ObjectiveTo investigate the expression of hypoxia inducible factor 1 (HIF-1α) in rats' retinae during the embryonic and earlier postnatal period.MethodsThe retinal expression patterns of HIF-1α protein and mRNA of embryonic day 12 (E12), E16, E20, and postnatal day 1(P1) and P5 rats were determined by immunohistochemical staining and reverse transcription polymerase chain reaction (RT-PCR).ResultsHIF-1α protein was detected in the neural epithelial layer and the pigment epithelial layer at all those 5 timepoints, with higher expression in the ganglion cell layer and the inner plexiform layer, and seems limited to the ganglion cell layer when retina became more mature. Embryonic rat retina had higher expression of HIF-1α protein and mRNA than postnatal retina, the difference was significant (P<0. 01). ConclusionThe expression of HIF-1α in rats' retinae differs from embryonic to earlier postnatal stages.

Objective To explore the relationships among social adaptation and the resilience,social support and coping style in undergraduate nursing students.Methods 758 students from two medical colleges in Shandong province were recruited by stratified random sampling method.They were assessed with China College Student Adjustment Scale (CCSAS),Resilience Scale for Adults (RSA),Social Support Rating Scale (SSRS),Simplified Coping Style Questionnaire (SCSQ).The data was analyzed with the structural equation mode.Results The social adaptation of undergraduate nursing students showed significantly positive association with the resilience,social support,positive coping style(r=0.113-0.607,P＜0.01),but the campus adaptation had negative association with negative coping style(r=-0.117,P＜0.01).The path analysis showed that the resilience,social support and coping style were the direct predictors of social adaptation (β=0.57,P＜0.05;β=0.0.26,P＜0.05;β=0.1,P＜ 0.05),and the resilience,active coping style played the mediating role between social support and social adaptation (β=0.31,P＜0.05;β=0.05,P＜0.05).Conclusion The social adaptation and the resilience,social support and active coping style of nursing undergraduates are closely related.

OBJECTIVE:To study the effective portion of the ultrafiltration membrane-separated ethanol extract of Pae-onia lactiflora and its antineoplastic activity in vitro. METHODS:The content of peoniflorin in ethanol extract of P.lactiflora was determined by HPLC. The drug-containing serum of mice was used to cultivate tumor cells such as HT29,HL60 and S180,then the inhibitory effect of P.lactiflora ultrafiltrate on the tumor cells and the association between dosage and administration time of the P.lactiflora ultrafiltrate were observed. RESULTS:P.lactiflora(10～100 g?kg-1) showed marked inhibition on all kinds of the above-mentioned tumor cells in a dose-dependent manner; the drug-containing serum also showed marked inhibition on all of kinds of tumor cells at different time in a time-dependent manner. CONCLUSION:The effective portion of ultrafiltration membrane-separated ethanol extract of P.lactiflora has antineoplastic activity in vitro.

BACKGROUND: Hypoxia inducible factor-1 α(HIF-1 α) is not only related to physiological reaction of hypoxia,but also takes part in normal embryonic development.OBJECTIVE: To study the alteration of HIF- 1 α in retina during rat development.DESIGN,TIME AND SETTING: Randomized contrast animal study,which was performed in the Shandong Provincial Molecular Virus Key Laboratory,Medical College of Qingdao University between January and September 2007.MATERIALS: Adult Wistar rats,nulliparity,clean grade,and weighing 200 250 g were used in this study.METHODS: Male and female rats were caged as the ratio of 1 : 1.Embryos were obtained at 12-day,16-day,and 20-day pregnancy.Eyeballs were obtained from newborn rats by anesthesia at 1-day,5-day,10-day,and 12-month birth.Retina was separated and made into paraffin section.MAIN OUTCOME MEASURES: Expressions of HIF 1 α protein and HIF-1 α mRNA in retina were measured by immunohistochemistry and semiquantitative reverse transcription-polymerase chain reaction at various dine points of embryonic development.RESULTS: HIF-1 α positively expressed at stratum neuroepitheliale retinae and purpurogenous membrane in the embryonic phase.Additionally,HIF-1 α still positively expressed at stratum neuroepitheliale retinae and purpurogenous membrane,especially in ganglionic cells and inner plexiform layer,in early development.With the gradual development,the positive expression was mainly located at stratum ganglionare retinae.HIF-1 α protein and mRNA expressions were the highest in the embryonic phase,lower in the development,and the lowest in the adult period.There were significantly differences among these three phases (P ＜ 0.01).CONCLUSION: HIF-1 α decreases gradually in retina and its expression is mainly located at stratum ganglionare retinae.

