Objective To study the application effect of somatostatin combined with psychological intervention. Methods 88 patients with acute pancreatitis treated in Hangzhou Hospital of Zhejiang Medical and Health Group from January 2016 to July 2017 were divided into two groups: observation group (n=44) and control group (n=44). Two groups of patients were treated with somatostatin, the control group received routine care, the observation group patients on this basis, take psychological intervention and other nursing interventions. Results The observation group after the therapeutical effect of somatostatin combined with psychological intervention, the cure rate (93.18％) was significantly higher than the control group (70.45％), and the incidence of complications (11.36％) and mortality (6.82％) than in the control group (40.91％, 27.27％), with statistical significance (P<0.05); at the same time, the observation group nursing satisfaction scores were significantly higher than the control group, significant difference (P<0.05). Conclusion In the clinical treatment of acute pancreatitis, take somatostatin combined with psychological intervention can improve the therapeutic effect, reduce the incidence of mortality and complications, improve patient satisfaction.

OBJECTIVE:To discuss the significance of pharmacoeconomics applying in essential medicine system(EMS) and the duty of licensed pharmacist. METHODS:The relationship between theory of pharmacoeconomics and EMS was analyzed. Moreover,the theory of pharmacoeconomics served as technique to apply in EMS. RESULTS&CONCLUSION:Pharmacoeconomics is the theoretical basis of establishment of EMS so that it is important significance to guide the choice of essential medicines,establishment and improvement the production,supplication and using system of essential medicines. Medical staff should carry out the monitory and evaluation of national essential medicine system(NEMS) in practice and implement NEMS consciously.

Objective To investigate the expression of apelin and its recoptor (APJ) in myocardium in insulin-resistant CIR rats with myocardial ischemia.Methods Totally 24 male SD rats were randomly divided into three groups:IR group,IR+ischemia group,the control group (n=8 each).Rats in IR and IR+ischemia groups were fed with the high fat diet.Rats in control group were given the basic diet.The rat model of insulin resistance was assessed by fasting blood glucose (FBG),fasting insulin (Fins) and insulin resistance index (HOMA-IR).The rat model of myocardial ischemia was conducted by subcutaneous injection of isoprenaline 1 mg/kg per day in IR+ ischemia group.The other groups were injected an equal volume of saline.The expression levels of apelin and APJ mRNA in myocardium were determined by real-time-PCR.The positive expression of apelin polypeptide was detected by immunochemistry.Results Compared with the control group,the apelin average optical density was increased in IR group and was decreased in IR+ ischemia group [(0.16±0.004) vs.(0.13±0.005),(0.10±0.002) vs.(0.13±0.0050),both P＜0.05].There was a significant difference in apelin average optical density between IR group and IR+ischemia group [(0.16± 0.004) vs.(0.10±0.002),P＜0.05].Compared with the control group,the relative expression of apelin mRNA was increased in IR group [(5.89±0.36) vs.(4.40±0.24),P＜0.05]The relative expression of apelin mRNA was decreased in IR± ischemia group as compared with IR group [(2.66 ± 0.17) vs.(5.89 ± 0.36),P ＜ 0.05].The APJ mRNA relative expression was increased in IR group as compared with control group and was decreased in IR+ ischemia group as compared with IR group [(10.46±1.06) vs.(6.54±0.63),(3.31±0.31) vs.(10.46±1.06),both P＜0.05].Conclusions The expressions of apelin and APJ are inhibited in insulin-resistant rats with myocardial ischemia,which attenuates their protective effects on myocardium.

