Graduate medical education, postgraduate medical education and continuing medi-cal education between China and the United States were compared in order to explore a better physi-cian training system of China. The physician training system of the United States has a series of ad-vantages such as strict access system, uniform training standard and closely linked among each stage, etc. We should make clear medical education standards and strengthen the cohesion between each stage, standardize the management mode and perfect the management system and promote regular as-sessment system.

Objective:To inspect and improve physician professionalism effectively and preliminarily build eval-uation index system for physician professionalism. Methods:A sample of 240 physicians selected randomly from 8 Three-A hospitals in Shanghai were investigated using a self-designed questionnaire. Then the method of analyt-ic hierarchy process was performed in this study to construct the evaluation model of physician professionalism and determine every index weight. Results: An index system was initially built for physician professionalism evalua-tion. This system comprised three level-1 indexes namely moral quality characteristics, achievement action char-acteristics and vocational cognitive characteristics, as well as 14 level-2 indexes that drew from level-1 including responsibility etc. , at the same time determined their weight distribution. The judgment matrix had completely con-sistency through consistency check, indicating that the weight coefficient can reflect the relative importance of every index. Conclusion:Moral quality characteristics is one of the most important components of physician professional-ism evaluation; responsibility consciousness and vocational ideal are vital for the growth of physicians; lifelong learning and communication skills with high weight reflects needs of modern health care industry development;medical ethics consciousness has a trend of strengthening in physician groups, and enhancing evaluation index sys-tem for physician professionalism has the operability.

Objective: To clone the full-length cDNA encoding squalene synthase (SS), a key enzyme of protostane type triterpenes biosynthesis, from Alisma orientalis and to perform bioinformatic analysis. Methods: With the total RNA as template, the full-length cDNA of SS in A. orientalis was cloned via homology-based cloning approach and rapid amplification of cDNA ends technique. The bioinformatics of the cloning SS gene was analyzed by DNAMAN and ExPASy online analysis. Results: The full-length cDNA (1 577 bp) of SS gene was obtained (GenBank accession number JX866770), with an open reading frame of 1 230 bp, encoding 409 amino acid polypeptides, which had higher homology with the known SS in other medicinal species. The calculated relative molecular mass was 4.68 × 104, the isoelectric point was 5.97, and there was no signal peptide in SS. The deduced protein sequence exhibited two conserved domains rich in Asp (DXXDD). Conclusion: The cDNA encoding SS from A. orientalis is cloned and reported for the first time. This work provides a foundation for exploring the biosynthetic pathway of protostane type triterpenes in A. orientalis and their applications in bioengineering.

OBJECTIVETo compare clinical outcomes of locking plate for proximal humeral fracture whether application of inferomedial screws.

METHODSFrom January 2012 to July 2013, 46 patients with proximal humeral fracture underwent locking plates were retrospectively analyzed. There were 25 males and 21 females aged from 29 to 80 years old with an average of 55.1 years old. Among them, 25 patients were treated with inferomedial screws (support group), including 13 males and 12 females aged from 38 to 80 years old with an average of (55.8 ± 11.8) years old; 8 cases were part two fracture,10 cases were part three fracture and 7 cases were part four fracture according to Neer classification. Twenty-one patients were treated without inferomedial screws (non-support group), including 12 males and 9 females aged from 29 to 79 years old with an average of (54.2 ± 14.8)years old; 6 cases were part two fracture, 9 cases were part three fracture and 6 cases were part four fracture according to Neer classification. Operative time, fracture healing time and complications were observed and compared, Neer scoring of shoulder joint were used to evaluate clinical effect.

RESULTSAll patients were followed up from 12 to 41 months with an average of 15.6 months. Operative time and fracture healing time in support group was (1.6 ± 0.4) h and (3.0 ± 0.6) months, and (1.5 ± 0.4) h and (3.1 ± 0.6) months in non-support group, while there was no statistical difference in operative time and fracture healing time between two groups. There was significant differences in Neer score between support group (89.7± 4.9) and non-support group (83.1 ± 7.1). No complication occurred in support group,while 4 cases occurred complications in non-support group.

CONCLUSIONLocking plate with inferomedial screws for proximal humeral fracture has advantages of stable fixation, less complications, quick recovery of function and satisfied clinical effect.

Adult ; Aged ; Aged, 80 and over ; Bone Plates ; Bone Screws ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Humeral Fractures ; physiopathology ; surgery ; Male ; Middle Aged ; Shoulder Fractures ; physiopathology ; surgery ; Shoulder Joint ; physiopathology ; surgery ; Treatment Outcome

Objective To investigate the relationship between dose and trough blood concentration of tacrolimus after orthotopic liver transplantation and the changes of time-dependent concentration. Methods The doses and trough blood concentrations of tacrolimus from 20 patients who survived longer than 1 year were summarized retrospectively.Results The initial oral doses of 0.15 mg?kg -1?d -1 as suggested by most surgeons led to 53.4 % of the measured whole blood concentrations in the first postoperative week were higher than 15 ?g/L, 23.3 % of them within 10 ?g/L to 15 ?g/L and 23.3 % of them lower than 10 ?g/L. The ratio of trough concentration/dose was increased gradually after transplantation and reached its peak at the second postoperative month, which was higher than those in the following month 3, 4, 5, 6, 7, 8 and 11 significantly (all P

