Objective To investigate the diagnosis and treatment for biliary papillomatosis. Methods 23 patients who were pathologically diagnosed as biliary papillomatosis and treated in our hospital from Jan. 2003 to Mar. 2008 were enrolled in this study. Their ages, genders, clinical manifestations, diagnostic approaches,histopathological findings, intraoperative findings, treatments and prognosis were analyzed retrospectively. Recal manifestations were abdominal pain (83.3%) and obstructive jaundice (72.2%). All the patients were diagnosed pathologically through intraoperative frozen section. No patient was diagnosed preoperatively. Anatomically, solitary lesion was observed in 10 patients (43.5%) and multiple lesions in 13 patients (56.5%), with a median tumor size of 2.6 cm. Microscopically, carcinomatous change was found in one patient, mild atypical hyperplasia in three, and medium atypical hyperplasia in one. Therapies mainly included radical excision and palliative external drainage. All but one patient recovered well postoperatively. This patient had anastomotic leak. All 23 patients were followed up with a mean period of 34 months. During the follow-up, three patients died as a consequence of biliary malignancy, one patient had the recurrence and others without recurrence. Conclusions Biliary papillomatosis is very difficult to diagnose preoperatively and the definitive diagnosis mainly depends on intraoperative and postoperative pathologic examination. To obtain a better prognosis, management should be aimed at radical excision. Intraoperative cholangioscopic evaluation and frozen section are strongly recommended to guide the choice of appropriate therapeutic approach.

Traditional Chinese medicine is the crystallization of civilization and wisdom of Chinese nation , in which the complex components exhibit unique advantages in anti-tumor therapy through multi-channel and multi-target.Through the summary of the litera-tures recently, the research on anti-tumor mechanism of traditional Chinese medicine was reviewed to provide reference for the deep re -search and clinical application of traditional Chinese medicine .

Objective:To study the preparation methods of N3-O-toluyl-flulorouracil (TFu) solid lipid nanoparticles(SLNs) and chitosan modified TFu SLNs. Methods: TFu-SLNs and chitosan modified TFu-SLNs were prepared by film dispersion-homogenization methods. The morphology, particle diameter and zeta potential were detected. The preparation methods were optimized by single factor experiments and an orthogonal design, and the stability of the nanoparticles was also studied. Results: The mean diameter of TFu-SLNs was 160. 2nm, and the zeta potential was -33. 2 mV. The mean diameter of chitosan modified TFu- SLNs was 400. 3nm, and the zeta potential was +12. 87 mV. With the concentration increase of chitosan, the zeta potential was enhanced. The optimized TFu-SLNs had higher reproducibility and stability. Conclusion:The formula of TFu-SLNs is optimized by an orthogonal design to obtain the optimal formula of TFu -SLNs and chitosan modified TFu-SLNs.

Objective To investigate the roles of theaflavins(TFs) in airway mucus hypersecretion induced by human neutrophil elastase(HNE). Methods Human lung adenocarcinoma cell A549 was stimulated by HNE for mucus hypersecretion,and TF monomers(TF1,TF2 and TF3) were used for intervention.The effects of TF monomers on viability of A549 cells were examined by MTT method.After the effective doses of TFs were determined,A549 cells were divided into 4 groups for experiment.In control group,A549 cells were cultured with serum-free medium.In HNE treatment group,A549 cells were treated with HNE(50 nmol/L) for 24 h.In TF monomer intervention groups,A549 cells were pre-treated with TF1,TF2 or TF3(50,100 or 200 ?g/mL) for 24 h,and were then treated with HNE for another 24 h.In AG1478 intervention group,A549 cells were pre-treated with AG1478(5 ?mol/L),an epidermal growth factor receptor blocker for 30 min,and were then treated with HNE for another 24 h.The changes in mucin(MUC) after treatment by different doses of TF1,TF2 and TF3,and by TF3(200 ?g/mL) for different time(12 h,24 h and 36 h) were detected.The changes in MUC5AC mRNA expression and MUC5AC protein expression were detected by RT-PCR and ELISA,respectively. Results The MUC5AC mRNA expression and protein expression in HNE treatment group were significantly higher than those in control group(P

