Clinical internships play an important role in higher medical education. According to the new standards in undergraduate medical education set by the MOE and MOH,we identified 4 main problems in our internships training,including lack of awareness of career planning,interns'absence from duty,lack of hands-on opportunities,psychological problems,etc. According to these problems,we carried out a series of solutions such as strengthening intern orientation,especially in aspects of professionalism and clinical skills training,optimizing the rotation schedule and improving the evaluation methods etc. Experiential evidence and perceptions of interns and their tutors showed that these changes were effective.

Objective To investigate how mobility training affects the synapses and their functioning in the region around a cerebral infarct.Methods One hundred and fifty rats were randomly divided into 5 groups:a mo- tor training group,a normal saline group,an Ara-c inhibition group,a mevastatin group and a control group.Cere- bral infarcts were surgically induced in all 150 rats,and the level of either glial fibrillary acidic protein(GFAP)or synaptophysin,and the cholesterol content around the infarct were observed at 7,21 and 42 days using immunohisto- chemical staining and high performance liquid chromatography.Results At 7,21 and 42 days after the infarct model was induced,significant differences in the optical density of either GFAP or synaptophysin and in cholesterol levels were noted between the motor training group and the control group.Ara-c inhibition was also significantly high- er in the controls.The optical density of synaptophysin and the cholesterol levels were significantly lower in the me- vastatin group than in the motor training group.Conclusion Motor skill training can improve synapse redefinition in rats with a model of acute cerebral infarct.Astrocytes may play a crucial role by means of the secretion of choles- terol in the region around the infarct.

Objective To compare the efficiency and safety of double-channel flexible ureteroscopy and electronic flexible ureteroscopy.Methods From April 2007 to 2016 July, clinical data of 836 cases flexible ureteroscopic holmium laser lithotripsy were collected. All the patients were randomly divided into electronic lfexible ureteroscopy group (n = 427) and double-channel lfexible ureteroscopy group (n = 409), the operation time, success rate of surgery, complications, residual stone rate of the two groups were compared.Results The success rate of surgery was 92.5% and 83.6% of the two groups respectively, the difference was significant (P < 0.05); postoperative systemic inlfammatory response syndrome (SIRS) were occurred in 10 cases and 13 cases respectively, which were cured and the difference was not statistically significant (P > 0.05); the average operation time was (81.1 ± 7.9) min and (95.3 ± 7.6) min respectively, the difference was significant (P < 0.05); The formation of stone street of electronic lfexible ureteroscopy group and double-channel lfexible ureteroscopy group were 17 cases and 25 cases. The residual stone rate of electronic flexible ureteroscopy group and double-channel flexible ureteroscopy group were 6 cases and 8 cases, of them were cleared after extracorporeal shockwave lithotrips (ESWL). There were no difference between the two groups (P > 0.05).Conclusion Both double-channel lfexible ureteroscopy and electronic lfexible ureteroscopy are effective and safe therapeutic modalities. Electronic flexible ureteroscopy is better than double-channel lfexible ureteroscopy in success rate of surgery because of its high deifnition and lfexible operation.

Objective To explore the risk factors ,prevention and treatment of the occurrence of perirenal hematoma after flexible lithotripsy. Methods We retrospectively analyzed the clinical data of 18 patients with symptomatic perirenal hematoma from 1259 who had undergone ureteral flexible lithotripsy in our hospital during the period of April 2007 to April 2016. Of the 18 patients,7 were complicated with diabetes mellitus,11 had urinary tract infection;15 were female,and 3 were male. Results Perirenal hematoma was confirmed by B ultrasound and CT,which situated on the Posterolateral side of the kidney in 8 patients,and on the lower pole and abdominal side in 10. Hematoma depth was 2.6-15.3 cm(average was 5.2 cm). The hematoma?related symptoms gradually disappeared in 11 patients 7 to 14 days after they received conservative treatment. 5 recovered gradually 15 days after undergoing hematoma puncture and drainage ,and 2 recovered 36 days after receiving open surgery for removal of hematoma. Conclusions Female,diabetes,urinary tract infection,bigger stone size,prolonged surgical duration,and infected stones were the risk factors for perinephric hematoma related to ureteroscopic lithotripsy. Full preoperative preparation ,effective anti?infection ,intraoperative improvement of calculus?breaking skills and use of large caliber semirigid through sheath,low pressure perfusion,shorter surgical duration,and staging surgery are effective ways to reduce the occurrence of perirenal hematoma.

