Objective To investigate the attitude of medical students towards standardized resident training in Shanghai and to provide references for policy adjustment.Methods Self-made questionnaire was used to investigate the attitude of 267 clinical medical students towards standardized resident training in Shanghai.Reference reviewing and expert consultation were also performed.Results Nearly eighty percent of students believed that they had basic knowledge of the training.Two thirds of students hold objective attitude towards the policy.Conclusions Income and pressure in finding jobs are the main reasons why students object the policy.Standardized resident training program need to improve in aspects of advertisement,incoming,quality of teaching staff,connection between medical education and training.

Objective: This study was designed to assess the protective effects of high-dose aprotinin on isolated rat hearts from ischemia-reperfusion injury. Method: The study consisted of two groups of rats. An isolated rat working heart model was established. Group A (n=16), received cardioplegia with high-dose aprotinin. Group B (n=16), received same cardioplegia only. The rat hearts were perfused for 30 minutes, then arrested for 40 minutes and reperfused for 30 minutes. The hemodynamic parameters, myocardial creatine kinase (CK) and myocardial ultrastructure were measured before ischemia and during reperfusion. Results: Recovery of cardial function, coronary flow and myocardial ultrastructure in group A was significantly better. CK level was lower in group A. Conclusion: High-dose aprotinin (1×106 KIU/L) may reduce myocardial ischemic and reperfusion injuries.

Objective To test the releasing property of a self-developed plastic drug delivery implant of anti-infective nano-hydroxyapatite(nano-HA)so as to provide a new local drug delivery system(LDDS)for treatment of osteomyelitis.Methods The nano-HA was used as the core carrier to load gentamicin(GM).It was coated with poly hydroxybutyrate-co-hydroxyvalerate /polyethylene glycol(PHBV/PEG)to prepare the nano-HA-PHBV/PEG-GM microspheres which were mixed with the fibrin sealant(FS)to develop a plastic implant.Then its antibacte rial and in vitro releasing properties were investigated.Results The plastic LDDS implant was found to have a fine drug delivery capability.The bacterial growth inhibition zone was found around the LDDS for 56 days in the antibacterial test.Three samples were soaked with liquid of PBS(phosphate buffered saline).The titer of GM released within the first day was 154.3 ?g/mL,and then the releasing maintained a slow level in the following days.After 49 days'releasing,the titer was 6.9 ?g/mL which was still higher than the MIC(2 ?g/mL)(minima l inhibitory concentration)of GM.Conclusion The plastic LDDS has a fine in vitro releasing property and may have a widespread application in treatment of osteomyelitis.

Objective To explore post-operative treatment and intensive care of infants with congenital heart disease(CHD).Methods Clinical data of post-operative treatment and intensive care in 264 infants with CHD were analyzed retrospectively from May.1998 to Apr.2006.Among them,256 cases underwent radical operation,and 8 cases with palliative operation.Results Sixteen cases died early.Among them,after operation,there were 8 cases with Fallot′s syndrome,2 cases with complete atrioventricular canal anomalous,3 cases with ventricular septal defect(VSD)and pulmonary hypoplasia(PH),1 case with tricuspid atresia,1 case with single ventricle,and 1 case with persistent truncus arteriosus.Causes of death include low cardiac output,acute renal failure,degree of Ⅲ atrioventricular block(AVB),lung infection,respiratory failure and arrhythmia.One case with complete pulmonary vein ectopia was discharged due to post-opertative refractory hypercapnia;1 case with atrial septal defect(ASD)and patent ductus arteriosus(PDA) died of refractory heart failure due to high pulmonary arterial pressure 1 year after operation;1 case with tetralogy of Fallot died of lung hemorrhage after radical correct operation followed by palliative outflow tract deo-ppilant operation.Of them 245 cases alive,there were 233 cases with heart function grade Ⅰ,12 cases with grade Ⅱ.Conclusion Correct management of respiratory system,systemic electrocardial care,handling with arrhthymia on time,low cardiac output and nutritional support are the important measures in improving survival rate of infants with CHD.

