Objective:To observe the effect of dissection and reconstruction on palatal muscles morphology in cats. Methods: Nine cats were randomly divided into three groups according to the extension of muscle dissection: small area group(<1/3 group),medium area group(1/3-2/3 group)and large-scale area group(>2/3 group).Control group was the normal palatal muscle in any normal side of the palate.Palatal muscles of all experimental groups were dissected from the posterior border of the hard palate and were reconstructed later. The morphology features and ultrastructure of palatal muscles were observed respectively by HE staining and transmission electron microcopy 1-3 month after operation. Results: There were no obvious differences in morphologic features and ultrastructure of palatal muscles between experiment and normal control groups when the range of palatal muscle dissection was less than 2/3. At early stage (1 month) after operation in large-scale area group, the arrangement of muscles fiber were in structural disorder with inflammatory cell infiltration and muscle fibril formation. The Z line was not distinct, muscles fiber became narrow and myocomma arrangement was not fully dense under transmission electron microcopy. At later stage (2 or 3 month after operation) in large-scale area group, the arrangement of muscles fiber were comparatively regular, neonatal muscles fibers became gradually mature and the amount of inflammatory cell had obviously decreased. Ultrastructure study showed that myocomma arrangement was more orderliness, and Z line became more distinct. Conclusion: It suggests that the extensive dissection of palatal muscles carried no fibrosis, and injury musculature could be repaired and regenerated.

Objective To understand the clinical distribution situation of streptococcus penumoniae (SP) and drug susceptibility test results to provide a basis for the clinical diagnosis,treatment and prevention of SP infection.Methods Totally 416 nonrepeat strains of SP were isolated during 2010 to 2015.Their identification and drug susceptibility test were performed by using the ATB Express bacterial identification system.The results were interpreted according to the standard of CLSI 2014 edition.Results In these 6 years,SP showed the isolation peak in spring and winter;the detection rate of respiratory tract specimens reached more than 90 ％;the young children and elderly people were predominant;SP maintained high sensitivity to penicillin,amoxicillin,etc.,the difference in the sensitivity rate and non-sensitivity rate had statistical significance(P＜0.05);but SP showed high level non-sensitivity to clindamycin,erythromycin,etc.,the difference in the sensitivity rate and non-sensitivity rate had no statistical significance (P＞0.05).Conclusion Although β-lactam antibiotics such as penicillin can still be used as the first choice of therapy,but PISP and PRSP show the increasing trend year by year;therefore the antibacterial drugs should be selected according to the drug susceptibility test results.

Background and purpose:In in vivo and vitro studies, Rhodiola shows anti-cancer effect, but there were few reports about the effects of Rhodiola on growth of breast cancer and its possible mechanism. Methods:Xenograft of Human breast cancer cells MDA-MB-435 in female BALB/c nude mice were treated with and without Rhodiola extracts. The tumor volume and proliferation index (PCNA and Ki67) of the xenograft were studied.Results:After Rhodiola was given to nude mice for 4 weeks, the mean tumor volume was smaller (99.95mm 3 vs. 174.60mm 3 ) compared to untreated group,but there was no statistical significance(P=0.535). The proportion and intensity of cellular Ki-67 staining in Xenografts were decreased as compared to the untreated group, (average H-score 152.8 vs. 86, P=0.014), the same trend could be found for cellular PCNA staining, but there was no statistical significance(242 vs.210,P=0.221).Conclusions:The mechanism of anti-cancer effect of Rhodiola may be partly through inhibiting the proliferation of cancer cells in vivo.

