Objective To understand employment status of the eight-year program medical graduates from different medical colleges and put forward reasonable proposals on the current prob-lems. Method Through questionnaire, we conducted research among eight-year program medical graduates of three different grades (Grade 04,05,06) on the general condition of employment, research level, actual working time, expectations and actual salary, satisfaction with jobs and so on. Data statis-tics was done by Excel 2007. Totally, our research involved 11 medical colleges and 389 questionnaires. Results 94.34% (367/389) of the eight-year program medical graduates work in top three hospitals. The top five factors affecting the employment were reputation of the school 86.38%(336/389), reputation of the Principal Investigator 66.83% (260/389), social relations 60.15% (234/389), scientific research level 52.96% (206/389) and gender 46.79% (182/389). The amount of published papers from those graduates and their satisfaction with jobs vary greatly. Conclusion Eight-year program medical grad-uates employment faces both opportunities and challenges, and a clear training objective and improve-ment of continuing medical education system for the eight-year program medical graduates will have great significance on the promotion of their employment.

Objective To investigate the correlation between apparent diffusion coefficient (ADC)value of MR diffusion weighted imaging (DWI)and Ki-67 expression in rectal cancer.Methods The data of 47 patients with rectal cancer confirmed by pathology were retrospectively analyzed.Pelvic MRI,rectum DWI and enhanced examination were performed preoperatively.According to the Ki-67 index,the patients were divided into A-D four Groups:Group A with Ki-67 <10% (-),Group B with Ki-67 10%-25%(+),Group C with Ki-67 26%-50%(++);and Group D Ki-67 > 50%(+++).ADC values were calculated in each group to analyze the correlation with the Ki-67 expression levels.Results The mean ADC value were (1.280 ± 0.200 )× 10 -3 mm2/s in Group A (13 cases),(1.044±0.046)×10 -3 mm2/s in Group B (14 cases),(0.987 ±0.256)×10 -3 mm2/s in Group C (9 cases), and (0.85 1±0.099)×10 -3 mm2/s in Group D (1 1 cases).The mean ADC values were significantly different in the different groups with different levels of Ki-67 expression (P =0.001).ADC value and Ki-67 expression were moderate negatively correlated (r = -0.577, P=0.000).Conclusion DWI and ADC measurement can evaluate indirectly the cell proliferation and prognosis of rectal tumor to some extent.

Evidence of the pharmacological activity of traditional Chinese medicine (TCM) provides the basis for clinical prescription. Study of the classification of Chinese medicines according to these activities is key to understanding the general active tendencies of medicinal prescriptions, exploring their material basis, investigating their properties and searching for their alternatives. Taking the herbal classic Shennong's Materia Medica Classic (Shennong Bencao Jing) for the data source, this paper studied the classification of Chinese medicines based on semi-supervised incremental clustering algorithm using "micro-cluster" concept in order to investigate the complex similarity among Chinese medicines. The results showed that 253 Chinese medicines were reasonably classified into 14 types, such as invigoration, clearing heat, diuresis, dredging blockages in the channels, treating gynecological conditions and treating strange diseases caused by ghosts. The results also showed that the other 112 Chinese medicines were classified into 112 individual types and the same high similarity to different known types was the main reason for this. The semi-supervised incremental clustering algorithm employed in the study had a high quality and a good development for clustering which is suitable for classification of Chinese medicines. This study illustrated the diversity of Chinese medicines and their complex similarities, thus aiming to provide innovative ideas and methods for related research.

Objectives To compare total laparoscopic gastrectomy with intracorporeal hand-sewn Gl reconstruction and laparoscopy-assisted gastrectomy for gastric cancer. Methods Between July 2009 and July 2010, 21 patients of gastric cancer underwent total laparoscopic D2 radical gastrectomy with intracorporeal hand-sewn reconstruction and 28 did laparoscopy-assisted D2 radical gastrectomy in Xijing Hospital of Digestive Diseases. All patients were operated on by an experienced surgeon. Patient demographics, TNM stage, location of tumor, the intraoperative and postoperative details of the two groups were compared. Results In the 21 patients undergoing total laparoscopic gastrectomy, there were 15 of distal gastrectomy and 6 of total gastrectomy, compared with 21 and 7 in laparoscopy-assisted group. In total laparoscopic group, intracorporeal hand-sewn technique was used for gastro-jejunal and jejuno-jejunal (J-J)anastomosis, and 25 mm circular stapler was used for esophago-jejunal anastomosis. The operation time was significant longer in total laparoscopic group than in laparoscopy-assisted group of (279 ± 65 ) min vs.(232 ±40) min (P ＜ 0.05 ). No significant difference was observed between the two groups in proximal margin [(5.7 ± 1.5 )cm vs. (5.1 ± 1.4) cm, P ＞ 0.05] and distal margin [( 3.1 ± 0.9 )cm vs. ( 2.9 ±0.9) cm,P ＞0.05]. The iv narcotic use in laparoscopy-assisted group was 1.8 d but it was not used in total laparoscopic group. The first passing flatus was on day 3 in total laparoscopic group compared with 4.8 d in laparoscopy-assisted group. Both groups had 2 postoperative early complications, one intra-abdominal infection and one lung infection in total laparoscopic group compared with one wound infection and one lung infection in laparoscopy-assisted group. There was no anastomosis-related complications after 4 months of follow-up. Conclusions The operation time and postoperative early complication was acceptable for selected patients treated by total laparoscopic D2 radical gastrectomy with intracorporeal hand-sewn GI tract reconstruction in hands of experienced laparoscopic surgeon.

