The low survival rate of stem cells in the ischemic myocardium microenvironment is the bottle neck in treating ischemic diseases with stem cell transplantation.It is able to increase anti-apoptotic ability of the stem cells and promote their effective differentiation towards myocardial cells directly and indirectly by pretreating the stem cells with cytokines,drugs or chemical compounds,or modifying gene expression to promote cell adhesion,survival or angiogenesis for repairing ischemic myocardium and improving heart function after transplantation of the stem cells.

General practice is a clinical practice which integrates a variety of disciplines and aims at providing basic health care services for individuals, families and communities. General prac-tice in China is now experiencing increasing development. In 2011, the Academic Degrees Committee of the State Council approved of the addition of general practice under the category of clinical medicine, initiating the education of postgraduates with professional degree majoring in general prac-tice. Through analyzing supervisor instruction, curriculum, skill training and assessment of postgrad-uates majoring in general practice, this paper thoroughly explored its training mode.

Objective To investigate the characteristics and risk factors of abdominal lymph node metastasis in thoracic esophageal squamous cell cancer.Methods The clinical data of 586 patients with thoracic esophageal cancer who underwent surgery via transabdominal and transthoracic approaches between June 2009 and June 2014 at the Sichuan Cancer Hospital were retrospectively analyzed.All the patients received resection of esophageal cancer and lymph node dissection, and the transabdominal right thoracic approach or cervico-thoracicabdominal triple incision was selected according to the condition of patients.No.18, 19, 20 lymph nodes were dissected seperately and No.16, 17 and lesser curvature lymph nodes were separated.All the specimens of lymph nodes were detected by regular pathological examination.Measurement data with normal distribution were presented as x ± s and count data were described as rate.Comparisons of rate between 2 specimens and among the multiple specimens were respectively analyzed using the chi-square test and partition of chi-squared.The multivariate analysis was done using the logistic regression.Results The number of lymph node dissected in 586 patients was 12 524 with an average number of 20 ± 11 per case, and the rate of lymph node metastasis was 55.63％ (326/586).The number of mediastinal lymph node dissected was 7 012 with an average number of 12 ± 5 per case, and a rate of mediastinal lymph node metastasis was 40.96％ (240/586).The number of abdominal lymph node dissected was 5 512 with an average number of 9 ± 8 per case, and a metastasis rate was 31.74％ (186/586).The abdominal lymph node metastasis rate of the upper, middle and lower thoracic esophageal cancer were 13.73％ (14/102), 31.51％ (92/292) and 41.67％ (80/192), respectively, showing a significant difference among the above 3 indexes (x2 =25.91, P ＜ 0.05).The lymph node metastasis rate in No.16, 17, 18,19, 20 and lesser curvature lymph nodes were 12.80％ (75/586), 16.89％ (99/586), 1.71％ (10/586),0.68％ (4/586), 1.71％ (10/586) and 2.05％ (12/586), respectively, with a significant difference among the above 6 indexes (x2 =287.95, P ＜ 0.05).The results of univariate analysis showed that the tumor location,surgical procedure, T stage, N stage, G stage, pathological stage and mediastinal lymph node metastasis were risk factors affecting abdominal lymph node metastasis of thoracic esophageal cancer (x2 =24.02, 23.97, 37.87,136.85, 38.79, 7.70, 154.27, P ＜ 0.05).The tumor in the lower thoracic portion, N3 stage and stage Ⅳ were independent risk factors affecting abdominal lymph node metastasis of thoracic esophageal cancer in the multivariate analysis (RR =5.80, 2.36, 2.76, 95％ confidence interval: 1.022-1.813, 1.317-3.950, 1.652-12.351, P ＜ 0.05).Conclusions Abdominal lymph node metastasis is common in thoracic esophageal cancer in which No.16 and 17 lymph nodes predominate, and it is easy to occur in patients with lower thoracic esophageal cancer, and advanced N stage and pathological type.

