Objective To analyze the medical undergraduates'employment intentions and determinants for policy recommendations on how to solve the contraction between the employment and human resources shortage working in the rural place.Methods Descriptive method was used for the employment recognition and unconditional logistic regression was employed for its factors analysis.Results 74.90% interviewees were not high for policy recognition,and only 21.16% undergraduates were willing to work in rural area.Logistic regression analysis found local culture and life environment (OR=2.668),institute performance(OR=0.630)and work challenge(OR=1.509)were key factors to affect their employment.Conclusion To give reform of primary institute performance mainly on pubic health service,take great importance on the medical service,improve work and life environment of rural workers and highly care health workers'career planning and development.

0. 05). Conclusion Chronic fluorosis has no obvious effect on myocardial collagen metabolism of rats and myocardial collagen is not likely the main target of fluoride.

Objective To carried out rat as deep inferior epigastic perforator (DIEP) flap necrosis model,to reveal the continuous blood fluid change in process of flap necrosis.Methods Seven SpragueDawley rats of male were used.The designed DIEP flap model was pedicled on the right-sided cranial perforator.Near-infrared fluorescent angiography was performed using SPY imaging system pre-and-aft operation and all angiography videos were compared and analyzed.Results Using SPY imaging system could observe the process of the blood fluid scattered from perforator through choke anastomoses to next vascular territories in living body.The study could clearly observe sequence change of blood fluid pr-and-aft operation,which could give the important information in revealing the reason of necrosis in DIEP flap.Cross-midline traffic vascular sparse and eventually could no longer wear through the contralateral abdominal wall vessel area and open in the region of lateral thoracic vascular occlusion of blood vessels to reach the flap to the far left side,and showed no blood flow in the dark zone.Conclusion The reasons of necrosis of contralateral distal zone of the flap model,are the choke anastomoses across the midline to the contralateral side appeared small,less intensity and the blood supply to contralatral distal zone should through twice choke anastomoses.

Objective:To discussed the diagnostic value of magnetic resonance cholangiopancreatography (MRCP), and the use of laparoscopic surgery in management of patients with choledochal cyst with extrahepatic bile duct anomaly.Methods:Of 330 consecutive patients who underwent laparoscopic choledochectomy at Guangzhou Women and Children's Medical Center from January 2010 to September 2018, there were 23 patients with extrahepatic bile duct anomaly. The data of these patients were retrospectively analyzed. There were 4 males and 19 females, with an average age of 3.2 (range 0.3~9.0) years. According to whether the extrahepatic bile duct anomaly was diagnosed by preoperative MRCP, these patients were divided into the preoperative MRCP diagnosis group and the preoperative MRCP undiagnosed group. The impact of MRCP in diagnosing bile duct anomaly to prevent bile duct injury, on operation time, hospital stay and the types of extrahepatic bile duct anomaly on outcomes of laparoscopic treatment were analyzed.Results:All the 23 patients with choledochal cysts complicated by extrahepatic bile duct anomaly were confirmed at surgery. The incidence of extrahepatic bile duct anomaly was 6.97% (23/330). There were 47.8% of type II AHD (11/23); 36.8% of type III AHD (7/23); 4.3% of type IV AHD (1/23); 17.4% (4/23) of the type with communication with accessory bile duct (CABD). The preoperative MRCP diagnosis group consisted of 14 patients, while the preoperative MRCP non-diagnosis group consisted of 9 patients, including 2 patients without MRCP. The diagnostic rate of MRCP in preoperative diagnosis of extrahepatic bile duct anomaly was 66.7%(14/21). The preoperative MRCP undiagnosed group, when compared with the preoperatives MRCP undiagnosed group, had a significantly higher bile duct injury rate [preoperative MRCP diagnosis group 7.1%(1/14), preoperative MRCP non-diagnosis group 55.6%(5/9)], and a significantly longer operation time [preoperative MRCP diagnosis group(232.6±10.0) min, preoperative MRCP undiagnosed group (278.9±22.45)min], (all P<0.05). Laparoscopic surgery was completed in 22 of 23 patients. One patient was converted to open surgery. AHD reconstruction was needed in 11 patients with type II AHD and 1 patient with type IV AHD. Seven patients with type III AHD did not require any surgical intervention for the anomaly. The 4 patients with CABD underwent simple ligation. Postoperative chyloperitoneum developed in 1 patient, who successfully responded to conservative treatment. Postoperative recovery was uneventful in the remaining patients. At a median follow-up of 2 years (range 1 to 5 years), no further complications, including intrahepatic bile duct dilatation and hepatic atrophy were detected. Conclusions:MRCP was effective in preoperative diagnosis of choledochal cysts with extrahepatic bile duct anomaly. It helped to decrease intraoperation injuries to bile duct anomalies. MRCP was also useful in classifying patients with extrahepatic bile duct anomaly to better preoperatively planning of surgical treatment strategies. Laparoscopic surgery could be completed in the majority of these patients with good postoperative results.