Objective To evaluate the angiogenic effect of the bone marrow mesenchymal stem cells (MSCs) transfected with adeno-associated virus (rAAV) -mediated human vascular endothelial growth factor 165 (VEGF165) gene, to detect the expression and bioactivity of VEGF in the MSCs.and to detect the expression and bioactivity of VEGF165 gene in the area of ischemic skeletal muscle in rats. Methods The MSCs were cultured by whole bone marrow culture method, then the MSCs were transfected with rAAV-VEGF165, the expression of VEGF was examined using ELISA and RT-PCR. The model of ischemic skeletal muscle was established by ligation in inbred rats. The rats were injected with PBS at the ischemic zone (group A), MSC (group B), hVEGF-transfected MSC (group D), and 7 days later they were injected with hVEGF transfected MSC (group C). Six weeks after the transfection, the capillary density of the ischemic zone was examined by factor Ⅷ stain. Results The MSCs were cultured successfully according to the expressions of positive CD44 and CD90,negative CD34. In rAVV-VEGF165 transfected group, the secretion levels of VEGF165 in supernatant were significantly higher than in non-transfected group 1,3,5,7 and 9 days after injection [(131. 98±6.00) ng/L vs. (68. 72±1.99) ng/L; (263. 96±4.58) ng/L vs. (76. 47±4.98) ng/L;(540. 85±5.97) ng/L vs. (89. 86± 1.99) ng/L; (208. 98± 5.06) ng/L vs. (84. 93±8. 97) ng/L;(174.45±5.00) ng/L vs. (68.71±5.98) ng/L, all P＜0.05]. On the position of 579 bp, highbrightness strip could be seen. There were no significant differences in growth curve and cell morphology between transfected group and non-transfected group. Six weeks after the transplantation, the capillary density was significantly greater in group D [(9.35 ± 2.72)/ vision]than in group A [(1. 05±0. 50)/vision] ,group B [(3.10± 1.43)/vision, both P＜0. 01)] and group C [(6. 95± 1.69)/ vision, P＜0. 05] Conclusions MSCs are helpful for the stable expression of hVEGF gene, and it is good cellular vehicle for VEGF genes. The effect of combined therapy is much better than separate transplantation of MSCs. The best time to transplant is 10 days after surgical operation.

Objective To evaluate the mitochondrial function of chondrocytes in Kashin-Beck disease (KBD) patients and its correlation with age.Methods Mitochondrial function was evaluated by analyzing the activities of respiratory chain enzyme complexes and citrate synthase (CS),intracellular adenosine triphosphate (ATP)contents, changes in mitochondrial membrane potential (ΔΨm),as well as the intracellular reactive oxygen species (ROS) contents.Correlation of mitodhondrial function and age was analyzed with linear regression.Results Activities of complexes Ⅱ (P = 0.001 ),Ⅲ (P = 0.005 )and Ⅳ (P = 0.005 )were reduced in KBD articular chondrocytes compared with cells from normal controls.However,the mitochondrial mass was increased in KBD samples. Cultured KBD chondrocytes had reduced cellular ATP level (P = 0.001 )and mitochondrial membrane potential (P =0.001),but increased citrate synthase activity (P =0.04)and intracellular ROS level (P <0.001).We found no correlation between mitochondrial function and donor age either in normal or in KBD chondrocytes. Conclusion Mitochondrial function is altered in articular chondrocytes of KBD,and no correlation was found between mitochondrial function and donor age.

The research data at home and abroad show that the overall burnout rate of clinical professional graduate students was high. They are vulnerable to burnout because of long duty hours, learn-ing pressure, intense and overloading work and especially the significantly reduced personal accomplish-ment in the situation of the contradiction between doctors and patients in our country. Burnout not only re-sults in psychological distress and physical symptoms, but also has negative effect on the quality of graduate medical education during residency training. Therefore, educators need to develop an active awareness of burnout and ought to perform interventions such as formulating the appropriate learning goals, improving the work efficiency, reducing work hours, positive psychological counseling and stress management training to prevent such occurrences.

