Objective To investigate couple's personality similarity effect on the marital quality,and to explore the vairance of such effect under different levels of spouse's depression. Methods The cross?sectional da?ta of 4644 couple from the national survey of mental health database in china( 2009) was used. Couples completed Locke ?Wallance marital adjustment test,The CES?D scale a self?report depression scale and Eysenck personality questionnaire short scale for Chinese version (EPQ?RSC). Results The personality similarities of couples(0.44 ±0.27) and their marital quality (wife (103.71±27.54),husband (106.15±26.94))had significant positive corre?lation ( r=0.25~0.27, P<0.01). Regression analysis showed the effect of personality similarity on the marital quality were varied according to the level of spouse depression( β=0.09?0.22, P<0.05) . Among participants whose husband or wife had higher level of depression,couple's personality similarity had stronger effect on his/her per?ceived marital quality. Conclusion Husband and wife personality similarity is related to marital quality signifi?cantly,and the spouse depression plays a significant moderating role in this relationship.

This thesis described the necessity for practicing the tutorial system of specialist training in Chinese medical education,the essential basic elements for the construction of the tutorial system of specialist training and also the necessity for further exploration in the patterns of the tutorial system of specialist training in China.

Objective To investigate the serum levels of heat shock protein 70 (HSP70) in uremic patients with different dialysis ages.Methods Ninety-two maintenance haemodialysis patients were divided into short-term group(from three months to 2 years,n =32),median-term group(from 2 to 5 years,n =37) and longterm group(more than 5 years,n =23) according to different dialysis ages.Enzyme-linked immunosorbent assay (ELISA) was used to measure the serum levels of HSP70 before and after haemodialysis in each group.Results The semm levels of HSP70 had significant difference both in median-term group and long-term group before and after haemodialysis(median-term group:(54.94 + 39.21) μg/L vs (69.72 + 39.90) μg/L,t =-2.068,P =0.047 ;long-term group:(46.17 +34.63) μg/L vs (74.07 ±41.11) μg/L,t =-2.814,P =0.010).But there was no statistics difference on the serum levels of HSP70 before and after haemodialysis in the short-term group((70.42 ±38.30) μg/L vs (62.89 ±43.01) μg/L,t =0.870,P =0.390).Conclnsion Haemodialysis patients with more stress protection ability are likely to obtain long term survival.

Objective To investigate the local immune response in condyloma acuminatum treated with aminolevulinic acid-photodynamic therapy (ALA-PDT).Methods In vitro and in vivo studies were performed.A previously established keratinocyte cell line human papilloma virus (HPV) 16E7/HaCaT which stably expresses HPV16E7 protein was used in this study.Peripheral blood mononuclear cells (PBMCs) were separated from 10 healthy volunteers.After pretreatment with ALA-PDT,HPV16E7/HaCaT cells were cocultured with the PBMCs for 3 hours in a Transwell chamber followed by the observation of chemotactic migration of PBMCs.Tissue samples were obtained from the lesions of 10 patients with condyloma acuminatum before,and at 1,2,3 and 48 hours after the first session of ALA-PDT.Immunohistochemistry was conducted to determine the number of CD4+ T cells,CD8+ T cells and CD68+ macrophages as well as CD4/CD8 T-cell ratio in the tissue samples.Results After 3-hour coculture with HPV16E7/HaCaT cells pretreated by ALA-PDT,PBMCs showed apparent chemotactic migration.Immunohistochemistry revealed a statistical increase in the number of CD4+ T cells,CD8+ T cells and CD4/CD8 T-cell ratio at 48 hours (all P ＜ 0.05),as well as in the number of CD68+ macrophages at 3 hours and 48 hours (both P ＜ 0.05) after the first session of ALA-PDT.Conclusion ALA-PDT may induce local antiviral immune response in condyloma acuminatum.

