With the size of graduate education continues to expand,deepening the reform of graduate education to improve the quality of graduate education has become the core of graduate education.This paper introduces the common problems and solution of graduate education in cilinical medicine professional degree.

Objective To explore the relationship between obesity phenotypes and adipocytokines in children.Methods Based on the Beijing child and adolescent metabolic syndrome (BCAMS) study,3 508 children (1 788 boys and 1 720 girls) aged 6-18 were recruited.In this study,participants were categorized into four groups:226 cases in general obese group,192 cases in abdominal obese group,1 004 cases in combined obese group and 2 086 cases in non-obese group,according to the sex,age,specific body mass index(BMI),and waist circumference (WC) equal to or greater than the 90th percentile for age and gender of school children in Beijing in 2004.The levels of plasma insulin,serum leptin,resistin and adiponectin were measured by sensitive,specific double-antibody sandwich enzyme-linked immunosorbent assays (ELISA).Analysis of covariance,multivariate linear regression and binary logistic regression analysis were performed.Results There were highest plasma insulin and serum leptin,and lowest adiponectin levels in combined obese group than those in other obese groups and non-obese group and resistin level in abdominal obese group was highest than those in other obese groups or non-obese group.Among subjects with general obesity and conbined obesity,WC was more important factor than BMI for plasma insulin[?(WC)=0.158 P0.05].With covariates adjusted,the odds ratios(OR)and 95% confidence intervals of general obesity,abdominal obesity and combined obesity were 3.46(2.44-4.91),5.41(3.87-7.57) and 10.10(8.26-12.35) for predicting hyperinsulinemia,respectively,5.83(4.02-8.45),7.07(4.97-10.05)and 20.82(16.49-26.28) for hyperleptinaemia,respectively,1.47(1.05-2.07),2.0(1.42-2.80) and 2.66(2.23-3.18) for hypoadiponectinaemia,respectively.Serum resistin was highest in abdominal obesity.Conclusion The levels of adipocytokines in children were correlated with the phenotypes of obesity,especially for abdominal obesity.

OBJECTIVETo explore the performance patterns of reaction point Jingtong in balance acupuncture through multi-center and big-sample clinical investigation. Methods The Jingtong points of balance acupuncture on healthy side and affected side were observed among 230 cases of cervical spondylosis and scores of self-discomfort in reaction point, color of skin, changes of skin, morphology of subcutaneous tissue and abnormal pressing pain were recorded. The software SPSS 15.0 was applied to statistically analyze the recorded scores.

RESULTSAmong 230 cases, the reaction point appeared in 226 cases, accounting for 98. 3%. Among the 226 cases who had reaction point, the total score of symptom and sign was (1.08+/-1.09) on the healthy side and (0. 84+/-1. 36) on the affected side, which had statistical significance (P<0. 01); score of self-discomfort in reaction point was (0. 76 +/-0. 83) on the healthy side and (0. 40+/-0.80) on the affected side, which had statistical significance (P<0.01); the score of skin color was (0.10+/-0.36) on the healthy side and (0. 03+/- 0. 19) on the affected side, which had statistical significance (P<0. 05); the score of abnormal pressing pain was (2. 47+/-2. 46) on the healthy side and (1. 39+/-2. 37) on the affected side, which had statistical significance (P<0. 01).

CONCLUSIONThe total score of symptom and sign of reaction point Jingtong on the healthy side is higher than that on the affected side, indicating positive reaction of Jingtong on the healthy side has specificity for cervical spondylosis. When patient has cervical spondylosis on either side of neck, the other side will have anomaly in Jingtong.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Neck Pain ; therapy ; Spondylosis ; therapy ; Young Adult

Forensic Medicine ; Humans ; Kidney Transplantation ; Polycystic Kidney Diseases

OBJECTIVETo compare the optimal references of waist circumference (WC) between Beijing and China in detecting cardiovascular risk factors in school-age children.

