The application of continuous quality improvement program in standardized residency training examination in the central Hospital of Shanghai Jiading was introduced to inquire into the way to improve the quality of standardized training of resident doctors. Through the steps of FOCUS-PDCA, we continuously improved the examination content and quality compliance training personnel, and developed the examination process including test, training, supervision, learning and using. After the implementation of the project, the percentage of the departments that meet the residency training examination requirements has been increased from 33.3%to 100%in our hospital. The percentage of the students that passed the licensed medical skills examination was 96.6%in that year. 100%of the students passed the graduation comprehen-sive examination. Year-end evaluation showed that the students' satisfaction degree to the teachers increased from 94.5%to 98.2%. Thus, through the implementation of CQI project, we achieved the goal of promoting teaching and promoting learning.

A series of novel tetrahydrocarboline derivatives was designed and synthesized in order to discover more potent peroxisome proliferator-activated receptor (PPAR) alpha/gamma dual regulators. The structures of these compounds were confirmed by 1H NMR and HR-MS; their PPAR-regulating activities were evaluated in vitro. Compounds 6h, 6n, 6p and 6q exhibited more potent PPARalpha agonistic activities than the control drug WY14643, while compounds 60, 6g, 6i and 6q exhibited more potent PPARgamma agonistic activities than the control drug rosiglitazone. Compound 6q was discovered as a potent PPARalpha/gamma dual agonist and deserves further investigation.
Animals ; Carbolines ; chemical synthesis ; chemistry ; pharmacology ; Cells, Cultured ; Drug Design ; Hypoglycemic Agents ; chemical synthesis ; chemistry ; pharmacology ; Molecular Structure ; PPAR alpha ; agonists ; PPAR gamma ; agonists ; Peroxisome Proliferator-Activated Receptors ; agonists ; Pyrimidines ; metabolism ; Structure-Activity Relationship ; Thiazolidinediones ; metabolism ; Transfection

OBJECTIVETo set up a mathematic model for determining individual risk and population risk of gastric carcinoma.

METHODSBased on principles and methods of probability and fuzzy mathematics, a case-control study was quantified and a mathematic model for the screening of gastric carcinoma was set up. Using two different calculation methods of weight coefficients, the thresholds were identified as 0.20 and 0.17, respectively. This mathematic model was then used to examine 63 cases and 693 normal persons.

RESULTSThe sensitivities and specificities were 69% and 63%. The different calculative methods of weight coefficients did not affect the results of the identification.

CONCLUSIONThe sensitivities and specificities were satisfactory indicating that it was convenient, feasible, economic and could meet the contented screening rate. It could be used to determinate the risk for gastric carcinoma both on individual and on population.

Case-Control Studies ; China ; epidemiology ; Female ; Humans ; Male ; Mass Screening ; methods ; Models, Theoretical ; Risk Assessment ; Risk Factors ; Sensitivity and Specificity ; Stomach Neoplasms ; epidemiology ; etiology ; prevention & control ; Surveys and Questionnaires

OBJECTIVE:To provide basis and thinking for the development of medicines for treating depression. METHODS:Rats with adaptive feeding for 7 d were randomly divided into normal group,depression group and treatment group(citalopram hy-drobromide 1 mg/kg),8 in each group. Rats in depression group and treatment groups randomly received once low-density stimula-tion in a day [catching tail stimulation(1 min),frequent flashing stimulation(120 times/min,12 h),noise stimulation(4 h),ice water swimming stimulation(1 h),hot water stimulation(45 ℃,1 h),electric shocking foot(10 Hz,1 mA,each time interval of 100 ms,100 times),no food and no water(24 h)] for 21 d to reduce stress depression model. Body mass of rats in 0,7 d of adaptive feeding and 7,14,21 d of stress were respectively weighed,and horizontal activity and vertical activity frequencies in open field test were detected. After stress,rats were intragastrically administrated related medicines for 30 d,then 5-hydroxytrypta-mine (5-HT) and tryptophan hydroxylase (TPH) expressions in brain,liver,kidney tissues were determined. RESULTS:Com-pared with normal group,the increasing trend of body mass in depression group and treatment group slowed down from the 14 d of stress(P<0.05). The horizontal activity frequencies in depression group and treatment group in 14,21 d of stress slowed more ob-viously than the previous time point (P<0.05 or P<0.01);vertical activity frequencies in 21 d of stress slowed more obviously than the previous time point (P<0.05 or P<0.01). After 30 d of administration,horizontal activity and vertical activity frequen-cies in treatment group were increased more obviously than the previous time point (P<0.01). Compared with depression group,brain tissue of rats,indicating that TPH can be used as a target for depression treatment.

