Objective To investigate the recognition status and attitudes of general practice medical professional for rural-oriented clinical medical (general practice direction) students, and provide effective basis for teaching reform. Methods Using cluster sampling method, a questionnaire survey was conducted among 305 rural-oriented medical students in Hubei Medical University who belonged to four different grades. The questionnaire effective recovery was 98.07%, SPSS 17.0 software was used to analyze data, pro-portion (%) were used for statistical descriptive, chi-square test and nonparametric test were used for statis-tical inference. Results 16% (49) students believed that it was not necessary for local medical colleges and universities to set up general practice professional, The rates of students who understood this professional training objectives, employment channel, the future work and professional developments were 82.3% (251 students ), 64.5% (197 students ), 69.2% (211 students) and 66.9% (204 students ), respectively. 27.5%(84) of the students still didn't understand this professional curriculum, and lower cognitive learning public health curriculum. Only 31.1%(105) of students were satisfied with the current general medicine education.52.5% (160) students thought that the professional curriculum system had problems, mainly for the course content overlap and course setting time being not reasonable. Different grades of students had different de-gree of satisfaction in the professional knowledge, the general practice of professional learning attitude, teaching arrangement . Conclusion We should strengthen rural-oriented medical students' ! professional education thought and their cognition of general medicine as soon as possible and integrate and optimize the curriculum system, adjust the teaching content and set up reasonable curriculum opening time.

OBJECTIVE: To evaluate the highly-selective regional vascular exclusion in the risk hepatectomy for liver tumor. METHODS: Short hepatic veins were ligated and divided followed by the dissection, and isolation of the inflow and outflow vessels of the tumor-bearing lobe, which were completely devascularized after the occlusion of these vessels. The blood loss volume, postoperative recovering situation of the liver function and the incidence of complication were observed in 68 cases. RESULTS: Main hepatic veins were dissected and isolated exo-hepatically in 65 cases. In the other 3 cases, the main hepatic veins were blocked by Satin skin clamp applied longitudely along the inferior vena cava. Hepatic pedicle was routinely excluded.The amount of blood loss was from 400 to 1200 (600+/-200) mL and 26 (65%) cases didn't receive transfusion.There was no operative mortality and liver function failure. Surgical complications included subphrenic abscess in 2 cases and bile leakage in 2 cases, which were cured conservatively. CONCLUSION Highly-selective regional exclusion of hepatic blood flow during the risk hepatectomy is safe and effective to prevent massive bleeding and to reduce the incidence of liver failure.
Adult ; Aged ; Female ; Hepatectomy ; methods ; Hepatic Veins ; surgery ; Humans ; Liver ; blood supply ; surgery ; Liver Neoplasms ; pathology ; surgery ; Male ; Middle Aged ; Vena Cava, Inferior ; surgery

OBJECTIVETo study the alkaloids of Macleaya cordata and their anti-tumor activities.

METHODAlcohol and liquid-liquid extraction were used methods were used to extract the alkaloids constituents, and silica gel, reverse-phase octadecylsilyl (ODS), sephadex LH-20 chromatographic methods and HPLC were applied to isolate and purify compounds. MS, NMR spectroscopic methods were used to determine their structures. Furthermore, the cytotoxicity of these chemical components for MCF-7 and SF-268 cell lines was measured by MTT method.

RESULTTwelve alkaloids were isolated from the fruits of M. cordata, and their structures were identified as: maclekarpine E (1), 6-acetonyldihyrochelerythrine (2), cavidilinine (3), 6-acetonyldihyrosanguinnarine (4), O-methylzanthoxyline (5), 6-methoxy-dihydrosanguinarine (6), spallidamine (7), 6-hydroxyldihydrochelerythrine (8), arnotianamida (9), dihydrosanguinarine (10), protopine (11), and cryptopine (12).

CONCLUSIONCompounds 1, 3, 7-9 were isolated from M. cordata for the first time, and compound 5 is a new natural product. The results of cytotoxic assay indicated that compound 6 showed strong cytotoxicity against MCF-7 and SF-268 cell lines with IC50 values of 0.61 μmol · L(-1) and 0.54 μmol · L(-1), respectively.

Alkaloids ; isolation & purification ; pharmacology ; Antineoplastic Agents, Phytogenic ; isolation & purification ; Cell Line, Tumor ; Humans ; Papaveraceae ; chemistry

OBJECTIVETo study the expression levels of ANXA1 and ANXA2 and elucidate their clinicopathological significance in adenocarcinoma, peritumoral tissues, adenomatous polyp and chronic cholecystitis of gallbladder.

METHODSEnVision(TM) immunohistochemical staining was used to detect the expression of ANXA1 and ANXA2 in paraffin-embedded tissue sections from resected specimens of adenocarcinoma (n = 108), peritumoral tissue (n = 46), adenomatous polyp (n = 15) and chronic cholecystitis (n = 35).

