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 .

Regulatory T cells (Tregs) are a subpopulation of CD4 +T cells highly expressing CD25 and Foxp3. Treg not only involves in autoimmune disease, infection and transplantation tolerance, but also plays a pivotal role in the suppression of anti-tumor immunity during tumor development. Current researches suggest the frequency of Treg is increased in tumor tissues and peripheral blood of patients with HCC, which is associated with HCC development, and affect survival rate and prognosis of HCC patients. Depletion of Treg together with surgical resection of the tumor could be a new approach for HCC, which can enhance tumorspecific T cell memory to remove latent metastasis and protect against recurrence for improvement of HCC therapeutic effect. This review presents the role of Treg in HCC development, the relationship between Treg and prognosis and its clinical practice.

Objective To establish drug resistant models of temporal lobe epilepsy induced by amygdala kindling,and to investigate the changes of cAMP response element binding protein (CREB) and phosphorylated cAMP response element binding protein (p-CREB) expression in the hippocampus tissues in order to explore their roles in drug resistant epileptogenesis.Methods Eighty adult male SD rats were randomly divided into control group (n =10) and model group (n =70).The 70 rats were used to prepare the amygdaloid kindled model of epilepsy by chronic stimulation of amygaloid basal lateral nucleus.The successful kindled models were randomly selected as drug resistant epileptic group (n =10) and drug sensitive epileptic group (n =10) according to their response to the phenytoin and phenobarbital.On the basis of behavioral observation,electrophysiology,pathological HE staining,CREB and p-CREB expression changes,we verified the reliability of the models and explored the differences among the three groups above.The changes of CREB and p-CREB expression were detected by immunohistochemical method and Western blotting assay.Results In control group,the electroencephalogram (EEG) frequency was (8.700 ±1.494) Hz;in drug sensitive epileptic group,the EEG frequency was (14.700 ± 1.159) Hz;in drug resistant epileptic group,the EEG frequency was (19.800 ± 1.686) Hz.The frequency differences among the three groups were statistically significant (F =144.202,P =0.000).By immunohistochemical staining,a large number of CREB and p-CREB positive cells were observed in drug resistant epileptic group.As compared with the control group (CREB 0.197 ±0.058,p-CREB 0.260 ±0.176),the expression levels of CREB and p-CREB were increased in drug sensitive epileptic group (CREB 0.361 ±0.151,p-CREB 0.656 ±0.234) and in drug resistant epileptic group (CREB 0.591 ± 0.150,p-CREB 1.077 ± 0.400).The difference among the three groups had statistical significance (F =24.206,20.376,both P ＜ 0.01).Conclusions The expressions of CREB and p-CREB were significantly increased in drug resistant epileptic rats.These findings indicate that the expressions of CREB and p-CREB may play certain roles in the drugresistant epileptogenesis.

Patients with advanced cancer often suffer from cachexia. The researches on cancer cachexis using Chinese medicine include theoretic and clinical studies. The thesis also includes:a systemic comparison to review the progress in recent years, a simple analysis on the problem and shortages of the researches, and a suggestion on the future direction,

OBJECTIVE: To study the characteristics and regularity of adverse drug reactions (ADR) occurred in our hospital. METHODS: A total of 241 ADR cases occurred in our hospital form Jan. 2006 to Jun. 2009 were analyzed statistically in respect of patients’ status, category of drug, route of administration, organs and system involved in ADR and clinical manifestations. RESULTS: Of the total 241 ADR cases, 69.71%ADR cases were induced by antibacterials. 71.78% ADR cases were induced via intravenous administration. ADR mainly appeared as lesion of skin and appendants (50.92%). CONCLUSION: It is necessary to intervene and guide clinical use of drug, strengthen the monitoring of ADR and reduce the occurrences of ADR.

Objective To activate the microglia cells by using thrombin,and then to observe the effect of precondition of rosiglitazone (RGZ)-pretreated on the expression change of peroxisome proliferator-activated receptor-γ (PPARγ),nicotinamide adenine dinucleotide phosphate:quinone oxidoreductase (NQO1) and γ-glutamylcysteine synthetase (γ-GCS).Methods Microglia cells were obtained from the brain tissues of the newborn rats and were primary cultured in vitro.The microglia cells were isolated in 14 days.The isolated microglia cells were randomly devided into normal control group (control group),thrombin stimulation group (stimulation group) and rosiglitazone intervention group (RGZ + TH group).The PPARγ,NQO1 and γ-GCS were observed by immunocytochemistry and real-time polymerase chain reaction (RT-PCR) methods.Results The immunocytochemistry showed that the number of stained cells of PPARγ,NQO1 and γ-GCS in stimulation group and RGZ + TH group were increased remarkably as compared with the control group.A significant increase of the PPARγ,NQO1 and γ-GCS was observed in the RGZ + TH group compared to the others.The RT-PCR method demonstrated that the expressions of PPARγ mRNA(211.88 ± 58.75),NQO1 mRNA(182.67 ± 62.09) and γ-GCS mRNA (188.17 ± 57.06) in RGZ + TH group were increased significantly as compared with the stimulation group (119.19 ± 44.58,101.73±32.19,108.81 ±19.71) or the control group (0.34±0.21,0.73±0.46,0.30±0.13;F=181.50,286.63,614.43,all P ＜ 0.01).Conclusion Medium-dose rosiglitazone-pretreated might increase the expression of PPARγ,NQO1 and γ-GCS in microglia cells activated by thrombin.Rosiglitazone might activate the PPARγso that increase its downstream gene to achieve its anti-oxidative stress effects.

