Talent training is the foundation for discipline construction and it is also the fundamental guarantee of hospital's sustainable development.The affiliated Zhongshan hospital of Fudan university launched investigations from the teaching management,teaching staff,resident and clinical skills to look for problems in clinical teaching and to propose improvement measures aiming at improving the clinical teaching and promoting hospital resident and specialists training.

Objective To establish the chromatographic fingerprint analysis for the quality control of Flos Genkwa.Methods RP-HPLC Method was applied to establish the chromatographic fingerprint.The separation was performed on a Kromasil C18 column(250 mm?4.6 mm,5 ?m)with a gradient elution composed of methanol and 0.05% phosphate acid.The column temperature was set at 35 ℃ and the flow rate was 1.0 mL/min.The detective wavelength was at 238 nm.Results Twenty-one characteristic peaks were established in the fingerprint.The mutual model of Flos Genkwa was established and the similarities were calculated.The similarity of 17 samples in all the 19 samples was more than 0.90.Conclusion The method is simple and accurate with good reproducibility.It can be used for the quality control of Flos Genkwa.

1. 40 cadavers were dissected in order to observe the position, formation and morphology of the osteo-fibrous canal (400 canals) of the posterior rami of the lumbar spinal nerves.2. The average lengths of the osteo-fibrous canals for the posterior ramus of the lumbar nerves in both sexes are: L_1 4.88mm, L_2 4.71 mm, L_3 4.61 mm, L_4 4.57mm, L_5 4.39 mm.3. The average longitudinal diameter of the outlets of the osteo-fibrous canals of the posterior rami of the lumbar nerves in both sexes are: L_1 6.38mm, L_2 6.73 mm, L_3 6.34mm, L_4 5.75mm, L_5 2.61mm.The average transverse diameters of the outlets of the osteo-fibrous canals of the posterior rami of the lumbar nerves in both sexes are: L_1 2.69mm, L_2 2.66mm, L_3 2.68mm, L_4 3.14mm, L_5 2.06mm.4. The shapes of the outlets of the osteo-fibrous canals of the posterior rami of lumbar nerves may be classified into four types: nearly circular 64.75% (259 sides); approximately ellipsoid 30.25% (121 sides); nearly triangular 3.00% (12 sides); nearly oblate 2.00% (8 sides).5. 320 inter-transverse ligaments were observed and measured.6. There was always an iliolumbar ligament interposed between L_5 and S_1.7. Further more, the authors discussed the relationship between the morphology of the nerves and the osteo-fibrous canals in connection with the possible causes of low back pain.

Objective:To investigate the expression of solute carrier family 35 member E1 (SLC35E1) and SLC35E2B in skin lesions of patients with Mycobacterium infections. Methods:Paraffin-embedded skin tissues of 31 patients confirmedly diagnosed with Mycobacterium infections were collected from Dermatology Hospital of Southern Medical University from 2014 to 2018, including 10 cases of multibacillary leprosy, 9 of nontuberculous mycobacterial infection, 7 of cutaneous tuberculosis, and 5 of erythema induratum. Meanwhile, paraffin-embedded skin tissues of 10 healthy individuals were collected, and served as normal control group. Immunohistochemical staining was performed to determine the expression of SLC35E1 and SLC35E2B in the lesional and normal control skin specimens, and immunofluorescence staining to observe the co-expression of CD68 and S100 with SLC35E1 and SLC35E2B in the skin lesions. Results:Neither SLC35E1 nor SLC35E2B was expressed in the normal control group, but high expression of SLC35E1 and SLC35E2B was observed in the dermis of skin lesions from the patients with leprosy, nontuberculous mycobacterial infection, cutaneous tuberculosis or erythema induratum. Immunohistochemical staining showed that the expression of SLC35E1 and SLC35E2B (expressed as average optical density) was significantly higher in the multibacillary leprosy group (0.143 ± 0.010, 0.169 ± 0.004, respectively) , nontuberculous mycobacterial infection group (0.278 ± 0.015, 0.229 ± 0.088, respectively) , cutaneous tuberculosis group (0.171 ± 0.010, 0.103 ± 0.016, respectively) and erythema induratum group (0.200 ± 0.015, 0.118 ± 0.021, respectively) than in the normal control group (both 0, all P < 0.05) . Immunofluorescence staining showed co-expression of SLC35E1 and SLC35E2B with CD68 in skin lesions of the patients with leprosy, nontuberculous mycobacterial infection, cutaneous tuberculosis. Conclusion:Both SLC35E1 and SLCE2B were markedly highly expressed in skin lesions of patients with Mycobacterium infections.

