9β,11β-Epoxypregn-4-ene-17α,21-diol-3,20-dione 21-acetate (Ⅰ) is a substrate for the production of 9β,11β-Epoxypregn-1,4-diene-17α,21-diol-3,20-dione (Ⅳ),which is a key precursor for the production of many 9-fluoro-substituted corticosteroid hormones.By comparing whole cells catalysis and cellular lysates conversion,it was found that whole cells of Mycobacterium sp.MS136 could only convert Ⅰ to 9β,11β-Epoxypregn-4-ene-17α,21-diol-3,20-dione (Ⅱ),and Ⅰ can be effectively converted toⅣ by cellular lysates.The reaction order is that Ⅰ is spontaneously hydrolyzed to Ⅱ and Ⅱ undergoes C1,2-dehydrogenation reaction to Ⅳ.In order to improve the productivity of Ⅳ,the key genes kstD,kstD3 and kstDM encoding C1,2-dehydrogenase (KSTD) were overexpressed in Mycobacterium sp.MS136 to enhance the C1,2-dehydrogenation reaction rate,and the results showed that 1 g/L substrate Ⅰ can be converted by recombinant strain MS136-kstDM cellular lysates at pH 7.0,the productivity of Ⅳ reached 78.4％ after 45 h,which is 38.9％ higher than original strain.The reaction rate is enhanced by optimizing the pH,and the results showed that 1 g/L substrate (Ⅰ) can be converted by recombinant strain MS136-kstDM cellular lysates at pH 7.5,the productivity of Ⅳreached 92.8％ after 45 h,which was 63.4％ higher than original strain.

Medical college of Xi`an Jiaotong university offered the functional experiment course in 1997. The courseincludes the basic knowledge of medical scientific research, the experimental design and the implementation of theexperiment, totally 24 hours. The course determines the key role of students in teaching, cultivates their ability to studyindependently and raises their comprehensive ability. The course assessment shows a good result.[

Objective To analyze the pathogenesis,therapy and outcome of pediatric cases with coagulation disorders (CD).Methods All these 137 patients were diagnosed as CD with the methods of hemoglutination five items and/or disseminated intravascular coagulation indexes.Then activity of specific coagulation factors,morphology of bone marrow,hepatorenal function and some other relative tests were performed to find out the cause of CD or the primary disease.Results Forty-three cases were diagnosed as genetic CD with 29 as hemophilia A,4 as hemophilia B and 10 as Von Willebrand disease;while the other 94 patients as acquired CD with 15 as vitamin K-dependence coagulation factor deficiency,22 as hepatic dysfunction,30 as disseminated intravascular coagulation and 1 as thrombotic thrombocytopenic purpura.Genetic CD was treated with replacement therapy to reduce the complication.There was 1 case in this group died of intracranial hemorrhage.Acquired CD was treated with short-term,specific and necessary replacement therapy on the basis of reasonable treatment of primary diseases.Eleven cases died finally in this cohort with 7 cases as liver failure and the other 4 cases as terminal leukemia or lymphoma.Conclusion Pediatric patients with CD were caused by genetic or acquired diseases.In clinic the reason of CD was mainly acquired.The treatment of genetic CD is the replacement of specific coagulation factor for life-long term.The outcome dependes on the lack of degree.While the therapy for acquired CD aims at the primary disease.The principle of blood transfusion is short-term and the outcome dependes on the therapic effects of primary diseases.

42 cases of OSCC and 20 of healthy tissues were studied to detect the expression of NIMA-related Kinase 2(NEK2)mRNA by Real-time PCR.Over expression of NEK2 mRNA was observed in OSCC (z =-6.328,P <0.05),the expression was correlated with the differentiation (z =-5.012,P <0.05)and clinical stage (z =-4.950,P <0.05)of the lesion,but not with the lymph node metastasis (z=-0.051,P >0.05),age (z =-0.365,P >0.05)and gender (z =-3.450,P >0.05).NEK2 gene may be involved in the develop-ment of OSCC.

