To improve the development of postgraduate and build up the consciousness of competition, we should assess the overall quality of postgraduate generally. The quality is about mentality and moral, science and culture, innovation, practice, physical and psychological health. The assessment system must have these points followed: overall, whole course, trendy, continuous, synthetic.

Objective:To observe the changes of 5-HT1B and D1DR expression in nucleus of SNr/GPi-VL-SMA pathway in pre and post-exhaustive exercise,and investigate the central mechanism of SNr/GPi-VL-SMA pathway modulating the occurrence and development of exercise-induced fatigue.Method:Twenty-four male Wistar rats were randomly divided into control group (CG),immediately after exhaustion group (EG),and 90min after recovery group (RG),each consists of 8 rats.The expression level of 5-HT1B and D1DR receptors in each group were observed with the immunohistochemistry technique.Result:Compared with CG,the positive cell area/scanning area value (R value) and the average optical density value (AOD value) of 5-HT1B receptor in SNr and GPi of the EG and RG rats both decreased significantly (P ＜ 0.05),while the R value and AOD value of D1DR both increased significantly(P＜ 0.05).The R value and AOD value of 5-HT1B receptor in VL of EG and RG rats increased significantly(P＜0.05,P＜0.01).In SMA,the R value and AOD value of 5-HT1B receptor of EG and RG rats increased significantly (P＜ 0.05),while,the R value and AOD value of D1DR receptor decreased significantly (P ＜ 0.05).Conclusion:Changes of 5-HT1B receptor and D1DR receptor expression in the nuclei of ‘SNr/GPi-VL-SMA'pathway caused the changes of the neurotransmitters release,thus affecting the excitability of the electrical activity of neurons,this might be one of the important ways for ‘SNr/GPi-VL-SMA'pathway modulating the exercise-induced fatigue and exercise performance.

Background and purpose:Inadequate surgical operation of gastric cancer may cause introgenic tumor cell dissemination and peritoneal seeding.This study introduced a new technique of the interrupted procedure to prevent gastric cancer cells dissemination in the radical resection of gastric cancer.Methods:Patients received gastric interrupted procedure employing the use of gastric interrupted forceps in the carcinoma of antrum,gastric body or cardia.The interrupted effect,complicated nature of the procedure and the preliminary result of CK19 mRNA expression in the portal blood by RT-PCR techniques of the interrupted group and the routine operation group were analyzed.Results:All the patients were successfully interrupted in the gastric operation,but there were some differences in the detailed procedure between the carcinoma of antrum,gastric body and cardia.Special attention should be given to the prevention of spleen scrape via the interrupted forceps,and to the posterior gastric trauma in case there is adhesion between the stomach and pancreas.Nine patients (9/17) of the routine operation group have positive portal blood CK19 mRNA expression whereas all 17 patients have negative portal blood CK19 mRNA expression in the interrupted group.Conclusion:The interrupted procedure is an easy,useful and safe method of manipulating and to preventing a large amount of gastric cancer cells from disseminating in the portal blood during the radical operation of gastric cancer.

AIM:To investigate the effects of atorvastatin reloading in pre-percutaneous coronary intervention ( PCI) period on endothelial progenitor cell ( EPC) count and inflammatory cytokine expression in the stable angina pectoris patients who had previously received long-term statin treatment.METHODS:The patients with stable angina pectoris that had received long-term statin therapy and planned to accept PCI were randomized into 3 groups:80 mg atorvastatin 12 h and 40 mg 2 h before coronary angioplasty (80 mg reloading), pre-operatively with 40 mg/d atorvastatin for 7 d (40 mg re-loading) , and without atorvastatin reloading ( no reloading ) .CD45 -/CD133+/CD34 +, CD45 -/CD34 +/KDR+ and CD45 -/CD144 +/KDR+EPCs in 100 μL peripheral blood were determined by flow cytometry 1 h prior to PCI and 1 h, 6 h and 24 h after PCI.The serum concentrations of soluble intercellular adhesion molecule 1 ( sICAM-1) , C-reactive protein ( CRP) and troponin I ( TnI) were analyzed immediately prior to and 24 h after PCI.RESULTS:(1) In 80 mg reloading group, the numbers of circulating CD45 -/CD133 +/CD34 +and CD45 -/CD34 +/KDR+early differentiation stage EPCs 1 h and 6 h after coronary angioplasty was significantly elevated compared with those before PCI (P<0.05).(2) In control group, the serum concentrations of sICAM-1 and CRP 24 h after PCI were significantly elevated ( P<0.05) compared with preoperative values.(3) The rise in serum TnI concentration from pre-to post-operation in 80 mg reloading group was lowerthan that in control group.CONCLUSION: The method of atorvastatin reload before PCI affects the number of EPCs inperi-operative period.High dose of atorvastatin application before PCI triggers early EPC circulation.The serum levels ofpost-operative inflammatory cytokine sICAM-1 as well as CRP are reduced by atorvastatin reloading before PCI.

