Graduate education is the maln approach to cultivate advanced medical talents. However, the current clinical research ability tralning for postgraduate students is poor. This article discusses about four possible reasons: the misunderstanding of the medical research, system defects of the endowment of scientific research fund, drawbacks of evaluation criteria, and deficiency of grad-uate student curriculum. In order to improve the clinical research ability of medical graduates, this article also discusses the possible solutions: clarifying the understanding, strengthening policy support, im-proving the evaluation methods, and perfecting the tralning course of the clinical medical research.

Aortic Valve Stenosis ; blood ; diagnosis ; etiology ; Child ; Coronary Artery Disease ; blood ; diagnosis ; etiology ; Coronary Vessels ; diagnostic imaging ; pathology ; Echocardiography ; Female ; Humans ; Hyperlipoproteinemia Type II ; blood ; complications ; diagnosis ; genetics ; Lipoproteins, LDL ; blood ; Triglycerides ; blood

Objective To study the effect of nursing intervention on postural hypotension of aged with heart disease.Methods Nursing intervention were gived to the 68 aged patients with heart disease and postural hypotension.The effect of nursing intervention on postural hyporension and hypotension associated symptoms were observed.Results The postural hypotension was improved and the incidence of hypotension associated symptoms were reduced after nursing intervention.Differences were statistically significant(P＜0.01).Conclusion Nursing intervention was effective on the improvement of postural hypotension.

Objective To analyze clinicopathologic characteristics and prognostic factors of the patients with invasive lobular carcinoma of breast. Methods Clinical data of 125 patients with invasive lobular carcinoma of breast treated at Cancer Center of Sun Yat-sen University from Jan. 1990 to Dec. 2008, were analyzed. The clinical characteristics, recurrence and survival of the patients were summarized. Results Median age of 125 patients was 45 years old (range, 27 to 76 years old). The patients with large tumor mass (≥ 3cm), positive local lymph node, more than Ⅱ stage and positive hormone receptor at diagnosis were 77 cases(61.6 %), 64 cases(51.2 %), 101 cases(80.8 %) and 112 cases(89.6 %), respectively. The median time of follow-up was 58 months (range, 11-222 months). Of the 125 patients, 32 had local recurrence and metastasis, and 18 died. The 5-year disease-free and overall survival rates were 82.2 % and 87.3 %, respectively. Multivariate COX regression analysis showed that whether endocrine therapy or not was only a prognostic factor of patients with invasive lobular carcinoma of breast. Conclusion There is no difference in media age of patients with invasive lobular carcinoma of breast at diagnosis from other pathologic type of breast cancer. These patients are usually with larger tumor masses, more lymph node metastasis and a higher proportion of positive hormone receptor. The prognosis of patients is not affected by clinicopathologic parameters.

Objectives To screen the differentially expressed proteins in serum of population chronically exposed to arsenic in drinking water,thus to provide candidate protein biomarkers for arsenic exposure and arsenicosis.Methods Subjects were selected from the drinking water type of endemic arsenicosis areas in Shanxi province,China.Demographic characteristics,history of arsenic exposure,cigarette smoking,alcohol drinking,health and other information were collected using questionnaire.The subjects were divided into low-arsenic group (with arsenic in drinking water ＜ 10 μg/L),medium-arsenic group( 10 - 50 μg/L),high-arsenic group( ＞ 50 μg/L),and arsenicosis group(the drinking water with arsenic ＞ 50 μg/L was replaced by low arsenic water ＜ 10 μg/L).The number of cases in each group was 30.The arsenicosis patients were diagnosed according to “Standard of Diagnosis for Endemic Arsenism” (WS/T 211-2001 ).With the principle of informed consent,blood samples were collected.Differentially expressed serum proteins of different arsenic exposure groups and arsenicosis group were screened by two-dimensional differential gel electrophoresis(2-D DIGE),and further identified by mass spectrometry (MS).Results An average of (1299 ± 167) protein spots were identified in 6 gel images and 688 protein spots were discovered repeatedly in at least 5 gels.There were 33 protein spots differentially expressed among low-,medium- and high-arsenic groups P ＜ 0.01).Fifty four protein spots were significantly different among low-,medium-,high-arsenic exposure groups and arsenicosis group(P ＜ 0.01 ).Twenty five protein spots were selected for MS analysis,and13 protein spots were identified.Compared with low-arsenic group,the expressions of apolipoprotein A-Ⅳ,retinol binding protein,and estrogen receptor hypothalamic isoform in medium- and higharsenic exposure groups were down regulated,and the expressions of component 4A and 4B were up regulated.Compared with low-,medium- and high-arsenic groups,the expressions of beta-2-glycoprotein Ⅰ,Keratin 1,hemopexin,complement C1r subcomponent,and ficolin-3 in arsenicosis group were down regulated,and the expressions of pigment epithelial-differentiating factor,alpha-1-microglobulin and carboxypeptidase N catalytic chain were up regulated.Conclusions Chronic arsenic exposure can significantly change population's serum protein expression.Differentially expressed proteins in arsenicosis patients will not decline with the decline of arsenic in a short term.Whether or not the differentially expressed proteins identified in this study can be used as biomarkers for arsenic exposure and arsenicosis needs to be further verified.

