Good standardized training of resident physicians is indispensable for high quality medical personnel building.This paper gives a brief introduction to the experiences of endocrinology fellowship trainings in three top hospitals in USA.On the basis of current simation in China,a new and improve the quality'is proposed,and a new approach is explored,which is a valuable reference for the endocrine resident trainings in China.

Adolescent ; C-Reactive Protein ; metabolism ; Cell Aggregation ; Child ; Child, Preschool ; Cytodiagnosis ; methods ; Female ; Humans ; Infant ; Leukocytes ; cytology ; Male ; Meningitis, Bacterial ; blood ; cerebrospinal fluid ; diagnosis ; Meningitis, Viral ; blood ; cerebrospinal fluid ; diagnosis ; Sensitivity and Specificity

Objective By constructing mortalin stably expressing ovarian cancer cell lines in A 2780 and A2780/cis, we demonstrate the role of mortalin in the ovarian cancer cell growth .Methods CCK-8 assay was used to measure cell viability in the overexpression mortalin group compared with the control group .The flow cytometry analysis was used to understand the effect of upregulated mortalin on the ovarian cancer cell cycle .Western blotting was used to determine the expression and phosphorylation level of MAPK /ERK and JNK/SAPK signal pathways .Results The results showed that increased expression of mortalin could accelerate ovarian cancer cell proliferation and promote G 1 transition, leading to a faster restoration of normal distribution of cell cycle .We found that mortalin overexpression significantly activated p-Raf and p-ERK1/2, but not p-JNK.Conclusion The results demonstrate that mortalin effect on the ovarian cancer cell proliferation contributes to active the MAPK-ERK signaling pathway .

Objective To assess the application effect of the catheter management software on the management of Indwelling urinary catheter in the Emergency intensive care unit (EICU). Methods A prospective control study of targeted surveillance of catheter-associated urinary tract infection was conducted from January 2014 to December 2015 in EICU. The patients were divided into two groups. The patients in control group (131 patients) were treated from January 1, 2014 to December 31, 2014 and received routine catheter management, and the patients in test group (135 patients) were treated from January 1, 2015 to December 31, 2015, and received catheter management by software. The catheter management software was developed and applied, and the process specification which collaborated with the software was established. The quality of the catheter management including the omission rate of the catheter management, the rate of urinary catheter-associated urinary tract infections (CAUTI) and the rate of catheter used etc were evaluated after the software's application. Results Through software applications, the omission rate of the catheter management, the omission rate of urine drainage bag replacementand the omission rate of urinary catheter replacement in test group were significantly lower than those in control group:0 vs. 36.64%(48/131), 0 vs. 15.27%(20/131) and 0 vs. 9.92%(13/131), P<0.01 or<0.05. The performance rate of catheter daily management in test group was significantly higher than that in control group: 99.26%(134/135) vs. 64.12%(84/131), P<0.01. The rate of CAUTI in test group was significantly lower than that in control group: 1.90‰ vs. 9.16‰, χ2=4.843, P=0.028. The rate of catheter used in test group was significantly lower than that in control group: 60.74%(82/135) vs. 73.28%(96/131), P<0.01. Conclusions The development and the establishment of the management software can improve the rate of implement, and declinethe rate of CAUTI.

Objective To explore the quality of life (QOL) and its influential factors among patients with 3 major rheumatic diseases. Methods A total of 216 patients with rheumatic diseases (84 patients with systemic lu- pus erythematosus, SLE, 83 with rheumatoid arthritis, RA, and 49 with ankylosing spondylitis, AS) were recruited. The information with regard to their quality of life, sociopsychological factors and the evaluation of disease activity were obtained by using the medical outcomes study short form-36 (SF-36) and clinic documents. Results Patients with rheumatic diseases scored significantly lower with each subscale of SF-36 as compared to those of a healthy popu- lation in China (P

