Reforming the managerial system and the educational system of higher medical education is the requirement of the social development in the twenty-first century. The article expounds the fundamental characteristics of medical education including small scale, longer-duration program, and high expenditure. It emphasizes the significance of following the rule of medical education, and analyzes the important position of medical college and the relation of medical college to affiliated hospitals and other related colleges in the comprehensive university. Based on the requirement of the social development and the trend of higher medical education internationalization, it also analyzes the necessity of the adjustment on the medical educational system and the way of the adjustment.

Intrahepatic cholangiocarcinomas (ICCA) are primary intrahepatic malignancies originating from biliary epithelia.While both hepatocellular cancer and ICCA can present as mass lesions within the liver,these cancers are distinct in their morphology,etiology,pathology,natural history and response to therapy.There is a need for accurate and sensitive molecular markers for the diagnosis of ICCA.Recent advances in elucidating molecular and genetic characteristics of ICCA offer the potential of molecular-based diagnosis of ICCA.Specific genetic mutations of IDH1/2,BAP1,p53,and KRAS,FGFR gene fusions and alterations in microRNA have all been described in ICCA.Although there are no accurate serum or biliary biomarkers currently available for diagnosis of ICCA,several potential candidates have been identified.Knowledge of specific genetic or molecular abnormalities offers potential for individualized approaches for the treatment of patients with ICCA in the future.

Objective To investigate the changes of psychological state and family environment of the patients with neurosis (including depression and anxiety) in the process of treatment. Methods The Hamilton depression scale (HAMD), Hamilton anxiety scale(HAMA), self-rating depression scale(SDS), self-rating anxiety scale(SAS), family environment scale(FES), and family adaptability and cohesion scale(FACESⅡ-CV) were used to evaluate the changes of psychological state and family relationship in the process of treatment among patients with depression and anxiety hospitalized in general hospitals (n=45) and their family members (n=45). Results Before intervention, values of HAMD, HAMA, SDS and SAS in patients were higher than normal ones, and were in line with the corresponding diagnostic criteria. After psychological intervention and medication for 2 to 3 months, symptoms such as depression and anxiety were improved significantly, and values of the above scales were within normal ranges. Besides, there was also significant improvement in FES and FACESⅡ-CV after intervention among the patients. All the values of the family members were in the normal ranges before intervention, however, significantly positive changes were observed after intervention. Conclusion With the improvement in depression and anxiety after intervention among patients, the psychological pressure of family members is released, and family relationship is partially restored. The rehabilitation of patients plays an important role in the restoration of family function.

Objective To evaluate urodynamic diagnosis of intrinsic sphincter deficiency (ISD) in female stress urinary incontinence. Methods Leak-point pressures (LPP) and maximum urethra close pressures (MUCP) were detected in 30 patients with female stress urinary incontinence,among whom there were 11 cases with type Ⅲ,19 type Ⅱ/Ⅲ. Results Of type Ⅲ incontinence the LPP was less than 50 cmH 2O in 10 out of 11 and in 17 out of 19 type Ⅱ/Ⅲ incontinence the LPP 50～100 cmH 2O ( P

AIM: To establish the method of determining procyanidin B2 content in grape seed extract by HPLC. METHODS: The determination was carried out with ZORBAX SB-C_ 18 column. The mobile phase consisted of acetonitrile-2% acetate buffer under the gradient elution condition, detection wavelength was at 280nm. RESULTS: There was a good linear relationship between the peak area and concentration in the range of 1~30 ?g/mL for procyanidin B2. The average of procyanidin B2 (n=5) was 99.29% and RSD=1.64%, respectively. CONCLUSION: The method is simple, accurate, reproducible and can be used for assay of procyanidin B2.

Objective To discuss the clinical application of MSCT-guided BARD gun biopsy in diagnosing pulmonary lesions. Methods Under MSCT-guidance percutaneous transthoracic biopsy of lung with BARD gun was performed in 68 patients with pulmonary lesions. Results All the procedures were well performed with the technical successful rate of 100%. The final diagnosis was based on the pathological findings or clinical follow-up observation. The accuracy of the qualitative diagnosis was 94.1%. Of 68 patients, squamous cell carcinoma was found in 30, adenocarcinoma in 21, metastases in 7, inflammatory pseudotumor in 3, lung abscess in 2, and tuberculosis in one. The false-negative rate in making diagnosis was 5.9%. The complication occurrence was 8.8%. Conclusion BARD gun has the advantage of making coaxial- multipoint biopsy. With the help of MSCT-guidance and the full use of the operating advantage of BARD gun, this technique is safe and reliable, with higher accuracy and less complications.