Objective To study the MRI findings and di agnostic value as well as pathological base of the knee iniury.Methods MRI features of knee injuries in 31 cases were r etrospectively analysed compared with the findings of operations and clinical ma nifestations.Results MRI findings were :(1)para-knee articular soft tissue swelling in 23 cases(74%);(2)MRI detected ligaments injury in 18 cas es (58%),dislocation of articular in 2 cases(6%);(3)bone contusions in 4 c ases(13%);occult fractures in 1 case(3%),disruption of articular cartilage 1 case(3%),fractures in 12 cases(39%);(4)meniscal injury in 15 cases(48% ),meniscal cyst in 2 cases(6%);(5)quadriceps femoris and kneecap tendon inj ury in 1 case(3%)respectively;(6)joint hydrocele in 29 cases(93%).Conclusion MRI can find a variety of pathological changes of knee injury and plays an important role in clinical treatment and predicting prognosis.

The aim of this study is to identify the present status of the scientific and technological personnel in the field of traditional Chinese medicine (TCM) resource science. Based on the data from Chinese scientific research paper, an investigation regarding the number of the personnel, the distribution, their output of paper, their scientific research teams, high-yield authors and high-cited authors was conducted. The study covers seven subfields of traditional Chinese medicine identification, quality standard, Chinese medicine cultivation, harvest processing of TCM, market development and resource protection and resource management, as well as 82 widely used Chinese medicine species, such as Ginseng and Radix Astragali. One hundred and fifteen domain authority experts were selected based on the data of high-yield authors and high-cited authors. The database system platform "Skilled Scientific and Technological Personnel in the field of Traditional Chinese Medicine Resource Science-Chinese papers" was established. This platform successfully provided the retrieval result of the personnel, output of paper, and their core research team by input the study field, year, and Chinese medicine species. The investigation provides basic data of scientific and technological personnel in the field of traditional Chinese medicine resource science for administrative agencies and also evidence for the selection of scientific and technological personnel and construction of scientific research teams.
Bibliography of Medicine ; Biomedical Research ; manpower ; Databases, Factual ; Humans ; Laboratory Personnel ; Medicine, Chinese Traditional ; methods ; Plants, Medicinal ; chemistry ; growth & development

Objective To explore the abilities and personal qualities that medical undergraduates need for their future clinical work, and develop their competency model. Methods The self-made ques-tionnaire survey on medical undergraduates' competencies was conducted among the 1326 medical under-graduates in a medical university by using the cluster sampling method, and the 1099 effective question-naires were collected with effective rates of 82.88%. The exploratory factor analysis was used to analyze the internal structure of competency item and to build the competency model. The rating method was used to calculate the weight of each competency item. Results The overall Cronbach's alpha coefficient of the competency questionnaire was 0.965, and the coefficient of each dimension was above 0.832. The KMO statistic value was 0.970, and the probability associated with Bartlett test statistic was P=0.000, showing that the questionnaire has high reliability and validity. The competency model of medical undergraduates covers six aspects, namely, craftsmanship, personal qualities, professional learning, interpersonal communication, psychological adaptation and the pursuit of excellence, which contain 49 factors. The cumulative variance contribution rate was 54.729%. The weights of these six aspects in the model were 0.204 4, 0.202 1, 0.175 3, 0.158 8, 0.137 6 and 0.121 8 respectively. Conclusion The competency model of undergraduate medi-cal students has a certain scientific and practical value, which can provide new evaluation methods and ideas for medical education objectives, quality assurance, teaching evaluation, medical personnel selection and training.