Objective To detect the M-type phospholipase A2 receptor (PLA2R),and thrombospondin type-1 domain-containing 7A (THSD7A) expression in renal tissue and the levels of their antibodies in adult idiopathic membranous nephropathy (IMN).Also to determine the value of the two markers in the diagnosis of IMN.Methods One hundred and sixteen patients with biopsyproven MN at the Second Hospital of Hebei Medical University from December 2014 to August 2015 were enrolled,including 86 patients with IMN,10 patients with HBV-MN and 10 patients with stage Ⅴ lupus nephritis (LN-Ⅴ).Twenty patients with minimal change disease (MCD) were regarded as control group.We conducted immunohistochemical analysis of the presence of THSD7A and PLA2R the Paraffin section and enzyme linked immunosorbent assay (ELISA) detecting serum PLA2R-AB and THSD7A-AB concentration to investigate whether there was a correlation between them and clinical indicators.Results Compared with the SMN and MCD groups,the positive rates of PLA2R and PLA2R-AB were significantly higher in IMN groups.Expression PLA2R was detected in 88.4％,47.4％,10％ and 0％ and PLA2R-AB in 82.6％,15％,10％,0％,respectively,of the patients with IMN,HBV-MN,LN-Ⅴ and MCD.Expression THSD7A was detected in 2.3％ of the patients with IMN while not detected in SMN and MCD.THSD7A-AB antibody was negative in all patients.Compared with serum PLA2R-Ab negative individuals,patients with serum PLA2R-Ab positive had lower serum albumin (P ＜ 0.001),higher urine protein excretion (P=0.01).The sensitivity of PLA2R-AB,PLA2R,THSD7A and PLA2R+THSD7A in the diagnosis of IMN were 82.6％,88.4％,2.3％,88.6％,and the specificity was 92％,66.7％,100％,66.7％,respectively.Conclusions PLA2R in renal tissue and serum PLA2R-AB are specific markers for the diagnosis of IMN,which are closely related with the severity of IMN.Expression of THSD7A is only positive in some of IMN patients with negative PLA2R,which can be used as a supplementary examination of IMN patients with negative PLA2R.

OBJECTIVETo introduce the application of pedicled anterolateral thigh (ALT) flap for total penile reconstruction and to investigate its feasibility and effect.

METHODSFrom May 2011 to May 2015, 12 male patients presented with absence of the penis or congenital malformation received phalloplasty with the pedicled ALT flap. Of them, the median age was 35 years old (range, 20-57 years). The size of the flaps ranged from 11 cm x 11 cm to 12 cm x 15 cm. 8 patients underwent urethra reconstruction with tube-in-tube flaps and other 4 patients with scrotal septal flaps. In this series, we performed one-stage urethral anastomosis in 4 cases and second-stage urethral anastomosis 6 months after the phalloplasty in 8 cases.

RESULTSAn acceptable reconstructed phallus was achieved in 10 patients. These flaps were primarily healed with satisfactory functional and cosmetic results. The reconstructed penis was completely necrosis because of the flap failure in one case. The distal half of the phallus was lost due to infection in one case. Both of them were treated with pedicled ALT flap from the other side. Reliable results were achieved. At a median follow-up of 1.5 year (range 1 to 4 years), 9 patients (90%) were fully satisfied with phallic cosmesis and size, and 4 patients who was married had successful sexual intercourse. 8 patients had normal urinate function. Fistula was developed in 2 patients (20%) which was treated with delayed repair at 6-12 months with local scrotal flaps.

CONCLUSIONSThe pedicled ALT flap can be simply used to reconstruct an entire penis as well as a urethra. It has several advantages including a less conspicuous donor site, greater bulk, better color match and no necessary for microsurgery.

