The amount of the research-oriented graduates is increasing in affiliated hospitals of medical universities.To create an effective training model can not only help students to succeed but also contribute great to the research level of hospitals.In this study,we summarized our experience,such as individualized teaching,the unity of thinking and performing,words and deeds as well as unity of clinic and research on the formation of research ideas,attitudes and styles.Based on our experiences we hope to provide meaningful methods for the training of medical graduates.

Objective To investigate the relationship between serum leptin and carotid intima-media thickness in patients with type 2 diabetes mellitus. Methods 35 patients with type 2 diabetes mellitus (DM) and 16 normal controls were studied. Fasting serum leptin, fasting glucose(FBG), HbAlc, C-peptide, lipide, systolic(SBP), diastolic blood pressure(DBP), body mass index (BMI) and waist circ-umference (WC) were measured in all subjects. The intima-media thickness (IMT) of common carotid artery was measured by high-resolu-tion ultrasound imaging. Results IMT of T2DM was positively correlated with leptin concentration. Conclusion Serum leptin concentra-tion is independently associated with the IMT of carotid artery, which suggest that leptin may be an independent risk factor of atherosclerosis.

Objective To explore the association of serum high-sensitivity C reactive protein (hs-CRP) level with leptin in patients with type 2 diabetes mellitns (T2DM). Methods 35 cases of T2DM patients were involved in the study and 16 normal subjects were taken as controls. Fasting serum leptin and CRP were measured .The relationship between them were also analyzed. Results Fasting serum hs-CRP concentration in T2DM group was higher than that in healthy control group, but serum ieptin levels is the same (P > 0.05). Partial correlation analysis demonstrated that fasting hs-CRP level was positively correlated with leptin (r =0.512 ,P =0. 018). Conclusion Fasting serum hs-CRP level is significantly raised in T2DM ,which is associated with leptin. There is chronic inflammatory reaction in T2DM patients,and leptin is possibly involved in inflammatory pathogenesis of T2DM.

Aim To investigate the effect of preventive administration of icariin on learning and memory abili-ties and brain mitochondrial oxidative stress in senes-cence-accelerated mouse prone8 ( SAMP8 ) . Methods
The 6-month-old SAMP8 mice were randomly divid-ed into the SAMP8 model group, ICA groups (75, 150 mg · kg-1 ) , the positive Diethylstilbestrol ( DES ) group and estrogen receptor inhibitor ICI182780 com-bined with ICA (150 mg·kg-1 ) group, with 8 mice in each group. 8 same month old SAMR1 mice were selected as the normal control group. After oral admin-istration for 8 weeks, Morris water maze test and step-down passive test were used to investigate the effects of preventive administration of ICA on learning and mem-ory abilities in SAMP8 mice. Cerebral cortex mitochon-dria were isolated to determine the effect of preventive administration of ICA on the oxidative stress by detec-ting reactive oxygen species ( ROS) level, lipid perox-ides ( MDA ) content, glutathione GSH content and catalase ( CAT ) activity. Results Preventive treat-ment of ICA could significantly improve the abilities of place navigation and space exploration of SAMP8 mice, enhance their reflex ability in step-down passive test. ICA could also reduce the level of ROS and MDA content, increase GSH content in brain mitochondria of SAMP8 mice. CAT activity was not obviously changed. Compared with ICA high dose group, the learning and memory abilities of mice in ICA and estrogen receptor inhibitor ICI182780 co-administrated group were signif-icantly decreased. However,brain mitochondria oxida-tive stress was not changed obviously. Conclusion Preventive administration of icariin can significantly improve learning and memory abilities and brain mito-chondrial oxidative stress in SAMP8 mice. The mecha-nism of ICA improving learning and memory abilities may be related to its estrogen-like effect;while the ac-tion on brain mitochondrial oxidative stress may be in-dependent of estrogen receptor.

Endothelialprogenitorcels(EPCs)arethepluripotentstemcelsofvascularendothelial cels. They have self-differentiation and proliferation ability. A large number of animal experiments and preliminary clinical studies have show n that EPCs have broad prospects of clinical application. This article review s the research status of EPCs and their application in the clinical treatment of ischemic stroke.

Objective To provide supportive evidences for the diagnosis of primary major depres-sive disorder (MDD) by analyzing the alterations of proinflammatory cytokines such as IL-1α, IL-6, IL-18, TNF-αas well as the total complement activity (CH50) in serum samples.Methods Hamilton Depression Rating Scale ( HAMD) was used to rate the severity of depression with the patients who were diagnosed as primary MDD.Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of IL-1α, IL-6, IL-18 and TNF-αand the CH50 in serum samples from 49 patients and 40 healthy subjects .Results Pa-tients with MDD showed significantly different levels of IL-6, IL-18, TNF-αand CH50 in serum samples as compared with that in healthy subjects (P<0.05).No significant difference with the level of IL-1αwas ob-served between the patients with MDD and healthy subjects (P>0.05).There were significant gender differ-ences with levels of IL-1αamong the patients with MDD (P<0.05).However, no significant differences with the levels of IL-6, IL-18, TNF-αand CH50 were found between male and female patients (P>0.05). Conclusion The changes of CH50 and certain proinflammatory cytokines such as IL-6, IL-18 and TNF-αmight be involved in the progression of MDD , suggesting the possibility of using them as indicators for the di-agnosis of MDD.