ObjectiveTo evaluate the protective effect of Xuebijing injection against renal injury in patients with sepsis, and to explore its possible mechanism.Methods A prospective randomized controlled trial (RCT) was conducted in which 62 severe patients with sepsis and septic shock admitted in Department of Critical Care Medicine of Jiangsu Province Traditional Chinese Medicine Hospital from June 2013 to December 2013 were randomly divided into control group and Xuebijing group, with 31 patients in each group. The patients in both groups received basic treatment for sepsis, and the patients in Xuebijing group were additionally given intravenous injection of Xuebijing 100 mL once a day for 7 days. In both groups, the changes in acute physiology and chronic health evaluationⅡ (APACHEⅡ) score were observed before treatment and 1, 3, 7 days after treatment, and the changes in the levels of interleukins (IL-6, IL-10), prothrombin time (PT), fibrinogen (Fib), activated partial thromboplastin time (APTT), serum creatinine (SCr), and Cystain C (Cys C) were determined before treatment and 1 day and 3 days after treatment.Results There was no statistically significant difference in APACHEⅡ score before treatment between two groups, however, the APACHEⅡ scores were significantly decreased in both groups 3 days and 7 days after treatment compared with those before treatment, and the degree of decrease in Xuebijing group was more obvious 7 days after treatment (13.61±7.62 vs. 16.34±8.70,P< 0.05). Serum concentrations of Cys C, SCr, IL-6, IL-10, PT, APTT, and Fib showed no difference between two groups before treatment (allP> 0.05), while after treatment the degrees of improvement of above indexes in Xuebijing group were obviously superior to those in control group, especially 3 days after treatment[Cys C (mg/L):1.12±0.11 vs. 1.35±0.14, SCr (μmol/L): 115.0±31.0 vs. 135.0±24.0, IL-6 (ng/L): 54.27±28.79 vs. 73.35±31.01,PT (s): 13.50±0.11 vs. 15.71±0.11, APTT (s): 43.66±0.31 vs. 48.03±0.55, Fib (g/L): 1.91±0.51 vs. 1.51±0.52, P< 0.05 orP< 0.01].ConclusionXuebijing injection has certain renal protective effect in patients with sepsis, and its mechanism is possibly related to the regulation and improvement of uncontrolled inflammatory response and coagulation function in sepsis.

Objective To construct tissue engineering nucleus pulposus by culture of rabbit bone marrow mesenchymal stem cells (rBMSCs)-nucleus pulposus acellular matrix scaffold (NPAMS)complexes (rBMSCs-NPAMS).Methods Several NPAMS were prepared,and rBMSCs was seeded into NPAMS.The scaffolds and complex were detected by general observation,HE stai-ning,immunohistochemical,qRT-PCR,scanning electron microscopy.Results The scanning electron microscopy showed the seed cell in nucleus pulposus ECM-derived scaffold could adhesion and growth.The cell attachment and proliferation were observed by HE staining.Immunohistochemical examination with typeⅡ collagen showed positive results.qRT-PCR revealed the time-depend-ent of the mRNA expression of collagen Ⅱ,and which was smaller than positive control(P<0.01).The relative expression of Ag-grecan mRNA grew in a time dependent fashion,which was still lower than positive control(P<0.01).Scaffolds and normal nucle-us pulposus had no statistical significance of the compression load under the same displacement of the compression(P>0.05).Con-clusion Natural nucleus pulposus acellular matrix scaffold composite allogeneic bone marrow mesenchymal stem cells can be suc-cessfully built into tissue engineering nucleus pulposus.

Objective:To test curriculum management effect of graduate students'clinical practice of counseling psychology.Methods:Totally 26 students [average age (24.5 ± 1.0) years] who completed 30-day interns summer were investigated with the self-made questionnaire evaluating the quality of clinical practice.Results:All students obtained promotion in practice activities,the attendance ranged from 50.0％ to 96.2％.The overall satisfaction was (3.8 ± 0.8) and the average degree of supervisors'satisfaction was (4.0 ± 0.8).There were 92.3 ％ of the students had participated more than 224 hours' practice and completed all tasks.After the interns,the students had significantly improved in all 8 aspects of professional abilities.Conclusion:In graduate education of counseling psychology,curriculum management of clinical practice may be an effective approach to improve students' clinical skills.