Standardized resident training is necessary for residents.The article focused on the establishment of standardized resident training model in the department of respiratory in Zhongshan Hospital of Fudan University.Zhongshan Hospital developed reasonable training plan,formulated strict evaluation and examination system and emphasized on cultivating practical,innovative and independent talents.Detailed measures included strengthening the basic knowledge and practical skills,developing independent learning ability,communication ability and innovative thinking and promoting medical ethics.All these experiences and explorations of standardized resident training in the department of respiratory will be beneficial.

Objective To determine whether vascular endothelial growth factor (VEGF) could be used as a tumor marker by detecting the VEGF levels in serum and effusion from malignant tumor patients. Methods VEGF concentrations were measured using an enzyme-linked immunosorbent assay in the serum from the healthy donors and in the serum and the malignant effusion from the patients. Results The serum VEGF levels from the malignant tumor patients was higher than that from the healthy donors, and there was a significant difference ( P

Air Pollutants, Occupational ; analysis ; Ammonium Sulfate ; analysis ; Chromatography, Ion Exchange ; methods ; Workplace

Angiogenesis Inhibitors ; therapeutic use ; Endostatins ; therapeutic use ; Histiocytic Sarcoma ; drug therapy ; Humans ; Male ; Middle Aged ; Recombinant Proteins ; therapeutic use

Objective To probe into the epidemic feature, pa tho genic spectrum and main risk factors of diarrhea during the field training in ar my. Methods Detection of morbidity,investigation of risk factor s and detachment of pathogen were performed. Results The diarrh eal incidence rate of army of field training was 4.36%(106/2 433), which was higher than that of hold garrison(0.98%, 2/204). The incidence rate of officers was lower than that of soldiers. Two incidence peaks concerned with the army motion course were foun d. The detection rate of lapactic bacteria from fecal of patients was 63.1%(65/1 03) and most of them were ETEC, followed by the plesiomonas shigelloides. Se ven ind ividual factors concerned with diarrhea disease were found with logistic analysi s, including dr inking unboiled water, going out to eating and so on. Conclusions Incidence of diarrhea in the army increased obviously during the field training and the chief pathogen are ETEC and plesiomonas shigelloides, at the same time, t he occurrence of diarrhea is related with many individual factors.

OBJECTIVETo study the overexpression of Sox9 gene on rabbit bone marrow mesenchymal stem cells for repairing articular cartilage injury in vivo.

METHODSRabbit bone marrow mesenchymal stem cells (BMSCs) were transduced with lentivirus vector containing Sox9 gene and then cartilage specific molecule was detected by RT-PCR in vitro. Total 48 knee joints of 24 mature New Zealand white rabbits were randomly divided into 3 groups according to different defect treatment. After animals anesthesia,a full-thickness cylindrical cartilage defect of 4 mm diameter and 3 mm deep was created in the patellar groove using a stainlesssteel punch. Meanwhile, the transfected cells were implanted to repair the rabbit model with full-thickness cartilage defects. Cartilage defects tissue was observed with light microscope, electron microscope, HE and immunohistochemistry staining to assess the repair of defects by the complex at 6 weeks or 12 weeks after the implantation.

RESULTSAt 3 days after the transfection, Sox9 gene expression was highest and Sox9 gene expression decreased with the increase of time. At 3 days after the transfection, the expression of collagen type II began and reached the peak at 14 days. It showed that the bone marrow mesenchymal stem cells went into chondrogenic differentiation after transfected by Sox9 gene. Histological observation showed that at 6 weeks after the operation, the defects in the experimental group was filled with hyaline like cartilage tissue, 12 weeks after operation,the defects of cartilage and subchondral bone had satisfactory healing. Both at 6 and 12 weeks postoperatively, the defects were filled with fibrous tissues in control groups. Meanwhile, immunohistochemical staining of sections with type II collagen antibodies showed the proteins in the regenerated tissue stained positive for type II collagen and stronger than the control groups. The histological scoring system indicated that the cartilage repair of experiment groups were better than the two control groups with statistical significances.

CONCLUSIONOverexpression of Sox9 gene on rabbit bone marrow mesenchymal stem cells (BMSCs) promote the repair of cartilage defect.

Animals ; Bone Marrow Cells ; metabolism ; Bone Marrow Transplantation ; Cartilage, Articular ; injuries ; metabolism ; Cell- and Tissue-Based Therapy ; Female ; Genetic Vectors ; genetics ; metabolism ; Humans ; Lentivirus ; genetics ; metabolism ; Male ; Mesenchymal Stem Cell Transplantation ; Mesenchymal Stromal Cells ; metabolism ; Osteoarthritis ; genetics ; metabolism ; therapy ; Rabbits ; SOX9 Transcription Factor ; genetics ; metabolism ; Tissue Engineering

