Most of the clinical teachers in medical colleges have not received training in the teaching profession.This article explores the post-job education system of the clinical teachers in our hospital,aiming at improving the quality of medical education.

BACKGROUND: Facial tie-over is a conventional method for skin graft fixation, but it needs further improvements due to the unsatisfactory fixation, survival quality, postoperational contraction and appearance. OBJECTIVE: To improve the survival quality of facial skin grafts using the modified wire frame tie-over for the fixation. DESIGN, TIME AND SETTING: An observation trial was carried out at the Department of Burns in Beijing Jishuitan Hospital from January 2003 to December 2007. PARTICIPANTS AND MATERIALS: A total of 23 patients suffered from facial burns and post-burn scar were enrolled from the Department of Burns in Beijing Jishuitan Hospital, 16 males and 7 females, with a mean age of (37?18) years. The wire frame tie-over skin grafts were used in 32 facial wounds, including 8 cheek wounds, 20 eyelid wounds and 4 perioral wounds. The 1.0-1.5 Kirschner wire frame, made of stainless steel, was shaped as the wound outline; the rubber bands and clip were sterilized with ethylene oxide. METHODS: All the patients were grafted by means of wire frame tie-over, and the maximal area of skin graft was 18 cm?10 cm. After the routine skin grafting, the Kirschner wire frame was sutured to the edge of wound, then tie-over was performed using the sutures or the sterilized rubber bands fixed on the wire frame. The wire frame was removed three to four weeks after operation. MAIN OUTCOME MEASURES: The survival of skin grafts was recorded at the removal of tie-over, including survival rate of skin grafts and appearance of crater phenomenon that was prominent at edges and depressed in center; The skin grafts were pictured to observe the early contraction at the removal of wire frames 3-4 weeks later. The patients who were potential for the long-term follow-ups were used to observe the long-term contraction. RESULTS: Among 32 wounds in 23 patients, 31 skin grafts had an excellent skin grafting, except a partial graft necrosis occurred in one case due to insufficient debridement. The skin grafts were flat and intact, no crater phenomenon was found. Three or four weeks after operation, the area of skin grafts maintained in original style, no early contraction was found. One year later, the patients appeared mild contraction of skin graft, and the skin appearance was satisfactory. CONCLUSION: Improved wire frame tie-over method can increase the survival quality of facial grafts and alleviate the graft contraction.

A simple and rapid expression and purification method of recombinant firefly luciferase was developed for bacteria detection. A modified luciferase gene from North American firefly Photinus pyralis was cloned into pET28a expression vector and the recombinant protein was produced in Escherichia coli BL21. The recombinant luciferase, equipped with a polyhistidine affinity tag, was purified by immobilized metal ion affinity chromatography (IMAC). The approach generated an abundant expression and an efficient purification of a recombinant luciferase with final yield 1.995mg/L of cell culture. Experiments on the recombinant luciferase also showed that the relative light units (RUL) of the enzyme were 5.8×108, and the specific activity was 2.9×1010 RLU/mg. By applying adenosine triphosphate (ATP) bioluminescence to detection of the coin bacteria using the recombinant protein, the ATP content of bacteria was 9.48×10-16mol/mL, and was identical to the bacteria counts (4500CFU/mL) in order of magnitude. Taken together, our results provided a simple and efficacious method of the preparation of recombinant luciferase, which could be applied in the determination of bacteria via ATP bioluminescence.