Objective To evaluate the therapeutic effects and to summarize the clinical experience of benign prostatic hypertrophy(BPH) with inguinal hernia in the elderly 70-89 years. Methods Clinical data of 32 patients 70-89 years old simultaneously undergone transurethral resection of prostate (TURP) and plug-mesh tension-free hernia repair from July 2000 to May 2005 were retrospectively analyzed and followed up. Results The average operating time was (85.0?12.8)minutes, the average blood loss was (90.0? 18.7 )ml. No postoperative death or life threatening complications were revealed. By 7-40 months of following up reported that there were no recurrence of hernia as well as no incontinence and urethral stenosis or other complications. IPSS,maximal flow rate and residual urine were evidently improved after operation. Conclusion Combined TURP and plug-mesh tension-free hernia repair is a safe and effective procedure for the elderly patients.

OBJECTIVETo isolate and culture mesenchymal stem cells (MSCs) from human fetal livers and describe their biological characteristics.

METHODSMSCs were acquired using an optimized method. Cell cycles and the immunophenotype of the cells were analyzed by flow cytometry. The osteogenic and adipogenic differentiations were induced and identified by specific stainings, and hepatic differentiation by morphology and RT-PCR.

RESULTSThe target cells derived from human fetal livers adhered to the plate with fibroblast-like morphology, whose surface markers were CD90, CD44, CD147 positive, and CD34, CD45, HLA-DR negtive. In the differentiation study, these cells could be induced to differentiate into osteogenic, adipogenic and hepatocyte-like cells.

CONCLUSIONMultipotent MSCs can be isolated and cultured from human fetal livers.

Cell Differentiation ; physiology ; Cell Separation ; Cells, Cultured ; Fetus ; Humans ; Liver ; cytology ; Mesenchymal Stromal Cells ; cytology

Background The excitotoxicity to retinal neurons caused by abnormal elevation of glutamate in retina is a common pathology concomitant with major blind-causing eye diseases.However,an effective approach to protect retinal neurons from glutamate-induced excitotoxicity is still lack.Intraperitoneal administration of α-melanocyte stimulating hormone(α-MSH)has been shown to protect hippocampal neurons from glutamate-induced excitotoxicity.Objective This study was to investigate the protective effect of α-MSH on glutamate-induced excitotoxicity in a chicken embryonic retinal explant culture system.Methods The retinas were isolated from chick embryos at embryonic day 9(E9) and cultured as explants.The explants at 3,5 and 7 days in vitro and the retinas at corresponding embryonic day 12,14 and 16(E12,E14,E16)were collected.The morphology of explant cultures was examined by hematoxylin and eosin staining,and the expression of melanocortin receptors (MCRs)was analyzed by real-time PCR.In the experiment of glutamate-induced excitotoxicity,the retinal explants at 4 days in vitro were treated with glutamate for 48 hours,α-MSH was incubated with the explants 30 minutes before and during the glutamate treatment period.Then the apoptotic cells were detected by TUNEL staining and quantified.The glutamate alone treated-explants and those treated with culture media were included as controls.The expression of glial fibrillary acidic protein(GFAP) at 48 hours after treatment in all retinal explants was analyzed by real-time PCR.Results Hematoxylin and eosin staining showed that the retinal explants exhibited similar morphology to those observed in the retinas from chick embryos at the corresponding developmental stages.The real-time PCR analyses of chick retinas showed that MC1R mRNA level at E9,E12,E14 and E16 was significantly lower than that in post-hatch day 1 (all P=0.000) ;whereas the transcript level of MC5R was significantly increased from E9 to E12 and E14 (both P =0.000),and then gradually decreased from E14 to P1.The expression of these genes showed similar temporal patterns in the retinal explant cultures.TUNEL staining revealed that treatment of the retinal explant cultures with α-MSH substantially and significantly reduced number of apoptotic cells induced by glutamate (P =0.000),which was accompanied by significant suppression of glutamate-induced GFAP up-regulation (P =0.000).Conclusions Application of α-MSH dramatically ameliorated glutamate-induced cell death in retinal explant cultures.This protective effect may be due to α-MSH-mediated suppression of astrogliosis caused by abnormal elevation of glutamate.