Objective To investigate the efficacy and safety of 5-aminolaevulinic acid-photodynamic therapy (ALA-PDT) in cervical condyloma acuminatum. Methods Forty-five patients with cervical condyloma acuminatum topically applied 10% ALA thermal gel followed by PDT. The treatment was repeated 14 days later if the lesion was not completely removed. Totally, 1 - 4 treatment sessions were given. Thirty-five patients with cervical condyloma acuminatum who received CO2 laser treatment served as the control. All patients were followed up for 12 weeks. Results Complete remission was achieved in 97.8% (44/45) of patients with cervical condyloma acuminatum treated by ALA-PDT, and among the 44 cured patients, 3 were treated by 1 cycle of ALA-PDT, 6 by 2 cycles, 20 by 3 cycles, and 15 by 4 cycles. The lesions of condyloma acuminatum were removed after 1 session of CO2 laser treatment in 30 patients, and after repeated treatments in 5 patients, with the complete remission rate being 100% (35/35). The overall recurrence rate calculated for the whole followup period in patients treated with ALA-PDT was significantly lower than that in patients treated with CO2 laser [6.8% (3/44) vs 31.4% (11/35), x2 = 6.497, P ＜ 0.05]. However, no significant difference in complete remission rate was found between the two groups (P ＞ 0.05). Almost all the patients in ALA-PDT group presented with pain of bythus during illumination, but no severe side effects or scar formation was observed. In patients treated with CO2 laser, adverse reactions mainly included bleeding, erosion, shallow ulcer and even scar formation. Conclusions Topical ALA-PDT is effective and safe for the treatment and reduction in recurrence of condyloma acuminatum, and may serve as a therapeutic option for cervical condyloma acuminatum.

Objective To establish a human keratinocyte cell line (HaCaT) stably expressing HPV16E7 protein. Methods HPV16E7 gene was amplified from CaSki cells using PCR and inserted into the eukaryotic expression plasmid pcDNA3.1. Then, the recombinant expression plasmid pcDNA3.1-HPV16E7 was transfected into HaCaT cells followed by G418 selection and identification by RT-PCR and Western blot. Results The recombinant eukaryotic expression plasmid pcDNA3.1-HPV16E7 was successfully identified by restriction enzyme digestion pattern and sequence analysis. Agarose gel electrophoresis of RT-PCR products detected the 297-bp fragment of HPV16E7 cDNA, and Western blot confirmed the stable expression of HPV16E7 protein. Conclusion A human keratinocyte cell line (HaCaT) stably expressing HPV16E7 protein is successfully established.

Objective To establish a model for cutaneous squamous cell carcinoma by irradiation of SKH-1 hairless mice with solar-simulated ultraviolet (solar UV), and to explore the biological characteristics of the model. Methods A total of 91 SKH-1 hairless mice were randomly divided into seven experimental groups (n = 10) and seven control groups (n = 3). The mice in experimental groups were irradiated with minimal erythema dose of solar UV 4 times per week for various durations (4, 8, 12, 16, 20, 24, 28 weeks), while the control mice received no irradiation. The general status and skin appearance of mice were observed during the treatment process. Mice were killed immediately after the last irradiation at different time points and pathological examination was carried out to observe the histological changes of skin lesions. Results Papules measuring equal to or more than 1 mm in diameter began to develop in some mice in experimental group 10 weeks after the first irradiation; tumors began to appear in 39.3% (11/28) of the remaining mice in experimental group on week 20, and in 100% (10/10) of the remaining mice on week 28. The cumulative dose approximated to 26.99 J/cm2 for UVB and 242.91 J/cm2 for UVA after 28-week irradiation. No tumor was observed in the control mice. Pathological examination revealed characteristic changes of squamous cell carcinoma in 30% of the mice on week 12, 33.3% on week 16, 60% on week 20, 87% on week 24, and 100% on week 28. Conclusions Ultraviolet could induce the hyperplasia of skin in SKH-1 hairless mice, and even cause the development of cutaneous squamous cell carcinoma after prolonged irradiation.

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.

