Diverticulitis of colon,the inflammation of colonic diverticulars,is connected with dietary,age and disorder of colonic environment.Due to the different cultures between western contries and orient nations,the morbidity,predilection site,clinical manifestation and management are different in diverticulitis of colons.Computed tomography(CT)has been the key diagnosic method,and it is able to guide transfixion pins to treat diverticulitis of colon.After medical treatment,most of patients can be relaxed,and only someone need operations.

Objective To understand the status quo of work satisfaction of the graduates of GP vocational training program by Zhongshan hospital Fudan university,to provide bases for making best GP career development strategy by health authorities.Methods Using short form of the career orientation inventory to conduct career investigation of the 152 graduates of GP vocational training program by Zhongshan hospital,Fudan university.152 questionnaires were issued and the effective response rate was 100％.Results The top of GPs' career anchor is job security orientation (106,69.7％),followed by technical competence (28,18.4％),service (8,5.3 ％),managerial (5,3.3 ％),autonomy (3,1.9％),lifestyle (1,0.7 ％),entrepreneurship (1,0.7 ％),pure challenge (0,0) and geographic security orientation (0,0).We found that for male GPs,they displayed higher score for entrepreneurship orientation than female GPs (t =2.775,P =0.006).Those older than 35 displayed higher score for geographic security orientation than those younger than 35 (t =-2.154,P =0.033).GPs with at least 10 years' work experience displayed higher score for geographic security orientation than those with less than 10 years' work experience (t =-2.414,P =0.017).The distribution of all types of career orientations of GPs was the same no matter how different their degrees and professional titles were.Conclusions Job security orientation and technical competence are the major job orientations of GP vocational training program by Zhongshan hospital,some career anchor orientations are related to age,gender and duration of work experience.Effective career management should be conducted based on these characters of the graduates' career orientation.

The blood supply of metatarsuses and pha-langeals in 30 cases of fetuses and infants was ob-served by microangiographic methods. The resultsdemonstrated that diaphyses and cartilages of bothends of metatarsuses and phalangeals gradually in-creased in the fetal period and appeared nourishingartery and cartilage canal. Both ends of metatar-suses and phalangeals gradually decrea.ed in the. infant period and cartilage canals gradually disap-peared also. These implied that the appearance ofcartilage canals was related to the size of cartilageblocks. Cartilage Canals were temporary bloodsystem of fetal cartilage. Characteristics of bloodsupply of metatarsuses and phalangeals: 1. Asym-metrical distribution of blood supply on metatar-suses and phalangeal, that is the blood supply ofepiphyseal end is richer than one of non--epiphy-seal end, is adapted with the difference of growthability at both ends. 2. There is distribution ofcartilage canals at the epiphyseal end of the distalphalanx, and it is adapted with having growth a-bility at the proximal end. These show that bloodsupply of metatarsuses and phalangeals is closelyrelated to their growth and development.

Objective To study the MRI findings of HE and the pathological mechanism and to improve the diagnosis and differential diagnosis of HE. Methods Five patients of HE diagnosed by clinical and laboratory examination were examined with conventional MRI scan. Additional DWI, MRA and enhancement MRI scan were performed on 3 patients in which abnormal findings was detected on the conventional MRI. The distribution of lesions and signal characteristics were analyzed. The ADC values of the lesions and of the contralateral non-lesion area were measured. Moreover, the possible pathological mechanisms of HE were discussed on the basis of changes of clinical and imaging manifestations in the two cases with serial clinical and MRI data. Results Of 5 patients, brain abnormalities were found in 3 cases,which showed scattered spotted supratentorial white matter lesions of isointensity on T1 WI and DWI, and high signal intensity on T2WI and fluid-attenuated inversion recovery (FLAIR). Meanwhile, multiple plaque-like lesions involving both white matter and gray matter were found, mainly located at the basal ganglia nuclei, hippocampus and cingulate cortex. The lesions demonstrated iso-or hypo-intensity on T1 WI,and iso-or hyper-intensity on T2 WI, FIAIR and DWI at the initial stage. No enhancement was found in these lesions and MRA disclosed no remarkable findings. The ADC value of the lesions [ (0. 449 ± 0. 092) ×10-3 mm2/s] was decreased significantly compared with the contralateral noninvolved area [ (0. 838 ±0. 062) × 10-3 mm2/s] at the early onset. In 2 cases with glucocorticoid therapy, together with symptom relief, MRI follow-up scan demonstrated the reduction of lesion volume, the signal change to hyperintensity on T1 WI and hypo-intensity on DWL The ADC of the lesions increased significantly. Conclusion The MRI could be one of the effective tools for diagnosis, differential diagnosis, and judging the prognosis and therapeutic results of HE. Meanwhile, it may be a non-invasive method to study the pathological mechanism of HE.

The main clinical symptoms of the patients are upper gastrointestinal tract haematemesis,hypersplenotrophy and hypersplenia.Most cases can be detected by ultrasonography,digital subtraction angiography(DSA),multislice CT(MSCT) or magnetic resonance angiography(MRA).Rex surgery,Hassab surgery or combination the shunt and disconnection combined operation et al are the preferred operation,therapy for children's cavernous transformation of portal vein will be further developed.The relevant literatures were collected in recent years to review the advancement of surgical therapy for children's cavernous transformation of portal vein.

