Setting up medical specialists education system is the requirement of the re-form and development of medical sciences and health causes and is a must to train medical specialists. It is of significance to perfect medical education and standardize residency training and management in China,so as to promote medical education and talents management to be in line with the world.

We have established the model of English ability training on the residency training project,and have provided the systematic training plan to 29 residents who were employed in 2005.This paper summarizes the effect and points out the further reform perspectives.

BACKGROUND:The rabbits were widely used as experimental animal models in the research on etiology and pathological mechanism of steroid-induced osteonecrosis of the femoral head. It is stil a valuable and realistic research topic to improve and to innovate the modeling technology nowadays. OBJECTIVE:To improve the modeling technology on osteonecrosis of the femoral head in rabbits induced by glucocorticoid combined with lipopolysaccharide, with the focus on its reduced mortality and the guaranteed successful rate of modeling. METHODS:A total of 28 New Zealand white rabbits were randomly divided into the control group (n=10) and improvement group (n=18). Models of steroid-induced osteonecrosis of the femoral head were established according to different methods. In the improvement group, rabbits were injected with sodium penicilin (5.0 mg/kg) and amikacin sulfate (1.63×104 U/kg) in the left gluteus muscle. Twenty-four hours later, al rabbits were injected with prednisolone acetate (20 mg/kg) in the right gluteus muscle. Forty-eighthours later, 5.0 μg/kg of lipopolysaccharide was intravenously injectedvia the ear. From then on, two injections of prednisolone acetate (20 mg/kg) were respectively performed alternately in the left and right gluteal muscle at an interval of each 24 hours. Sodium penicilin (5.0 mg/kg) and amikacin sulfate (1.63×104 U/kg) were intraperitonealy injected for 2 consecutiveweeks. In the control group, 10 μg/kg lipopolysaccharide was injectedvia the ear vein of rabbit. From then on, prednisolone acetate (20 mg/kg) was intramuscularly injected at an interval of each 24 hours, totaly three times. Benzylpenicilin sodium 20×104 U/rabbit was intramuscularly injected once a week. RESULTS AND CONCLUSION:Rabbit models of steroid-induced osteonecrosis of the femoral head were successfuly established in both groups. Compared with the control group, the mortality was significantly reduced after model establishment in the improvement group, and the bone lacuna and osteonecrosis of the femoral head were apparent. These findings indicated that the improved technology of model establishment of steroid-induced osteonecrosis of the femoral head could be used to aleviate the damage degree on the gluteal muscles, to guarantee the successful rate of modeling, and to noticeably reduce the mortality of rabbits.

90 without intestinal canal whirl sign was used as the diagnostic standard for whirl sign.Two experienced physicians evaluated the mesenteric vessel whirl sign and its morphological characteristics(including its site,rotation direction,rotation angle,distance between the start and end points of rotating vessels,and rotation radius) and associated signs.The difference in characteristics of whirl sign was compared between volvulus and non-volvulus patients.Results Mesenteric vessel whirl sign was found in 72 out of the 626 patients,including 64(10.4% ) in volvulus group and 8(88.9% ) in non-volvulus group.Mesenteric vessel whirl sign was complicated by intestinal canal whirl sign in 8 volvulus patients,complicated by superior mesenteric artery stricture in 6 volvulus patients.Mesenteric vessel whirl sign complicated by intestinal canal whirl sign was observed in only 2 non-volvulus patients with no superior mesenteric artery stricture.A difference in rotation angle and the start and end points of rotating vessels was found between the two groups(P

Objective To discuss the ability of 64 slices CT to display the image of peripancreatic vessels. Methods 105 patients underwent abdomen enhancement scans. The scan data of aterial phase and venous phase were reconstructed respectively, the peripancreatic vessels were displayed by means of volume rendering (VR) and multiplanar volume reconstructions (MPVR). The percentage of successful display of the peripancreatic vessels were calculated. Results ①The display frequency of the peripancreatic big arteries and veins, including celiac trunk artery(CTA), common hepatic artery (CHA), 1eft gastric artery(LGA), splenic artery (SA), gastroduodenal artery (GDA), right gastloepiploic artery(RGEA), superior mesenteric artery (SMA), portal vein(PV), superiormesenteric vein(SMV), spleenic vein (SV)was 100%. ②The display frequency of small arteries including superior pancreaticoduodenal artery (PSPDA), inferior pancreaticoduodenal artery (PIPDA), dorsal pancreatic artery (PDA), transverse pancreatic artery (PTA), pancreaticomegana artery (PMA) and caudal pancreatic artery (PCA) ranged from 43.3% to 97.20%,while of the posteriorsuperior pancreaticoduodenal vein (PSPDV) and posterior-inferior pancreaticoduodenal vein (PIPDV) was 71.4% and 30.5% respectively. ③The display frequency of the peripancreatic small vessels by the multiplanar volume reconstruction (MPVR) was higher than that of the volume rendering (VR)(P＜0.05). Conclusions Multislice CT can display the peripancreatic peripancreatic vessels. Furthermore, there is a significant difference in the display frequency of the peripancreatic small vessels between the MPVR and VR reconstruction methods.

