Purpose:To study the value of nuclear DNA morphological parameters in differential diagnosis. Methods:Using the cellular image analysis instrument to quantitate nuclear DNA morphological parameters (including area, perimeter, major diameter, equivalent circle diameter and nuclear shape factor) in 38 cases of ovarian mucinous cystadenomatous and 5 normal ovarian epithelial tissue, and to analyze the relationship between histodifferentiation and nuclear morphological. Results:Statistical analysis showed that there were significant differences between the groups ( P 0.05). Conclusions:Nuclear DNA morphological parameters of ovarian mucinous cystadenomatous are useful markers, and may have some significance in pathological diagnosis.

Objective To study the feasibility of reducing radiation dose in aorto-iliac and lower extremity arteries CT angiography (CTA) with low tube voltage (100 kV) and automatic tube current modulation(ATCM).Methods Totally 61 patients requiting aorto-iliac and lower extremity arteries CTA for clinical reasons were prospectively enrolled in study.The patients were randomly assigned to 3 groups:Group A(120 kV),Group B (100 kV) and Group C (100 kV with automatic tube current modulation).Both quantitative and qualitative analysis were included in this research.Group C was divided into obese group(BMI≥ 24.9 kg/m2) and normal group(BMI ＜ 24.9 kg/m2).The radiation doses were analyzed respectively among two groups.Results The subjective evaluations of image quality for axial,MIP and VR were good.There were no significant differences among group A,B and C in SNR and CNR (P ＞0.05).The effective dose of group A,B and C was 8.20 mSv,5.36 mSv,and was 7.48 mSv,respectively Group B was 34.6％ less than group A.Group C was 39.5％ more than group B,and there was no significant differences between group A and C (P ＞ 0.05).The effective dose of group C1 was 7.11mSv,group C2 was 9.69 mSv,the E with group C1 were significantly less than group C2 (t =-3.163,P ＜0.05),the effective dose of group C1 was 13.3％ less than group A (Z =-2.822,P ＜ 0.05),but the group C2 was more than group A (P ＞ 0.05) and group B (Z =-3.426,P ＜ 0.05).Conclusions Lowkilovoltage (100 kV) CT scanning protocol is feasible in multi-detector CT angiography for aortoiliac and lower extremity arteries.Automatic low tube voltage (100 kV) with automatic tube current modulation (ATCM) scanning protocol can be used for someone with BMI less than 24.9 kg/m2.

Objective To assess the feasibility of low-dose MDCT pulmonary angiography (MDCTPA) by using low kVp combined with individual-adapted low tube current protocol and noise reduction filter algorithms.Methods Fifty-six consecutively patients with MDCTPA were enrolled in the study.The patients were randomly divided into group A (120 kVp,100 mAs) and group B (100 kVp,individual-adapted tube current about 1.0 mAs/kg).Two series of images were reconstructed in group B:B1 with standard filter algorithms (FC13,B1) and B2 with noise reduction filter algorithms (FC11,B2).The image noise,quality and radiation dose in two groups were compared.Results The CTDIvol,DLP and E of group B were 5.1 mGy,83.3 mGy· cm and 1.4 mSv respectively,which were reduced by 64.3％,66.4％ and 66.7％,respectively (F =32.57,12.32,11.98,P ＜ 0.05) when compared with those in group A.Compared with group A,the image noise in B1 was increased by 118.2％ (t =10.05 P ＜0.05),the central and peripheral SNR and CNR and scores were increased by 51.5％,46.6％,50.8％,45.3％and 20.4％,respectively(t =7.20,6.30,6.58,5.54,8.35,P ＜ 0.05).Compared with B1,the image noise in B2 was reduced by 32.5％ (t =6.12,P ＜0.05),the central and peripheral SNR and CNR and scores were increased by 46.2％,46.2％,45.9％,46.9％ and 18.4％ (t =3.19,3.55,2.95,3.37,5.42,P ＜0.05).Compared with group A,the image noise in B2 group was increased by 47.3％ (t =4.03,P ＜0.05),the central and peripheral SNR and CNR and scores were reduced by 29.1％,21.8％,28.2％,19.6％ and 8.2％(t =4.06,2.82,3.68,2.22,3.02,P＜0.05).Conclusions Keeping effective diagnostic image quality,the protocol with low kVp and individual-adapted low tube current for low-dose MDCT pulmonary angiography would be effective and feasible,and the radiation dose would be significantly reduced.