OBJECTIVE:To study the pharmacokinetic characteristics of triflusal capsule in healthy volunteers. METHODS:In ran-domized test,36 healthy volunteers were randomly divided into 3 groups. They were given low-dose,medium-dose and high-dose of Triflusal capsule(300 mg,600 mg and 900 mg),qd,for one day,and then pharmacokinetic study of single dose of Triflusal capsule was conducted;Triflusal capsule medium-dose group was continuously given medicine for 13 days,and then pharmacokinetic study of multiple dose of Triflusal capsule was conducted. The plasma concentration of triflusal was determined by LC-MS/MS,and Zorbax SB-C18 column was used with methanol-0.2% formic acid (80:20,V/V) at the flow rate of 0.2 ml/min. ESI was adopted in MRM mode,negative ion detection was carried out,quantitative analysis m/z 247.1→161.1(triflusal),m/z 294.0→250.0(internal standard, diclofenac sodium). Pharmacokinetic parameters were calculated by using WinNonlin 6.2 software,and the difference of them were compared. RESULTS:The linear range of triflusal were 0.05-20 μg/ml. The main pharmacokinetic parameters of triflusal capsules high-dose,medium-dose and low-dose groups were as follows:t1/2 were (0.45 ± 0.20),(0.47 ± 0.10),(0.43 ± 0.20) h;tmax were (0.56±0.20),(0.60±0.20),(0.47±0.40)h;cmax were(3.30±0.98),(10.65±3.26),(13.96±4.88)μg/ml;AUC0-8 h were(3.99±0.93), (13.29±1.72),(19.62±6.78)μg·h/ml;within dose of 300-900 mg,linear relationship was found between cmax,AUC0-8 h and dose(R2=0.954,0.986). When reaching stable state of multiple dose,average blood concentration was(0.71±0.20)μg/ml;main pharmacokinetic parameters were as follows:AUCs(17.10±4.82)μg·h/ml,t1/2(0.49±0.10)h,tmax(0.85±0.62)h,cmax(11.58±3.99)μg/ml,AUC0-8 h (16.99±4.84)μg·h/ml,AUC0-∞(17.08±4.81)μg·h/ml;accumulation factor(1.28±0.40). tmax and t1/2 of single dose were similar to those of multiple dose. CONCLUSIONS:LC-MS/MS can determine the content of triflusal in human plasma rapidly and accurately, and accumulation phenomena exist in healthy Chinese volunteers,which shows linear pharmacokinetic characteristics.

Objective To establish a rabbit posttraumatic acute diffuse brain swelling (PADBS) model and investigate the mechanism of action.Methods Fifty New Zealand rabbits were assigned to control group (n =10) and model group (n =40) according to random number table.The animal model of sinus balloon compression was established under intracranial pressure monitoring by using intracranial pressure probe.The model group was subdivided equally at 1.5 hours after compression,1.5 hours after decompression,3 hours after decompression and 4.5 hours after decompression,for which intracranial pressure,brain water content,pathological mechanism and ultrastructure were measured dynamically.Results The success rate of modeling was 83％ (33/40).Intracranial pressure was (4.9 ± 0.8)mmHg in control group,(50.1 ± 4.3) mmHg in 1.5 hours after compression group,(45.2 ± 1.7) mmHg in 1.5 hours after decompression group,(48.6 ± 2.2) mmHg in 3 hours after decompression group,and (59.1 ±2.5)mmHg in 4.5 hours after decompression group (P ＜0.05).Brain water content was (75.0 ± 0.6) ％ in control gorup,(76.7 ± 0.8) ％ in 1.5 hours after compression group,(77.3 ± 0.5) ％ in 1.5 hours after decompression group,(78.5 ± 0.6) ％ in 3 hours after decompression group,and (79.4 ± 0.7) ％ in 4.5 hours after decompression group (P ＜ 0.05).Vasogenic brain oedema was seen 1.5 hours after decompression.Cytotoxicity brain swelling generated with brain tissue destroyed 3 hours after decompression.The vicious cycle of high intracranial pressure and brain tissue destruction occurred 4.5 hours after decompression.Conclusion Under intracranial pressure probe monitoring,the rabbit model of PADBS by sinus balloon compression has stable pressure of the sinus balloon and has good reliability and repeatability,which provides a reliable evidence for further study on the possible mechanism and treatment methods of PADBS.

