A questionnaire was used to survey the perspective of the 22 mentors,24 students, 27 graduate students and 27 public health units on the competence of MPH student. The result showed that the practice skill,analyzing skill,program plan and practice skill,and emergency reaction abil-ity got more attention. This suggested that to the training of MPH,the training objective should focus on the ability to resolve problems; the curriculum should focus on the characters of public health and on the practice training.

Background and purpose: The position of thymidine kinase 1 (TK1) expression during cell division is in the cytoplasm. It is a catalytic enzyme to convert deoxythymidine into thymidylate. It is the key enzyme of pyrimidine salvage pathway. The aim of this study was to analyze the serum expression level of TK1 in patients with breast cancer, and explore the application of serum TK1 test in clinical assessments of diagnosis, treatment and prognosis for breast cancer. Methods: Patient data were collected from the patients admitted in Comprehensive Breast Health Center at Rui Jin Hospital. Chemiluminesence dot blot assay was used to detect serum TK1 levels in 145 breast cancer patients and 55 patients with breast ifbroadenoma. The correlations of serum TK1 levels with breast tumor biological behavior was further studied. Results:Serum TK1 expression levels was signiifcantly increased in breast cancer patients [(2.749±0.122)pmol/L] when compared to breast fibroadenoma patients[(1.319±0.126)pmol/L, P<0.000 1]. Serum TK1 levels were statistically increased in patients with lymph node metastasis (P=0.049), distal metastasis (P=0.003 1), and late TNM stages (P=0.01). No serum TK1 level differences were found in patients with different ages (P>0.05), different tumor grades (P=0.453) and different tumor size (P=0.908). Preoperative imaging results including breast ultrasound, breast mammography and breast magnetic resonance were analyzed by assessments of BI-RADS category, and serum TK1 levels in patients with different BI-RADS categories were studied. Serum TK1 levels in patients with breast ultrasound BI-RADS categories 4C-6 were signiifcantly higher than those with category 0-4B (P<0.001). Consistently, the serum TK1 levels in patients with MR BI-RADS categories 4C-6 were higher than categories 0-4B (P=0.005). The serum TK1 levels in patients with mammography BI-RADS categories 4C-6 were higher than categories 0-4B (P=0.032). The serum TK1 levels were signiifcantly increased in patients with ER high expression in breast tumor tissues than those with low expression (P=0.034). Serum TK1 levels had no differences in patients with different expression levels of PR, HER-2 and MIB-1 (P>0.05). Most patients were followed up in our outpatient department for about 2 years. No progression-free survival differences were found in 2years. Conclusion:Serum TK1 test might be a potential tool for screening, prognosis determination and effect evaluations of targeted therapy in breast carcinoma.

Objective To assess the correlation between coronary heart disease and common carotid artery and femoral artery atherosclerosis with two-dimensional color Doppler ultrasound (2D-CDUS). Methods Ninety patients with coronary heart disease were divided into three subgroups according to the extent of coronary artery stenosis observed with coronary angiography, and 50 normal subjects were taken as normal group. Ultrasound examination with high-frequency linear array probe was performed to measure IMT of common carotid and femoral artery in order to observe the plaque and extent of stenosis, the formation of blood dynamics, physical characteristics and hemodynamic environmental parameters. Results Among the coronary disease groups, common carotid artery and the femoral artery IMT, atherosclerotic plaque in the number, rate and all points increased along with the degree of coronary artery stenosis increasing. Physical characteristics and its hemodynamic environmental parameters had some changes with the increase of atherosclerosis. Conclusion The atherosclerosis of common carotid artery and the femoral artery are closely related with coronary atherosclerosis.

Objective To discuss the key technique of ultrasound-guided biopsy in superficial lymph nodes,and to explore the value of ultrasound in qualitative diagnosis for the lymph nodes.Methods Three hundred and twenty-five patients who underwent ultrasound-guided lymph node biopsy from Jan 2006 to Jan 2009 were retrospectively reviewed.Results The sizes of the lymph nodes were 0.8 cm×1.0 cm-5.0 cm×7.0 cm.Each patient was punctured 3 to 6 times.Pathological results showed lymph nodes in 230 patients (70.77%) were malignant,including metastatic carcinoma in 134 patients,malignant lymphoma in 96 patients,while lymph nodes in 87 patients (26.77%) were benign,including specific infection in 82 patients,non-specific infection in 5 patients,whereas uncertain in 8 patients (2.46%) .The tissue amount got from biopsies could be used for qualitative pathological diagnosis in 317 patients (97.54%) .Taking lymph node with the ratio of long diameter to short diameter less than 2,unclear medulla structure,multi-vessel and arterial resistance index≥0.65 as the standard,the diagnostic accuracy rate of malignant lesions was 76.41%.Conclusion Ultrasound-guided biopsy of superficial lymph nodes is convenient and effective for pathological diagnosis.

