Anemia, Aplastic ; mortality ; pathology ; therapy ; Child ; Disease-Free Survival ; Graft vs Host Disease ; prevention & control ; Hematopoietic Stem Cell Transplantation ; methods ; Humans ; Immunosuppressive Agents ; therapeutic use ; Risk Factors ; Severity of Illness Index ; Tissue Donors ; Transplantation Conditioning ; methods ; Transplantation, Homologous ; Unrelated Donors

Internal medicine(IntMed) is one of the major subjects in medical undergraduate courses.With the transformation of medical mode from experience medicine to EBM,EBM shall be melted into IntMed teaching to change traditionary teaching mode and improve the teaching quality of IntMed,which helps to culture more new medical talented persons.

Objective To discuss the advance and experience of postoperative management in multivisceral transplantation(MVT).Methods Five patients with abdominal multiple organs malig- nances were subjected to multivisceral transplantation.The excised specimens included the liver,pan- creas,duodenum,stomach,spleen,mesentery and all of the involved lymph nodes.The transplanted organs were liver,pancreas,duodenum and parts of intestine.Patients were monitored and sustained stably in breath,hemodynamics and homoeostasis.The coagulation was also monitored and kept in balance.The intensive immunosuppressive protocol,including steroid,tacrolimus,mycophenolate mofetil and Zenapax,was used to prevent the acute rejection.The endocrine and exocrine of pancreas were tested,color Doppler examination was done every day,and Somatostatin was used to prevent pancreatitis.Drugs to bacteria,fungus and virus infection were prophylactically used.Results All patients waked up with 4-6 h after operation and began recovering with 3-7 days.Dynamic examina- tions revealed that the functions of grafted liver,pancreas and duodenum were satisfactory.No com- plications of acute rejection,pancreatitis,bleeding and thrombosis occurred.Conclusion Many ques- tions in postoperative management related to multivisceral transplantation are devoted to study.Nice experience of management to organ transplantation,detailed monitoring and prophylactically medica- tions are safeguards to steady recovering and further prognosis.

AIM: To investigate the angiogenesis effect and protective mechanism of cordycepin on rhesus macaque choroid- retinal endothelial ( RF/ 6A) cell line cultured in high glucose condition.
METHODS: Cultured RF/ 6A cells were divided into normal control group, high glucose group and high glucose (HG) + different concentration cordycepin groups (HG+ 10μ g/ mL group, HG+ 50μ g/ mL group, HG+ 100μ g/mL group). The cell proliferation was assessed using cholecystokinin octapeptide dye after treated for 48h. The cell migration was investigated by a Transwell assay. The tube formation was measured on Matrigel. Furthermore, the impact of cordycepin on high glucose - induced activation of VEGF and VEGF receptor 2 (VEGFR-2) was tested by Western blot analysis.
RESULTS: Compared with normal control group, cell viability markedly increased in high glucose group ( P <0. 05). Cordycepin inhibited RF/ 6A cell proliferation in a dose- dependent fashion: 10. 2 ± 0. 9%, 23. 4 ± 1. 5% and 31. 1±1. 2% inhibition as the concentrations of cordycepin were 10, 50 and 100μ g/ mL, respectively. The difference had statistically significant (P<0. 05) compared with high glucose group. The number of cell migration were 55. 6±2. 70, 87. 4 ± 2. 40, 65. 4 ± 2. 7, 57. 8 ± 2. 38, 62. 4 ± 2. 77 in normal control group, high glucose group and HG+10μ g/mL group, HG + 50μ g/ mL group, HG + 100μ g/ mL group respectively. Migration of RF/ 6A conspicuously increased in high glucose group ( P < 0. 05) compared with normal control group; while showing a gradually reducing trend with the increase of cordycepin dose and a statistically significant difference compared with high glucose group (P<0. 05). The number of tube formation were 18. 7±2. 08, 25. 7 ± 1. 52, 19. 9 ± 1. 57, 16. 3 ± 2. 51, 5. 67 ± 1. 72 in the abovementioned group. Similarly showing a gradually reducing trend with the increase of cordycepin dose and a statistically significant difference with high glucose group (P< 0. 05). In addition, the number of tube formation of RF/ 6A in high glucose group significant increased compared with normal control group ( P < 0. 05 ). The expression of VEGF and VEGFR-2 dramaticlly increased in high glucose group vs normal control group, oppositely gradually decreased with the increase of cordycepin concentrations, and had a statistically significant difference vs high glucose group (P<0. 05).
CONCLUSION: Cordycepin can suppress the proliferation, migration and tubu formation of RF/ 6A in high glucose condition, might via inhibiting expression of VEGF and VEGFR-2.