Objective:To design and construct the replication-deficient recombinant adenovirus Ad-siCTGF which can silence the expression of connective tissue growth factor (CTGF) by RNA interference and verified its function. Methods:A specific sequence, which was verified to be able to silence CTGF gene with high efficiency, was cloned into pSES-HUS vector to produce the shuttle plasmid pSES-siCTGF. The plasmid after Pme Ⅰ linearization was cotransduced with pAdEasy into BJ5183 E.coli strains to construct recombinant vector Ad-siCTGF. After linearization treatment with Pac Ⅰ enzyme digestion Ad-siCTGF was transfected into HEK293 cells via liposome mediation. The recombinant adenovirus was packaged. The titer of the Ad-siCTGF was increased after three times of cross-infection. 4T1 cells were infected with the adenovirus. The silencing efficiency was tested by real-time fluorescence quantitative (RFQ)-PCR and Western blotting.Results:Pac Ⅰ enzyme digestion electrophoresis indentified that recombinant adenovirus was successfully constructed. The titer of the recombinant adenovirus Ad-siCTGF was 2.6×10~(10) pfu/mL after amplification and purification. The CTGF mRNA and protein expression in 4T1 cells were decreased by 36.27% and 31.56%, respectively, compared with the control groups.Conclusion:The recombinant adenovirus which can silence the expression of CTGF was successfully constructed. It laid a good foundation for further investigation of the action mechanism of CTGF in tumor cells.

Objective To investigate the effects of artesunate (AS) on septic lung injury in mice and to study the modulation of heme oxygenase-1 (HO-1) in lung in order to clarify the mechanism of AS action.Methods Sixty male Kunming mice were randomly (random number) divided into four groups: Sham group (n =15), CLP group (n =15), AS + CLP group (n =15) and AS + ZnPP + CLP group (n =15).Cecal ligation and puncture (CLP) method was employed to induce septic lung injury.AS (15 mg/ kg) was injected into the abdomen of mice 2 hours before the CLP procedures, and ZnPP Ⅸ, an inhibitor of HO-1, was intraperitoneally injected in dose of 40 μmol/kg 1 hour after the AS injection.The equivalent volume of normal saline was intraperitoneally injected instead in mice of Sham group and CLP group.The mice were sacrificed 24 hours after the CLP procedures.The TNF-α, IL-6 in serum were assayed by ELISA method.The lung injury score and wet/dry ratio were measured.The western blotting and immunohistochemistry methods were used to determine HO-1 protein expression in lung tissue.The protein level of nuclear factor-E2-related factor-2 (Nrf-2), an important transcriptional factor of HO-1 in lung tissue was also analyzed by western blotting.One-way analysis of variance (ANOVA) was used for comparisons among the groups, and SNK-q (Student-Newman-Keuls) test was performed for further comparison, and difference was statistically significant at P ＜ 0.05.Results The TNF-α (pg/mL) (54.37 ± 15.59 vs.627.45 ± 117.03, P ＜ 0.05), IL-6 (pg/mL) (81.53 ± 26.89 vs.898.52 ± 222.78, P ＜ 0.05) in serum was increased, and the lung protein exudation, pulmonary edema (wet/dry weight ratio: 4.27 ± 0.22 vs.6.78 ±0.73, P ＜ 0.05), pulmonary pathology injury (lung injury score: 2.20 ± 0.2 vs.13.25 ± 2.67, P ＜ 0.05) were aggravated by CLP.The HO-1 and Nrf-2 were up-regulated in lung tissue in CLP group compared with the sham group (P ＜ 0.05).After the intervention of AS, the HO-1 and Nrf-2 were further increased (P＜0.05), theTNF-α (pg/mL) (627.45 ±117.03 vs.307.88 ±72.33, P＜0.05), IL-6 (pg/mL) (898.52 ± 222.78 vs.413.47 ± 115.14, P ＜ 0.05) in serum, lung protein exudation, pulmonary edema (wet/dry weight ratio: 6.78 ± 0.73 vs.5.05 ± 0.61, P ＜ 0.05), pulmonary pathology injury (lung injury score: 13.25 ± 2.67 vs.4.95 ± 1.46, P ＜ 0.05) were attenuated compared with the CLP group.However, the protective role of AS in the septic lung injury in mice was partly reversed by ZnPP, and no significant difference was detected between the AS + CLP + ZnPP and CLP group (lung injury score: 12.15 ± 2.95 vs.13.25 ± 2.67, P ＞ 0.05;wet/dry weight ratio: 6.78 ± 0.73 vs.6.29 ± 0.82, P ＞ 0.05).Conclusions AS plays protective roles in septic lung injury, and it is attributed to limiting lung inflammation via up-regulation of HO-1.

