Objective: To establish the norm of occupational stress norm, as well as gender normative sample in southwest China. Methods: In this study, cross-sectional study method, and a synthetic way of sorting and randomized sampling were adopted to deal with research targets with revised occupational stress inventory (OSI-R) for 4278 participants.Results: The results of gender show that there were heavier occupational role , stronger interpersonal and physical strain in male than that in female(166.5?27.0/158.5?26.4,25.6?4.4/25.1?4.4,22.6?5.6/21.2?5.2,P

Physician-patient communication skill is the core clinical capability,and its im-portance is more and more recognized by educationists.Introducing the communication skill education into the standardized resident training can improve the residents'clinical and communicative ability and train them to be the comprehensive quality talents.

OBJECTIVE: To investigate the possible stimulating mechanism of Huoxue Bushen Mixture (HXBSM), a traditional Chinese compound medicine, on hair growth of mice via measuring the variance of skin blood vessel neogenesis and vascular endothelial growth factor (VEGF) expression in the hair follicle. METHODS: Hot rosin and paraffin mixture depilation were used to induce C57BL/6 mice hair follicle to enter from telogen into anagen. Ninety C57BL/6 mice were divided into 3 groups randomly: HXBSM group, Yangxue Shengfa Capsule (YXSFC, another traditional Chinese compound medicine) group and untreated group. The mice were fed with corresponding drugs after modeling. The hair growth of the mice was observed every day. Every ten mice out of each group were executed respectively at day 4, 11 and day 17. Skin blood vessel neogenesis was counted through pathological section and VEGF expression in the hair follicle was measured via immunohistochemical method. RESULTS: The number of local blood vessel neogenisis in the HXBSM group observed was larger than that in the untreated group at day 4 (P<0.05); and evidently larger than that in the YXSFC group and the untreated group at day 11 (P<0.05). The expression of VEGF in the hair follicle was distinctively higher than that in the YXSFC group and the untreated group at day 11 and day 17 (P<0.05). CONCLUSION: HXBSM up-regulates VEGF expression to accelerate blood vessel neogenesis and hair growth.

BACKGROUND:Poly-D,L-lactic-co-glycolic acid (PLGA) that was characterized as absorbable,weak cytotoxicity,and adjustable hardness was ideal to be synthetized artificial spinal dura mater.Because of lacking of functional group at the surface of PLGA,it should be modified to fit the demand of satisfied biocompatibility.OBJECTIVE:To study the biocompatibility of PLGA membrane modified by type-Ⅰ collagen and chitosan.DESIGN,TIME AND SETTING:Contrast observation study,which was carded out in the Biochemistry and Molecular Biology Laboratory Shanghai University of Traditional Chinese Medicine from May to December 2007.MATERIALS:Porous PLGA membrane was provided by Jinan Banzheng Biology-Technology Co.,Ltd.,type-Ⅰ collagen by Sigma Company,USA,chitosan by Shanghai Qisheng Biological Agent Medical Apparatus and Instrument Company,and L929 L cell by Cellular Institute of Shanghai Academy of Life Science,Chinese Academy of Science.METHODS:PLGA membrane (P membrane),PLGA/type-Ⅰ collagen composite membrane (PG membrane),PLGA/type-Ⅰ collagen/chitosan (9:1) composite membrane (PGC 9:1 membrane) and PLGA/type-Ⅰ collagen/chitosan (5:5) composite membrane (PGC 5:5 membrane) were produced through a certain process.MAIN OUTCOME MEASURES:Contact angle,absorption rate and cytotoxicity were tested.Morphological changes of L929 L cell cultured for 1,3,and 7 days were observed under fiberscope.RESULTS:Contact angle was shown as PG membrane＜PGC 9:1 membrane＜PGC 5:5 membrane＜P membrane (P＜0.01 );absorption rate was shown as P membrane＜PGC 5:5 membrane＜PGC 9:1 membrane＜PG membrane (P＜0.01).L929 L cell was characterized as well distribution,expansion and appearance after inoculation of PG membrane,PGC 9:1 membrane and PGC 5:5 membrane.Cytotoxic experiment (MTT methods) showed that,on the 1st day,there was no significant difference in absorbency among groups (P＞0.05).On the 3rd and 7th days,there were significant differences between P membrane and PG membrane or PGC 9:1 membrane,and between PGC 9:1 membrane and PCK2 5:5 membrane (P＜0.05).PGC 9:1 membrane could further improve cell adhesion and proliferation,and PGC 5:5 membrane could inhibit cell proliferation and differentiation.CONCLUSION:Type-Ⅰ collagen and chitosan appended to the exterior of PLGA can enhance the biocompatibility of membrane.In terms of biocompatibility,PLGA/type-Ⅰ collagen/chitosan (9:1) composite membrane can be fit to the qualification as a type of material of artificial spinal dura mater.