BACKGROUND: Recent studies indicate that after indirect co-culture of neonate rat myocardial cells and bone marrow mesenchymal stem cells, bone marrow mesenchymal stem cells can differentiate into myocardial cells successfully. OBJECTIVE: To induce human bone marrow mesenchymal stem cells (hBMSCs) to differentiate into endothelial cells using human umbilical vein endothelial cells by indirect co-culture. DESIGN, TIME AND SETTING: In vitro study of cell engineering was done at the Medical Research Center of Guangdong Provincial People’s Hospital between January and July 2007. MATERIALS: Small quantities of bone marrow were obtained from 11 children with congenital heart disease but without hematologic diseases through manubrium of sternum puncture in the congenital heart defect corrective surgery after the permission of family member. Umbilical cord of full-term normal delivery healthy newborn was provided by the Department of Obstetrics, the First Affiliated Hospital of Sun Yat-sen University. Fresh cattle jugular vein was provided by Guangdong Dali Meat Cattle Butchery. METHODS: The hBMSCs were isolated and purified using density gradient centrifugation method and were cultured in vitro. Human umbilical vein endothelial cells were obtained from newborn umbilical cord by enzyme digestion. Cell culture insert with semipermeable membrane combined with 6-well plate was used to do indirect co-culture induction. Human umbilical vein endothelial cells were expanded in the cell culture insert, passage 3 bone marrow mesenchymal stem cells were expanded in the 6-well plate outside the culture insert at the density of 1?105 cells/well, the initial ratio of the two kinds of cells was 1:5, then low-glucose DMEM culture solution containing 10% fetal bovine serum was added, cells were cultured for 14 days. Co-culture of bone marrow mesenchymal stem cells and bone marrow mesenchymal stem cells was used as control. Introduced endothelioid cells were cultured and then seeded on the cell-free cattle jugular vein intravascular stent. MAIN OUTCOME MEASURES: Morphology changes of induced cells; introduced endothelioid cell surface antigen detected through immunocytochemical staining; the growth and adhesion condition of endothelioid cells on the intravascular stent observed under scanning electronic microsope. RESULTS: The morphologies of introduced endothelial cells were uniform, introduced endothelial cells presented a cobblestone-like appearance, they amplified fast and expressed endothelial cell-specific surface marker CD31 and vWF and the positive rate was over 99%. They also could form a continuous unicellular layer on the cell-free cattle jugular vein intravascular stent. CONCLUSION: Human umbilical vein endothelial cells can induce hBMSCs to differentiate into endothelial cells successfully and to adhere and grew on the cell-free cattle jugular vein intravascular stent through indirect co-culture method.

Objective To investigate the effect and mechanism of serotonin (5-HT) and secretin(SEC) on afferent discharge of vagus in rats. Methods Spontaneous afferent discharge of subdiaphragmatic vagus nerve was recorded in urethane anesthetized rats. The effects of 5-HT, 5-HT3 receptor antagonist and 5-HT+SEC on the discharge of subdiaphragmatic vagus nerve were investigated by intravenous injection of different dosage of 5-HT(3, 10, 30 ?g/kg), Granisetron (1 mg/kg) and 5-HT+SEC. Results Intravenous 5-HT caused obvious exciting effect on spontaneous afferent discharge of subdiaphragmatic vagus nerve. The 5-HT3 receptor antagonist significantly inhibited the effects of 5-HT. 5-HT+SEC could augment the effect of 5-HT on spontaneous discharge. Conclusion The exciting effect of 5-HT on afferent discharge of subdiaphragmatic vagus nerve is possibly mediated by 5-HT3 receptor related to vagus nerve afference. Secretin can augment the exciting effect of 5-HT on spontaneous discharge of vagus afferent nerve.

Objective To evaluate MRI in diagnosis and follow-up of Achilles tendon rupture. Methods From April 2003 to May 2005, 24 cases of closed Achilles tendon rupture were examined in our department with MRI. It was performed through sagittal T1WI, T2WI, GE-STIR and axial TME imaging. Four cases were followed up with MRI after 4 to 8 weeks. Results MRI could determinate the severity and exact location of Achilles tendon rupture by demonstrating signal changes of Achilles tendon. In this series, complete rupture of Achilles tendon mostly occurred at the median part, with augmentation and high signal on T2WI. MRI demonstrated high signal on T2WI in partial rupture of Achilles tendon. The signal intensity in the four cases followed up by MRI was shown to decrease. Conclusion MRI is a valuable tool for clinical diagnosis and follow-up of Achilles tendon, because it provides enough information through signal changes at the tendon.