Objective To investigate the application of CUSUM (cumulative sum control chart) curve in cardiac clinical teaching of resident surgeon education.Methods We chose a surgeon of 10years work experience of attending the preparation operation of internal mammary artery as control reference (standard group,28 patients) and a resident engaged in professional clinical cardiac work no more than 5 years as group 1,a professional training physician engaged in cardiac surgery clinical work more than 5 years as group 2 and took 40 patients' data respectively from the two groups' preparation of internal mammary artery operation.And then we recorded the postoperative mammary artery flow,internal mammary artery preparation time and adverse events data and made statistics analysis with SPSS 19.0,and CUSUM curve with Matlab R2012b polynomial curve.Results When the density of operate interval and the operate numbers came to about 25 cases,the polynomial eurve's slope rate went up to 0,regardless the surgeons' experience,CUSUM value was accumulated from 66 to 76,and overcame the learning curve successfully.However,when the density of operate interval did no reach the standard,the surgeon's CUSUM ploynomial cmwe slope rate never reached to 0,and can't overcome the learning curve.Conclusion CUSUM curve gives a clear quantitative indicator to the cultivation of clinical physician,and makes teaching teachers can understand the young physicians' learning process,so as to change the teaching plan,help young physicians cross the learning curve as soon as possible.

Animal model plays an important role in prevention and control of infectious disease, which could link basic research in laboratory with clinical diagnosis and treatment for human patients.Mouse is the most widely used animal model of infectious disease, however, adult immunocompetent mice are resistant to some pathogens.The highly genetically diverse Collaborative Cross (CC) mice could recapitulate many of the genetic characteristics of an outbred population, such as humans.Based on this, this review will focus on the application and research progress of CC mice in infectious disease (including viruses, bacteria, fungi etc.), which could provide useful reference data for expansion of animal model resource bank, and implement of precision medicine of major and new emerging infectious diseases.We hope this review could serve as a modest spur to induce other researchers to come forward with their valuable contributions.

Objective To investigate the physical and mental health of Shandong medical personnel.Methods 3200 medical personnel were randomly selected from hospitals of Shandong province,selfhealth,depression and sense of work stress were measured and analyzed statistically.Results 36.3％ of medical staff was in depression state,and even about 22.5％ of the subjects was in moderate or severe depression state.Male and female medical staff showed no difference in sense of work pressure.Senior medical staff showed higher working pressure than middle-class,junior-class and low-level medical personnel,but middleclass,junior medical staff and low-level medical staff showed no significant difference.In the aspect of self-health status,male and female medical personnel showed no significant differences,senior,middle-class and junior-class medical staff reported worse self-health status than low-level medical personnel.Conclusions Managers should pay attention to physical and mental health of medical personnel,adopt pertinent measures to reduce their mental pressure in order to promote their physical and mental health.

This paper reviews the research progress in relations between indoor air pollution and human health for the last 20 years,and focuses on: the studies on environmental risk assessment methods; the major health effects caused by indoor air pollution; the minor and limited health effects caused by indoor air pollution; other key issues concerned.

Objective To assess accuracy and safety of ultrasonography guided or sonography X-ray guided percutaneous neddle biopsy(US-PCNB or CT-PCNB) for diagnosis of pulmonary masses.Methods Seventy one patients with radiographic evidences of pulmonary mass underwent US-PCNB or CT-PCNB.The diagnostic results of US-PCNB or CT-PCNB were confirmed by surgery or by follow-up examinations.Results The accuracy rate for diagnosis of pulmonary malignancy US-PCNB and CT-PCNB was 96 2% vs 94 7%.Complications occurred 3 87% vs 5 26%.Conclusions There was no statistically differences between US-PCNB and CT-PCNB.US-PCNB suitable for pulmonary tumors of around type.CT-PCNB suitable for pulmonary tumors of central type.

Objective To study the leaf morphology and structure of Cyclocarya paliurus.Methods Foliar maceration,preparation of venation order,sectioning paraffin blocks,and scanning electron microscope were used to study the leaf morphology and structure.Results Cuticular papillates,glandular hairs,peltate scales,and non-glandular hairs presented on the leaf epidermis of C.paliurus.Anomocytic stomata were confined to the lower epidermis.Large cluster crystals existed in the uppermost layer of palisade cells.Midrib included one closed vascular system and one additional vascular strand.Secondary veins are semicraspedodromous and form marginal loops,tertiary veins are percurrent,quaternary veins form orthogonal or polygonal areoles filled up by branched and freely ended veinlets.Conclusion These structure characteristics are first reported and are useful for leaf identification of C.paliurus from other Juglandaceae plants.

