This paper reviewed the origin,the evolution and the present status of academic medical careers.And it further analyzed the international developmental trend of academic medical careers.The aim is to offer some revelations for the practices of national medical education which is facing the reforms of Chinese medical and healthcare system.

Whether low dose of endocrine disruptors(EDs) have adverse effects on human health is a hot spot in recent ten years.Many researchers consider that EDs lower than non-observed adverse-effects level can produce biological effects.In this paper the author expatiated the concept and mechanism of low dose effect of EDs,summarized some noso-biological-effects of low dose EDs to children.At the same time,some arguments of this field were introduced.

Medical faculty’s appointment is one of the key factors to determine the health of medical education. The appointment reform ideology of medical school of Harvard University is to comform with the development trend of medicine science. Embodied in 2008 appointment reform is the integration of basic medical research, teaching and clinical work, stressong both academic freedom and multiple appointment standards so as to emphasize the excellent academic achievement.

Blood transfusion therapy is widerly used in pediatric surgery as it's validity in many acute and chronic pediatric diseases.Compared to adults,pediatric perioperative transfusion therapy,particularly the approach to massive blood transfusion can be quite complex because of the unique physiologic characteristics.Perioperative transfusion therapy in children can cause significant metabolic disturbance,and further,cause severe complications.This paper presents an overview of the physiologic characteristics which related to pediatric perioperative transfusion therapy.And also the metabolisms related to massive perioperative blood transfusion in children.These may accordingly primarily useful to treat the pediatric patients.

Perioperative blood transfusion therapy for coagulation factor deficiency in children is very important to save patient's life or conducive to the postoperative recovery.With the advances in transfusion medicine,the cooperation through pediatric hematologists and surgeons in the perioperative period,more and more operation of children accompany coagulation factor deficiency can be safety finished.Different types of coagulation factor deficiency in children are treated by high-purity clotting factor,in order to correct abnormal coagulation factors levels.Clinical data showed that coagulation factor deficiency in children after proper treatment can be safely performed surgical procedure.

Objective To study the effects of prenatal exposure to diethylstilbestrol(DES) on expressions of ACTIN and proliferating cell nuclear antigen(PCNA) in the development of gubernaculum testis of fetal male mice.Methods Pregnant mice were randomly divided into 6 groups and injected with DES subcutaneously from the 9th gestational day to the 17th day at dosages of 0,25,50,100,200 ?g?kg~(-1)?d~(-1) dissolved in 0.2ml dimethyl sulfoxide(DMSO).The mice in the control group were given normal saline alone.The mice were sacrificed and the fetuses were quickly removed for fixation on the 17th day.Histological changes were observed with light microscope by sliced serially in coronal plane.The expressions of ACTIN and PCNA in gubernaculum testis were detected by immunohistochemical methods.Results In experimental groups,the gubernaculum testis of mice was hypoplasia.The expressions of ACTIN and PCNA in gubernaculum testis were lower in the DES treated groups than those in the control group with obvious dose-effect correlation(P

Disorders of sex development (DSD) is a complex disease that involves multiple traditional professional disciplines.Multidisciplinary team(MDT) mode is a particularly advantageous treatment mode that has been developed in recent years for the diagnosis and treatment of complex diseases.This article is based on the analysis of research progress at home and abroad about DSD and MDT,and the latest advances application of MDT treatment try for DSD,probe into how to establish a DSD-MDT treatment mode in theory preliminarily.

