As the medical college students are scattered to each practice hospital, the status of the secondary clinical medical colleges' education management to interns is weakened, and the problems and contradictions are becoming increasingly prominent. In the process of internship education management, through the establishment of the secondary medical colleges' interconnection management working mecha-nism, we can effectively solve the outstanding problems in the current internship edu-cation management, to achieve mutual trust between the secondary clinical medical college and the training hospital, and en-hance the effectiveness of the management of interns.

Adult ; Calcinosis ; diagnostic imaging ; pathology ; surgery ; Cysts ; diagnostic imaging ; pathology ; surgery ; Diagnosis, Differential ; Female ; Humans ; Lymphatic Vessel Tumors ; pathology ; Mucocele ; pathology ; Parasitic Diseases ; pathology ; Spleen ; diagnostic imaging ; Splenectomy ; Splenic Diseases ; diagnostic imaging ; pathology ; surgery ; Tomography, X-Ray Computed

Objective: To explore the relationship between air pollutants and pediatric outpatient volumes in Baoshan District, Shanghai Municipality. Methods: Data of meteorological factors, air pollutants and pediatric outpatient volumes in four general hospitals were collected in Baoshan District from 2015 to 2019, and a generalized additive model was used to fit the Poisson-like distribution. The exposure-response relationship between fine particulate matter (PM2.5), sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3) and total pediatric outpatient volumes and pediatric respiratory outpatients. Results: The median of the average daily temperature and relative humidity were 18.7 (interquartile range, 14.4) ℃ and 74.5% (interquartile range, 18.0%) in Baoshan District from 2015 to 2019, respectively. The median of the average daily concentrations of PM2.5, SO2, NO2 and O3 were 35.0 (interquartile range, 35.0), 11.0 (interquartile range, 7.0), 45.0 (interquartile range, 31.8) and 84.5 (interquartile range, 50.0) μg/m3, respectively. The median of the average daily total and respiratory pediatric outpatient volumes were 680 (interquartile range, 246) and 392 (interquartile range, 253). Spearman rank correlation analysis showed that temperature, relative humidity, PM2.5, SO2, NO2 and O3 were associated with total and respiratory pediatric outpatient volume (all P<0.05). Under the single pollutant model, the excess risk of total and respiratory pediatric outpatient volume due to PM2.5 (ER=0.318, 0.257), SO2 (ER=1.610, 2.546), and NO2 (ER=0.808, 0.839) reached the maximum effect on the same day, and the effect of O3 (ER=0.102, 0.222) reached its maximum at the first day of lag. Under the multi-pollutant model, after O3, SO2, NO2 and PM2.5 were introduced, a exposure-response relationship between air pollutants and total pediatric outpatient volumes was the largest on the sixth day after the lag (ER=0.419). There was no exposure-response relationship between air pollutants and respiratory pediatric outpatient volumes. Conclusion PM2.5, SO2, NO2 and O3 are associated with total and respiratory pediatric outpatient volumes, and the lag effects due to different air pollutants are different.

With the global development of medical information standard, construction work of traditional Chinese medicine (TCM) information standard system has been promoted rapidly. The framework of ancient Chinese medical literature clinical terminology classification standardization is one of the foundations of TCM language system. Its research will further promote and perfect TCM information standard system. We have adhered to the connection among ancient TCM classification framework, modern TCM and western medicine classification framework. Exploration on framework construction of ancient Chinese medical literature clinical terminology classification standardization was based on previous work of Chinese medicine clinical terminology classification and code standard, reference frame structure of SNOMED CT, research findings of classification standard framework of Chinese medicine clinical terms, andQian Jin Fang.

Objective:To study the effect of Ginkgo biloba extract (EGb761) on metabolism of aflatoxin B_1(AFB_1) in Wistar rats. Methods:Seventy one Wistar rats were divided into three groups at random: group A (AFB_1 group), group B (AFB_1+EGb761 group), and group C (control group). The rats in groups A and B were given AFB_1(intraperitoneal injection, 100-200 μg/ kg body weight, 1-3 times/week). The rats in group B were fed the food containing EGb761 while the rats in groups A and C were given normal food. Blood samples were collected and liver biopsy was performed on the 14th, 28th and 42nd week. All the rats were sacrificed at the 64th week. The incidence of hepatoma was observed. The hepatic phase Ⅰ drug-metabolizing enzyme CYP450 and phase Ⅱ enzyme GST were detected by spectrometry. The serum AFB_1-lysine adduct was determined by high performance liquid chromatography (HPLC). The expression of 8-hydroxydeoxyguanosine(8-OHdG) was measured by immunohistochemistry. Results:The incidence of hepatocellular carcinoma (HCC) in group B was significantly lower than that in group A (26.92% vs 76.00%,P<0.001). No hepatocellular carcinoma developed in group C. EGb761 had no effects on the activities of CYP450 and GST in rat liver tissues. The level of AFB_1-lysine adduct reached the peak (4 356.01 pg/mg albumin) at the 14th week in group A. EGb761 significantly inhibited the formation of AFB_1-lysine adducts in serum by 13.07% at the 14th week (P＝0.033), and 73.63% at the 42nd week (P＝0.002). The expression of 8-OHdG protein in rat liver tissues in group B was significantly lower than that in group A at the 28th, 42nd, and 64th week (P<0.05). Conclusion:The main mechanism underlying the effect of EGb761 in blocking hepatogenesis induced by AFB_1 may not be fully related with its influence on the activity of liver phase Ⅰ and phase Ⅱ metabolizing enzymes. EGb761 inhibites the production of AFB_1-lysine addcuts, decreases the expression of 8-OHdG protein, and finally alleviates the DNA oxidative injury, which may be one of the mechanisms for the effects of EGb761 in inhibiting or delaying hepatogenesis induced by AFB_1.

