Though the study on the simulated testing to the doctors both in China and Japan,we can find out the similarities and differences in these two educational systems,and further analyze the related factors,thus providing the valuable reference to improve the system of medical examination,reform the model of medical education and foster qualified practitioners.

Objective To investigate the effect of the gene polymorphism of cholesterol ester transfer protein (CETP) on the serum lipid levels in renal transplant patients.Methods Serum total cholesterol (TC),triglyceride (TG),low density lipoprotein (LDL),high density lipoprotein cholesterol (HDLC),apolipoproteins (Apo A1,B,E) and lipoprotein(a) [Lp(a)] were measured. Polymerase chain reaction-restriction fragment length polymophism (PCR-RFLP) was used to detect CETP gene polymorphism in renal transplant recipients.Results Serum levels of TC,TG,HDLC,LDLC,ApoB,ApoE in the renal transplant recipients were increased significantly after transplantation. The allele frequency and the distribution of the TaqⅠ(intron 1) and MSPⅠ(intron 8) genotypes showed no significant difference between the controls and the renal transplant recipients. The serum TG level was significantly higher in renal transplant recipients with the genotype TaqⅠB1/B1 than those in the patients with genotype TaqⅠ B1/B2 and B2/B2. But there was no statistical difference among the serum lipid levels in renal transplant recipients with different MSPⅠgenotypes.Conclusion The serum lipid levels were increased significantly in transplant after transplantation,and the patients with CETP genotype TaqⅠB1/B1 liable to develop hypertrglyceridemia.

Objective To study the effectiveness of conventional ultrasonography(US) and color Doppler flow imaging(CDFI) in differentiation of malignant and benign nodules of thyroid gland. Methods One hundred and fifty three consecutive patients with thyroid nodules who were to undergo surgery were examined before thyroidectomy by US and CDFI. The vascular pattern on CDFI was classified as follows: TypeⅠ,absence or little blood flow; Type Ⅱ, rich perinodular blood flow,absence or little inside; Type Ⅲ, marked intranodular and perinodular blood flow. Results On histology, 87 cases(263 nodules) were diagnosed as benign and 66 cases(109 nodules) as malignant. There was no correlation between solitary or multiple thyroid nodules and incidence of thyroid cancer. Differences of the US characteristic between the benign and malignant nodules of thyroid gland showed statistical significance (p

Objective To investigate the effect of apolipoprotein E (ApoE) gene polymorphism on lipid metabolism of renal transplant recipients before and after transplantation. Methods ApoE gene polymorphism was detected by Polymerase chain reaction restriction fragment length polymorphism and serum lipid levels were measured by biochemical method. Results Serum lipid levels in the recipients were increased significantly at 3rd month after renal transplantation, and were ulteriorly elevated at 6 th month and the first year. The patients with higher total serum cholesterol (TC) and triglyceride (TG) levels were only accounted for 2.9 % and 7.6 % respectively before renal transplantation, but for 28.6 % and 46.7 % respectively at 3rd month after renal transplantation ( P

In order to investigate the roles of MTA2 in the pathogenesis of ovarian epithelial cancer, the expression of MTA2 in 4 ovarian cell lines were detected by semi-quantitative RT-PCR and Western-blot assays. MTA2 expression in normal, borderline, benign and malignant epithelial ovarian tissues was immunohistochemically examined. The expression of MTA2 mRNA and protein was detected in all of 4 cell lines of ovarian epithelial cancer. The expression of MTA2 mRNA and protein was higher in strong migration cell lines than in weak migration ones. In borderline and malignant ovarian tissues tested, MTA2 staining was dramatically stronger than in normal and benign tissues (P < 0.01). The expression levels in malignant ovarian tissues were significantly higher than that in borderline epithelial ovarian tissues (P < 0.01). The expression of MTA2 was correlated with clinical stage, histopathological grade and lymph node metastasis. It was concluded that the high expression of MTA2 was associated with more aggressive behaviors of epithelial ovarian cancer. MTA2 provides a novel indicator of ovarian cancer.

