Objectives:This study aims to summarize the research progress of multiple-site physician practice to determine further research directions. Methods:Literature on Chinese multiple-site physician practice between 1949 and 2013 was obtained from CNKI, Wan fang database and CQVIP database, the annual volume distribution of se-lected documents was been described and the topics and content of literature cited at least once were summarized through literature content analysis. Results:The volume of literature increased rapidly from 2009, guided by related government policies. Content analysis is insufficient in the research areas of supporting policies, international experi-ences, relevant laws and empirical studies. Suggestions: Further research should focus on multiple-site physician practice policies themselves and supporting policy analysis, international comparisons of multiple-site physician prac-tice systems, studies into relevant laws and regulations and empirical studies based on quantitative methods.

Objective To observe the changes in expressions of spleen regulatory T cells (Tregs)and the related factor forkhead box protein-3 (Foxp3) after irradiation with different doses of X-ray in mice at different times,and to elaborate the effects of X-rays on regulatory T cells and Foxp3.Methods 112male ICR mice were randomly divided into 2 groups and irradiated by X-rays at the doses of 0.075 and 2 Gy,respectively.The mice were killed at 0,4,8,16,24,48,and 72 h post-irradiation and the spleens removed.Flow cytometry was used to detect the percentage of CD4 + CD25 + Treg and protein expression of (Foxp3),and RT-PCR was used to exmiamine the mRNA expression of Fox3.Results Compared with those before irradiation,the CD4 + CD25 + Treg positive rates began to increase and peaked at 8 h post-irradiation with 0.075 Gy at 8,16,24,72 h(t = 8.73,10.55,4.21,4.65 ,P ＜ 0.05) and 2 Gy at 8,16,48,72 h(t = 4.65,4.28,3.71,2.88,P ＜ 0.05),and then slightly decreased,but still remained at high levels.The mRNA protein levels of Fox3 did not change significantly after exposure to the dose of 0.075 Gy,but began to significantly increase at 8 h after exposure to the dose of 2 Gy.However,the Foxp3 protein level began to increase 4 h post-irradiation,peaked at 16 h,and then slightly decreased,but still ramained at high levels (t =2.59,3.37,3.70,3.20,P＜0.05).Conclusions The changes in expressions of Tregs and Foxp3 after high- and low-dose X-ray irradiation may be used to explain the differences in immune effects induced by ionizing radiation at different doses.

Animals ; Diazepam ; pharmacology ; Drug Antagonism ; Electroencephalography ; Female ; Male ; Pyrazoles ; poisoning ; toxicity ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo compare the clinical effects of different surgical methods for the epicanthus corrective surgery.

METHODSCanthoplasty with asymmetric Z-flap is applied in 46 cases, Y-V advancement procedure for epicanthoplasty is applied in 42 cases. The epicanthus aesthetic measurement were measured and calculated by software before and after surgery, the diameter of the iris was measured as a reference value,and the postoperative scar was assessed by VSS scale. At the same time, by measuring the lateral canthal distance, the accuracy of the measurement method can be verified.

RESULTSAll patients were satisfied with the long-term results and there were no recurrences of the epicanthal fold. The shortening ratio of the ICD is 8.36% in the group with the Z-plasty, and 5.88% in Y-V plasty. the lateral canthal distance have no diffrence before and after surgery.

CONCLUSIONSTwo surgical methods can get good results. The magnitude of correction in Z-plasty may larger than Y-V plasty, but postoperative retraction may existed in Z plasty.

Blepharoplasty ; methods ; Cicatrix ; Esthetics ; Eyelids ; surgery ; Humans ; Recurrence ; Software ; Surgical Flaps

Objective To investigate the mitral annular three dimensional configuration changes after application of two dimensional mitral annuloplasty.Methods Includes criteria:serious mitral prolapse without other cardiac disorders,with age ranged from 18 to 60 years old.Three dimensional echocardiography was performed before the surgery in the operation room.The mitral annular three dimensional configuration,the mitral prolapse and regurgitation grades were examined.And same procedure was done after the mitral repair.All the measure results were expressed as x ± s and the statistical analysis was performed using SPSS 19.0 software.Results Totally 42 cases were enrolled,including 28 posterior prolapse and 14 anterior prolapse cases.All the mitral repair got satisfied none or mild regurgitation.The mitral annulus moved consistently as saddle shape during the whole cardiac cycle,the lowest annulus part was at the commissure and the highest part was at the anterior and posterior annulus centers.During the systolic phase the non-planer angel between anterior and posterior annuls was bigger than in diastolic phase.The annulus circumference,transverse,longitudinal diameters decreased compared with before the surgery.Preoperative mitral transverse diameter and longitudinal diameter values are almost the equal size,indicating the mitral annulus was in nearly round shape.However the longitudinal/transverse ratio reached 0.88 after surgery which implied the annulus configuration recovery after annuloplasty.After the mitral annuloplasty the annular height decreased from (8.4 ± 0.6) mm to (3.2 ±0.1) mm while the annular height/transverse diameter ratio decreased from 0.24 to 0.15,which may be affected by the application of the two dimensional rigid artificial annulus.Non-planar angle between the anterior and posterior mitral annuls increased from(136 ± 13)degrees to(145 ± 14) degrees after mitral repair.Conclusion The mitral annulus configuration may have planarization changes due 1o the apply of two dimentional artificial annulus.