OBJECTIVETo explore bone marrow-derived mesenchymal stem cells (BMSC) mediated gene directed enzyme prodrug targeting anti-tumor therapy (GDEPT).

METHODSCYP1A2 gene was cloned from human hepatocytes by RT-PCR, and the eukaryote expression vector was constructed and transferred into Raji cells and human BMSCs via liposome. The targeted anti-tumor effect of BMSC-CYP1A2 cooperated with dacarbazine (DTIC) was measured. RT-PCR and Western blot were used to detect the expression of CYP1A2. Migration assay was detected with Transwell Plates. MTT was used to evaluate the growth inhibitory effect. Cell apoptosis was determined with Annexin V-FITC/PI staining by flow cytometry(FCM).

RESULTSThe results of FCM and differentiation induction were in line with the characteristics of BMSC. The expression of CYP1A2 was confirmed by RT-PCR and Western blot. Growth inhibition of Raji-CYP1A2 cells was increased with DTIC concentration in a dose-dependent manner (IC(50) was 1.67 mmol/L). However, BMSC was less sensitive to the cytotoxic effects of DTIC (IC(50) of 9.26 mmol/L and 7.53 mmol/L for BMSC-pcDNA3.1 and BMSC-CYP1A2 cells, respectively) than Raji cells did (IC(50) of 5.62 mmol/L and 1.67 mmol/L for Raji-pcDNA3.1 and Raji-CYP1A2 cells, respectively). BMSC migrated toward Raji cells in Transwell plate. BMSC-CYP1A2 cells mediated a bystander killing effect for CYP1A2-negative Raji cells when they were co-cultured with BMSC-CYP1A2 cells.

CONCLUSIONDTIC can be catalyzed by CYP1A2 in vitro. BMSC-based enzyme prodrug system of CYP1A2 and DTIC can induce lymphoma cell apoptosis targetedly via bystander killing effect.

Apoptosis ; drug effects ; genetics ; Bone Marrow Cells ; Cells, Cultured ; Cytochrome P-450 CYP1A2 ; genetics ; Dacarbazine ; pharmacology ; Genetic Vectors ; Humans ; Lymphoma ; pathology ; Male ; Mesenchymal Stromal Cells ; Transfection

OBJECTIVETo investigate the relationship between Arg778Leu/Gln gene mutation spot in ATP7B and TCM Syndrome type in Chinese patients with Wilson disease (WD).

METHODSExon 8 of ATP7B of 90 WD patients and 30 healthy controls were amplified by PCR and analysed by restriction enzyme Msp I, the TCM Syndrome type of the patients was differentiated at the same time.

RESULTSIn the 90 WD patients, 34 with Arg778Leu/Gln of exon 8 were detected, among them 20 cases belonged to the TCM Syndrome type of endogenous Liver-Wind agitation.

CONCLUSIONOnset age of WD patients with Arg778Leu/Gln mutation is later than that without this mutation. Arg778Leu/Gln mutation might be related to the TCM Syndrome type of endogenous Liver-Wind agitation.

Adenosine Triphosphatases ; genetics ; Adolescent ; Arginine ; genetics ; Asian Continental Ancestry Group ; Cation Transport Proteins ; genetics ; Child ; Copper-transporting ATPases ; Diagnosis, Differential ; Exons ; Female ; Hepatolenticular Degeneration ; diagnosis ; genetics ; Humans ; Leucine ; genetics ; Male ; Medicine, Chinese Traditional ; Phenotype ; Point Mutation

