The training mode of the medical doctoral students in Albert Einstein College of Medicine is relatively perfect. Its advances are mainly embodied in the following three aspects:detailed and comprehensive training in scientific research capabilities, great emphasis on the process control and the strict assurance system in quality control. The above training mode helps Albert Einstein Col-lege of medicine to set up the good medical doctoral cultivation characteristics with the tolerance, competition, flexibility and freedom. To learn from those good traits, great efforts should be made in our medical doctoral cultivation mode to strengthen the role of tutor team, ensure the students' inter-ests, deepen the academic exchanges and meet the various needs of society.

Objective To investigate the effect of pretend play training based on Learn to Play program on pretend play capabilities of children with autism. Methods The researchers referred some training strategies in Learn to Play program, and designed a pretend play train-ing which adapted to autistic children's level of development. And then they conducted the pretend play training on three autistic children for four weeks. After that they used Child-Initiated Pretend Play Assessment to assess the effect of the intervention before, after and two weeks after training. Results The percentage of pretend play actions, the number of object substitutions and the number of imitated actions in-creased in some degrees in the children. Conclusion The pretend play training based on Learn to Play program can promote the pretend play capabilities of children with autism.

At present,the commonly used tumor markers,with low sensitivity and low specificity,can 't achieve the purpose of early diagnosis.However,autoantibodies against tumox-associated antigens have been detected in the asymptomatic stage of cancer and thus can serve as biomarkers for early cancer diagnosis.Moreover,due to autoantibodies are found in sera,they can he screened easily using a noninvasive approach.The discovery of panels of autoantibodies with high sensitivity and specificity will help to improve the diagnostic and prognostic for the patients with cancer.

OBJECTIVE ToevaluatetheeffectandmechanismofPaecilomyceshepialimycelium
(PHM)onexhaustedfatigueinmice.METHODS Micewereforcedtorun30minadayforconsecutive 18 d using the wheel running fatigue apparatus, and the speed was gradually increased from 10.2 m·min -1 to 12.6 m·min -1 .On d19,these animals were forced to run 60 min to establish an exhausted fatigue model.Every day,40 min before the run training,the animals were ig administered with PHM (140,280,560 mg·kg -1 )and modafinil (13 mg·kg -1 ).The number of electric shocks was recorded on d5,d9,d1 3,d1 7 and d1 9,respectively,and the body mass of each mouse was recorded daily.The levels of muscle glycogen (MG),liver glycogen (LG),serum urea nitrogen (SUN),serum lactic acid (SLA)and serum creatine kinase (CK)were detected by commercially available kits. RESULTS Duringthelastexhaustedrunningond19,thenumberofelectricshocksofthemodelgroup was markedly larger than that of the drug administration groups.When compared to the normal control group,the model group showed a significant decrease in the level of either MG or LG,but a significant increase in the level of either SUN or CK.The nu mber of electric shocks of the PHM in the moderate and high dose groups was 133 ±55 and 1 15 ±41 times,respectively,which was significantly smaller than that of the model group 240 ±89 (P<0.01 ).The levels of MG and LG of the PHM560 mg·kg -1 group were (1 .28 ±0.24)mg·g -1 and (40.9 ±1 0.2)mg·g -1 ,respectively,which were significantly higher than those of the model group〔MG:(0.91 ±0.26)mg·g -1 ,LG:(22.2 ±2.9)mg·g -1;P<0.01〕,and the levels of SUN,SLA and CK of this PHM group were (5.8 ±1 .3)mmol·L-1 ,(5.7 ±1 .7)mmol·L-1 and (0.6 ±0.2)kU·L-1 ,respectively,which were significantly lower than those of the model group 〔SUN:(7.5 ±2.1 )mmol·L-1 ,SLA:(7.1 ±1 .8)mmol·L-1 ,CK:(0.8 ±0.3)kU·L-1;P<0.05〕.The number of electric shocks of the modafinil group was also significantly smaller than that of the model group (P<0.01 ),but there were not any significant differences between the modafinil group and the model groupinthelevelsofMG,LG,SUN,SLAorCK.CONCLUSION ThisstudyshowsthatPHMcanhelp relieve fatigue,which might be associated with its abilities to increase the storeage of energy sources,to enhance the aerobic metabolis m,and to decrease the accu mulation of metabolic products.

