Objective To understand the status quo of work satisfaction of the graduates of GP vocational training program by Zhongshan hospital Fudan university,to provide bases for making best GP career development strategy by health authorities.Methods Using short form of the career orientation inventory to conduct career investigation of the 152 graduates of GP vocational training program by Zhongshan hospital,Fudan university.152 questionnaires were issued and the effective response rate was 100％.Results The top of GPs' career anchor is job security orientation (106,69.7％),followed by technical competence (28,18.4％),service (8,5.3 ％),managerial (5,3.3 ％),autonomy (3,1.9％),lifestyle (1,0.7 ％),entrepreneurship (1,0.7 ％),pure challenge (0,0) and geographic security orientation (0,0).We found that for male GPs,they displayed higher score for entrepreneurship orientation than female GPs (t =2.775,P =0.006).Those older than 35 displayed higher score for geographic security orientation than those younger than 35 (t =-2.154,P =0.033).GPs with at least 10 years' work experience displayed higher score for geographic security orientation than those with less than 10 years' work experience (t =-2.414,P =0.017).The distribution of all types of career orientations of GPs was the same no matter how different their degrees and professional titles were.Conclusions Job security orientation and technical competence are the major job orientations of GP vocational training program by Zhongshan hospital,some career anchor orientations are related to age,gender and duration of work experience.Effective career management should be conducted based on these characters of the graduates' career orientation.

Abstract Exposure to atmospheric PM2.5 is closely related to the morbidity and mortality of kidney diseases such as chronic kidney disease, membranous nephropathy and kidney cancer. Acute and chronic PM2.5 exposure lead to the damage of glomerular filtration and kidney tissue of mice. PM2.5 induces cellular oxidative stress, inflammatory response, endoplasmic reticulum stress, renin angiotensin system and bradykinin system activation, so that causes renal blood vessel and tissue damage, decreases glomerular filtration rate and clearance capacity, and mediates the occurrence of kidney damage and diseases. This article reviews the studies into the impact of PM2.5 on kidney and its mechanism form 2016 to 2020, so as to provide the basis for the prevention and treatment of kidney injury induced by PM2.5.

Objective To quantitatively analyze and compare the texture features of thermal and chemical lesions on the porcine striated muscle, in vitro extracted from high-frequency ultrasonograms using computer-assisted image analysis technique, and to investigate the application values. Methods The thermal lesion and chemical lesion were induced in vitro in porcine striated muscle by microwave ablation and anhydrous acetic acid injection, respectively. The two dimension (2D) ultrasonographic ifndings were qualitatively compared between the groups of thermal and chemical lesion models, in which eight textural features in geometric mathematics extracted from 2D ultrasonograms were quantitatively analyzed by a technique of computer-assisted image analysis named multiscale decomposition method of echo intensity of interface relfections. Results As expected, microwave ablation and anhydrous acetic acid caused signiifcant changes of several texture features extracted from ultrasonograms. There were significant differences between the normal group and microwave ablation group in grayscale mean (Mean), irregularity (IRGL) and periodicity of distribution (POD) as follows (Mean: 1.9143±0.2914 vs 1.2334±0.3357, t=-5.306, P=0.000; IRGL: 0.5577±0.0334 vs 0.5092±0.0459, t=-2.957, P=0.007; POD: 0.000 27±0.000 005 vs 0.000 29±0.000 008, t=4.782, P=0.000). There were signiifcant differences between the normal group and anhydrous acetic acid injection group in number of blobs (NOB), size of blobs (SOB) and periodicity of distribution (POD) as follows (NOB: 51.0324±13.6998 vs 31.6042±4.8315, t=4.633, P=0.000; SOB:16.4843±3.9349 vs 25.6230±2.3555, t=6.903, P=0.000;POD:0.000 26±0.000 015 vs 0.000 29±0.000 008, t=-4.459, P=0.000). For each group of injured regions, there were significant differences between the microwave ablation group and anhydrous acetic acid injection group in Mean, IRGL, NOB and SOB as follows (Mean: 1.2664±0.2688 vs 1.9143±0.2914, t=-5.661, P=0.000; IRGL: 0.5220±0.0422 vs 0.5577±0.0334, t=-2.295, P=0.032;NOB:51.0324±13.6998 vs 34.5856±2.6362, t=4.048, P=0.000;SOB:16.4843±3.9349 vs 25.3176±2.3501, t=-6.676, P=0.000). Conclusion Technique of computer-assisted image analysis named multiscale decomposition method of echo intensity of interface relfections, based on multiscale blob features extraction, was useful to differentiate ultrasonic texture features between the groups injured in our study, which established quantitative muscle ultrasound as a practical and reliable tool for the muscle injury diagnosis to distinguish the structural changes induced by different physiochemical factors.

