Objective To investigate the application of CUSUM (cumulative sum control chart) curve in cardiac clinical teaching of resident surgeon education.Methods We chose a surgeon of 10years work experience of attending the preparation operation of internal mammary artery as control reference (standard group,28 patients) and a resident engaged in professional clinical cardiac work no more than 5 years as group 1,a professional training physician engaged in cardiac surgery clinical work more than 5 years as group 2 and took 40 patients' data respectively from the two groups' preparation of internal mammary artery operation.And then we recorded the postoperative mammary artery flow,internal mammary artery preparation time and adverse events data and made statistics analysis with SPSS 19.0,and CUSUM curve with Matlab R2012b polynomial curve.Results When the density of operate interval and the operate numbers came to about 25 cases,the polynomial eurve's slope rate went up to 0,regardless the surgeons' experience,CUSUM value was accumulated from 66 to 76,and overcame the learning curve successfully.However,when the density of operate interval did no reach the standard,the surgeon's CUSUM ploynomial cmwe slope rate never reached to 0,and can't overcome the learning curve.Conclusion CUSUM curve gives a clear quantitative indicator to the cultivation of clinical physician,and makes teaching teachers can understand the young physicians' learning process,so as to change the teaching plan,help young physicians cross the learning curve as soon as possible.

Objective To establish a quick method to probe the environmental estrogen-like compounds via fluorescent imaging analysis in high content analysis (HCA) technology.Methods HCA assays were performed to quantitatively in-vestigate the effect of collected environmental pollutants , including bisphenol A , nonylphenol , 1,2-phenylenediamine , 4-aminophenol, resorcinol, 3-aminophenol, 1,4-phenylenediamine and 2,5-diaminotoluene on nuclear granules formation ( Foci-formation) of estrogen receptor α( ERα)-EGFR( enhanced green fluorescent protein ) fusion-protein, which was se-lected as a research model in this study .The results were confirmed by the ERαtranscriptional activity by luciferase as-says.Results Compounds 1,2-phenylenediamine, 4-aminophenol, resorcinol, 3-aminophenol, 1,4-phenylenediamine and 2,5-diaminotoluene sulfate could not induce the ERα-EGFR nuclear granule formation.17-β-Estradiol, bisphenol A, or nonylphenol enhanced ERα-EGFR nuclear granule formation in a dose-dependent manner .The EC50 value was (4.17 ± 0.41) nmol/L, (1.48 ±1.79) μmol/L,or (3.70 ±0.78) μmol/L, respectively.The minimum detectable concentration was 1 nmol/L (17-β-estradiol)and 300 nmol/L (bisphenol A, nonylphenol).In luciferase tests, 17-β-estradiol, bisphe-nol A, or nonylphenol increased ERαtranscriptional activity in a dose-dependent manner ,and the EC50 value was (4.46 ±0.56) nmol/L, (2.31 ±0.21) μmol/L, or (6.60 ±0.94) μmol/L, respectively.The minimum detectable concentration was 3 nmol/L (17-β-estradiol), 300 nmol/L (bisphenol A),and 1 μmol/L (nonylphenol).Conclusion As an efficient method for ERαagonist identification , HCA assays based on the cell image phenotypes analysis can be used in quick recog -nition of environmental compounds with ER agonist-like activity.In all experimental compounds , only bisphenol A and non-ylphenol have a clear ER agonist-like activity .

Medicated diet has a long history in China. It is a special dietary form under the guidance of basic theo-ries of traditional Chinese medicine (TCM). This article discussed the characteristics, hot spots and methodological development of current study on medicated diet. It also discussed on current misunderstandings on the study of med-icated diet, such as lack of the guidance of systematic theory, not well-formed system, lack of professional personnel and their limitations, in order to promote the subject development of medicated diet.

Objective To determine the diagnostic value of 8-hour pH monitoring in gastroesophageal refulux disease(GERD)and compare its sentivity and specificity with that of 24-hour monitoring.Methods Patients had been given esophageal manometry and ambulatory 24-hour pH monitoring.The 8-hour datas were analyzed from the standard ambulatory 24-hour pH recording.GERD was confirmed if DeMeester Score was no less than 14.72 according to the routine pH monitoring,then DeMeester score was reanalyzed according to 8-hour period,the same dignosis cirteria was used for 8-hour pH monitoring.Results Totally 221 patients met the entrance criterion.The 8-hour test had a sensitivity of 93.5% when compared to the 24-hour test and a specificity of 95.9%.Kappa test and Mc-nemar test verified the two monitor periods were with considerable consistency.The Pearson coefficient correlation was 0.929 with P value less than 0.001.Conclusion The 8-hour analysis is as sensitive and specific as the routine test for demonstrating GERD.By using this method,patients may suffer less discomfort and appear enhanced compliance.

OBJECTIVE:To outline the development of phytomedicine in Germany to offer a reference for traditional Chinese medicine.METHODS:From the aspects of research,production and market to make an exposition of phytomedicine's develop?ment in Germany.RESULTS:There existed a gap between Germany and China in technology and standards in production of botanicals.CONCLUSION:We should use the experience of Germany in developing botanicals to draw up international quality standard of traditional Chinese medicine.

