Objective To investigate the expression and significance of Ezrin in skeletal muscle of myopathy patients. Methods The skeletal muscle specimens with obviously regenerating muscle fibers were obtained from 9 patients with pseudohypertrophic muscular dystrophy (DMD) and 5 patients with polymyositis (PM). Then frozen serial sections were made and the sections were treated with HE stain, immunohistochemistry stains including anti-Ezrin and anti-Neural cell adhesion molecule (NCAM) monoclonal antibodies. The pathological changes and the expression of Ezrin were observed. Results The small regenerating fibers, central location of nucelus and basophilia endochylema were observed under HE stain both in the patients with DMD and PM. Anachromasis of anti-NCAM monoclonal immunohistochemistry stain was found in the regenerating muscle fibers. Positive Ezrin expression was also detected in the regenerating fibers. However, this expression tapered gradually as the mature process of skeletal muscle. The expression of Ezrin was negative in the mature fibers. Ezrin expressed in the myoblasts. Conclusions Ezrin may be closely related to the regenerating skeletal muscle fibers of DMD and PM patients.

This study examined the impact of luteinized unruptured follicle (LUF) on endometrial receptivity. The menstrual cycle of 17 LUF patients (LUF group) and 13 ovulatory women (control group) was monitored by measuring LH level in urine and by ultrasonic examination. An endometrial biopsy at the sixth to tenth day after LH surge was taken in all the patients. The expressions of endometrial ER, PR and integrin ανβ3 were immunohistochemically determined. At the same time, the serum levels of E(2) and P were detected by chemiluminescence. The results exhibited that (1) The mean serum P level in LUF group (7.32±2.56 ng/mL) was significantly lower than that in control group (11.17±3.17 ng/mL) (P<0.01). But there was no significant difference in the mean serum E2 levels between LUF group (179.35±81.60 pg/mL) and the control group (198.58±75.23 pg/mL) (P>0.05); (2) The mean expression intensities of ER, PR in endometrium of LUF group (183.86±2.43, 167.94±3.04) were significantly higher than those in control group (109.35±6.31, 105.98±4.07) (P<0.01); (3) The mean expression intensities of integrin ανβ3 in endomtrium of LUF patients (114.90±11.38) were significantly lower than those in control group (191.34±1.82) (P<0.01); (4) The change profile of integrin ανβ3 expression in the endometrium of LUF patients was in positive relation with serum P level (r=0.77, P<0.01), but bore no significant relationship with serum E(2) level (r=0.01, P>0.05). It was concluded that the depression of serum P levels in LUF patients was closely related to the failure of the down-regulation of ER and PR, and the low expressions of integrin ανβ3 also suggested that the delayed implantation and the impaired endometrial receptivity had impact on embryonic implantation.

Objective:To explore the methods to improve the professional core competencies of medical students in the standardized residency training.Methods:A total of 82 medical students who participated in the standardized residency training ("resident students" for short) in the same period were selected in this study, and the self-edited professional core competencies textbooks were used for regular theoretical study, and at the same time, clinical practice cases were collected for regular scenario reduction teaching. When the resident students entered the department and after 12 months of the standardized training, the professional core competencies training evaluation scale was used to evaluate and compare the scores of the resident students, and the value of the above-mentioned training model to improve the professional core competencies of the resident students was evaluated. SPSS 18.5 was performed for t test between groups. Results:After being trained by the above model, the selected students had significantly improved such competencies as communication, cooperation and problems solving ( P<0.05). Compared with the scores of resident students before and after the training, there was no significant difference in communication and cooperation with other students ( P>0.05), with low satisfactory communication with the leader ( P>0.05), but the problem-solving ability had been significantly improved ( P<0.05), while the score of which was low and it should be pay more attention to in the future training. Conclusion:In the process of standardized residency training, the application of the above-mentioned training model can significantly improve the professional core competencies of resident students, and at the same time, it's necessary to strengthen the cultivation of satisfactory communication with leaders and problem solving ability.