Objective To stuay CT findings of adrenal gland trauma(AGT).Methods The CT images of adrenal gland trauma which were found in 1712 patients who had emergency abdominal CT examinations for assessment of blunt force trauma were analyzed restrospectively.Results Among 1712 cases.we identified 29 patients(1.7%)with adrenal gland traumatic lesions.A total of 32 lesions were found.Twenty-six lesions were unilateral(23 right-sided,3 left-sided),and 3 cases were bilateral(6 lesions).Main CT findings were as followed:(1)Adrenal hematomas appeared as discrete round or oval masses expanding the adrenal gland in 22 patients with 25 lesions.The lesions were hyperdense or of homogeneous density in plain scan and did not enhance in three-phase contrast-enhanced dynamic scan.The splayed adrenal limbs around hematoma were enhanced significantly as eurvilinear structures.(2)Mild to moderate uniform swelling of gland was shown in 4 cases.(3)Diffuse irregular hemorrhage obliterating the gland was shown in 3 cases.Contrast extravasation was shown in 1 case,which was active bleeding from the broken adrenal gland proven by operation.Associated CT findings included strand-like hemorrhage of the periadrenal fat and posterior pararenal hemorrhage mimicking thickened diaphragmatic crus.The concurrent injuries of ipsilateral thorax or/and abdomen were found in 25 patients.Conclusion The AGT has typical CT findings.Familiarity with characteristic CT findings of adrenal trauma is essential for the radiologist to avoid misdiagnosis.

Objective To explore the effectiveness and safety of branch protection technique with provisional stenting strategy in coronary bifurcation lesions by utilizing jailed balloon protection technique after pre-dilation in branch with cutting balloon. Methods 32 patients undergone jailed balloon protection technique after pre-dilation in branch with cutting balloon during January, 2015 to May, 2016 in Peking University of People's Hospital were enrolled consecutively in our study. 32 patients were involved including a total of 32 bifurcation lesions which were medina type 1,1,1 (n = 25, 78. 1% ), Medine type 0,1,1 (n =5,15. 6% ) and Medine type 1,0,1 (n = 2, 6. 3% ). For side branch diameter ≥2. 5 mm, the diameter ratio of cutting balloon to side branch was 1: 1. The angiography success rate after using branch protection during main branch stent implantation, perioperative complications and major adverse cardiac events were observed. Results ( 1 ) The angiography success rate of branch protection was 100% . ( 2 ) No perioperative complications and major adverse cardiac events were observed. Conclusions Side branches were effectively protected in provisional stenting strategy by applying jailed balloon protection technique after pre-dilation using branch cutting balloon.

Objective To observe the clinical outcome of modified posterolateral approaches for the treatment of posterolateral tibial plateau fractures. Methods From January 2012 to January 2015,13 patients with posterolateral tibial plateau fractures were identified in the Second Hospital of Changzhou Affiliated to Nan?jing Medical University. All the posterolateral fractures were fixated with a plate. The knee function was evaluated at the last follow?up by the Hospital for Special Surgery( HSS) Score,and the occurrence of postoperative compli?cations were observed. Results Thirteen patients were followed up for an average of 14. 4 months,all patients obtained bony union. There were no significant differences regarding the mean HSS score among 3 months, 6 months and 1 year post?operation((71. 6±1. 5) points, (76. 4±1. 6) points, (83. 2±1. 1) points;P=0. 154) . There were no significant differences regarding the tibial plateau angle and posterior slope angle on radiograph?ies of inside and outsideamong immediate,6 and 12 months postoperation((83. 7±1. 7)°,(84. 3±1. 5)°,(85. 1 ±1. 4)°,(85. 4±1. 5)°;(7. 7±1. 5)°,(7. 7±1. 4)°,(7. 7±1. 3)°,(7. 6±1. 8)°;P=0. 223,0. 191). No com?plications associated with the approach were observed and there was no infection,no malunion or fixation failure either. Conclusion In the treatment of posterolateral tibial plateau fractures,the modified posterolateral approa?ches can result in excellent fracture reduction under direct visualization and allow for posterior buttress plating.

