Standardized rotary residency training is an important part of clinical medical education. Traditional clinical teaching can't meet the rapid development of oncology medicine. In the rotary residency training in oncology department, we put forward the problems encountered in clinical practice, stimulate the interest and initiative of residence, the PBL teaching model is combined with the evidence-based medicine in the teaching process through the relevant training, literature review and discussion. By standardizing the treatment concept the residence's understanding of the basic theory and frontier knowledge of oncology was improved, the thinking innovation and clinical practice ability of the residency doctors were enhanced.

Objective:To evaluate the feasibility of integrating 3D photos and cone-beam computed tomography (CBCT)images and to assess the degree of error that may occur during the above process,and to analyze soft and hard tissue changes after orthognathic surgery using this new method.Methods:Ten patients with maxillofacial deformities were chosen.For each patient,CBCT scans and stereophotographic images were taken before and 3 months after surgery.3D photos were superimposed onto the CBCT skin im-ages using relatively immobile areas of the face as a reference.3D color maps and mean distances were used to evaluate the errors that might occur during the process.Two reference planes were set up using cer-tain points.The distances between Prn (pronasale),Sn (subnasale),Ls (labrale superior),ANS (anterior nasal spine),A (subspinale),UIE (upper incisor edge)to the coronal plane were calculated before and af-ter surgery.In order to verify the repeatability of this method,we examined the distances twice at two-week intervals.Paired t test was used to evaluate the reproducibility.Results:CBCT and 3D photos could be successfully fused with clinically acceptable errors.This new method could be used to evaluate soft and hard tissue changes after orthognathic surgery.The 3D color maps showed that the two images could be fused with minimal errors.The mean distances were within 0.3 mm,and the locations of landmarks on maxilla and mandible such as Ls,ANS,A,UIE changed significantly after orthognathic surgery (P <0.05). Landmarks on the nose such as Prn,Sn had little changes after surgery (P >0.1 ).The paired t test showed that the mean value and standard deviation were (0.08 ±0.98)mm.Conclusion:Fusing of CBCT and 3D stereophotographic images used as a new method in evaluating soft and hard tissue changes after orthognathic surgery was feasible and accurate.The virtual 3D composite craniofacial models permitted concurrent assess-ment of hard and soft tissues during diagnosis and treatment planning.Maxillary and mandibular locations had significant association with orthoganthic surgery while the nasal tissue was not simp affected by surgery.

Objective To investigate the clinical efficacy of ligation of intersphincteric fistula tract (LIFT) for the treatment of high anal fistula.Methods The clinical data of 77 patients with high anal fistula who were admitted to the Puren Hospital and Chaoyang Hospital from January 2011 to June 2012 were retrospectively analyzed.All the patients were treated using the LIFT method (LIFT group,37 patients) or fistulectomy + threaddrawing therapy (thread-drawing group,40 patients).The operation time,healing time,time and severity of postoperative pain,recurrence and anal sphincter dysfunction were compared between the 2 groups.The measurement data,the count data and the rank data were analyzed using the t test,chi-square test,and the rank sum test,respectively.Results The operation time of the LIFT group and the thread-drawing group were (21.4 ± 2.0) minutes and (20.6 ± 1.9) minutes,with no significant difference between the 2 groups (t =1.911,P ＞ 0.05).In the LIFT group,17 patients felt low-grade pain,no patient felt medium-grade or severe pain.In the thread-drawing group,7 patients felt low-grade pain,14 patients felt medium-grade pain,19 patients felt severe pain.The duration of postoperative pain in the LIFT group and the thread-drawing group were (3.0 ± 1.3) days and (14.1 ± 1.5)days,respectively.The severity and duration of postoperative pain of the LIFT group were significant lower and shorter than those of the thread-drawing group (u =-7.189,t =34.534,P ＜ 0.05).The healing time,anal scar area and anal sphincter function score were (26.0 ± 1.9) days,(1.24 ± 0.20) cm2 and 1 in the LIFT group,and (40.7 ± 2.8) days,(2.64 ± 0.25) cm2 and 4 in the thread-drawing group,with no significant difference between the 2 groups (t =26.574,26.868,Z =-7.513,P ＜ 0.05).The effective rate of the 2 treatment methods were 100％.The cure rate and recurrence rate were 51.4％ (19/37) and 5.4％ (2/37) in the LIFT group,and 42.5％ (17/40) and 2.5％ (1/40) in the thread-drawing group.There were no significant differences in the cure rate and recurrence rate between the 2 groups (x2=0.605,0.433,P ＞ 0.05).Conclusion LIFF method has higher cure rate for high anal fistula with short time of postoperative pain and healing,good anal sphincter function and low recurrence rate.

