Unclear cultivating aim and training plan as well as tutors' lacking of experience are the main problems of the postgraduate education for clinical medicine professional degree,which will cause the quality of clinical postgraduate training to fall greatly.Through the analysis,the author proposes increasing management authority of rotating disciplines for graduates,establishing tutor groups in rotating disciplines,making clear training plan,increasing the clinical simulation skill training courses,training and optimizing the professional master's tutors,which is to fit the needs of the postgraduate education for clinical medicine professional degree and to provide related references.

Background Intermittent exotropia is a type of strabismus that between latent extropia and manifest extropia.The assessment of fusional convergence/divergence is important for understanding control ability of exodeviation in children with intermittent exotropia.Objective This study was to analyze the correlations between fusional convergence/divergence and control ability of exodeviation in children with intermittent exotropia.Methods Sixty-three children with intermittent exotropia were recruited in Beijing Tongren Eye Centre from July 2013 to February 2014 under the informed consent of children and their parents.Angle of deviation was measured by wearing prism and covering method alternately.The control ability of exodeviation was evaluated and scored by the Revised Newcastle Control Score (RNCS),and fusional convergence and divergence were measured with 1 Δ-40Δ horizonal prisms and regulating targets.The correlations between the measured parameters of fusional convergence/divergence and control scores of exotropia were analyzed by Spearman rank correlation analysis.Results The mean diopter of the right and left eyes was (-1.95 ± 1.63)D and (-2.01 ± 1.73)D,respectively,and the mean deviation angle for distantly and near was (36.67 ± 15.69) Δ and (38.25 ± 14.83) Δ,respectively,without significant differences between them (diopter:t =-0.13,P＞0.05;deviation angle:t =-0.57,P＞0.05).Considerably negative correlations were found between the breakpoints of fusional convergence for distant or near and control scores of exodeviation (rs =-0.41,P=0.03;rs =-0.56,P＜0.01).No significant correlations were found between the breakpoints of fusional divergence for distantly or near and control scores of exodeviation (rs =0.05,P =0.78;rs =0.04,P ＜0.75).In addtion,there was no significant correlation between fusional recovery level and control scores (both at P ＞ 0.05).Conclusions Breakpoints of fusional convergence may be useful in grading the severity of intermittent exotropia in children,and it is probably one of the surgical indications of intermittent exotropia.

Targeting induced local lesions in genomes (TILLING) is a reverse genetics method for functional genomics research.It is possible to screen for point mutations in the populations of EMS mutagenesis with highthroughput and lowcost. EcoTILLING a method based on TILLING ,was developed for detecting multiple types of polymorphisms in germplasm collections,such as single nucleotide polymorphism,small deletion and insertion etc.Rice is a very important food crop and a model plant for genome research also. There are complete genome sequence and a lot of other bioinformatics resources about it.So the markerassisted breeding is becoming more and more important in rice breeding. Some issues based on TILLING about identifying germplasm based on gene sequence,EMS mutagenesis breeding,developing functional marker in rice breeding in future were discussed.

OBJECTIVETo explore the effects of extracts from ginseng, notoginseng and chuanxiong (Ext) on the angiotensin II induced aging of human umbilical endothelial cells (HUVECs) in vitro.

METHODSCultured HUVECs were divided into 5 groups, the blank control group (A), the model group (B), and the three intervening groups (C, D and E). Except those in Group A, all cells were induced into aging model cells by Ang II in a final concentration of 10(-6) mol/L, and to the three intervening groups, corresponding treatments with low dose Ext (C), high dose Ext (D) and valsartan (E) were accessed. Changes of aging in HUVECs were observed by SA-beta-gal staining; cell cycle was analyzed by flow cytometry; contents of reactive oxygen species (ROS) in cells was measured by laser confocal microscopy; levels of nitric oxide (NO) and anti-superoxide anion in culture medium were examined by nitrate reductase method; and the protein expression of NAD (P) H oxidase p47phox, as well as the angiotensin type 1 and 2 receptor (AT1 R, AT2R) were detected by Western blot.

RESULTSCompared with Group A, in Group B, the positive beta-gal stained HUVECs increased and stagnated at G0-G1 phase, with the fluorescence intensity of ROS evidently enhanced; in the culture medium content of NO and anti-superoxide anion were lowered, and protein expression of p47phox and AT1 R up-regulated. While these aging figures were improved in Group C and D. After intervention with high or low dose of Ext, beta-gal stained HUVECs decreased showing less cells in G0-G1 phase and more cells in G2-M phase, the fluorescence intensity of ROS reduced, contents of NO and anti-superoxide anion increased, and the protein expression of p47phox and AT1 R down-regulated.

CONCLUSIONExt could delay the aging of HUVECs induced by angiotensin II, it is possibly by way of down-regulating the expression of NAD (P) H oxidase subunit-p47phox through AT1 R, and further reducing the superoxide anion production.