Objective To establish and identify the induced pluripotent stem cell(iPSC) line reprogrammed from human umbilical cord mesenchymal cells(HuMSCs).Methods HuMSCs were cultured by adhesion method,and OCT4,SOX2,KLF4,c-Myc,NANOG,LIN-28 were transfected into HuMSCs with lentiviral victor to reprogramme HuMSCs into iPSC.Morphological observation,pluripotency genes (SOX2,TDGF1,THY-1,OCT4,REX1 and TERF1) expression,alkaline phosphatase detection,karyotype analysis,embryonic stem cells (ESC) specific proteins (NANOG,OCT4,SSEA-4,TRA-1-81) immunofluorescence staining,differentiated into teratomas in vivo(inject the iPSC into SCID mice) and embryniod bodies in vitro were performed to exam the pluripotency of the iPSC.Results Four days after being infected by lentivirus,the HuMSCs became round-shape; 10 days after infection,some embryonic stem(ESC)-like colonies appeared.Fourteen days after infection,picked up the regularly shaped colonies and cultured several passages.About 1.25％ HuMSCs were reprogrammed into iPSC.The iPSC presented clone-like growth like ESC.All the cells were positive to alkaline phosphatase staining and expressed the pluripotency genes.The iPSC also expressed the ESC specific proteins,and karyotype analysis showed normal chromosome caryotype (46,XY).Furthermore,the iPSC could form embryoid bodies in vitro,expressed alpha fetoprotein(AFP),smooth muscle actin(SMA) and β-tubulin.The iPSC could alsoform teratomas in vivo.Conclusion OCT4,SOX2,KLF4,c-Myc,NANOG,LIN-28 can reprogram HuMSCs into iPSC efficiently.

The mechanism of testicular descent in development of testis in embryonic period is very complex,and undescended testes(cryptorchidism) is a very common anomaly of the male genitalia.As it is close relatively with the later impaired fertility and cancer risk,involving reproduction,development,endocrinology and psychology,et al,the explorations of the mechanisms of testicular descent are continuing,and the studies on undescended testes such as the exact cause,pathogenesis,proper strategies for diagnosis and treatment are in progress.Along with some muddle becoming clear,the new puzzles often emerged.Perhaps this is getting closer to the truth.This paper is basically outlining the current research situation from the known and unknown aspects.

Objective:To explore the testicular descent process and temporal morphology and position changes of its neighboring tissues and organs in mice with three dimensional (3D) histological reconstruction technique.Methods:Tissue below the kidney plane of male Kunming mice was harvested on gestation days (GD)15, GD17, GD19, postnatal days (PD)3 and PD7.The tissue was then serially sectioned and stained with hematoxylin and eosin (HE). Slices were scanned and saved by the PerkinElmer automatic section analysis system.Afterward, Photoshop software was used for image registration and alignment, and 3D-doctor software was employed for 3D reconstruction and analysis.Results:(1)The epididymis enveloped the testis, and the tail of the epididymis was connected with the gubernaculum, but no direct connection was found between the lower pole of the testis and the gubernaculum.During pregnancy, each part of the epididymis and the vas deferens of mice were piled up into a mass, making it hard to identify the epididymis.The gubernaculum leads to " swelled" . After birth, the epididymis became large, elongated, and morphologi-cally recognizable, and the gubernaculum degenerated into fibrous cords.During the whole process, the volume of gubernaculum was significantly smaller than that of testicle.(2)Testicles on both sides were similar in shape and asymmetrical in position.The left testicle was lower than the right testicle, and descended before the right one.During pregnancy, testicles on both sides descended from the lower pole of the kidney, the left testical stopped at the lower part of the bladder.and the right one stopped at middle part of the bladder.After birth, the left testicle dropped below the neck of the bladder.Finally, the left testicle was lower than the right testicle.(3) The epididymis descend prior to the testicles.Throughout the process, the tail of the epididymis descended before the testicles, and it pulled the whole epididymis down.Testicles entered the scrotum along the descending path of the epididymis.After the complete descent, the tail of the epididymis remained below the testicles.Conclusions:Through observation, the testicular descend process in mice includes the following steps.First, the tail of the epididymis is pulled down to the inner ring by the gubernaculum, and the tail and body of the epididymis expand the inner ring and the inguinal canal through their morphological changes.The epididymis then continues to go down into the scrotum and expands it.Finally, the testicles and the head of the epididymis follow the epididymis body and enter the scrotum through the enlarged inner ring and inguinal canal.