Postgraduate education must be systematic and explicit.In recent years,the cultivation of domestic tertiary education for postgraduate students conducted a multi-disciplinary approach.This article give comment on the current postgraduate training objectives,methods,curriculum and training process,training instructors,and puts forward some problems to be discussed in depth.

Background and purpose:The morbidity and mortality of lung cancer are currently the highest malignant tumor in China and the world. Most onset age of the illness is after 60 years old. Therefore, surgical resection of lung cancer in the elderly is very worthy of concern. This study aimed to investigate the clinical features, epidemic characteristics and conditions in perioperative period between the elderly and middle-aged patients with lung cancer, and provide the reference for clinical treatment.Methods:Totally 1 019 patients with lung cancer who were admitted to the hospital and accepted the operations in department of thoracic surgery in Shanghai Pulmonary Hospital from Jan. 2007 to Dec. 2012 were analysed retrospectively. The clinical data including gender, pathological type, TNM stage, intraoperative amount of bleeding and post-operative length of hospitalization were compared.Results:There was a signiifcant difference in sexual factors between these two groups (P?0.05), and compared with the middle-aged group, the proportion of male was more higher in the elderly group (76.91%vs 52.81%). Adenocarcinoma was the most common and squamous carcinoma was the next in both two groups. The constituent ratio of the pathlogical type between the elderly group and the middle-aged group was statistically signiifcant (P?0.05). The squamous carcinoma in the elderly group was higher than that in the middle-aged group (37.5%vs 15.6%). On the contrary, adenocarcinoma was more common in the middle-aged group (72.8%vs 50.7%). StagesⅡa,Ⅱb, andⅢa were more common in the elderly group and stagesⅠa, andⅠb were the most clinical stage in the middle-aged group. The clinical stage between two groups was statistically significant (P?0.05).The intraoperative amount of bleeding was higher and the post-operative length of hospitalization was longer in the elderly group, with a signiifcant difference as compared with that in the middle-aged group(P?0.05). And there was a signiifcant difference in incidence of accompanying diseases between the two groups, compared with the middle-aged group, the proportion of accompanying diseases was more higher in the elderly group(58.6%vs42.3%).Conclusion:Elderly patients with lung cancer are more common in males, with adenocarcinoma being the most common. The cancer mostly belongs to a medium or advanced stage. Elderly patients have the trend with more amount of bleeding in operation and lengh of stay.

A total of 68 patients with histologically proven endometrial cancer were preoperatively evaluated with a 3.0 T magnetic resonance (MR) unit.Two radiologists interpreted the depth of myometrial invasion on T2-weighted and diffusion-weighted(DW) MR (b =700 s/mm2) imaging.Myometrial tumor spread was classified as superficial (＜ 50％) or deep (≥50％ myometrial thickness).Statistical methods included Kappa statistics for reader agreement,accuracy assessment and receiver operating characteristic analysis for diagnostic performance comparison.For assessing the depth of myometrial invasion,the diagnostic accuracy,sensitivity and specificity were as follows:T2-weighted imaging-reader 1st,61.8％,60.0％ and 65.2％;reader 2nd,66.2％,64.4％ and 69.6％ ; T2-weighted combined DW imaging-reader 1st,86.8％,84.4％and 91.3％ ; reader 2nd,89.7％,86.7％ and 95.7％.Reader agreement was excellent for T2-weighted combined DW imaging (Kappa =0.818).For assessing deep myometrial involvement,ROC analysis showed that the diagnostic accuracy was significantly higher on T2-weighted combined DW imaging than that on T2-weighted imaging.The AUC (area under the curve) values measured by two readers on T2-weighted and T2-weighted combined DW imagings were 0.626,0.879 and 0.670,0.912 respectively.The addition of 3.0T MR diffusion-weighted to T2-weighted imaging can improve the diagnostic performance of MR imaging in the assessment of myometrial invasion.

As a new physical penetration technology for transdermal administration, theFu’s cupping therapy was established in the past decade. It had obvious characteristics of Chinese medicine and unique advantages, such as simple device, easy to operate, and economical. Referring to the relevant research reports in recent years, this overview was given in several aspects, including its features, penetration factors,in vitro andin vivoevaluation method and other penetration technologies. The understanding of development trends in the pharmaceutical field laid the foundation for further study of Fu’s cupping therapy of new physical penetration.

