Apoptosis ; Gene Expression Profiling ; Hepatic Stellate Cells ; pathology ; Humans ; Liver ; metabolism ; Liver Cirrhosis ; genetics ; metabolism ; pathology ; Liver Diseases ; genetics ; metabolism ; pathology ; MicroRNAs ; metabolism ; physiology ; Transforming Growth Factor beta1 ; metabolism

We report a case of a large asymptomatic Rathke cleft cyst in a 14-year-old boy. This cyst was of considerable size, measuring 2x1.8x1.8 cm, but did not produce any symptoms and was confined to the suprasellar area. The cyst wall was lined by pseudostratified ciliated columnar epithelium with goblet cells. The lining epithelium of the Rathke cleft cyst was immnoreactive for cytokeratin, EMA and CEA.
Cysts

BACKGROUND:Hepatocyte transplantation as an effective method for liver failure has been confirmed by animal models and clinical application.However,limited source and poor proliferation of hepatocyte graft limit its development.Studies have shown that bone marrow mesenchymal stem cells(MSCs)have potentials to differentiate into hepatocyte and bile epithelial celts,with strong proliferation.OBJECTIVE:To explore the therapeutic effect of bone marrow MSCs transplantation on liver failure of New Zealand white rabbits.METHODS:Adult male New Zealand rabbits were treated with D-galactosamine,and 3 mL hepatocyte suspension(1×109/L)was injected into the liver of transplantation group,but the control group was injected with the same volume of culture solution with no bone marrow MSCs.Alanine aminotransferase(ALT)and aspartate aminotransferase(AST)activity was detected 48,72 hours,1,4 weeks following transplantation,and pathological detection was performed at 4 weeks.RESULTS AND CONCLUSION:The liver functional index following transplantation of bone marrow-derived MSCs transplantation was significantly decreased,and ALT and AST activity at 4 weeks was significantly less than the control group(P ＜ 0.05).At 4,the transplantation group displayed disorderly hepatic cord,hepatocyte swollen and degeneration,necrosis,accompanied by bleeding and inflammatory cell infiltration.In addition,the hepatic lobule structure was detectable,and regenerative hepatocyte increased among necrotic hepatocyte;small cells with large ratio of nucleus and cytoplasm at header,central vein and surrouding necrosis focus extended to the liver tissues.

Purpose: This study to identify valuated the competency in nursing leadership among new nurses through the perception of nursing managers. Methods: This a total of 136 nursing managers from two general hospitals in the Seoul metropolitan area were included in this study. Nursing leadership competencies in new nurses were measured using the Student Leadership Practices Inventory developed by Kouzes and Posner. We identified priorities in the development of nursing leadership competencies for new nurses. Results: The overall importance and performance of nursing leadership competencies for new nurses were assessed by nursing managers at an average of 3.92±0.37 and, 2.84±0.50, respectively. Of the 30 nursing leadership competencies, 11 would need to be maintained and strengthened, seven would need to focus on improvement efforts, and 11 would have low priority. The last one was overdone. Conclusion Of the 18 items of high importance based on the nursing leadership competencies among new nurses identified, for seven items indicating low performance, the performance of nurses should be improved by introducing nursing leadership development programs after they enter the work environment. Eleven low-priority nursing leadership competencies require a long-term strategic approach and need to spread the understanding of nursing leadership throughout the nursing organization.

Sixty-three patients with permanent sigmoid colostomy were surveyed to evaluate their satisfaction and complications with the "irrigation technique" and the "atural evacuation" of the colostomy management (irrigation technique; 32 patients, natural evacuation; 31 patients). All patients had colostomy for at least 12 months without disease recurrence. Each patient was interviewed in addition to standard questionnaire. The irrigation was not associated with any major complication including colonic perforation. The irrigation was used younger age group than the natural evacuation (53+/-10 vs. 62+/-12, P=0.01). The frequency of bowel movement was lower in the irrigation than in the natural evacuation (5.1+/-2.5/wk vs. 10.8+/-9.0/wk, P=0.04). Five patients (16%) of the irrigation experienced spontaneous bowel action but only one patient suffered from it. The time spent for managing irrigation was 59+/-13 minutes. Twenty-three patients (74%) of the natural evacuation suffered from one or moreproblems such as expensive apparatus, leakage, skin irritation or odor. Sixteen patients (52%) of the natural evacuation and 2 patients (6%) of the irrigation were restricted in social activity (P=0.0001). Thirteen patients (42%) of the natural evacuation and 1 patient (3%) of the irrigation were dissatisfied with colostomy management (P=0.002). Thus, the irrigation technique seems to be more effective and satisfactory method for managing colostomy without compromising patient's social activity when it is performed in appropriately selected patients.
Colon ; Colon, Sigmoid ; Colostomy* ; Humans ; Odors ; Surveys and Questionnaires ; Rectal Neoplasms ; Recurrence ; Skin

OBJECTIVETo study the relationship between TCM syndrome type and HBV-DNA in serum and peripheral blood mononuclear cells (PBMCs) in chronic hepatitis B (CHB) patients.

METHODSThe serum HBV markers,HBV-DNA levels in serum and PBMCs, were quantitatively detected in 220 CHB patients by PCR method, and TCM syndrome type of 205 patients were differentiated.