Objective To determine whether platelet activation is associated with active ulcerative colitis (UC). Methods Platelet aggregability was assessed by means of SH 93 intelligent blood aggregation and coagulation tester; P selectin and thromboxane B 2 (TXB 2) were detected by means of ELISA method in patients with UC as well as in controls, including healthy volunteers and patients with irritable bowel syndrome (IBS). Colonoscopy and biopsy were performed in 43 patients with UC. Results Increased circulating platelet aggregability was detected in active ulcerative colitis compared with IBS and healthy controls ( P

BACKGROUND: In recent years, there are some effects on using pancreatic islet cell or pancreas transplantation in the treatment of diabetes. But there are still two major problems: lack of donor and immune rejection. Mesenchymal stem cells can be induced to islet-like cells in vitro. OBJECTIVE: To study the progress in the differentiation of insulin secretion cells induced by mesenchymal stem cells. RETRIEVAL STRATEGY: A computer-based online search of Pubmed was undertaken for the related English articles dated from August 1997 to August 2007 with the of "mesenchymal stem cells,insulin secreting cell". At the same time, we searched China Journal Full-Text Database for the related Chinese articles published between August 1997 and August 2007 with the same key words. Total retrieved 108 literatures which are firstly selected into the inclusive criteria: ①The articles focusing on the mesenchymal stem cells induced differentiation into insulin secreting cells. ②choose articles at the same field or published in authoritative magazine published in the recent time. Exclusive criteria: ①Repeated experiments or ②Meta analysis articles. LITERATURE EVALUATION: All the literatures are about the differentiation of insulin secretion cells induced by bone marrow mesenchymal stem cells. Of the 30 selected literatures, 2 are reviews and the others are clinical or basic experiment study. DATA SYNTHESIS: ①Because the pancreas is similar to the nervous system in the mechanism of development and control, now people think that nerve growth factor may be the key signal to the pancreas development. Mesenchymal stem cells have an ability of multi-differentiation; it can be induced into nestin positive cells by using epidermal growth factor and basic fibroblast growth factor. Mesenchymal stem cells will be further induced to pancreatic cells if we add conditioned medium as the appropriate micro-environment for islet cells. ②Now identification and functional study of insulin-like cells are for the following areas: observe whether there is islet-like cells group gathered by cell morphology; test insulin, glucagons and somatostatin expression after induction; test insulin and glucagons gene expression using RT-PCR method after induction; to study the function of induced pancreatic cells by using glucose-stimulated insulin release test. CONCLUSION: As the research about mesenchymal stem cells can be induced islet-like cell in vitro becoming ever-changing technology, it becomes a new program of cell therapy to diabetes in face of all problems. According to all the present experimental results, the insulin secretion of induced pancreatic islet cells is much smaller than the normal amount of insulin secretion. Therefore, how to induce efficiently with human physiology of islet cell in vitro and then transplant safely into the human body will bring a new leap of diabetes treatment.

BACKGROUND: Cells grew slowly in a low number after conventional induction. Growth factor can accelerate induction speed, but growth factor is expensive. OBJECTIVE: To verify the efficiency of differentiation of human bone marrow mesenchymal stem cells (BMSCs) into osteoblasts in vitro in a inductor without growth factor. DESIGN, TIME AND SETTING: The control cytology observation experiment was conducted from July 2007 to February 2008 at the Center Laboratory of Hospital Affiliated to Medical College of Qingdao University. MATERIALS: Bone marrow was collected from diabetic patients undergoing autologous stem cell transplantation. Informed consent was obtained from patients. METHODS: Using density gradient method, BMSCs were separate and primary cultured. At the third passage, BMSCs were incubated in 0.1 ?mol/L dexamethasone, 10 mmol/L ?-glycerine sodium, and 50 ?mol/L vitamin C. BMSCs in the control group were left intact. MAIN OUTCOME MEASURES: Morphology of BMSCs was observed under a phase contrast microscope. Morphological changes were measured by alkaline phosphatase staining and calcified nodules staining after induction. RESULTS: Under the phase contrast microscope, the third passage of BMSCs was uniform, spindle. At 7 days, cells were confluence. Some cells were overlapped over time. Mesenchymal tissues gradually piled up, with mineralization, multiple nodes. At 14 days, brown mineralized nodes were found under an inverted microscope. At 21 days, mineralization in fragmentis were formed. Von Kossa method demonstrated black calcified nodules and positive alkaline phosphatase. CONCLUSION: BMSCs can be induced into osteoblasts easily, with high and rapid proliferation.

Chimeric antigen receptor-transduced-T (CAR-T) cells shows strong cytotoxicity to the tumor with specific antigen by CTL effects and cytokines releasing without MHC-restriction.As multiple clinical trials from cancer centers around the West countries reported recent years,anti-CD19-CAR T cells can not only induce complete remission of B-cell malignancies resistant,but also eliminate the minimal residual disease (MRD) at the molecular level.It is believed that the obstacles from bench to clinic will be cleared and CAR will become one of the main cancer therapies with breakthroughs in comprehensive treatment of tumors.