Objective To evaluate the feasibility and safety of the robot - assisted system YunSRobot for remote manipulation endoscopy. Methods When the master of YunSRobot was installed in the gastroenterology office in Chinese PLA General Hospital, the robot slave and upper gastrointestinal simulation model (Takahashi Lm103,Japan) were installed at the same time in the State Key Laboratory of Robotics, Shenyang Institute of Automation. Three physicians were trained to operate the master robotics and performed gastroscopy on the simulation model based on network cloud. Each physician performed 3 procedures of oesophagogastroduodenoscopy (EGD) by YunSRobot using traditional manual endoscopy, on-site operating mode, and remote manipulation mode, respectively. The operating time, lumenal anatomic exposure,man-machine interaction and other parameters were recorded. Results The number of standard pictures obtained by traditional manual endoscopy group, on-site operating group and remote manipulation group were 39.9±0.3, 39.8±0.4, 39.9±0.3, respectively. The images of all five lesions could be obtained by each operation. The operating time in the duodenum of remote group was longer than that of on-site group, with average time (78.2±16.0)s vs. (68.9±15.8)s (P=0.021) respectively. As to the operating time on other parts or total time, all three groups were comparable. Although there was a mean delay of (572.1±48.5) ms in remote operation group, the operation was still smooth. However, compared with on-site group, the percentage of clear view time in the duodenum was significantly shortened in remote group: [(77.8±8.2)% vs. (83.9 ± 6.4)% , P=0.024]. Statistically significant difference was detected in percentage of clear view time neither in other sites, nor was in the total operating time between two groups. The operating time in each part of remote group was obviously longer than that of manual group as followings, pharyngeal (27.3±4.2) s vs. (9.2±1.3)s (P<0.001), esophageal (29.7±6.4)s vs. (19.3±1.6)s (P=0.004), stomach (56.7±17.0)s vs. (40.3±7.0)s (P=0.003), pylorus (20.2±5.5)s vs. (9.3±1.3)s (P<0.001), duodenum (78.2±16.0)s vs. (29.3±5.6)s (P<0.001). Thus the total operating time was also longer in remote group as (559.0±87.2)s vs. (253.1±16.6)s (P<0.001). The respective time in pharynx, esophagus, stomach, pylorus, duodenum, or the overall time was all longer in remote group than that in manual group. Conclusions The soft endoscopy robot YunSRobot has satisfactory safety and stability. Remote upper gastrointestinal endoscopy can be completed based on common network and an endoscope simulation model with smooth operation. The inspection time by YunSRobot robot per part and the overall time are longer than those of manual operation on site, still, remote operating time meets the standard of upper gastrointestinal endoscopy.

The clinical features and laboratory tests results of two cases with Fanconi anemia (FA) who were admitted to the Department of Children′s Hematology and Endocrinology, the Provincial Hospital Affiliated to Shandong First Medical University in 2017 were analyzed.Sanger sequencing and multiplex ligation-dependent probe amplification(MLPA) of FA-related genes was carried out.One case was female, 4 years and 3 months old.The other case was a 6-year-old male.The main manifestations were recurrent fever, asthenia and bleeding points in both legs.The girl had milk coffee spots scattered on her legs and waist, and her left thumb nail was absent.The boy had no obvious physical examination abnormality, but his left atrium and left ventricle were large and segmental myocardial damage could be seen by echocardiography.Bone marrow biopsies of both cases showed hypo-proliferation (40%) or extremely low proliferation (10%), and no megakaryocyte was found.There were no significant abnormalities in chromosome aberration, single cell gel electrophoresis, cluster of differentiation(CD) 41, CD 55, and CD 59 and chromosome karyotype.Gene sequencing revealed that the two children had compound heterozygous mutations of Fanc A gene, which came from parents.The heterozygous mutation of c1838delT was found in the exon 21 of the female child and her father, which resulted in amino acid shift mutation pIi613Tfs*27.The heterozygous deletion mutations in exons 1-3 of Fanc A gene were found in the female child and her mother by the MLPA results.The gene sequencing analysis of the male child and his family members showed the heterozygous mutation of c4124_4125del in the exon 41 of the child and his mother, which resulted in amino acid shift mutation p. T1375Sfs*49.The heterozygous deletion mutations were observed in exons 23-40 of the male child and his father, according to the MLPA results.The main basis of diagnosis of FA is to sequence the related genes of suspected children.The c1838delT is a new mutation of Fanc A gene.