Speeding up the training of quality personnel in clinical medicine is an important historic mission of clinicians. Practice has proven that the training, growth and maturity of quality clinical personnel are inseparable from clinical practice. Thus, firstly, clinical workers must, in accordance with the goals of training, rigorously enforce process management, including implementation of the training regulations, strict assessments, and cultivation of abilities in doing scientific research and writing up research papers. Secondly, the overall quality of postgraduates must be enhanced. Thirdly, files of postgraduates must be set up. Fourthly, experience in training academic degree postgraduates in clinical medicine should be constantly summed up, including ways of strengthening organization and control and clarifying goals and requirements

Through the research and practice of computer basic course at medical colleges, the paper summarizes the experience of using modern technical means, to reform the traditional teaching ideas, teaching methods, teaching means and teaching management, to diversify teaching resources sharing. It also analyzes the shortcomings and makes recommendations to further strengthen the course development.

Objective To investigate the causes, diagnosis and surgical treatment of ERCP related duodenal per﹣foration. Methods Clinical data of 6 cases of surgical treatment of ERCP related duodenal perforation were retro﹣spective analyzed. All the 6 perforation patients underwent emergency surgical procedure, including 3 cases trans﹣fered from other hospital after duodenal perforation. 4 cases with a history of abdominal surgery. Preoperative con﹣firmed bravery manager stone 4 cases, 1 case of obstructive jaundice after gallbladder surgery, bile duct expansion in 1 case. Results Perforation causes include duodenum mirror improper operation related in 2 cases, duodenal papilla sphincterotomy related 3 cases (1 case of pre-dissection operation with needle knife), small endoscopic sphincteroto﹣my combined with endoscopic papillary balloon dilation lead to perforation in 1 case.4 cases of intraoperative found right kidney week pneumatosis, 2 cases of postoperative CT found after peritoneal pneumatosis, effusion. All patients with surgery including common bile duct exploration, T tube drainage, duodenal perforation repair, jejunum colostomy, among them 2 cases at the same time line of gastrointestinal anastomosis. 5 cases recovered, 1 case died. Conclusions Inappropriate duodenal papilla sphincter incision indications and Many previous abdominal surgery have higher perforated ration;Found in time, reasonable treatment is the most important;For serious typeⅠand typeⅡperforation, active surgical treatment in time, can effectively reduce serious consequences caused by the ERCP related perforation.

