Based on the analysis on the present status and importance of medical humanity education for inter-national medical students during the clinical internship, this paper discussed the importance of strengthening medi-cal students′humanistic education during the clinical internship and proposed ways to promote the humanity educa-tion:optimizing the setting of humanity education curriculum and adhering to the humanity education throughout the whole process of clinical internship;improving the clinical supervisors′humanity quality and ensuring the quality of humanity education;holding the orientation of evaluation and adding the humanity quality as one of the evaluation indicators; establishing hospital atmosphere with humanity spirit and highlighting environmental education effect;building theuniversity-intern hospital two-grade platform of humanity education and standardizing the relevant systems.

Objective To observe the effect of limbal incision before and after phacoemulsification corneal astigmatism degree.Methods 46 patients with cataract (76 eyes) were randomly divided into two groups.23 cases (40 eyes) in group A received a temporal clear corneal incision phacoemulsification.23 cases (36 eyes) in group B received the upper clear corneal incision cataract ultrasound breast surgery.Results In group A,preoperative corrected visual acuity was (0.13 ±0.10)D,after 3 months of corrected visual acuity was (0.79 ± 0.13)D.In group B,preoperative corrected visual acuity was (0.14 ± 0.11)D,after 3 months of corrected visual acuity was (0.76 ± 0.15)D,the patients after 3 months corrected visual acuity was significantly improved than before treatment (t =4.127,P ＜0.01),the postoperative visual acuity was not statistically significant(t =0.605,P ＞ 0.05).Two groups postoperative corneal anterior surface,surface astigmatism values were gradually reduced,3 months after operation in group A after corneal anterior surface,surface astigmatism value were (0.45 ± 0.24) D,(0.09 ± 0.06) D ; those in B group were (0.52 ± 0.25) D,(0.09 ± 0.07) D,which were significantly lower than 1 week after operation and postoperation(t =2.232,2.128,all P ＜ 0.05).The remaining time two groups of corneal astigmatism value had no significant difference (P ＞ 0.05).Conclusion Temporal clear corneal incision phacoemulsification recovery of visual acuity is better,and less than the above changes of corneal astigmatism corneal incision operation.

Erythropoiesis ; physiology ; Humans ; Mitochondria ; physiology ; Mitochondrial Degradation

Objective To analyze the double contrast-enhanced ultrasonography (DCUS) features of periamupullary carcinoma for enhancing the ultrasound diagnostic value of the disease.Methods The DCUS and clinical data of 40 patients with periampullary carcinoma confirmed by histopathology were reviewed.Results (1) The displaying rate of the lesions and the judgment of lesion location was statistically higher on DCUS than that of ordinary ultrasound (P ＜ 0.05).(2) DCUS features of periampullary carcinoma:the size of most lesions was less than 30 mm except for 1 case in which no lesion was found; In 100％ (39/39) of the lesions,the morphology did not change with duodenum movement ; In 64.1％ (25/39) of lesions hyperenhancement or isoenhancement was displayed in the arterial phase,with low enhancement in the venous phase; In 87.2％ (34/39) of lesions homogeneous enhancement was displayed; In 95％ (38/40) the bile ducts were moderately or severely dilated.The lesion locations and whether the lesions projected into the duodenal cavity or not were statistically different between the three different types of periampullary carcinoma (P ＜ 0.05).The lesions projected into the duodenal cavity of duodenum were more commonly seen in papillary carcinoma and ampullary carcinoma than distal common bile duct carcinoma.The lesion size,whether the lesion morphology changed or not with duodenum movement,enhancement level,enhancement homogeneity,the degree of bile duct dilatation,whether there was pancreatic duct dilatation or not were not statistically different between the three different types of periampullay carcinoma (P ＞ 0.05).Conclusions DCUS is an effective way to show periampullay carcinoma,and is helpful to diagnose periampullary carcinoma and distinguish the three different types of periampullary carcinoma.

