Mini-clinical evaluation exercise(Mini-CEX) is a new tool used to evaluate clinical skill of internal residents.Through necessity,operation and practice of Mini-CEX applied in internal residents' clinical teaching,the paper makes it known that Mini-CEX is consistent with six requisitions of resident competence raised by Accreditation Council of Graduate Medical Education (ACGME).It increases medical and directorial quality,and is combined with doctor training abroad.Mini-CEX should be spread in training and examination of internal residents.

Objective To observe the effects of Kuijiening Plaster point application on the levels of pro-inflammatory cytokines IFN-γ, IL-12 and anti-inflammatory cytokines IL-4, IL-10 in serum and colonic tissue of ulcerative colitis (UC) rats with spleen-kidney yang deficiency; To investigate the possible mechanism of Kuijiening for the treatment of UC with spleen-kidney yang deficiency. Methods Sennae Folium solution gavage, ice water stimulation and trinitrobenzene-sulfonic acid ethanol combinative methods were applied to establish the models of UC rats with spleen-kidney yang deficiency. Rat models were randomly divided into control group, model group, application group and SASP group, 10 in each group. The control group and model group were given medicine-free cataplasm matrix point application and perfused with NS. The application group was given Kuijiening Plaster point application and perfused with NS. SASP group was given medicine-free cataplasm matrix point application and perfused with SASP. The courses were 28 days. General conditions of rats in each group were observed during treatment. The general morphology and pathological form of colonic tissue were observed with naked eye and light microscopy through HE staining respectively in each group post-treatment. Pathological features were observed and scored by HE dyeing. Levels of IFN-γ, IL-12, IL-4 and IL-10 in serum and colonic tissue of rats in each group were detected with ELISA. Results The general conditions, gross morphology and optical microscope pathological morphology of colonic tissue improved and scores decreased in application group and SASP group. Compared with the model group, levels of IL-4 and IL-10 significantly increased, while the levels of IFN-γ and IL-12 decreased in serum and colonic tissue in application group and SASP group, with statistical significance (P<0.01). Moreover, levels of IL-4 and IL-10 in application group decreased not as much as those in SASP group, while IFN-γ and IL-12 concentration increased higher than SASP group, without statistical significance (P>0.05). Conclusion Kuijiening Plaster point application can play a role in treating UC with spleen-kidney yang deficiency through partially restoring the balance between pro- and anti-inflammatory cytokines in serum and colon tissue of rats.

78 min,HCT

Bronchoalveolar Lavage ; methods ; Humans

The pathological subtypes of breast cancer can be further divided into different molecular subtypes based on their immunohistochemical staining, such as estrogen receptor (ER) , progesterone receptor (PR) , human epidermal growth factor receptor2 (HER2) and Ki67 expression, including luminal subtype, HER2 overexpression subtype and triple negative subtype. The luminal subtype is defined as ER and/or PR positive. In molecular mechanism, the expression activity of ER can regulate the expression of PR, so the expression of ER and PR is usually consistent. However, in the process of detection, some breast cancers with inconsistent ER/PR expression often appear, especially those with ER (-) /PR (+) . There is still controversy about whether such cases are true. Patients with this type of breast cancer should be subjected to ER and PR immunohistochemical staining again, and then reclassified according to HER2 status. The expression of ER/PR is closely related to the efficacy of endocrine therapy for breast cancer, so its test results will directly affect the treatment options of clinician. This article will review and discuss the research progress of the causes and mechanisms of ER (-) /PR (+) breast cancer.

OBJECTIVETo investigate the influence of male age on the pregnancy outcomes of in vitro fertilization-embryo transfer (IVF-ET).

METHODSWe retrospectively analyzed 7,533 cycles of IVF-ET performed between January 1, 2009 and October 31, 2013. We divided the samples into three groups according to the female age (< 30, 30-34, and 35-38 yr), each again subdivided into six groups based on the male age (< 30, 30-32, 33-35, 36-38, 39-41, and ≥ 42 yr). We compared the rates of implantation, pregnancy, miscarriage, and live birth among different age groups.