This study was undertaken to observe the biochemical changes in striatum of Parkinson's disease (PD) rat model by modified proton magnetic resonance spectroscopy. 12 SD rats were divided into model (n=7) and control (n=5) groups. At 3 weeks after the injection of 6-hydroxydopamine into right striatum, 1H-MRS on the striatum was taken by modified proton magnetic resonance spectroscopy, and then tyrosine hydroxylase (TH) immunostatining was used to visualize the changes of the neurons in substantia nigra and neurites in striatum. The results showed that TH positive neurons and neurites in the substantia nigra compacts (SNc) and striatum in the normal side of the rat model of PD were decreased (P < 0.05), which proved the successful establishment of PD models. The NAA/Cr ratio of the injected side striatum of model group was lower than that of the normal side (P < 0.05). The ratios of Cho/Cr showed no significant difference between the two sides (P > 0.05). These results indicated that the modified 1.5T 1H-MRS should be a noninvasive technique which could provide useful information about the biochemical metabolites in striatum for the study of PD in rat model.
Animals ; Corpus Striatum ; enzymology ; Female ; Magnetic Resonance Spectroscopy ; methods ; Male ; Oxidopamine ; Parkinson Disease, Secondary ; chemically induced ; metabolism ; Rats ; Rats, Sprague-Dawley ; Tyrosine 3-Monooxygenase ; metabolism

Objective:To summarize and analyze the clinical and genotype features of female-restricted X-linked syndromic mental retardation-99(MRXS99F, OMIM: 300968)caused by USP9 X gene mutation, and to improve the clinicians′ understanding of the disease. Methods:Clinical data and genotypes of 2 children with MRXS99F treated in the Children′s Hospital of Nanjing Medical University in March 2020 (case 1) and June 2020 (case 2) were analyzed, and the relevant databases at home and abroad were reviewed to summarize the clinical characteristics and gene variation characteristics of the disease.Results:The 2 cases were 6 months old (case 1) and 5 years old (case 2), both showed psychomotor retardation.Case 1 presented a short stature, pigment abnormality, characteristic facial features, hypotonia, recurrent respiratory tract infections, laryngeal cartilage hypoplasia, atrial septal defect, feeding difficulty, hearing loss and brain hypoplasia.Case 2 had abnormal electroencephalogram.As confirmed by whole-exome sequencing, two children carried c. 6972+ 1G>A, c.6437C>T of USP9 X, respectively.Neither of the 2 variations was previously reported.Twenty-two cases of MRXS99F caused by USP9 X gene mutation were reported in 4 literatures globally, and 24 cases were combined with this study.The clinical manifestations of 20/22 children had special faces.All of them accompanied mental retardation combined with motor and language retardation, and carried neonatal variation. Conclusions:This is the first case report of MRXS99F induced by USP9 X gene variation in China.MRXS99F caused by functional deletion and variation of USP9 X gene is mainly characterized by psychomotor retardation, language disorder, special face and multiple congenital malformations.For children with unexplained growth retardation, special face and multiple congenital malformations, genetic testing like high-throughput sequencing should be carried out as early as possible to determine the etiology.

Objective:To evaluate the effect of electroacupuncture postconditioning on the expression of microRNA-1 (miRNA-1) in rats with arrhythmias induced by myocardial ischemia-reperfusion (I/R).Methods:Twenty-four clean-grade healthy adult male Sprague-Dawley rats, aged 2-3 months, weighing 280-320 g, were divided into 3 groups ( n=8 each) using a random number table method: sham operation group (S group), I/R group and electroacupuncture postconditioning group (EP group). The model of myocardial reperfusion arrhythmia was established by ligating the left anterior descending branch of coronary artery for 30 min followed by 30-min reperfusion in anesthetized rats.The artery was only isolated without ligation after thoracotomy in group S. Bilateral Neiguan acupoints were stimulated for 30 min starting from the time point immediately after reperfusion in EP group.The occurrence of arrhythmia during reperfusion was recorded.The rats were sacrificed at 30 min of reperfusion, and hearts were removed for examination of the pathological changes of the myocardium and for determination of miRNA-1 expression (by quantitative real-time polymerase chain reaction) and expression of Kir2.1 and connexin 43 (Cx43) (by Western blot). Results:Compared with S group, the incidence of arrhythmia was significantly increased, the expression of miRNA-1 was up-regulated, and the expression of Kir2.1 and Cx43 was down-regulated in I/R and EP groups ( P<0.05). Compared with I/R group, the incidence of arrhythmia was significantly decreased, the expression of miRNA-1 was down-regulated, and the expression of Kir2.1 and Cx43 was up-regulated in EP group ( P<0.05). The pathological changes of myocardium were accentuated in I/R and EP groups when compared with S group, and the pathological changes were significantly attenuated in EP group when compared with I/R group. Conclusion:The mechanism by which electroacupuncture postconditioning reduces the occurrence of reperfusion arrhythmia is related to up-regulation of Kir2.1 and Cx43 expression after down-regulation of miRNA-1 expression in rats.

