotense or slight hyperintense to the surrounding hepatic parenchyma.There was a significant difference between isotense/slight hyperintense and obvious hyperintense and histopathological differentiation (P ＜ 0.05).There was no significant difference between isotense/slight hyperintense and moderate hyperintense and histopathological differentiation (P ＜ 0.05).There was no significant difference between moderate hyperintense and obvious hyperintense and histopathological differentiation (P ＞ 0.05).Visually evaluated signal Intensity of HCC showed an inverse correlation with histopathological differentiation (r =-0.324,P ＜ 0.05).On DWI,the tumors tended to show a brighter signal with decreasing histopathological differentiation.(2) There was a significant difference in DWI signal intensity value among the well,moderately and poorly differentiated HCCs (P ＜ 0.05).The SI value of well differentiated HCCs was lower than that of moderately differentiated HCCs and poorly differentiated HCCs (P ＜ 0.05).The SI value of moderately differentiated HCCs was lower than that of poorly differentiated HCCs.However,there was no significant difference between the SI value of the moderately and poorly differentiated HCCs (P ＞ 0.05).ROC analysis showed that the optimal cutoff point of SI value in diagnosing well differentiated HCCs was 66.5.A cutoff SI value equal to or less than 66.5 was used to differentiate well-differentiated HCC from moderately-and poorly-differentiated HCC with a sensitivity of 90.1％ and a specificity of 71.9％.Conclusions On DWI,the tumors tended to show a brighter,visually evaluated signal intensity and higher quantitative signal intensity with decreasing histopathological differentiation (P ＜ 0.05).The quantitative signal intensity of HCC assessed with DWI signal intensity could only predict well differentiated HCC.It was limited in predicting histopathological differentiation of HCC using evaluating signal intensity and quantitative signal intensity of HCC assessed with DWI.

One hundred and forty six elderly patients with constipation undergoing colonoscopy during March 2012 and August 2013 were randomly assigned to trial and control groups.Seventy patients in trial group received Macrogol electrolytes powder combined with Chinese herb medicine Simo decoction for bowel preparation and 76 patients in control group received macrogol electrolytes powder only.The first defecation,times of defecation and tolerance of patients were compared between two groups.The quality of bowel preparation was evaluated by endoscopists with Boston Bowel Preparation Scale (BBPS).The first defecation time was shorter in trial group than that in control group (55.7 ± 27.9 vs.72.9 ± 34.8,P ＜ 0.05).However,no statistical significance was found in the times of defecation and tolerance of patients between two groups.The mean BBPS score in trial groups was higher than that in control group (7.87 ± 1.08 vs.6.97 ± 0.96,P ＜ 0.05).Chinese herb medicine Simo decoction combined with conventional method shows satisfactory result for bowel preparation in elderly patients with constipation undergoing colonoscopy.