Objective To understand the differences of competency assessment of residents from the hospital director of clinical departments and resident physicians and to explore residency training mode for future ability training of the residents .Methods Study was performed in a third-grade class-A hospital in Beijing to understand the difference of capacity ,creativity evaluation be-tween the directors of clinical department and resident physicians through a questionnaire survey and statistical analysis .Results Results showed no statistically significant differences between the directors of clinical department and resident physicians in com-puter application ,and the remaining capacities were lower in the directors of clinical department than in the resident physicians .Be-sides ,the resident physicians hold that the residents were poor in research capacity ,creativity and legal awareness .Conclusion The study prompts us to strengthen the clinical expertise and skills training of residency ,also we should pay attention to the training of comprehensive ability .

Objective To explore the protective effect of monosialoganglioside (GM1) on rats with acute brain trauma and its relevant mechanism.Methods Localized brain contusion model in rats were constructed by Feeney's method.65 SD rats were randomly divided into three groups: sham-operation group (n=5), brain injury group (n=30) and GM1 group (n=30).The rats were killed at 3, 7, 14, 28, 56, 168 h after administration, 5 rats in each group (1 rats in sham-operation group).Bax and Bcl-2 protein expression and PARP were decected by immunohistochemical method.The neuronal apotosis was detected by TUNEL.Results There were significant differences in expression of Bax and Bcl-2 protein between brain injury group and sham-operation group at each time point (P<0.05).There were significant differences in expression of Bax and Bcl-2 protein between GM1 group and brain injury group at each time point ( P <0.05 ) , while there were no significant differences in expression of Bax and Bcl-2 protein after 14 h between GM1 group and sham-operation group.After administration, the Bax/Bcl-2 values decreased and was obvious at 14 h.Degradation of PARP and rate of neuronal apotosis in brain injury group at each time point were significantly higher than those in sham-operation group (P<0.05).Degradation of PARP in GM1 group at 28 h, 56 h, 168 h were significant lower than those in brain injury group (P<0.05), and rate of neuronal apotosis was lower at each time point than those in brain injury group (P<0.05).Conclusion GM1 could reduce value of Bax/Bcl-2, degradation of PARP and apoptosis in rats with traumatic injury brain.

Objective To study the function of vascular endothelial growth factor (VEGF) in type 2 diabetes model rats and its effect on focal cerebral ischemia induced by middle cerebral artery occlusion in these rats. Methods Focal cerebral ischemia was induced by middle cerebral artery occlusion for 6 hours in type 2 diabetes rats and normal control rats.Blood vessels morphology was examined by ink perfusion,infarct size was measured by TTC and expression of VEGF and CD34 were evaluated by immunohistochemistry staining. Results Ink perfusion revealed increased number of small vessels in type 2 diabetes rats. Infarct size was significantly smaller in type 2 diabetes rats ( ( 80. 07 ± 11.21 ) mm3 ) than that in normal controls ((98. 91 ± 14. 86) mm3,t = 2.48,P = 0. 0326). There were more hemorrhage lesions in the ischemic hemisphere in type 2 diabetes rats when comparing with the controls. VEGF and CD34 showed significantly higher expression in type 2 diabetes rats than in normal controls. Conclusions High expression of VEGF and CD34 are found in type 2 diabetes rats after middle cerebral artery occlusion. There is cerebrolvascular remodeling in diabetes rats. While this diabetes-induced remodeling appears to prevent infarct expansion,the changes also increase the risk of hemorrhagic transformation. The latter may result in poor prognosis.

[Abstrract] Objective To investigate the changes of fibdnogen (Fib) and homocysteine (Hcy) in patients with progressive cerebral infarction,and their relationship with triglyceride (TG),cholesterol (TC),high-density lipoprotein(HDL-C) and low density lipoprotein(LDL-C),Methods A total of 246 patients with acute cerebral infarction with clear diagnosis and complete clinical data from department of Neurology in the People's Hospital of Qinghai Province from June 2012 to June 2015 were selected and divided into progressive cerebral infarction group (progressive group,n =61) and non-progressive cerebral infarction group (non-progressive group,n =185)according to the deterioration of their condition.The changes of Fib and Hcy in patients with progressive cerebral infarction,and their relationship with TG,TC,HDL-C and LDL-C were analyzed.Results At the 2nd,7th day after admission,the Fib and Hcy levels in the progressive group were (5.56 ± 1.14)g/L,(5.11 ± 1.35)g/L,(26.09 ± 6.47) μmol/L,(23.32 ± 5.78) μmol/L,respectively,which were significantly higher than those in the non-progressive group [(4.44 ± 0.97) g/L,(4.09 ± 0.58) g/L,(18.33 ± 5.02) μmol/L,(16.97 ± 6.31) μmol/L],the differences were statistically significant (t =7.478,5.729,9.710,6.955,all P ＜ 0.05),Pearson's correlation analysis showed that Fib bad significantly positive correlation with whole blood viscosity,whole blood reduced viscosity,plasma viscosity and hematocrit (r =0.613,0.544,0.507,0.496,all P ＜ 0.05),Hcy had significantly positive correlation with carotid intima-media thickness,TG,TG,and LDL =C (r =0.593,0.601 0.527,0.452,all P ＜ 0.05),Conclusion The levels of Fib and Hcy are closely related to progressive cerebral infarction,Fib and Hcy in patients with acute cerebral infarction can be used as detection index for progressive cerebral infarction.