Adult ; Anastomosis, Surgical ; methods ; Coitus ; Feasibility Studies ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Necrosis ; etiology ; Penis ; abnormalities ; surgery ; Reconstructive Surgical Procedures ; methods ; Scrotum ; Surgical Flaps ; pathology ; transplantation ; Thigh ; Time Factors ; Urethra ; surgery ; Young Adult

According to ICH, Chinese Pharmacopoeia and supplementary requirements on the separation and purification of herbal extract with macroporous adsorption resin by SFDA, hexane, acetidine, ethanol, benzene, methyl-benzene, o-xylene, m-xylene, p-xylene, styrene, diethyl-benzene and divinyl-benzene of residual organic solvents and macroporous resin residues in Akebia saponin D were determined by headspace capillary GC. Eleven residues in Akebia saponin D were completely separated on DB-wax column, with FID detector, high purity nitrogen as the carry gases. The calibration curves were in good linearity (0.999 2-0.999 7). The reproducibility was good (RSD < 10%). The average recoveries were 80.0% -110%. The detection limit of each component was far lower than the limit concentration. The method is simple, reproducible, and can be used to determine the residual organic solvents and macroporous resin residues in Akebia saponin D.
Chromatography, Gas ; instrumentation ; methods ; Drug Contamination ; prevention & control ; Organic Chemicals ; analysis ; Reproducibility of Results ; Resins, Synthetic ; chemistry ; Saponins ; analysis ; isolation & purification

NOD/SCID (non-obese diabetic/severe combined immunodeficient) mice are immune deficient mice which are made by backcross of severe combined immunodeficient mice with non-obese diabetic mice strains. NOD/SCID mice are both innate immune deficiencies and lack of T and B lymphocytes. Various tumor cells can be implanted in this kind of mice, the rejection and graft-versus-host disease (GVHD) occur fewer. Therefore, NOD/SCID mice gradually become a useful tool for the study on Experimental Hematology. This paper comprehensively reviews the biological characteristics of NOD/SCID mice, the establishment of human leukemia model, stem cell transplantation, drug research, deficiency and improvement of NOD/SCID mice in application for study.
Animals ; Disease Models, Animal ; Hematology ; methods ; Leukemia ; Mice ; Mice, Inbred NOD ; Mice, SCID ; Models, Animal ; Research ; trends

This study was aimed to investigate the effect of polypeptide extract from scorpion venom (PESV) on PI3K, p-Akt signal protein regulating K562 cell apoptosis and its mechanism. The K562 cells were cultured with PESV for different time, the cell growth curve was determined by MTT method, the levels of PI3K and p-Akt proteins were detected by Western blot. The results showed that as compared with control group, the apoptosis rate of K562 cells treated with PESV increased, the levels of PI3K and p-Akt expression decreased. It is concluded that the PESV inhibits the proliferation and promotes the apoptosis of K562 cells probably through suppressing the expression of PI3K and p-Akt signal proteins.
Apoptosis ; drug effects ; Cell Proliferation ; drug effects ; Humans ; K562 Cells ; Phosphatidylinositol 3-Kinases ; metabolism ; Proto-Oncogene Proteins c-akt ; metabolism ; Scorpion Venoms ; pharmacology ; Signal Transduction ; drug effects

OBJECTIVETo discuss the methods for urethral external meatus and glanuloplasty after correction of hypospadias.

METHODSThe V shape flap on the dorsal side of glan, combined with the bilateral glan flaps were moved to the ventral side. The flap at the ventral side of urethral external meatus was turned over. Then the urethral external meatus was repositioned to the top end of glan with the ventral defects covered by the dorsal flaps. Then the coniform glan was reconstructed.

RESULTSFrom January 2008 to December 2013, 28 cases were treated, including glandular hypospadias, postoperative retraction of external urethral meatus and meatal stenosis. 21 patients were followed up for 1 -12 months (average, 1 month) with marked improvement of glan appearance and retraction of external meatus. No meatal stenosis happened.

CONCLUSIONSPostoperative retraction of urethral external meatus and meatal stenosis can be corrected by V shape flap on the dorsal side of glan combined with the bilateral glan flaps. The flat appearance of glan can be improved. It is an ideal method for glandular hypospadias.

Humans ; Hypospadias ; surgery ; Male ; Penis ; surgery ; Postoperative Complications ; surgery ; Postoperative Period ; Surgical Flaps ; Urethra ; surgery ; Urethral Stricture ; etiology ; surgery