Background Postoperative ametropia, especially large astigmatism after deep anterior lamellar keratoplasty (DALK) for keratoconus often results in poor visual acuity.Though postoperative ametropia can be corrected by wearing glasses or performing corneal refractive surgery, the visual quality of patients is still poor, and the operations are difficult to implement because of insufficient corneal thickness.Toric intraocular collamer lens (TICL) implantation appears to have good corrective efficacy on severe astigmatism,but the research on the eyes after DALK is still less.Objective This study was to evaluate the efficacy and safety of TICL implantation for the ametropic eyes following DALK for keratoconus.Methods This study protocol was approved by Ethic Commission of Nanjing Drum Tower Hospital,and written informed consent was obtained from each patient prior to any medical procedure.A self-controlled serial observational research was carried out.Eight ametropic eyes of 8 patients who received the DALK for keratoconus before 18 months were enrolled in Nanjing Drum Tower Hospital from August 201 1 to March 2012, with the spherical diopter range from 0 D to-7.5 D and cylindrical diopter range from-2.5 D to-6.0 D.TICL implantation was performed on the eyes.The eye examinations were carried out before surgery and 1 week,3 months,6 months, 1 year and 2 years after surgery,including uncorrected visual acuity (UCVA) ,best corrected visual acuity (BCVA) ,comprehensive optometry, corneal astigmatism degree, the central corneal thickness and anterior chamber depth (ACD), corneal endothelial cell counts (ECD) ,intraocular pressure.The examination outcomes were compared before and after surgery.The intraoperative and postoperative complications were observed to evaluate the safety of TICL implantation for the ametropic eyes following DALK for keratoconus.Results The UCVA and BCVA were obviously improved at 6 months after TICL implantation in comparison with before surgery and maintained stable during the follow-up duration.The mean spherical diopter was from-0.5 D to-1.0 D and the mean cylindrical diopter was from-0.5 D to-2.0 D after surgery.The corneal endothelial cell counts were (2 520.2 ± 307.2) , (2 496.2 ± 306.2) , (2 469.6±304.5) , (2 432.0 ± 305.4), (2 383.4 ± 309.4)/mm2, and the intraoeular pressures were (14.57 ± 3.75), (16.62±4.21), (16.57±3.56), (15.66±3.37), (15.13±3.48) mmHg, showing insignificant differences among different time points (F =0.375,P =0.825;F =9.871, P =0.394).No significant differences were found in mean ACD and intraocular pressure between before and after surgery (t =1.56 ,P =0.16).The axial deviation of TICL was less than 10° in all the operated eyes 6 months after surgery.No intraoperative and postoperative complications were found during the follow-up duration.Conclusions TICL implantation is a safe and effective alternative and viable approach to myopic and astigmatism patients following DALK for keratoconus.

Objective To investigate the effect of recombinant adenovirus-mediated basic fibroblast growth factor (bFGF),interleukin-1 receptor antagonist protein (IL-Ra) and insulin-like growth factor(IGF)-1 gene transfection on human osteoarthritis chondrocytes.Methods Monolayer cultures of human osteoarthritis chondrocytes were transfected with recombinant adenovirus carrying genes encoding the following cytokines: human bFGF,IL-1Ra and IGF-1.Six days later,levels of gene expression and glycosaminoglycan (GAG) in culture supernatant were detected.The proliferation and apoptosis of chondrocytes were analyzed by methyl thiazolyl tetrazolium (MTT) and flow cytometry respectively.Matrix biosynthesis was observed by toluidine blue staining and immunohistochemistry examination of type Ⅱ collagen.The expression of type Ⅱ collagen,MMP-3 and TIMP-1 were analyzed by immunoblotting.Comparisons between groups were performed with one-way ANOVA analysis.Results The expression of all transgenes was high following adenoviral transfection compared with the OA control group (P<0.05).The delivery of bFGF alone promoted the cell proliferation and resulted in a significant enhanced biosynthesis of type Ⅱ collagen and proteoglycans of chondrocytes (P<0.05).Compared with bFGF transfection alone,as two or three of the genes were transfected in different combinations,apoptosis rate of chondrocytes was decreased [(26.1±1.6)%,(19.4±1.0)%.(18.4±1.1)%,(13.9±1.8)%.respectively P<0.05].There was marked enhancement of matrix synthesis and expression of TIMP-1.At the same time,the expression of MMP-3 was inhibited.Conciuslon The bFGF gene transfection mediated with adenoviral vectors can greatly promote cell proliferation and increase matrix synthesis in vitro. Compared to the expression of bFGF alone, concomitant gene transfection of bFGF, IL-IRa and IGF-1 in different combinations plays a complementary role, further enhances matrix synthesis and inhibits matrix degradation.

