High-quality medical talents must possess high accomplishment of logical thinking,but the current logic thinking standard of medical students is far from the needs of modern medical development.Therefore,setting up of a "logical thinking training" course for medical students is necessary and significant for the innovation,diagnosis,nursing care and management of modern medicine.The theoretical and practical conditions for the new course are both mature with feasibility.

Objective To observe the regulation effect of transforming growth factor alpha(TGFα) on expression of glutamate transporter(GLAST)and ingestion activity of retinal M(u)ller cells in mice.Methods To take the retinal tissue of Kunming mouse at postnatal 7～10 day.and then cultured M(u)ller cells according to literature.The 3～4 generation cultured cells of the same primary cell were divided into two groups at random:①TGFα group:maintained in different concentrations of TGFα as 50,75,125 and 150 ng/ml,3 holes in each concentration;②Control group:cultured by Eagle culture medium which improved from Dulbeccon and contained 20%fetal calf serum.The influence of different concentrations TGFα on GLAST activity in M(u)ller cells were observed by L-3H-glutamate uptake detection;the expression of GLAST mRNA in M(u)ller cells was determined by RT-PCR;the expression of GLAST protein was detected with immunocytochemical staining.Results With the increase of TGFα concentration.both L-3H-glutamate uptake and GLAST mRNA expression were increased.The L-3H-glutamate accumulation had got to the maximum uptake at concentration of 125 ng/ml,which was 266% of that in control group,meanwhile,the expressions of GLAST mRNA also got to the maximum as 4 times of control group.Immunocytochemical staining indicated that the effect of 125ng/ml TGFα on expression of GLAST protein was higher than that in the control group,the differences between two groups were statistically significant(P＜0.05).Conclusion TGF-α can increase GLAST activity through up-regulating the expression of GLAST mRNA and protein.

Mesenchymal stem cells(MSCs) have became the hot spot in cell tissue engineering,cell replacement therapy,gene therapy and transplant research fields. Recent studies have shown that changes in oxygen concentrations affect many biological characteristics of MSCs. Under different oxygen concentrations,MSCs have different proliferation,differentiation,migration and chemotoxis abilities. Hypoxia is a kind of common pathophysiological status,which can promote the proliferation,apoptosis,migration and chemotoxis abilities of MSCs,while hypoxia impacts the differentiation ability depending on different cell types. The mechanism of these response might be involved in hypoxia-inducible factor-1(HIF-1) ,chemokines and their receptors,and matrix metalproteinases. Hypoxia can activate HIF-1 signaling pathway,which upgrades the expression of stromal-derived factor-1(SDF-1) ,and forms microenvironments which stem cells are adapted to and grow in. SDF-1 increases the adhesion,migration and homing of circulating CXCR4-positive progenitor cells to ischemic tissue,and promotes degradation of extracellular matrix,then enhances the migration ability of MSCs by modulating the expression of matrix metalloproteinase and its protein as well.

Human bocavirus ; genetics ; isolation & purification ; metabolism ; pathogenicity ; Humans ; Neonatology ; Research Report

Basic research program is essential to the investigation of the pathogenesis of ocular diseases and the development of novel strategies for the prevention and treatment for these diseases. With increasing support of research grants at various levels, basic research in ophthalmology has gained great achievement in China in recent years. A number of studies have recently been published in well known peer-review international journals and won the State Scientific and Technological Progress Awards. However, we have to keep it in mind that basic research in ophthalmology should be improved qualitatively meanwhile, the imbalance in basic study among different areas needs to be resolved in the near future.

Objective:To deeply understand the real experience of family members of patients in the neurosurgery intensive care unit during the period of accompanying them, and to provide reference for managers to formulate nursing countermeasures to improve the coping ability of family members.Methods:Descriptive phenomenological research method in qualitative research was adopted to conduct in-depth interviews with family members of 12 patients admitted to a neurosurgery intensive care unit in Shanghai, manage the interview data with Nvivo11 software, and use Colaizzi's seven-step analysis method to summarize and analyze the topic.Results:There were four themes: adhere to and do not give up, adhere to was due to the trust and affirmation of the medical care, do not give up was because it was difficult to give up blood kinship, adhere to the hope of life because of patients; timing change of emotional experience, first aid period: helpless to rescue and expecting the condition to stabilize, complication peak: understanding the characteristics of the disease and paying attention to the treatment progress, stable period: uncertain prognosis and desire for emotional companionship.The powerlessness of the future; learn to self psychological adjustment.Conclusions:The family members of patients with severe neurological diseases have both negative experience and positive feelings, and the accompanying experience and needs at different stages of the disease are changing dynamically. According to the cognition and needs of the family members, exploring and developing palliative medicine, tapping the potential of the family members from a positive perspective and improving coping ability are one of the ways to maintain the stable mental health of the family members.