Objective To investigate the clinical efficacy of preoperative full reset combined with minimally invasive treatment of extreme distal pilon fractures.Methods A retrospective analysis was made on 34 patients (35 ankles) with tibial fractures extremely close to the distal articular surface treated surgically between January 2011 and January 2015.There were 21 mnales and 13 females,aged 20-71 years (mean,36.2 years).Injury resulted from traffic accidents in 32 patients and high falls in two.Using the AO/OTA fracture classification system,type 43-B3 was noted in three patients,43-C1 in five patients,43-C2 in 18 patients and 43-C3 in eight patients.Calcaneal traction combined with manipulative reduction was used to correct fracture displacement preoperatively.All fractures were stabilized by minimally invasive percutaneous plate osteosynthesis (MIPPO) through single or combined medial,anteromedial and anterolateral approaches while minimizing damage to bone attachment and continuity of soft tissue,after soft tissue swelling subsided.For the patients with articular surface collapsing with severe comminution,a series of procedures were done under direct vision including using the talus articular surface as a mold,stable fixation with fine Kirschner (1-1.5 mm) and thin screws (2.1-2.7 mm series) and impaction bone grafting below subchondral bone.Thereafter,distal tibia anatomical short multi-directional locking plate fixation,distal nail support and early ankle joint functional exercise were done.Burwell-Charnley radiological evaluation system was used for radiological assessment,and TeenyWiss scoring system for ankle clinical symptoms and function.Postoperative complications were recorded.Results Follow-up lasted for 11-38 months (mean,16.6 months).No infection,wound disunion,or plate exposure occurred.Burwell-Charnley radiological evaluation system showed anatomic reduction in 32 patients,unsatisfactory reduction in one,and poor reduction in one.According to the Teeny-Wiss scoring system,the results were excellent in 31 patients,good in two and poor in one,with the excellentgood rate of 97％.Three patients suffered traumatic arthritis after operation and alleviated after oral administration of painkiller.Conclusion With use of full reset combined with manipulative reduction to correct fracture displacement,minimally invasive locking plate,distal row of nails,impaction bone grafting and limited fixation,the patients with extremely distal tibial pilon fractures achieve satisfactory reduction,stable fixation,and early functional exercise.

Objective To investigate the correlation between apparent diffusion coefficient (ADC)of diffusion weighted imaging (DWI)and prognostic factors in rectal cancer.Methods 5 5 patients with rectal cancer were confirmed pathologically.Conventional pelvic MRI and DWI examination were performed,and the mean ADC values of tumor were measured preoperatively.The patients were divided into two groups with or without lymph node metastasis,and were also divided into four groups with negative,weakly positive,positive or strongly positive expression of EGFR in rectal cancer.The ADC values were calculated in each group,and the correlation of ADC values with the lymph node status and EGFR expression classification were analyzed.Results In 5 5 patients with colorectal cancer,there were 13 lesions with lymph node metastasis and the positive expression rate of EGFR was 67.2%.There were no significant difference in mean ADC value between the groups with and without lymph node metastasis (P=0.342).The number of lesions with negative,weakly positive,positive and strongly positive EGFR expression were 18,15,12 and 10.The difference in the mean ADC values among negative,weakly positive,positive and strongly positive expression groups of prognostic factor EGFR was not significantly different (P=0.412).There were also no correlations in the prognostic factors mentioned above (r=0.183 and -0.324,all P>0.05).Conclusion The ADC value can not be used to predict the prognosis and to provide more valu-able information for individualized therapy in patients with rectal carcinoma,which needs further studiy in the future.