Objective To investigate the application of the parenteral nutrition prescriptions for tumor patients in a tertiary hospital .Methods In this cross-sectional study , the parenteral nutrition prescriptions of all tumor inpatients in a tertiary hospital were collected from May to June in 2015 .The general data of patients who had used parenteral nutrition , the types of parenteral nutrition products , as well as the ratio of energy to ni-rogen ( E/N) , glucose/lipid ( G/L) ratio, non-protein energy to nitrogen ratio , and liquid volume were recor-ded and analyzed .Results Parenteral nutrition prescriptions were collected from 528 patients and showed high irrationality.The nutrient insufficiency rate was nearly 58.3%.The E/N (100:1 ~200:1) accounted for 32.3%and the G/L ( 1:1 ~2:1 ) 20.6%.Conclusions The rational application of parenteral nutrition should be a priority in clinical settings .A clinical nutrition supporting team may be established in tertiary hospi-tals to guide the appropriate use of parenteral nutrition .

Objective To explore an effective evaluation method for students' self-and peer-assess-ment. Methods The students of 6 groups participating in extracurricular teaching activities were selected as research subject. Traditional method (final score = mean score of group/2 + teacher's score/2) and mean difference method [final score=teacher's score-(mean difference of group-mean difference of all groups)] were used to calculate final score of each group, and effect of two methods were compared. Results Scores of most groups were higher than the teacher's scores, and high scores were given by group 3 in self- and peer-assessment. The final score of all groups were higher than teacher's scores in traditional method. Compared with teacher's scores, final scores increased significantly in group 1, 4, 5 below mean difference, final score decreased significantly in group 2, 3 above mean difference, and final score did not differ in group 6 equal to mean difference in mean difference method. Conclusion The mean difference method can reflect the effect of student's self- and peer-assessment, and guide student to make objective and accurate evaluation. It is a more reasonable and scientific evaluation method for self-and peer-assessment.

OBJECTIVE To summarize the clinical features, diagnosis, treatment and prognosis of laryngeal rhabdomyosarcoma.METHODS The clinical data of 5 cases of adult laryngeal rhabdomyosarcoma treated in Beijing Tongren Hospital between 2003 and 2015 were analyzed retrospectively.RESULTS All the 5 cases firstly presented with hoarseness. 1 case was treated by combined therapy (surgery followed by radiotherapy and chemotherapy). 2 patients received surgical treatment combined with chemotherapy. 1 patient received surgical treatment only. Another patient received chemotherapy only. Pathological type: 4 patients were embryonal rhabdomyosarcoma, 1 patient was pleomorphic rhabdomyosarcoma. In the follow-up of a period from 11 months to 8 years, 2 cases were alive without tumor, 3 patients were dead.CONCLUSION Adult laryngeal rhabdomyosarcoma is rare. Surgical resection combined with chemotherapy is the main treatment method, and the prognosis is related to the pathological type and tumor stage.

Objective To assess the value of magnetic resonance imaging for acute pancreatitis.Methods 77 patients of acute pancreatitis were examined with holding breath MRI sequence.Transverse scan:2D Flash T 1WI/T 1W+FS,TSE T 2WI+FS or HASTE+FS,Trufisp.Coronals scan:2D Flash T 1W+FS.MRCP was used in 34 patients.2D Flash dynamic contrast enhanced were used in 77 patients.Results 59 cases of acute edematous pancreatitis showed swelling and low signal intensity on T 1WI and higher signal intensity on T 2WI.Excepted the above findings,18 cases of hemorrhagic necrosis pancreatitis alos showed the higher signal intensity on T 1WI and peripancreatic exudative hydrops.Conclusion MRI is a reliable method for demonstrating acute pancreatitis.

Objective To explore whether the antagonistic effect of decorin (DCN)on progression of glomeruloselerosis is associated with the inhibition of the expression of type I and type II transforming growth factor-? receptors (TGF-?R I and TGF-?R II )in mesangial cells (MsC). Methods RT-RCR and Western blot analysis were used to detect the expression of TGF-?R I and TGF-?R II mRNA and their proteins on cultured rat MsC stimulated by exogenous TGF-?1. Lipofectin-mediated method was used to transfect DCN vector into MsC. After screening and identifying of transfected MsC, RT-PCR and Western blot analysis were adapted to detect the changes of TGF-?R I and TGF-?R II expression respectively. Results The expression of TGF-?R I and TGF-?R II mRNA and their proteins on normal MsC stimulated by exogenous TGF-?1 increased in time-dependent manner and reached the peak at 24th hour. Compared with normal and untransfected MsC (1P-1), the mRNA and protein expression of TGF-?R I and TGF-?R II on MsC (3D-5, 7D-1) transfecled by DCN gene decreased significantly, and DCN gene transfection could antagonize the increase of mRNA and protein expression of both receptors caused by exogenous TGF-?1. Conclusions The expression of both TGF-?R I and TGF-?R II decreases obviously in MsC overexpressing DCN gene, which may be one of the importan antagonistic mechanisms of decorin involved in the development of glomeruloselerosis mediated by TGF-?.