To explore the relativity between alexithymia and cognitive function in somatoform disorder patients.A total of 40 patients aged 18-65 years fulfilling the criteria of ICD-10 for somatoform disorders were recruited as research group.And 40 normal healthy subjects were selected as control group.Toronto alexithymia scale-20 (TAS-20) was employed to examine the alexithymia.And cognitive abilities screening instrument (CASI) was used to measure their cognitive ability.The 9-factor scores and total score of CASI test in patients with somatoforill disorder were significantly lower than those in the normal controls (P ＜ 0.05 or ＜ 0.01).The 3-factor scores and total score of TAS-20 test in patients withsomatoforill disorder were significantly higher than those in the normal controls (P ＜ 0.05 or ＜ 0.01).In research group,CASI scores were negatively correlated with the TAS-20 scores (P ＜0.05 or 0.01).

Objective To observe the efficacy and safety of cetuximab chemotherapy combined with irinotecan in the treatment of advanced colorectal in the elderly.Methods 40 irinotecanresistant patients with K-Ras wild type were randomized to cetuximab weekly combined with irinotecan group (group A) and cetuximab biweekly combined with irinotecan group (group B).In group A,cetuximab was given at an initial dose of 400 mg/m2,followed by weekly 250 mg/m2.In group B,cetuximah and irinotecan were given at 500 mg/m2 and 180 mg/m2 respectively every two weeks.Time to progression (TTP),overall survival (OS) and toxicity were compared between the two groups.Results There were no significant differences in objective response rate (RR),disease control rate (DOC),TTP and OS between goup A and group B (30.0％ vs.25.0％,60.0％ vs.55.0％,5.8 months vs.5.6 months,9.8 months vs.9.5 months,respectively,all P＞0.05).Grade 3 or more toxicities including hematological toxicity,gastrointestinal reactions and skin toxicity were found in 2 cases,2 cases and 1 case respectively in group A and 3 cases,1 case and 2 cases respectively in group B.The two groups had no significant differences in toxicities (all P＞0.05).Conclusions Cetuximab combined with irinotecan therapy is effective in the treatment of advanced colorectal cancer in elderly irinotecan resistant patients.Cetuximab biweekly regimen is more convenient but has the same efficacy and toxicity as compared with cetuximab weekly regimen.

BACKGROUND:Previous studies have shown that apoptosis, a central feature of articular chondrocytes, plays a dominant role in cartilage damage, which is one of the pathological factors of articular cartilage degeneration. OBJECTIVE:To observe the effects of meditcated serum containingDuhuojisheng Decoction on the expression of cytochrome C, proCaspase-9 and proCaspase-3 in rat degenerative chondrocytes in vitro and to investigate the possible molecular biological mechanism ofDuhuojisheng Decoction in the treatment of knee osteoarthritis. METHODS:A cultivation system of degenerative chondrocytes in vitro was established. After treatment with meditcated serum containingDuhuojisheng Decoction or blank serum for 24 and 48 hours, the protein expression of cytochrome C, proCaspase-9 and proCaspase-3 was measured by western blot assay. RESULTS AND CONCLUSION: In the cytoplasm, the release of cytochrome C was reduced gradualy in both groups in a time-dependent manner, and the release amount of cytochrome C was significantly lower in the medicated serum group than the blank serum group (P < 0.05). In mitochondria, cytochrome C leakage was gradualy decreased in both groups, and it was decreased significantly in the medicated serum group compared with the blank serum group (P < 0.05). The protein expression of proCaspase-9 and proCaspase-3 was gradualy increased in both groups, especialy in the medicated serum group; the medicated serum containingDuhuojisheng Decoction could promote the protein expression of proCaspase-9 and proCaspase-3 in a time-dependent manner, and there was a significant difference at 24 and 48 hours (P< 0.01). These findings indicate that the medicated serum containingDuhuojisheng Decoction can inhibit the apoptosis of osteoarthritis chondrocytes through inhibiting the release of cytochrome C and the activation of Caspase-9 and Caspase-3.

Objective To explore the effect of theta burst stimulation (TBS) paradigm of repetitive transcranial magnetic stimulation (rT-MS) on executive function in patients with chronic schizophrenia. Methods 60 patients meeting DSM-IV for chronic schizophrenia disor-ders criteria were enrolled. They were randomly divided into TBS group (n=30) and sham intervention group (n=30). They were assessed with digit span performance, space span performance and Wisconsin Card Sorting Test (WCST) before and 4 weeks after intervention. Re-sults After intervention, the forward score of digit span performance, the total score and forward score of space span performance increased (P<0.05), the error selection percentage, the error selection number and the percentage of error number of WCST decreased, the percentage of conceptual level of WCST increased (P<0.05) in the TBS group. However, there was no significant difference in the digit span perfor-mance, space span performance and WSCT in the sham intervention group (P>0.05). There was significant difference in all the items be-tween 2 groups after intervention (P<0.05). Conclusion TBS paradigm of rTMS could improve the executive function in schizophrenic pa-tients.

Objective To assess whether topiramate prevents body weight gain in patients with olanzapine .Methods The ran‐domized controlled trials(RCTs) about topiramate for prevention of weight gain with olanzapine from 1998 to 2013 were searched in the Cochrane Library ,Pubmed ,EMbase ,WanFang Data ,CNKI and VIP .Two reviewers independently screened the literatures ,ex‐tracted the data ,and evaluated the methodological quality .Then Meta‐analyses were conducted by using RevMan 5 .1 software .Re‐sults The total of 11 RCTs were included .Among the 549 patients were involved .The results of Meta‐analyses showed that the ef‐ficacy of the topiramate group was superior to that of the control group in lessen body mass with significant difference (MD= -3 .68 ,95% CI:-5 .16- -2 .19 ,Z=4 .86 ,P<0 .01) .Conclusion Topiramate addition therapy is effective in attenuating olanzapine‐induced weight gain .