Anemia, Hemolytic, Congenital ; etiology ; Female ; Hepatitis ; complications ; Humans ; Infant ; Syndrome

Objective To investigate the effect of blocking VEGF expression on the radiation sensitivity of esophageal cancer cell line TE-1 in vivo. Methods 32 male Balb/c/nu nude mice were randomly divided into four groups, including control group, radiation group, anti-VEGF group, and anti-VEGF + radiation group. The anti-VEGFcDNA cells were subcutaneously injected into the paw pats of mice (2 × 106/100 μl). The subcutaneous tumors were irradiated with 18 Gy of 60Co y-rays when the diameter of tumors varied from 0. 8 to 1.0 cm. The volume of the tumors was measured before and after irradiation, respectively. The expression level of VEGF mRNA and protein were examined by RT-PCR and Western blotting, respectively. Apoptotic cells were detected by electron micrographs. Results Latent period of the tumor formation of anti-VEGF group was lengthened compared with other groups(t = 13. 898,P ＜0.01 ). The volumes of tumor in anti-VEGF group [ ( 1207. 50 ± 97.07 ) mm3 ] and anti-VEGF +radiation group [ ( 1057. 5 ± 91.50 ) mm3 ] were not statistically different post-irradiation ( t = 1. 124, P ＞0.05 ) , but smaller than those in control group [ ( 5442. 50 ± 185.08 ) mm3 ] and radiation group [ (2922. 50 ± 152. 773)mm3 ] with statistical differences( t = 9. 475-21. 238, P ＜ 0. 01 ). The expression level of endogenous VEGFmRNA and protein in anti-VEGF group and anti-VEGF + radiation group were statistically different from control group and radiation group (F = 387.394, 13.519, P ＜ 0.01 ).Conclusions Antisense VEGF could inhibit the proliferation of esophageal cancer cell in the nude mice.Effect of blocking VEGF expression before irradiation on esophageal cancer xenografts might be limited.

Objective To evaluate the effect of training for therapists based on Kirkpatrick's Four-level Model. Methods Totally 39 ther-apists who completed 2014 Beijing Clinical Shortage of Manpower Training Programs (Therapist) were investigated with Kirkpatrick's Four-level Model, named reaction, learning, behavior and results. Results For reaction level, the total satisfaction was high, but different with the degree of education, especially in the items of Participate in Training, Type of Cases, Organizing on Practice Training, Organizing Case Discussions and Get A Lot of Benefits from the Training (F>4.59, P<0.05). For learning level, the test scores were significantly differ-ent before and after the training (t>9.53, P<0.001). For behavior level, the self-reports of the therapists, and the reports from their depart-ment directors and colleagues all agreed that their ability improved after training (t>4.44, P<0.001). For results level, eleven therapists passed the rehabilitation therapist test, two therapists participated in some researches, and one published an article. Conclusion The thera-pists satisfied in the training, that may improve the ability of therapists to contribute to their organization.

Background and Purpose:It has been proved that CD117 may be used as an immunology marker for diagnosis of leukemia of myeloid origin.The relationship between CD117 expression and effect of chemotherapy on the patients with Acute Nonlymphoblastic Leukemia(ANLL) remains unclear.This study is to investigate the relationship between CD117 expression and the response of patients with ANLL to chemotherapy.Methods:Flow cytometery(FCM) was used to detect the positive rate and the levels of CD117 expression of the bone marrow mononuclear cell(BMMNC) from 38 patients with acute lymphoblastic leukemia(ALL) and 81 patients with ANLL,respectively.All-trans Retinoic Acid(ATRA) was taken to treat M_(3) type of ANLL and protocol DA and/or HA was used to treat the other types.ANLL was divided into two groups: positive(+) and negative(-) expression of CD117.At the same time we compared the difference of rates of complete remission(CR) between CD117(+) and CD117(-) groups from ANLL after chemotherapy.Results:Positive percentage of expression of CD117 in ALL and ANLL groups were 13% and 70% respectively(P=0.000).Positive levels of CD117 decreased successively as follows: M_(3)/ M_(1)、M_(2)/ M_(6) / M_(4)、M_(5).CR rates of CD117(+) and CD117(-) groups of ANLL after chemotherapy were 51%(29/57) and 67%(16/24)(P=0.192),respectively.Conclusions:CD117 may serve as an immunology marker for the diagnosis of ANLL,but positive or negative expression of CD117 in ANLL was not associated with the response of the patients with ANLL to chemotherapy.

Objective To explore the methods of training for therapists. Methods The students participated in 2014 Beijing Clinical Shortage of Manpower Training Programs (Therapist) by Beijing Quality Control and Improvement Center of Medical Rehabilitation accepted theoretical and operating training and tests. They were interviewed for the situation of training program. Results 39 students had completed the training with the average age of (28.41±6.05) years. The average scores of theory test was (76.23±5.70), and it was (87.18±8.00) of operation. The score of theory test was more than that before the training (P<0.01). From interview, a total of 59 recommendations were obtained, which focused on the quality of training of training provider and the support from sending institutes. Conclusion Beijing Clinical Shortage of Manpower Training Programs (Therapist) has improved the academic and operative level of therapists.

Nutrition support is an important part of comprehensive treatment strategy for critically ill patients. After long-term scientific research and practice, great progress has been made in theoretical cognition and clinical application. The authors summarize the metabolic charac-teristics and nutritional support strategies of critically ill patients based on their pathophysiological changes, in order to provide rational and theoretical basis for reasonable and effective nutrition support strategy in critically ill patients.