The efficacy of ~(131)I treatment of hyperthyroidism in children and adolescents was evaluated. Being unsuitable for medical therapy,31 patients (aged 11-18 years) with hyperthyroidism received ~(131)I treatment with a dose of 0.925-3.33 MBq/g of thyroid and were followed-up for 20 to 76 months.Fifteen patients were euthyroid,5 suffered from late-onset hypothyroidism,and 11 were still hyperthyroid,but their symptoms and signs of hyperthyroidism were markedly improved.Of the 18 patients with thyroid-associated ophthalmopathy (TAO),8 patients recovered,4 were improved,TAO in 1 patients deteriorated and in S patients remained unchanged.~(131)I is a relative safe and effective treatment for children and adolescents above 10 years old with hyperthyroidism,being unsuitable for medical therapy.

Copy number aberrations (CNAs) in chromosome arm 8q have been associated with unfavorable clinical outcomes of several cancers and progressive tumor characteristics of hepatocellular carcinoma (HCC).This study was to identify correlation of CNAs in 8q with clinical outcomes of HCC patients,and further screen for differentially expressed genes in outcome-related CNAs.Array comparative genomic hybridization and expression arrays were performed to detect CNAs and expression levels,respectively.The correlations between CNAs in 8q and outcomes were analyzed in 66 patients,with a median follow-up time of 45.0 months (range,2.6-108.6 months).One hundred and nine cases were further evaluated to identify differentially expressed genes in the potential outcome-related CNAs.Copy number gain in 8q was observed in 22 (33.3 ％) of the 66 HCC cases.The most recurrent gains (with frequencies ＞20％) were 8q13.3-21.3,8q21.3-23.3,8q23.3-24.13,8q24.13-24.3,and 8q24.3.Survival analysis showed that 8q24.13-24.3 gain was significantly associated with reduced overall survival (P=0.010).Multivariate Cox analysis identified 8q24.13-24.3 gain as an independent prognostic factor for poor overall survival (HR=2.47;95％CI=1.16-5.26;P=0.019).A panel of 17 genes within the 8q24.13-24.3 region,including ATAD2,SQLE,PVT1,ASAP1,and NDRG1 were significantly upregulated in HCCs with 8q24.13-24.3 gain compared to those without.These results suggest that copy number gain at 8q24.13-24.3 is an unfavorable prognostic marker for HCC patients,and the potential oncogenes ATAD2,SQLE,PVT1,ASAP1,and NDRG1 within the regional gain,may contribute coordinately to the 8q24.13-24.3 gain-related poor prognosis.

A"3+2"standardized training program of assistant general practitioner was launched in Shanghai Jiading District in 2012 in order to train new medical talent in suburb area.The program was developed through the jointed efforts among the government,medical school and train bases.The model was designed as training assistant general practitioners with distinctive sequential education process in different levels and stages.After five years of practice,the"3+2"standardized training program of assistant general practitioner has accomplished its goal,which provides a reference for training assistant general practitioners in Shanghai Municipality.

OBJECTIVETo investigate the effect of RNA interference of the RelB gene on the radiosensitivity of the mouse prostate cancer cell line RM-1 and its mechanism.

METHODSWe constructed RelB siRNA-expressing lentiviral vectors targeting the RelB gene with the molecular biological technique, and determined the expressions of RelB mRNA and protein on radiation after transfection with siRelB mediated by liposome using RT-PCR and Western blot, respectively. We also detected the apoptosis of RM-1 cells by FCM assay and their radiosensitivity by clonogenic assay.