METHODSPercentile curves for WC were drawn by sex using LMS method based on 21 787 children and adolescents aged 7 - 18 from Beijing Child and Adolescent Metabolic Syndrome Study. The 75(th) and the 90(th) percentiles by age and by gender of WC percentile curves were chosen as the optimal WC reference for 3 - 18 years old children and adolescents in Beijing. The sensitivities (Se) and specificities (Sp) were compared between Beijing and China WC references based on the evaluation of cardiovascular risk factors including hypertension, dyslipidemia, impaired fasting glucose and non-alcoholic fatty liver disease (NAFLD) in the test population being composed of 4927 school children aged 7 - 18 years. The predictive values for those cardiovascular risk factors were compared between the two optimal thresholds through comparison of the odds ratio (OR) in regression analysis.

RESULTSThe optimal reference for Beijing children and adolescents aged 3 - 18 years ranged from 51.8 to 78.2 cm for the 75(th) percentile in boys and 50.8 to 72.1 cm in girls, and the 90(th) percentile increased from 54.0 to 86.0 cm in boys and 53.3 to 77.3 cm in girls. The Ses of Beijing and China WC references in detecting hypertension were 0.74 and 0.82 in boys and 0.68 and 0.73 in girls; the Ses were 0.69 and 0.80 in detecting low-high density lipoprotein in boys and 0.64 and 0.71 in girls; and they were 0.98 and 1.00 in boys and both were 0.93 in girls for NAFLD. The Sps of Beijing and China WC references in screening hypertension were 0.62 and 0.53 in boys and 0.68 and 0.63 in girls, respectively. In predicting low-high density lipoprotein, the Sps were 0.59 and 0.50 in boys and 0.66 and 0.61 in girls, the Sps were 0.60 and 0.50 in boys and 0.56 and 0.51 in girls for predicting NAFLD. After adjustment for age and gender, ORs and their 95% credibility intervals (CI) of the 90(th) WC percentiles of Beijing and China school children were 6.3 (5.2 - 7.7) and 6.0 (4.9 - 7.4) in predicting hypertension. Both predictive ORs and their 95%CIs were 1.3 (1.1 - 1.5) in predicting impaired fasting glucose and the both were 2.9 (2.5 - 3.4) for dyslipidemia. In predicting NAFLD the ORs and their 95%CIs were 49.1 (12.0 - 201.6) and 69.8 (9.7 - 504.2) for Beijing and China WC optimal references, separately.

CONCLUSIONCompared with Chinese WC reference, WC reference of Beijing had high Sps in screening cardiovascular risk factors in 7 - 18 years old children. The predictive values were not significant different between Beijing and China WC references for almost all cardiovascular risk factors except NAFLD. The WC reference in Beijing was more practical and handy for reference in Beijing and other north developed metropolises.

Adolescent ; Cardiovascular Diseases ; epidemiology ; etiology ; Child ; Child, Preschool ; China ; epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Male ; Reference Values ; Risk Factors ; Waist Circumference ; Waist-Hip Ratio

OBJECTIVETo explore the relationship between serum level of leptin and the components of metabolic syndrome in a group of mid-aged Chinese population.

METHODS345 adults (184 men and 161 women) aged 46 - 53 were enrolled from Fetal Origin of Adult Disease (FOAD) cohort to participate the clinic examination including anthropometry, measurements of blood pressure, fasting and 2 hr plasma levels of glucose and insulin, serum levels of lipid and leptin. HOMA-IR index was calculated to estimate individual insulin resistance. Metabolic syndrome (MS) was diagnosed according to the definition criteria issued by the International Diabetes Federation (IDF) in 2005.

RESULTSThe prevalences of central obesity, higher serum level of triglyceride (TG), lower serum level of high-density lipoprotein (HDL-C), IFG, higher blood pressure and MS were 53.0%, 47.5%, 34.2%, 26.7%, 33.9%, 31.9% in this mid-aged population, respectively. Serum geometric mean level of leptin was higher in females than in males. Serum level of leptin increased with the prevalence of MS and components of abnormal metabolism. The serum level of leptin compared with central obesity, higher blood pressure, higher serum level of triglyceride (TG), lower serum level of high-density lipoprotein cholesterol (HDL-C), IFG and MS was significantly higher respectively (P < 0.05) without HDL-C in males. The serum level of leptin increased with the number of components of abnormal metabolism subjects had (P < 0.001).