OBJECTIVE:To establish a method for the decoction of isoflavone content and its acid hydrolysis conversion rate in the flower of Pueraria lobata. METHODS:Using the flowers of Pueraria lobata as raw material,the isoflavone with main com-ponent of tectoridin in the flower of P. lobata was prepared with ethanol,ethyl acetate extracted,ethanol recrystallized and puri-fied,and it was converted to tectorigenin with hydrolysis in hydrochloric acid. By screening the solvent and wavelength,UV spec-trophotometry was established to determine tectovidin and tectorigenin,and calculate the isoflavone content and acid hydrolysis con-version rate of tectoridin(expressed by the relative percentage of tectorigenin). It was compared with HPLC detection results,the accuracy of UV method was evaluated. RESULTS:The solvent was 70％ethanol solution containing 1％triethylamine,and the iso-flavone content was detected at wavelength of 339,274 nm. The linear range of tectoridin was 8.80-29.33 nmol/mL(r=0.9999). RSDs of precision(n=6),stability(n=5)and reproducibility(n=6)tests were lower than 1.94％;average recovery was 99.7％(RSD=1.77％,n=9). There were no statistical significances in the contents of total flavonoids (UV:17.64-25.55 nmol/mL vs. HPLC:17.39-24.40 nmol/mL) and the relative percentage of tectorigenin (UV:57.65％-87.59％ vs. HPLC:55.62％-91.14％). CONCLUSIONS:The established method is accurate,reliable,and can be used for the rapid determination of acid hydrolysis con-version rate of tectoridin.

Objective To explore convenient and practical semi-quantitative MRS indicators in diagnosis of prostate cancer.Methods One hundred patients with completer MRS data and clinical data were enrolled in the study.The following parameters were assessed to evaluate their efficacy in diagnosis of prostate cancer, (Cho + Cr)/Cit of single voxel, mean (Cho + Cr)/Cit of the whole area and (Cho + Cr)/ Cit positive voxel ratio at the sextant level.Similarly, all the parameters mentioned above and mean (Cho +Cr)/Cit positive voxel ratios of the whole gland were assessed at the whole gland level.Pearson test and Kappa test were used in the research.Results Two thousand nine hundred and forty-five voxels were assessed including 1203 in cancer positive region and 1742 in cancer negative regioa The range of the (Cho + Cr) /Cit ratio in cancer positive region was from 0.22 to 8.00 (median, 1.87), and that in cancer negative region was from 0.11 to 8.00 (median, 0.53).The (Cho + Cr)/Cit ratio in cancer positive region was higher than that in cancer negative region (Z =28.48, P<0.01) with partial overlap.On the level of sextant, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of (Cho + Cr)/Cit ratio> 0.911 to diagnose prostate cancer were 81.4% (179/220),64.2% (194/302), 62.4% (179/287) 、82.6% (194/235) 、71.5% (373/522) respectively; those of mean (Cho + Cr)/Cit ratio>0.911 were 77.3% (170/220),77.2% (233/302),71.1% (170/239),82.3% (233/283),77.2% (403/522) respectively; those of positive voxel ratio>0.519 were 73.2% (161/220),80.8% (244/302)、 73.5% (161/219),80.8% (244/302), 77.6% (405/522) respectively; the consistency between mean (Cho + Cr) /Cit ratio and positive voxel ratio was high (Kappa=0.907).On the level of the whole prostate, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of (Cho + Cr)/ Cit ratio>0.911 to diagnose prostate cancer were 94.3% (50/53),40.4% (19/47),64.1% (50/78), 86.4% (19/22),69.0% (69/100) respectively; those of mean (Cho + Cr)/Cit ratio>0.911 were73.6% (39/53),83.0% (39/47), 83.0% (39/47), 73.6% (39/53), 78.0% (78/100) respectively; those of maximum positive voxel ratio> 0.519 were 88.7% (47/53),61.7% (29/47),72.3% (47/65),82.9% (29/35),76.0% (76/100) respectively; those of mean positive voxel ratio>0.519 were 62.3% (33/53), 85.1% (40/47), 82.5% (33/40), 66.7% (40/60), 73.0% (73/100) respectively; the consistency between mean (Cho + Cr)/Cit ratio and mean positive voxel ratio was fairly high (Kappa =0.818).Conclusion Single voxel criteria were suggested to diagnose clinically suspected prostate cancer.Maximum positive voxel ratio criteria were suggested to guide localization in biopsy.