This study aimed at evaluating the quality of the precise powder decoction pieces (PPDP) of L.japonicae Flos (LJF) compared with the traditional commercial slices with chemical fingerprint methods and DNA molecular identification technology.Different specifications of PPDP were prepared,their dry extract contents were in contrast with that of commercial slices.The three batches of commercial slices were collected,and the content uniformity,fingerprint and similarity evaluation before and after the mixing and pulverization were studied by HPLC-DAD and DNA sequence alignment.As a result,the paste rate of PPDP was slightly higher than that of the traditional commercial slices.The dissolution of chlorogenic acid of PPDP was higher than that of the traditional commercial slices.RSD of inter-assay dissolutions of chlorogenic acid of commercial slices was 11.93％,which was reduced to 8.29％ after mixing and preparing into PPDP.The fingerprint showed that the slimilarity of the fringerprint of the mixed and powdered LJF was elevated with 7 common peaks.All the common peaks were increased at different levels.In conclusion,compared with traditional commercial slices of LJF,PPDP apparently improved the dissolution rate and the quality uniformity,indicating that the boiled powder of CRP obviously presented vantages in clinic.

Objective To develop a computer-assisted multiangular guiding system for interventional ultrasound.Methods A computer-assisted multiangular guiding system was developed which included a high-accuracy electromagnetic tracker and a passive arm with 5 degree-of-freedom.The electromagnetic tracker was used to track ultrasound probe and needle.The position of B-mode ultrasound image plane and needle were displayed in real-time in the reconstructed 3D ultrasound.The passive arm was used to assist needle delivering.A 10mm ball immersed in a transparent water tank and a formal acoustical prototype was punctured with random angle by using this system.The systematic precision was assessed.Results The whole progress was finished successfully,the ball was touched by the tip of the needle for all the occasions,the error of the system was less than 5mm.Conclusion The computer-assisted multiangular guiding system can get rid of the limitation of angle and make the operation flexible and accurate.

AIM: To observe the effect of piceatannol on the kidney of diabetic nephropathy rats in early stage, and to explore the possible mechanisms.METHODS: The rats were randomly divided into 5 groups: control group, model group, low dose of piceatannol treatment group, medium dose of piceatannol treatment group and high dose of piceatannol treatment group.The rat model of diabetic nephropathy was induced accordingly, and the rats received 20 mg/kg, 40 mg/kg or 60 mg/kg of piceatannol by gavage once a day for 4 weeks.Blood glucose was detected by glucometer.The urea nitrogen and creatinine levels in the serum were measured by urease-glutamate dehydrogenase enzymatic and inosine acid oxidase methods, respectively, and 24 h urinary microalbumin was analyzed by immune transmission turbidimetry test.Moreover, the pathological changes of the kidney tissues were observed under microscope with HE staining.The protein expression of TGF-β1 and Smad 7 and the phosphorylation levels of Smad2 and Smad3 were determined by Western blot.RESULTS: Compared with model group, piceatannol treatment significantly decreased the levels of blood glucose, blood urea nitrogen and urinary microalbumin, but had no effects on serum creatinine.Furthermore, HE staining showed that the increased mesangial cells, matrix hyperplasia and degenerated epithelial cells in model group were markedly inhibited after piceatannol treatment.Additionally, piceatannol treatment also reduced the protein expression of TGF-β1 and Smad 7, and the phosphorylation levels of Smad2 and Smad3.CONCLUSION: Piceatannol attenuates pathological progression in the kidney of diabetic nephropathy rats in early stage, which may be through inhibiting TGF-β/Smad signaling pathway.

Objective To assess the diagnostic value of multiple-slice spiral CT (MSCT) perfusion imaging technique in pancreatic cancer by measuring and comparing the dynamical characteristics of blood flow between normal pancreas and pancreatic cancer. Methods The CT perfusion imaging were obtained using Siemens Somatoma MSCT scanner in 44 patients with normal pancreas tissue and 18 patients with pancreatic cancer. The mean blood flow (BF),blood volume (BV), time to start (Trs), time to peak (TIP), permeability and patlak blood volume (pBV) were measured and statistically analyzed by using Siemens Body peHusion software package. Results The mean BF, BV, Trs, TIP, permeability and pBV of normal pancreas were: (90.60±29.25) ml·100 ml-1·min-1, (190.35±43.8) ml/L, (205.3±160.2) s, (1403.5±334.0)s, (99.47±49.9) 0.5 ml·100 ml-1·min-1, (157.8±52.5) ml/L, respectively. The mean BF, BV, TTS, TrP, per-meability and pBV of pancreatic cancer were (22.9±10. 63) ml·100 ml-1·min-1, (52.38±18.08) ml/L, (194.3±76.0) s, (1549.5± 308.5)s, (115.25±33.55) 0.5 ml·100 ml-1·min-1, (83.16±41.45) ml/L respectively. The mean BF, BV, pBV and permeability between normal pancreas and pancreatic carcinoma were statistically significant (P<0.01). However the mean TTS and TIP between normal pancreas and pancreatic carcinoma were not statistically significant (P>0.05). Conclusion There are significant differences between perfusion values of pancreatic carcinoma and normal pancreatic tissue, and MSCT perfusion imaging is helpful in diagnosing pancreatic carcinoma.

