Objective To study the present development of human resource allocation and development trends of traditional Chinese medicine.Methods Literature review was used to study the present development of such human resources in China.Results As of 2015, TCM institutions accounted for 4.73 percent of the total medical institutions in China, and Chinese medicine personnel accounted for 7.40 percent of the total medical workers in the country.The number of staff with education below undergraduate degree in TCM hospital accounted for 35.6% of the total.Conclusions Education level of TCM hospital staff is expected to elevate, and their education needs to respect the law of growth for such human resources and professional development.Continuing education calls for greater attention for elevation of the human resources in general.

Objective:To discuss the effect of treatment of complicated intra-articular distal radius fractures with extended flexor carpi radialis approach.Methods: A retrospective analysis of 38 cases with fresh complicated intra-articular distal radius fractures treated by using extended flexor carpi radialis approach in our hospital from October 2012 to March 2015,with 25 males and 13 females.The average age was (52.76±8.62) years (32-64 years).The average time to surgery was (5.42±1.91) d (3-10 d),with left wrist 17 cases and right wrist 21 cases.All the patients were with C3 distal radius fractures according to Association for the Study of Internal Fixation (AO/ASIF) classification.The follow-up was conducted 1,2,3,6,and 12 months after operation,including AP and lateral X-ray,wrist extension and flexion,radial deviation and ulnar deviation,forearm pronation and supination,and grip strength.At the end of 6 and 12 months after operation,all the patients were evaluated by using the mo-dified Garland-Werley score and patient rated wrist evaluation (PRWE).Results: All the patients got good bone union,and their follow-up time was more than 12 months.The average follow-up time was (16.37±2.85) months (12-22 months).The score of modified Garland-Werley evaluation 6 months post-operation was 5.37±2.82,excellent and good rate was 84.21％,the score of modified Garland-Werley evaluation 12 months post-operation was 5.03±2.60,excellent and good rate was 86.84％.The score of PRWE 6 months post-operation was 15.82±8.38,the score of PRWE 12 months post-operation was 12.17±7.58.Conclusion: The extended flexor carpi radialis approach is effective for the treatment of complicated intra-articular distal radius fractures and can avoid the complications of volar and dorsal combination approach.

Objective To evaluate the cross-screws fixation for displaced radial neck fractures.Methods A total of 29 patients with displaced radial neck fracture (Mason type Ⅱb) were treated by open reduction and cross-screws fixation at our department from October 2009 to August 2012.They were 18 males and 11 females,aged from 18 to 56 years (average,37.2 years).The fractures affected 16 left and 13 right sides.The time from injury to operation was from 3 to 72 hours,with an average of 33.9 hours.All fractures were displaced by more than 2 mm or angulated by more than 30°,and caused by simple falling.The elbow function was evaluated by the Broberg & Morrey scoring system at one year postoperation.Results All the 29 patients were followed up for an average of 16 months (range,from 12 to 29 months).All fractures healed within 3 months,ranging from 4 to 12 weeks (mean,10.6 weeks).By the Broberg & Morrey scores at one year postoperation,15 patients were rated as excellent,10 as good,3 as fair and one as poor,giving an excellent to good rate of 86.2％.No wound infection,neural injury,fracture displacement or fixation failure occurred.No implants were removed due to local uneasiness.Conclusion Cross-screws fixation can achieve satisfactory outcomes for radial neck fractures.

AIM: The expression of the mouse ? 2 microglobulin (? 2 m) in NIH3T3 cells transfected with the mouse ? 2m sense and antisense RNA was detected to clarify the effect of mouse ? 2m sense and antisense RNA on the expression of MHC classⅠgene. METHODS: The mouse sense and antisense RNA, pcDNA3-? 2mSN and pcDNA3-? 2mAN, were constructed and were transfected into NIH3T3 cells by lipofectamine. RT-PCR and Western blot were used to detect the expression of ? 2m in those cells. RESULTS: The expression of the mouse ? 2m in the cells transfected with pcDNA3-? 2mSN was increased, while it was decreased in those cells transfected with pcDNA3-? 2mAN. CONCLUSION: pcDNA3 -? 2mAN can downregulate the expression of the ? 2m in NIH3T3 cells.

