Clinical medical postgraduate education is an important part of higher education in China.We analyzed the current status,major problems existed,direction of the reform and the prospect in the training system.Unifying cultivation criterion,diversifying form of academic degree system,making selection standard strict for advisors and decreasing the proportion of research work for doctors were considered as the effective measures to address these issues.

Objective To explore the cognitive function,feature of P 300 event-related potentials and the relationship of them in children with epilepsy.Methods Auditory P 300 was measured by oddball paradigm and intelligence quotient was tested by WSIC-RC in 38 children with epilepsy.Results 1. The rates of FIQ less than normal IQ were 65.8 %, impaired intelligence 28.9 % in patient group. 2.The latencies and the amplitudes of P 300 were significantly delayed and decreased respectively in both patient groups (P

Lymph node metastasis is one of the main methods of metastasis and it affects the the prognosis of patients with gastric cancer. It is reported that the rate of tumor recurrence in patients with tumor-negative lymph nodes detected by routine pathology is approximately 25%, which is a factor that affects the survival. It is reported that the phenomenon associates with lymph nodes micrometastasis closely. The article will tou-ch the latest development on micrometsstasis.

Objective To evaluate the efficacy and prognostic factors of combined medical thera-py with amitriptyline, cimetidine and intravesical resiniferatoxin post-hydrodistention for patients with painful bladder syndrome/interstitial cystitis (PBS/IC). Methods Twenty-nine patients with PBS/ IC according to NIDDK criteria were enrolled. There were 6 males and 23 females with average age of 52±14 years and average duration of symptoms of 3.7±1.9 years before diagnosis. The patients were divided into 2 groups. Non-concomitant disease group included 10 cases without concomitant disease and 7 cases with unrelated diseases such as hypertension and diabetes mellitus. Concomitant disease group included 5 cases with history of bladder neck incision, 3 cases with history of transurethral re-section of the prostate, 2 cases with history of gynecologic disease and 2 cases with history of gyneco-logic operation. Patients of concomitant disease group still had the painful bladder syndrome after 3 months when the primary disease had been cured. All patients were treated with amitriptyline (25 mg twice a day), cimetidine (800 mg per day) and intravesical resiniferatoxin (1-2 times) post-hydrodis-tention. The primary assessment index was O'Leary-Sant score. The secondary assessment index was pelvic pain score, mean voiding times per day and mean volume of each micturating. The data of pa-tients before treatment and after follow-up≥9 months were collected to evaluate the efficacy and prog-nostic factors of the combined treatment. Results The mean follow-up for all patients was 9.2±6.0 months. Patients were followed up at month 1 and month 6 after discharge. Then, patients would be followed up at each 6 months interval. The overall remission rate was 65.5% (19/29). Complete re-mission rate was 41.4% (12/29). Partial remission was 24. 1% (7/29). Non-remission rate was 34.5% (10/29). For all patients, the pre-treatment mean voiding times per day were 29±15, voiding volume each time was 64±36 ml, average O'Leary Sant score was 23. 8±4.8, and they were signifi-cantly improved post-treatment (17±12 times, 172±108 ml, 13. 3±10.4, respectively, P<0.001). O' Leary-Sant score of concomitant disease group was lower than that of non-concomitant disease group (21.5±4.7 vs 25.4±4.3, P=0.030). However, complete remission (8.3%, 1/12) of con-comitant disease group was lower than that(64. 7%, 11/17) of non-concomitant disease group (P= 0. 003). In independent variables of patients age, sex, duration of symptom, O'Leary Sant score pre-treatment, and whether or not with concomitant disease, according to the results of Logistic Regres-sion, patients with concomitant disease would have poor prognosis (P-0.008, partial regression coef-ficient was -3. 899, OR was 0. 020). Conclusions Treating PBS/IC patients with amitriptyline, ci-metidine and intravesical resiniferatoxin post-hydrodistention is effective. However, concomitant dis-eases such as gynecologic disease or urethra operation history can impair the effectiveness of these treatment.

ObjectiveTo evaluate the efficacy and safety of Sirolimus (SRL) in immunosuppression following liver transplantation. Methods SRL was applied in 21 patients totally.Indication for adoption was Tac-related nephrotoxicity (4/21), suspiciously Tac-related hepatoxicity (8/21), Tac overdose (3/21), renal insufficiency pre-operation (2/21), or cancer (4/21). Median follow-up was 25. 4 months. Results SRL provided an adequate prophylaxis against rejection in all study patients, with one case of acute rejection. Sirolimus was Withdrawn in 2 cases due to its sideeffect. Tat-induced hepatoxicity in 6 cases and nephrotoxicity in 3 cases were relieved significantly.Conclusions SRL given alone appears to be an effective primary immunosuppressant regimen fororthotopic liver transplantation patients. Early conversion contributes to significant improvement of Tac-related hepatoxicity and nephrotoxicity.