AIM: To study the effect of hydrogen sulfide on wound healing of skin ulcer in diabetic rats . METHODS:Male SD rats were randomly divided into 3 groups, including non-diabetic control (NDC) group, untreated diabetic control ( UDC) group, and treated diabetic administration ( TDA) group.Diabetic rats were induced by intraper-itoneal injection of streptozotocin (STZ).After 1 week, wound healing model was prepared by making a round incision ( 2.0 cm in diameter ) on the dorsal skin in full thickness .The rats from TDA group received 2%sodium bisulfide ointment on the skin ulcer wound , and the animals from UDC and NDC groups received control cream .After 21 d of treatment with sodium bisulfide , blood samples were collected for biochemical analysis , including prothrombin time ( PT) , thrombin time (TT), and fibrinogen (FIB) in plasma, as well as the activity of superoxide dismutase (SOD) and the content of malondi-aldehyde ( MDA) in the serum.White blood cells ( WBC) and lymphocytes were also counted .Granulation tissues from the wound were processed for histological examination and Western blot analysis was used to detect heme oxygenase -1 ( HO-1) and tumor necrosis factor α(TNF-α) expression.RESULTS:Compared with UDC group, sodium bisulfide treatment accelerated wound healing of skin ulcer (P<0.01), and increased the activity of SOD in serum (P<0.01) in the diabet-ic rats.The declined number of WBC and lymphocytes , prolonged PT and TT , and decreased FIB levels in rats treated with sodium bisulfied were also confirmed .Pathological section showed that there were inflammatory cell infiltration , and irregu-lar and loose fibril alignment in the granulation tissue of rats from the UDC group , but there were regular fibril alignment and increased angiogenesis in the granulation tissue of rats from the TDA group (P<0.05).Furthermore, sodium bisulfide treatment raised HO-1 protein expression , and decreased TNF-αprotein expression in the diabetic rats .CONCLUSION:Hydrogen sulfide accelerates the wound healing of skin ulcer in the rats with diabetes .The beneficial effect of H 2 S may be associated with formation of granulation , anti-inflammation , and antioxidation .

Objective To establish an ion chromatography method to determine the content of galactosamine in heparin sodium sample. Methods The content of galactosamine was determined by the ratio of response value of galactosamine and glucosamine.The determination was performed on an Dionex ICS, and the separation was carried out on a Amino acids capture column (30 mm ×3 mm), Series protect column (30 mm × 3 mm)and analytical column CarboPac PA20 (150 mm ×3 mm).The mobile phase was 14 mM potassium hydroxide solution at a flow rate of 0.4 mL/min; the column tempertature was at 30℃; the injection volume was 10μL.Results Glucosamine hydrochloride had good linearity within the range of 1.013 -16.211μg/mL(Y=2.303 4X+0.824 2,r=0.998 3), the average accuracy was 92.7%, and RSD was 3.2%(n=9), the limit of detection was 0.101 3μg/mL, and the limit of quantitation was 0.337 7μg/mL.D-Galactosamine hydrochloride had good linearity within the range of 0.010 2 -0.162 5 g/mL, (Y=31.157X-0.114 4,r=0.999 3).The accuracy was 102.1%, RSD was 2.4%(n=9).The limit of detection was 0.001 0μg/mL, and the limit of quantitation was 0.003 4μg/mL.The determination of galactosamine in 3 batches of heparin sodium raw material was not detected, (0.02 ±2.1)%, (0.03 ±1.5)%, respectively, which were all lower than the limit value (1%) of United States Pharmacopeia regulation.Conclusion The method for the determination of galactosamine in total hexose amine is successfully developed , which could be used as reference for improvement of the quality standard of heparin sodium.

Objective To evaluate the ultrasonic characteristics of nasal bone absence at 16-34 weeks of pregnancy referring to fetal chromosomal anomalies. Methods The ultrasonic findings of the 20 fetuses with nasal bone absence at second or third trimester in Peking Union Medical College Hospital were reviewed referring to chromosomal karyotyping and labor induction or birth outcomes. Results The ultrasound features of the 20 fetuses including:(1) There were 17 fetuses showed bilateral nasal bones absence. The sonographic features were absence of hyper echo of nasal bone underneath the skin on either sagittal or transverse section. There were 5 fetuses showed multiple abnormalities:Four fetuses showed cardiac abnormalities (three showed atrioventricular septal defect, one showed ventricular septal defect, one showed ventricular septal defect with abnormal great vessels). One fetus showed duodenal obstruction′double bulbs′. The other minor abnormalities including short femur and humerus, increasing echogenetic bowels, aberrant right subclavian artery, mild unilateral ventriculomegaly, mild renal pelvic ectasia, outreached tongue, abnormal gestures of hands. (2) There were 3 fetuses showed unilateral nasal bone absence. The sonographic features were absence of hyper echo of either nasal bone on transverse section but with hyper echo on sagittal section. Two fetuses showed cardiac abnormalities (one fetus showed atrioventricular septal defect, one showed ventricular septal defect). The other minor abnormalities including short femur and humerus, hyper echogenetic bowels, increasing thickness of nuchal translucency or nuchal fold. Twelve fetuses were induced labor but only one had biopsy showed accordant result with ultrasound. (3) Karyotyping results:there were 9 of trisomy 21, 1 of 4p-and 7 of normal karyotype fetuses showed bilateral nasal bone absence. There were 2 of trisomy 21 and 1 of normal karyotype fetuses showed unilateral nasal bone absence. (4) Birth outcomes and follow-up:twelve fetuses induced labor but only one fetus had biopsy. Eight fetuses were born until term and 5 fetuses showed normal in follow-up. The results of twelve fetuses showed concordant with ultrasonic ifndings. Conclusions Characteristics of the nasal bone absence are absence of bilateral or unilateral nasal bones. If we ifnd nasal bone absence in prenatally ultrasound screening, the karyotyping should be recommended in order to detect chromosomal abnormalities especially trisomy 21.