Objective To investigate the mechanisms underlying the effect of 5-aminolevulinic acid photodynamic therapy (ALA-PDT) on cutaneous squamous cell carcinoma (SCC) in mice.Methods A model of cutaneous SCC was established in 21 SKH-1 hairless mice,which were treated with topical ALA 8％ cream followed by single irradiation with He-Ne laser at a total dose of 30 J/cm2 (ALA-PDT).Three mice were sacrificed before and at 1,3,6,12,24 hours and 7 days after the irradiation,separately,and SCC tissue was taken from the mice.Transmission electron microscopy (TEM) and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) were performed to determine the pattern of tumor cell death(necrosis,apoptosis and autophagy) during 1-24 hours after ALA-PDT,and immunohistochemical techniques were used to estimate the expressions of LC3B and CD34 on SCC cells,as well as the quantity of CD1a+ cells,CD4+ T and CD8+ T lymphocytes in SCC tissue 7 days after the irradiation.Statistical analysis was done by two-sample t test using SPSS 17.0 software.Results TEM showed gradual necrosis and apoptosis (especially necrosis) of tumor cells and formation of autophagosomes in macrophages within 24 hours after ALA-PDT.The number of apoptotic cells per high power field (× 400) in SCC tissue significantly increased at 24 hours compared with that before ALA-PDT (7.30 ± 2.18 vs.2.00 ± 0.69,P ＜ 0.05).As immunohistochemistry revealed,there was a significant decrease in the number of CD34+ cells (1.33 ± 0.58 vs.19.00 ± 2.66,P＜ 0.01),but a marked increase in that of CD1a+ ce1ls (23.01 ± 2.04 vs.10.33 ± 1.88,P＜ 0.05),CD4+ T cells (28.67 ± 1.76 vs.12.40 ± 2.27,P＜ 0.05),CD8+ T cells (25.79 ± 2.37 vs.11.67 ± 1.45,P ＜ 0.05) and LC3B+ interstitial cells (30.6 ± 3.21 vs.21.44 ± 4.3,P ＜ 0.05) per high power field (× 400) in SCC tissue on day 7 compared with that before ALA-PDT.Conclusions ALA-PDT may directly kill SCC cells by inducing cell necrosis and apoptosis rather than autophagy.Additionally,ALA-PDT can injure microvascular endothelial cells and cause the aggregation of dendritic cells,CD4+ T cells and CD8+ T cells in SCC tissue.

Objective To identify the expression of a fusion gene GCA formed from GM-CSF gene and LMP2A gene of Epstein-Barr virus (EBV) in a recombinant BCG (rBCG) and to study its immunoge-nicity.Methods The rBCG was constructed to express the fusion gene GCA and the expressed products were detected by Western blot assay .ELISA was performed to measure specific antibody titers in serum sam-ples from mice immunized with rBCG .Lactate dehydrogenase assay was used to analyze the cellular immuni-ty of mice.A mouse model of EBV-positive gastric carcinoma was established to evaluate the therapeutic effects of rBCG.Results The target proteins of GM-CSF and LMP2A were successfully expressed in rBCG . The specific antibodies were detected in rBCG immunized mice as indicated by ELISA .The maximum anti-body titer reached 1 ∶27 900 [(326.5±7.8) pg/ml] as injection with rBCG 5×108/mouse.The rBCG in-duced cytotoxicity of cytotoxic lymphocytes (CTLs) to EBV-positive gastric carcinoma cells (GT39) (with a killing rate of 89.6%±6.8%) was significantly higher than that of control group (P<0.05) The sizes of tumor in PBS control group [(1964.0±548.7) mm3] and BCG group [(1268.65±72.4) mm3] were big-ger than those in rBCG group [(168.64±78.80) mm3].Conclusion The rBCG expressing GM-CSF and LMP2A fusion gene was successfully constructed .The rBCG could induce humoral and cellular immune re-sponses in mice and inhibit the growth of tumor .