RESULTSThere were no statistically significant differences in basal E2, FSH, endometrium thickness on the day of hCG administration, number of oocytes retrieved, and days of embryo transfer among different male age groups (P > 0.05). The implantation rate showed an age-dependent decrease in the < 30, 30-32, 33-35, 36-38, 39-41, and ≥ 42 yr male groups, 41.1, 42.0, 39.5, 31.3, 40.7, and 48.6% among the women aged < 30 years (P < 0.05), 40.3, 36.4, 35.1, 35.3, 29.4, and 37.3% among the women aged 30-34 years (P < 0.05), and 48.2, 17.8, 25.3, 23.5, 22.1, and 23.8% among the women aged 35-38 years (P < 0.05). The miscarriage rate was significantly higher in the ≥ 39 yr than in the 30-32 and 33-35 yr male age groups among the women aged 30-34 years (P < 0.05), but showed no remarkable differences among the other male age groups in the women aged < 30 and 35-38 years (P > 0.05). No statistically significant differences were observed in the rates of pregnancy and live birth among different male age groups (P > 0.05).

CONCLUSIONMale age has some influence on the rates of implantation and miscarriage but not on the rates of pregnancy and live birth in IVF-ET.

Abortion, Spontaneous ; epidemiology ; Adult ; Age Factors ; Embryo Implantation ; Embryo Transfer ; Female ; Fertilization in Vitro ; Humans ; Male ; Oocyte Retrieval ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Retrospective Studies ; Sex Factors

11.1mmol/L were treated by 2 weeks CSⅡ.The elements of 2 hours postprandial,insulin,C-peptide, HbAlc,HOMA-?,and HOMA-IR were analyzed and compared before and after treatment,and the control of post- prandial of patients for 2 years was observed.Results The excellent control of FPG and 2h PG in 36 patients were achieved stably in(5.6?0.4)mmol/L and(8.2?1.4)mmol/L below the condition of(13.6?1.5)mmol/L and (20.1?4.0)mmol/L before treatment(P

Objective To study the anti-neuroglioma effect of methyl-mercuric chloride(MMC) by observing the morphological changes of apoptotic neuroglioma cells induced with MMC in rats with brain neuroglioma.Methods The rat models of neuroglioma were established,and divided into two groups.The rats in experimental group were lavaged with MMC 1 week after injected with C6 glioma cells,10 mg?kg-1every day,the rats in control group were treated with sodium chloride at the same dose.24 d after inoculation all rats were sacrificed except natural death,the brain tissues were obtained,and the pathohistological changes were observed under light microscope and transmission electron microscope.Results The macropathological result showed that the tumor volume in experimental group was smaller than that in control group.Under light microscope,in experimental group the growth density of C6 ghioma cells was lower than that in control group,and the apoptotic cells with smaller volume and karyopyknosis were found.The result of transmission electron microscope showed that in experimental group,the glioma cells had some changes such as karyopyknosis,chromoplasm margination,nuclear fragmentation and vacuolar degeneration and so on.Conclusion MMC has inhibitory effect on the proliferation of C6 glioma in rats in vivo,its mechanism may be related to inducing the apoptosis of neuroglioma cells.

Objective To determine the expression level of CD154 in systemic lupus erythematosus(SLE) and its role in the pathogenesis. Methods CD154 were detected by flow cytometry in CD19+ peripheral blood lymphocytes from 16 active lupus patients and 14 healthy controls. Effects of anti-CD154, on the proliferation and IgG secretion by peripheral B lymphocytes were also observed. Results ① The positive rates and mean fluroscence intensity of CD154 in peripheral blood B lymphocytes from active lupus [(36?17)%,364?238] were significantly higher than from normal controls[(10?8)%, 124?97], (P