Objective To explore the application value of plastic biliary stent and fully covered self-expandable metallic stent (FCSEMS) in endoscopic retrograde cholangio pancreatography (ERCP) for treatment of benign biliary stricture after liver transplantation.Methods The retrospective cross-sectional study was conducted.The clinical data of 54 patients with benign biliary stricture after liver transplantation undergoing ERCP treatment who were admitted to the First Affiliated Hospital of Xi'an Jiaotong University between January 2010 and August 2016 were collected.Among 54 patients,44 had simple anastomotic stricture and 10 had non-anastomotic stricture.All the patients underwent stent implantation by ERCP.Patients with stricture within 1 month postoperatively initially selected single plastic stent or endoscopic nasobiliary drainage (ENBD),and then changed into multiple plastic stents at the second stent replacement.Patients with stricture after 1 month postoperatively selected multiple plastic stents,multiple plastic stents after balloon dilation or FCSEMS.Observation indicators:ERCP situations,stent implantation,time of stent indwelling,postoperative complications,stent dislocation,treatment outcome and follow-up situations.Patients were followed up by outpatient examination and telephone interview up to November 2016.Clinical symptoms of patients were observed within 1 month postoperatively and liver function and abdominal ultrasound were retested.Liver function and remission degree of biliary stricture were monitored regularly once every 3 months.Measurement data were described as average (range).Results All the patients underwent successful ERCP,of which 53 completed the process of ERCP and 1 rejected treatment due to economic problems.All the 54 patients received 140 times ERCPs with an average of 2.59 times per person,21 times ENBDs,11 times FCSEMSs and 108 times plastic stent implantations (including 35 times single stent implantations,46 times double stents implantations,23 times 3-stents implantations and 4 times 4-stents implantations).All the 54 patients were followed up for 3-143 months,with an average time of 73 months.Of 44 with anastomotic stricture,34 received plastic stent implantation and 98 times ERCPs,with an average number of stent implantation of 2 (range,1-4) and an average time of stent indwelling of 10.7 months (range,9.0-13.0months);the postoperative acute pancreatitis,biliary infection,hyperamylasemia and adverse stent implantation or dislocation were detected in 4 persons every time,7 persons every time,10 persons every time and 3 persons every time,respectively;26 patients were cured and 5 were improved,with an effective rate of 91.2％ (31/34);3 patients with noneffective treatment continued to undergo ERCP and 3 patients had recurrence of anastomotic stricture.Among 10 patients with initial FCSEMS implantation,12 times ERCPs were performed,with an average time of stent indwelling of 7.6 months (range,6.0-12.0 months);postoperative biliary infection,hyperamylasemia and stent dislocation were detected in 1 person every time,1 person every time and 1 person every time,respectively;8 patients were cured,with an effective rate of 8/10;of 2 patients with persistent stricture,1 patient received contrast examination after stent removal,showing a comparative stricture in level 1 branch of intrahepatic duct and considering combined ischaemia,and then underwent the second implantation using multiple plastic stents;the other patient had elevated level of jaundice at 3 months after stents removal and received ERCP,showing anastomotic inflammatory polyp,and then underwent FCSEMS implantation again.Ten patients with non-anastomotic stricture received plastic stent implantation and 30 times ERCPs,with an average number of stent implantation of 3 (range,2-4) and an average time of stent indwelling of 11.3 months (range,10.0-14.0 months);the postoperative acute pancreatitis,biliary infection,hyperamylasemia and adverse stent implantation or dislocation were detected in 2 persons every time,5 persons every time,2 persons every time and 1 person every time,respectively;3 patients were cured and 3 were improved,with an effective rate of 6/10;of 4 patients with noneffective treatment,2 died of gradually deteriorating liver function and 2 underwent the second liver transplantation.Conclusions Stent implantation in ERCP is safe and effective for treatment of benign biliary stricture after liver transplantation,single plastic stent should be used in the early period (within 1 month) and multiple plastic stents should be used in the later period.Although FCSEMS has a higher displacement rate,it should be recommended due to a better clinical effect,lower incidence of complications and simple operation.For patients with non-anastomotic stricture,plastic stent should be used for extrahepatic biliary stricture,with a good clinical effect,and there is worse effect in stent implantation through ERCP for multiple intrahepatic biliary strictures.

The aim of the present study is to investigate the effects of sequoyitol (Seq) on expression of eNOS and NOX4 in aortas of type 2 diabetic rats. Type 2 diabetic rats induced by high fat and high sugar diet and low dose of streptozotocin (STZ, 35 mg x kg(-1)) and were administered Seq (12.5, 25 and 50 mg x kg(-1) x d(-1)) for 6 weeks. The fasting blood glucose (FBG) and body weight were tested. Acetylcholine (Ach) induced endothelium-dependent relaxation and sodium nitroprusside (SNP) induced endothelium-independent relaxation were measured in aortas for estimating endothelial function. Aortic morphological change was observed with HE staining. The level of serum insulin was measured by radioimmunoassay. The total antioxidative capacity (T-AOC), malondialdehyde (MDA) and NO levels in aortas were determined according to the manufacturer's instructions. In addition, the expressions of eNOS and NOX4 in aortas were measured by immunohistochemisty, real-time PCR or Western blotting. The results showed that Seq significantly decreased FBG and insulin resistance, and improved aortic endothelium-dependent vasorelaxation function. The expressions of NOX4 and MDA content were obviously decreased, while the expression of eNOS, the levels of NO and T-AOC increased significantly in aortas of diabetic rats with Seq treatment. In conclusion, Seq protects against aortic endothelial dysfunction of type 2 diabetic rats through down-regulating expression of NOX4 and up-regulating eNOS expression.
Animals ; Aorta ; metabolism ; pathology ; Blood Glucose ; metabolism ; Body Weight ; Diabetes Mellitus, Experimental ; chemically induced ; metabolism ; physiopathology ; Diabetes Mellitus, Type 2 ; chemically induced ; metabolism ; physiopathology ; Hypoglycemic Agents ; pharmacology ; Inositol ; analogs & derivatives ; pharmacology ; Insulin ; blood ; Insulin Resistance ; Male ; Malondialdehyde ; metabolism ; NADPH Oxidase 4 ; NADPH Oxidases ; metabolism ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase Type III ; metabolism ; Oxidation-Reduction ; drug effects ; Rats ; Rats, Sprague-Dawley ; Streptozocin ; Vasodilation ; drug effects

