Objective To survey on the graduate students about their own requirements, the guid-ance of tutors and the compliance, and put the gists for the educators and administrators. Methods Using the comprehensive questionnaires including Eugenie Creativity Test and Motivation Scale, the investigation surveyed on 900 graduate students in a medical university about their requirements and tutors' concerned aspects in their opinions, which was whether influenced by Intelligence (creativity), the Non-Intelligence factors (motivation) or not. Epidata 3.1 was used to input data of the investigation, and SPSS 16.0 statistical software was used to analyze it. The items were set as multiple-choices, and the percent of responses was used. Results The students thought the tutors' concerned aspects were mainly creative thinking [61.1%(1129/1847)], research methods [58.2%(1075/1847), specialty knowledge [41.8%(772/1847)], scientific spirit
[35.4%(654/1847)], academic morality [24.3%(516/2124)] and book knowledge [5.4%(100/1847) ], while the graduate students paid more attention to its research methods [72.4%(1538/2124)], innovative thinking [64.0%(1359/2124), professional knowledge [60.0%(1274/2124)], the spirit of science [33.9%(720/2124)], academic morality [24.3%(516/2124)] and book knowledge [10.0%(212/2124)]. The percentages of research methods and specialty knowledge concerned by most of the students were higher than those tutors' con-cerned in the students' opinion. The percentages of specialty knowledge concerned by the students with high innovation and motivation were 56.2%(443/789) and 58%(345/595), which were higher than those concerned by the tutors 38.5%(255/662) and 29.4%(148/503). Conclusion In the students' opinion, tutors concerned more creative thinking, the students concerned more research methods, while they concerned similarly in the other aspects. For the students, the guidance of the tutors cannot still meet their study demands, espe-cially in research methods and specialty knowledge. Those with different motivations and innovations have different study requirements.

To investigate the gene typing, molecular characteristics of virulence and resistance associated gene of Clostridium difficile from clinical isolates in China, the genes tcdA,tcdB of toxin A and B, cdtA,cdt B of binary-toxin, and erm B of clindamycin resistance were detected by conventional PCR. Genotyping of toxic C. difficile were conducted by means of analysis of 16s-23s internal spacer region polymorphism with PCR assay. Then the antibiotic resistance of toxic C. difficile to ampiciline, clindamycin, metronidazole and vancomycin was conducted with E-test. It was found that 8 toxic C. difficile strains were demonstrated out of 12 clinical isolates, in which 5 strains were tcdA+ and tcdB+, and 3 strains tcdA- and tcdB+, accounting for 62.5% and 37.5% respectively. Binary-toxin genes detection were negative in all the strains. Clindamycin resistance associated gene ermB was positive in 4 out of 8 toxic C. difficile strains, accounting for 50%. 8 toxic isolates were typed into 4 gene types, the dominant type was ZR I,accounting for 62.5%. Resistance rate of 8 toxic C. difficile strains against ampiciline(AC), clindamycin(CM), metronidazole(MZ) and vancomycin(VA) was 37.5%,87.5%,12.5%, and 0 respectively. No isolates belonged to ribotype 027 or 078. Isolation rate of toxic C. difficile is high to 66.7%. There is obvious gene polymorphism in clinical isolates of Chinese toxic C.difficite, and ZR I is preponderant genotype in 4 genotypes. C. difficile shows some resistance to ampiciline, clindamycin, metronidazole, but susceptive to vancomycin.

Objective To evaluate the efficacy of tibial bone-skin flap grafts in the management of se- vere traumatic osteomyelitis complicated with bone and skin defect in leg to avoid amputation.Methods From March 1998 to Aug.2004,12 cases of the traumatic osteomyelitis complicated with bone and skin defect in leg were treated with vascularized tibial bone-skin flap graft.The longest flap was 17cm,widethest 10cm, The longest bone flap was 12cm.They were followed up for 0.6 to 5 years.Results All the tibial bone-skin flaps survived completely,2 cases of osteomyelitis recurred.The followed-up,from 0.5 to five years,showed good bone union in all cases,averageing 15 weeks.The infection was under control.The leg function and con- tour were satisfactory.Conclusion The tibial bone-skin flap has the advantages of having distinguished sign of anatomy,highly vascularized,easy to obtain,simply and flexible procedure,improving circulation,short- ens hospitalization and suitable for treatment of traumatic osteomyelitis complicated with bone and skin defect in leg.