OBJECTIVE： To provide reference for standardization and improvement of teaching model for endocrinology speciality in community clinical pharmacists training base. METHODS： Based on the requirments of community clinical pharmacists training in Shanghai，  the characteristics and contents of community clinical pharmacists training were summarized， and teaching characteriatiostics， effect evaluation and problems werer analyzed on the basis of the acutual situation in our hospital. RESULTS & CONCLUSIONS： Community clinical pharmacists training has the characteristics of training for chronic diseases， short training cycle， and support from the medical consortium platform. Its contents are theoretical learning and professional knowledge training， pharmaceutical care and medication education， case discussion， homework guidance and comment. Compared with other specility， endocrinology speciality has the characteristics of strengthening comprehensive pharmaceutical care （for example， pharmaceutical care of diabetic patients should pay attention not only to hypoglycemia， but also to hypobaric， hypolipidemic and complications）， emphasizing medication treatment management （MTM） teaching （provide a series of professional services such as medication education， counseling and guidance， and medical reorganization for patients， so as to improve the safety， effectiveness and compliance of medication， and then control blood glucose， delay or avoid complications）， emphasizing the cultivation of health education ability and communication ability. The evaluation of training effect included the evaluation of trainees and teachers. The former includes objective evaluation （theoretical knowledge test， bedside medication education assessment and homework assessment） and subjective evaluation （attendance， attitude， clinical practice performance）. The latter is mainly scored by trainees on teachers （including professional level， teaching attitude， teaching ability and content）. Through the training， it is found that the trainees’ literature retrieval ability is poor， the trainees have not clear idea to diabetic patients， the homework writing and typesetting are not standardized； the teaching teachers have less experience and teachers could not teach the students in accordance with their aptitude and provide individualized training. The training and teaching mode needed to be further improved.

Objective To evaluate the capability of four tests for identification of the in vitro suscepti-bility of tigecycline against Acinetobacter and Enterobacteriaceae isolates.Methods Disk diffusion test was per-formed to detect the sensitivity of 158 Acinetobacter and 339 Enterobacteriaceae isolates to tigecycline.The mini-mum inhibitory concentrations ( MICs) of tigecycline for non-sensitive isolates were detected by using broth dilu-tion method ( BDM) , MIC Test Strip ( MTS) and agar dilution method.The differences with antimicrobial sus-ceptibility among the four different methods were evaluated.Results Tigecycline showed good antibacterial ac-tivity against both non-sensitive Acinetobacter and Enterobacteriaceae isolates with most of the MIC50 values in the sensitivity range of (0.5-2) mg/L and all of the MIC90 values of 4 mg/L.The MIC50 and MIC90 values measured by BDM were respectively 1 mg/L and 4 mg/L.The sensitivity rates presented by the results of BDM were re-spectively 87.1%and 70.2%based on the standards made by Food and Drug Administration (FDA) and Euro-pean Committee on Antimicrobial Susceptibility Testing ( EUCAST) .Agar dilution method indicated that most of the MICs of tigecycline to Acinetobacter and Enterobacteriaceae isolates were two dilutions higher than those de-tected by BDM with essential agreement (EA) rate of 56.5%.Both the very major error (VME) and the major error (ME) values were 0 and the categorical agreement (CA) rate was 46.8%according to the FDA standard.The VME and CA values were 0.8% and 24.2% based on EUCAST standard.Compared with agar dilution method, MTS showed better results in determining the susceptibility of Acinetobacter and Enterobacteriaceae iso-lates to tigecycline with MIC50 and MIC90 values of 1.5 mg/L and 4 mg/L, which was similar to the capability of BDM.Referring to the FDA and EUCAST standards, the sensitivity rates were 83.1% and 21.0%, the CA rates was 81.5%and 29.8%, and the EA rate was 71.8%.Most of the results tested by MTS were one dilution higher than those by BDM.FDA standard showed better correlation than EUCAST standard.Disk diffusion method showed the ME, mE, VME and CA values were respectively 19.4%, 71.8%, 0 and 8.9%according to FDA standard.Conclusion Disk diffusion method, MTS and agar dilution method all showed differences with BDM in susceptibility testing.The capability of MTS was similar to that of BDM.The results evaluated by FDA standard were better than those by EUCAST standard.The in vitro susceptibility of bacteria to tigecycline could be tested by disk diffusion method using FDA standard for evaluation, and confirmed with MTS if isolates were resistance or intermediate strains.The BDM could be performed for further confirmation if necessary.

Objective To discuss the experience of open heart operation on beating in complex and severe congenital heart diseases. Method This kind of operation was put to use in 48 cases of the heart diseases in order to observe the effect of myocardial protection, prevention from air embolism,exposure of the operative field, and cardiopulmonary bypass. Results Operation field exposure was clear enough to finish the manipulation. One cases was eventiful postoperatively and died(2.08%). Conclusion Open heart operation on beating with slight hypothermia might have much feasibility in the part of complicated and severe congenital heart diseases.

OBJECTIVETo determine the protective effect of pomegranate polyphenols on cardiac function in rats with myocardial ischemia/reperfusion (I/R) injury and explore the possible mechanism.