OBJECTIVETo investigate the protective effect and mechanism of sequoyitol (Sep) on high glucose-induced human umbilical vein endothelial cells (HUVECs) injury.

METHODSHUVECs were cultured with high glucose (30 mmol/L) in the presence or absence of sequoyitol (0.1, 1 and 10 micromol/L) for 24 h. Cell proliferation was measured by BrdU marking and cell cycle was detected by flow cytometry. 2', 7'-dichlorofluorescein diacetate was used to evaluate intracellular reactive oxygen species (ROS) levels. The NO, malonydialdehyde (MDA) and H2O2 levels were determined by colorimetric method according to the manufacturer's instructions. The expression of endothelial nitric oxide synthase (eNOS) and NADPH oxidase 4 (NOX4) were measured by real-time PCR and Western blot.

RESULTSIn the present study, we found that sequoyitol pretreatment for 1 h significantly decreased cell injury, promoted cell proliferation. Meanwhile sequoyitol significantly down-regulated NOX4 expression and decreased the level of ROS, MDA and H2O2 and obviously increased NO levels and up-regulated eNOS expression.

CONCLUSIONSequoyitol alleviates high glucose-induced cell injuries in HUVECs via inhibiting oxidative stress and up-regulating eNOS expression.

Cell Proliferation ; Cells, Cultured ; Glucose ; toxicity ; Human Umbilical Vein Endothelial Cells ; drug effects ; metabolism ; Humans ; Hydrogen Peroxide ; metabolism ; Inositol ; analogs & derivatives ; pharmacology ; Malondialdehyde ; metabolism ; NADPH Oxidase 4 ; NADPH Oxidases ; metabolism ; Nitric Oxide Synthase Type III ; metabolism ; Oxidative Stress ; Reactive Oxygen Species ; metabolism

Adenocarcinoma ; metabolism ; secondary ; surgery ; Carcinoembryonic Antigen ; metabolism ; Carcinoma, Hepatocellular ; metabolism ; secondary ; surgery ; Colectomy ; Colonic Neoplasms ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Humans ; Keratin-18 ; metabolism ; Liver Neoplasms ; metabolism ; secondary ; surgery ; Male ; Middle Aged ; alpha-Fetoproteins ; metabolism

