Good standardized training of resident physicians is indispensable for high quality medical personnel building.This paper gives a brief introduction to the experiences of endocrinology fellowship trainings in three top hospitals in USA.On the basis of current simation in China,a new and improve the quality'is proposed,and a new approach is explored,which is a valuable reference for the endocrine resident trainings in China.

Blast Injuries ; Deafness ; etiology ; Humans

Aim To research the protective effect and mechanisms of taurine on myocardial ischemia and reperfusion injury in rats. Methods Myocardial ischemia reperfusion models were established in SD rats. The effects of taurine on the size of myocardial infarction and the changes of activity of SOD , and the levels of MDA and NO in myocardium and plasma of rats with myocardial ischemia and reperfusion injury were observed. Results In rats with myocardial ischemia and reperfusion injury, the taurine could reduce the size of myocardial infarction (P

Objective:To investigate the diagnostic value of spiral CT head and neck angiography on carotid artery stenosis in patients with acute cerebral infarction.Methods:A total of 60 patients with acute cerebral infarction(ACI),who were treated in Affiliated Hospital of Yan'an University from January 2014 to January 2016,were selected as observation group,and 60 patients with non-acute cerebral infarction,as control group.The two groups of patients underwent spiral CT head and neck angiography.The degrees of carotid artery stenosis and the distribution of vascular plaques were compared between the two groups.The diagnostic value of spiral CT head and neck angiography in the diagnosis of carotid artery stenosis of the patients with ACI was evaluated.Results:The detection rates of mild and moderate stenosis in the observation group were significantly higher than those in the control group (P＜0.05),while the detection rates of severe stenosis and occlusion had no significant difference compared with the control group (P＞0.05).The total detection rate of stenosis in the observation group was higher than that in the control group (P＜0.05).There were plaques detected in the carotid bifurcation,common carotid artery,internal carotid artery and external carotid artery in the two groups.The total detection rate (69.4％) of the observation group was significantly higher than that (41.2％) of the control group (P＜0.05).Conclusion:Application of 128-slice spiral CT can effectively assess the head and neck angiography on carotid artery stenosis in patients with acute cerebral infarction.This method has a higher detection rate from mild to moderate stenosis and bilateral carotid artery plaques in the patients with ACI,and it has application value in the clinical diagnosis and prognosis.

Air Pollutants, Occupational ; analysis ; Gas Chromatography-Mass Spectrometry ; methods ; Volatile Organic Compounds ; analysis ; Workplace

Air Pollutants, Occupational ; analysis ; Chromatography ; methods ; Sulfur Dioxide ; analysis ; Workplace

A BBB co-culture cell model consisting of rat brain microvascular endothelial cells (BMEC) and astrocytes (AS) was established to study the effect of Angelica dahurica coumarins on the transport behavior of puerarin across blood-brain barrier (BBB) in vitro and in vivo. The barrier function of this model was evaluated by measuring the transendothelial resistance, phenol red permeability and BBB related protein expression. The permeability assay and western blot methods were performed to study the effects of Angelica dahurica coumarins on the BBB permeability and the expression of BBB related protein. The animal experiment protocols in this study were approved by the Animal Ethics Committee of Xi'an Jiaotong University (Animal Ethics No.: 2021-1329). The results showed that the established BMEC/AS co-culture model could be used to evaluate drug transport across BBB in vitro. After combined with Angelica dahurica coumarins, the transport capacity of puerarin was significantly increased in vitro and in vivo. Additionally, Angelica dahurica coumarins enhanced BBB permeability and inhibited the protein expression of P-glycoprotein (P-gp), zonula occludens-1 (ZO-1) and occludin. Angelica dahurica coumarins might increase BBB permeability by inhibiting the expression of P-gp and tight junction protein, thereby increasing the content of puerarin in brain tissue.

Objective To improve the level of early detection and treatment of pyonephrosis. Methods This study included 41 cases(17 men and 24 women;mean age,49 years)of pyonephrosis.A variety of examinations,including urinary analysis,blood analysis,kidney nuclear medicine scan,ultrasonog- raphy,intravenous urography(IVU),and CT were used for the early diagnosis of pyonephrosis.Pereutaneous nephrostomy(PCN)drainage was done for the interim management of pyonephrosis,then phase 2 operation was performed in 28 cases.The double-J tube was placed in ureter by ureteroscope for drainage,and then phase 2 operation was done in 2 cases.Emergency operation was done in 10 cases.The remaining 1 case un- derwent ESWL after anti-infective therapy.Results Definite diagnosis of pyonephrosis before operation was made by invasive examinations in 31 cases(75.6%),and by percutaneous drainage in 4 cases;the other 6 cases were detected during operation.Only 6 cases(14.6%)underwent nephrectomy;the other 35 cases (85.4%)underwent kidney-sparing operation.Follow-up of 3 months to 9 years was available in 37 cases. No nephrectomy was needed in 33 cases with spared kidney.Serum creatinine was normal in the 4 cases un- dergoing nephrectomy.Conclusions The key to the treatment of pyonephrosis by kidney-sparing surgery is early diagnosis,timely drainage and relief of obstruction.Ultrasonography plays an important role in the early diagnosis of pyonephrosis,and CT has a high sensibility in the diagnosis.Pereutaneons nephrolithotomy (PCNL)secondary to drainage through pereutaneous nephrostomy was beneficial to the patients with kidney stones or upper ureter stones.