Dried roots and rhizomes of Salvia miltiorrhiza (Danshen) are among the most commonly used traditional Chinese medicines in clinic. The material basis for its efficacy mainly includes hydrophobic tanshinones and hydrophilic salvianolic acids. The traditional effects of Danshen are "removing stasis and relieving pain, activating blood to promote menstruation, clearing heart fire and tranquilization". According to modern pharmacological studies, Danshen and its main components have cardiovascular and cerebrovascular protective effect. Recent studies showed that Danshen and its main components also demonstrated protective effects on liver injury models induced by carbon tetrachloride, D-galactosamine, acetaminophen and alcohol. In this paper, the hepatoprotective effect and mechanism of Danshen were summarized and studied.
Animals ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; chemistry ; pharmacology ; Humans ; Liver ; drug effects ; Protective Agents ; chemistry ; pharmacology ; Salvia miltiorrhiza ; chemistry

Objective To investigate the value of 99Tcm-methoxyisobutylisonitrile (MIBI) scintigraphy in assessing the preoperative chemotherapy response and multidrug resistance of osteosarcoma.Methods From January 2007 to October 2008, 12 patients (female:4, male:8; mean age:16.3 years,range:8-27 years) underwent early (10min) and delayed (120 min) 99Tcm-MIBI scintigraphy before and after preoperative chemotherapy.Seven cases had osteosarcoma at the distal femurs, 2 at the proximal tibias, 2 at the upper end of humerus and 1 at the fibula.The tumor-to-background ratio (T/B) and washout rate (WR) were calculated.Tumor necrosis was classified according to Huvos criterion after limb salvage surgery.Immunohistochemical staining for P-glycoprotein(gp) was examined.Spearman correlation analysis and t-test were performed.Results According to Huvos criterion, 7 patients were classified as good responders with more than 90% of tumor cell necrosis and 5 as poor responders with less than 90% of tumor cell necrosis.R value (ratio of early phase T/B after and before chemotherapy) was significantly lower in good responders than that in poor responders (0.473 ± 0.21 vs 0.998 ± 0.06, t= 5.342, P= 0.000 ).R value was significantly correlated with the degree of tumor cell necrosis ( rs=- 0.87, P= 0.000 ).WR was significantly higher in patients with positive P-gp expression than that in patients with negative P-gp expression ((38.36 ±18.64)% vs (6.40±5.87)%, t= -3.278, P=0.008).There was significant correlation between the WR and P-gp expression (rs = 0.91, P= 0.001 ).Conclusion 99Tcm-MIBI scintigraphy is a feasible non-invasive technique to assess the chemotherapy response and to detect P-gp expression of osteosarcoma.

OBJECTIVETo explore the correlation between electronic bronchus mirror and Chinese medical syndrome typing of Mycoplasma pneumonia children.

METHODSTotally 198 Mycoplasma pneumonia children inpatients were assigned to three syndrome types according to Chinese medical syndrome typing and self-formulated typing standards of electronic bronchus mirror, i.e., Fei-qi accumulation of damp and heat syndrome, Fei-qi accumulation of toxicity and heat syndrome, deficient vital qi leading to lingering of pathogen syndrome. The correlation between electronic bronchus mirror and Chinese medical syndrome typing was explored.

RESULTSAs for comparison between electronic bronchus mirror and Chinese medical syndrome typing, Kappa value (K^) was 0.645 and Spearman coefficient correlation (r) was 0.653 (P < 0.01) for Fei-qi accumulation of damp and heat syndrome; K^ was 0.724 and r(s) was 0.727 (P < 0.01) for Fei-qi accumulation of toxicity and heat syndrome; K^ was 0.506 and r(s) was 0.515 (P < 0.01) for deficient vital qi leading to lingering of pathogen syndrome.

CONCLUSIONChinese medical syndrome typing of Mycoplasma pneumonia children was moderately in line with inspection typing under electronic bronchoscope with significant correlation.

Bronchoscopy ; Child ; Humans ; Inpatients ; Medicine, Chinese Traditional ; Pneumonia, Mycoplasma ; classification ; diagnosis

To build a reversed phase ion-pair chromatography to determination content of Dencichine from Panax notoginseng. Using Tetrabutyl ammonium hydroxide ions by the combination of reagent and HPLC method without derivatization to test the content of dencichine directly. The optimum conditions of supersonic extraction were solid-to-liquid ratio 1: 20, Continuous ultrasonic extraction: twice, each time 15 minutes; 3,500 r · min⁻¹, then centrifuging 15 minutes. Dencichine in different age, place, part and the different Processing mode were examined. The method is simple with sound separation degree and stability, which can facilitate the determination of dencichine content directly and provide the basis in quality standard of raw material.
Amino Acids, Diamino ; analysis ; Chromatography, Reverse-Phase ; methods ; Drugs, Chinese Herbal ; analysis ; Panax notoginseng ; chemistry ; Plant Roots ; chemistry

Objective:To discuss the structure of medical humanistic curriculum system based on the research of quality features of excellent doctors .Methods:The goal , content and form of humanistic curriculum were based the factor of famous doctors'competencies which was build on the basis of literature review and experts'interview. Results:Ability and attitude or values accounted for high proportion of overall quality features .Humanities con-tained in most factors of excellent doctors'quality features;guiding significance of the structure of medical humanis-tic curriculum system is provided with excellent doctors'quality features .Conclusion:We should focus on the inte-gration of humanistic knowledge and practice , push humanities course into every stage of the medical education , further enrich category and quantity of medical humanities course and teaching form of medical humanities course , perfect the examination mode of medical humanities course in order to cultivate more excellent doctors .