Medical record writing may open up the clinical intern's clinical field of vision his,raise clinical thought,and improve his medical comprehensive ability.The clinical intern in medical record writing has the following questions:the delayedwriting,unstandard language and the unreal content and so on.Through the centralizing teaching,teachers'prompt counsel and interns'initiation and so on,clinical interns'medical record writing quality may be enhanced.

Objective By comparing the plasma levels of adiponectin respectively in colorectal carcinoma patients to healthy controls to discuss the relationship between adiponectin and colorectal carcinoma. Methods Plasma samples collected from 38 colorectal cancer cases, 38 healthy controls, respectively, were analyzed with a specific ELISA assay. Results The mean adiponectin levels in colorectal cancer pa-tients and healthy controls were 159.89 and 184.5 pg/mL,respectively. Obviously colorectal cancer patients had significantly lower plasma adiponectin concentrations compared with healthy controls(P=0.001). And a inverse correlation was found between plasma adiponectin levels and tumor size with significantly lower levels of adiponectin in tumors≥5 cm (P=0.04), while no similar relationship was found between adiponectin and p53, Dukes stages(P>0.05). Conclusions Lower plasma levels of adiponectin are associated with color-ectal carcinogenesis closely. And the lower plasma levels of diponectin were positively related to the degree of tumor size. It can presume that adiponectin play a vital role in the process of colorectal carcinogenesis.

Objective To study the effects of high albumin, high glucose and low bovine serum on the phenotypic transformation of renal tubular epithelial cells. Methods The normal human kidney proximal tubular eel] line (HKC) was cultured for 30 days in the presence of high albumin (1.5 g/L), high glucose(25 mmol/L) and low bovine serum(2% ) . Morphological changes were observed by electronic microscopy. Immunohistochemistry stain was used to examine the expression of cytokeratin, vimentin, a-SMA, collagen Ⅰ and TGF-pl protein. Western blot was applied to further detect the process of collagen I protein expression, and in situ hybridization was used to examined the expression of collagen Ⅰ gene. Results Renal tubular epithelial cells cultured in high albumin, high glucose and low bovine serum showed obvious morphologic changes, including elongated shape, decrease of microvilli and mitochondria, and increase of rough endoplasmic reticulum under electronic microscopy. Immunohistochemistry stain revealed the reduction of cytokeratin, and enhancement of vimentin, ?-SMA, TGF-?1 and collagen Ⅰ. Western blot demonstrated that the expression of collagen Ⅰincreased in a time-dependent manner, and in situ hybridization showed that collagen type Ⅰ mRNA increased as well. Conclusion High albumin, high glucose and low bovine serum induce phenotypic transformation of renal tubular epithelial cells into mesanchymal cells.

Objective: Cellular proliferate inhibition, senescence or apoptosis are induced by telomere shortening through the activation of P53 pathway, but so far, little is known of the mechanism. This study aimed to clarify the molecular regulation of P53 through telomere pathway by the investigation of molecular interaction between P53 and the main telomere associated protein telomeric repeat binding protein 1(TRBP1) in vitro. Methods: Glutathione S-transferase (GST) alone and 4 different human P53-GST fusion proteins were expressed in E. coli. and purified through glutathione Sepharose TM 4B by affinity chromatography, P53s were wild type P53 (1-393), N terminal truncated form P53 2C (95-393), C terminal truncated form P53 N5 (2-293) and single amino acid mutant P53 R175H (175 arginine to histidine). Glutathione Sepharose TM 4B, purified GST alone and P53 fusions were mixed with human breast cancer cell line MCF-7 cellular protein extracts through in vitro binding assay-pull down, the molecular interaction between P53 and TRBP1 were detected by Western blot. Results: SDS-PAGE and Coomassie brilliant blue staining showed that the molecular weights of all the purified proteins were as expected and purities were over 90%. Western blot of TRBP1 showed that both wild type P53 and P53 R175H could bind to TRBP1 of MCF-7 cells, and their binding capacities are similar, whereas GST alone and Glutathione Sepharose TM 4B beads couldn’t. Compared with both of them, the interaction between P53 2C and TRBP1 enhanced dramatically, but between P53 N5 and TRBP1 reduced significantly.Conclusion: P53 can interact with TRBP1 directly and in vitro, C terminus of P53 (293-393) is the structural domain of their interaction. This C terminus domain dependent interaction between P53 and TRBP1 may be related to the cellular activities induced by telomere dynamic changing.

Objective To investigate the prognosis of two decompression approaches for cervical spondylotic myelopathy. Methods 86 cases were divided into two groups. 40 cases were underwent decompression by anterior decompression, fusion and internal fixation with titanium screws and plate and 46 cases underwent posterior single opendoor laminoplasty. To investigate the prognosis of two decompression approaches for single compressive segment, two compressive segments, three compressive segments and four compressive segments. Results All cases were followed up for 20 ～ 73 months with an average of 43 months. The mean JOA recovery rate was significant different between single compressive segment group (P ＜ 0.05), and no significant difference between two compressive segments and three compressive segments(P ＞ 0.05), and significant difference between four compressive segments groups (P ＜0.05). Conclusion For single compressive segment, the anterior surgery has a good surgical result,for two or three compressive segments, anterior and posterior surgery had same effect, for the four compressive segments, posterior surgical effect was good.

The article introduces the experience of Clinical teaching of anesthesiological undergraduate under "3+2" pattern.We have enhanced the teaching effect by making the detailed teaching plan for overall situation,strengthening clinical guidance and teaching of one by one,educing the students subjective initiative and utilizing kinds of methods to raise the students' comprehensive capacity.

