Cultivating clinical comprehensive ability is one of the core and main purposes for surgical clinical education.According to the characteristics in clinical teaching of hepatobiliary surgery,we combined basic theory with clinical practice and discussed on the problems of how to improve medical students' clinical comprehensive abilities including clinical operational ability,logical thinking ability,scientific research innovative ability and the doctor-patient communication ability and how to cultivate medical ethics and professional competence from aspects of basic clinical skills training,translational medicine concept,etc.

Objective To study the inhibition effect of leech extract on HepG2 cells. Methods Human hepatocellular cancer cell line HepG2 were treated with different concentrations of leech extracts which were extracted by method of freeze-thawing with liquid nitrogen and contrasted with that by method of water extracting and ethanol precipitating. The inhibition effects and cell morphous were examined by MTT assay and Acridine orange (AO) fluorescent staining method respectively. Result The 6～15 mg/mL drug concentrations of leech extract by method of freeze-thawing with liquid nitrogen had an obvious inhibition on proliferation of HepG2 cells in a dose-dependent manner, and the effect was better than that by method of water extracting and ethanol precipitating (P

Objective To investigate the molecular and cell signal transduction mechanisms by Lactobacillus cell wall extract(LCWE)inducing human-β-defensin-2(hBD-2)expression in human vaginal epithelial cells.Methods The induction of hBD-2 in human vaginal epithelial cells(WZV-1)by LCWE was observed using real-time PCR and Western blot.After stimulating WZV-1.the activation of NF-κB and p38MAPK signaling pathways were determined by Western blot.The induction of hBD-2 in WZV-1 cells by LCWE was observed with signaling pathways inhibitors of NF-κB and p38MAPK using real-time PCR and Western blot.Results The results showed that LCWE significantly upregulated hBD-2 expression in the time and dose-dependent manner.The maximal stimulatory effect of LCWE on the expression of hBD-2mRNA in WZV-1 cells were observed at the concentration of 50μg/ml after treatment for 8 h.After stimulation by 50μg/ml LCWE,Western blot analysis demonstrated that the phosphorylation of p38MAPK increased at 0.5 h significantly,peaked at 1 h,moreover the concentration of NF-κB in nucleus increased at 0.5 h significantly(P<0.05),peaked at 2 h.Blocking with inhibitor of NF-κB and(or)p38MAPK pathways results in decreased levels of HBD-2 expression.Conclusion These findings suggest that p38MAPK and NF-κB pathways play the important roles in induction of hBD-2 expression by LCWE in human vagihal epithelial cells.

HRP was injected into the cervical (3 cases) or lumbar (2 cases) spinal cord unilaterally in 5 adult cats. Labeled cells were discovered in the hypoth alamus and nearby areas. There was no obvious difference in labeling between cervical and lumbar injection cases. Labeled cells were found bilaterally with ipsilateral preponderance.he paraventricular nucleus was most heavily labeled; the posterior and lateral hypothalamic areas were less. A few labeled cells were found in the dorsal hypothalamic area and the supramamillary nucleus. Forel's area was also weakly labeled and occasional cells were found in the subthalamic nucleus and zona incerta.We were unable to find labeled cells in the dorsomedial nucleus. Labeling of the supramamillary nucleus, which was found in this sutdy, has not been mentioned in the literature available to us.