METHODSFifty SD rats were randomized into 5 equal groups, including a sham-operated group, an I/R model group, and 3 pomegranate polyphenol dose groups (150, 300, and 600 mg/kg). The rats were subject to a 45-min left main coronary artery occlusion followed by a 180-min reperfusion to induce myocardial I/R injury except for the rats those in the sham-operated group. The cardiac functions were monitored continuously during the experiment. At the end of the reperfusion, arterial blood samples were obtained to measure plasma contents of lactate dehydrogenase (LDH), creatine kinase (CK), malondialdehyde (MDA) and the activities of superoxide dismutase (SOD). Triphenyltetrazolium chloride (TTC) staining was used to evaluate the infarct size.

RESULTSCompared with the sham-operated group, all the rats with I/R showed significantly decreased left ventricular systolic pressure (LVSP), maximal rates of increase/decrease of the left ventricular pressure (±dp/dtmax) (P<0.01) and significantly increased left ventricular end-diastolic pressure (LVEDP) (P<0.01). Compared with the I/R model group, all the 3 pomegranate polyphenol groups had significantly improved cardiac function (P<0.05), decreased plasma contents of CK, LDH and MDA (P<0.01), increased SOD activities (P<0.01), and obviously reduced infarct size (P<0.01).

CONCLUSIONPomegranate polyphenols can protect the cardiac function of rats with I/R injury probably in association with their actions in enhancing oxygen free radical scavenging activity and decreasing lipid peroxidative damage of the myocardial tissues.

Animals ; Creatine Kinase ; blood ; Heart ; drug effects ; L-Lactate Dehydrogenase ; blood ; Lipid Peroxidation ; Male ; Malondialdehyde ; blood ; Myocardial Reperfusion Injury ; metabolism ; physiopathology ; Myocardium ; metabolism ; Oxidative Stress ; drug effects ; Polyphenols ; pharmacology ; Punicaceae ; Rats ; Rats, Sprague-Dawley ; Reactive Oxygen Species ; metabolism ; Superoxide Dismutase ; metabolism

Objective To study the characteristics of the sciatic nerve injuries inflicted by highvelocity triangle fragments in swine.Methods According to the injury position,14 swines weighing (34.29±5.2)kg were divided into two groups.All swines were shot by 0.37 g triangle fragments at (773.1±12.4)m/s aimed at the midpoint of the lateral body surface projection of the right sciatic nerve in Group A(n=7)and at 2 cm aside from sciatic nerve in Group B(n=7).The entrance,exit and length of wound tract,distance between nerve and wound tract were detected,and the pathology of sciatic nerve and wound tract at 48 hours after injury were observed under light microscope and electron microscope.Results The course of the fragments was deviated to different extent.Six sciatic nerves were in primary wound tract,four of which were lacerated and ruptured at different degrees.The light microscope showed pathological changes including severe hemorrhage and edema,leukocytic infiltration,neurotmesis,axonotmesis and light myelin coloration;while electron microscope showed severe degeneration of myelin sheath and neuraxon distortion.Six nerves(one in Group A and five in Group B)were in the concussion zone,with the distance between sciatic nerve and primary wound tract for(2.07±0.45)cm.Hyporrhea and hyperemia under perilemma and perineurium,partial nerve fiber disrupt and axonotmesis were observed by light microscope and partly myelin sheath delamination by electron microscope.Two nerves (one in Group A and another in Group B)were in the contusion zone,with moderate pathological changes.Conclusions The track of high velocity triangle fragments is unstable in the tissues.High disrupt rate,severe and wide extent lesion,early Wallerian degeneration are the main characteristics of direct injuries of swine's sciatic nerves.Indirect injuries can induce pathologic changes too,for which the lesion severity is related to the distance between nerves and primary wound tract.

In this paper, we lay down a homogenization training standard for resident standardized training through a joint discussion among experts from three national resident standardized training bases. The aim of the homogenization of resident standardized training quality shall be reached through the synchronous implementation of tutorial system and comprehensive formative evaluation, the strengthening of training quality process management and the promotion and advancement of training quality of resident standardized training.

[Objective]To analyze the general characteristics of medical characters in Jia Cang Ji(Home Collected Works),and verify the inheritance relationship of Danxi school in Wu region before the mid-Ming Dynasty.[Methods]Using the literature research method,by sorting out and analyzing the family background,medical activities and social relations of the medical characters recorded in Jia Cang Ji,the lineage of Danxi school in Wu region is clarified.[Results]Most of the medical characters in Jia Cang Ji come from families of medical generation and have frequent communications with each other.Some of them have a close relationship with the Danxi school.WANG Bin is the third-generation successors of Danxi school,while WANG Kuan,SHENG Yin,and HAN Cun are the fourth-generation successors,WANG Min,LIU Yu,and SHENG Kai are the fifth-generation successors,and WANG Guan is the sixth-generation successor.[Conclusion]The records of medical characters in Jia Cang Ji play an important role in clarifying the inheritance of Danxi School in Wu region.It can be seen that Bieji(Collections of Individual Writers)is of great value in discovering the medical historical sources.