ObjectiveTo investigate the curative effect and prognostic impact of radical resection assisted by transcatheter arterial chemoembolization (TACE) in the treatment of intrahepatic cholangiocarcinoma (ICC). MethodsThe clinical data of 80 patients with ICC who were admitted to the Department of Hepatobiliary Surgery in our hospital from January 2008 to December 2010 were retrospectively analyzed. Thirty-five patients in the control group received radical resection, while forty-five patients in the observation group received adjuvant TACE therapy following radical resection. The curative effect and survival time were compared between the two groups. Comparison of continuous data between the two groups was made by t test, and comparison of categorical data was made by chi-square test. ResultsThe observation group had significantly lower serum levels of alpha-fetoprotein, carcinoembryonic antigen, carbohydrate antigen 19-9, and alanine aminotransferase than the observation group at 6 months after surgery (47.35±13.76 vs 83.54±24.17 μg/L, t=19.58, P＜0.05; 30950±125.55 vs 37585±136.77 μg/L, t=101.33, P＜0.05; 20.86±10.38 vs 34.18±8.55 ng/ml, t=29.46, P＜0.05; 25.44±819 vs 58.56±22.58 U/L, t=32.25, P＜0.05). The 1-year, 2-year, and 3-year survival rates in the observation group were significantly higher than those in the control group (χ2=11.43, P＜0.05; χ2=20.15, P＜0.05; χ2=9.87, P＜0.05). The mean survival period was significantly longer in the observation group than in the control group (t=15.38, P＜0.05). According to the analysis of factors influencing the survival period in patients with ICC, patients with a tumor size larger than 5.0 cm, a low degree of differentiation, and metastasis had a significantly lower long-term survival rate and a significantly shorter mean survival period than other patients (P＜0.05). ConclusionThe adjuvant TACE therapy after radical resection is a safe and effective method in the treatment of ICC. The tumor size, degree of differentiation, portal vein tumor thrombus, and metastasis have a strong prognostic impact.

OBJECTIVETo explore the anatomical basis and clinical application of axial subdermal vascular network skin flap (ASVNF) in the management of deep burn wounds.

METHODSTwelve samples of skin and subcutaneous tissue of lower extremities from adult cadavers were anatomically observed. The course, branching and the architecture of the subdermal vascular network (SVN) in the superficial facia and the ultra-thin area of the anterolateral femoral and saphenous axial subdermal vascular network skin flaps were intensively studied. The wounds in twenty-six patients with deep burn injury in the limbs were repaired with ASVNF.

RESULTSThe circular thinning method was employed in the preparation of anterolateral femoral ASVNF whose blood supply was provided by the musculocutaneous perforators. And the "U" shaped ultra-thin method was employed in the preparation of saphenous ASVNF, whose blood supply was directly provided by skin vessels. The flaps in these 26 patients survived very well in terms of the flap color, texture, contour and function after followed-up for 0.5 approximately 2.5 year.

CONCLUSIONThinning methods for different kinds of ASVNF should be individualized. ASVNF might be an optimal choice in the management of deep burn wounds due to its obvious advantages.

Adolescent ; Adult ; Burns ; surgery ; Dermis ; anatomy & histology ; blood supply ; Female ; Humans ; Male ; Middle Aged ; Skin Transplantation ; methods ; Surgical Flaps ; blood supply ; Time Factors ; Wound Healing

In recent years, it is found that the classical IKKα and IKKβ pathway were closely relates with hematological tumors, except the classical pathogenesis, moreover the classical IKKβ pathway is deeply studied. The studies indicated that the IKKβis activated to phosphorylate the NF-κB through multiple cascades under the effect of extracellular IL-6, TNF-α and other stimulating factors. At the cellular level, the classical IKKβcan promote the tumor cell survival and proliferation, reduce the cell apoptosis, and promote the angiogenesis and cell transfer. Although the classical IKKα plays a role in regulating IKKβ activity, but its role in non-classical pathway is more prominent. This review briefly summarizes the latest advance of researches on the pathogenesis of hematological malignancies in term of IKKα and IKKβpathway, so as to provide the theoretic basis for deeply understanding and studying the pathogenesis of hematologic tumors. At present, blocking the classical IKKα and IKKβ pathway has become a new target for treatment of hematological tumors, moreover, some specific inhibitor for IKKα and IKKβpathway have been developed, for example, LY2409881, BMS 345541 and so on. Most of these drugs are in clinical trials and display some good anti-tumor effects.
Cell Survival ; Hematologic Neoplasms ; Humans ; I-kappa B Kinase/metabolism* ; NF-kappa B/metabolism* ; Signal Transduction ; Tumor Necrosis Factor-alpha