This paper illustrates the characteristics of medical English in terms of vocabulary,syntax and style in order to enhance the understanding of medical English for medical students and improve their ability of medical English reading and translation.

Objective To strengthen the ability of clinical thinking and the ability to solve practical clinical problems for medical students.Methods Medical undergraduates studying in affiliated hospitals of Tongji university from 2005 to 2010 were enrolled The clinical thinking training and assessment in clinical teaching were enhanced by introducing problem-based learning,case-based learning and by strengthening the role of interns in clinical work and emphasizing clinical thinking ability assessment during various kinds of clinical skills examinations.Meanwhile,the teaching management and supervision were improved.The awareness and ability of clinical teachers to train students′ clinical thinking were aroused and cultivated through teaching staff training so as to ensure that clinical thinking training and assessment were involved in the whole process of clinical teaching.Results The students' abilities of self-study,scientific thinking and oral expression were improved.The passing rates of our graduates in national general medical practitioner test were increasing yearly from 2006 to 2008.Conclusion Strengthening clinical thinking ability training during clinical teaching plays an active role in improving clinical skills in medical students.

Objective The aim of this study is to evaluate the safety and efficacy of partial pancreatectomy as part of primary cytoreductive surgery in advanced epithelial ovarian cancer (EOC). Methods A total of 8 patients were recruited in this study who underwent partial pancreatectomy during the primary cytoreductive surgeries for advanced EOC in Fudan University Shanghai Cancer Center from April 2009 to July 2015. Their clinicopathological characteristics, diameter of metastatic tumors, the scope of cytoreductive surgeries, residual diseases after cytoreductive surgeries, postoperative complications and survival situation were retrospective analyzed. Results (1) Clinicopathological characteristics:the median age of these patients was 58 years old(range: 39-63 years old). The median value of preoperative serum CA125 was 1 688 kU/L(range: 119-5 000 kU/L). The median diameter of metastatic tumors involved in pancreatic body or tail was 4.5 cm (range:3-10 cm). All the tumors from the 8 patients were confirmed to be high-grade serous carcinoma. Four patients were staged as International Federation of Gynecology and Obstetrics (FIGO)Ⅳ, and the other 4 patients were staged as FIGOⅢc. (2) Tumor metastases and the scope of cytoreductive surgeries:all of these 8 patients had widely disseminated ovarian cancer, with involvement of upper abdominal, middle abdominal and pelvic cavity. Each patient underwent extensive intra-abdominal cytoreductive surgeries, including hysterectomy, bilateral salpingo-oophorectomy, omentectomy, pelvic periton-ectomy, splenectomy, partial pancreatectomy. Each patient had cytoreductive surgeries of 9.6 different sites on average. Of all 8 patients who underwent partial pancreatectomy, 7 patients had pancreatic tails removed;the other 1 patient had pancreatic body and tail removed. The median volume of blood loss during surgery was 1 350 ml(range:300-3 500 ml), blood transfusion was performed in 7 patients with the median volume of 1 150 ml (range: 500-1 800 ml). (3) Residual diseases after cytoreductive surgeries: optimal cytoreduction was achieved in all patients, with microscopic residual disease in 3 patients, residual tumors diameter < 0.5 cm in 3 patients, and residual tumors diameter between 0.5 and 1 cm in 2 patients. (4) Postoperative complications: 4 patients suffered from complications including pancreatic leakage (2/8), intraperitoneal hemorrhage (1/8) and pancreatic pseudocyst accompanied by infection (1/8). These complications were treated successfully by conservative managements. (5) Survival situation: during the median follow-up duration of 17 months (ranged from 2 to 46 months), 5 patients were still alive until the end of follow-up, including 4 cases under treatment and 1 case survived 29 months without relapse after treatment. Three patients were respectively died in 5, 20 and 46 months after surgery. Conclusion There is a higher risk of postoperative complications of pancreas resection as part of primary cytoreductive surgery in advanced epithelial ovarian cancer, but the resection of pancreatic metastases and part of the pancreas is feasible and necessary.

Objective To investigate the appearance of solid papillary carcinoma (SPC)of breast on MRI and mammography correlated with histopathological features.Methods Fifteen patients with breast SPC diagnosed from January 2011 to January 2013 were enrolled.Their MR and mammography imaging findings were retrospectively reviewed,15 patients had MRI and 11 patients had mammography.The correlation between pathological characteristics and imaging findings was made.Results All the SPC displayed a solid-papillary growth pattern together with Luminal A type,and 14 cases showed neuroendocrine markers.On mammography,only three cases showed the abnormality.The most frequently seen MRI feature was its location in the posterior of areola (11 cases),ductal ectasia on T1WI (11 cases) and high signal intensity on T2WI.The enhancement patterns included non-mass-like enhancement (10 cases),mostly manifested as ductal with clumped enhancement (5 cases) and segmental with pebble shaped enhancement (4 cases),whereas mass-like enhancement (5 cases) exhibited as annular heterogeneous enhancement.Conclusions SPC is difficult to detect on mammography,but the MRI features may suggest its distinct histological type as papillary tumor.The ultimate diagnosis still depends on histopathology and immunohistochemical results.