Objective: To explore the application safety for off-label using of rotational atherectomy. Methods: A total of 112 patients received rotational atherectomy in our hospital from 2010-01 to 2015-12 were enrolled in this study. There were 9 off-label indications for using of rotational atherectomy which included vein grafts, massive thrombotic burden, unprotected left main coronary artery disease, culprit lesions of acute myocardial infarction, severe coronary dissection, signiifcant impaired left ventricular function (LVEF<30%), severe three-vessel coronary disease, diffuse long coronary lesions (≥25mm) and angulation lesions (≥45°). The patients were divided into 2 groups: Off-label group, the patients with ≥ 1 above mentioned indication(s),n=67 (59.8%) and On-label group, the patients without any indication,n=45 (40.2%). Rotational atherectomy related complication rates were compared between 2 groups including slow lfow/no lfow, stuck of rotablator, coronary artery perforation, guide wire fracture and in-hospital MACE as urgent CABG, acute in-stent thrombosis and cardiac death. Results:①The most common complication was slow lfow/no lfow and its occurrence rates were similar between 2 groups (4.5%vs 8.9%),P>0.05.②Off-label group had 1 patient with stuck of rotablator (1.5% vs 0%) and 1 cardiac death (1.5% vs 0%), both P>0.05; On-label group had 1 patient with acute in-stent thrombosis (2.2% vs 0%),P>0.05. Conclusion: Off-label using of rotational atherectomy did not increase the incidence of slow lfow/no lfow in relevant patients, other severe complications and in-hospital MACE occurrence were also rare.

Eleven compounds were isolated and purified from the barks extract of Nothopanax delavayi and their structures were identified as serratagenic acid-3-O-alpha-L-arabinopyranosyl-28-O-beta-D-glucopyranosyl ester (1), serratagenic acid-3-0-alpha-L-arabi-nopyranosyl-28-O-[alpha-L-rhamnopyranosyl-(1-->4)-beta-D-glucopyranosyl-(1-->6)-beta-D-glucopyranosyl] ester (2), serratagenic acid (3), serratagenic acid-3-O-alpha-L-arabinopyranoside (4), serratagenic acid-beta-O-beta-(2', 4'-O-diacetyl) -D-xylopyranosyl-28-O-[alpha-L-rhamnopy-ranosyl-(1-->4)-beta-D-glucopyranosyl-(1-->46)-beta-D-glucopyranosyl] ester (5), serratagenic acid-3-O-alpha-(4'-O-acetyl)-L-arabino pyrano-syl-28-0- [-alpha-L-rhamnopyranosyl-(1-->4)-beta-D-glucopyranosyl-(1-->6)-beta-D-glucopyranosyl] ester(6), serratagenic acid-3-O-alpha-(2'-O-acetyl)-L-arabinopyranosyl-28-O-[-alpha-L-rhamnopyranosyl- (1-->4) -beta-D-glucopyranosyl-(1-->6)-beta-D-glucopyranosyl] ester(7), serratagenic acid-3-0-beta-D-xylopyranosyl-28-O-[-alpha-L-rhamnopyranosyl-(1-->4)-beta-D-glucopyranosyl-(1-->6)-beta-D-glucopyranosyl] ester (8), protocatechuic acid (9), ethyl caffeate (10) and caffeic anhydride (11) by physicochemical properties and spectroscopic data analysis. Among them, compounds 3-4 and 9-11 were firstly isolated from the genus Nothopanax, and compounds 5-8 were isolated from this plant for the first time.
Araliaceae ; chemistry ; Drugs, Chinese Herbal ; chemistry ; Magnetic Resonance Spectroscopy ; Molecular Structure ; Plant Bark ; chemistry

Aortic Aneurysm, Abdominal ; surgery ; Endovascular Procedures ; adverse effects ; Humans ; Intestinal Fistula ; diagnosis ; etiology ; Male ; Middle Aged

Purpose To observe the functional expression of calcium sensing receptor ( CaSR) in human gastric cancer SGC-7901 cell line, the effect of CaSR on intracellular calcium, cell proliferation and migration of SCG-7901. Methods The expression and distribu-tion of CaSR were detected by Western blotting and immunofluorescence observation in SGC-7901. The intracellular concentration of free calcium ( [ Ca2+] i ) was determined by confocal laser scanning microscopy. MTT, flow cytometry and scratch test were used to an-alyze the impact of CaSR the proliferation and the migration capabilities of SGC-7901 cell. Results CaSR protein was expressed in SGC-7901. Extracellular calcium or calindol significantly increased the expression of [Ca2+]i, CaSR and E-cadherin;In addition, the migration capabilities were decreased. Conclusion CaSR is expressed in SGC-7901. The activation of CaSR induces the expression of E-cadherin, and decreases migration ability.