Angiotensin II ; antagonists & inhibitors ; Cells, Cultured ; Cellular Senescence ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Endothelial Cells ; cytology ; drug effects ; Humans ; Panax notoginseng ; chemistry ; Plant Extracts ; pharmacology ; Umbilical Veins ; cytology

Objective To evaluate the effect of ultrasound-guided arterial catheterization in internships of anesthesiology.Methods Sixty students were randomly divided into ultrasound-guided teaching group(n=30,3 male) and traditional teaching group (n=30,4 male).In the two groups,the ultrasound-guided arterial catheterization technology and artery catheterization technique were adopted respectively for teaching.The success rate of arterial catheterization was compared between the two groups after 2 months internships and when finishing internships of anesthesiology.The questionnaire was investigated in ultrasoundguided teaching group after finished internships of anesthesiology.Results The success rate of arterial catheterization in ultrasound-guided teaching group was extremely higher than in traditional teaching group after 2 months internships of anesthesiology (52 ± 8)％ vs.(38 ± 10)％,(x2=7.746,P=0.005).After finishing internships of anesthesiology,the success rate of arterial catheteri-zation was (67±7)％ in ultrasound-guided teaching group and (59 ± 9)％ in traditional teaching group (x2=5.531,P=0.036).And all students thought ultrasound-guided arterial catheters teaching was helpful to them and could improve their learning interest.Conclusion Ultrasound-guided arterial catheterization is beneficial to the internship teaching of undergraduate of anesthesiology,which can help them to master the arterial catheterization technique better,and improve the success rate of arterial catheterization and their learning interest.

Objective To investigate the symptoms on depression in patients with viral hepatitis. Methods A cross-sectional study was conducted among the patients with viral hepatitis in infectious diseases Hospital of Taiyuan. The questionnaire included a Eysenck Personality Questionnaire, self-rating depression scale (SDS) , and a self-designed one related to information regarding general conditions of the disease and social support. Results (1)Depression symptom prevalence rate among chronic viral hepatitis patients was 54.7% (116/212). (2) Factors as age, occupation, education, confirmed time, number of recurrence and anti-virus treatment, self-confidence on recovery, satisfaction on the surrounding environment etc. that might be associated with depression. (3) The severity of depression was significantly negative correlation with social support scores, objective support scores, subjective support scores (r=-0.262, P=0.000;r=-0.228, P=0.001 ; r=-0.270, P=0.000). (4) There was positive correlation noticed between severity of the depressive disorder and Eysenck Personality two dimensions scores, while the scores of introversion and extroversion scores were negatively correlated (r=-0.330, P=0.000) but positively correlated to the emotional stability scores (r=0.309, P=0.000). Conclusion (1) Patients with hepatitis showed symptoms of depression to a certain degree. (2) Factors as age, occupation, education, economic situation, confirmed time of diagnosis, number of recurrence and anti-virus treatments, confidence on recovery, satisfaction on the surrounding environment might be associated with symptoms of depression. (3) There was positive correlation between severity of depressive and Eysenek Personality two dimensions scores but the scores of introversion and extroversion scores were negatively correlated.

A total of 118 patients with type 2 diabetes mellitus were divided into acarbose treatment group ( A group,n =58 ) and no acarbose treatment group ( B group,n =60),and 57 healthy subjects were used as control group (C group).The quantification of fecal bifidobacteria and enterococcus faecalis in these subjects was made by realtime PCR.The results showed that fecal bifidobacteria contents in A and B groups were lower and enterococcus faecalis contents were higher compared with C group.After four weeks of intervention,fecal bifidobacteria contents in A and B groups increased ( P＜0.01 ),especially in A group,while enterococcus faecalis contents decreased ( P＜0.05 )compared with the baseline.Univariate correlation analysis showed that bifidobacteria content was negatively associated with lipopolysaccharides(LPS),advanced glycation index,high sensitive C reactive protein ( hs-CRP),and body mass index ( BMI ) at baseline ( P＜0.05 or P＜0.01 ).The enterococcus faecalis content was positively associated with levels of monocyte chemoattractant protein-1,LPS,tumor necrosis factor-α,hs-CRP,plasminogen activator inhibitor-1,BMI,and HbA1c (P ＜0.01 ).After four weeks of intervention,the above associations disappeared.Stepwise multivariate regression showed that basal BMI,HbA1c,and age contributed to the increase in the number of enterococcus faecalis,and BMI negatively contributed to the decrease in number of bifidobacteria.

