Objective:To investigate the pediatricians' needs in the contents of continuing medical education (CME), and the influencing factors of participating in CME, so as to provide references for improving their vocational ability.Methods:Questionnaire survey was carried out for the pediatricians from county-level medical institutions in the nine provinces of China. The questionnaire contents included: basic information, CME contents needs, and influencing factors of participating in CME. SPSS 22.0 was used for chi-square test.Results:A total of 465 questionnaires was recovered, among which 463 were qualified, with a pass rate of 99.6%. Research showed that ① In terms of competency training needs, pediatricians had higher training demand for ability of diagnosis and treatment of children's diseases, pediatrics basic skills and skills related to children's health care, etc. Pediatricians with junior or intermediate title had higher training demand for ability of self-learning and access to learning resources ( P < 0.01); and pediatricians with senior title had higher training demand for teaching ability ( P < 0.05). ② In terms of pediatrics specialty content training needs, pediatricians had higher demand for neonatology, infectious, respiratory, critical medicine, developmental behavior and digestion in order. ③ Regarding the influencing factors of CME, too few opportunities to participate in training, too busy to have time to participate, and defects in curriculum arrangement were the main factors affecting the CME participation of pediatricians. Conclusion:Pediatricians with different professional title had different training needs for CME contents. Lack of CME resources, contradiction between work and study, and curriculum arrangement deficiencies might be the main influencing factors affecting the CME participation of pediatricians working at county-level medical institutions.

OBJECTIVETo explore the effect of 3-n-butylphthalide pretreatment on the delayed neuronal death(DND) and the expreesion of heat shock protein70 (HSP70) in rat hippocampus after ischemia/ reperfusion.

METHODSAll rats were randomly divided into sham group (n = 36), total cerebral ischemia (TCI) group (n = 36), butylphthalide (NBP) group (n = 6), NBP + TCI group( n = 36), quercetin + NBP + TCI group (n = 6), dimethyl sulfoxide (DMSO) + NBP + TCI group (n = 6). The model of total cerebral ischemia/reperfusion was established by blocking vertebral arteries and carotid arteries. In sham group, TCI group and NBP group, the animals were further divided into instantly, 6 h, 12 h, 1 d, 3 d, 5 d groups according to the time interval after sham operation or TCI. Histological changes of the hippocampus were evaluated using thionin staining under light microscope by determining the delayed neuronal death (DND) and the expression of HSP70 was assayed using immunohistochemistry.

RESULTSNBP pretreatment could reduce delayed neuronal death in CA1 of hippocampus induced by TCI-reperfusion injury in rats, and up-regulated the expression of HSP70 in CA1 hippocampus of brain ischemic/reperfusion for 5 days. Quercetin blocked the acquirement of the brain ischemic tolerance induced by NBP preconditioning.

CONCLUSION3-n-butylphthalide (NBP) prevents the neurons from ischemia/reperfusion injury through upregulating the expression of HSP70.

Animals ; Benzofurans ; pharmacology ; CA1 Region, Hippocampal ; cytology ; pathology ; Cell Death ; Cerebral Infarction ; drug therapy ; HSP70 Heat-Shock Proteins ; metabolism ; Ischemic Preconditioning ; Neurons ; cytology ; Rats ; Rats, Wistar ; Reperfusion Injury ; drug therapy

Transforming growth factor-β is an important cytokine with various bioactivities, including embryonic development, wound healing, chemotaxis and cell cycle regulation. Epithelial-mesenchymal transition (EMT) is the main pathway of tumor cell to obtain the ability of invasion and metastasis. The TGF-β is the key factor known to induce EMT in cancer cells and plays an important role in the process. In recent years, some progress has been obtained. Some TGF-β inhibitors have approved in the market or in clinical trials. TGF-β inhibitors can play an important role on the treatment of tumors, glaucoma, liver and kidney fibrosis disease and scar repair. Novel TGF-β inhibitors reported in recent years were reviewed in this article.
Epithelial-Mesenchymal Transition ; Humans ; Neoplasms ; Transforming Growth Factor beta ; antagonists & inhibitors ; Wound Healing