By using(S)-MonoPHOS and ［Rh(COD)2］BF4 as catalyst, the asymmetric hydrogenation reactions of methyl-2-acylamino-3-arylacrylate and the effect of different amino protective groups on hydrogenation efficacy were studied. The products resulting from asymmetric hydrogenation were hydrolyzed by hydrochloric acid, and the corresponding amino acids were obtained at yields of 63%- 92%.

In the investigation of asymmetric catalytic hydrogenation reaction, (Z)-methyl-2-acetamidocinnamate is often used as a standard substrate to assess the chiral catalysts. However, its previous syntheses suffered from low yield, relying on column chromatography for isolation. Herein, (Z)-methyl-2-acetamidocinnamate was obtained with 68. 5% isolation yield via simple operations such as wash and extraction using dicyclohexylcarbodiimide(DCC)as dehydrant and 4-dimethylaminopyridine(DMAP)as catalyst in the last synthetic step.

Objective:To observe the dynamic changes of serum RANTES during the treatment with nucleos(t)ide analogues combined with pegylated interferon alpha (peginterferon-α), and further analyze the predictive effect of RANTES on HBsAg clearance in patients with chronic hepatitis B.Methods:98 cases of chronic hepatitis B with quantitative HBsAg < 3 000 IU/ml and HBV DNA < 20 IU/ml after≥1 year NAs treatment were enrolled. Among them, 26 cases continued to receive NAs monotherapy, 72 cases received NAs combined with pegylated interferon alpha therapy. The changes in RANTES during treatment were observed. The receiver operating characteristic curve was used to analyze the early changes of RANTES to predict the HBsAg clearance during 48 weeks.Results:During 48 weeks, 15 cases (20.83%) had achieved HBsAg clearance in combination group, while no patient had achieved HBsAg clearance in NAs group. The overall serum RANTES level had decreased from baseline in NAs and combination group. At week 48, in the combination group, the serum RANTES level was decreased more significantly in patients with HBsAg clearance than patients without. Further analysis showed that, in combination group, HBsAg clearance rate of patients with serum RANTES decreased at week 12 and 24 was higher than patients with elevated (29.17% vs. 4.17%, P = 0.014; 28.00% vs. 4.55%, P = 0.052), and quantitative HBsAg reduction was larger significantly [(1.49 ± 1.26) log 10IU/ml vs. (0.73 ± 0.81) log 10IU/ml, P = 0.017; (1.54 ± 1.27) log 10IU/ml vs. (0.57 ± 0.56) log 10IU/ml, P = 0.004]. Receiver operating characteristic curve analysis showed that the baseline quantitative HBsAg and the reduction in quantitative HBsAg and serum RANTES during the early period were predictors of HBsAg clearance after 48-week combination therapy. Furthermore, the combination of baseline quantitative HBsAg and 12 - or 24-week reduction of serum RANTES were better predictors of HBsAg clearance than that of baseline quantitative HBsAg combined with HBsAg decrease at week 12 or 24. The area under the receiver operating characteristic curve of the former was 0.925 and 0.939, while that of the latter was 0.909 and 0.929, respectively. Conclusion:Early reduction of serum RANTES at week 12 and 24 can predict HBsAg loss in CHB patients receiving addition of peginterferon-α to ongoing NAs Therapy, so serum RANTES could be one of the key immunological markers for predicting HBsAg clearance.