Objective To introduce the technique.indication and outcome of treatment of degenerative Achilles'rupture with transfer of flexor hallucis longus tendon and V-Y tendinous flap. Methods From October 2003 to May 2006,21 cases of degenerative Achilles'tendon rupture were treated in our department using transfer of flexor hallucis longus tendon and V-Y tendinous flap.Rivets were used in 17 cases and surface screws in 4.They were followed up for 12 to 18 months(average,14). Results According to the Arner-Lindholm criteria for curative results,19 of the 21 cases were excellent and 2 good.Follow-ups revealed no Achilles'tendon re-rupture,infection,skin necrosis,stiff ankle,or injury to nerves and vessels.Walking gaits nearly recovered to normal.The repair strength allowed early functional exercise of the Achilles'tendon. Conclusion Transfer of flexor hallucis longus tendon combined with V-Y tendinous flap can cure the degenerative Achilles'tendon ruptures and defects of Achilles'tendon within 3 cm.

Objective To investigate the effect of linezolid on procalcitonin ( PCT) in the treatment of methicillin resistant staphylococcus ( MRS) infection.Methods 85 cases with MRS infection in our hospital were grouped, control group received vancomycin treatment, study group received linezolid, 2 weeks for 1 courses.Clinical effect were compared to explore the linezolid effect of PCT levels in patients with MRS infection.Results After treatment, defervescence time, bacterial clearance time, bacterial clearance rate and 48 hour mortality rate between two groups of patients had no significant difference.Compared with the control group, ICU treatment time in the study group was significantly lower ( P<0.05 ) .There was no significant difference in total effective rate between two groups.After treatment, the PCT and CRP in study group were lower than control group(P<0.05).Conclusion Linezolid has significant function to reduce the serum PCT level of patients with methicillin-resistant staphylococcus infection procalcitonin, which has better clinical curative effect.

Uncoupling protein, a protein that participates in proton transport in the inner mitochondrial membrane, has some physiologic functions such as regulating thermogenesis, maintaining body temperature, regulating energy balance and adenosine triphosphate production, controlling reactive oxygen species production, and restraining apoptosis. It takes part in the pathophysiological processes in a number of diseases. The article reviews the uncoupling protein gene, distribution and regulation, the roles in peripheral tissues and central nervous system, and its possible relationship with cerebral infarction.

The paper presents a flexible and simple direct analysis in real-time ( DART) device without grid electrode for mass spectrometer injection. It contained inert carrier gas, ionizer, heater and temperature-controller etc. Excluding the grid electrode and then reducing the structure units, the device could be easy to build up in low cost and flexible to connect with a variety of mass spectrometers. The experimental conditions like the kind of carrier gas, flow rate and temperature were investigated for the device. By using argon as carrier gas, flow rate as 7. 5 L/min, and temperature of heat tape as 300 ℃, the device was used to analyze benzene alcohol, linoleic acid, dichlorvos emulsion, mosquito coils, citrus peel, and sample ( propranolol hydrochloride) on thin-layer plate combined with mass spectrometer. The results were accurate and the device was stable and reliable.

Objective To investigate the early diagnostic value of traditional scoring systems in critical acute pancreatitis.Methods From Jan 2007 to Ju12013,consecutive 184 patients with AP who were admitted to the surgical intensive care unit of the Institute of General Surgery,Nanjing Generai Hospital of Najing Militery Region within 72 h from the onset of the disease were studied.Patients were assigned to four groups,including mild,moderate,severe and critical AP according to the determinant based classification and the receiver operating characteristics(ROC) curve was used to predict the presence of critical AP,and Z test and logistic regression was applied to determine the diagnostic value of traditional scoring systems.Results The area under ROC (AUC) of Sofa,BISAP and CTSI score for early diagnosis of critical AP was 0.896,0.877 and 0.862;the best cut off value was 4.5,9.5 and 2.5.Moreover,the AUC of APACHE Ⅱ and Ranson score was 0.807 and 0.707,and the best cut off value was 8.5 and 3.5,respectively.Z test showed early diagnosis rate of Sofa,BISAP,CTSI score was significantly higher than that in Ranson score,and the difference between the two groups was statistically significant (P ＜ 0.05);though they were higher than APACHE Ⅱ score,the difference between the two groups was not statistically significant (P ＞ O.05).Logistic regression showed that high APACHE Ⅱ,Sofa,BISAP and CTSI score were independent risk factors for the development of critical AP (P ＜ 0.05).Conclusions Sofa,CTSI and BISAP score may be clinically important for early diagnosis of critical AP.

Percheron artery infarct (PAI) is uncommon clinically.One case had an acute onset of coma,impaired left limb activities,verbal incoherence,drinking cough and vertical gaze palsy after regaining consciousness.Magnetic resonance imaging (MRI) showed symmetrical high signal intensity on diffusion-weighted imaging (DWI) in bilateral paramedian thalami and a distinct pattern of V-shaped midbrain hyperintensity on DWI.Magnetic resonance angiography (MRA) showed left-sided embryonal posterior cerebral artery (PCA) from ipsilateral internal carotid artery (ICA).Systemic treatment yielded a poor prognosis.