AIM: To investigate the effect and the mechanism of apolipoprotein (a) [apo (a) ] on proliferation of vascular smooth muscle cells ( VSMCs). METHODS: All VSMCs used in experiments were serial subcultured from primary cells and were identified by immunohistochemistry staining of a - actin. Cell growth assay was observed as cell counting and MTT assay. Western blotting was also employed to detect the related mechanism. RESULTS: All cells used in experiments were confirmed as VSMCs. Although apo (a) enhanced VSMCs proliferation, this effect was attenuated by anti -integrin α_vβ_3, LM609.Use these reagents alone had no effect on VSMCs growth. The results of Western blotting demonstrated that focal adhesion kinase (FAK) was activated by apo (a) and the expression of total or phosphorylated transforming growth factor β_1 (TGF -β_1) was also decreased. However, these effects described above were all blocked by LM609.CONCLUSION: Apolipoprotein (a) enhances VSMCs proliferation and this effect is mediated by integrin α_vβ_3, which activates FAK and attenuates TGF - β_1 and phospho -TGF - β_1 expression.

Objective To investigate the effect of oncolytic adenovirus vector SG600-IL24expressing human melanoma differentiation associated gene-7 (mda-7/IL-24) on hepatocellular carcinoma cell lines with different metastatic potential of HepG2, SMMC7721, MHCC97L and normal liver cell line LO2. Methods The oncolytic adenovirus SG600-IL24 which carrying mda-7/IL-24 gene was transfected into hepatocellular carcinoma cell lines and normal liver cell line. The mRNA and protein expression of mda7/IL-24 in HepG2, SMMC7721, MHCC97L and LO2 cell lines was confirmed by RT-PCR,ELISA assay and Western blot respectively. MTT assay and flow cytometry were used to study tumor cell proliferation and cell cycle in vitro. Hoechst33258 and flow cytometry were studied to indicate the apoptosis effects. Results It was confirmed by RT-PCR, ELISA assay and Western-blot that the exogenous mda-7/IL-24 gene was highly expressed in HepG2, SMMC7721, MHCC97L and LO2 cell lines. MTT and apoptosis detection indicated that MDA-7/IL-24 can induce the growth suppression (the inhibition rate was 75% ±2. 5% ,86% ±3. 5% ,and promotes apoptosis ( the apoptosis rate was 56. 5% ± 4. 0% , 34. 4% ± 2. 0% , 43. 3% ± 2. 5%cell lines at G2/M phase ( the blocking rate was 35. 4% ± 4. 2% , 40. 5% ± 5. 0% , 42. 0% ± 5. 0%metastatic potential hepatocellular carcinoma cell lines but not in normal liver cell line.Conclusions Oncolytic adenovirus vector SG600-IL24 can selectively induce growth suppression, promote apoptosis in hepatocellular carcinoma lines in vitro but not in normal liver cell LO2.