Objective:To investigate the overall recurrence rate and the pattern of treatment failure in thoracic esophageal cancer (TEC) patients after minimally invasive esophagectomy (MIE), and to evaluate the significance of adjuvant therapy after MIE.Methods:Clinical data of TEC patients who underwent MIE with or without neoadjuvant chemotherapy in the Fourth Hospital of Hebei Medical University between 2016 and 2018 were retrospectively analyzed. The pathology-based lymph node metastasis (LNM) rate, overall recurrence rate, and pattern of treatment failure following MIE were analyzed by SPSS 26.0 statistical software. Cox regression model was used to identify the high-risk factors for recurrent disease. Propensity score matching was performed to compare the survival of patients between the postoperative radiotherapy group and non-radiotherapy group.Results:A total of 443 eligible patients were enrolled in this study, and the pathology-based LNM rate in all groups was 42.0%. The overall recurrence rate was 34.8%. Regional lymphatic metastasis was the most frequent pattern of recurrence (24.2%), followed by distant metastasis (19.4%). Multivariate Cox regression analysis identified pT 3-4 stage and pN + stage as the independent risk factors for recurrence. At the same time, the total number of lymph nodes dissected ≥12 and the number of lymph nodes dissected ≥7 in the neck clavicle and upper mediastinum could reduce the risk of tumor recurrence. The 1-, 3-, and 5-year disease-free survival (DFS) rates in the postoperative radiotherapy group and non-radiotherapy group were 83.5%, 66.8%, 60.7%, and 79.2%, 61.6%, 57.2%, respectively ( χ2=0.13, P=0.715). The 1-, 3-, and 5-year overall survival (OS) rates in two groups were 92.0%, 72.0%, 67.5% and 84.0%, 68.0%, 55.4% , respectively ( χ2=0.43, P=0.513). Conclusions:Regional lymphatic and distant metastases are the main patterns of recurrence for TEC patients after MIE with or without neoadjuvant chemotherapy. pT 3-4 stage, pN + stage, insufficient total number of lymph node dissection and insufficient number of lymph nodes in neck supraclavicular and upper mediastinal dissection are high-risk factors for postoperative recurrence. The survival rate in the postoperative radiotherapy group tends to be higher than that in the non-radiotherapy group. Adjuvant therapy, including postoperative radiotherapy, may remain necessary.

Antibody-drug conjugates(ADCs)are commonly heterogeneous and require extensive assessment of exposure-efficacy and exposure-safety relationships in preclinical and clinical studies.In this study,we report the generation of a monoclonal antibody against monomethyl auristatin E(MMAE)and the development,validation,and application of sensitive and high-throughput enzyme-linked immunosor-bent assays(ELISA)to measure the concentrations of MMAE-conjugated ADCs and total antibodies(tAb,antibodies in ADC plus unconjugated antibodies)in cynomolgus monkey sera.These assays were suc-cessfully applied to in vitro plasma stability and pharmacokinetic(PK)studies of SMADC001,an MMAE-conjugated ADC against trophoblast cell surface antigen 2(TROP-2).The plasma stability of SMADC001 was better than that of similar ADCs coupled with PEG4-Val-Cit,Lys(m-dPEG24)-Cit,and Val-Cit linkers.The developed ELISA methods for the calibration standards of ADC and tAb revealed a correlation be-tween serum concentrations and the OD450 values,with R2 at 1.000,and the dynamic range was 0.3-35.0 ng/mL and 0.2-22.0 ng/mL,respectively;the intra-and inter-assay accuracy bias％ranged from-12.2％to-5.2％,precision ranged from-12.4％to-1.4％,and the relative standard deviation(RSD)was less than 6.6％and 8.7％,respectively.The total error was less than 20.4％.The development and validation steps of these two assays met the acceptance criteria for all addressed validation parameters,which suggested that these can be applied to quantify MMAE-conjugated ADCs,as well as in PK studies.Furthermore,these assays can be easily adopted for development of other similar immunoassays.