Objective EpCam and Wnt/ β-catenin pathway in colon carcinoma and its clinic-pathological significance of the distribution,studying the relationship between EpCam and Wnt / β-catenin.Methods Retrospective analysis detected by immunohistochemistry 60 cases of colon cancer,20 cases of adjacent atypical hyperplasia,60 normal colon tissue EpCam and Wnt / β-catenin protein expression.Results (1)normal colon tissue,cancer tissue and cancer tissue showed positive expression EpCam clear upward trend,were 23.5％,62.3％,96.5％ ; with normal colonic mucosa to cancer transformation,β-catenin in the membrane expression of the positive rate decreased,while the cytoplasm is followed by increased expression rate in poorly differentiated carcinoma or even nuclear expression,EpCam strong positive expression of Wnt / β-catenin cytoplasmic-positive rate of histological type,depth of invasion,lymph node metastasis; (2)the EpCam with the Wnt / β-catenin expression showed a positive correlation (r =0.653,P ＜0.05) ;(3)high expression EpCam and Wnt / β-catenin in patients with colon significant increase in cancer recurrence rate and 5-year survival rate was significantly reduced.Conclusion EpCam and Wnt / β-catenin pathway in colon cancer positively is correlated,EpCam and Wnt / β-catenin is connected with high expression and tumor invasion,metastasis and prognosis.

Objective To prove the advantages of telemetry by comparing with the traditional methods in safety pharmacology.Methods To monitor continuously the heart rate, respiratory rate, blood pressure and ECG of Beagle dogs by traditional and telemetry methods respectively, analyze and compare the changes between anesthetized and conscious dogs before and after feeding.Results Maintenance of anesthesia changed significantly the heart rate, respiratory rate, blood pressure and QT interval in the ECG of animals.The changes of physiological indicators in 24 h is not obvious in conscious animals, and showed a certain biorhythm.Compared with the conscious animals, the anesthetized dogs’ heart rate was significantly higher, blood pressure increased significantly, QRS and QTcf interval prolonged significantly, respiratory frequency decreased, heart rate increased significantly after feeding, and QTcf interval extended very significantly.Conclusions Traditional methods in safety pharmacology affect animal physiological indicators such as heart rate, blood pressure, respiratory rate and QT interval, which affect the objectivity of drug evaluation.Using conscious animals by telemetry can reduce these errors, however, the interference from outside should be eliminated.

Objective:To identify the tannin-related constituents in the extracts of pomegranate peel by HPLC-ESI-MS. Methods:The separation was performed on a Kromasil C18 column (250 mm × 4. 6 mm,5 μm) with the mobile phase of water and acetonitrile. The flow rate was maintained at 1. 0 ml·min-1 and the detection wavelength was set at 256nm. The samples were analyzed in negative modes. Results:Five tannin-related constituents including gallic acid, punicalin,punicalagin,corilagin and ellagic acid were identified from the extracts of pomegranate peel. Conclusion:The new method is accurate and rapid. It can be used to identify the tannin-related constituents in pomegranate peel and provide new ideas for the research of active components in traditional Chinese medicine as well.

Objective To observe the feasibility and safety of dexmedetomidine used in motor evoked potentials(MEP)monitoring in patients undergoing neurosurgery.Methods Thirty ASA Ⅰ orⅡ patients,male 1 5 cases,female 1 5 cases,aged 20-60 years,weighing 40-80 kg undergoing neuro-surgery receiving MEP monitoring were randomly divided into 2 groups (n =1 5 each):control group (group C)and dexmedetomidine group (group D).In group D,dexmedetomidine 0.5 μg/kg was in-fused over 10 minutes before anesthesia induction,and then was infused at a rate of 0.5 μg·kg-1 · h-1 toward the end of operation.Group C received the equal volume of normal saline.HR,MAP and BIS were recorded at admission to the operating room (T0 ),skin incision (T1 ),when the muscle re-laxants were stopped (T2 )and 50 minutes later (T3 ).The current intensity and the time when first MEP was induced after muscle relaxant was stopped,the amplitudes and latencies of MEP on thenar muscle at T3 ,the total consumption of anesthetics,and development of adverse effects were also re-corded.Results Compared with T0 ,HR in group C at T1 ,T3 and MAP in group C at T1-T3 was in-creased,HR in group D was decreased at T2-T3 (P <0.05).Compared with group C,HR and MAP were decreased at T1-T3 in group D(P <0.05).The amount of propofol consumed and the current in-tensity inducing MEP were lower in group D than in group C (P <0.05).The amplitude of MEP at T3 was higher in group D than in group C (P <0.05).Compared with group C,the incidences of hy-pertension and tachycardia were decreased in group D,and the incidence of bradycardia was increased (P <0.05).Conclusion Dexmedetomidine used in MEP monitoring in patients undergoing neurosur-gery can meet the operation requirements,maintain hemodynamic stability,reduce the incidences of adverse reactions,and improve monitoring quality of MEP.It is a safe and feasible anesthesia method.