OBJECTIVETo further understanding of lymphoma of salivary gland through clinicopathologic analysis.

METHODSClinical findings, pathologic features, clinical staging, therapy and prognosis of 4 cases were reviewed and clinically analysed.

RESULTSDifferent treatment were received by the 4 patients, one had stage IIIA disease and three had stage IE disease. All patients got their illness completely remitted.

CONCLUSIONMucosa-associated lymphoid tissue lymphoma of the salivary glands is an indolent disease. Different treatments can all result in prolonged remission, and it has better outcome than other NHL.

Aged ; Female ; Humans ; Lymphoma, B-Cell, Marginal Zone ; diagnosis ; pathology ; therapy ; Middle Aged ; Parotid Neoplasms ; diagnosis ; pathology ; therapy ; Prognosis ; Submandibular Gland Neoplasms ; diagnosis ; pathology ; therapy

OBJECTIVESTo study the contact allergenic activities of trichloroethylene (TCE) and its three metabolites trichloroacetic acid, trichloroethanol and chloral hydrate.

METHODSA modified guinea pig maximization test (GPMT) was adopted. The skin sensitization (edema and erythema) was observed in trichloroethylene, trichloroacetic acid, trichloroethanol, chloral hydrate and 2,4-dinitrochlorobenzene.

RESULTSThe allergenic rate of TCE, trichloroacetic acid and 2,4-dinitrochlorobenzene was 71.4%, 58.3% and 100.0% respectively, and that of trichloroethanol and chloral hydrate was 0%. The mean response score of TCE, trichloroacetic acid and 2,4-dinitrochlorobenzene was 2.3, 1.1, 6.0 respectively. The histopathological analysis also showed an induction of allergenic transformation in guinea pig skin by both TCE and trichloroacetic acid.

CONCLUSIONTCE appears to be a strong allergen while trichloroacetic acid a moderate one. On the other hand, both trichloroethanol and chloral hydrate are weak sensitization potentials. Immunologic reaction induced by TCE might be postulated as the pathological process of this illness. Consequently, it is suggested that in the mechanism of Occupational Dermatitis Medicamentose-Like (ODML) induced by TCE, the chemical itself might be the main cause of allergy. As one of its metabolic products, trichloroacetic acid might be a subordinate factor.

Allergens ; toxicity ; Animals ; Chloral Hydrate ; toxicity ; Dermatitis, Allergic Contact ; etiology ; immunology ; Dermatitis, Irritant ; etiology ; immunology ; Ethylene Chlorohydrin ; analogs & derivatives ; toxicity ; Guinea Pigs ; Skin ; drug effects ; immunology ; Toxicity Tests ; Trichloroacetic Acid ; toxicity ; Trichloroethylene ; metabolism ; toxicity

OBJECTIVETo introduce the application of percutaneous epididymal sperm aspiration (PESA) in the differential diagnosis between obstructive and non-obstructive azoospermia, and to investigate the association of the results of PESA with testis volume and the level of serum follicle stimulating hormone (FSH).

METHODSA total of 118 patients with diagnosed azoospermia were included. Their testis volume was measured by model method, the serum gonadal hormone level examined by chemoluminescence assay, and the epididymal fluid obtained by puncturing the head of the epididymis with a size-7 butterfly needle.

RESULTSSperm was found in the epididymal fluid in 60 of the patients, 56 with normal and 4 with smaller testis volume, and 55 with normal and 5 with higher FSH level. No sperm was detected in the other 58 cases, 34 with normal and 24 with smaller testis volume, and 38 with normal and 20 with higher serum FSH level. The rate of successful PESA was significantly higher in patients with normal testis volume or normal serum FSH level than in those with smaller testis volume (P < 0.05) or higher serum FSH level (P < 0.05).

CONCLUSIONPESA is a quick, convenient and effective method for the differential diagnosis between obstructive and non-obstructive azoospermia.

Adult ; Azoospermia ; diagnosis ; Epididymis ; Follicle Stimulating Hormone ; blood ; Humans ; Male ; Middle Aged ; Punctures ; methods ; Spermatozoa ; Testis ; pathology