OBJECTIVETo explore the effect and mechanism of hirudin on atherosclerotic plaques in apolipoprotein E knockout (ApoE(-/-)) mice.

METHODSTotally 24 ApoE(-/-) mice, 7-8 weeks old were fed with high fat diets. They were randomly divided into the recombinant hirudin treatment group (drug group) and the model group according to body weight and different dens, 12 in each group. Twelve C57BL/6J mice, 7-8 weeks old fed with high fat diet were recruited as the normal control group. Recombinant hirudin (0.25 mg/kg) was intraperitoneally injected to mice in the drug group from the 10th week old once every other day for five successive weeks. Equal volume of normal saline was injected to mice in the model group. Mice in the normal control group received no treatment. All mice were sacrificed after fed with high fat diet until they were 20 weeks old. Serum levels of total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), high-sensitive C-reactive protein (hs-CRP), E-selectin, interleukin-6 (IL-6), and stromal metalloproteinase-2 (MMP-2) were detected. The plaque/lumen area and extracellular lipid composition/ plaque area were analyzed by HE staining and morphometry. Changes of signaling molecules in store-operated calcium channels, including stromal interacting molecule 1 (STIM1), Orail protein, and transient receptor potential channel 1 (TRPC1) were determined by Western blot. Results Lipid plaque formed in the aorta vessel wall of 20-week old mice in the model group. Compared with the normal control group, serum levels of TC, TG and LDL increased (P<0.01), hs-CRP, E-selction, IL-6, and MMP-2 obviously increased (P<0.01, P<0.05) in the model group; expression levels of STIM1, TRPC1, and Orail significantly increased (P<0.01). Compared with the model group, the plaque/lumen area and the extracellular lipid composition/plaque area significantly decreased in the drug group (P<0.05, P<0.01); serum levels of TC and LDL, hs-CRP, E-selction, IL-6, and MMP-2 obviously decreased (P<0.05, P<0.01); expression levels of STIM1, TRPC1, and Orail were significantly down-regulated (P<0.05, P<0.01).

CONCLUSIONHirudin could significantly improve lipids and endothelial functions of ApoE(-/-) mice, down-regulate expression levels of STIM1, Orai1, and TRPC1, and thus delaying the occurrence and development of atherosclerosis.

Animals ; Aorta ; Apolipoproteins E ; metabolism ; Atherosclerosis ; C-Reactive Protein ; Cholesterol ; Diet, High-Fat ; Drugs, Chinese Herbal ; E-Selectin ; Hirudins ; metabolism ; Interleukin-6 ; Lipids ; Lipoproteins, HDL ; Lipoproteins, LDL ; Mice ; Mice, Inbred C57BL ; Mice, Knockout ; Plaque, Atherosclerotic ; metabolism ; Recombinant Proteins ; metabolism ; Triglycerides

OBJECTIVETo investigate the neuro-immune regulatory mechanism of Heart Benefiting recipe (HBR), an effective recipe for treatment of Alzheimer's disease (AD).

METHODSUsing immunohistochemical and RT-PCR methods, the neuro-immunological pathological changes in the AD rat model induced by beta-amyloid protein (A beta1-40) via lateral cerebral ventricle injection, including mainly the glial fibrillary acidic protein expression and inflammatory cytokines IL-1beta, IL-6mRNA and beta-amyloid protein precursor (APPmRNA) gene expression were studied. And the effects of HBR on these parameters were observed.

RESULTSDeposition of A beta in cerebral tissue could induce activation of stellate glial cells and abnormal increased levels of inflammatory cytokines (IL-1beta and IL-6mRNA), also the elevation of APPmRNA level. HBR could effectively control the above-mentioned pathological changes.

CONCLUSIONHBR could effectively control the inflammation and the A beta immune cascade reaction in brain of AD patients, it is one of the important therapeutic mechanisms of the recipe.

Alzheimer Disease ; chemically induced ; metabolism ; Amyloid beta-Peptides ; Amyloid beta-Protein Precursor ; biosynthesis ; genetics ; Animals ; Brain ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Interleukin-1 ; biosynthesis ; genetics ; Interleukin-6 ; biosynthesis ; genetics ; Male ; Neuroprotective Agents ; pharmacology ; RNA, Messenger ; biosynthesis ; genetics ; Random Allocation ; Rats