Objdcts: To survey the mental health status of patients suffered from mammary gland cancer and the influence facts.Methods:Adopt SLC-90 sheet and questionaire of influence for basic status of mental health,to survey the mental health character and influence facts of 50 patients suffered from mammary gland cancer,contrasting with 50 healthy women.Results: The SLC-90 Summation of the patients are obviously higher than that of healthy women,P

Objective To investigate the influential factors to the prognosis of senile patients with bladder cancer. Methods One hundred and forty-five senile patients with bladder cancer confirmed by pathology from 1998 to 2008 were clinically investigated and analyzed using measuring scales of Functional Living Index-Cancer (FLIC), Functional Assessment of Cancer Therapy-General (FACT-G) and Cancer Rehabilitation Evaluation System short form (CARES-SF). The factors influencing the prognosis were selected and quantified, and the relationship between the factors and prognosis was statistically analyzed. Results By retrospective analysis of clinical data, it was revealed that, suppose every 5 years from 65 were as an age grade, the age-gradient was positively correlated with the survival rates (r=0.687, P

Objective To investigate clinical characteristics of moderate and severe ovarian hyperstimulation syndrome (OHSS) in assisted reproductive technique .Methods The clinical data of 179 cases with moderate and severe OHSS receiving in vitro fertili‐zation‐embryo transfer (including ICSI) in the hospital from June 2012 to April 2013 were analyzed retrospectively .According to the clinical characteristic ,the OHSS was classified as as the moderate type and severe type ,and the late type and early type . Results It was no statistics difference between moderate type and severe type in the patients age ,number of retrieved oocytes ,ad‐mission transaminase ,proportion of fibrinogen normal numbers(P> 0 .05) .But it was a statistics difference between moderate type and severe type in the occurring time days of hospitalization ,hematocrit on admission ,albumin value ,transaminase maximum ,albu‐min dosage used ,proportion of paracentesis number ,pregnancy rate(P < 0 .05) .It was no statistics difference between early type and late type in the patients age ,admission transaminase ,proportion of fibrinogen normal numbers(P> 0 .05) .But it was a statistics difference between early type and late type in the number of retrieved oocytes ,the proportion of moderate OHSS patients ,days of hospitalization ,hematocrit on admission ,albumin value ,transaminase maximum ,albumin dosage used ,proportion of paracentesis number ,pregnancy rate(P< 0 .05) .Conclusion Synthesizing OHSS patients′ blood indexes ,we can evaluated patients′ pathogenet‐ic condition ,the treatment of disease ,and took appropriate preventive measures as soon as possible .Patients with late type may be have more severe pathogenetic condition than patients with early type .

Objective The aim of the current study was to investigate the prognostic value of extracapsular lymph node spread in gastric cancer patients and to find correlations with clinicopathological parameters.Methods Clinicopathological data of 131 gastric cancer patients who underwent gastrectomy with lymphadenectomy were analyzed retrospectively. The number of metastatic lymph nodes with extracapsular spread were determined. Multivariate analysis was performed to find the clinical prognosis affecting extracapsular lymph node involvement. Results Seventy-eight patients (59.5%)had perigastric lymph node metastasis. Fortysix cases were detected extracapsular lymph node involvement. The 5-year cumulative survival rate for patients with extracapsular lymph node spread was 13. 5% , while 32 patients with lymph node metastasis but without extracapsular involvement had a 5-year survival rate of 39.3%. The survival rate decreased significantly with the increase of extracapsular lymph node involvement(P =0.001). Extracapsular lymph node involvement was significantly associated with the higher number of metastatic lymph nodes, the location of lymph node metastasis, tumor invasion depth and distant lymph node metastasis. In the multivariate analysis, extracapsular lymph node spread also remained as an independent prognostic factor(P =0.003). Conclusions Extracapsular lymph node involvement is a convenient and reliable prognostic index, and is an independent prognostic factor in gastric cancer patients. In future staging systems for gastric cancer, extracapsular lymph node involvement should be considered, be pathologically checked and reported in order to determine extracapsular spread status.

The teaching reform on functional experiment is an attractive problem of the medical teaching development at present. Our school has opened the course of functional experiment according to integrating and recombining with physiology, pathologic physiology and pharmacology, which brought into playing a positive role in enhancing the medical students' capability of practice, the comprehensive application of knowledge and the consciousness of innovation. However, some problems still exist and further practice is needed for more improvement.

Objective:To measure the salary satisfaction level of medical staff in county-level public hospitals and provide reference for the design of policy reforms. Method:Eight county-level public hospitals were investigated. All analyses were performed using SPSS 19. 0 via statistical description and binary logistic regression. Results: The total salary satisfaction of the medical staff was 48 . 8%, and the average score was 54 . 05 ± 18 . 04 . The welfare satis-faction is the lowest (38. 8%), and the average score is 7. 98 ± 3. 51. Logistic regression analysis shows that the ac-ademic degree, department category, working hours per week, acceptance of bribes, and officially budgeted posts are the main factors affecting overall compensation satisfaction. Conclusion:The overall salary satisfaction level of medi-cal staff in county-level public hospitals is very low, and the welfare satisfaction is the lowest. Establishing the rea-sonable level of compensation, the rise of compensation, and the welfare mechanism are feasible choices to improve salary satisfaction.