Objective To explore the unified assessment methods based on present situation of after-department examination during the internship in the department of obstetrics and gynecology.Methods The present situation of after-department examination in the department of obstetrics and gynecology in 36 comprehensive hospitals of Chongqing Three Gorges Medical College were investigated through interviews and research papers including 12 grade A hospital of the first class hospital (33.33％),19 grade A hospital of the second class(52.78％) and 5 grade B hospital of the second class(13.89％).Totally 137 students of clinical major in 4 grade A hospital of the second class were enrolled and were divided into study group(n=72) and control group(n=65).hems of theoretical examination and skill examination as well as the evaluation standard were established combining with the syllabus of the licensed assistant doctors and the talent training scheme requirements.Students in study group were trained according to the practice syllabus,skill examination requirement and evaluation require-ment while those in control group had no cmresponding requirement.After-department examination was organized by school at the end of internship.The full score of theoretical examination and skill examination score was 50 respectively.Smvey results of after-depamnent examination were analyzed by Fisher's Exact Test and the results of after-depamnent examination were analyzed by t test.Results The hospitals having the after-department examination accounted for 80.56％(29/36).The hospitals having the after-depamnent examination according to the practice syllabus requirements accounted for only 20.69％(6/29).After the intervention,theoretical examination scores of study group and control group were 40.31 ± 3.47 and 35.78 ± 4.92,respectively,with statistically significant differences(t=6.26,P=0.000).The skills assessment scores of study group and control group were 40.42 ± 3.02 and 34.05 ± 5.18,respectively,with statistically significant differences(t=8.90,P=0.000).Conclusions The after-department examination in hospital is in a state of randomness,so unified assessment methods are necessary.

BACKGROUND:Constructing a three-dimensional tissue-like structure in vitro plays a critical role in modern tissue engineering and regenerative medicine. Several advances have been made in the past decade. However, it is stil a chal enge to promote microvascular-like structure formation and improve limited nutritional transportation, thereby promoting cel viability.
OBJECTIVE:To explore the feasibility of constructing a three-dimensional microvascular-like structure through the co-culture technique.
METHODS:Human bone marrow mesenchymal stem cel s and human endothelial cel s were co-cultured on a three-dimensional porous silk scaffold. Cel proliferation was analyzed by Pico-green DNA assay. Their growth profiles were evaluated by scanning electron microscope and laser scanning confocal microscopy, respectively. The mRNA levels of von Wil ebrand factor and CD31, two key functional markers of endothelial cel s, in the co-cultured endothelial cel s was assayed by real-time quantitative reverse transcription-PCR.
RESULTS AND CONCLUSION:The three-dimensional culture system constructed by the silk scaffold and bone marrow mesenchymal stem cel s provided an ideal microenvironment for cel growth and proliferation in vitro. Moreover, this microenvironment was capable of promoting endothelial cel differentiation evidenced by their significantly improved mRNA levels of von Wil ebrand factor and CD31. Premicrovascular-like structure was also observed in the co-cultures under the confocal microscope. Thus, al the data supported that the unique co-culture system could promote endothelial cel differentiation and self-assembling in vitro. This culture system provides a robust tool for the studies addressing microvessel-based tissue engineering.

BACKGROUND:The quantity and quality of seed cel s is a critical bottleneck of the development of vascular tissue engineering. To address this issue, stem cel-derived endothelial cel s have been a hot spot in this field due to their potential in providing the ideal seed cel s.
OBJECTIVE:To elucidate the effect of vascular endothelial growth factor (VEGF) supplementation combined with hypoxic culture condition on the lineage-specific differentiation of embryonic stem cel s into endothelial cel s.
METHODS:Serum-free medium mTeSR?1 was applied to cultivate H9 cel s in vitro. A conditioned medium containing 50μg/L vascular endothelial growth factor was utilized to induce H9 cel s to differentiate into endothelial cel s under the hypoxic culture condition (5%O2). The cel under normal condition (5%CO2) with or without vascular endothelial growth factor served as controls. The phenotype and function of human embryonic stem cel s-derived endothelial cel s were assayed by immunofluorescence staining, quantitative RT-PCR, and low-density lipoprotein uptake experiment.
RESULTS AND CONCLUSION:Compared with the control group, the H9 cel s were induced to be differentiated into endothelial-like cel s more efficiently when they were cultivated under a conditioned medium with vascular endothelial growth factor supplementation under the hypoxic condition. These differentiated cel s not only expressed some important surface markers of endothelia cel s, including kdr, pecam, but also took in low-density lipoprotein to form microvessle-like structures. This culture system supports a synergy effect of vascular endothelial growth factor and hypoxic environment that can efficiently promotes the lineage-specific differentiation
of embryonic stem cel s into endothelial cel s with good phenotype and functionality.