Objective To observe the effect of external use of Curcuma oil on the hyperplasia of mammary glands in rats and explore the mechanism. Methods Sixty female Wistar rats were randomly divided into following groups:normal con-trol group, model control group, Sanjierubi plaster group, low-, medium- and high-dose curcuma oil emulsion groups ( n=10 each).The models of hyperplasia of mammary glands were established by intramuscular injection of estradiol benzoate and proges-terone into the medial part of the rat hind limb.Different doses of medicines were given for 4 consecutive weeks.Enzyme-linked im-munosorbent assay, HE staining and immunohistochemistry were used to investigate the action mechanism of curcuma oil emulsion against mammary gland hyperplasia. Results Curcuma oil emulsion had preventive and therapeutic effects on the hyperplasia of mammary glands.The diameter of breasts was significantly reduced, the body weight restored, serum estradiol, follicle-stimulating hormone and prolactin levels profoundly decreased, progesterone, testosterone and luteinizing hormone levels markedly increased and the number and diameter of lobular acini obviously reduced in high-dose curcuma oil emulsion group when compared with those in model control group (P<0.05 or P<0.01). Conclusion Curcuma oil emulsion can remarkably improve the disturb-ance of serum hormones and inhibit the occurrence of hyperplasia of mammary glands.

This study investigated the modulatory effect of synthetic cannabinoids WIN55,212-2 on 5-HT(3) receptor-activated currents (I(5-HT3)) in cultured rat trigeminal ganglion (TG) neurons using whole-cell patch clamp technique. The results showed that: (1) The majority of examined neurons (78.70%) were sensitive to 5-HT (3-300 μmol/L). 5-HT induced inward currents in a concentration-dependent manner and the currents were blocked by ICS 205-930 (1 μmol/L), a selective antagonist of the 5-HT(3) receptor; (2) Pre-application of WIN55,212-2 (0.01-1 μmol/L) significantly inhibited I(5-HT3) reversibly in concentration-dependent and voltage-independent manners. The concentration-response curve of 5-HT(3) receptor was shifted downward by WIN55,212-2 without any change of the threshold value. The EC(50) values of two curves were very close (17.5±4.5) μmol/L vs. (15.2±4.5) μmol/L and WIN55,212-2 decreased the maximal amplitude of I(5-HT3) by (48.65±4.15)%; (3) Neither AM281, a selective CB1 receptor antagonist, nor AM630, a selective CB2 receptor antagonist reversed the inhibition of I(5-HT3) by WIN55,212-2; (4) When WIN55,212-2 was given from 15 to 120 s before 5-HT application, inhibitory effect was gradually increased and the maximal inhibition took place at 90 s, and the inhibition remained at the same level after 90 s. We are led to concluded that-WIN55,212-2 inhibited I(5-HT3) significantly and neither CB1 receptor antagonist nor CB2 receptor antagonist could reverse the inhibition of I(5-HT3) by WIN55,212-2. Moreover, WIN55,212-2 is not an open channel blocker (OCB) of 5-HT(3) receptor. WIN55,212-2 significantly inhibited 5-HT-activated currents in a non-competitive manner. The inhibition of I(5-HT3) by WIN55,212-2 is probably new one of peripheral analgesic mechanisms of WIN55,212-2, but the mechanism by which WIN55,212-2 inhibits I(5-HT3) warrants further investigation.

Objective To assess the efficacy and safety of premedicaton with pronase before upper gastrointestinal endoscopy (UGI).Methods A total of 440 outpatients from 5 centers were randomly assigned to receive endoscopy with one of three premedications as follows:dimethylpolysiloxane (DMPS) and pronase (group A,n =170) ; DMPS and sodium bicarbonate (group B,n =170) ; DMPS,pronase and sodium bicarbonate (group C,n =100).Six endoscopists,who were unaware of the premedication types,calculated the visibility scores (range,1 to 4) of the antrum,gastric body,and fundus.The sum of the scores from the three locations was defined as the total visibility score.Results With regards to routine white light endoscopy,the total visibility score of group C was significantly higher than that of group A (P =0.0001),and the score of group A was significantly higher than that of group B (P =0.0019).Concerning chromoendoscopy,the total visibility score of group C was significantly higher than that of group A (P =0.0054),and the score of group A was also significantly higher than that of group B (P ＜ 0.0001).Conclusion Combined application of pronase,dimethylpolysiloxane,and sodium bicarbonate before UGI endoscopy significantly improves endoscopic visualization.

Objective To explore the effectiveness of 125I seed implantation for gastric cancer and to determine whether the therapy could increase the survival rate.Methods Seventy-six gastric cancer patients in stage Ⅱ or Ⅲ were involved and randomly divided into treatment group (n =42) and control group (n =34)by simple random sampling method.The patients in the control group underwent D2 or D3 surgery and the patients in treatment group underwent D2 or D3 surgery plus interstitial implantation of 125I seeds.All patients signed the informed consents.Treatment results were evaluated as CR,PR,NC and PD.CR and PR were considered as effective and the effective rate was calculated.All patients were followed up and the three-or five-year survival rate was calculated,the complications were examined.x2 test was used to compare the significant difference between the two groups.Results The total effective rate in control group was 50.00％ (17/34),lower than that of treatment group (73.81％,31/42; x2 =4.578,P＜0.05).In the treatment group,the three-year and five-year survival rates were 61.90％(26/42) and 42.86％(18/42) respectively,and the corresponding rates in the control group were 11.76％(4/34) and 0(0/34) respectively (x2=19.771,19.094,both P＜0.001).Both of the two groups had few severe side effects.Conclusion Radical surgery plus 1~Iseed implantation is effective and safe for the treatment of stage Ⅱ or Ⅲ gastric cancer and can further improvelong-term survival.