Objective To investigate the value of 18 F-fluorodeoxyglucose (18 FDG)positron emission tomography and computer tomography (PET/CT)in the diagnosis and localization of ectopic ACTH syndrome (EAS)induced by lung cancer,and to increase the accuracy rate of diagnosis of EAS.Methods 8 patients were histopathologically proven to be lung cancer.18 FDG PET/CT wholebody and brain scan were performed;magnetic resonance imaging (MRI),99m Tc-octreotide (OCT)imaging and inferior petrosal sinus sampling (IPSS)were done in all patients.On 18 FDG PET/CT images,the SUVmax values of lesions and the SUVmax ratio of lesion tissue to normal lung tissue were calculated.Results ① 8 patients with EAS included 2 cases of carciniod,4 cases of atypical carciniod,and 2 cases of small cell lung cancer.The ACTH levels in inferior petrosal sinus and peripheral veins of 8 patients had no difference.②The chest CT showed there were pulmonary nodules in 6 cases (75%),among them 2 cases were atypical lesions.5 cases of pituitary adenomas were found by MRI (25%),and OCT imaging was positive in 2 cases (25%).③The 18 FDG PET/CT showed nodular,mass like or patch samples with high metabolic activity in 8 cases (100%)of pulmonary lesions.The SUVmax of tumor was 0.72 to 14.05 (3.67±4.68),and the ratio of SUVmax of lesion tissue to normal lung tissue was 1.69 to 27.54 (8.14 ± 9.63).18 FDG hypermetabolism was found in 8 cases of bilateral adrenal hyperplasia,while 4 cases showed pituitary tumor.Conclusion Lung cancer is a common source of EAS,especially carcinoid.18 FDG PET may show lower glucose metabolism.18 FDG PET/CT should be used as an assisted method to diagnose EAS.

PURPOSE: The aim of the present study was to evaluate the prognostic value of magnetic resonance imaging (MRI)‒determined lymph nodal necrosis (LNN) in nasopharyngeal carcinoma (NPC) and explore the feasibility of an N-classification system based on the 8th edition of the American Joint Committee on Cancer (AJCC) system. MATERIALS AND METHODS: The MRI scans of 616 patients with newly diagnosed stage T1-4N1-3M0 NPC who were treated with definitive intensity-modulated radiotherapy (IMRT) were reviewed. RESULTS: Multivariate analysis showed that LNN was an independent negative prognostic predictor of distant metastasis free survival (hazard ratio, 1.634; 95% confidence interval, 1.023 to 2.609; p=0.040) and overall survival (hazard ratio, 2.154; 95% confidence interval, 1.282 to 3.620; p=0.004). Patients of classification N1 disease with LNN were reclassified as classification N2, and classification N2 disease with LNN as classification N3 in the proposed N-classification system. Correlation with death and distant failure was significant, and the total difference between N1 and N3 was wider with the proposed system. CONCLUSION: MRI-determined LNN is an independent negative prognostic factor for NPC. The proposed N classification system is powerfully predictive.
Classification ; Humans ; Joints ; Lymph Nodes ; Magnetic Resonance Imaging ; Multivariate Analysis ; Necrosis ; Neoplasm Metastasis ; Neoplasm Staging ; Prognosis ; Radiotherapy, Intensity-Modulated

Objective To investigate the effects of different irradiation techniques on dose distribution in target volume and normal tissues after the radical surgery for gastroesophageal junction adenocarcinoma,and to provide the optimal regimen for clinical treatment.Methods A total of 9 patients with gastroesophageal junction adenocarcinoma who underwent radical esophagus-proximal gastrectomy or total gastrectomy were enrolled.The therapeutic regimens of five-field static intensity-modulated radiotherapy (IMRT),volumetric-modulated arc therapy (VMAT),and helical tomotherapy (HT) were designed for each patient,and the dose-volume histogram was used to evaluate the effects of different irradiation techniques on the conformity index (CI) and homogeneity index (HI) of target volume and the surrounding normal tissues. The prescribed dose was 45 Gy at 1.8 Gy/fraction.The patients received oral S-1 as concurrent chemotherapy at a dose of 80 mg/(m 2? d) twice a day during radiotherapy.Results Compared with IMRT and VMAT,HT had better CI and HI of the target volume,as well as a better protective effect on the intestinal tract and bone marrow.Compared with IMRT and HT,VMAT had a lower V20 and V30 for the left kidney and a lower V30 for the heart,while IMRT had lower V5 and V10 for both lungs;V20 and mean dose showed no significant differences between the three techniques.HT had the highest mean sub-field hop count,followed by IMRT and VMAT.Conclusions IMRT, VMAT, and HT can meet the clinical requirements,but besides ensuring the best CI and HI of the target volume,HT has a good protective effect on the intestine and spinal cord and can help to reduce the incidence of adverse events in patients.