Background and purpose:Nowadays, about therapy of laryngeal carcinoma, people are paying more and more widely attention to ifnding out how to improve quality of patients’ life besides radical surgery. For glottic laryngeal carcinoma which invading anterior commissure or bilateral vocal cord, we performed modiifed frontolateral partial laryngectomy or modiifed cricohyoidoepiglottopexy, and contrastive analyzed the therapeutic efifcacy of the two ways. Methods:Sixty cases patients of glottic laryngeal carcinoma who treated in Hunan Provincial Tumor Hospital during 2005 to 2010, which invaded the anterior commissure or bilateral vocal cord, were randomly attributed to two groups as A and B;30 patients of group A were underwent modiifed frontolateral partial laryngectomy and repaired with bilateral sternohyoid muscle lfap, 30 patients of group B were treated by modiifed cricohyoidoepiglottopexy. Follow-up time of each patient was 5 years postoperation and clinical data were retrospectively analyzed. Results:The 5-year survival rate was 86.7%in group A as well as 83.3%in group B, and there was no statistical difference between two groups (P=0.718). Pronunciation function:22 cases in group A and 21 cases in group B whose pronunciation function can be competent in the noisy environment, and can pronounce“a”and“i”vowel;8 cases in group A and 9 cases in group B can pronounce only a“ha”,“hi”sound, that couldn’t communicate with others in a noisy environment. There was no statistical difference in pronunciation function between the two groups (P=0.774). Incidence of deglutition disorder 4 weeks postoperation:group A was 0 (0/30), group B was 16.7%(5/30), and the difference between the two groups was statistically signiifcant (P=0.026);average time of extubation postoperation:group A was (10±2.3) d, group B was (20±4.6)d, and the difference between the two groups was statistically signiifcant (P=0.0000);recurrence rate of dyspnea after extubation:group A was 16.7%(5/30), group B was 0 (0/30), and there was statistically signiifcant difference between the two groups (P=0.026). Conclusion: For the glottic laryngeal carcinoma which invading anterior commissure or bilateral vocal cord, there was no statistical difference in 5-years survival rate and function of pronunciation between modified frontolateral partial laryngenctomy and modified cricohyoidoepiglottopexy postoperation. The former had less postoperative deglution disorder, earlier extubation time, and to some extent, alleviated the suffering of the patients, but part of these patients needed secondary surgery due to dyspnea which resulted by radioactive tissue adhesion after extubation. The latter had more serious deglution disorder postoperation, longer recovery time, and relatively longer time to extubating, showed no again dyspnea after extubation, and had more extensive adaptation disease. In a word, each way of operation has its advantage respectively.

Objective To investigate the clinical effect of QianlieShutong capsule in combination with tamsulosin in the treatment of benign prostatic hyperplasia ( BPH) and its effects on serum testosterone and estrogen.Methods 114 cases of BPH were randomly divided into control group (n=54) and observation group (n=60).The control group were treated with tamsulosin, while the observation group were treated with QianlieShutong capsule in combination with tamsulosin.Then, the curative efficacy, improvement of related indexes, level of serum testosterone, estrogen and adverse reactions were compared.Results The observation group had a total therapeutic efficacy ratio of 95.0%, which was statistically higher than that of 83.3% in control group (P<0.05).In comparison with control group after the treatment, international prostate symptom score (IPSS), residual urine (Ru), prostate volume (PV) in observation group statistically decreased, and maximum flow rate (Qmax), level of estrogen increased (all P<0.05), while level of testosterone in two groups was statistically same.During the treatment, there’ s no case of severe adverse reaction.And the incidence of adverse reactions in the observation group was 13.3%, which was statistically same with that of 11.1% in control group.Conclusion Combined treatment of QianlieShutong capsule and tamsulosin is effective for BPH, which can significantly increase curative efficacy, improve related indexes and regulate level of sexual hormone with minor adverse reactions.

A new embedded telemetry system for potentiometric sensors was developed. The system consisted of a transmitter unit, a receiver unit and a personal computer ( PC) . The transmitter unit included a current amplifier, a∑-Δanalog-to-digital converter ( ADC) , a microcontroller unit ( MCU) and a radio module. The receiver unit was composed of a radio module, a microcontroller unit and a serial-to-USB converter module. The receiver unit was connected to an upper computer via a universal serial bus ( USB ) . The embedded software written in C language controlled the signal acquisition and transmission. The computer software written in LabVIEW language was used for data storage and display. The range of the acquisition voltages was from-1. 17 V to +1. 17 V. In order to verify the accuracy and reliability of this system, a control experiment had been done with this system and a digital multimeter. Moreover, a response test of acidity changes had been done with the self-made H+ selective electrode. The results showed that the accuracy of this system could be up to 0. 1 mV and it had strong anti-noise ability. The square of the linear correlation coefficient of the response of the changes in pH values was 0 . 998 . The curve of the results measured by this system was consistent with that measured by the commercial electrochemical analyzer. The system was built with standard hardware components and the size of the transmitter unit was only 29 mm×14 mm×11 mm. It can be easily used for remote and real-time detection for the potentiometric sensor.