RESULTSThe positive rates and scores of ANXA1 and ANXA2 were significantly higher in adenocarcinoma (59.3%, 56.5%; 3.2 ± 0.9, 3.4 ± 0.8) than those in peritumoral tissues (34.8%, 1.1 ± 0.8, P < 0.01; 30.4%, 1.0 ± 0.8, P < 0.01), adenomatous polyp (26.7%, 0.9 ± 0.7, P < 0.05 or P < 0.01; 26.7%, 0.9 ± 0.8, P < 0.05 or P < 0.01) and chronic cholecystitis (17.1%, 0.7 ± 0.9, P < 0.01; 20.0%, 0.8 ± 0.8, P < 0.01). The benign lesions with positive ANXA1 and/or ANXA2 expression showed mild to severe atypical hyperplasia of the gallbladder epithelium. The positive rates of ANXA1 and/or ANXA2 were significantly lower in the well-differentiated adenocarcinoma, in a maximal diameter of < 2 cm, with no metastasis to lymph nodes and no invasion to surrounding tissues than those in the moderately or poorly-differentiated adenocarcinoma, in a maximal diameter of ≥ 2 cm, with metastasis to lymph nodes and invasion in surrounding tissues (P < 0.05 or P < 0.01). A high consistence was found between the expression levels of ANXA1 and ANXA2 (χ(2) = 67.84, P < 0.01), and a close positive correlation between the scores of ANXA1 and ANXA2 (r = 0.78, P < 0.01) in gallbladder adenocarcinoma. Kaplan-Meier analysis and multivariate Cox regression analysis showed that ANXA1 or ANXA2 was not an independent prognostic predictor in gallbladder adenocarcinoma.

CONCLUSIONThe expression levels of ANXA1 and/or ANXA2 may be important biological markers in the carcinogenesis, progression and biological behaviors of gallbladder adenocarcinoma.

Adenocarcinoma ; metabolism ; pathology ; surgery ; Adenocarcinoma, Mucinous ; metabolism ; pathology ; surgery ; Adenomatous Polyps ; metabolism ; pathology ; Adult ; Aged ; Annexin A1 ; metabolism ; Annexin A2 ; metabolism ; Cholecystectomy ; methods ; Cholecystitis ; metabolism ; pathology ; Female ; Gallbladder ; metabolism ; pathology ; Gallbladder Neoplasms ; metabolism ; pathology ; surgery ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness ; Proportional Hazards Models ; Survival Rate

OBJECTIVETo compare the diagnostic value study the technique of ultrasonography, magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP) in common duct stones.

METHODSThree hundreds and eighty-four patients suspected common duct stones from August 2005 to October 2007 were undergone abdominal ultrasonography, MRCP and ERCP.

RESULTSThere was stone in common duct in 370 and no stones in 14 of 384 patients. Ultrasonography indicated stones 268 cases, 8 false positive result was among them. MRCP diagnosed stones in 362 cases and false positive result in 6 cases, ERCP diagnosed stones 370 cases. The diagnostic accuracy of ultrasonography, MRCP and ERCP was 70.3% (260/370), 96.2% (356/370) and 100% respectively.

CONCLUSIONSThe diagnostic accuracy of ultrasonography for common duct stone was little higher, US should be used as a primary checking method. There was higher concordance between MRCP and ERCP for common duct stone. Combination of MRCP and ERCP can improve diagnostic accuracy of common duct stone.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangiopancreatography, Magnetic Resonance ; Choledocholithiasis ; diagnosis ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Ultrasonography

The descriptive cross sectional surveys were carried out among the outstanding clinical physicians in the field of acupuncture and moxibustion by using the survey sampling. The fuzzy comprehensive evaluation techniques was applied to evaluate the opinions of clinical experts in the field of acupuncture and moxibustion in order to classify the spectrum of diseases related to the musculoskeletal and connective tissue. After the statistical analysis on sixty-four diseases with 104 subtypes, the spectrum of diseases were determined as grade I spectrum of diseases with 13 subtypes of diseases, grade II spectrum of diseases with 51 subtypes of diseases, grade III spectrum of diseases with 10 subtypes of diseases, and grade IV spectrum of diseases with 30 subtypes of diseases. The outcomes reveal that acupuncture and moxibustion therapy have been applied widely for musculoskeletal diseases and connective tissue related diseases.
Acupuncture Therapy ; methods ; Bone Diseases ; therapy ; Connective Tissue Diseases ; therapy ; Cross-Sectional Studies ; Humans ; Moxibustion ; methods ; Muscular Diseases ; therapy ; Surveys and Questionnaires

Adult ; Cystadenoma, Serous ; surgery ; Digestive System Surgical Procedures ; methods ; Female ; Humans ; Insulinoma ; surgery ; Male ; Middle Aged ; Pancreas ; injuries ; surgery ; Pancreatic Neoplasms ; surgery ; Splenic Artery ; surgery ; Splenic Vein ; surgery