Objective To design a multiplex PCR for simultaneous identification and toxigenic type characterization of Clostridium difficile isolates. MethodsThree pairs of primers were designed for the amplification of a species-specific internal fragment of the tpi( triose phosphate isomerase) gene, an internal fragment of the tcdB ( toxin B) gene, and an internal fragment of the tcdA ( toxin A) gene. Twenty-one standard strains including Clostridium difficile ATCC 9689 and 47 isolates of Clostridium difficile were applied for the assessment of detection limit, specificity and detections of the multiplex PCR, respectively. Toxin A and Toxin B of 47 isolates were analyzed by ELISA. ResultsThe detection limit for DNA concentration of the multiplex PCR was 0.5 pg/μl. The specificity was determined to be 100％. Among the results of 47 isolates detected by multiplex PC R, 37 strains were tpi ( + )/tcdA (+)/tcdB ( + ), 10 strains were tpi ( + )/tcdA (-)/tcdB ( - ). Tpi ( + )/tcdA ( - )/tcdB ( + ) was not found. The toxin detection of 47 isolates by ELISA showed that 20 isolates were positive and 27 isolates were negative. Twenty isolates of toxin (+) by ELISA were all tpi( +)/tcdA( +)/tcdB(+) by multiplex PCR. ConclusionThe multiplex PCR method combined diagnosis and toxigenic type characterization contributes to the diagnosis for Clostridium difficile infection.

Objective To investigate the status of life quality in the elderly in Shanxi Province Changzhi City, and to analyze its influencing factors. Methods The quality of life, activities of daily living and status of community services were measured simultaneously by 36-Item Short Form Health Survey (SF-36). Activities of Daily Living Scale, Community Healthy Needs Scale and survey results were used and analyzed using t-test, correlation and stepwise regression analysis. Results According to the criterion of life quality in the elderly which were proposed by Zhang Lei, the quality of life in the elderly scored 72. 1-117.0, reached 98.5%. The quality of life in the elderly was impacted by the ability of caring oneself, marital status, degree of culture, economic situation and so on. The demand rate for health guidance and periodic physical examination was higher. Conclusions The quality of life in the elderly is at a medium level. There is a wide gap between the demand of community healthy services and the utilization of community healthy services.

Objective To determine the conditioning regimen suitable for mice allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods Twelve BALB/c mice were randomly divided into 2 equal groups to undergo X-ray irradiation by linear accelerator at the dose of 7.0 Gy (pure X-ray group) or 60Co source irradiation at the dose of 7.0 Gy (pure γ-ray group).Thirty mice were randomly divided into 2 equal groups to undergo X-ray irradiation and then infusion of bone marrow from donor mice via caudal vein (X-ray + transplantation group) or γ-ray and then infusion of bone marrow via caudal vein (γ-ray + transplahtation group).3,5,7,10,15,20,and 30 d later peripheral blood samples were collected to calculate the number of white blood cells (WBCs) and detect the chimeric rates of lymphocytes by flow cytometry.5,10,and 20 d after irradiation 15 mice were killed with their lung,liver,small intestine,spleen,and femurs taken out to undergo pathological examination.Results The survival rates during the period 5-15 days of the γ-ray + transplantation group were all significantly higher than those of the X-ray + transplantation group.The pathological changes of organs of the X-ray +transplantation group were all more severe than those of the γ-ray + transplantation group.Since the fifth day after transplantation cells originating from the donor began to appear in the peripheral blood.The chimeric rate of the γ-ray + transplantation group 10 days after transplantation was (95.53± 2.57) %.The chimeric rates 5,10,and 20 days after transplantation of the γ-ray + transplantation group were all significantly higher than those of the X-ray + transplantation group (t = 15.263,3.256,P < 0.05).The WBC count of both irradiation groups decreased to the lowest level 5 d later and began to increase 10 days after transplantation and the WBC counts of the γ-ray + transplantation group 10 and 20 days aftertransplantation were both significantly higher than those of the X-ray + transplantation group (t = 3.624,6.695 ,P < 0.05).The chimeric rats of the peripheral lymphocytes 10 and 20 days after transplantation of the γ-ray + transplantation group were both significantly higher than those of the X-ray + transplantation group (t = 12.317,8.295,P < 0.05).The homogeneity rate of transplantation of the γ-ray +transplantation group was better than that of the X-ray + transplantation group.Conclusions As a conditioning regimen in allogeneic hematopoietic stem cell transplantation γ-ray irradiation causes milder injury and accelerated reconstitution of hematopoiesis and immunity,in comparison with X-ray irradiation.