RESULTSArranged from low to high, the percentages of CHB patients with the serum HBV-DNA > or = 1.0 x l0(5) copy/mL (high viral loading) in the five syndrome types were as follows: damp-heat retention in middle-jiao syndrome (DHRS, 55.2%), blood stasis blocking collateral syndrome (BSBC), Gan-Shen yin deficiency syndrome (GSYS), Pi-Shen yang deficiency syndrome (PSDS) and Gan stagnation with Pi deficiency syndrome (GSPS, 82.5%), the difference was significant between DHRS and GSPS; those with HBV-DNA in PBMCs infection were: GSYS (27.3%), DHRS (34.3%), BSBC (53.1%) and GSPS (77.2%). The percentage in GSPS was the highest, which was significantly different to that in other syndromes.

CONCLUSIONAmount of serum HBV-DNA and PBMCs HBV-DNA infection has certain correlation with the TCM syndrome type of CHB. The highest percentage of patients with HBV-DNA > or = 1.0 x l0(5) copy/mL and PBMCs HBV-DNA infection presented in CHB patients of GSPS type. We should pay more attention to strengthen genuine qi to eliminate pathogenic factors in treatment of CHB.

Adolescent ; Adult ; Aged ; DNA, Viral ; blood ; Diagnosis, Differential ; Female ; Hepatitis B virus ; genetics ; Hepatitis B, Chronic ; pathology ; therapy ; virology ; Humans ; Leukocytes, Mononuclear ; virology ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Syndrome ; Young Adult

OBJECTIVETo analyze the chemical constituents of supercritical carbon dioxide extraction products from Cnidium monieri.

METHODFour-factor and three-level orthogonal experimental design was used to optimize the SFE conditions as guided by the content of total coumarins in the extract. The chemical constituents were separated and identified by recrystalization.

RESULTOptimum extraction process was established: 25 MPa as extraction pressure, 50 degrees C as extraction temperature, 6.5 MPa as separation pressure and 60 degrees C as separation temperature.

CONCLUSIONChanges in extraction pressure, temperature, time, pulverized degree and separation pressure affect the extracting results remarkably. The two kinds of chemical constituents were separated by recrystallization from C. monieri and identified by the methods of UV, IR, MS, NMR.

Chromatography, Supercritical Fluid ; Cnidium ; chemistry ; Coumarins ; chemistry ; isolation & purification ; Fruit ; chemistry ; Furocoumarins ; chemistry ; isolation & purification ; Plants, Medicinal ; chemistry

Recently nitric oxide (NO) is known as a bioactive molecule modulating secretory activity in various glandular tissues. Previously we have localized bNOS, a neuronal isoform of nitric oxide synthase, in the pancreatic tissue, particularly in the pancreatic islet of Langerhans and in the neurons of intrapancreatic ganglia. It implies that NO may play the important roles in regulation of pancreatic secretion by transmitting the neuronal signals from autonomic nervous system to endocrine and/or exocrine system of pancreas. We also revealed that NO is involved in regulation of insulin secretion and its synthesis. The present study was designed to elucidate the regulatory effect of NO on the pancreatic exocrine secretion by way of insulo-acinar axis. For the experiment, we observed modification of amylase secretion in the rats treated with N(G)-nitro-L-arginine-methyl ester (NAME), a potent NOS inhibitor. In addition, we observed the expression of clusterin which is known to be a protein associated with cell viability in order to assess the cytotoxic effect of NO. The present study showed that the intra-pancreatic NO is involved in regulation of amylase secretion of pancreatic acinar cells. Amylase immunoreactivity was significantly decreased at 60 and 90 min after NAME injection, although little change was seen during 30 min after treatment. However, the amylase immunoreaction was recovered toward the normal range at 120 min after NAME treatment. In electron-immunolabeling experiment, we observed the secretory granules with higher electron density, but less immunolabeling for amylase at 60~90 min after NAME treatment, while they restored normal feature and labeling density at 120 min. Clusterin expression increased along with the time course of experiment and demonstrated a highest level at 120 min after NAME injection. Taken together, the above results indicate that lowered level of NO induced by NAME treatment reduces amylase secretion of acinar tissue. It implies that increased level of NO in physiological range may stimulate pancreatic exocrine secretion.
Acinar Cells ; Amylases ; Animals ; Autonomic Nervous System ; Axis, Cervical Vertebra ; Cell Survival ; Clusterin ; Ganglia ; Insulin ; Islets of Langerhans ; Neurons ; Nitric Oxide Synthase ; Nitric Oxide* ; Pancreas ; Rats ; Reference Values ; Secretory Vesicles

Clinical practice record manual contains the information about medical students' clinical studying process, clinical teaching process and the concept of clinical teaching management. First, we should design and optimize clinical practice record manual and then collect and analyze the relevant data. In addition, we should give the analysis to the students, teachers, clinical departments and hospitals on time, and at the same time, get their feedback. Through these steps, we can find and solve the problem efficiently and promote the quality of teaching, learning and management of clinical internship, so as to improve the clinical teaching quality control standard.

This paper is based on conflicting issues in clinical teaching between undergraduates and residents, also around cultivating goals on clinical competency. In order to enhance medicine-education collaboration and conception of continue education and improve clinical teaching management system for integration of undergraduates and residents, five measures should be put into practice. First, define the re-sponsibility of physicians at all levels. Then, accord training standards for clinical teachers' admission. Next, accord clinical teaching norms and documents. In addition, clinical teaching assistants are selected from intermediate physician for guiding clinical teachers. Finally, explore the integration of clinical teaching mood for training between undergraduates and residents, to promote the connection of clinical teaching for graduates and residents.