Objective To investigate the prognosis of local resection in patients with low rectal cancer, and assess surgical indications for this procedure. Methods One hundred and twenty-four patients with low rectal cancer from Jan 1975 to Dec 2006 were analyzed, the clinicopathologic features and surgical, outcome were examined as prognostic factors. Survival rate was estimated by Kaplan-Meier method and compared by Log-Rank test, prognostic factors were analyzed by multivariate COX proportional hazards model. Results The 5-year survival rate of 124 patients underwent local resection was 90.7 %(97/107), there were 4.8 %(6/124) patients with complications and 15.3 %(19/24) ones with local recurrence.The infiltration, vascular invasion, the size of tumor and the histological grade were significant prognostic factors of overall survival, but gender, age, the tumor site and the macroscopic type were not. Multivariate analysis indicated that the tumor infiltration were independent poor prognostic factor. Conclusion Local resection is suitable for Tis and T1 low rectal cancer, and those with high local recurrence factors should undergo radical resection. Strict follow-up and adjuvant therapy is necessary for local excision.

Objective To compare the therapeutic effect of debridement,bony fusion and internal fixation through subscapularis transthoracic and posterolateral approach in treating upper thoracic tuberculosis.Methods Between January 2002 to February 2014,a total of 43 patients with upper thoracic tuberculosis were analyzed retrospectively.There were 21 patients in subscapularis transthoracic approach group and 22 patients in posterolateral approach group.Several parameters of the two groups were compared,including gender,age,segmental tuberculosis,intraoperative blood loss,operative time,complications of operation,hospital stay,the cure rate,the Cobb angle,Frankel scale and so on.Results There was no significant difference in gender,age,segmental tuberculosis,ESR,Frankel scale,Cobb angle between the two groups before surgery.The operative time was 196± 10 min in subscapularis transthoracic approach group,whereas it was 142±13 min in posterolateral approach group.The operative time of subscapularis transthoracic approach group was significantly longer than posterolateral approach group.There was no significant difference in intraoperative blood loss,complications of operation,hospital stay and the cure rate.The followed up of subscapularis transthoracic approach group and posterolateral approach group was 28.0± 14.7 months and 27.3± 15.5 months respectively.The preoperative Cobb angle was 36.5°±4.8° and the postoperative Cobb angle was 24.8°±5.6° in subscapularis transthoracic approach group.The correction rate was 30.9％.The preoperative Cobb angle was 34.5°±5.2° and the postoperative Cobb angle was 10.2°±2.6° in posterolateral approach group.The correction rate was 68.5％.Thus,the correction rate of posterolateral approach group was significant better than subscapularis transthoracic approach group.The neurological score of Frankel scale was significantly restored in two groups after operation,and there was no significant difference between two groups.Conclusion For upper thoracic tuberculosis,the therapeutic effect of debridement,bony fusion and internal fixation through subscapularis transthoracic and posterolateral approach could achieve the same good clinical results.However,the posterolateral approach was better than subscapularis transthoracic approach in surgical trauma,surgical duration and kyphosis correction.Therefore,it is recommended to use the posterolateral approach in treating upper thoracic tuberculosis.

Objective To explore the p27 gene expression and clinical significance in acute leukemia (AL).Methods RT-PCR was used for testing the mRNA levels of p27 gene in bone marrow mononuclear cell of 65 cases of newly diagnosed AL patients and 41 controls.The correlation between the p27 gene expression positive rate and age, sex, peripheral blood white blood cell count and extramedullary infiltration were analyzed simultaneously in AL patients.Results The positive rate of p27 gene expression (36.9 ％,24/65)was significantly lower in AL group than that in the control group (87.8 ％,36/41) (P ＜0.05),and which was lower than the control group (P ＜0.05) in the AML group (34.2 ％,13/38) and the ALL group (37.5 ％,9/24).However,comparing AML group with ALL group,the difference was not statistically significant (P ＞0.05).At the same time,compared the p27 gene expression positive rate of ≥ 14 years old group (52 cases) and ＜14 years old group (13 cases),and also compared in male group (34 cases) and in female group (31 cases),there was no statistically difference (P ＞0.05); Compared the p27 gene expression positive rate of peripheral blood white blood cell count ≥20×109/L group (31 cases) and ＜20×109/L group (34 cases),also compared with in extramedullary infiltration group (37 cases) and in no extramedullary infiltration group (28 cases),the relationship of p27 gene expression positive rate with peripheral blood white blood cell count as well as extramedullary infiltration was a negative correlation (r =-0.284,P ＜ 0.05,r =-0.300,P ＜ 0.05).Conclusion There is p27 mRNA expression deletion in AL patients,and the deletion is present in the AML and ALL at the same time.p27 mRNA expression is negatively correlated with peripheral blood white blood cell count or extramedullary infiltration,which might be one of the mechanisms of occurrence and development of AL.

Objective To explore the effect of intensity of 1 Hz repetitive transcranial magnetic stimulation (rTMS) to right Broca's ho-mologue on nonfluent aphasia after stroke. Methods 40 inpatients were equally divided into low-intensity group and high-intensity group, who received rTMS (1 Hz for 10 minutes) once a day and twice a day respectively for 10 days. They were assessed with Western Aphasia Battery (WAB) before and after intervention, and 2 months after intervention. Results The scores of content and fluency, auditory compre-hension, naming, repetition and AQ improved more in the high-intensity group than in the low-intensity group (P<0.01). It maintained more for 2 months in the scores of content and fluency, repetition and AQ (P<0.05). Conclusion High-intensity rTMS can promote the improve-ment of speech in patients with nonfluent aphasia after stroke that remains for a long term.