Objective To analyze the clinical features, recurrent characters in patients with recurrent Tolosa-Hunt syndrome (THS). Methods The clinical data of 24 hospitalized patients with recurrent THS from January 2006 to May 2016 were collected The general features, clinical manifestations, disease courses, recurrent features, lab and imaging studies, treatment measures and outcoming of recurrent THS patients was investigated , and compared with 69 patients with first attack THS in corresponding period. Results Recurrent THS patients were 25.8%(24/93) of total THS. The male rate in recurrent group was significantly higher than that in first attack group: 66.7%(16/24) vs. 42.0%(29/69), P<0.05. The involved rate of trigeminal nerves in recurrent group was significantly lower than that in first attack group:16.7%(4/24) vs. 33.0%(23/69), P<0.05. The disease courses were from 3 months to 20 years. The total recurrent frequencies were from 2 to 10 times. The recurrence occurred in the same side in 18 patients, and in contralateral in other 6 patients. The intervals were from 3 months to 6 years, and average intervals were 1.9 years. Two patients recurred in hormone reduction, and 22 patients recurred in hormone withdrawal. All cases received MRI examination. Nineteen patients (79.2%) of them had lesions in cavernous sinus. 16 patients had one side lesions and 3 patients had bilateral lesions. The recurrent patients still had good responds to corticosteroids treatment. Conclusions Recurrences in THS are common, taking place in about 26%total patients, and usually at an interval of months or years from the initial attack. These recurrences may be ipsilateral, contralateral, or rarely, bilateral. Corticosteroids are still effective to recurrent cases.

Objective: To analyze the influential factors of job burnout among psychiatrists.Methods: Psychiatirsts were evaluated by questionnaires.Results: In general,the job burnout of psychiatrists was very serious.There were significant differences in gender in burnout individual level;the person of 31-35 age was prone to job burnout,and the middle-aged staffs’ job burnout was comparatively in high level;There was significantly correlated show between psychiatrists job burnout level and social support.Besides,there was significantly correlated show between psychiatrists job burnout level and coping way.Conclusion: Psychiatrists Burnout is a high-risk population.To better enhance the stability of their profession,we need concern psychiatrists’mental health from the integrated perspective,and improve their level of social support constantly,and prevent occupational burnout from the perspective of medical education early.

AIM: To study the effect of mobilization of stem cells by exogenous recombinant human granulocyte-colony stimulating factor (rhG-CSF) on the repairing process of reendothelialization and neointima hyperplasy on ballon injured rat carotid arteries. METHODS: Male Wistar rats were randomly divided into rhG-CSF group and NS+injury group. The animals were injected daily with 30 ?g/kg rhG-CSF or 0.9% NaCl for 7 days, then underwent balloon angioplasty of the common carotid arteries which were harvested and processed for scanning electron microscopy (SEM), Evans blue staining, morphometric analysis of endothelialization and neointimal formation at 1 h, 3 d, 5 d, 7 d, 14 d after injury. Immunohistochemistry for proliferation cell nuclear antigen (PCNA) and RT-PCR for eNOS mRNA were also conducted for evaluating the proliferation of cells of the vessel wall and the possible mechanism of the repairing. RESULTS: SEM and Evan’s blue staining showed increased reendothelialization of the denuded vessels in rhG-CSF-treated animals compared with that NS+injury animals [(60.6?7.3)% vs (41.6?3.3)%,P

Objective To investigate the changes in morphology and senescence-associated markers of the marrow-derived cardiac stem cells (MCSCs) from rats at different ages and to explore the impacts of age on proliferation, survival and differentiation of MCSCs. Methods With single-cell cloning culture, MCSCs were selected from the bone marrow of young, adult and aged male SD rats respectively. Ultrastructural changes of the cells were viewed under a transmission electron microscope.The senescence-associated changes were examined with SA-β-galactosidase staining and reactive oxygen species(ROS) staining. Distribution of cell cycle of MCSCs from different age groups was evaluated with flow cytometric analysis. Rates of the survived and apoptotic cells were determined by Annexin V/PI double-labeled flow cytometric analysis and Hochest33342 staining. Differentiation of the MCSCs toward cardiomyocytes was induced with BMP-2. Expression of cardiac transcription factors and cardiac specific genes of the cells after induction were examined with RT-PCR. CTnT expression of the cells also be examined with immunocytochemistry. Results The nucleus/plasma ratio of the cells from aged rats decrease and there are some myelin bodies in the cells of aged group. With increasing of age, the MCSCs in S+G2/M phase reduce, while β-galactosidase-positive cells and ROS-positive cells increase. Survival rate of the cells from aged rats is lower than that of the cells from young rats. At four week after induction with BMP-2, expression of Nkx2.5, GATA-4, cTnT mRNA and Cx-43 mRNA of the cells of young group increase significantly. In adult and aged group, expression of the cardiac transcription factors and cardiac specific genes is lower than that of the cells in young group. In immunocytochemical staining, cTnT expression of the cells in young group is stronger after induction with BMP-2. As compared with that of the cells in young group, cTnT expression of the cells in aged group is weak after induction. Conclusion With increasing of age, MCSCs show senescent changes, including their abilities of proliferation, survival and differentiation toward cardiomyocytes decrease.