Peking University Health Science Center has various characteristics of educational manage-ment practice such as clear three level management, diversified management training and strict quality control, and at the same time there exist many deficiencies, such as lack of the implementation of management regulations and the requirements caused by multi-level management and management quality having ups and downs be-cause of human factors and etc.. By introducing life cycle management into national continuing medical educa-tion project management, we make management run through the whole life cycle of national continuing medical education project, namely five aspects of management from reporting and publishing, planning and publicity, holding and supervision, graduation and certificates, as well as summary and feedback, which plays an impor-tant role in standardizing the national continuing medical education project and improving the quality of the project.

Objective To study the effects of taking clopidogrel on relevant indicators of platelet aggregation function in 138 cases acute coronary syndrome (ACS) .Methods The platelet function analyzer and flow cytometry were adopted to detect the ADP‐induced platelet aggregation rate ,P selectin and activated GP Ⅱ b/ Ⅲ before medication and on 7 d after taking clopidogrel . Results The platelet aggregation rate after taking clopidogrel for 7 continuous d was decreased significantly (P<0 .01);the P se‐lectin level and activated GP Ⅱ b/ Ⅲ a expressed on platelet surface were significantly reduced (P<0 .01) as well .Conclusion Taking clopidogrel could reduce the platelet aggregation significantly in the patients with ACS and has the effect for inhibiting the platelet aggregation .

Objective To investigate CT and MRI imaging of Warthin tumor of parotid gland.Methods CT and MRI character-istics of 5 1 patients confirmed as Warthin tumor by operation and pathology were analyzed retrospectively.Results Among 5 1 cases, 43 patients were males,and 8 patients were females.A total of 84 lesions were found in all cases,20 cases had at least 2 lesions.The margins of lesions were well-defined.68 lesions were round or elliptical.45 lesions located in the posterior and inferior quadrant of the parotid gland completely or premodinantly.The density and signal of most lesions were homogeneous.The parenchymal area of most lesions showed an early moderate-remarkable enhancement.Small blood vessels surrounded the lesions in 1 9 cases.Conclusion CT and MRI are important and valuable for the diagnosis of Warthin tumor.

Objective To discuss the relationships between qi-arrival and mind-control, qi-arrival and qi-regulation, and to define qi-arrival by tracing the relevant records in Nei Jing (Classic of Internal Medicine) and Nan Jing (Classic of Difficult Issues). Method Thirty-seven relevant ancient books of the two classics were reviewed and the notes by WANG Bing, MA Shi, and YANG Shang-shan were referred. Result Mind-control requires the spirits of the practitioner, patient and environment, as well as observing and waiting for the arrival of qi. Regarding qi-regulation, theories involve that qi-arrival achieves same reinforcing and reducing effect as qi-regulation, qi-regulation is elucidated from the correct location of acupoint, proper needling depth and direction, and to regulate qi by observing the arrival of qi. Besides, the changes of internal and external environments also influence qi-arrival via qi-regulation and mind-control. Conclusion Qi-arrival is closely related to mind-control and qi-regulation in obtaining, differentiation, and adjustment. Mind-control and qi-regulation assist each other through the whole acupuncture process, which is the core of qi-arrival.

Objective:To introduce a 2-stage treatment protocol for the management of temporomandibular joint ankylosis with sec-ondary deformities in adults.Methods:24 adult patients (9 males and 15 female)(30 joints)at the average age of 26.1 years un-derwent TMJ reconstruction as the initial surgery,followed by orthodontic treatment and correction of secondary deformities as the sec-ond surgery.Clinical outcome was assessed based on maximal incisal opening,radiography and medical photography.Results:Skele-tal deformities were significantly improved in all patients,satisfactory occlusion was achieved with the orthodontic treatment,average maximal incisal opening increased from 3.4 mm to 32.5 mm(P <0.05).Conclusion:The 2-stage treatment protocol is an effective approach for management of TMJ ankylosis with secondary deformities in adult patients.