CONCLUSIONThe serum level of leptin in this population is significantly associated with MS and components of MS. Hyperleptinemia could be a new component of metabolic syndrome. It might be a target in selection of MS and relative diseases.

China ; epidemiology ; Cholesterol, HDL ; blood ; Cohort Studies ; Female ; Humans ; Hyperinsulinism ; blood ; Insulin ; metabolism ; Insulin Resistance ; Leptin ; blood ; Male ; Metabolic Syndrome ; blood ; epidemiology ; Middle Aged ; Obesity ; blood

This study was aimed to analyze the biological characteristics of rabbit bone marrow mesenchymal stem cells (rBM-MSCs) and their response to different growth factors. Rabbit BM-MSCs were separated from bone marrow mononuclear cells by using adherent cultivation. Biological characteristics were investigated by optical and electron microscopy. Immunophenotype of rBM-MSCs was measured by flow cytometry. The expression of collagen was detected by RT-PCR. Differentiation potential was identified by specific staining and RT-PCR. The response of rBM-MSCs to IL-1, 3, 8 and HGF with different concentrations were tested by MTT. The results showed that the rBM-MSCs gave rise to a population of adherent cells characterized by the presence of a predominant cell type with a typical fibroblast-like morphology and could be cultured for over 15 passages. CD44 was highly expressed on F5 rBM-MSCs (32%) and CD45 was lowly expressed (4.7%). Type I collagen was highly expressed, while type II collagen was lowly expressed and type X collagen was not detected on rBM-MSCs using RT-PCR method. In various conditions inducting differentiation, rBM-MSCs could differentiate into the osteoblast, chondrocyte, adipocyte and neuron-like cells. The rBM-MSCs were sensitive to IL-3, even low concentration (10 ng/ml) of IL-3 could promote the proliferation of rBM-MSCs effectively (>32%, P < 0.01), whereas high concentration IL-3 inhibited it significantly. It is concluded that rabbit BM-MSCs were successfully isolated and culture-expanded. The biological characteristics of rabbit BM-MSCs are similar to those of human and rhesus BM-MSCs. IL-3 with low concentration can promote the proliferation of rBM-MSCs effectively, but high concentration of IL-3 can inhibit their proliferation.
Animals ; Bone Marrow Cells ; cytology ; physiology ; Cell Differentiation ; Cell Proliferation ; Cells, Cultured ; Cytokines ; pharmacology ; Granulocyte-Macrophage Colony-Stimulating Factor ; pharmacology ; Male ; Mesenchymal Stromal Cells ; cytology ; physiology ; Rabbits ; Recombinant Proteins

The ZM-1 tissue microarrayer designed by our groups is manufactured in stainless steel and brass and contains many features that make TMA (tissue microarray) paraffin blocks construction faster and more convenient. By means of ZM-1 tissue microarrayer, biopsy needles are used to punch the donor tissue specimens respectively. All the needles with the punched specimen cylinders are arrayed into the array-board, with an array of small holes dug to fit the needles. All the specimen cylinders arraying and the TMA paraffin block shaping are finished in only one step so that the specimen cylinders and the paraffin of the TMA block can very easily be incorporated and the recipient paraffin blocks need not be made in advance, and the paraffin used is the same as that for conventional pathology purpose. ZM-1 tissue microarrayer is easy to be manufactured, does not need any precision location system, and so is much cheaper than the currently used instrument. Our method's relatively cheap and simple ZM-1 tissue microarrayer technique of constructing TMA paraffin block may facilitate popularization of the TMA technology.
Biopsy, Needle ; instrumentation ; Equipment Design ; Female ; Humans ; Immunohistochemistry ; Male ; Neoplasms ; enzymology ; Paraffin ; Tissue Array Analysis ; instrumentation

Aged ; Angioplasty, Balloon, Coronary ; instrumentation ; methods ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; pathology ; therapy

Aneurysm, False ; etiology ; surgery ; Blood Loss, Surgical ; Carcinoma ; Carotid Arteries ; Carotid Artery Diseases ; etiology ; surgery ; Humans ; Nasopharyngeal Neoplasms ; radiotherapy ; Rupture