Objective: To evaluate the intestinal trophic effects and adverse reactions of nasojejunal and jejunostomy tube im-plants on patients with total gastrectomy. Methods:A total of 86 patients with advanced gastric cancer were randomly and equally di-vided into two groups. Groups A and B received enteral nutrition therapies through nasojejunal and jejunostomy feeding tube implants, respectively. The therapeutic efficacy of the two methods of enteral nutrition therapy and the corresponding adverse reactions observed in the two groups were compared. Results:Group B patients demonstrated shorter anal evacuation and defecation times than group A patients, the difference is statistically significant (P<0.05). Moreover, the bodyweight, total protein, and albumin levels of the patients significantly decreased in both groups after enteral nutrition therapy was administered (P<0.05). Postoperative nutritive indexes were higher in group B than in group A;however, no significant difference was obtained between the two groups (P>0.05). Nonetheless, the patients in group B tolerated the treatment well compared with those in group A (P<0.05). The complication rates of groups A and B were 18.6%and 23.3%, respectively, but this difference was not significant (P>0.05). Conclusion:Patients subjected to total gastrecto-my showed higher tolerance to jejunal tube implants for enteral nutrition than to nasojejunal tube implants, indicating that jejunal tube implants can be used to improve the nutritional status of patients.

The causes of panniculitis are various and complex, and infection is one of the important causes. Streptococcal infection is the most common cause in Europe and the United States with a low incidence of tuberculosis. In areas with a high incidence of tuberculosis such as China, Mycobacterium tuberculosis infection is an important cause of panniculitis, which commonly manifests as erythema induratum of Bazin and erythema nodosum. Erythema induratum of Bazinis is most closely related to tuberculosis, often clinically manifests as nodules, plaques and ulcers on the flexor aspect of the lower extremities, and pathologically manifests as lobular panniculitis. Erythema nodosum can be considered as an early symptom of tuberculosis, and serves as a predictive indicator of tuberculosis. It often manifests as erythema, nodules and few ulcers on the extensor aspect of both lower limbs, and is pathologically characterized by septal panniculitis. Antituberculosis treatment often yields favorable outcomes in patients with erythema induratum of Bazin or erythema nodosum. Therefore, clarifying the relationship between Mycobacterium tuberculosis and panniculitis is of great significance to the treatment and prognosis of panniculitis, especially in areas with a high incidence of tuberculosis.

OBJECTIVETo develop a reversed-phase HPLC method for simultaneous determination of gastrodin, adenosin, 4-hydroxybenzyl alcohol and 4-hydroxybenzaldehyde in Rhizoma Gastrodia.

METHODA Kromasil C18 column (4.6 mm x 250 mm, 5 microm) was used with a methanol-water-0.1% acetic acid gradient elution system. The eluates were detected at 270 nm, the flow rate was 1.0 mL x min(-1) and the column temperature was 35 degrees C.

RESULTThe linear range of gastrodin, adenosin, 4-hydroxybenzyl alcohol and 4-hydroxybenzaldehyde were 19.1-383 (r = 0.999 9), 0.620-12.4 (r = 0.999 9), 2.45-49.0 (r = 0.999 9), 0.280-5.63 mg x L(-1) (r = 0.999 6), respectively. The average recoveries (n = 9) of the four components were 96.7% -97.7%, RSD < 1.6%.