Objective To discuss the influence of the progress and result in gastic cancer operation through application of neo-adjuvant chemotherapy in multi-disciplinary team (MDT).Methods Clinical data of the patients treated in MDT model 45 cases and non-MDT model(78 cases) were respectively analyzed,and the index about pathologic change,histologic transform and operative result between the two groups were compared.Results In the index of pathologic change,the incidence of abdominal adherence and ascites and pyloric obstruction in MDT model group were obviously less than non-MDT model group( P ＜0.05 ).In the index of histologic transform,texture of mesentery in MDT model group was more fragile than non-MDT model group( P ＜0.05).In the index of operative results,the operative duration and intra-operative bleeding in MDT model group were less than non-MDT model group (P ＜0.05).Conclusion Neo-adjuvant chemotherapy has certain influence in gastric caneer operation,but the successful operations were performed by standard and correct procedures.Therefore,optimizing combined therapy in MDT model and constructing preoperative evaluation system with neo-adjuvant chemotherapy.

Objective To investigate the expressions and clinical pathological significance of EpCAM and the β-catenin pathway in colon cancer,and the correlation between EpCAM andβ-catenin.Methods Immunohistochemistry was used to detecte the expressions of EpCAM and β-catenin proteins in colon cancer tissues and corresponding adjacent tissues of 70 cases of colon cancer patients,the clinical and pathological features of colon cancer and their relationship were retrospective analyzed.Results ①EpCAM and β-catenin protein expressions in colon cancer tissue was 52 cases (74.3％) and 55 (78.6％) positive respectively; EpCAM and β-catenin proteins in cancer adjacent tissues in 13 cases( 15.7％ ) and 9 cases ( 12.9％ ) were positive,the differences were statistically significant.②the EpCAM expression is positively correlated with the β-catenin expression ( r =0.616,P ＜ 0.01 ).③The expressions of EpCAM and β-catenin correlated with the tumor differentiation,invasion depth,lymph node metastasis and TNM staging related ( P ＜ 0.05).Conclusion EpCAM and β-catenin pathways in colon cancer positively correlate,and closely correlate with colon cancer.The expression level of EpCAM and β-catenin can be used as a reference for the colon disease course and healing.

Objective To explore the effects of lamotrigine on the cognitive function and the quality of life in epilepsy patients.Methods This was a prospective study and 91 newly diagnosed epilepsy patients were enrolled.The neuropsychological tests score and the quality of life in epilepsy inventory(QOLIE-31) were obtained before and after the treatment with lamotrigine.A battery of neuropsychological tests comprised the auditory verbal learning test(AVLT), the logical memory test(LMT), the digital symbol test(DST), the stroop color word test(SCWT), the trail making test(TMT), the verbal fluency test(VFT), the WAIS block design test(WBDT), the WAIS digital span test(WDST)and the Boston naming test(BNT). Results The repeated assessments in the patients taking lamotrigine were associated with significant improvements in many domains.The greatest changes were observed in the immediate and delayed recall of AVLT, DST, the time consuming of SCWT card C and TMT test A and B, the immediate and delayed recall of LMT, VFT, WBDT and BNT.For the quality of life, significant improvements were recorded in the fields of the seizure worry(38.81?16.06 vs 45.68?15.18), the overall quality of life(59.12?13.50 vs 64.99?13.33), the social function(64.59?25.14 vs 69.41?22.70)and the self-health evaluation (71.18?13.73 vs 76.75?11.30).Conclusion Improvements of the cognitive function and the quality of life can be observed in the initial period of medication with lamotrigine in epilepsy patients.