Objective To observe the level of serum hepatocyte growth factor(HGF)in patients with hypertension(HT).Methods HGF,fasting plasma glucose(FBG),postprandial plasma glucose(2hPG),glycosylated hemoglobin A1c(HbA1c),total cholesterol(TC),triglyceride(TG),systolic blood pressure(SBP),diastolic blood pressure(DBP),body mass index(BMI)and waistline(w)were detected in 30 patients with hypertension,30 patients with hypertension complicated by type 2 diabetes mellitus(T2DM),and 30 normal controls such indexes as.Results The level of serum HGF in HT group[(413.87±90.87)ng/L],and HT+T2DM group[(413.72±98.72)ng/L]were higher than that in control group[(120.45±25.11)ng/L](P＜0.05),but there was no significance between HT group and HT+T2DM group(P＞0.05).There existed a positive correlation between HGF and FBG,SBP(r=2.273,r=5.353,P＜0.05).Conclusion Higher levels of HGF is found in patients with hypertension and hypertensin complicated with T2DM,which indicates the severity of dysfunction of vascular endothelium.

Objective To explore the clinical therapeutic effects of St. John's Wort exact (SWE)on depressive disorder and blood glucose in elderly type 2 diabetic patients Methods 118 patients with type 2 diabetes and depressive disorder were randomly assigned to SWE group (26 cases),lorazepam group (22 cases ), psychotherapy group (24 cases), physicotherapy group (24 cases) and control group (routine therapy,22 cases) for 12 weeks' treatment. The clinical effects were evaluated with the percentage reduction in HAMD score after the treatment, HbAlc levels were obtained to monitor glycemic control. Results (1) The percentage reduction in HAMD score in SWE group was the highest (80. 8%), and it was lower in lorazepam group ( 63. 6%), psychotherapy group (62. 5%) and physicotherapy group(58. 3%). The percent decrease in H AMD score was higher in four groups than in control group ( 18. 2%) and the difference was significant (P < 0. 01). The therapeutic effect of SWE was better than the others(P0. 05). (2) The level of HbAlc in SWE group (6.5±0. 6)% was significantly lower than the others [( 7. 5 ± 0. 8) %, (7.4 ± 0. 8) %, (7. 4 ±1.0) % (P < 0. 01 )]. Conclusions St. John' s Wort exact (SWE) can efficiently improve the depressive disorder in elderly type 2 diabetic patients, and it is good for controlling blood glucose of the patients.

Objective To evaluate the efficacy and safety in the treatment for gravitation wrinkles and unsatisfied shape with raonopolar and bipolar radiofrequency (RF) technique. Methods 28 patients were enrolled in this study. Every patient was treated for four times with an interval of 14 days by Accent Pro radiofrequency electric device (Alma Lasers Ltd). The clinical photographs were taken before and after the treatment, and the parameters were recorded during the treatment. The clinical efficacy and safety was evaluated 1 month after the treatment by comparing photographs and patients' satisfaction. Results Satisfactory rates were as follows: 85 % in doctor side, and 90 % in patients' side. No blister, scald, pigmentation and scar were observed during the treatment. Conclusion High frequency electric technique can be effective for the treatment of gravitation wrinkles and skin tightening by heating tissue deeply and non-invasively. Our clinical study shows that RF is an effective, non-invasive treatment with less pain and low side effects.