OBJECTIVE: To explore the laparoscopic partial gastrectomy and the indications. METHODS: Eighteen patients who underwent laparoscopic partial gastrectomy from August 2005 to May 2006 were analyzed retrospectively. RESULTS: Sixteen patients (including 6 with gastric cancer, 9 with duodenal ulcer, and 1 with gastric multiple polyps) underwent laparoscopic partial gastrectomy. The other two patients underwent an open surgical procedure (1 patient with the tumor size large than 6 cm, and the other patient with bleeding after loosening one clip). The rate of intraoperative subcutaneous emphysema was 5.88% (1/17), and no death occurred. The operation time was (285+/-30)min on average, the estimated blood loss was (130+/-50)mL, and the hospitalization was (11+/-4)d. One case of obstruction of distal loop happened after the surgery, and the rate was 6.25% (1/16). The patients were followed up for 1 approximately 9 months postoperatively. Trocar puncture-site metastases occurred in one patient. CONCLUSION Laparoscopic partial gastrectomy is safe and feasible with skillful laparoscopic technique and with restricted indications, and the surgical outcome may be similar to that of the open surgery.
Adult ; Female ; Gastrectomy ; methods ; Humans ; Laparoscopy ; Male ; Middle Aged ; Retrospective Studies ; Stomach Diseases ; surgery

OBJECTIVETo study the difference of the gene expression profile and to identify the different expression after transfection of the ARL-1 gene.

METHODSThe cDNA probes were synthesized from total RNA of study group and control group, which was differentially hybridized to cDNA chips and confirmed by a gene specific semiquantitative reverse transcription polymerase chain reaction (RT-PCR).

RESULTSSix kinds of gene expression were increased and 9 kinds of gene expression were decreased. The findings were correlated with protein metabolism, signal pathway, metastasis, and drug resistance.

CONCLUSIONScDNA chips showed that gene expression profile of liver carcinoma cell was changed after transfection of the ARL-1 gene. It is a useful method in understanding the mechanism of drug resistance.

Aldehyde Reductase ; genetics ; Drug Resistance, Neoplasm ; Gene Expression Profiling ; Humans ; Liver Neoplasms ; drug therapy ; genetics ; Oligonucleotide Array Sequence Analysis ; Transfection

Objective To study the distribution of ameloblastin(AMBN) gene polymorphism in coal-fire caused fluorosis (CFCF) in Chongqing municipality and the relationship between AMBN gene polymorphism and the susceptibility to dental fluorosis.Methods Under a case-control study,100 children aged 8-12 and 30 adults with dental fluorosis were enrolled in Wushan and Fengjie counties of Chongqing from December 2010 to February 2011.Another 100 children aged 8-12 and 30 adults with non-dental fluorosis were chosen as internal control groups together with 50 childrenand 30 adults without dental fluorosis were selected as external control groups in the non-epidemic area of Yubei district.DNA was extracted from peripheral blood sample of these people.Genotype of AMBN gene 7 extron 538_540delGGA,10 extron 657A＞G and 13 extron 986C＞T loci were detected using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP)technique.Results The rates of 7 extron 538_540delGGA loci among case,internal and external control groups were as follows:GGA/GGA-/-61.2％ (74/121),78.5％ (102/130),74.3％ (52/70) ;GGA/-:24.0％ (29/121),15.4％ (20/130),22.9％ (16/70) ;-/-:14.8％ (18/121),6.1％ (8/130),2.8％ (2/70),the difference was statistically significant (x2=14.353,P＜0.05).The AA appeared to be 86.8％(105/121),93.1％(121/130),91.4％(64/70) and AG were 13.2％(16/121),6.9％(9/130),8.6％ (6/70),with difference not statistically significant (x2=2.972,P＞0.05).CC appeared as 81.0％ (98/121),90.0％(117/130),87.1％(61/70) while CT as 19.0％(23/121),10.0％(13/130),12.9％(9/70),with difference not statistically significant (x2=4.319,P＞0.05).In comparing with the two control groups,the frequency of GGA/GGA was decreasing (x2 values were 8.957,3.405,respectively,P＜0.05) while the frequency of-/-was increasing (x2 values were 5.134,6.833,respectively,P＜0.05).Results from the univariate analysis showed that the individuals who were carrying-/-genotype had an increased risk of suffering from fluorosis (OR values were 2.7,5.9,respectively,P＜0.05).When compared with the internal control group,the CT genotype of case group showed an increase (x2=4.139,P＜0.05) while individuals that carrying CT genotype had an increased risk of suffering from fluorosis (OR=2.1,P＜0.05),in epidemic-area.Conclusion Our results showed that the 7 extron 538_540delGGA and the 13 extron 986C＞T loci polymorphism in AMBN gene might serve as the susceptibility factors causing the coal-fired fluorosis.