To investigate the therapeutic effect and molecular mechanism of the main flavonoid components of Silybum marianum (S. marianum) on nonalcoholic fatty liver disease (NAFLD), we identified nine flavonoids in S. marianum through TCMSP, PubChem database and corresponding literatures. The potential therapeutic targets of NAFLD were predicted by SwissTargetPrediction, GeneCards and Venny 2.1.0 platform, while the protein-protein interaction (PPI) network of potential targets was analyzed using String platform and Cytoscape software. Then GO and KEGG pathway enrichment analysis were performed using David 6.8 database, followed by molecular docking verification using AutoDock software. In vitro, components with higher degree value in the "components-targets-pathway" network were chosen for further analysis. L02 cells were used to establish lipid accumulation model and treated with different components. Furthermore, the effects of four pure active compounds from S. marianum on lipid accumulation in hepatocytes were analyzed by oil red O staining. The results showed that the main nine flavonoids extracted from S. marianum contained 24 potential NAFLD targets. Several critical pathways closely related to NAFLD process were identified by GO and KEGG enrichment analysis, including phosphatidylinositol 3-kinase-protein kinase B (PI3K-Akt) pathway, type 2 diabetes pathway, tumor necrosis factor (TNF) pathway and insulin resistance pathway. The results of molecular docking further indicated that the core components displayed strong binding abilities with key targets respectively, and silandrin showed better binding activity as compared to other components. The results obtained from L02 cells showed that the lipid accumulation was reduced by treatment with isosilybin A, isosilybin B, silydianin and silychristin, while the activity of isosilybin B was better than that of isosilybin A. Taken together, we concluded that the main flavone components of S. marianum could improve lipid accumulation through multiple signaling pathway in hepatocytes, and this could be a potential new strategy for the treatment of NAFLD.

Objective To assess the relationship between the recurrence of esophageal varices fol?lowing endoscopic esophageal varix ligation (EVL) and esophageal collateral veins(ECV)under endoscopic ultrasound ( EUS) , and analyze the predictive value of EUS for recurrence of esophageal varices. Methods Sixty patients with cirrhotic portal hypertension combined with esophageal varices underwent EVL for eradica?tion of varices. Endoscopy and EUS were performed before ligation to detect and describe the type of esopha?geal varices, and grade, location, and the number of ECV. Over a 12?month period, variceal recurrence was examined. The statistical analyses were performed to assess the relationship between esophageal varices fol?lowing EVL and ECV. Results Of the 60 patients, 29 ( 48?3%) had variceal recurrence within 12 months after EVL. Univariate logistic regression analysis showed that severe peri?ECV ( OR=22?67;95%CI:4?37? 117?47, P<0?001) ,severe para?ECV( OR=16?31;95%CI:0?84?108?14, P=0?018) , multiple peri?ECV ( OR=22?67;95%CI:4?37?117?47, P<0?001) , and the presence of perforating veins ( OR=6?67,95%CI:1?46?30?43,P=0?014) were significantly related to the variceal recurrence after EVL. Multivariate logis?tic regression model showed that severe peri?ECV ( OR=24?39;95%CI:2?34?253?78,P=0?008) and mul?tiple peri?ECV (OR=24?39;95%CI: 2?34?253?78,P=0?008) severe para?ECV(OR=19?42; 95%CI:4?84?148?54,P=0?012) remained independent prognostic factors for variceal recurrence. The sensitivity and specificity of multivariate logistic regression model in predicting variceal recurrence were 89?2% and 90?5%, respectively (prognostic value AUC=0?946).The sensitivity and specificity were 86?4% and 87?7% in pre?dicting variceal recurrence( prognostic value AUC=0?871) . Conclusion Recurrence rate of esophageal var?ices after EVL is high. EUS can clearly depict ECV. Severe peri?ECV and multiple peri?ECV are significant and independent prognostic factors associated with variceal recurrence risk. EUS before EVL will help predict variceal recurrence after EVL.

OBJECTIVETo study the role of PTEN gene involved in the biological behavior of human gastric carcinoma cells and underlying molecular mechanisms.

METHODSGastric carcinoma cell line, SGC7901, was transfected with plasmid PBP-PTEN and stable high PTEN expression clones were selected by Western blot and cell immunohistochemistry screening. Cell proliferation rate and apoptosis index of transfected cells were investigated by growth curve analysis, colony-formation assay and flow cytometry (FCM). Expressions of vascular endothelial growth factor (VEGF), matrix metalloprotease-2 (MMP-2) and MMP-9 proteins in cell culture supernatant and cytoplasm were determined by ELISA, gelatin zymogram, Western blot and cell immunohistochemistry.

RESULTSStable clone with high level expression of PTEN was successfully established (PTEN-SGC7901). Cell doubling time of PTEN-SGC7901 was longer than that of the control cells (P < 0.05). The size and colony-forming efficiency of PTEN-SGC7901 cells deceased compared with those of the control. The relative colony-inhibition efficiency of PTEN-SGC7901 to SGC7901 (naïve untransfected) and PBP-SGC7901 (control vector transfected) cells were 69.8% and 64.8%, respectively. PTEN-SGC7901 clone had more cells at G1 phase (P < 0.05) compared with that of the control. However, the apoptosis index did not show significant differences among the three groups (P > 0.05). There were significantly less VEGF and MMP-9 protein expressions in the PTEN-SGC7901 culture supernatant and cytoplasm (P < 0.05). In contrast, the MMP-2 expression among three cell groups had no significant difference (P > 0.05).