Objective To study the clinical significance of cell factors in plasma samples of hand?foot?mouth disease. Methods Sixty?nine cases hand?foot?mouth diseases children who were treated in Fifth People’ s Hospital of Wuxi from July to December 2014 were selected as research objects,and divided into normal hand?foot?mouth disease group with 48 cases and severe hand?foot?mouth disease group with 21 cases. Twenty healthy children were selected as healthy control group. Serum samples were collected from 3 groups of subjects. The lev?el of IgA,IgG and IgM were detected by immune turbidity method. The level of IFN?γ, IL?10, IL?13 and IL?2 were detected by flow cytometry. Results The level of serum IgG,IgA of severe hand?foot?mouth disease group patients were (12. 33±8. 58) g/L,(0. 78±0. 55) g/L,significantly lower than control group((7. 09±6. 36) g/L,(0. 61±0. 36) g/L) and the normal hand?foot?mouth disease group((7. 41±5. 07) g/L,(0. 57±0. 41) g/L),the differences were significant(P<0. 05),while there was no significant difference between normal hand?foot?mouth disease group and control group( P>0. 05) ,and there was no significant difference in term of the level of IgM among the three groups( P>0. 05) . The level of serum IFN?γ,IL?2,IL?13 of severe hand?foot?mouth dis?ease group were (0. 95±0. 67) ng/L,(1. 07±0. 64) ng/L,(1. 25±0. 46) ng/L,significantly lower than normal hand?foot?mouth disease group((2. 72±1. 15) ng/L,(2. 07±1. 53) ng/L,(2. 31±1. 35 ) ng/L) and the control group((1. 83±1. 12 ) ng/L,(1. 61±1. 37) ng/L,(1. 99±0. 75) ng/L),the differences were significant(P<0. 05). The level of serum IL?10 of normal hand?foot?mouth disease group was (2. 69±1. 33) ng/L,significant?ly higher than severe hand?foot?mouth disease group ( ( 1. 54 ± 1. 23 ) ng/L ) and control group ( ( 1. 35 ± 1. 12 ) ng/L) ,the differences were significant( P<0. 05) . Conclusion The level of serum cytokines can reflect the ge?netic profile status,understand the development trend of the disease,provide a reliable index for early clinical in?tervention.

Objective To study the effect of local mild hypothermia on the expression of matrix metallopro- teinases-2/9 (MMP-2/9) and brain edema in experimental intracerebral hemorrhage (ICH) in rat. Methods One hundred and forty-five Wistar rats were randomly divided into a normothermia sham-operation (NSO) group ( n = 15 ), a normothermia intracerebral hemorrhage (NICH) group (n = 75 ) and a mild hypotbermia intracerebral hemor- rhage (MHICH) group (n = 75). Autologous arterial blood was stereotaxically injected into the right caudate nucleus of the rats of the NICH and MHICH groups to make intracerebral hemorrhage model. The rats in the MHICH group were then subjected to 4 hours of local mild hypothermia, while those in the NICH group were under the room temper- ature. The brain water content, permeability of brain-blood barrier (BBB) and expressions of MMP-2/9 were meas- ured by immunohistochemistry method at 6 h, 24 h, 72 h, 5 d and 7 d after operation. Results In NICH group, the brain water content, permeability of BBB and expression of MMP-9 all began to increase at 6 h and peaked at 3 d after injection of blood and still higher than the NSO group at 7 d. The expression of MMP-2 only began to increase little at 24 h and peaked at 5 d after operation and remained highly expressed at 7 d. In the MHICH group, the chan- ges of brain water content, permeability of BBB and expression of MMP-9 were similar to those of the NICH group, but the extent of changes was significantly lower at the every time point. In NICH group and MHICH group, MMP-9 expression was positively correlated with both the brain water content and the permeability of BBB, but MMP-2 ex- pression was not correlated with them. Conclusion Mild hypothermia might protect BBB against injury caused by ICH and relieve brain edema and inflammation reaction through inhibiting the expression of MMP-2/9.