Pulmonary vein isolation (PVI) is a new ,effective and radical method to cure atrial fibrillation .Within a period after radiofrequency ablation (RFA) ,coagulation system is activated in patients ,then thrombus incident such as cerebral embolism may happen .The present article made a review on its mechanism .

ObjectiveTo assess the current situation of postgraduates knowledge about medical research design and optimize the curriculum setting of research design.MethodsAn investigation was carried out in the postgraduates of 2011 using questionnaires in a medical university..The questionnaire ineluded basic information of participants and cognition of basic methods of research design.ResultsA total of 473 postgraduates participated in the investigation.Among them,311 systematically learned medical statistics before enrollment,and 275 ( 58.14％ ) once participated in scientific researches.Most of them ( ＞80％ ) knew about the 10 basic methods of research design listed in the questionnaire,but only a few of them were familiar with them,and some even didn't know about the methods.ConclusionWe should pay attention to the culture of scientific research thought in statistical design,strengthen the practice of research design teaching,and the curriculum of research design should be led into undergraduate course.

Objective To investigate the evaluation of medical doctoral students on medical statistics teaching. Methods An investigation was carried out among doctoral students of 2012 using questionnaires in a medical university. A total of 272 doctoral students were investigated and 266 (97.79%)of them had learned medical statistics before enrollment. Statistical description was used to analyze enumeration data by calculating cases and percentages. Results More than 88.00% of them thought that medical statistics was helpful for their future work. More than 60.00% of them thought that the present teaching contents were appropriate and about 93.00% of them thought that examina-tion mode was appropriate. However,65.00% of them thought that the class hours were not enough and some con-tents should be explained more clearly. Conclusions Both basic statistics methods and advanced statistics methods should be given consideration to. Some frontier or hot knowledge of medi-cal statistics should be arranged and the class hours should be increased to expand the content of teaching.

Ear Neoplasms ; pathology ; Ear, External ; pathology ; Humans ; Infant ; Male ; Pilomatrixoma ; pathology

Objective To investigate the effects of ISO-1, a selective MIF tautomerase activity inhibitor, on liver metastasis in a BALB/c mouse model of colonic cancer. Methods Micmporous migration assay was used to determine the effect of ISO-1 on the invasion abilities of CT26 cells. Orthotopic transplantation of fresh colonic tumor fragments into the hernial sac of cecum was used in a BALB/c mouse model of eolorectal cancer. Thirty mouse models were divided into three groups and treated respectively with ISO-1 (0. 2 ml, 20 mg/kg), 5% DMSO and NS ( normal sodium) twice a week, iutraperitoneally. After 4 weeks, mice were sacrificed and the whole livers were made into serial slices to detect the occurrence of liver metastasis. Serum MIF tautomerase activities were measured using L-dopachrome methyl ester, ELISA was used to test serum VEGF concentrations. Immunohistochemical staining of CD31 was used for comparing microvascular density (MVD) of tumor tissues. Results 100 μmol/L ISO-1 treatment for 24 hours significantly reduced the average number of the cells penetrating polycarbonates, ( 151 ± 19 ) vs. ( 178 ± 9 ), P<0. 01. Serum MIF tautomerase activities were significantly inhibited after ISO-1 treatment (51% vs. 81%, P <0. 01 ). Compared with DMSO and NS treatment, ISO-1 decreased the occurrence of liver metastasis ( 10% ,60% and 70% ,respectively;x2 = 8. 30, P < 0. 05 ). Also ISO-1 decreased serum VEGF levels ( 15 ± 7 ) pg/ml, ( 63 ± 11 ) pg/ml and ( 67 ± 8 ) pg/ml, respectively; P < 0. 01 and the MVD of tumor tissues (17±4) ,(36±7) and( 38±5) ,respectively; P<0. 01. Conclusion In vitro ISO-1 inhibits the invasion ability of CT26 cells. In vivo ISO-1 reduces the occurrence of liver metastasis, possibly by a mechanism of inhibiting MIF tautomerase activities, down-regulating the expression of VEGF and reducing MVD.