It is crucial to improve the health care quality during the progress of constructing the new health care system in both urban and rural area.On the condition of increasing government commonweal investment for the basic health care,the standardized training program for the district medical practitioners will become the pivotal step to improve district health care in urban and rural area,standardize medical service,reduce the medical cost and optimize the accessibility to medical care for the mass.Taking the consideration on the personal resource of district medical service in the urban and rural area in China,certain strategic proposals related to the standardized training program for the fundamental medical practitioners are discussed.

OBJECTIVE To describe the clinical, CT or MRI, pathological characteristics of desmoplastic fibroblastoma for helping the diagnosis and treatment. METHODS The clinical data of 4 cases with desmoplastic fibroblastoma were retrospectively analyzed. RESULTS The tumors of all 4 cases were found in the compartment of muscles, and can be removed by conservative excision. The 4 cases were followed up for 38, 7, 6, 3 months respectively, and no local recurrences were found. CONCLUSION Desmoplastic fibroblastoma is a benign fibroblastic neoplasm with distinctive clinical, CT or MRI imaging and pathological characteristics. Optimal management is conservative excision with functional preservation. Needle aspiration cytology and immunohistochemistry are of non-diagnostic value.

OBJECTIVE To investigate the significance of expression of p53, Mdm2 and p21WAF/ CIP1 proteins and their relationships. METHODS Pathological specimens from thyroid carcinoma, adjacent non-tumor thyroid tissues and thyroid benign lesions were examined for p53, Mdm2 and p21WAF/CIP1 proteins by tissue microarray technique and immunohistochemistry method. RESULTS The positive expression rate of p53, Mdm2 and p21WAF/CIP1 in thyroid carcinoma was 50.6 %(37/73), 63.0 %(47/73) and 38.4 %(28/73) respectively. The expression of p53 and Mdm2 increased(P

Establishment of the “Happy Reading Club” was to create a personal reading space for undergraduates. The reading situation of undergraduates was analyzed with the creation processes of “Happy Reading Club” summa-rized.The reading popularizing activities were described, including questionnaire investigation of reading, sign of DIY “tree”, and recommendation of classic booklist, with the existing problems pointed out.

Humans ; Nasal Obstruction ; surgery ; Treatment Outcome ; Turbinates ; surgery

Objective To discuss the clinical efficacy of hot-tonifying needling in treating stomachache due to deficient cold in spleen-stomach.Method Forty patients with stomachache due to deficient cold in spleen-stomach were divided into a treatment group and a control group by using random number table method according to registration order, 20 cases in each group. The control group was intervened by twisting tonifying method, while the treatment group was intervened by hot tonifying needling method. The Visual Analogue Scale (VAS) was observed before and after the treatment, and the clinical efficacies were compared.Result The VAS scores were significantly changed after the treatment in both groups (P<0.05); there was a significant difference in comparing the VAS score between the two groups after the treatment (P<0.05); the difference in the change of VAS score between the two groups was statistically significant (P<0.05). The total effective rate was 95.0％ in the treatment group, versus 60.0％ in the control group, and the difference was statistically significant (P<0.05), and there were significant differences in comparing the clinical efficacy and relapse rate between the two groups (P<0.05).Conclusion Hot-tonifying needling is effective in treating stomachache due to deficient cold in spleen-stomach, with less adverse effects and lower relapse rate.

In order to evaluate the effect and mechanism of the mulberry leaf alkaloid, flavones, and polysaccharide intervention on diabetes, the overall metabolite profiling characteristics for the plasma of diabetic mouse was performed by using an ultra-performance liquid chromatography/electrospray-tandem mass spectrometry (UPLC-ESI-MS). The 8 potential biomarkers were found in diabetic mice plasma based on the data of MS/MS characteristics obtained from the UPLC-OrbitrapMS analysis, which mainly involved in sphingolipids, amino acid metabolic pathway. The principal component analysis showed that the normal group and model group were obviously distinguished and implied that metabolic disturbance was happened in diabetic mice plasma. The extracts of mulberry leaf flavonoids, polysaccharide, alkaloid had exhibited the effects of callback function for diabetic mice through regulating the amino acid metabolism and sphingolipid metabolism.