AlM:To observe the efficacy of using botulinum toxin A in the treatment of blepharospasm.
METHODS: Totally 113 patients with blepharospasm were managed with a local injection of botulinum toxin A, and the therapeutic effect was evaluated.
RESULTS:Fifty-nine cases ( 52. 2%) had a complete remission of symptoms, 49 patients ( 43. 4%) presented with obvious relieved spasm, 4 cases ( 3. 5%) were partially relieved and the 1 patient ( 0. 9%) remained unchanged. The total effective rate was 99. 1%. The time of beginning effect was 1-14d. The recover time was mostly in 14d. The average of therapeutic effect lasted 1-9mo. Adverse reactions such as mild palpebra dysraphism, palpebra ptosis and local subcutaneous blood stasis were found in 23 patients, and the symptoms disappeared in 2-4wk.
CONCLUSlON:Botulinum toxin A can effectively control medium and severe blepharospasm by injecting a little dose on local muscle.

The extracting technology of salidroside, tyrosol, crenulatin and gallic acid from Rhodiolae Crenulatae Radix et Rhizoma was optimized. With extraction rate of salidroside, tyrosol, crenulatin and gallic acid as indexes, orthogonal test was used to evaluate effect of 4 factors on extracting technology, including concentration of solvent, the dosage of solvent, duration of extraction, and frequency of extraction. The results showed that, the best extracting technology was to extract in 70% alcohol with 8 times the weight of herbal medicine for 2 times, with 3 hours once. High extraction rate of salidroside, tyrosol, crenulatin and gallic acid were obtained with the present technology. The extracting technology was stable and feasible with high extraction rate of four compounds from Rhodiolae Crenulatae Radix et Rhizoma, it was suitable for industrial production.
Chemical Fractionation ; methods ; Chemistry, Pharmaceutical ; methods ; Coumarins ; isolation & purification ; Drugs, Chinese Herbal ; isolation & purification ; Gallic Acid ; isolation & purification ; Glucosides ; isolation & purification ; Phenols ; isolation & purification ; Phenylethyl Alcohol ; analogs & derivatives ; isolation & purification ; Rhizome ; chemistry ; Rhodiola ; chemistry

Nowadays the role of genetic findings in determining the diagnosis, therapy and prognosis of acute myeloid leukemia (AML) has become more valuable. To improve and validate the detection of clonal chromosomal aberrations in leukemia, we designed a combined application of karyotyping with multiplex reverse transcription-polymerase chain reaction (RT-PCR) and fluorescence in situ hybridization (FISH), and addressed the expression and distribution of fusion genes among the subtypes of Chinese adult patients with de novo AML. Multiplex RT-PCR assays were performed on 477 samples from newly diagnosed AML patients, and cytogenetic data were obtained from 373 of them by R or G banding techniques and those in some cases were confirmed by FISH. The PCR products in some suspected cases were tested by two-directional sequencing. The results showed that except unqualified samples, fusion genes were detected by multiplex RT-PCR in 211 of 474 patients (44.51%), including AML1-ETO, CBFβ-MYH11, PML-RARα, PLZF-RARα, NPM-RARα, MLL rearrangements, BCR-ABL, DEK-CAN, SET-CAN, TEL-PDGFR, TLS-ERG, AML1-MDS1 (EVI-1). In 373 patients, who took both multiplex RT-PCR and karyotype analysis, the detection rate of chromosomal aberrations by using multiplex RT-PCR and karyotyping was 160/373 (42.89%) and 179/373 (47.98%) respectively, and the combination could optimize the detection rate of clonal genetic abnormalities to 216/373 (57.90%). The PCR results from 11 cases "normal" in karyotyping but abnormal in RT-PCR for MLL rearrangements were confirmed by two-directional sequencing. It is concluded that karyotype studies remain the cornerstone for genetic testing; conventional cytogenetics and molecular-based methods are complementary tests for the detection of clonal genetic aberrations in AML, especially for the cryptic or submicroscopic aberrations. Once a genetic marker has been identified by combined analysis, it could be used to monitor residual disease during/after chemotherapy, by quantitative RT-PCR and/or FISH.