Objective To analyze the elonal gene rearrangement and complementarity determining region 3 (CDR3) Repertoire of TCR β-chain in fine needle aspiration biopsy (FNAB) specimens of peripheral T-cell lymphoma. Methods The TCR CDR3 region genes of 24 TCR Vβ subfamilies were amplified by utilizing RT-PCR technology, and the CDR3 size lengths of TCR β-chain were analyzed with genesean technology for 4 healthy individuals and 4 patients with peripheral T-cell lymphoma. The clonality of T cells presumed by spectratyping was further confirmed by CDR3 sequencing. Results TCR β-chain presented specific repertoire skewing in 4 cases with peripheral T-cell lymphoma, and only 1-4 TCR Vβ subfamily T cells were identified, respectively. Clonal expanded T cells, including mono, bioclonal and oligoclonal trend patterns, in one or more Vβ subfamilies were found in all cases. The mono expanded T cells have different CDR3 amino acid sequences. Conclusion Characteristic T cells cloning proliferation and selected usage of TCR Vβ subfamily T cells were found in 4 cases with peripheral T-cell lymphoma. The sequences of CDR3 in different TCR clone proliferation are different.

Objective To explore the clinical the efficacy of large diameter esophagogastric internal fistula combined with fundoplication and modified Heller surgery for treatment of achalasia.Methods From June 2008 to March 2014,18 patients diagnosed as achalasia were se-lected into this suty,and they were divided into the observation group (8 cases)and the control group (10 cases).Patients of the observation group were received large diameter esophagogastric internal fistula combined with fundoplication while patients of the control group received modified Heller surgery.Compared the surgical curative effect and complications between the two groups.Results All the 18 patients suc-cessfully completed the arranged surgical treatment.The imaging examination 3 months after the operation showed that the contrast agent suc-cessfully passed through the esophagus,cardia and the anastomosis,and then went into the gastric lumen.The total effective rate was 100% in the observation group 12 months after operation,while it was 60% in the control group,and the difference between the two groups was statisti-cally significant (P =0.014).The incidence of complications in the observation group was lower than that of the control group,the difference was statistically significant (P =0.026).Conclusion Large diameter esophagogastric internal fistula combined with fundoplication for treat-ment of achalasia is safer,and there is a possibiltiy to cure the achalasia.

Objective: To compare the safety and efifcacy of platelet glycoprotein IIb/IIIa antagonist in treating STEMI patients by intracoronary-intravenous administration and intravenous administration.
Methods: We searched PubMed, Embase, Cochrane library, CNKI, VIPH and Wanfang database, the retrieval stopped at 2014-03. According to 5.0.2 Cochrane handbook, 2 scientists collected 2494 STEMI patients treated by IIb/IIIa antagonist from 20 references, and they were divided into 2 groups. Combination group, the patients received intracoronary, then intravenous administration, n=1258 and Intravenous group, the patients receive only intravenous administration, n=1236. RevMan 5.0 software was used for Meta-analysis.
Results: At 1 month after PCI treatment, compared with Intravenous group, the Combination group had better conditions of TIMI 3, TMP 3, ST segment recovery, MACE occurrence and MI area changes, all P<0.01; Combination group also showed better conditions of angina recurrence, death and post-operative target vessel revascularization, all P<0.05. LVEF was similar between 2 groups at 1 week after PCI. MI recurrence, post-operative bleeding and thrombocytopenia were similar between 2 groups at 1 month after PCI, all P>0.05.
Conclusion: Intracoronary-intravenous administration of platelet glycoprotein IIb/IIIa antagonist had the better effect for treating STEMI patients without increasing the side effects of post-operative bleeding and thrombocytopenia.

Objective: To evaluate the efifcacy and safety on clopidogrel combining proton pump inhibitor (PPI) for treating the patient after percutaneous coronary intervention (PCI) by Meta analysis.
Methods: We searched MEDLINE, EMBASE, Cochrane Library and conference databanks, the retrieval time ended at 2014-03 and 14 references were selected for Meta analysis by RevMan 5.2 software. A total of 52274 patients were enrolled and divided into 2 groups, Control group, the patients received clopidogrel, n=43809 and Combination group, the patients received clopidogrel and PPI n=8465. The efifcacy and safety were compared between 2 groups.
Results: Compared with Control group, the patients in Combination group showed increased all cause death rate (OR=1.20, 95% CI 1.05-1.37), re-myocardial infarction (MI) (OR=1.19, 95% CI 1.07-1.33) and in-steut re-vascularization (OR=1.22, 95% CI 1.08-1.39), all P<0.05; while the MACE (OR=1.29, 95% CI 0.98-1.69), in-stent thrombosis (OR=1.22, 95% CI 0.97-1.54) and gastro- intestinal bleeding (OR=0.95, 95% CI 0.55-1.67) were similar between 2 groups, all P>0.05. Further analysis found that PPI (such as omeprazole and esomeprazole) could compete the CYP2C19 enzyme location of clopidogrel, increase the risk of cardiovascular events and decrease the gastrointestinal protection.
Conclusion: Clopidogrel combining PPI may increase the risk of all cause death, MI, in-stent revascularization and decrease the gastrointestinal protection in patients after PCI, especially for omeprazole and esomeprazole which may compete the CYP2C19 enzyme location of clopidogrel.