An investigation of the dietary conditions and the growth of children was made from February to May 1982 in 14 nurseries and kindergartens in G districts of Tianjin.The results showed: the calorie intake was lower than 80% of the daily allowance of normal children in 11 of 14 nurseries and kindergartens while the protein intake was lower than 70% of the daily allowance in 12. The levels of other nutrients were also lower. The heights and body weights of children in these institutions belonged to B class of 6 grades by Zhou Qi-yuan.The causes of calorie and protein insufficiency and some suggestions were discussed.

Objective To investgate the value of various parameters obtained from monoexponential, biexponential, and stretched exponential diffusion?weighted imaging models in the differential diagnosis of breast lesions. Methods A retrospective study performed in 54 patients with pathologically confirmed malignant tumors(n=30), benign lesions(n=34) and normal fibroglandular tissues (n=30). All patients underwent T1WI, T2WI, dynamic enhancement and diffusion weighted MRI with multi?b values at a 3.0 T magnetic resonance imaging unit. All parameters were measured at a workstation. ADC was calculated by using monoexponential analysis(b=0, 800 s/mm2). Slow apparent diffusion coefficient (ADC?slow), fast apparent diffusion coefficient (ADC?fast), and perfusion fraction (f) were calculated using the biexponential model. Distributed diffusion coefficient (DDC) and water molecular diffusion heterogeneity index (α) were obtained from diffusion?weighted images using the stretched exponential model. All parameters were statistically compared among normal fibroglandular tissues, benign lesions and malignant tumors using Kruskal?Wallis rank sum test. Mann?Whitney U test were used for further comparisons between specific group pairs. ADC values were compared with ADC?slow and DDC for different groups by paired Wilcoxon test. Correlations between ADC?value, ADC?slow and DDC were assessed by using Spearman rank correlation coefficient. Receiver operating characteristic curve was used to analyze and compare the ability of these parameters in differentiation of benign and malignant breast lesions. Results The ADC, ADC?slow, f, DDC and α values were significantly different among the normal fibroglandular tissues, benign tumors and malignant tumors (P<0.05). Further differential comparisons of the four parameters between each pair showed that the ADC, ADC?slow, f, DDC and α values were significantly lower in malignant tumors than both in normal fibroglandular tissues and benign tumors(P<0.016 7). The ADC values of normal fibroglandular tissues, benign tumors and malignant tumors were significantly higher than ADC?slow and DDC (P<0.05). The f and DDC had higher area under the receiver operating characteristic curve (0.688 and 0.657 respectively). The optimal cutoff values for ADC, ADC?slow, f, DDC and α were 1.235 × 10-3mm2/s, 0.428 × 10-3mm2/s, 57.8%, 1.175 × 10-3mm2/s and 0.721, respectively. Theαvalue showed higher specificity (65.5%) and the f value had higher sensitivity (82.9%). Conclusion The parameters derived from biexponential and stretched exponential DWI could be helpful for differentiation between benign and malignant breast tumors.

Objective Recent studies have found that Roux-en-Y gastric bypass( RYGB) can inhibit the levels of blood glucose in type 2 diabetes,but its mechanism still remains unknown. In present study,we observed the effect of RYGB on insulin and GLP-1of type 2 diabetes mice. Methods The 12-week-old male SD rats were divided into four groups:group A ( no surgery,normal diet) ,Group B ( no surgery,DM diet+STZ injection) ,group C ( gastric bypass surgery+normal diet) ,group D ( gastric bypass surgery+DM diet+STZ injection) . One week after surgery rehabilitation,the diabetes model was built by STZ ( revulsant of the classical diabetes model) and high-fat-control diet. After four months,the changes of blood glucose,OGTT,body weight,food intake,water intake in each group were examined. Furthermore,the patho-logical changes of insulin and pancreatic were detected by HE staining. Meanwhile,the liver PEPCK gene and protein expression were detec-ted by using RT-PCR and Western blot. Results Four groups of rats all have significant changes in diet and weight. HE staining suggests the disseminated hyperemia and edema in pancreas and showed that islet has been severe damaged. Compared with no treatment normal diet,nor-mal rat+DM diet+STZ injection,has a markedly elevated blood glucose level 3 days later,insulin,OGTT,GLP,and ITT all have remarkable changes in different time periods,with a statistically significance (P<0. 05). Compared with the normal rat+DM diet+STZ injection group, RYGB + DM diet+ STZ injection group showed that these indicators of pancreas pathological changes significantly,glucose,insulin,OGTT, GLP,ITT all have significantly drop,as well as the gene and protein expression of PEPCK (P<0. 05). Conclusion RYGB can exert influ-ence on the change of insulin,OGTT,GLP,ITT and PEPCK in islets of type 2 diabetes rats,which may play a positive role in the further clini-cal applications.