Based on the principle of non-covalent interactions between oligopeptides and paclitaxel for improving the solubility of paclitaxel, an oligopeptide, N terminal-W(L)-FFGREKD-C terminal (W8), was designed and the solubilization effect of W8 on paclitaxel was detected through experiments. The binding efficiency and the possible optimal conformation were optimized by molecular docking program. The solubilization effect of W8 on paclitaxel was determined by RP-HPLC. And the solubilization mechanism of oligopeptide to paclitaxel was proposed at molecular level. It was indicated from the docking result that there existed pi-pi interactions and several hydrogen-bond interactions between the oligopeptide and paclitaxel. After being solubilized by the oligopeptide, the aqueous solubility of paclitaxel was increased to 28 times. This study provided basis for further research of the solubilization of paclitaxel by oligopeptide and confirmed a novel approach for the design of safe oligopeptide solubilizing excipient.

This investigation was to assess the prevalence and risk factors of hypertension in 35 to 70 years old adults living in Xicheng District of Beijing. Cluster sampling was conducted in 2230 adults, and only 1958 individuals agreed to enter into the study. Written informed consents were obtained before questionnaire and physical examination. A total of 1889 data were used for analysis. The prevalence rate of hypertension was 47.8% (n=902). The age-standardized prevalence rate was 40. 1%. Hypertension was seen in 368 men (53.0%) and 534 women (44.7%) (P=0.0005). The rates of disease awareness, treatment, and control were 47.5%, 38.5%, and 24.1%, respectively. The prevalence of hypertension increased with age (P<0.0001). Linear trend was found between body mass index (BMI) and systolic blood pressure (P<0.0001). In multiple logistic model analysis, the hypertension risk for men was 1.33 times that of women (95% CI, 1.08-1.64), for participants with obesity was 2.81 times that of those with normal weight (95%CI, 2.00-3.97). Hypertension has become one of the most concerned public health problems in the district. Middle-aged people should pay attention to changed blood pressure, especial for overweight men. Health promotion should be needed for hypertension prevention. More attention should be paid to substantial increase in hypertension.

Objective To explore the relationship between gastric juice pH and hospital-acquired pneumonia ( HAP) , the gastric bacterial colonization and etiology of HAP in neurologic intensive care unit patients by monitoring gastric juice pH value.Methods From October 2014 to May 2015, consecutive seventy-two tube feeding patients admitted in the Department of Neurology Intensive Care Unit in Xijing Hospital were enrolled in this research.The type and concentration of pathogens from gastric contents were collected, while samples from upper respiratory tract and pharynx were detected dynamically at the same time.Results (1)The group with new onset HAP was higher in gastric juice pH (6.4(5.4,6.4) vs 5.4 (2.5, 6.4), Z=-2.37, P=0.01); (2) The isolation rate of colonized bacteria in gastric cavity was associated with the pH of gastric juice , achieving 60.8% ( 42/69 ) in HAP group; ( 3 ) When the gastric juice pH was >4, the isolation rate of Gram-negative bacilli in gastric cavity obviously increased (63.6%(28/44) vs 35.7%(10/28),χ2 =5.323, P=0.021); (4)The same pathogens were found in stomach-pharynx-upper respiratory tract in 7 cases ( 17.5%) of the total 40 HAP patients.Conclusion Increased gastric juice pH was associated with gastric colonization , especially Gram-negative bacilli , and may lead to a higher incidence of new onset HAP in patients on enteral feeding.

Objective:Explore the efficacy of pulmonary wedge resection in the treatment of non-small cell lung cancer (NSCLC) and risk factors for postoperative recurrence, and construct a risk prediction model.Methods:A retrospective analysis of the clinical data of 126 NSCLC patients were admitted to Mianyang Central Hospital from June 2018 to June 2020. According to different surgical methods, the patients were divided into pulmonary wedge resection group ( n=88) and lobectomy Group ( n=38). Compare the metastasis rate, recurrence rate, and fatality rate at 1 year after the two kinds of operations; according to the recurrence of the lung wedge resection group, the patients are divided into recurrence group ( n=15) and non-recurrence group ( n=73). The general data and preoperative laboratory examination indexes of the two groups of patients were compared; multivariate Logistic analysis of factors affecting postoperative recurrence of patients; a risk scoring model was constructed and its predictive value was evaluated. Enumeration data was expressed by the number of cases and percentage (%), and the comparison between groups was performed by chi-square test. Multivariate Logisitic regression analysis of factors affecting the recurrence of NSCLC patients at 1 year after pulmonary wedge resection; a risk scoring model was constructed according to risk factors, and X-tile software was used to obtain the cutoff value of the score; a calibration curve was used to evaluate the accuracy of the risk prediction model prediction The clinical decision curve evaluates the effectiveness of model predictions. Results:The surgical margin metastasis rate and mortality of patients in the pulmonary wedge resection group were 0 and 6.82%, and the lobectomy group were 13.16% and 21.05%, respectively. The differences between the two groups were statistically significant ( P<0.05); The proportion of patients with smoking history, vascular thrombus cancer, lymph node dissection ≤ 15, carcinoembryonic antigen >5 ng/mL, neutrophil to lymphocyte ratio>2.5, soluble CD105>4 ng/mL, vascular endothelial growth factor >9 ng/mL and matrix metalloproteinase 9 (MMP-9) > 300 μg/L in recurrent group were significantly higher than those in non-recurrent group. All of them were risk factors for recurrence after wedge pneumonectomy ( P<0.05); the above risk factors were incorporated into the risk scoring model, and weights of 22, 38, 25, 33, 20, 27, 36, and 30 were assigned respectively, and patients were classified as medium according to the cut-off value. Risk patients (≤78 points), high-risk patients (>78 points and ≤162 points), and extremely high-risk patients (>162 points). Conclusions:The effect of thoracoscopic wedge resection in the treatment of NSCLC is significantly better than that of thoracoscopic lobectomy. The construction of a risk scoring model for predicting postoperative recurrence of patients is beneficial to early identification of high-risk groups in clinical practice, and to guide medical staff to adopt personalized treatment and nursing care measures.