Animals ; Disease Progression ; Kidney Diseases ; physiopathology ; Kidney Glomerulus ; drug effects ; pathology ; Rats ; Renal Agents ; pharmacology ; Renin-Angiotensin System ; drug effects ; Sclerosis

Objective:To retrospectively analyze the data of patients undergoing extracorporeal membrane oxygenation (ECMO) during perioperative period of cardiac transplantation and provide objective and reliable evidence for further clinical promotion.Methods:Collect the clinical data of patients undergoing heart transplantation and ECMO support in Fuwai Hospital, analyze the duration of ECMO support, combined use of aortic balloon counterpulsation (IABP), and complications during the supporting period. All statistical analyses were processed by SPSS 23.0 software. Independent sample Student's test was employed for normal distribution and Mann-Whitney U test for abormal distribution. χ2 or Fisher exact test was utilized for comparinge the classification data between groups. Results:All ECMO support models were intravenous-arterial ECMO (V-A ECMO). Eight patients successfully bridging heart transplantation through VA-ECMO. Sixty-one patients (89.7%) who had undergone cardiac transplantation were successfully weaned from ECMO while 48 patients (70.5%) survived and discharged. The most common complications during circulation support are bleeding, acute renal insufficiency, and pulmonary infection. Patients with ECMO support in the operating room had a better rate of survival and weaning off(95.6%, 84.4%) than those with ECMO at the bedside of ICU(72.2%, 27.8%).Conclusions:ECMO can provide adequate circulation and respiratory function support for heart transplant patients, and it is an indispensable treatment for patients to go through the perioperative period of heart transplant surgery smoothly. It is advocated to use IABP combined with ECMO in the early stage and at the same time to increase the perfusion of vital organs, improve the prognosis of patients and obtain good outcomes.

OBJECTIVETo observe the influence of different concentrations of bisphenol A (BPA) on glucose metabolism and lactate dehydrogenase (LDH) expression in rat Sertoli cells in vitro and investigate the mechanisms of BPA inducing male infertility.

METHODSUsing two-step enzyme digestion, we isolated Sertoli cells from male Wistar rats and constructed a primary Sertoli cell system, followed by immunohistochemical FasL staining. We randomly divided the Sertoli cells into a control group to be cultured in the serum-free minimal essential medium (MEM) plus dimethyl sulfoxide (DMSO) and three experimental groups to be treated with 100 nmol/L, 10 μmol/L, and 1 mmol/L BPA, respectively, in the MEM plus DMSO. After 48 hours of treatment, we measured the proliferation of the cells by CCK-8 assay, determined the concentrations of metabolites by NMR spectroscopy, and detected the expression of LDH in the Sertoli cells by RT-PCR and Western blot.

RESULTSThe purity of the isolated Sertoli cells was (96.05 ± 1.28)% (n = 10). Compared with the control group, the 100 nmol/L, 10 μmol/L, and 1 mmol/L BPA groups showed no remarkable changes in the proliferation of Sertoli cells ([98 ± 8]%, [96 ± 3]%, and [95 ± 3]%, P >0.05), but the 10 μmol/L and 1 mmol/L of BPA groups exhibited significantly decreased concentrations of intracellular glucose ([3.89 ± 0.07] vs [3.36 ± 0.24] and [3.04 ± 0.21] pmol/cell, P <0.05) and lactate ([0.43 ± 0.06] vs [0.29 ± 0.05] and [0.20 ± 0.03] pmol/cell, P <0.05). The expression of LDH mRNA was decreased with the increased concentration of BPA, while that of LDH protein reduced only in the 1 mmol/L BPA group (P <0.05).

CONCLUSIONHigh-concentration BPA decreases the expression of LDH and alters glucose metabolism in Sertoli cells, and therefore may reduce the provision of lactate for germ cells and impair spermatogenesis.

Animals ; Benzhydryl Compounds ; administration & dosage ; pharmacology ; Cell Proliferation ; drug effects ; Cells, Cultured ; Culture Media, Serum-Free ; Dimethyl Sulfoxide ; pharmacology ; Glucose ; metabolism ; In Vitro Techniques ; Infertility, Male ; chemically induced ; L-Lactate Dehydrogenase ; metabolism ; Male ; Phenols ; administration & dosage ; pharmacology ; RNA, Messenger ; metabolism ; Random Allocation ; Rats ; Rats, Wistar ; Sertoli Cells ; drug effects ; metabolism ; Spermatogenesis ; drug effects