The projection from the lower brain stem to the spinal cord was studied with HRP method by injecting HRP into the cervical and lumbar enlargements of the spinal cord of 10 cats.The follwing nuclei were found to have spinal projections:1) The reticular formation: Numerous retrogradely labeled cells were seen in the nuclei of gigantocellularis and medullae oblongatae centralis subnucleus ventralis, fewer in the nuclei pontis centralis caudalis and oralis. A few labeled neurons were also found in the nuclei of medullae oblongatae centralis subnucleus dorsalis, parvocellularis, paragigantocellularis laterlaris, paramedium reticularis subnucleus ventralis and cuneiformis. Most of them projected to the spinal gray matter ventral to the dorsal horn except the nuclei of medullae oblongatae centralis subnucleus dorsalis and parvocellularis which projected mainly to the dorsal horn.2) The raphe nuclei: Nuclei of raphe pallidus, magnus and obscurus projected to both the cervical and lumbar enlargements, while nucleus raphe dorsalis only to the gray matter ventral to the dorsal horn of the cervical enlargement.3) The gracile and medial cuneatus nuclei projected somatotopically to ipsilateral spinal cord.4) The cranial nuclei: The Edinger-Westphal nucleus, nuclei of nervi oculomotor principalis, tractus spinalis nervi trigemini and tractus solitarii and the nuclei vestibularis lateralis, medialis, superior and spinalis were found to project to spinal cord. There was somatotopic arrangement in the nucleus vestibularis lateralis.5) The nuclei of locus coeruleus, subcoeruleus, parabrachialis lateralis and medialis, neucleus retroambigualis and the Kolliker-Fuse nucleus projected bilaterally to the spinal cord.6) The red nucleus: Large amount of labeled cells were seen in the controlateral red nucleus. The ventrolateral part of the red nucleus projected to the cervical enlargement while the dorsornedial part to the lumbar enlargement.7) The superior colliculus and the griseum centrale mesencephali projected to the gray matter ventral to the dorsal horn of the cervical enlargement.

HRP was injected into C_6, C_7, L_5, L_6 or T_(5～7) spinal gray. The retrogradely labeled cells and anterogradly labeled terminal arborizations were traced in L_5 and T_5 in cervical injection cases, C_5 and T_5 in lumbar cases, and C_5, L_5 in thoracic cases.Large amount of labeled cell were consistently found in laminae Ⅶ (including the lateral horn of the thoracic cord) and Ⅷ, next numerous in lamina Ⅴ and Ⅹ region. Lamina Ⅰ was found labeled in the cervical and lumbar cord, but virtually not found in the thoracic cord. Labeled cells were few and inconsistent in laminae Ⅳ and Ⅵ. A few labeled lamina Ⅸ cells could be found in the thoracic cord, only occasionally in the lumbar cord, but could not be found in the cervical cord. Laminae Ⅱ and Ⅲ were free from labeled cells in all cases. The labeled terminal arborizations were more widespread and could be found in practically every lamina, being densest in region Ⅹ, laminae Ⅶ (including the lateral horn of the thoracic cord) and Ⅷ. In lumbar injection cases a prominent plexus of labeled terminal arborization could be seen in the ventrolateral part of the C_5 ventral horn. Corresponding plexus was not found in the lumbar cord in cervical injection cases.Some labeled terminal arborizations were found in close approximation to or overlapping with labeled cells or unlabeled motor neurons.These results imply that: (1) The occurance of labeled cells and labeled terminal arborizations in the lateral part of lamina Ⅶ (lateral horn) suggests that intersegmental connection is related to visceral activities as well as somatic ones. (2) Labeled cells were consistently found in region Ⅹ which was also the area of dense labeling of terminal arborization, suggesting that this region plays a remarkable role in intersegmental connection. (3) Long ascending bundle connects the lumbar enlargement with the ventrolateral part of the motor neurons directly. (4) The close approximation of labeled terminal arborization and labeled cells signifies direct intersegmental feedback circuit.

The cervical, thoracic, or lumbar spinal gray was injected with HRP or WGAHRP unilaterally in 18 adult rabbits and the anterograde labeling was traced in the pontine nucleus and the caudal pontine ventrolateral tegmentum.In the pontine nucleus labeled terminal arborizations were found in its caudal 1/3, distributing in the paramedian nucleus, the dorsal part of peduncular nucleus and the dorsolateral nucleus. In the ventrolateral tegmentum four small cell groups were found labeled which were temporarily denominated as VLPT_(1～4) groups. In all locations labelings were found bilaterally and no apparent somatotopical localization could be identified.The cytoarchitecture of VLPT_(1～4) was studied on Nissl sections and their relationship with Meessen and Olszewski's (M-O's) "k" and "m" groups and with pontobulbar body was discussed. VLPT_2 (corresponding to the ventral part of M-O's "k") and VLPT_3 (corresponding to a part of M-O's "m") join each other to form one group which then merges into the dorsolateral nucleus of the pontine gray. They apparently form a part of the pontobulbar body.