Objective To investigate the respective effects of highly concentrated amino acids, highly concentrated glucose and mixture of the above two on the proliferation and extracellular matrix synthesis of glomerular mesangial cells. Methods Mesangial cells were cultured with mannitol (13.3 mmol/L ), highly concentrated amino acids (13.3 mmol/L), highly concentrated glucose (30.5 retool/L) and the mixture of highly concentrated amino acids and highly concentrated glucose repectively. Mesangial cell proliferation was examined by MTT and flow cytometry. The mRNA expression of TGF-β1,ColⅣ and fibronectin (FN) was detected by semi- quantitative RT-PCR, and the protein expression was detected by ELISA, Western blot and radioimmunoassay. Results (1) Cellular proliferation was increased in response to amino acids and was further enhanced by increased levels of both amino acids and glucose in a time-depentent manner. And the most prominent action occured at 48 hours. (2) Among the three group, mesangial cell cycle was affected, and the number of G0/G1 mesangial cells was reduced, but the number of cycle S cells was improved. (3) In the three group, the mRNA and protein expression of TGF-β1 was improved [protein unit: ng·ml-1·(105 cells)-1, 3023±85, 3163±80, 3321+85 vs 1506±63, P< 0.05]. (4)In the three group, the mRNA and protein expression of Col Ⅳ and FN was enhanced [protein unit: ng'ml-1(105 cells)-1, Col Ⅳ:16.78±2.56, 18.65±2.56, 22.83±2.45 vs 10.22±2.54, P<0.01; FN:18.47±2.34, 13.58±3.13, 17.98±2.56 vs 8.22±2.54, P<0.05]. The expression of Col Ⅳ mRNA and protein was stronger when the cells were cultured with the mixture of highly concentrated amino acids and highly concentrated glucose. Conclusions Highly concentrated amino acid can promote cell proliferation similarly to highly concentrated glucose, which may be through increasing the activity of mesangial cells and the synthesis of extracellular matrix via TGF- β1 signaling way. Highly concentrated amino acid has the synergism with highly concentrated glucose.

Adult ; Aged ; Cerebrovascular Circulation ; drug effects ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Hemorheology ; Humans ; Male ; Microcirculation ; drug effects ; Middle Aged ; Migraine Disorders ; drug therapy ; physiopathology ; Nails ; blood supply ; Phytotherapy

Objective To investigate the significance and safety of repeat transurethral resection(Re‐TUR) for treating stage T1 of non‐muscle invasive bladder cancer .Methods The clinical data were retrospectively analyzed on 41 cases of stage T1 of non‐muscle invasive bladder cancer in this department of our hospital from January 2013 to November 2014 .All cases underwent Re‐TUR at 4-6 weeks after primary surgery .Among them ,33 cases were male and 8 cases were female ,24 cases were single tumor and 17 cases were multiple tumors at first operation .The maximal tumor diameter was ≥ 3 cm in 13 cases and <3 cm in 28 cases . The first treatment was transurethral resection of bladder tumor(TURB‐t) .The pathological report was the stage T1 of urothelium cancer .Results All 41 cases were completed the operation smoothly ,and no serious complication occurred .In the postoperative pathological examination ,7 cases(17 .07% ) had tumor residue or tumor recurrence ,among them ,3 case had residue f tumor base and 4 cases were new onset tumor;the pathological grade at Re‐TUR in 1 case was increased from G2 to G3 .The follow up lasted for 3―27 months(average 13 .2 months) ,9 cases relapsed ,3 cases (42 .86% ,3/7) were positive at Re‐TUR and 6 cases(17 .65% , 6/34) were negative at Re‐TUR .Conclusion Re‐TUR for treating stage T1 of non‐muscle invasive bladder cancer is safe and feasi‐ble ,its significance to pick out high‐risk patient for conducting further active treatment ,which may have certain effect for reducing the recurrence rate of non‐muscle invasive bladder cancer .