Objective To explore the effect of Xinkang Tablets on myocardial apoptosis index,collagen volume fraction and sarcoplasmic reticulum Ca2+-ATPase activity of rats with adriamycin-induced heart failure.Methods The chronic heart failure (CHF) SD rat model was established by intraperitoneal injection of doxorubicin.After successful modeling,the rats with CHF were randomly divided into 5 groups,namely model group,western medicine group,and low-,middle-and high-dose of Chinese medicine groups,10 rats in each group.The rats in the above groups were given intragastric administration of distilled water,22.5 μg/kg of Digoxin mixed suspension,9,18,36 g/kg of XinkangTablets,respectively,in the volume of 10 mL/kg of distilled water dilution,once a day,for 5 continuous weeks.Another the same batch of 10 SD rats were randomly allocated to the sham operation group,and were treated with intragastric administration of the same volume of distilled water.And then the apoptotic rate of myocardial cells was measured by TUNEL method,the collagen volume fraction (CVF) was measured after Masson staining,and the sarcoplasmic reticulum Ca2+-ATPase activity was determined by inorganic phosphate assay.Results Compared with the sham operation group,the apoptotic rate of myocardial cells and CVF in the model group were increased(P ＜ 0.01),indicating that the myocardial remodeling occurred in rats with CHF.Compared with the model Group,the apoptotic rate of western medicine group and three Chinese medicine groups was significantly decreased(P ＜ 0.01),suggesting that Digoxin and Xinkang Tablets can relieve apoptosis to certain extent.The CVF in Digoxin group and middle-and high-dose of Chinese medicine groups were lower than those in the model Group (P＜ 0.05 or P＜ 0.01),indicating that Digoxin and Xinkang Tablets can delay the myocardial fibrosis.Last but not least,the SERCA2a activities in the middle-and high-dose of Chinese medicine groups were higher than those in the model group (P ＜ 0.05 or P ＜ 0.01),suggesting that Xinkang Tablets may relieve myocardial remodeling and improve cardiac function through the regulation of SERCA2a activity.Conclusion Xinkang Tablets decrease the apoptotic rate and myocardial cell volume fraction probably through the regulation of SERCA2a activity,which may play a role in counteracting apoptosis and myocardial fibrosis,and ultimately delay the remodeling of the myocardium.

Objective To evaluate septin-9 and clusterin protein levels in the peripheral blood samples from epithelial ovarian cancer patients, and explore its clinical significance. Methods Clinical data of 200 patients in Cancer Hospital,Chinese Academy of Medical Sciences from Jan. 29, 2008 to Feb. 1,2010 were collected. The peripheral blood samples were obtained from 137 epithelial ovarian cancer patients, 12 borderline ovarian tumor patients, 10 benign ovarian tumor patients, 41 benign pelvic lesion patients and 58 healthy women. The septin-9 and clusterin protein levels in the plasma were measured by double antibody sandwich ELISA or ELISA. The clinical significance of clusterin and septin-9 in plasma was analyzed. The diagnostic efficacy of septin-9 and clusterin protein in the detection of ovarian cancer was evaluated by the area under the curve (AUC) of the receiver operating characteristic (ROC) curve. Results Double antibody sandwich ELISA showed: the mean levels of plasma septin-9 in epithelial ovarian cancer patients or benign pelvic lesion patients were significantly higher than that in healthy women detedted by double antibody sandwich ELISA (P<0.01). The mean levels of plasma septin-9 in epithelial ovarian carcinoma patients with tumor family history or distance metastasis were significantly higher than those patients without (P<0.05). While the expression level of septin-9 protein in peripheral blood of ovarian cancer patients was not related to the patient age, pathologic stage, pathologic differentiation, smoking history, treatment history (including surgery, radiotherapy and chemotherapy) and lymph node metastasis (all P>0.05). ELISA showed: the mean level of plasma clusterin in epithelial ovarian cancer patients was significantly higher than that in healthy women deteded by ELISA (P=0.021). The expression level of clusterin protein in peripheral blood of ovarian cancer patients was not related to the above clinical pathological parameters (all P>0.05). To distinguish between ovarian cancer patients and healthy women by septin-9 protein expression level in plasma, when AUC was 0.712 and cut off was 0.28, the sensitivity of detection ovarian cancer by septin-9 protein expression was 82.5%, and the specificity was 50.0%. To distinguish between ovarian cancer patients and healthy women by clusterin protein expression level in plasma, when AUC was 0.636 and cut off was 87.96 pg/L, the sensitivity of detection ovarian cancer by clusterin protein expression was 71.5%, and the specificity was 41.4%. Conclusions The expression of septin-9 and clusterin protein in peripheral blood of ovarian cancer patients is increased, especially the expression level of septin-9 protein with related to the distant metastasis. The study results shown that the detection of septin-9 and clusterin in plasma has a certain diagnosis value in ovarian cancer, which may be a potential markers for ovarian cancer.