Objective To evaluate the value of diffusion-weighted imaging (DWI) in the differential diagnosis of cystic pancreatic lesions.Methods Thirty-four cystic pancreatic lesions confirmed clinically or pathologically were collected,including 11 case of non-neoplastic pseudocyst,5 cases of simple cyst,6 cases of serous cystadenoma,10 cases of mucinous cystadenoma and 2 cases of mucinous cystadenocarcinoma.All the patients underwent routine serial MR and echo-planar DW imaging examination of the pancreas with b values of 0 and 600 s/mm2.The appearances of signal intensity of DWI with all cysts were recorded.ADC maps were reconstructed,and the ratio of the cysts and cyst-to-pancreas ADC (ADCR) were calculated.The receiver operating characteristic (ROC) curves were constructed to evaluate the diagnostic value of ADC and ADCR.Results Among all the 16 non-neoplastic cysts,2 cysts were slightly hyperintense in DWI,and 14 cysts were isointense.Among all the 18 neoplastic cysts,17 cysts appeared slightly hyperintense or hyperintense in DWI,and 1 cyst was isointense.The difference between the two groups was statistically significant (P ＜ 0.001).The ADC values of non-neoplastic and neoplastic cysts were (3.30 ± 0.30) × 10-3,(2.74 ± 0.34) × 10-3 mm2/s ; and the ADCR values of non-neoplastic and neoplastic cysts were 1.85 ± 0.20,1.31 ± 0.21,the difference between the two groups was statistically significant (P ＜ 0.001).The areas under the ROC curves of ADC and ADCR diagnosing neoplastic cysts were 0.94 ± 0.04,0.98 ± 0.02,respectively.An ADC of 3.105 × 10-3 mm2/s showed 81.3％ sensitivity and 94.4％ specificity for predicting neoplastic cysts.An ADCR of 1.525 showed 100％ sensitivity and 88.9％ specificity for predicting neoplastic cysts.Conclusions Diffusion-weighted imaging is of importance in the diagnosis and differential diagnosis of pancreatic cysts,and can be applied as a complementary tool for routine MRI.

Objective To investigate the magnetic resonance imaging (MRI) and computerized tomography (CT) imaging findings of hepatic angiomyolipoma (AML).Methods Twelve cases of hepatic AML,which were confirmed by pathologists between 2009 and 2011 in our hospital,were retrospectively analyzed.Results There were 3 males and 9 females with an average age of 44.17 years (range,34 to 60 years).There were 14 lesions,8 in left lobe,6 in right lobe.All of 12 cases were confirmed as angiomyolipoma by pathologists.Nine cases were performed with MRI,2 with CT,and 1 with both CT and MRI.The border of lesions were clear in 8 cases.Fat contents were shown on CT and/or MRI in 8 cases.After administrated with contrast medium,the lesion enhancement was still apparent or slightly decreased in 9 lesions from portal phase to delayed phase.The suppression of portal vein and inferior vena cava by tumor were seen in 5 lesions.Abnormal vascular distortion was seen in 6 lesions.None of 12 lesions were found with portal vein thrombosis.Conclusion The diagnosis of hepatic angiomyolipoma should be considered when CT and MRI show good boundaries,intratumoral fat content,delayed lesion enhancement,and vascular distortion.