Objective To investigate the changes of serum transforming growth factor-β1 (TGF-β1),interleukin-10(IL-10) and interferon-γ(INF-γ) in elderly patients with hepatic fibrosis and their correlation with hepatic fibrosis.Methods One hundred and thirty-three patients diagnosed by pathological hepatic tissue were enrolled as case group who were in the first affiliated hospital of Xinxiang Medical University from 2007 to 2013.The enzyme-linked immunosorbent assay (ELISA) was applied to detect of serum levels of TGF-β1,IL-10and IFN-γ.Meanwhile 21 healthy people were recruited as control group.Results Comparison with the control group,the levels of TGF-β1 and IL-10 were significantly higher(TGF-β1:(217.4 ± 7.5) ng/L vs.(57.2±4.8) ng/L,t =15.61,P＜0.01;IL-10:(29.6 ±3.2) ng/L vs.(15.1 ±7.5) ng/L,t =11.44,P＜0.01),while IFN-γlevel was lower ((51.9 ± 3.5) ng/L vs.(75.8 ± 5.9) ng/L,P =0.03) in case group.The serum levels of TGF-β1,IL-10,IFN-γand stages of hepatic fibrosis was correlated and the correlation coefficients were 0.786,0.644 and-0.822 respectively (P ＜ 0.05).Conclusion Serum levels of TGF-β1,IL-10 and IFN-γ in patients with hepatic fibrosis are proved to be with ability of predicting the development of hepatic fibrosis and the post treatment.

Objective To establish osteochondral scaffolds with remained calcified cartilage zone for finding an ideal scaffold for tissue engineered repair of osteochondral defect.Methods Cartilage zone was harvested from fresh adult porcine knee to fabricate type Ⅱ collagen hydrogel.Bone blocks measuring 8 mm in diameter with calcified cartilage zone were prepared by trephine and acellular treatment was performed.Histological staining was used to identify complete removal of cells.To fabricate the osteochondral models containing calcified cartilage zone,type Ⅱ collagen was seeded onto the acellular bone blocks with calcified cartilage zone,lyophilized,and cross-linked with 10 g/L of genipin ethanol solution.Then cell seeding and scanning electron microscope were performed after the models were established.Results HE staining,toluidine blue staining,solid green staining,safranin O staining,and DAPI staining showed cells were completely removed from bone blocks by decellularized process.Porosity of type Ⅱ collagen sponge was (91.1 ±3.8) ％ and pore size was (79.7 ± 17.1) μm.Porosity of acellular bone blocks was (73.5 ±2.6)％ and pore size was (470.2 ± 158.8) μm.Cells seeded onto osteochondral scaffolds grew well by scanning electron microscope.Conclusion Osteochondral scaffolds with calcified cartilage zone provide good biocompatibility and suitable pore size and porosity and may be an ideal material for repairing osteochondral defect in tissue engineering.

Objective To investigate incidence,diagnosis and treatment strategy of delayed esophageal complications after anterior cervical spine surgery.Methods The clinical data of 2316 patients who had undergone anterior cervical spine surgery from January 2001 to December 2011 were analyzed.The delayed esophageal complications were defined as esophageal perforation,esophago-tracheal fistula,esophago-cutaneous fistula,diverticulum of esophagus,esophagopleural fistula and esophageal stenosis that occurred 2 weeks after spine surgery.Results Delayed esophageal complications occurred in 4 patients,and the incidence was 0.17％.Esophageal perforation occurred in 2 patients; the incidence was 0.09％.Case 1 was a 31-year-old man who was found to have esophageal diverticulum and perforation 7 years after anterior cervical spine surgery.Then he underwent removal of implant,excision of diverticulum,and repair of esophagus with sternohyoid muscle flap and omohyoid muscle flap.Case 2 was a 46-year-old man who was found to have esophageal diverticulum 3 years after cervical spine surgery.He also underwent removal of implant,excision of diverticulum,and repair of esophagus with sternohyoid muscle flap and omohyoid muscle flap.Case 3 was a 58-year-old woman who was found to have esophageal diverticulum 5 years after cervical spine surgery.She underwent removal of implant,excision of diverticulum,and repair of esophagus with sternocleidomastoid muscle flap.Case 4 was a 56-year-old woman who was found to have esophageal perforation 3 years after cervical spine surgery.She underwent removal of implant and repair of esophagus with sternocleidomastoid muscle flap.All 4 patients recovered after operation.Conclusion The incidence of delayed esophageal complications after anterior cervical spine surgery is low,and the diagnosis is difficult.X-ray,digestive tract radiography,and gastrointestinal endoscopy are the main diagnostic tools.Surgical treatment is the main and effective management.