Aim To compare the inhibition of lipid peroxidation of ethyl acetate extract( EAE) and n-buta-nol( BE) extract from Coreopsis tinctoria Nutt. in vitro. To investigate the parameters such as body weight, bio-chemical indexes in plasma, and viscera indexes on type 2 diabetes mice by intraperitoneal injection of streptozotocin ( STZ ) . Methods The extracts were prepared by response surface methodology. The ex-tracts were suspended in distilled water and defatted with petroleum ether. The aqueous layer was succes-sively extracted with ethyl acetate and n-butanol. The inhibition of lipid peroxidation activity was determined by thiobarbituric acid method. The effects of extract BE on diabetic mice were observed at the dosage of 0. 2,0. 4,0. 8 g·kg-1 ( ig) for 4 weeks. The parame-ters were observed such as weight of body changes, or-gan coefficients of liver, pancreas and kidney, bio-chemical indexes in plasma and viscera pathological sections. Results In the linoleic acid reaction system, the SC50 value of the EAE and BE was ( 443. 96 ± 11. 24) mg·L-1, (840. 29 ± 16. 38) mg·L-1, re-spectively, and that in rat liver homogenate was (23. 59 ± 3. 67 ) mg · L-1 , ( 60. 37 ± 4. 27 ) mg · L-1 , respectively. Compared with diabetic model group, BE could significantly improve the trend of weight loss, and increase viscera indexes. The patho-logical sections showed that BE had the recovery and improvement effects on the damage of liver, pancreas and kidney. Conclusions The extracts of C. tinctoria have a certain anti-lipid peroxidation activity in vitro. And BE has a certain capacity to improve and repair damaged organs for DM mice.

Objective To explore the effects of aminolevulinic acid-based photodynamic therapy (ALA-PDT) on the proliferation and apoptosis of HaCaT cells stably expressing human papillomavirus type 16 E7 protein (HaCaT/HPVl6 E7 cells).Methods Cultured HaCaT/HPV16 E7 cells were divided into several groups: blank control group receiving no treatment, ALA group treated with ALA alone, irradiation group irradiated with 630-nm red laser (30 mW/cm2,12 J/cm2), ALA-PDT groups pretreated with ALA for 5 hours followed by 630-nm red laser radiation at 4, 8, 12 J/cm2 respectively.CCK8 assay was performed to determine the survival rate of cells at 24 hours after PDT, and flow cytometetry and confocal microscopy were conducted to detect cell apoptosis and observe cell morphology respectively at 3 hours.Results At 24 hours, the survival rate of cells was 68.98％ ± 1.03％, 46.03％ ± 2.96％ and 23.57％ ± 3.83％ in the 4-,8-and 12-J/cm2 ALA-PDT groups respectively, significantly lower than that in the blank control group, ALA group and irradiation group (99.15％ ± 0.64％, 98.13％ ± 0.83％ and 96.85％ ± 1.37％ respectively, all P ＜ 0.05).With the increase in radiation dose, cell apoptosis was accelerated with obvious morphological changes and shrinkage of cells in the ALA-PDT groups.Conclusion ALA-PDT can inhibit the proliferation, and promote the apoptosis of HPV-infected HaCaT cells in a dose-dependent manner within a certain range of radiation dose.