Objective To investigate the influence of fast track surgery(FTS) on the concentrations of serum IL‐6 ,IL‐10 , and TNF‐αin pancreatic cancer patients ,and its clinical significance .Methods Eighty patients undergoing pancreatic cancer opera‐tion were divided into FTS nursing group and traditional nursing group .The concentrations of serum IL‐6 ,IL‐10 ,and TNF‐αin dif‐ferent times before and after operation ,and the same period between groups were measured .Results (1)The concentrations of ser‐um IL‐6 ,IL‐10 ,and TNF‐αwere no significantly difference in two groups before operation(P>0 .05);the concentrations of serum IL‐6 in the first and third postoperative day were higher than those before operation in the observation group (P<0 .05);there was no significant difference of the concentrations of serum IL‐6 between the fifth postoperative day and before operation(P>0 .05);the concentrations of serum IL‐6 after operation were higher than those before operation in the control group(P<0 .05);the concentra‐tions of serum IL‐6 in the same time after operation in the observation group were lower than those in the control group(P<0 .05);(2)The concentrations of serum IL‐10 in the first ,third and fifth postoperative day were higher than those before operation in the observation group(P<0 .05);the concentrations of serum IL‐10 in the first and third postoperative day were higher than those be‐fore operation in the control group(P<0 .05);the concentrations of serum IL‐10 in the same time after operation in the observation group were higher than those in the control group(P<0 .05);(3)The concentrations of serum TNF‐αin the first postoperative day were higher than those before operation in the observation group(P<0 .05);there was no significant difference of the concentra‐tions of serum TNF‐αbetween the third and fifth postoperative day and before operation(P>0 .05);the concentrations of serum TNF‐αin the first and third postoperative day were higher than those before operation in the control group(P<0 .05);there was no significant difference of the concentrations of serum TNF‐αbetween the fifth postoperative day and before operation in the control group(P>0 .05);the concentrations of serum TNF‐α in the first and third postoperative day in the observation were lower than those in the control group(P<0 .05) .Conclusion FTS could significantly reduce inflammatory reaction ,improve immunosuppres‐sion and helps to recover .

AIM:To observe the effect of rosiglitazone (RGZ) pretreatment on the expression of peroxisome proliferator-activated receptor γ( PPARγ) , nuclear factor E2-related factor 2 ( Nrf2 ) and heme oxygenase-1 ( HO-1 ) in the microglia cells activated by thrombin.METHODS:Microglia cells were obtained from the brain tissues of the newborn rats and were primarily cultured in vitro.After cultured for 14 d, the microglia cells were used in the experiment.The iso-lated microglia cells were randomly divided into normal control group, thrombin stimulation group ( TH group) , rosiglita-zone intervention group ( RGZ +TH group ) and retinoic acid intervention group ( RA +TH group ) .The expression of PPARγ, Nrf2 and HO-1 was observed by immunocytochemistry, real-time PCR and Western blot.RESULTS:The number of positive staining cells of PPARγ, Nrf2 and HO-1 in TH group, RGZ+TH group and RA+TH group were increased re-markably as compared with control group.The significant increases in PPARγ, Nrf2 and HO-1 were observed in RGZ+TH group compared with other groups.The mRNA expression of PPARγ, Nrf2 and HO-1 in RGZ+TH group was increased significantly as compared with TH group, control group or RA+TH group (P<0.01), Besides, the mRNA expression of Nrf2 and HO-1 in RA+TH group was decreased as compared with TH group or RGZ+TH group (P<0.01).The protein levels of PPARγ, Nrf2 and HO-1 in RGZ+TH group were significantly increased as compared with TH group, control group or RA+TH group (P<0.01).The protein expression of Nrf2 and HO-1 in RA+TH group was decreased as com-pared with TH group or RGZ+TH group (P<0.01).CONCLUSION:Rosiglitazone pretreatment might increase the ex-pression of PPARγ, Nrf2 and HO-1 in the microglia cells activated by thrombin.By inhibiting the expression of Nrf2 after RA pretreatment, the expression of the downstream gene HO-1 is also influenced.The anti-oxidative stress effects of rosigli-tazone might be achieved partly by modulating Nrf2 to control the downstream gene HO-1.