Objective To investigate the expressions of metallothionein-2A (MT-2A), E-cadherin, interleukin-6 (IL-6), cyclin E, proliferating cell nuclear antigen (PCNA) and bcl-2 in prostate cancer tissues and their correlation with biochemical recurrence of prostate cancer. Methods Tissue specimens from 128 cases of prostate cancer who underwent radical prostatectomy in Shanxi Dayi Hospital from October 2012 to October 2017 were processed and transferred into tissue microarrays, the clinicopathological parameters of patients were also recorded. The expression levels of MT-2A, E-cadherin, IL-6, cyclin E, PCNA and bcl-2 were detected by immunohistochemical avidin-biotin complex (ABC) staining. The correlation between different molecular markers and biochemical recurrence of prostate cancer was analyzed. Results The biochemical recurrence rate of 128 patients with prostate cancer was 30.5％ (39/128). The biochemical recurrence rates of low-risk, intermediate-risk and high-risk prostate cancer patients were 14.8％(8/54), 38.7％(24/62) and 58.3％ (7/12), respectively. The risk classification and pathological T stage of patients with prostate cancer were associated with the expressions of MT-2A, cyclin E, IL-6 and E-cadherin (all P< 0.05). Multivariate Cox risk model showed that the high risk classification (HR= 1.81, 95％CI 1.56-2.19, P=0.042), MT-2A positive expression (HR= 2.01, 95％CI 1.08-3.15, P= 0.005), cyclin E positive expression (HR= 1.79, 95％CI 1.08-2.21, P= 0.042) and E-cadherin negative expression (HR= 1.92, 95％ CI 1.22-2.45, P= 0.020) were the independent risk factors for biochemical recurrence of prostate cancer. Conclusion The expression of MT-2A, cyclin E and E-cadherin may serve as independent predictors for biochemical recurrence of prostate cancer.

Abdominoscrotal hydrocele is rare in clinic. In the past, routine examination and diagnosis were difficult, easy to be misdiagnosed. The daily operations were mostly completed through the groin area or abdominal incision, the wound is large. The application of laparoscopy can clearly diagnose the abdominoscrotal hydrocele through "springing back ball" sign, and can cure the disease by laparoscopic resection of interperitoneal mass and closure of the internal ring. It is worthy of clinical application. In this article, we summarized and analyzed the clinical experience of 15 cases of children with abdominoscrotal hydrocele diagnosed and treated by laparoscopy, to explore the value of the laparoscopic technology in the diagnosis and treatment of the abdominoscrotal hydrocele.

Objective To study the acute effect of vagus nerve stimulation (VNS) on status epilepticus (SE) in rats.Methods Forty-eight male Wistar rats were randomly divided into 4 groups:Group A (VNS preconditioning group),accepted VNS at 2 h before pilocarpine injection,Group B (VNS treatment group),accepted VNS immediately after pilocarpine injection,Group C (negative control group),implanted with electrode without stimulation,and Group D (SE model group),without electrode implantation (n=1 2).Lithium-pilocarpine was used to kindle the rats to establish SE models.Stimulation parameters used in the procedure of VNS were as follows:frequency,30 Hz; pulse width,0.5 ms; current,1 mA; and duty cycle,on-30 s,off-30 s.Behavior changes were observed and caspase-3 expression in dentate gyrus was detected 72 h after pilocarpine injection.Results (1) The seizure frequencies of grade Ⅳ and Ⅴ (Racine grading) in group A and B were significantly fewer than those in group C and D (P＜0.05); the seizure frequency of grade Ⅴ in group A was significantly fewer than that of group B (P＜0.05); SE latency in group A was significantly longer than that in other groups (P＜0.05).(2) Expressions of caspase-3 in the dentate gyrus of group A and B were significantly lower than those of group C and D (absorbancy values being 5854.7±856.5,6244.8±806.0,11957.0±1948.1 and 11543.2±1734.7,P＜0.05).Conclusion VNS has an acute seizure-suppressing effect on SE in rats and it can also reduce neuronal apoptosis induced by SE in hipocampus.