Purpose To compare the CT features of hepatic metastases of gastro-entero-pancreatic adenocarcinomas with and without neuroendocrine differentiation [NED(+) and NED(-)] and to explore the value of CT features in differentiation of the two groups.Material and Methods From January 2009 to December 2015,abdominal CT scans of 17 pathologically proved cases of NED(+) gastro-entero-pancreatic adenocarcinomas with hepatic metastases and 34 pathologically proved cases of NED(-) hepatic metastases with sex,age and primary site matched were retrospectively reviewed.CT features including hepatic metastases number,size,distribution,shape and enhancement were assessed,as well as presence of lymphadenopathy or ascites.Differences of CT features between the two groups were analyzed.Results Compared with NED(-) group,hepatic metastases of NED(+) group more frequently demonstrated a peripheral enhancement on artery phase (94.1％ vs.44.1％,P＜0.05),and more washout on portal venous phase (41.2％ vs.5.9％,P＜0.05),while hepatic metastases of NED(--) group showed more plateau type (91.2％ vs.58.8％).There was no significant difference of other findings between the two groups (P＞0.05).Logistic regression revealed that enhancement area in hepatic artery phase and enhancement changes in portal venous phase were independent factors for differential diagnosis (P＜0.05).The area under the ROC curve of combining the two features was 0.811 (P＜0.05).Conclusion There are some different CT enhancement features between NED(+) and NED(-) hepatic metastases of gastro-entero-pancreatic adenocarcinomas,which are helpful in differential diagnosis.

Objective To evaluate the effect of using standardized patients (SP) in psychiatry class teaching.Methods A standardized patient was used when giving instructions on seven years clinic medicine students of Fudan university,the effect of this teaching model was assessed.Results Totally 96.19％ of students believed that standardized patients teaching model was better than the traditional model.Students in classes of using standardized patients scored higher than students in classes without using standardized patients.Conclusion The standardized patients teaching mode,recognized by almost all students,is believed to help students to better master the knowledge of psychiatry.

Objective To explore the changes of the hippocampal formation and the myelinated nerve fibers in the hippocampal formation of aged female Long-Evans rat. Methods The hippocampal formation and the myelinated nerve fibers in the hippocampal formation of 5 young (6-month old), 5 middle-aged (18-month old) and 6 aged (28-month old) female Long-Evans rats were quantitatively investigated with the stereological techniques and transmission electronic microscope technique. Results There were no significant changes in the volume of hippocampal formation, the volume density, the total volume, the length density and the mean diameter of the myelinated nerve fibers in the hippocampal formation among young, middle-aged and aged rats. When compared to that of young rats, the total length of the myelinated nerve fibers in the hippocampal formation of middle-aged rats was significantly increased by 63.6%. When compared to that of middle-aged rats, the total length of the myelinated nerve fibers in the hippocampal formation of aged rats was significantly decreased by 47.5%. When compared to that of young rats, the total length of the myelinated nerve fibers in the hippocampal formation of aged rats was non-significantly decreased by 13.8%. Conclusion Although the reason why the total length of the myelinated nerve fibers in the hippocampal formation of middle-aged rats was longer than that of young rats needs further investigations, the present results together with our previous findings in white matter and cortex further suggest that there are age-related changes of the myelinated nerve fibers in the normal aged brains.

Objective To analysis the influence factors of standardization in the hierarchical chain management of type 2 diabetes and to enhance the hierarchical chain management of type 2 diabetes.Methods ( 1 ) Six hundred and ninty patients with type 2 diabetes completed 1 years management were divided into well-controlled glycosylated hemoglobin ( HbAlc ) group (＜7.0％ ) and bad-controlled glycosylated hemoglobin (HbAlc) group ( ≥ 7.0％ ).The conditions of diet,physical activity,medication,self-blood sugar monitoring and participation in health seminars were investigated and analyzed.(2) The patients were divided into standardized management group and not standardized management group.Their age,sex,educational background,occupation,monthly income per person,medical security,the course,cognition for glycuresis,two-way transfer,and chronic complications were investigated and statistically analyzed.Results ( 1 ) The proportions of physical activity (70.1％ vs 54.2％,x2=6.163,P=0.018),self-blood sugar monitoring(60.4％ vs 43.8％,x2=6.268,P=0.016) and participation in health seminars (56.0％ vs 41.7％,x2=4.577,P=0.045) in the well-controlled HbAlc group were significantly higher than those in the bad-controlled HbAlc group.(2) Their age [(61.08 ±10.04) years old vs ( 57.75 ± 9.89 ) years old,t=2.539,P=0.012],educational background ( ratio of low educational attainment:8.3 ％ vs 17.2％,x2=6.426,P=0.041 ),medical security (own expense ratios:4.6％ vs 11.5％,x2=3.543,P=0.048 ),awareness of diabetes ( ratio of poor awareness of diabetes:19.4％ vs 41.0％,x2=17.518,P=0.000 ),two-way transfer ( ratio of not transfer treatment:4.6％ vs 14.8％,x2=7.662,P=0.022) and chronic complications ( ratio of chronic complication:41.7 ％ vs 26.2％,x2=6.130,P=0.017) were significantly different between the standardized management group and not standardized management group.(3) Logistic regression analyses indicated that the age ( OR=0.954,P=0.006),monthly income per person ( OR=4.101,P=0.018 ),medical security ( OR=7.617,P=0.003 ),cognition for glycuresis ( OR=0.030,P=0.000),two-way transfer ( OR=9.079,P=0.000) and chronic complications ( OR=0.456,P=0.031 ) were the risk factors of standardized management.Conclusion We should focus on the impact factors affecting the standardized management of patients including age,monthly income per person,medical security,awareness of diabetes,ratio of not transfer treatment,positive strategies for chronic complications,improve the hierarchical chain management of type 2 diabetes,and then make the diabetic patients to early participate in standardization management of diabetes mellitus and delay the appearance of complications.