Objective:The purpose of this study was to analyze the expression profile of miRNAs in children with autism spectrum disorders (ASD), and to discuss the clinical significance of differentially expressed miRNAs.Methods:MiRNA microarray was used to analyze the expression of miRNA in peripheral blood of 3 pairs of ASD patients-healthy controls; 17 pairs of ASD patients-healthy controls were used to verify the differentially expressed miRNA; Receiver operating characteristic (ROC) curve was used to analyze the differential expression the value of miRNA in the diagnosis of ASD.Results:A total of 32 differentially expressed genes were screened by 3 pairs of miRNA microarray including 12 up-regulated miRNAs and 20 down-regulated miRNAs. miRNA verification of 20 differentially expressed miRNAs showed miR-15a-5p, miR-27a-3p , miR-142-3p and miR-142-5p were significantly down-regulated in children with ASD, with statistically significant difference (all P<0.05). ROC curve analysis showed that the area under the curve (AUC) of the above four miRNAs diagnosing ASD were all greater than 0.70, with sensitivities 94.12%, 100%, 100%, and 82.35%, respectively. Conclusions:The expression of miR-142-3p, miR-27a-3p/miR-15a-5p, and miR-142-5p is down-regulated in the peripheral blood of ASD patients, and has the potential as biomarkers for early screening of ASD.

Objective:To investigate the satisfaction of clinical interns to the department and teachers under the merging mode of standardized residency training and clinical practice, and to explore the feasibility to further implement the mode in clinical practice.Methods:Cluster sampling was used to design the scale, which included the importance attached by department to the teaching work, the rationality of the arrangement of practice content, the implementation of teaching activities, the quality of teaching activities, the status of out-department examination, the demonstration of medical ethics of teachers, the teaching attitude and knowledge lecturing of teachers, the revision of medical records and the guidance of skills operation, etc. The questionnaire survey was conducted among clinical interns in a hospital from July 2018 to June 2019. SPSS 22.0 was used to conduct t test or rank sum test of two independent samples, and the analysis of multiple groups of data was performed by means of variance analysis. Results:A total of 1 230 questionnaires were sent out, and 1 195 were returned, with an effective recovery rate of 97.15%. The overall satisfaction of interns was (9.62±0.39). The interns gave the highest evaluation on the medical ethics and medical style of the teacher (9.75±0.78), and the lowest evaluation on the teaching quality of all departments (9.52±1.15). There were significant differences among the evaluations ( F=7.30, P<0.001). Conclusion:Under the merging mode of standardized residency training and clinical practice management, all teaching and research sections and departments have fulfilled various teaching tasks according to the requirements, but the teaching quality and connotation construction need to be further strengthened.

Objective: To summarize the effective of high intensity interval training on cognitive executive function among adolescents through Meta analysis,and to provide reference for medical rehabilitation and physical education practice. Methods: Literature search was conducted for Chinese and English keywords "High Intensity Interval Training", "Cognition", "Cognition Function"，"Executive Function" and "Executive Controls" regarding the effect of high intensity interval training on cognitive executive function among adolescents published prior to September 20, 2020 in PubMed, Cochrane library, Web of science, Embase, the China National Knowledge Infrastructure (CNKI), the Wanfang database and the VIP database. Stata 14 software and Revman 5.3 software were used for Meta analysis, fixed effect or random effect model was used to combine the results based on the heterogeneity. Results: The response time of Stroop test immediately after acute high intensity interval training significantly decreased ( SMD=0.70，95%CI =0.28-1.11， z=3.29，P <0.01); there was no significant change in response time of Stroop test 30 min after training ( SMD=0.23，95%CI=-0.14-0.60，z=1.23，P >0.05); the correct rate of Stroop test immediately after acute high intensity interval training increased significantly ( SMD=0.26，95%CI=0.03-0.50，z=2.21，P <0.05); there was no significant change in correct rate of Stroop test 30 min after training ( SMD=-1.38，95%CI=-4.28-1.52，z=0.93，P >0.05). After long term high intensity interval training, the response time of Stroop and TMT test were significantly shortened ( SMD=0.38, 95%CI=0.07-0.70, z=2.41, P < 0.05 ). Conclusion Acute and long term high intensity interval training can effectively improve cognitive executive function among adolescents, but the long term effect of acute training is unclear.