BACKGROUND: Hemorrhagic cystitis remains a common complication of hematopoietlc stem cell transplantation.Granulocyte-macrophage colony stimulating factor (GM-CSF) affects proliferation and differentiation of hematopoietic stem/progenitor cells, adjusts functions of monocytes, granulocytes, lymphocytes and endothelial cells.OBJECTIVE: To investigate the protective effects of GM-CSF bladder irrigation in hemorrhagic cystitis after allogeneic hematopoietic stem call transplantation.DESIGN: Case analysis.PARTICIPANTS: A total of 15 hematopathy patients undergoing allogenic hematopoietic stem cell transplantation at the Zhongshan Hospital of Sun Yat-sen University from January 2004 to August 2006 (routine treatment group). A total of 16 hematopathy patients undergoing allogenic hematopoietic stem cell transplantation from September 2006 to December 2008 (GM-CSF group).METHODS: In the routine treatment group, patients received mesna, hydration, alkalization and forced diuresis in the prevention of hemorrhagic cystitis. In the GM-CSF group, GM-CSF was infused into the bladder in addition to mesna,hydration, alkalization and forced diuresis in the prevention of hemorrhagic cystitis 24 hours before cyclophosphamide treatment. Catheter was extracted 3 days following cyclophosphamide withdraw. Following washing with saline, the bladder was emptied. 10 mL of saline and 5 mL of lidocaine were added into 300 μg of GM-CSF. The mixture was infused into the bladder for 60-120 minutes.MAIN OUTCOME MEASURES: The following parameters were measured: occurrence of hemorrhagic cystitis and its correlation to graft versus host disease, as well as the occurrence of cytomegalovirus infection and urinary system infection.RESULTS: Compared with routine treatment group, the occurrence rate of hemorrhagic cystitis was significantly decreased in the GM-CSF group (x2=4.39, P < 0.05), mean duration of hemorrhagic cystitis and duration of hospitalization were significantly shortened (t=3.97, P < 0.05; t=3.13, P < 0.05), and the occurrence rate of over grade HI hemorrhagic cystitis was significantly reduced (x2=5.04, P < 0.05). Cystitis degree was associated with degree and duration of graft-versus-host disease (r = 0.76).Compared with the routine treatment group, cytomegalovirus infection rate was slightly decreased in the GM-CSF group (x2=0.28, P> 0.05), and occurrence rate of over grade Ⅲ hemorrhagic cystitis was higher in patients with cytomegalovirus infection.Compared with the routine treatment group, the occurrence rate of urinary system infection was slightly reduced in the GM-CSF group (x2=0.28, P > 0.05).CONCLUSION: GM-CSF bladder irrigation is well tolerated and often effective, and should be considered as a preparative regimen of hemorrhagic cystitis after allogeneic hematopoietic stem call transplantation.

Objective To investigate the value of ischemia modified albumin (IMA) detection in preliminary diagnosis of acute myocardial infarction (AMI).Methods The levels and variations of IMA,cTnI and CK-MB in 103 patients with acute chest pain were measured continuously at 0,4,6,12,24 hours after admission respectively.Thirty healthy subjects were observed as normal controls.Results Twenty three patients were diagnosed as AMI in the end,the sensitivity and specificity rates right after admission were 89.3％ and91.3％ for IMA,48.4％ and 92.3％ for CK-MB,30.6％ and 93.7％ for cTnI respectively.The sensitivity values at the 6th hours after admission were 91.3％ for IMA,52.2％ for CTnI and 34.8％ for CK-MB respectively.The specificity was 100.0％ when the IMA was detected in combination with CK-MB or cTnI.The sensitivity of co-detection was significantly higher than that any single detection at sixth hours after admission (x2 =15.99,P ＜ 0.01 ).Conclusion Plasma IMA assessment is helpful for early diagnosis of AMI,and will significantly improve the sensitivity early diagnosis of AMI.The co-detection of IMA and CK-MB or cTnI obviously surpasses any single detection,and has extremely vital clinical significance.