OBJECTIVE:To provide reference for medication and chemotherapy in patients with colorectal cancer. METH-ODS:Through retrospective study,case histories and doctor’s advice of the colorectal cancer patients receiving chemotherapy in our hospital during 2011-2014 were consulted to analyze the chemotherapy,medication and irrational drug use. RESULTS:A total of 593 cases of colorectal cancer patients with chemotherapy frequency of 1 940 times were collected to analyze the choice of che-motherapy regimen mainly from the following aspects:indications of chemotherapy,choice of chemotherapy regimen,chemothera-py process and chemotherapy period. There was 409 cases of irrational drug use according to the analysis of drug dosage,selection of solvents and drug concentration,the unqualified rate was 21.08% . CONCLUSIONS:The medication and chemotherapy in pa-tients with colorectal cancer in our hospital are basically rational,but there are still certain problems and shortcomings. In future clinical applications,the medication and chemotherapy need to be improved.

Objective:To observe the expression and significance of Jagged1 in fibrovascular membranes of proliferative diabetic retinopathy (PDR).Methods:Sixty preretinal fibrovascular membrane specimens collected from fifty-seven patients (60 eyes) with PDR during vitrectomy in The Affiliated Hospital of Qingdao University from July 2014 to July 2015 were set as the PDR group.The patients were divided into the injection group (30 cases, 32 eyes) and non-injection group (27 cases, 28 eyes) according to whether they received anti-vascular endothelial factor drug intravitreally before surgery.Ranibizumab injections were administered to the patients in the injection group intravitreally 2-7 days before surgery.Eighteen macular epiretinal membrane specimens obtained from 18 non-diabetic patients were served as the control group.Hematoxylin-eosin staining was applied to observe the structural festures of specimers. The immunohistochemical staining was used to detect the expression levels of Jagged1, Delta-like 4(Dll4) and Notch1 in the injection and non-injection groups, and the real-time fluorescent quantitative polymerase chain reaction was performed to detect the relative expression levels of Jagged1, Dll4 and Notch1 mRNA in the three groups.Pearson linear correlation analysis was used to evaluate the relationships between the expression of Jagged1 mRNA and both Dll4 mRNA or Notch1 mRNA in the PDR fibrovascular membranes.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of The Affiliated Hospital of Qingdao University (No.QYFYWZLL25645). Written informed consent was obtained from each patient.Results:The neovascularization was found in fibrovascular membranes of PDR with a light microscope, and the lumen of the new blood vessels in the injection group was narrow, but relatively dilated in the non-injection group.There was no neovascularization found in the macular epiretinal membranes.The immunohistochemical staining revealed that there was the positive expression of Jagged1, Dll4 and Notch1 proteins in all PDR membranes, mainly located in the vascular endothelium during neovascularization.The absorbance values of Jagged1, Dll4 and Notch1 proteins were 6.25±1.82, 6.87±1.89 and 5.12±2.14 respectively in the non-injection group, which were all higher than 1.46±0.37, 1.55±0.24 and 1.32±0.53 respectively in the injection group, showing statistically significant differences ( t=5.168, P=0.014; t=6.012, P=0.008; t=3.453, P=0.030). There were statistically significant differences in Jagged1, Dll4 and Notch1 mRNA relative expression levels among the three groups ( F=77.337, 62.305, 51.869; all at P<0.01). The relative expression levels of Jagged1, Dll4 and Notch1 mRNA in the fibrovascular membranes with PDR were significantly higher than those of control macular epiretinal membranes, and the relative expression levels of Jagged1, Dll4 and Notch1 mRNA of the injection group were significantly lower than those of the non-injection group (all at P<0.05). The expression level of Jagged1 mRNA was positively correlated with expression levels of both Dll4 and Notch1 mRNA ( r=0.925, 0.950; both at P<0.05). Conclusions:There is a high expression of Jagged1 in the vascular endothelium of fibrovascular membranes with PDR and the Jagged1 expression is positively correlated with the expression of Dll4 and Notch1.The effect of Jagged1 on the neovascularization in PDR may be related to Dll4 and Notch1.