Objective To investigate the effects of ketamine on neuronal nitric oxide synthase (nNOS) activity and carboxy-terminal PDZ ligand of nNOS (CAPON) expression in the prefrontal lobe of mentally depressed rats.Methods Adult male Sprague-Dawley rats,aged 2.5-3.0 months,weighing 210-260 g,were used in the study.Menial depression was induced by exposing the rats to chronic unpredictable mild stress.Twenty-four animals in which mental depression was successfully induced were randomly divided into 2 groups (n =12 each):mental depression group (group D) and ketamine group (group K).Another 12 rats were chosen and served as control group (group C).Group K received intraperitoneal ketamine 10 mg/kg once a day for 7 consecutive days,while groups C and D received intraperitoneal normal saline 10 ml/kg instead of ketamine.Sucrose preference test and open field test were performed before administration and at 1 day after the end of administration.The total distance,number of rearing and sucrose preference percentage (SPP) were recorded.The rats were sacrificed 1 day after the last test for determination of the expression of nNOS and CAPON protein (using immuno-histochemistry)and mRNA (by RT-PCR) in the prefrontal lobe.Results Compared with group C,the total distance was shortened,the number of rearing and SPP were significantly decreased,the expression of nNOS protein and mRNA was up-regulated and the expression of CAPON protein and mRNA was down-regulated in groups D and K (P ＜ 0.05).Compared with group D,the total distance was prolonged,the number of rearing and SPP were significantly increased,the expression of nNOS and mRNA was down-regulated and the expression of CAPON protein and mRNA was up-regulated in group K (P ＜ 0.05).Conclusion Ketamine can improve the depressive state through promoting the expression of CAPON and inhibiting nNOS activity in the prefrontal lobe of mentally depressed rats.

Objective To explore the clinical value of expression levels of serum COX-2 in patients with advanced NSCLC before and after EGFR-TKI treatment. Methods The serum was collected from 58 cases. Before and after targeted therapy , the serum COX-2 level was examined by ELISA. Meanwhile , CT scan was exercised to evaluate the treatment. Follow-up interview was done. The relationship among the change in expression level of serum COX-2 , efficacy and PFS was analyzed. Results The serum COX-2 level significantly decreased in the response group (t = 11.258, P = 0.000) and increased in the PD group (t = -7.759, P =0.000) after EGFR-TKI treatment, and not significantly changed in the SD group (t = 1.424, P = 0.170). Before treatment, the baseline serum COX-2 level in the response group was significantly higher than that in the SD group and the PD group (F = 20.852, P = 0.000 ). Before the targeted therapy, the higher the level of serum COX-2 was, the longer PFS patients would enjoy. Conclusion Detection of the serum COX-2 contributes to the judgment of therapeutic effect of EGFR-TKI and can be used as a prediction of EGFR-TKI drugs outcomes for patients with advanced NSCLC.

Objective To evaluate the effect of small-dose ketamine on the onset time and course of modified electroconvulsive therapy (MECT) in mentally depressed rats.Methods Sixty SPF adult male SpragueDawley rats,aged 2-3 months,weighing 220-250 g,were randomly divided into 6 groups (n =10 each) using a random number table:normal control group (group C),depression group (group D),ECT group,propofol + ECT group (group PE),ketamine + ECT group (group KE) and ketamine + propofol + ECT group (group KPE).The depression model was established by chronic unpredictable mild stress (CUMS).Mter CUMS,C,D and ECT groups received intraperitoneal normal saline 8 ml/kg,group PE received intraperitoneal propofol 100 ml/kg,group KE received intraperitoneal ketamine 10 ml/kg,and group KPE received intraperitoneal ketamine 10 ml/kg + propofol 80 ml/kg.All the groups received ECT once a day for 7 consecutive days starting from the time point when righting reflex was lost except C and D groups.Open-field test was performed before CUMS,at 1 day after CUMS and at the end of each ECT (T0 8).The total distance and the number of standing on the back legs were recorded.Morris water maze test was performed at 2 days after CUMS and 1 day after the end of therapy,and the escape latency and time of staying at the original platform quadrant were recorded.Results Compared with group C,the total distance was shortened and the number of standing on the back legs was reduced,the escape latency was prolonged,and the time of staying at the original platform quadrant was shortened at T1-8 in D,ECT,PE and KE groups and at T1 5 in KPE group,and no significant was found in KPE group in the total distance,number of standing on the back legs,escape latency,and time of staying at the original platform quadrant at T6-8.Compared with group D,the total distance was prolonged and the number of standing on the back legs was increased at T6-8 in ECT and PE groups and at T4-8 in KE and KPE groups,the escape latency was prolonged,and the time of staying at the original platform quadrant was shortened in ECT group,and the escape latency was shortened,and the time of staying at the original platform quadrant was prolonged in KPE group.Compared with ECT and PE groups,the total distance was prolonged and the number of standing on the back legs was increased at T4-7 in group KE and at T4-8 in group KPE,and the escape latency was shortened,and the time of staying at the original platform quadrant was prolonged in KPE group.Compared with group KE,the total distance was prolonged and the number of standing on the back legs was increased at T6.7,the escape latency was shortened,and the time of staying at the original platform quadrant was prolonged in KPE group.Conclusion Small-dose ketamine can shorten the onset time and course of MECT in mentally depressed rats.