Objective To investigate the relationship between the helper T cell 17 (TH 17)/ Regulatory T cells (Treg cells) balance in peripheral blood with acute graft-versus-host reaction (aGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT),as well as the impact of anti-thymocyte immunoglobulin (ATG) on helper T cells in peripheral blood.Method Seventyeight hematologic patients underwent allo-HSCT,conditioning with or without ATG.Ten healthy volunteers severed as a control group.The helper T and regulatory T cells in peripheral blood were detected by flow cytometry.Enzyme-linked irnmunosorbent assay (ELISA) was used to detect serum concentrations of interleukin(IL)-17,IL-21,IL22,IL23,γ interferon (IFN-γ),and transforming growth factor β1 (TGF-β1).Result The percentage of Treg cells,TH17 cells and ratio of TH17/Treg cells in patients without aGVHD showed no significant difference from the healthy controls (P＞ 0.05).As compared with control group and non aGVHD group,the ratio of Treg cells was increased,the percentage of TH 17 cells,and TH 17/Treg cells were significantly increased in 1-2-degree aGVHD group (P＜0.01).With increased degree of aGVHD,the difference as above was more significant in 3-4-degree aGVHD recipients (P＜0.01).In aGVHD group,the IL-17,IL-23,IL-21 and IFN-γ concentrations were higher than the healthy group (P＜0.01) and non-aGVHD group (P＜0.05).Serum TGF-β1 level in aGVHD group was significantly decreased as compared with healthy group and non-GVHD group (P＜0.05),while IL-22 concentrations showed no statistically significant difference among three groups (P＞0.05).In anti-thymocyte immunoglobulin (ATG) pretreatment group,the absolute count of peripheral blood lymphocytes was less than in healthy control group (P＜0.01).In ATG group,the absolute counts of TH1 cells,TH17 cells,CD3+ CD4+ cells and non-TH1/17 cells were less than in non-ATG group (P =0.0000),while the absolute counts of lymphocytes,CD3+ CD4-cells,and TH 1/17 cells were less than in non-ATG group,but there was significant difference (P＞0.05).Conclusion The balance of TH 17/Treg cells and related cytokines were closely associated with aGVHD after allo-HSCT,and ATG influences the reconstruction of TH 17 and Th1 cells at early stage.

Objective To evaluate the effects of sevoflurane postconditioning on the oncosis and apoptosis in cardiomyocytes during ischemia-reperfusion (I/R) in isolated rat hearts and the role of extracellular signalregulated protein kinase 1/2 (ERK1/2) signal transduction pathway in it.Methods Seventy-two isolated rat hearts perfused in a Langendorff apparatus were randomly divided into 6 groups (n =12 each) using a random number table:sham operation group (group S),myocardial I/R group (group I/R),sevoflurane postconditioning group (group SP),PD98059 vehicle dimethyl sulfoxide (DMSO) group (group DMSO),selective ERK1/2 inhibitor PD98059 group (group PD),and sevoflurane postconditioning + PD98059 group (group SP + PD).The hearts were subjected to ischemia for 30 min followed by 2 h reperfusion in the other groups except group S.In SP,DMSO and PD groups,the hearts were perfused with K-H solution saturated with 3.0％ sevoflurane,DMSO (＜0.2％) and PD98059 (20 μmol/L),respectively,for 15 min starting from the end of ischemia until 15 min of reperfusion,and then with plain K-H solution for 105 min.In group SP+ PD,the hearts were perfused with K-H solution saturated with 3.0％ sevoflurane and PD98059 for 15 min starting from the end of ischemia until 15 min of reperfusion.Myocardial infarct size and expression of porimin and caspase-8 proteins (by Western blot) were measured at the end of reperfusion.Results Compared with S group,the myocardial infarct size was significantly increased,and the expression of porimin and caspase-8 proteins was up-regulated in the other groups (P ＜ 0.05).Compared with I/R group,the myocardial infarct size was significantly decreased,and the expression of porimin and caspase-8 proteins was down-regulated in group SP (P ＜ 0.05),and no significant changes were found in the other groups (P ＞ 0.05).Conclusion Sevoflurane postconditioning can activate ERK1/2 signal transduction pathway and inhibit the oncosis and apoptosis in cardiomyocytes,thus attenuating I/R injury in isolated rat hearts.