Objective The aim of the study was to determine the placenta volume (PV) at 11-13+6 weeks of gestation by three-dimensional ultrasound (3DUS) in combination with birth weight, placenta weight, placenta volume at birth and maternal age, body mass index (BMI) additionally. Methods From June 2011 to July 2012, placental volumes were prospectively measured by VOCAL (Virtual Organ Computer-aided Analysis) method in 129 normal pregnancies of Peking Union Medical College Hospital at 11-13+6 weeks of Gestation, multiples of the median was calculated (MOM) after logarithmic10 transformation referring to different crown-rump length (CRL) groups. The normal pregnancies were selected without any combinations or fetal abnormalities, then recorded the birth weights, placenta diameters and thicknesses and placenta weight at delivery. The maternal basic status was also concluded in the study. Results Correlation analysis results: (1) The transformed placenta volume MOM showed a significant correlation (Spearman rho=0.200, P<0.05) with birthweight but not with placenta weight or placenta volume calculated as ellipsoid (Spearman rho=0.164, 0.112 respectively, P>0.05). (2) The birthweight showed significant correlations with placenta weight, placecnta volume and maternal BMI (Spearman rho=0.478, 0.361, 0.259 respectively, P<0.01). (3) The placenta weight at birth showed a significant correlation with placenta volume at birth (Spearman rho=0.467, P<0.01) and maternal BMI (Spearman rho=0.198, P<0.05). Regression analysis results: (1) Birth weight (g)=1136.9+1530.9×MOM+45.3×BMI-15.0×maternal age (r=0.29, P=0.01<0.05). (2) Placenta weight (g)=88.1+315.3×MOM+10.0×BMI+0.1×maternal age (r=0.27, P=0.02 <0.05). Conclusions The placental volume at 11-13+6 weeks of gestation has significant correlation with birthweight. This might assist in the identification of the high risk pregnancies caring large or low for gestational age fetuses.

OBJECTIVE To explore the effect of aqueous extract of Zheng Chaihu Yin(ZCH)on paracetamol(acetaminophen,APAP)-induced hepatotoxicity. METHODS Male ICR mice were divided into three scenarios randomly:the single treatment dose of ZCH,multiple treatment or pretreatment dose of ZCH. Each scenario had a up control group and an APAP model group,while single treatment dose of ZCH group had a ZCH group at the same time. The dose of APAP and ZCH was 500 mg·kg-1 and 36 g · kg- 1,respectively. 24 h after the last administration,plasma and liver samples were prepared. Ultra- performance liquid chromatography/quadrupole- time- of- flight mass spectrometry (UPLC-Q-TOF-MS)based metabolomics profiling was used to examine changes in plasma after expo?sure to ZCH,APAP or co-exposure to ZCH and APAP. Glutamic pyruvic transaminase (GPT) and glutamic oxaloacetic transaminas (GOT) values were determined by a biochemical auto analyzer in plasma. Histopathologic changes in the liver were observed and the area was calculated after HE staining. The data were analyzed with SPSS16.0 statistical software and the results were compared with the test between the two groups to find biomarkers. Also,SIMCA software was used for partial least squares-discriminant analysis (PLS-DA) pattern recognition. RESULTS Compared to control group, APAP dosing alone caused an increase in plasma transaminases and alterations in multiple metabolic pathways. Compared to APAP group,decrease in plasma transaminases was noted when ZCH was administered after or prior to APAP. Histopathologic results showed that in the single treatment group, multiple treatment group and pretreatment group,ZCH could alleviate the liver damage induced by APAP from (32.3 ± 12.0)% to (14.2 ± 9.9)%,(8.6 ± 7.9)% to (5.2 ± 1.7)% and (32.5 ± 10.0)% to (5.2 ± 6.4)%(P<0.05). Similarly,the PLS-DA of the LC-MS data showed that the groups dosed with APAP alone were the most distinct from controls,while animals dosed with ZCH prior to or after APAP treatment were located near control group. Metabolic spectrum results showed that ZCH could restore the changes in endogenous substances including lipid metabolism,amino acid metabolism,sugar metabolism and energy metabolism induced by APAP to normal. CONCLUSION ZCH water-extraction plays major roles in the regulation of metabolism on APAP-induced liver injury. These studies demonstrate that UPLC-Q-TOF-MS-based metabolomic analysis can be sensitively and accurately predict the initiation and progres?sion of liver injury and greatly contribute to a better understanding of the hepatoprotective effects of ZCH in a clinical environment.