Objective To investigate the expression of forkhead box protein P1(FOXP1)in gastric mucosa-associated lymphoid tissue(MALT)lymphomas and its relationship with histological morphology and prognosis. Methods In this study.samples of 43 MALT lymphoma were studied histologically and divided into monomorphic histology group and polymorphic histology group according to their cellular features.The expressions of FOXP1 and NF-κB in gastric MALT lymphoma were evaluated immunohistochemically by two-step method of Envision,and the clinicopathological features and prognosis were analyzed retrospectively.Results The nuclear expressions of FOXP1 in 43 cases with gastric MALT lymphoma were 44%(19 of 43),including strong immunoreactivity in 7 cases and moderate immunoreactivity in 12 cases.There were 4 cases with positive immunoreactivity in moninorphic histology group and 15 cases in polymorphie histology group,and the difference was statistically significant(15%vs.88%,P＜0.01).All the postoperative recurrent cases were strongly positive with FOXP1 stain,and it was closely with FOXP1 expression(P＜0.01).The median survival time(26 months)in polymorphic histology group was significantly shorter than that(123 months)in monmorphic histology group(P＜0.01),and the median survival time was significantly longer in negative FOXP1 expression group than that in moderate FOXP1 expression group and in strong FOXP1 expression group(115 vs.55 vs.12 months)(P＜0.05).similarly,the median survival time in nuclear factor kappa B(NF-κB)expression group was significantly shorter than that in negative NF-κB expression group(26 vs.131 months)(P＜0.01).The median survival time in stageⅠ(98 months)and stage Ⅱ(121 months)was significantly longer than that in stage Ⅱ E+Ⅳ(33 months)(P＜0.01).By multivariate COX regression analysis.FOXP1 nuclear expression and clinical stage were independently prognostic factom. Conclusion FOXP1 expression may be used as a biomarker for the assessment of malignant transformation to diffuse large B-cell lymphoma(DLBCL)and predicting prognosis.

Objective: To determine whether 3-dimentional CT scans is able to effectively improve the detection rate of AO B3 distal radius fractures in clinics.Methods: From Jan 2013 to Jan 2014, 30 patients with distal radius fractures were retrospectively enrolled in this study, all the patients directly visited the skeletal trauma emergency department in Beijing Jishuitan Hospital post injury and all of them accepted open reduction and internal fixation of distal radius fractures at last.All the radiographic data including X ray films and 3-dimentional CT scans of these patients were collected.Two independent observers were required to make primary AO classifications for each fracture by X rays at first, then to make final AO classifications by 3-dimentional CT scans.Finally, the detection rates of CT scans and plain films for AO B3 distal radius fractures and B3.3 distal radius fractures were compared, the agreements of the two methods for diagnosing AO B3 and B3.3 fractures were calculated by Cohen''s Kappa calculations.Results: All the 30 fractures were confirmed to be AO B3 distal radius fractures intraoperatively, and 10 of them were B3.3 fractures.The results were completely consistent with the results of 3-dimensional CT scans.However, only 80%(24/30) AO B3 distal radius fractures and 60%(6/10) B3.3 distal radius fractures could be diagnosed only by X rays.The detection rate of CT scans was proved to be significantly higher than X rays for diagnosing B3 distal radius fractures(100% vs.80%,P<0.05), the detection rate of CT scans was also proved to be significantly higher than that of plain films for detecting B3.3 distal radius fractures(100% vs.60%,P<0.05).The agreement of 3-dimentional CT scans and X ray was poor for detecting both the AO B3 distal radius fracture and B3.3 distal radius fracture (kappa=0).Most importantly, in the study process, two special kinds of B3 distal radius fracture were initially found and described by us.One was named as radial B3 fracture, and the other was named as ulna B3 fracture.Conclusion: 3-dimentional CT scans can effectively improve the detection rate of B3 and B 3.3 distal radius fractures, and also help find two special kinds of B3 fractures.