Objective To investigate the expression of DNM T1 and PDCD4 in Tongue Squamous cell carcinoma and their signif‐icance to Clinical .Methods The protein expression of DNM T1 and PDCD4 in 40 cases of TSCC tissues and The adjacent no tumor tissues were measured by Elivision Two Step immunohistochemical method(IHC) ,the relationship between DNM T1 ,PDCD4 and clinicopathological parameters were analyzed .Results There was positively over expression of DNM T1 while the expression of PD‐CD4 was at a low lever or lost in TSCC tissues ,the expression of two genes DNM T1 and PDCD4 in the adjacent no tumor tissues were in contrast ;there was a significant negative correlation between DNM T1 and PDCD4 expression in TSCC(r = - 0 .452 ,P<0 .05) .The expression of DNM T1 protein were associated with histopathological differentiation types ,regional lymph node metasta‐sis and TNM staging(P< 0 .05) ,it had nothing to do with age and gender ;the expression of PDCD4 protein were associated with regional lymph node metastasis and TNM staging(P< 0 .05) ,and it had nothing to do with age ,gender ,histopathological differenti‐ation types .Conclusion Implying the abnormal expression of DNM T1 and PDCD4 protein might be closely related to the develop‐ment and progression of TSCC .DNM T1 may be participates in the inactivation of PDCD4 expression ,and led to the development of the cancer at last .

ObjectiveTo investigate the value of CEUS in differential diagnosis of benign and malignant thyroid solid lesions.MethodsTotally 45 patients with thyroid solid lesions underwent CEUS examination.The enhancement mode and blood perfusion characteristics of malignant and benign lesions were analyzed,and the results were compared with pathology.ResultsCEUS diagnosed 31 benign lesions and 14 malignant masses.The diagnostic accordance rate of CEUS was 93.75％ (30/32) and 92.31％ (12/13) for benign and malignant lesions respectively.In 31 benign lesions,27 (27/31,87.10 ％) showed entire homogeneous enhancement,4 (4/31,12.90％) presented inhomogeneous enhancement.In 14 malignant masses,1 (1/14,7.14 ％) showed homogeneous hypoechoic enhancement,12 (12/14,85.71％) presented inhomogeneous hyperechoic enhancement and 1 (1/14,7.14％) presented non-enhancement.ConclusionCombined with two-dimensional grey scale ultrasound and CDFI,CEUS enables dynamic observation of the microvascular perfusion of thyroid lesions,therefore helps to differentiate benign and malignant thyroid lesions.

OBJECTIVE:To extract and purify organic acids with macroporous resins from Folium Isatidis.METHODS:Folium Isatidis was extracted with 70% aqueous ethanol(pH=2)by Soxhlet extraction.The process was optimized by employing orthogonal test design with the content of anthranilic acid as the index.RESULTS:The resin HPD100 had much better adsorption capacity and desorption ratio by using 3 BV 60% aqueous ethanol to extract organic acids in Folium Isatidis than other resins.The results showed that HPD100 possessed the better ecomic under the concentration of sample 0.18mg?mL-1,the condition of pH 3.5,and flowing rate of 2BV?h-1.CONCLUSION:Macroporous resin HPD100 may be value of isolating and purifying the organic acids from Folium Isatidis.