A total of 256 medical professionals at the hospitals of different levels were interviewed and requested to complete the relevant questionnaires.The findings revealed that the top five unsatisfied items were growth & development,working conditions,doctor-patient relationship,income and social status.The levels of job satisfaction varied with their specific occupations and technical titles.Around two thirds of them once had the thought of leaving their pre-hospital care posts.

Objective To survey the prevalence of diabetes mellitus in adults of urban inhabitants of Shanghai. Methods Of 9376 adults aged 30 years and over, 1137 whose capillary blood glucose concentrations≥6. 7mmol/L 2 hours after 100g steam-bread meal underwent to OGTT and measurement of height.body weight and WHR. WHO (1985) standard was used as diagnostic criteria, the results were compared with those diagnosed with ADA (1997) criteria. Results According to WHO criteria,the prevalence rates of DM was 4. 16 %,and the prevalence rate of IGT was 4. 26%. But according to ADA(1997) criteria, the prevalence rate of DM was 4. 76%. The prevalence rate of DM and IGT were significantly increased with increasing age in those aged over 40. The prevalence rates of DM and IGT were much higher in patients with BMI≥25 than in those with BMI

Emergencies ; Rescue Work

This paper introduced the concept of humanistic therapy and its connotation and application in the field of surgery, the spiritual essence and the docking and bioethics.The authors also analyzed the perioperative patients need humanistic therapy, including technology, ethics, psychology, the needs of the practice; discusses the humanistic therapy in clinical practice,includes:practice conditions, personnel, measures and problems.

Background and purpose:P38 mitogen-activated protein kinase (P38MAPK) signal transduction pathway is involved in occurrence, development and transfer process in a wide variety of tumors. Urokinase-type plasminogen activator (uPA) plays an important role in tumor invasion and metastasis. This study aimed to explore the clinical signiifcance of the P38MAPK signaling pathway and the expression of uPA in ovarian cancer.Methods:The expressions of uPA, P38MAPK, ERK and AKT were detected in 49 cases of cervical adenocarcinoma by immunohistochemistry. The expressions of uPA and P38MAPK were detected by Western blot in ovarian cancer cell lines HO8910, HO-8910PM, SKOV3 and CAOV3. The changes of uPA and P38MAPK were detected by SB203580, a speciifc inhibitor of P38MAPK signal transduction pathway.Results:The result of immunohistochemical method showed that positive expression rates for uPA, P38MAPK, ERK and AKT were 61.22%, 57.14%, 53.06% and 55.10%, respectively. The expression of the uPA was positively correlated with the P38MAPK (r=0.865,P=0.001), and related with clinicopathologic stage, differentiated degree, lymph node metastasis, but not related with age and histologic type (P>0.05). The expressions of AKT and ERK were related with the lymph node metastasis and greater omentum metastasis(P<0.05), but not related with age and histologic type (P>0.05). The expression of uPA in HO-8910PM was higher than that in ovarian cancer cell lines HO8910, SKOV3 and CAOV3, and the expression of uPA reduced when the P38MAPK signal transduction pathway was cut off by the SB203580. The expressions of P38MAPK and uPA were negatively correlated with the prognosis of ovarian cancer (Log-rank=3.897 and 11.044,P=0.048 and 0.001). Conclusion:The P38MAPK signal transduction pathway was activated in ovarian cancer. The activated P38MAPK signal transduction pathway can raise the expression of uPA, which may contribute to the development of ovarian cancer. The result indicates that the P38MAPK signal transduction pathway and uPA might play an important role in the invasion and metastasis of ovarian cancer. P38MAPK and uPA might be useful markers for evaluating prognosis of ovarian cancer.

Objective To analyze the epidemiographic features of malignant tumors of urinary system in renal allograft recipients in our center.Methods A retrospective analysis was performed on 3150 patients who received renal transplantation between June 1978 and Autumn 2006.Twelve cases of urinary tumors were selected for study.Results Among 3150 recipients,33(1.05%)were diag- nosed as malignancies including 12(0.38%)cases in urinary system.The mean age of these patients when diagnosed as urinary tumors was 58.3?4.6(range 48-66).The mean duration of immunosup- pressive treatment was 62?18(range 26-120)months.Six cases received cyclosporine A+azalthio- prine+prednisone(CsA+Aza+Pred),5 cases cyclosporine A+mycophenolate mofetil+prednisone (CsA+MMF+Pred),and one case tacrolimus+mycophenolate mofetil+prednisone(FK506+MMF +Pred).Surgical treatment was carried out in 11 patients.Ten of them were still alive.One case died of cerebral hemorrhage.Conclusions Malignant tumors of urinary system,especially TCC is an im- portant complication in renal transplantation in our center.The occurrence of malignant tumors is inti- mately related to immunosuppressive treatment.The immunological status of patients after renal transplantation should be evaluated in follow-up studies.The treatment consists of complete resection of the mass,decreases of immunosuppressants,chemotherapy or radiotherapy.