RESULTSThe expressions of RelB mRNA and protein were significantly lower in the RM-1 cells than in the control and negative interference groups after transfection with RelB siRNA (P < 0.05), while the apoptosis of RM-1 cells remarkably higher in the siRelB-RM-1 than in the control group after radiation treatment (P < 0.05). The activity of MnSOD was markedly decreased (P < 0.05), and the radiosensitization rate of the RM-1 cells in the RelB-RM-1 group was 5.13 after radiation treatment.

CONCLUSIONRNA interference of the RelB gene could enhance the radiosensitivity of the mouse prostate cancer cell line RM-1, which might be associated with its inhibition of Mn-SOD expression and induction of cell apoptosis.

Animals ; Apoptosis ; Cell Line, Tumor ; Cell Proliferation ; Genetic Vectors ; Male ; Mice ; Prostatic Neoplasms ; genetics ; radiotherapy ; RNA Interference ; RNA, Small Interfering ; genetics ; Radiation Tolerance ; genetics ; Superoxide Dismutase ; metabolism ; Transcription Factor RelB ; genetics ; Transfection

OBJECTIVETo develop a therapeutic vaccine against human tumors associated with human papillomavirus type 16E6E7 (HPV16E6E7) which is modified from a Chinese patient of the cervical cancer which possessing the antigenicity and no transforming activity, and explore more active vaccine for inducing cellular immunity with mouse co-stimulatory molecular B7-1 gene.

METHODSThe modified E6E7 gene expression plasmid pVR1012-fmE6E7 was constructed and transfected Cos-7 cells, and the E7 protein specific expression was testified by immunofluorescence assay. C57BL/6 mice were immunized intramuscularly with pVR1012-fmE6E7 alone or in combination with B7-1 gene expression plasmid (pcDNA3.1-B7-1). The activity of cytotoxic T lymphocytes (CTLs) was analyzed with 51Cr specific release assay and the specific antibody in sera was analyzed by indirect ELISA. HPV16 positive C57BL/6 tumor cells C3 were inoculated subcutaneously in the vaccinated mice to assay the growth of transplanted tumors.

RESULTSThe specific CTLs and antibody from immunized mice were induced efficaciously by the E6E7 gene immunization, and co-administration of B7-1 gene could significantly enhanced the CTLs immune responses of fmE6E7, and protected 33% immunized mice against C3 tumor cells challenge. In contrast, all the mice immunized only with fmE6E7 gene developed transplanted tumors after C3 cells challenge. There was no difference in E7 specific antibody responses between mice immunized with the E6E7 gene only and co-administration with B7-1 gene.

CONCLUSIONSThe modified E6E7 gene can be used as target gene for developing DNA vaccine, and B7-1 gene may represent an attractive adjuvant for enhancement of the specific cellular immune responses.

Animals ; Antibodies, Neoplasm ; immunology ; B7-1 Antigen ; genetics ; immunology ; Female ; Mice ; Mice, Inbred C57BL ; Neoplasm Transplantation ; Oncogene Proteins, Viral ; genetics ; immunology ; Papillomavirus E7 Proteins ; Repressor Proteins ; T-Lymphocytes, Cytotoxic ; immunology ; Transfection ; Uterine Cervical Neoplasms ; immunology ; pathology ; virology ; Vaccines, DNA ; immunology

The relationship of HLA-A, -Cw alleles on HIV infection and AIDS disease progression in the Chinese Yi ethnic group of Sichuan province were investigated. The genetic polymorphisms of HLA-A, -Cw alleles of 102 unrelated healthy Chinese Yi ethnic individuals, 68 HIV-1 infected and 21 HIV positive long-time survivors were typed by PCR-SSP assay. Statistic signifiance was determined by the χ2 test with the SPSS software. No significant differences were observed between the HLA-A, -Cw alleles of the 68 HIV-1 infected and 102 non-infected Chinese Yi control individuals. Whereas the prevalence of A*3601,Cw*14(01-03)and Cw*0304 was significantly higher in 21 long time survivors compared with 102 healthy controls with P values of 0.016, 0.016 and 0.000 by χ2 or the Fisher exact test respectively. The result implies that A*3601,Cw*14(01-03) and Cw*0304 may be associated with slow AIDS disease progression in the Chinese Yi ethnic group, further studies on this association may yield insight on the pathogenesis of HIV-1 infection.