Objective:To test the expression of Minichromosome maintenance complex component 7(MCM7) protein in hepato-cellular carcinoma(HCC) of different species including human, rat and tree shrew (tupaia) by cross-species oncogenomics approach, and to investigate the relationship between the expression of MCM7 and the development of hepatocellular carcinoma and its clinical significance. Methods:Western blot and Immunohistochemistry were applied to detect the expression levels of MCM7 protein in HCC tissues,corresponding HCC-adjacent liver tissues and normal liver tissues collected from different species including human, rat and tree shrew, respectively. The clinicopathologic factors were also analyzed with the results of Immunohistochemistry. Results:Western blot analysis showed that the expression of MCM7 protein in HCC tissues of human and rat were higher than that in corresponding HCC-ad-jacent liver tissues and normal liver tissues, respectively and significantly (P<0.05). However, the expression of MCM7 protein in HCC tissues of tree shrew were also higher than that in corresponding HCC-adjacent liver tissues and normal liver tissues, but no significant difference was found among three types of tissues (P>0.05).There was also no significant difference between HCC-adjacent liver tis-sues and normal liver tissues in three species (P>0.05). Immunohistochemical analysis showed that MCM7 protein was mainly ex-pressed in nucleus of HCC cells, and the positive rate of MCM7 protein in HCC tissues of human, rat and tree shrew were significantly higher than that in corresponding HCC-adjacent liver tissues and normal liver tissues, respectively (P<0.05). However, no significant difference was found between HCC-adjacent liver tissues and normal liver tissues (P>0.05). Moreover, the protein level of MCM7 was intimately related to patient's HCC stage, extrahepatic metastases and postoperative recurrence (P<0.05). Conclusion:MCM7 protein might play a pivotal role in hepatocarcinogenesis. In addition, it was probably related to patient's HCC stage, extrahepatic metastases and postoperative recurrence. It seems very likely that MCM7 may be applied as a new molecular target in HCC prevention and treat-ment.

Objective To evaluate the correlation between 3 different instruments,SF-36 Health Survey,Hospital for Special Surgery (HSS) knee score and Rasmussen Score,for measurement of surgical outcomes of tibial plateau fractures,and their clinical significances as well.Methods Included in this study were 94 patients with tibial plateau fracture who had been consecutively treated and followed up from January 2009 through February 2015 at our department.Their surgical outcomes were measured by SF-36 Health Survey,HSS-knee score and Rasmussen Score respectively for health-related quality of life (HRQL),knee function,and reduction of fracture.Pearson correlation test was used to determine the correlation between the 3 measurement instruments.Results 94 cases eventually finished their following-ups.The mean follow-up was 41.2 months (range,from 12 to 75 months).The Rasmussen scores for their first postoperative X-ray films averaged 14.7 ± 2.1 points,their HSS-knee scores at the final follow-up averaged 81.0 ± 13.7 points,and their SF-36 scores at the final follow-up averaged 85.5 ± 10.0 points.Statistical analysis showed that the HSS-knee score was positively related to the SF-36 score and Rasmussen score (P ＜ 0.05) but not to the Rasmussen score (P ＞ 0.05).Conclusions Fine reduction may be the basis for good functional recovery of the knee and good functional recovery may benefit the HRQL of the patients,but merely good fracture reduction does not promise a high HRQL for patients with tibial plateau fracture.In the treatment of tibial plateau fractures,it is not enough to take care of fracture reduction and functional recovery,and the HRQL of patients should be taken into consideration.More attention should be paid to other important factors influencing the HRQL of patients.

Objective To investigate changes in serum levels of antinuclear antibody(ANA), anti?double?stranded DNA(dsDNA)antibody and anti?extractable nuclear antigen(ENA)antibody before and after anti?tumor necrosis factor?α(TNF?α)therapy in psoriatic patients. Methods Clinical data obtained from 32 patients with psoriasis were analyzed retrospectively. Of the 32 patients, 13 received intravenous injection of 5 mg/Kg infliximab at week 0, 2, 6 for 3 sessions, then once every 8 weeks(infliximab group), while other 19 received subcutaneous injection of 25 mg etanercept twice every week(etanercept group). The treatments in the 2 groups both lasted more than 3 months. Serum levels of ANA, anti?dsDNA antibody and anti?ENA antibody and changes of clinical symptoms were detected and observed respectively before each treatment in the infliximab group, as well as every 3- 6 months in the etanercept group. The 75%reduction in psoriasis area and severity index(PASI75)and disease activity score of 28 joints(DAS28) were used to evaluate clinical efficacy. Serum levels of ANA, anti?dsDNA antibody and anti?ENA antibody were measured by indirect immunofluorescence(IIF)assay, Western blot analysis combined with enzyme?linked immunosorbent assay(ELISA), and Western blot analysis, respectively. Results After 3?month treatment, the 32 patients achieved clinical remission to different extents. Of 32 patients receiving anti?TNF?αtherapy, 7(21.9%)developed new autoantibodies. Concretely speaking, 4 patients in the infliximab group developed autoantibodies in 8.3 ± 5.1 months, including 3 cases positive for ANA and 3 for anti?ENA antibody. Three patients in the etanercept group developed autoantibodies in 9.0 ± 3.0 months, including 3 cases positive for ANA and 1 for anti?ENA antibody. Conclusion Partial patients with psoriasis may develop autoantibodies after anti?TNF?αtherapy.