Objective:In order to improve the quality of standardized residency training in a tertiary hospital in Beijing, and to establish a multi-dimensional evaluation system based on post competency and professional accomplishment.Methods:The residents trained in our hospital were evaluated by questionnaires sent by third parties from the five aspects of evaluation by patients, peers, nurses, superiors and themselves. In this paper, SPSS 24.0 software was used to analyze the reliability and validity of the multidimensional evaluation scale. The evaluation results were analyzed by ANOVA and Pearson correlation analysis.Results:The hospital met the requirements for the post competency and professional accomplishment of the residents, and the overall level was good. However, the teamwork ability of some residents, especially the medical communication still needs to be improved.Conclusion:This study has enabled residents to pay more attention to the development of daily post competencies and professional accomplishment behaviors. It has provided an example basis for the further development of standardized residency training in the hospital, and carried out preliminary exploration for the design of training modules.

Objective To investigate the effects of nerve growth factor (NGF) on the expression of 67-kDa laminin receptor (67LR) in human bile duct carcinoma QBC939 cells, and study the possible mechanism of perineural invasion and metastasis of bile duct carcinoma. Methods ( 1 ) The expression of a high-affinity receptor for NGF, TrkA, was detected by immunofluorescence staining. ( 2 ) QBC393 cells were pretreated by β-NGF at different concentrations ( 1, 10, 100,200 μg/L), and then the mRNA and protein expressions of 67LR were examined by Real-Time PCR and Western blot assay. QBC939 cells were divided into control group and β-NGF (1, 10, 100,200 μg/L) groups. (3) The ideal concentration of β-NGF was selected according to the results of previous tests, and then the mRNA and protein expressions of 67LR were re-examined by adding specific TrkA inhibitor K252a at different concentrations ( 100,200,300 nmol/L). QBC939 cells were divided into control group, β-NGF 100 μg/L group and K252a ( 100,200,300 nmol/L) groups. All data were analyzed by one-way analysis of variance or LSD-test. Results (1) A strong expression of TrkA was detected in the membrane of QBC939 cells. (2) The mRNA and protein expressions of 67LR in QBC939 cells were 0.35 ± 0.06 and 0. 32 ± 0.05 in the control group, 0.38 ±0.14 and 0.50 ±0.09 in the β-NGF 1 μg/L group, 0.62 ±0.14 and 0. 69 ±0. 13 in β-NGF 10 μg/L group, 0.90 ± 0.08 and 0.93 ± 0.07 in the β-NGF 100 μg/L group, and 0. 70 ± 0. 10 and 0. 76 ±0.07 in the β-NGF 200 μg/L group, there were significant differences among the five groups (F = 22. 4, 14. 6,P ＜0.05). The mRNA and protein expressions of 67LR in the β-NGF 100 μg/L group were significantly higher than those in the control group ( t = 19. 0, 21.0, P ＜ 0. 05 ). (3) The mRNA and protein expressions of 67LR in the QBC939 cells were 0.35 ±0.10 and 0.41 ±0.10 in the control group, 0. 88 ±0. 14 and 0.84 ±0.10 in the β-NGF 100 μg/L group, 0.80±0.08 and 0.76 ±0.04 in the K252a 100 nmol/L group, 0.67 ±0.12 and 0.61 ± 0.09 in the K252a 200 nmol/L group, and 0. 43 ± 0.07 and 0. 50 ± 0. 12 in the K252a 300 nmol/L group, there were significant differences among the five groups ( F = 14. 1, 8. 9, P ＜ 0.05 ). There were no significant differences in the mRNA and protein expressions of 67LR between the K252a 300 nmol/L group and the control group (t =1.02, 0. 85, P＞0.05). Conclusion In bile duct carcinoma cells, NGF enhances the expression of 67LR by combining with TrkA, which might be the mechanism of NGF mediating perineural invasion of bile duct carcinoma.

Objective To understand the characteristics of complications occurred after endoscopic thyroidectomy and its prevention and treatment.Methods Retrospective analysis on the clinical effects and complications of 105 cases of endoscopic thyroidectomy.ResultsThe average operative time was 85 minutes in the 105 cases.Five cases were transferred to open operation because of bleeding and 11 cases transferred for the intraoperative pathology of papillary carcinoma.After operation,subcutaneous ecchymosis occurred in 5 patients,subcutaneous emphysema in 10 cases,neck and anterior chest skin tautness and discomfort in 7 cases,parathyroid injury in 2 cases.No superior laryngeal nerve or recurrent laryngeal nerve injury was found in the 105 cases.ConclusionUnder strict control on operation indications,proficient and meticulous endoscope operative skills,familiarization with the anatomical structure of thyroid,and timely and proper treatment on postoperative complications can reduce and prevent the occurrence of complications.

AIM:To determine the right ventricular angiotensin converting enzyme2 (ACE2) activity in adult SD rats under normoxia and hypoxia environment,and to detect the relationship between ACE2 and high altitude heart disease initially. METHODS:Adult male Sprague Dawley (SD) rats were raised under hypoxia environment simulated to high altitude (5 000 m,23 h/d),then divided into hypoxia 1 d,15 d and 30 d groups randomly. The control group was set up under normoxia environment. The right ventricular function,ponderal index,pulmonary artery pressure and right ventricular ACE2 activity were determined. The effect of captopril or nitrendpine on cardiac ACE2 activity in hypoxia 30 d group was also observed. RESULTS:The dramatic up-regulation of cardiac ACE2 expression of mRNA and protein and its activity in hypoxia 30 d group was observed,together with obvious increase in right ventricular function,ponderal index and pulmonary artery pressure. Although captopril or nitrendipine depressed pulmonary artery pressure and cardiac function dramatically,no significant alteration of right ventricular ACE2 activity was detected. CONCLUSION:Chronic hypoxic exposure promotes the ACE2 expression and activity in right ventricular,indicating that ACE2 may be correlated to the changes of cardiac architecture and function induced by hypoxia. Up-regulation of ACE2 expression maybe contribute to the increase in right ventricular ACE2 activity,and pulmonary artery hypertension may not be the main reason for the changes of ACE2 activity under hypoxia environment.