Objective To explore the curative effect and security of transurethral holmium laser resection for adult ureterocele.Methods 22 cases with adult ureterocele were retrospectively studied.Eight adult ureterocele cases were male and 14 cases were female.The mean age was 36.5 years (ranged from 20 to 67years).All of the patients were unilateral onset,15 cases on the left side and 7 cases on the right side.The mean course of the disease was 31 months (ranged from 15d to 12 years).The clinical presentations were varied.All 22 cases were treated by tran-surethral holmium laser resection.About one -third of cyst wall were left in order to avoid vesicoureteral reflux and hydronephrosis.Results All 22 cases succeeded uneventfully.The pathologic study confirmed that 22 cases were ure-terocele.The mean hospital stay was 8days (ranged from 6 to 12days).Mean follow -up time was 17 months (12 -26 months),while 2 cases were lost.All 20 cases urine alalysis was normal.Five patients showed no hydronephrosis, while 10 cases showed less hydronephrosis.Cystoscopy showed all 20 cases ureteral healing was smooth,and none showed recurrence of ureterocele.Voiding cystourethrography showed none of vesicoureteral reflux.Conclusion Transurethral holmium laser resection would be a good choice for adult ureterocele,because the treatment has the advantages of simple operation,low requirement of equipment,safety and reliability.Especially for the primary level hospital,transurethral holmium laser resection is worth further clinical promotion.

Objective To improve the detail of the surgery for cicatricial ectropion,and the the effect was investigated. Methods Based on 46 patients withⅡ,Ⅲdegree cicatricial ectropion admitted to our department,choose the junction of normal skin and scar tissue as the incision line according to the degree of ectropion and local situation,and to reserve and recover the orbicularis oculi muscle as possible. The released areas exceeded separately the external canthus and reached the level of eye fissure,take advantage of full-thickness skin graft to correct the parallel lines and make fixation to the eyelid ectropion fusion skin graft on external canthal ligament. Results After followed up for 6 months to 2 years,46 cases of eyelid skin grafts survived completely and eyelids were in good reduction,with none case of incomplete eyelid closure. Conclusion Choose the surgical incision and the released areas in a proper way to reserve the structural integrity of orbicu-laris muscle and make skin graft fixation to inner and external canthal skin can prevent effectively the recurrence of ectropion and improve surgical progress.

Objective To investigate the expressions of CD133 and CD44 and their prognostic significance in gastrointestinal stromal tumors (GIST).Methods Streptavidin perosidase (SP) method of immunohistochemistry was used to detect expressions of CD133 and CD44 proteins in 42 cases of GIST, and the relationship between their expressions and tumor size, mitotic count were analyzed by univariate and multivariate factor analyses.Results The expressions of CD133 and CD44 proteins in GIST were 21.4％ (9/42) and 78.6％ (33/42), respectively.The expressions of CD133 and CD44 proteins were significantly correlated with tumor size and mitotic count (P ＜ 0.05).Univariate factor analysis showed that the overall survival of GIST patients with positive CD133 protein (23.2 months) was shorter than that of patients with negative CD133 protein(63.1 months) (P ＜ 0.05).The overall survival of GIST patients with negative CD44 protein (23.2 months) was shorter than that of patients with positive CD44 protein (63.3 months) (P ＜ 0.05).Multivariate factor analysis showed that tumor size, mitotic count and CD44 protein were independent prognostic indicators for survival time after operation.Conclusions The positive expressions of CD133 and CD44 proteins might be the prognostic factors of GIST patients.

AIM: To explore inductive methods of hematopoietic stem cell (HSC) from embryonic stem cells (ESC) in vitro. METHODS: Using mice E14 line, the first step was the primary differentiation in which the ESC form embryoid bodies (EB) in methylcellulose-based cultures with SCF and VEGF. The second step involved the plating of cells originating from the EB into three different system of cultures containing SCF, VEGF,IL-3, IL-6 and EPO for HSC. And identifying HSC by flow cytometry analysis, colonogenic cells assay and Wright-Giemsa stain were also used. RESULTS: By two-step differentiating, it showed that HSC differentiated slowly in methylcellulose medium, percent age of CD34+/Sca-1+ cells slight increased about(31.5?4.7)% after day 14 induction. However, EBs were induced after 10 days to fast differentiate for HSC with more cells population by coculture on bone marrow stromal cells feeder. Flow cytometry analysis showed that percentages of CD34+/Sca-1+ cells might reached to (47.8?6.3)%. The more optimistic system of differentiation was bone marrow stromal cells feeder (BMSCF) in combination with supernatants of stromal cells from mice fetal liver(SSCFL), it significant supported differentiation of ESC into HSC with higher percent (53.6?7.2)%. Colonogenic cell assay and Wright-Giemsa stain confirmed that it possessed character of hematopoietic progenitors. CONCLUSION: Using methods of two-step differentiation, mice ESC were induced to differentiate into HSC by coculturing with BMSCF and SSCFL in combination of SCF,VEGF,IL-3,IL-6 and EPO.