Recent studies suggested that the prostate cancer may arise from prostate cancer stem cells that share some same characteristics with normal stem cells. The purpose of this study was to detect the differences of Nanog expression between PC3 prostate cancer cell line and its tumor stem cells, and the relationship was preliminarily examined between Nanog and prostate cancer and its tumor stem cells. By using magnetic active cell sorting (MACS), we isolated a population of CD44(+)/CD133(+) prostate cancer cells that display stem cell characteristics from PC3 cell line. Immunohistochemistry revealed positive expressions of CD44, CD133 and α(2)β(1)-integin in the isolated cells. CCK-8 analysis showed that isolated cells had a strong proliferative ability. The formation of the cell spheres in serum-free medium and holoclones in serum-supplied medium showed that the cells were capable of self-renewing, indicating that the isolated cells were a population of cancer stem-like cells derived from PC3 cell line. Western blotting exhibited that the isolated cells had higher experession of Nanog, an embryonic stem marker, as compared with PC3 cells. Our study showed that Nanog might be helpful in sustaining the self-renewal and the undifferentiation of prostate cancer stem cells, and may serve as a marker for prostate cancer stem cells for isolation and identification.

Objective To explore the clinical effects of enema combined with massage therapy on jaundice in premature infants.Methods Seventy-five premature infants with jaundice were randomly divided into 3 groups,enema combined message therapy group(group A),abdominal massage therapy group(group B),and double-side phototherapy group(group C).All 3 groups were received the same formula fee-ding,intravenous nutrition and identical drug treatment.Group A was given enema with mixed kaiselu and normal saline together with 60 times clockwise abdominal massage once a day for 2 weeks.Group B only received abdominal massage twice per day for 2 weeks.Transcutaneous bilirubin(TB) indexes of all the premature infants in the 3 groups were detected and transformed into total TB concentrations every morning,through version of MINOLTA JM-102 transcutaneous bilirubin radiometer made in Japan.When TB index counted more than 196.58 ?mol/L,group A and B were given single-side phototherapy for 24 hours.Neither enema nor abdominal massage was given to group C,and double-side phototherapy was applied when TB indexes were above 196.58 ?mol/L.Daily TB indexes,duration of jaundice and phototherapy,time of meconium exhaustion,defecation times in each day,incidence of constipation and feeding intolerance were recorded.Results Duration of jaunhospitalized and phototherapy were significantly shortened in group A compared with those of the other groups.In 34 premature infants who were hospital for at least 2 weeks,TB indexes in group C were lower than those in group B on the 9th day.On the 12th day and the 14th day,TB indexes in group A and C were lower than those in group B(Pa

OBJECTIVETo explore the effects of chronic hypoxia on left and right ventricular function and the expression of cardiac transient receptor potential canonical (TRPC) channels in rats.

METHODSForty eight SD male rats were randomly divided into control group (CON) and chronic hypoxic pulmonary hypertension model group (CH) (n = 24). In CH group, rats were exposed in chronic hypoxia environment (10% +/- 0.2% O2) to induce myocardial hypertrophy. After 3 weeks, mean systemic arterial pressure (mSAP), right ventricular systolic pressure (RVSP), left ventricular systolic pressure (LVSP), left or right ventricular pressure maximum rate of rise (LV/RV + dp/dt(max)), left or right ventricular pressure maximum rate of descent (LV/RV-dp/dt(max)), right ventricular hypertrophy index (RVMI) and left ventricular hypertrophy index (LVMI) were measured. Left and right ventricular myocardium tissue sections were stained by HE and observed under light microscope. Real-time polymerase chain reaction (real-time-PCR) and Western blot were performed to detect the expression of TRPC subfamily.