Objective To investigate the contents of dioxane in shampoo and bath lotion type of cosmetics. Methods Headspace gas_chromatography was applied to determine the concentration of dioxane in cosmetics. Results Significant differences were observed between 122 national products of shampoo with a detectable rate of 63.9% and a value of P95 of dioxane concentration of 173.4 ?g/g and 64 imported and joint_venture products of shampoo with a detectable rate of 56.2% and a value of P95 of dioxane concentrations of 34.68 ?g/g (P

OBJECTIVE:To establish the method for the determination of pemetrexed disodium in human plasma. METHODS:The plasma sample was determined by HPLC after protein were precipitated with strong acid. The determination was performed on Xterra?RP 18 column with mobile phase consisted of acetonitrile-50 mmol/L sodium dihydrogen phosphate buffer solution(15∶85) at the flow rate of 1.2 ml/min. The detection wavelength was set at 225 nm. RESULTS:The linear range of pemetrexed disodium were 1.0-32.0 mg/L (r=0.999 9,n=5) with recoveries of 86.35%-87.25%. RSDs of inter-day and intra-day were lower than 4.21%(n=5). Minimum detection concentration of plasma was 0.05 mg/L. The patients with high plasma concentration easily suf-fered from arrest of bone marrow. The plasma concentration was(18.56±4.50)mg/L,which could induce ADR;when the plasma concentration was (14.05 ± 6.72) mg/L,no ADR was found. There was statistical significance after t-test (P<0.05). CONCLU-SIONS:The method is simple,quick,accurate,sensitive and suitable for the plasma concentration determination of pemetrexed di-sodium and human pharmacokinetics study.

Objective To study the effect of tumor necrosis factor(TNF) and endothelin(ET) on the formation of murine hyperdynamic circulatory syndrome(HCS).Methods Circulation stable HCS model was produced in rats by partial portal vein ligation.Portal blood TNF and ET was determined pre and post injection of anti rat TNF and hemodynamics was monitored simultaneously.Results TNF level did not change 0 5 hour after partial portal vein ligation,but it increased significantly at 24 hour and maintained at this high level thereafter. ET was on a small increment at different time after partial portal vein ligation.The TNF level decreased significantly to the level in controls and ET remained unchanged after injection of anti rat TNF,while HCS was partially ameliorated. Conclusion [WT5”BZ] TNF may be related with the start and maintenance of HCS,and there is no causality between ET and the development of HCS.

A model of vascular smooth muscle cell proliferation was estabolished by balloon angioplas-ty in rat's aorta. We found that treatment with batroxobin decreased plasma fibrinogen level after angio-plasty, and inhibited the increase in smooth muscle cell count of injured vascular wall and incorporation rate of H-TdR into vascular tissues effectively. The results suggest that batroxobin may have clinically prospective significance in prevention and therapy of angioplasty-induced restenosis.

Objective To explore the effect of abortion, effect of Yunnan Baiyao Combined with Wujia Shenghua capsule in patients with medical abortion vaginal bleeding time.MethodsSelect 98 cases from March 2014 to May 2016 by drug abortion in second hospital of shandong university, were randomly divided into combined group and control group with 49 cases in each group, two groups were given routine drug treatment, combined group was given Yunnan Baiyao combined with Wujia Shenghua capsule, comparing the two groups of patients with abortion, vaginal bleeding time.ResultsCombined group and control group differences in the complete abortion rate was not statistically significant, combinde group of pregnant sac discharge time is shorter than the control group (P<0.05);combined group with the duration of vaginal bleeding, vaginal bleeding and vaginal bleeding in 7~14 days>14 days the percentage of patients were lower than those in control group (P<0.05);combinde group of vaginal bleeding (16.33%), the amount of menstrual and menstrual amount (59.18%), > menstruation (24.49%) and the control group (12.24%, 38.78%, 46.94%) with significant difference (P<0.05);combined group of menses time, menstrual duration compared with the control group, the difference was not statistically meaning.ConclusionYunnan Baiyao combined with Wujia Shenghua capsule can accelerate the gestational sac discharge, shorten the time of vaginal bleeding, reduce the amount of vaginal bleeding.

AIM: To compare the clinical effect of Tianshu Capsule(Rhizoma Chuanxiong,Rhizoma Gastrodiae,efc) on migraine with Flunarizine. METHODS: 82 cases of patients with migraine were divided randomly into the treatment group(40 cases),which were treated with oral Tianshu Capsule,4 capsules(1.36 g),3 times daily after meals,and the control group(42 cases),which were treated with Flunarizine(Sibelium) 5 mg quaque nocte,for 2 months.One year follow-up was carried out.The frquency and duration of migraine were analyged before and after treatment,and duration of positive results after withdraw of drugs were also recorded.The body weight,blood and urine routine,liver and kidney function as well as electrocardiograph were compared before and after treatment. RESULTS: In the treatment group the frequency and duration of migraine decreased more than that of control group.The positive results remained longer in the Tianshu Capsule group(P