Objective To establish an accurate method for determining the content of three components in Fufang Buwu Syrup. Methods TLC scanner was selected to detect three components with silica gel G thin layer plate. The sample was separated by using cyclohexane-ethyl acetate-methylenechloride-formic acid (3∶1∶1∶0.2),λS=300 nm. Results The linearity between peak area and ferulic acid was achieved in the range of 0.36-0.84μg, psoralen was achieved in the range of 0.12-0.28 μg, emodin was achieved in the range of 0.01-0.05 μg. The average recovery was 100.7%, 100.8%, 101.0%, and RSD was 1.26%, 1.44%, 1.86%, respectively. Conclusion The method is simple and accurate, which can be used for quality control of Fufang Buwu Syrup.

Alcoholic liver disease ( ALD ) , a chronic progres-sive disease, threatens human health seriously. An increasing number of studies have shown that gut flora dysbiosis plays an important role in the development of ALD. Intestinal microbiota maintains a steady state under normal conditions, regulating gut flora normal physiological function. However, chronic alcohol consumption produces intestinal bacteria overgrowth and dysbio-sis, including the alteration of the composition of intestinal mi-croflora, the increment of gut permeability and bacterial translo-cation. Subsequently, the host immune is activated, promoting the production of inflammatory cytokines in liver, which plays a central role in the development of ALD. Notably, the supple-ment of prebiotics or probiotics reverses the intestinal flora disor-der,ameliorating the clinical symptoms effectively in ALD pa-tients. The evidence impies that the modulation of dysbiosis may be effective in the prevention and treatment of ALD. This review summarizes the research progress on the mechanism of the devel-opment of dysbiosis-mediated ALD, to provide a theoretical basis for the research on intestinal flora and ALD.

Background Proliferative vitreoretinopathy (PVR) is one of the major causes of retinal detachment surgery failure.Based on proteomic studies of PVR vitreous,the insulin-like growth factor binding protein-6 (IGFBP-6) protein was specifically expressed in the vitreous and serum of PVR patients.Furthermore,its expression level is higher in the vitreous and serum in severe PVR patients than that in mild PVR patients.Objective This experiment was to detect the expression of IGFBP-6 in a PVR rat model.Methods Seventy 7-week old male SPF Wistar rats were included and were randomized into the PVR model group and control group.A mixture of RPE-J cell suspension(5 μl) and platelet-rich plasma (5 μl) was intravitreally injected in the left eyes of adult Wistar rats to establish the PVR model,and normal saline solution was administered in the same way in the control group.The rat eyes were clinically examined 1 week,2,3 and 4 weeks after injection,and PVR was graded based on the criteria of Francine.The animals were sacrificed after 1 week,2,4 or 8 weeks for the preparation of retinal sections and liver extraction.Expression levels of IGFBP-6 mRNA in the rat retina and liver were assayed by real-time Q-PCR.The expression of IGFBP-6 protein in the rat serum and vitreous was detected by ELISA.The use of animals complied with the Regulations for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission.Results Purified IGFBP-6 RNA was extracted from the liver and retina of Wistar rat and quantified by real-time Q-PCR.The expression level of IGFBP-6 mRNA in retina was (3.79± 1.33) × 10-4 in the PVR model rats,showing a significant decline in comparison with the control rats with a level of(8.32±2.96) × 10 4,4 weeks after injection (t =3.42,P＜0.01).The expression of IGFBP-6 mRNA in the 4th week was significantly lower than that of 1 week,2 or 8 weeks after the establishment of the PVR model(P＜0.05).No significant difference was found in the IGFBP-6 mRNA level in the liver between the PVR group and control group(27.60± 14.01 × 10 4 vs.25.01 ± 12.04 ×10-4,respectively),as well as among the different time points(P＞0.05).IGFBP-6 mRNA content in the retina was significantly reduced in grades 1,2 or 3 of the PVR groups compared with the control group(P＞0.05),but there was no significant difference among the different grades of PVR groups (P＞0.05).Concentrations of IGFBP-6 protein in grades 1,2 and 3 of the PVR model group were (221.00 ± 19.32),(229.63 ± 18.89) and (225.70 ± 26.71) μg/L,with a significant elevation in comparison with (173.25 ±21.11) μg/L of the control group (t =2.14,P＜0.05).However,there was no significant change among the different grades of PVR groups(t=1.24,1.46,P＞0.05).The concentrations of IGFBP-6 protein in the vitreous and serum were higher in PVR rat samples (vitreous:225.44±19.36 μg/L;serum:108.48 ± 15.78 μg/L) than in control rats (vitreous:173.25 ± 21.11 μg/L,serum:95.96 ±17.40 μg/L)(P＜0.05).Conclusions The concentrations of IGFBP-6 protein in the vitreous and serum increase in PVR rats.The results indicate that the increased IGFBP-6 in the vitreous might be a localized autocrine secretion of the eye.