RESULTSRVSP, RVMI, RV + dp/dt(max) and RV-dp/dt(max) were markedly elevated in CH group (P < 0.01) in comparison to CON group. LVMI was markedly reduced in CH group in comparison to CON group (P < 0.01). LVSP, LV + dp/dt(max) and LV- dp/dt(max) had no significant changes in CH group in comparison to CON group. Right ventricular myocardial cells of CH group became thick, the nuclei stained deeply, the shape of nuclei became not regularity. Left ventricular myocardial fibers did not change significantly. There was significant difference in the levels of mRNA and protein of TRPC1 between CON and CH groups.

CONCLUSIONFor three weeks exposed to chronic hypoxia induced right ventricular hypertrophy specifically, raised the mRNA and protein expression of TRPC1 on right ventricular myocardial cells . TRPC1 might be involved in the development of cardiac hypertrophy.

Animals ; Disease Models, Animal ; Hypertension, Pulmonary ; metabolism ; physiopathology ; Hypoxia ; metabolism ; physiopathology ; Male ; Rats ; Rats, Sprague-Dawley ; Transient Receptor Potential Channels ; metabolism ; Ventricular Function, Left ; physiology ; Ventricular Function, Right ; physiology

Antimony ; blood ; Humans ; Spectrophotometry, Atomic ; methods

Background Glycogen synthase kinase-3β (GSK-3β)plays an important role in glucose metabolism,and it may be affect the occurrence of diabetic retinopathy(DR).ObjectiveThe present study was to investigate the effect of valsartan and fluvastatin on the expression of GSK-3β in retina of diabetes rat model.MethodsDiabetes mellitus models were induced by intrapenetoneal injection of streptozotocin(STZ) in 47 clean Sprague-Dawley(SD) rats and were then randomedly divided into 4 groups.Ten other normal rats were served as normal control group.Sodium carboxy methyl cellulose solution,valsartan,fluvastatin,valsartan+fluvastatin and sodium carboxy methyl cellulose solution was given by oral once per day for 12 weeks respectively in diabetes control group ( n =12),valsartan group ( n =12 ),fluvastatin group ( n =11 ),valsartau + fluvastatin group ( n =12 ) and normal control group.Twelve weeks after administration of drugs,blood glucose was measured and compared among various groups,and the expression of p-GSK-3β ( Ser-9 ) protein in retina was quantified and located by Western blot and immunohistochemistry,respectively.Results Twelve weeks after use of drugs,the level of blood glucose was(5.28±0.30),(26.08±3.33 ),(26.03 ±2.66 ),(25.90± 2.86 ),(25.99 ± 2.14 ) mmol/L in the normal control group,diabetes control group,valsartan,fluvastatin,valsartan + fluvastatin group,respectively,showing a significant difference among the 5 groups ( F =110.74,P＜0.01 ).Western blot showed that the grey value of p-GSK-3β ( Ser-9 ) /β-actin in retina in the diabetic control group was significant higher than the normal group(2.774±0.139 vs 1.927±0.111,q =15.79,P＜0.01 ),and that in valsartan,fluvastatin,valsartan+fluvastatin group was lower than the diabetic control group ( 1.895 ±0.090,2.051 ± 0.113,1.537 ± 0.071 vs 2.774 ± 0.139 ) ( q =1 3.69,13.48,23.06,P ＜ 0.01 ).The grey value of p-GSK-3β (Ser-9)/β-actin in the valsartan+fluvastatin group was declined in comparison with the valsartan group and fluvastatin group ( q =6.67,9.58,P＜0.01 ).Immunohistochemistry showed that the p-GSK-3β(Ser-9) protein was expressed all over the retinal layers and obviously in retinal ganglion cell layer(GCL) in normal control group.But the p-GSK-3β(Ser-9) protein was expressed significantly in diabetic control group.The expression of p-GSK-3β (Ser-9)protein was attenuated both in valsartan and fluvastatin groups and further attenuated in valsartan + fluvastatin group. Conclusions p-GSK-3β (Ser-9) protein is overexpressed in GCL of retina of diabetes rat.Both valsartan and fluvastatin can inhibit the expression of p-GSK-3β (Ser-9) and even getting stronger when they combined.