CONCLUSIONThe method is accurate, sensitive and reliable for determination of gastrodin, adenosin, 4-hydroxybenzyl alcohol and 4-hydroxybenzaldehyde in Rhizoma Gastrodia.

Chromatography, High Pressure Liquid ; methods ; Chromatography, Reverse-Phase ; methods ; Drugs, Chinese Herbal ; chemistry ; Gastrodia ; chemistry

OBJECTIVETo investigate the occupational health risk level of workers exposed to 2,4,6-trinitrotoluene (TNT) in arms industry, so as to provide basis for revising the standard of diagnosis for chronic TNT poisoning, and making protective measures for workers.

METHODSThe retrospective study about the morbidity of total malignant tumor was taken on the male workers exposed to TNT over one year from eight military factories during 1970 to 1995.

RESULTSThe morbidity of total malignant tumor in male TNT exposed workers were markedly higher than that of controls, and the relative risk (RR) was 2.32. Compared with the total malignant tumor mortality of male populations in large and medium cities in 1973 to 1975 and 1990 to 1992, the standardized mortality ratio(SMR) were 71.8 and 179.6 respectively, the CI of 99% was 71.8-144.2, indicating that the morbidity of malignant tumor of male workers exposed to TNT was higher than that of normal populations. Liver cancer morbidity was 31.91% of the total malignant tumor, and its mortality was 3.97 times of the controls. Compared with the liver cancer mortality of male populations in large and medium cities in 1973 to 1975 and 1990 to 1992, SMR were 150.5 and 381.6 respectively, these data were significantly different, and CI of 99% was 59.3-184.0. The average death age of the TNT exposed workers (51.7 years old) was younger than that of the same factory control(54.1 years old) and male populations(55.6 years old) in large and medium cities. The incidence of liver cancer was closely related to the length of service, the kinds of job in a factory and the level exposed to TNT, and alcohol consumption was synergistic with TNT carcinogenesis.

CONCLUSIONThe morbidity of malignant tumor of male workers exposed to TNT was markedly higher than that of normal populations. Liver cancer was the most remarkable malignancy, and its incidence was closely related to the length of service and the kinds of job and the level exposed to TNT.

Humans ; Incidence ; Liver Neoplasms ; chemically induced ; epidemiology ; Male ; Occupational Exposure ; adverse effects ; Retrospective Studies ; Trinitrotoluene ; toxicity ; Weapons

It has become a consensus that there is a correlation between psoriasis and obesity, but the exact mechanism is not yet clear. Studies demonstrate that common inflammatory pathways and insulin resistance may contribute to the association between psoriasis and obesity. Understanding the impact of obesity on the occurrence and treatment of psoriasis will be beneficial to the treatment of psoriasis.

Periarticular fracture of the shoulder is a common type of fractures in the elderly. Postoperative adverse events such as internal fixation failure, humeral head ischemic necrosis and upper limb dysfunction occur frequently, which seriously endangers the exercise and health of the elderly. Compared with the fracture with normal bone mass, the osteoporotic periarticular fracture of the shoulder is complicated with slow healing and poor rehabilitation, so the clinical management becomes more difficult. At present, there is no targeted guideline or consensus for this type of fracture in China. In such context, experts from Youth Osteoporosis Group of Chinese Orthopedic Association, Orthopedic Expert Committee of Geriatrics Branch of Chinese Association of Gerontology and Geriatrics, Osteoporosis Group of Youth Committee of Chinese Association of Orthopedic Surgeons and Osteoporosis Committee of Shanghai Association of Chinese Integrative Medicine developed the Chinese expert consensus on the diagnosis and treatment of osteoporotic periarticular fracture of the shoulder in the elderly ( version 2023). Nine recommendations were put forward from the aspects of diagnosis, treatment strategies and rehabilitation of osteoporotic periarticular fracture of the shoulder, hoping to promote the standardized, systematic and personalized diagnosis and treatment concept and improve functional outcomes and quality of life in elderly patients with osteoporotic periarticular fracture of the shoulder.