Objective To investigate the knowledge awareness of medical staff in department of Obstetrics and Gynecology,on prevention of mother-to-child transmission of hepatitis B virus(HBV).Methods Medicatl staff,who attended national or local medical conferences of Obstetrics and Gynecology from July 29th to October 25th in 2011,were invited to complete a questionnaire containing questions on clinical implications of HBV serologic markers,relevant prevention measures and including intervention measures for both pregnant women and infants.Data were collected and analyzed by Chi-square test or Fisher's exact test.Results A total of 559 answers were analyzed.Of the 559 staff,85.0％(n=475) were doctors and 15.0％(n=84) were nurses.The percentages ofstaff from primary,secondary and tertiary hospitals were 13.2％(n=74),36.9％(n=206) and 49.9％ (n=279).Overall,90.0％ (503/559) participants agreed that positive hepatitis B surface antigen (HBsAg) was contagious,but 27.5％ (154/559) mistook that the presence of antibody against hepatitis B e antigen (anti-HBc) and/or antibody against hepatitis B core antigens (anti-HBc) with negative HBsAg was contagious.Totally,96.3％ (519/539) respondents knew that pregnant women should be screened for HBV infection,and those from secondary hospitals had more consciousness of HBV screening for pregnant women than those from tertiary hospitals [99.0％ (201/203) vs94.7％(250/264),x2=6.466,P=0.011].Although,95.3％ (511/536) realized that infants of mothers with positive HBsAg should receive hepatitis B immunoglobulin (HBIG) and vaccination,but 61.6％ (330/536) and 80.4％ (427/531) of the enrolled medical staff knew the exact regimen.With the available immunoprophylaxis,13.8％ (74/536) participants mistakenly believed that cesarean section may prevent HBV mother-to-child transmission,and only 13.0％ (69/532) correctly answered that neonates of women with positive HBsAg can be breast-fed.Additionally,54.4％ (290/533) participants mistakenly believed that HBsAg positive pregnant women needed HBIG injection during pregnancy to reduce HBV mother to-child transmission.Conclusions Medical staff in obstetric and gynecological department has essentially mastered the strategies of prevention of mother-to-child transmission of HBV,but much more details should be stressed.

OBJECTIVE: To explore the mechanisms of the effects of Runing Recipe in anti-invasion and anti-recurrence of breast cancer by experimental research in vitro. METHODS: SD female rats were randomly divided into Runing Recipe-treated group and its decomposed formulas Kidney-Warming Recipe and Liver-Soothing Recipe-treated groups, tamoxifen (TAM) -treated group, cyclophosphamide (CTX) -treated group, and normal control group to make medicated serums. Methods of matrigel basement membrane and real-time reverse transcription polymerase chain reaction were employed to investigate the gene expressions of vascular endothelial growth factor (VEGF), matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) after MDA-MB-435 cells were treated with the medicated serums. RESULTS: The gene expression of VEGF was dropped in CTX-treated, TAM-treated and Liver-Smoothing Recipe-treated groups. The gene expression of TIMP-1 was up-regulated in CTX-treated, Runing Recipe-treated and Kidney-Warming Recipe-treated groups; while MMP-9 was down-regulated in these groups. CONCLUSION: The mechanisms of Runing Recipe in inhibiting the cancer cell invasion may be related to down-regulating the gene expressions of VEGF and MMP-9, and up-regulating the gene expression of TIMP-1.

Objective To explore the clinical effect of hysteroscopic scar defect correction in the treatment of cesarean scar.Methods Eighty-four cases patients with cesarean section uterine incision scars who were treated in Affiliated Hospital of Hubei Polytechnic University from August 2015 to July 2016 were selected and randomly divided into observation group with hysteroscopic surgery and control group with vaginal surgery,42 cases in each group.The operation condition,clinical efficacy and the incidence of complications of the two groups were observed and compared.Results The amomt of blood loss,hospitalization expenses,hospitalization time and operation time in the observation group were (22.45±3.78) ml,(3028.89±218.79) yuan,(3.89 ±0.80) d,(20.13±2.90) min respectively,in the control group were (40.56±5.48) ml,(4189.58±269.78)yuan,(5.46 ± 1.02) d,(30.78 ± 6.99) min respectively,the differences were significant (P ＞ 0.05).The incidence of infection,relapse and incisional wound healing in the observation group were significantly lower than in the control group,the differences were significant (P＜0.05).The total effective rate was 90.48％ in the observation group and 85.71％ in the control group after treatment,the difference was not significant(P ＞0.05).Conclusion Hysteroscopic scar repair has the same effect as that of vaginal surgery,but the rate of blood loss and complication is lower than that of vaginal operation,which is safer and more effective.