Objective To explore an effective method of isolating and culturing the vascular endothelial cells of rat thoracic aorta.MethodThe thoracic aorta was harvested under aseptic condition from the thorax of a Wistar rat.The peripheral connective tissue and fat of the thoracic aorta were stripped and disposed,and then the thoracic aorta was turned inside out to expose the intima.The thoracic aorta was ligated with silk and cauterized on both ends with heated forceps.Then the thoracic aorta was cultured in medium DMEM/F12 containing 20% newborn calf serum in a 50 ml culture bottle which was already blanketed with rat tail collagen.The thoracic aorta was discarded and the new culture medium was added into the culture bottle six days later.The migrating cells were differentially digested by 0.125% pancreatic enzyme for serial subcultivation.The cells were identified by immunohistochemical method with anti-Ⅷ factor antibody.ResultA small amount of cells were seen to migrate from the aorta and adhered to the bottom of culture bottle 6 days after cultivation;the migrating cells spread to cover most part of the bottom of culture bottle 12-14 days later.About 70% of the migrated cells were in a confluent monolayer.The confluent cells grew rapidly after being digested with pancreatic enzyme,and they showed a typical cobblestone appearance.The cells were identified as endothelial cells with 100% expression of Ⅷ factor,which was regarded as the marker of endothelial cells.ConclusionThe method established in the present study is simple and easy to handle,it does not need collagen enzyme and endothelial cell growth promoting substrate,and it is economical and applicable.It is especially suitable for isolation and cultivation of vascular endothelial cells of vessels of small caliber.

Objective To evaluate the effect of temporal resolution of breast dynamic contrast-enhancing (DCE)-MRI on pharmacokinetic parameters and diagnostic performance in benign and malignant breast lesions.Methods Retrospective review was performed on 26 benign and 29 malignant breast lesions which were proven pathologically by surgery or biopsy.Dynamic contrast enhanced breast MRI using a new volume-interpolated-breath-hold examination sequence combining parallel acquisition, Dixon fat separation and time-resolved imaging with interleaved stochastic trajectories (CDT-VIBE) was performed in all patients.The original time resolution of this sequence was 12 s and based on which, dynamic sequences with different temporal resolutions of 24 s, 36 s, 48 s and 60 s were simulated by a sample-removing method and were used for the calculation of pharmacokinetic parameters, including volume transfer constant (Ktrans), constant flux rate (Kep), volume of extravascular extracellular space (Ve) and area under the curve at initial 60 s (iAUC), to observe their changes with different temporal resolution.The repeated measurement of analysis of variance was used to explore significant changes in pharmacokinetics parameters with different temporal resolution.To evaluate the diagnostic efficiency of parameters with different temporal resolution, ROC analysis was performed in accordance with pathological findings.Results With decrease of temporal resolution from 12 to 60 s, there was a significant increase in Ktrans and Kep of benign lesions [Ktrans: (0.147±0.084)/min to (0.170 ± 0.085)/min, Kep: (0.321± 0.176)/min to (0.433± 0.175)/min] and steady decrease in Ktrans and Kep of malignant lesions [Ktrans: (0.373±0.210)/min to (0.259± 0.122)/min, Kep: (0.929 ±0.402)/min to (0.581 ± 0.143)/min];the changes of Ve were less significant and irregular;the values of iAUC decreased both in benign [(9.192± 4.660) to (7.388± 3.065)] and malignant [(20.221±9.876) to (12.850±5.194)] lesions.The changes in all parameters with different time resolution were statistically significant in benign and malignant lesions (all P＜0.05).By pair-wise comparison between different time resolution, the changes of K among 12 s, 24 s and 36 s (all P＜0.05), the changes of Kep between 12 s and others (all P＜0.01), the changes of Ve between 24 s and others (all P＜0.01), and the changes among all pairs of iAUC were significant (all P＜0.05) except for 12 s and 24 s (P=1.000).The best AUC value of Ktrans and Kep between benign and malignant lesions were achieved with 12 s dynamic sequences (0.887, 0.939), and the best AUC value of iAUC was with 24 s sequences (0.877).The AUC values of Ve were between 0.511 to 0.601, which was lower than that of other three parameters.Conclusion A 24 s or higher temporal resolution of DCE-MRI should be able to provide consistent differentiation of pharmacokinetic parameters in benign and malignant breast lesions.