OBJECTIVETo observe the effect of Jianpi Bushen Qingchang Huashi Recipe (JBQHR) on proliferation and migration of bone marrow mesenchymal stem cells (BMSCs).

METHODSBMSCs were isolated and cultured in vitro with adherence screening method to prepare cell suspension. No drug intervention was given to BMSCs in the vehicle control group. JBQHR at 0.39, 0.78, 1.56 µg/mL was added in BMSCs of low, mid, and high dose JBQHR groups for co-incubation. Its effect on the proliferation of BMSCs was detected by CCK-8. BMSCs migration and chemotactic ability was detected using Transwell method. Each dose JBQHR combined ERK kinase inhibitor U0126 was set up as control. The phosphorylation of extracellular regulated protein kinase (ERK) and CAMP responsive element-binding protein (CREB) were detected by Western blot.

RESULTSCompared with the vehicle control group, the proliferation of BMSCs and BMSCs migration number could be promoted in the 3 JBQHR groups (P < 0.05). Besides, the proliferation of BMSCs was better in mid and high dose JBQHR groups than in the low dose JBQHR group (P < 0.05). Compared with the vehicle control group, the phosphorylation of ERK and CREB could be elevated in the 3 JBQHR groups (P < 0.05), and could be inhibited by U0126 (P < 0.01). Compared with the low dose JBQHR group, the phosphorylation of ERK increased in mid and high dose JBQHR groups with statistical difference (P < 0.05).

CONCLUSIONJBQHR could promote the proliferation and migration of BMSCs, and its mechanism might be related to ERK/CREB signaling pathway

Cell Movement ; drug effects ; Cell Proliferation ; drug effects ; Cells, Cultured ; Cyclic AMP Response Element-Binding Protein ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Extracellular Signal-Regulated MAP Kinases ; metabolism ; Humans ; MAP Kinase Signaling System ; Mesenchymal Stromal Cells ; cytology ; drug effects

Objective To explore the approaches to improve the detection of early gastric and precancerous lesions for basic level hospi-tals. Methods The 72 patients with abnormal gastric mucosa observed by gastroscope arranged with pathology after acetic acid-indigo car-mine dyeing were considered as the dyeing group, and 68 patients with abnormal gastric mucosa observed by gastroscope directly arranged with pathology were considered as the control group. The dyeing conditions of gastric mucosa were observed and compared to pathology detec-tion. The detection rate of early gastric cancer and precancerous lesions in the two groups were compared. Results After acetic acid-indigo carmine dyeing, there were 16. 7% of demonstrated discoloration, 63. 9% of poor dyeing, and 14. 3% of even dyeing. The detection rate of early gastric cancer and high grade intraepithelial neoplasia in patients with mucosa discoloration (91. 7%) was obviously higher than that in patients with poor dyeing (8. 6%) or even dyeing (0. 0%). The detection rate of low grade intraepithelial neoplasia or intestinal metaplasia in patients with poor dyeing (82. 6%) was obviously higher than that in patients with mucosa discoloration (8. 3%) or even dyeing (14. 3%). The detection rate of early gastric cancer and precancerous lesions in dyeing group (13. 9%,63. 9%) was obviously higher than that in control group (2. 9%,29. 4%). Conclusion The acid-indigo carmine dyeing could increase the diagnosis of early gastric cancer and precancerous lesions in basic level hospital. It is adaptable to extend approach in basic level hospital for its low cost and simple operation.