Objective To compare the safety and feasibility of two-incision modified and traditional Nuss procedures for children with pectus excavatum.Methods From October 2005 to October 2007,totally 208 cases of pectus excavatum received Nuss surgeries,including three-incision traditional Nuss in 103 cases and two-incision modified Nuss in 105 cases,in our hospital. The perioperative records,complications and the surgical outcomes of the two groups were compared.Results The procedures were completed in all of the 208 patients.The rate of good outcomes in the two groups were similar (94.3% vs.88.3%,x~2=2.318,P= 0.128).Whereas,the operation time and hospital stay of the modified group was significantly shorter than those in the traditional group [(39.2?7.4) min and (6.3?0.7) d vs (45.4?9.2) min and (7.2?0.9) d;t=5.361,P=0.000 and t=8.059,P=0.000]. Furthermore,the modified group had significantly less intraoperative blood loss (median,2.8 ml) than the other group (x~2=5.158, P=0.000).No significant difference was found in the rage of postoperative complications between the two groups (Traditional group: pneumothorax in 1,haemothorax in 1,pericardial perforation in 1,and injuries to the diaphragm or liver in 2;Modified group: pneumothorax in 4,and pericardial perforation in 1;x~2=0.001,P=0.975).The patients were followed up for 3 to 30 months, during which none of them had recurrence or long-term complications.Conclusions Two-incision modified Nuss procedure is not only less traumatic,but also results in shorter operation time and hospital stay,and less blood loss,than the traditional procedure.In addition,as the contralatcral structures are visible during the operation,the modified method is more simple and safer.

Objective To compare the effectiveness of nose jejunal tube (NJT) and nasogastric tube (NGT) in providing early enteral nutrition for patients with severe craniocerebral injury. Methods Forty patients with severe craniocerebral injury and required early enteral nutrition were equally and randomly divided into NJT group and NGT group based on the tube type. The biochemical indicators, gastrointestinal tract tolerance, and complications were compared between these two groups. Results Serum albumin, blood glucose, and lymphocyte count were not significantly different between these two groups before and immediately after nutritional support (all P ＞0. 05). However, 14 days after nutritional support, the blood sugar level significantly decreased compared with the baseline levels in the NJT group (P =0. 0001). The incidences of reflux (P = 0. 001) and abdominal distension (P =0.011) were significantly lower in NJT group than in NGT group. Conclusion NJT is superior to NGT in providing early enteral nutrition for patients with severe craniocerebral injury.

EML4-ALK fusion gene is a new molecular type of non-small cell lung cancer,which is formed by inversion of two gene segments on chromosome 2.Up to now,9 subtypes have been found and all of them have deteriorated and carcinogenic abilities. The detection rate of this fusion gene is much higher in patients who have adenocarcinoma,never or seldom smoke and lack EGFR/KRAS mutation.This fusion gene codes ALK tyrosine kinase,that abnormally phosphorylates downstream products through signaling pathways,leading to canceration.Therefore,the specific inhibitors which target this fusion gene could inhibit its expression and have good treatment effect.At present,the relevent inhibitors which are undergoing clinical trials are PF02341066 and TAE684.

Objective To investigate the effects of local delivery c-myc antisense oligodexynucleotides on neointimal hyperplasia after angioplasty in rabbits. Methods The celiac arterial endothelium of 75 male Japanese white rabbit (2.5?0.5 kg) were denuded after being fed with cholesterol-supplemented diet to establish the model of atherosclerotic stenosis of celiac arteries. The animals were randomized into the antisense DNA group (Group Ⅰ), sense DNA group (Group Ⅱ), saline control group (Group Ⅲ) and simple angioplasty group (Group Ⅳ). The drugs were injected intramurally using a porous balloon. The local vessels were collected at the 24 th hour and the 4 th week after the procedure for morphological observation. C-myc mRNA level was measured by means of RT-PCR and c-myc protein with immunohistochemical staining. Results RT-PCR showed that c-myc mRNA level in Group Ⅰ was lower than that of Group Ⅱ, Group Ⅲ and Group Ⅳ after the first 24 hours. The ratio of neointimal area (NEA) to medial area (MA) and NEA/MA in Group Ⅰ were significantly less than those of Group Ⅱ, Group Ⅲ and Group Ⅳ. Immunohistochemical staining showed that the percentage of c-myc protein positive cells was less in Group Ⅰ than those of the other groups. Conclusion Transcatheter local delivery of c-myc antisense oligonucleotides reduces neointimal hyperplasia after angioplasty in rabbits.