Objective To explore the hierarchical chain management model in blood glucose control and its influence factors in patients with diabetes mellitus.Methods Health management database of diabetic patients was established in 2007 and managed by hierarchical chain management.The number of the patients reached to 1010 till 2011.The blood glucose control of diabetic patients was analyzed and its influence factors were analyzed by multivariate unconditional Logistic regression method.Results The concentration of glycosylated hemoglobin( HbA1c ) of 1010 patients with type 2 diabetes was (8.21 ±:2.70)％.Four hundred and eighty-seven cases (48.22％) reached the blood glucose standard,303 cases (30.00％)reached the blood pressure standard,245 cases (24.26％) reached the blood lipids standard,and 76 cases (7.52％) reached all three standards.Multivariate analysis showed that occupation (OR =2.521,95％ CI:1.871 - 3.397),education level (OR =1.890,95％ CI:1.642 - 2.174),disease course (OR =1.035,95％CI:1.016 -1.055),systolic pressure (OR =1.016,95％ CI:1.007 -1.025) and triglyceride (OR =1.204,95％CI:1.063 - 1.365) were the risk factors of blood glucose control (P ＜0.01).Conclusions Hierarchical chain management model is helpful for the blood glucose control in patients with type 2 diabetes.The comprehensive control and treatment of type 2 diabetes should be taken combined with related risk factors,such as blood pressure,blood lipids and diabetes disease course.

Objective To explore the hierarchical chain management model of type 2 diabetes and determine its evaluation.Method Based on the hierarchical chain management of the three community health service institutions and Dahua hospital in Shanghai Xuhui district,215 cases of type 2 diabetes had been involved in the study.Results Compared with the baseline before management,lasting blood glucose (FBG),2 h postprandial glucose (2hPBG),glycosylated hemoglobin (HbA1c),low density lipoprotein cholesterol (LDL-C),systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the diabetes after 12 months' management declined [(8.50 ±2.81) mmol/L,(11.09 ±4.01) mmol/L,(8.56 ±2.41)% ,(3.31 ± 1.06) mmol/L,(139.06 ±20.68) mm Hg (1 mm Hg = 0.133 kPa),(78.20 ± 12.11) mm Hg vs.(7.41 ±2.04) mmol/L,(9.03 ±2.46) mmol/L,(7.34 ± 1.59)% ,(3.00 ± 1.06) mmol/L,(135.48 ± 17.82) mm Hg,(77.27 ±11.83) mm Hg],and the differences were statistically significant(P＜0.01 );control rate of FBG,2hPBG,HbA1c,LDLC,SBP,DBP had improved significantly [19.5% (42/215),20.9% (45/215),24.7%(53/215),20.0%(43/215),27.4%(59/215),30.2%(65/215) vs.50.7%(109/215),53.0% (114/215),54.0%(ll6/215),42.3%(91/215),47.0%(101/215),45.6%(98/215)](P＜0.01).Conclusion Primary and secondary-care hospital based hierarchical chain management model is valid and can be implemented for type 2 diabetes.