This study was aimed to elucidate the expression of costimulatory molecule CD80 and CD86 in HL-60 cells induced by proteasome inhibitor MG132 and its effect on allogeneic mixed lymphocyte reaction. Acute myelocytic leukemia cell line HL-60 and chronic myelocytic leukemia cell line K562 were cultured. The viability of the cells was measured by flow cytometry. Proteasome inhibitor MG132 at the concentrations of 2 or 3 µmol/L was used to stimulate the HL-60 cell cultured for 24 h and 48 h respectively, and the Annexin V/7-AAD staining and flow cytomotry were used to detect the apoptosis of the HL-60 cells. HL-60 and K562 cells were treated with 1 µmol/L MG132 for 24 h and 48 h respectively, then CD80 and CD86 antibodies were added, finally the expression of CD80 and CD86 was analysed by flow cytomery. The mRNA expression of CD86 in the HL-60 cells treated with 1 µmol/L MG132 was detected by RT-PCR. HL-60 and K562 cells were treated by 1 µmol/L MG132 and then underwent irradiation of 75 Gy (60)Co to kill the cells with their antigenicity preserved. Peripheral blood mononuclear cells (PBMNCs) of healthy volunteers, as reactive cells, were isolated and inoculated into the (60)Co irradiated HL-60 cells of different concentrations, as stimulating cells, CCK-8 was added and then the A value of absorbance was measured at the wave length of 450 nm in an enzyme labeling instrument. The results showed that the cell viability of the HL-60 cells treated with 1 µmol/L MG132 for 24 h an d 48 h was 92.95% and 85.87% respectively. The apoptotic rates of the HL-60 cells treated with MG132 increased in dose-and time-dependent manner. High-concentration of MG132 directly killed HL-60 cells. Before MG132 treatment K562 cells did not express CD86, but the CD86 expression of the HL-60 cells was up-regulated time-dependently after MG132 treatment (P < 0.01). The mRNA expression of CD86 in the HL-60 treated with MG132 was up-regulated time-dependently (P < 0.01). CCK-8 test showed that the proliferation level of PBMNC gradually increased along with the concentration of HL-60 cells treated with MG132 and reached its peak when the concentration of the HL-60 cells was 1×10(5) (P < 0.01). No remarkable proliferation of PBMNC was observed in the K562 groups no matter if the HL-60 cells had been treated with MG132. It is concluded that the high concentration of MG132 can directly kill HL-60 cells, low-concentration of MG132 can induce the expression of costimulatory molecule CD86 in HL-60 cells, also can improve the proliferation of PBMNC.
Apoptosis ; B7-2 Antigen ; immunology ; Cell Survival ; Flow Cytometry ; HL-60 Cells ; Humans ; K562 Cells ; Leukocytes, Mononuclear ; drug effects ; Leupeptins ; pharmacology ; Lymphocyte Culture Test, Mixed ; Proteasome Inhibitors ; pharmacology ; Reverse Transcriptase Polymerase Chain Reaction ; Up-Regulation

The present study was aimed to investigate the function of diffusion weight imaging (DWI) combining with magnetic resonance spectroscopy (MRS) in the grading of brain gliomas. 12 cases low grade and 17 cases high grade of brain gliomas patients were examined with DWI and MRS, with all tumors confirmed by pathology in advance. The apparent diffusion coefficient (ADC) values, their corresponding metabolite ratios of Cho/Cr, Cho/NAA and tumor cellularities of tumor solid enhanced parts were measured. The ratios of Cho/Cr and Cho/NAA and their corresponding ADC values had significant differences between their high and low grade gliomas values, respectively. The ADC values demonstrated a negative correlation with Cho/Cr, Cho/NAA, and a significant negative correlated with Cho/Cr. And the ADC values demonstrated strong negative correlations with tumor cellularities. DWI combining with MRS could provide more valuable information in evaluating gliomas grading.
Adolescent ; Adult ; Aged ; Brain Neoplasms ; diagnosis ; pathology ; Child ; Diffusion Magnetic Resonance Imaging ; methods ; Female ; Glioma ; diagnosis ; pathology ; Humans ; Hydrogen ; Magnetic Resonance Spectroscopy ; methods ; Male ; Middle Aged ; Neoplasm Grading ; Young Adult