CONCLUSIONSPTEN expression suppresses the growth and proliferation of gastric carcinoma cell SGC7901, possibly through an inhibition of the expressions of VEGF and MMP-9.

Apoptosis ; Cell Cycle ; Cell Line, Tumor ; Cell Proliferation ; Gene Expression Regulation, Neoplastic ; Humans ; Matrix Metalloproteinase 2 ; metabolism ; Matrix Metalloproteinase 9 ; metabolism ; PTEN Phosphohydrolase ; genetics ; metabolism ; Plasmids ; Stomach Neoplasms ; metabolism ; pathology ; Transfection ; Vascular Endothelial Growth Factor A ; metabolism

OBJECTIVESTo investigate prognostic effect of postoperative resection-margin status for intraoperatively positive resection margin in advanced gastric cancer and discuss the treatment choice for intraoperatively positive resection margins.

METHODSA retrospective study was investigated in 64 advanced gastric cancer patients with positive resection margin after potentially curative resection. The survival between 50 patients who was re-excised to a negative resection margin (NR group) and 14 patients who were left with positive resection margin (PR group) was compared. Prognostic factors were analyzed using univariate and multivariate Cox regression model analysis.

RESULTSThe median survival in the PR group was 17.0 months (95%CI: 11.6 - 22.4) as compared with 23.0 months (95%CI: 20.5 - 25.5) in the NR group (P = 0.045). However, resection-margin status lost significance on multivariate analysis. In the subgroup of D2 lymphadenectomy, the median survival in the PR group and NR group were 17.0 months (95%CI: 12.0 - 22.0) and 24.0 months (95%CI: 19.8 - 28.1) respectively; multivariate analysis further identified resection margin status as an independent prognostic factor.

CONCLUSIONSRe-excision for intraoperatively positive margin to negative margin improves the prognosis of the patients with advanced gastric cancer, and re-excision is the first choice when intraoperative frozen section detects a positive margin. Routine frozen section of resection margin should be mandatory in all advanced gastric cancer undergoing potentially curative surgery.

Female ; Follow-Up Studies ; Frozen Sections ; Gastrectomy ; methods ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Stomach Neoplasms ; surgery

AIM: To synthesize three novel esterified-derivatives of mangiferin and evaluate their hypoglycemic activities. METHODS: Acetic, propionic, and butyric anhydride were reacted with mangiferin, respectively. The hypoglycemic activity of the derivatives was evaluated using a hyperglycemic mouse model induced by streptozotocin (STZ), and the islet cells were checked by biopsy inspection. RESULTS: 7, 2', 3', 4', 6'-penta-acetyl-mangiferin (PAM), 3, 6, 7, 2', 3', 4', 6'-hepta-propionyl-mangiferin (HPM) and 3, 6, 7, 2', 3', 4'-hexa-butyryl-mangiferin (HBM) were synthesized and their structures were identified by MS,(1)H, (13)C NMR, and 2D NMR. These three compounds were reported for the first time. PAM group (0.5, 0.25 mmol·kg(-1)), HPM group (0.5, 0.25 mmol·kg(-1)), and HBM group (0.5, 0.25, 0.125 mmol·kg(-1)) mice showed strong hypoglycemic activity (P < 0.01); mangiferin group (1, 0.5 mmol·kg(-1)), PAM group (0.125 mmol·kg(-1)) and HPM group (0.125 mmol·kg(-1)) showed marginal hypoglycemic activity (P < 0.05); mangiferin group (0.25 mmol·kg(-1)) had the potential for a hypoglycemic effect, although it did not demonstrate that statistically. In histological examination, the islet cells of the PAM, HPM, and HBM groups could recover from the STZ damage; islet cells of the mangiferin group could recover also, but less than the esterified-derivative groups. CONCLUSION Derivatives could repair the damaged islet cells, and had higher lipid-solubility and stronger hypoglycemic activity than mangiferin itself. There existed a structure activity effect, and a solubility effect relationship: the larger esterification moieties, or the higher lipid-solubility, the stronger the hypoglycemic activity (no ester → acetyl → propionyl → butyryl). Esterified derivatives of mangiferin are potential compounds for new anti-diabetes drugs.
Animals ; Diabetes Mellitus, Experimental ; drug therapy ; Esterification ; Humans ; Hypoglycemic Agents ; administration & dosage ; chemical synthesis ; chemistry ; Islets of Langerhans ; drug effects ; Male ; Mice ; Molecular Structure ; Xanthones ; administration & dosage ; chemical synthesis ; chemistry