The somatotopical pattern of the spinal projection to the lateral reticular nucleus (LRN) was examined in 16 rabbits. The anterograde transport of HRP method were used.1. Cervical, thoracic and lumbar segments all gave rise to small numbers of fibers projecting to bilateral lateral reticular subtrigeminal subnucleus (Lrs).2. Cervical, thoracic and lumbar projections to the LRN were bilateral but the cervical ascending fibers terminated predominately on the ipsilateral side. The lumbar ascending fibers projected chiefly to the contralateral side. The thoracic cord gave fibers to bilateral LRN. No significant difference could be seen between the two sides. There were certain overlapping among the distribution areas of the terminal branches from different parts of the cord.3. The spinal projections of the rabbit were predominately terminated in the caudal half of the LRN. It showed a somatotopical pattern. The cervical cord projected to the lateral 3/5 of the lateral reticular magnocellular subnucleus (Lrm) and its neighbouring part of the lateral reticular parvocellular subnucleus (Lrp). The thoracic cord projected to the medial 3/5 of the Lrm and its neighbouring part of Lrp. The lumbar cord gave afferents to the Lrp and its neighbouring part of Lrm.

HRP or WGA-HRP was injected into the rabbit cervical, thoracic, or lumbar spinal gray unilaterally and the retrograde labeled ceils and anterograde labeled terminal branches in the nucleus of the solitary tract were studied. The labeled cells were found in the caudal part of the nucleus. The amount of the labeled cells in the cervical and thoracic injection cases out numbered that of the lumbar cases. In all the cases labeled ceils were most concentrated near the obex level, mainly located ventromedial to the tract. Some could be found ventral, ven- trolateral, lateral and medial to and in the vicinity of the tract. In the medial part of the nucleus labeled cells were limited in its ventral part dorsal to the dorsal motor nucleus of the vagus nerve. No labeling could be ascertained in the subnucleus parvocellularis. In the thoracic injection cases a group of labeled cells were discovered dorsolateral to the tract where only a few labeled ceils could be found in the cervical and lumbar cases. Labeled terminal branches largely accompanied the labeledcells. Thus the chance of establishing direct synaptic contact between spino-solitary fibers and the spinal projection cells of the nucleus of the solitary tract is great. At the level of obex a narrow band of terminal labeling along the dorsolateral border of the nucleus was identified. Except occasionally no labeled cells were found in this zone, an area probably related to cardiac function.

Objective To study the expression and clinical significance of the SALL4 in human gastric carcinoma tissues. Methods The expression of SALL4 in 91 samples of gastric carcinoma and 37 samples of normal gastric tissues was detected by RT-PCR,Western blot and immunohistochemistry,and its relationship with the clinical data were analyzed statistically.Results The positive expression rate of SALL4 in gastric carcinoma(74.7%)was significantly higher than that(18.9%)in normal gastric mucosa tissues(P <0.05).Moreover,with the decreased with the differentiation of gastric carcinoma,the positive expression rate of SALL4 was increased.The expression of SALL4 mRNA and protein in gastric carcinoma tissues were significantly higher than that in normal gastric tissues(P <0.050).The expression levels of SALL4 were relevant to lymph node metastasis(P =0.001),infiltra-tion depth(P =0.029)and the differentiation degree of gastric carcinoma(P =0.050).Conclusion SALL4 was highly expressed in gastric cancer tissues and relevant to lymph node metastasis,infiltration depth and the differentiation degree,which may have play an important role in the development of gastric cancer.