Animals ; Benzylisoquinolines ; pharmacology ; Brain Ischemia ; metabolism ; Interleukin-1beta ; metabolism ; Interleukin-8 ; metabolism ; Male ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism

Humans ; Infant ; Lymphohistiocytosis, Hemophagocytic ; complications ; Male ; Mucocutaneous Lymph Node Syndrome ; complications

A strain of canine parvovirus (CPV) was isolated from feces of an ill puppy in an animal hospital in Wuhan, China. It was designated as CPV/WH02/06. This isolate was identified as serotype CPV-2a by the hemagglutination test, CPV Ag detection strip, electron microscopy, and PCR. The vp2 gene was cloned and sequenced and assigned GenBank accession number EU377537. A 1242 bp segment of the 5' region of the vp2 gene was cloned and inserted into the binary vector pBI121 and used for Agrobacterium-mediated tobacco transformation. Transgenic tobacco plants were selected on MS medium supplemented with 100 μg/mL kanamycin and 100 μg/mL timentin. Integration of the vp2 gene into the tobacco genome was confirmed by PCR using T1 progeny plants, and the expression of the VP2 protein was confirmed by Western blotting.

Objective To explore the effective therapeutic methods for hepatolithiasis.Methods We retrospectively analyzed the clinical material of 178 hepatolithiasis patients who underwent surgical therapy.Among the 178 patients,107 patients were treated with T-tube drainage(including 7 patients with left hepatic lobe or quadlrate lobe resection),and 71 patients were treated with bile duct-intestinal anastomosis(including 11 patients with left hepatic lobe or quadrate lobe resection).Results Recurrence rate of postoperative angiocholitis in the two groups was 49.5 % and 24 % respectively,and the reoperation rate was 28.7 % and 8 % respectively.Conclusions The key to prevent recurrent angiocholitis and reduce the reoperation rate is to relieve biliary tract stricture,remove the focus of infection and provide unobstructed bile duct drainage.

BACKGROUND:Silk fibroin, as an inorganic mineralization template, can induce hydroxyapatite crystal growth, and combined with nano-hydroxyapatite can simulate the inorganic and organic components of natural bone, which is expected to become the most ideal bone graft material. OBJECTIVE:To prepare the silk fibroin/nano-hydroxyapatite composite material and investigate its treatment outcomes in spinal fusion. METHODS:Silk fibroin/nano-hydroxyapatite composite was synthesized by the co precipitation method with silk fibroin and calcium phosphate as raw materials, to simulate the structure and composition of the bone tissue. The crystal phase composition and microstructure of the composite scaffold were analyzed by X-ray diffraction and transmission electron microscope. Osteoblasts were seeded onto the composite, and the cel adhesion and proliferation were observed under inverted microscope. The lumbar posterolateral spinal fusion models were established in the New Zealand rabbits, fol owed by treated with autologous bone graft (control group) and composite (composite group), respectively. The gross, radiological and histological observations of bone fusion were compared between groups. RESULTS AND CONCLUSION:Silk fibroin/nano-hydroxyapatite composite appeared to be fascicular under electron microscope, the length was 200-500 nm and width was 20-30 nm. And the hydroxyapatite was about 200 nm in length and 50 nm in width. X-ray diffraction showed that the bottom of diffraction peak was wide, and the peak was not sharp. Transmission electron microscope found that cel s adhered wel onto the composite scaffold at 2 days. Scanning electron microscope showed that the polygonal, oval or conical cel s covered most of the composite scaffold holes, presented obvious mitotic phase at 5 days. The third generation of MC3T3-E cel s tended to rise at first 3 days, and then decreased. The fusion site of L5-6 transverse process was strong, and non-bony fusion occurred. At the same time, numerous new bones were visible in the composite group. Hematoxylin-eosin staining showed a large number of cel aggregation, abundant osteoblasts surrounding cartilage, and the bone tissues were in a regular arrangement in the composite group. Moreover, irregular trabecular bone with medul ary cavity was found in the composite material. These results suggest that the silk fibroin/nano-hydroxyapatite composite with the similar structure and composition of natural bone can achieve satisfactory fusion effect in the rabbit lumbar posterolateral fusion.