The anti-apoptotic members of Bcl-2 family proteins, Bcl-2 and Mcl-1, are considered therapeutic targets of various cancers. In this article, we developed four hydrophobic tag (HyT)-based protein degraders of Bcl-2/Mcl-1, based on a Bcl-2/Mcl-1 dual inhibitor S1-6, and tested their capability in Bcl-2/Mcl-1 degradation and apoptotic induction in MCF-7 cells. Interestingly, different linkers in the HyT degraders led to selective Bcl-2/Mcl-1 degradation, though the degraders S1-D1-S1-D4 maintained the pan-Bcl-2 family binding capacity. Among them, S1-D2 and S1-D4, two compounds bearing a hydrophobic linker or a PEG linker, were observed to potently and selectively induce the ubiquitination and proteasomal degradation of Bcl-2 and Mcl-1 in living cells, with a degradation rate of more than 80% or 60%, respectively. Moreover, the HyT-based degraders showed increased lethality of cancer cells compared to the parent inhibitor S1-6, demonstrating that the advantage of degraders to the occupancy-based inhibitors.

OBJECTIVEEffects of ginsenoside Rb1, Rg1 and Re on neurotrophic factor signal transduction pathway using liposome-mediated transfection of eukaryotic cells approach.

METHODThe injury model was established by treating SH-SY5Y cells with 0.6 mmol x L(-1) of corticosterone (CORT) by 24 h. SH-SY5Y cell were pretreated with CORT for 30 min followed by co-treated with 120,60 and 20 micromol x L(-1) of Rb1, 120, 80 and 40 micromol x L(-1) of Rg1 and 120, 80 and 40 micromol x L(-1) of Re for 24 h. Cells viability was determined by Cell Counting Kit (CCK) assay. CREB expressing Luciferase reporter gene was constructed and transfected with plasmid containing hRaf, hcAMP, hAkt, hCaMK gene into human embryonic kidney (HEK293) cells using liposornal transfection reagent lipofection 2000. The expression of CREB before and after it addion of Rb1, Rg1 and Re was examined by Luc assay system and Western blotting.

RESULTCompared with normal control group, CORT significantly decreased the viability of SH-SY5Y cells to 67.21% (P < 0.01). CCK results show that Rb1 (60 micromol x L(-1)), Rg1 (80 micromol x L(-1)) and Re (80 micromol x L(-1)) on SH-SY5Y cells have significant protective effect (P < 0.01). Lucassay and Western blotting results show that the gene and protein levels of CREB increased significantly through the pathway of Raf and Akt with Rb1 and Rg1 (P < 0.01), Re can increase significantly the gene and protein levels of CREB through the pathway of Raf and CaMK II.

CONCLUSIONRb1, Rg1 and Re protects SH-SY5Y cells from CORT-induced damage and the neuroprotective mechanism may be associated with the Raf-CREB, Akt-CREB and CaMK II -CREB pathways.

Calcium-Calmodulin-Dependent Protein Kinase Type 2 ; genetics ; metabolism ; Cell Line ; Cell Survival ; drug effects ; Cyclic AMP Response Element-Binding Protein ; genetics ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Genes, Reporter ; Ginsenosides ; pharmacology ; Humans ; Panax ; chemistry ; Proto-Oncogene Proteins c-akt ; genetics ; metabolism ; Signal Transduction ; drug effects ; raf Kinases ; genetics ; metabolism

Objective To investigate the value of Real-time PCR in the diagnosis of invasive aspergillosis(IA) and to compare it with galactomannan antigen assays.Methods A retrospective study was performed on 110 episodes of hospitalization of 88 patients who were at risk of invasive aspergillosis at Peking University First and Renmin Hospital from May 2008 to December 2010.23 cases with diagnosis and clinical diagnosis IA were classified as infection group and 87 cases with suspected diagnosis and non-IA were classified as non-infeciton group according to the international criterion.Real-time PCR and gaiactomannan antigen detections were performed on 257 serum samples.A receiver operating characteristic curve (ROC)was developed based on the quantitative cycle numbers and an optimal cut off value of quantification cycle (Cq) was determined.The sensitivity (Se),specificity (Sp),positive predictive value (PPV) and negative predictive value (NPV) were calculated under different considerations among which McNemar chi-square tests were used for statistical analyze.Results The area under ROC curve of Real-time PCR for the diagnosis of IA was 0.91 (95％ CI:0.825-0.995) and the optimal cut off value of Cq was 39.45.The Se and Sp of one positive PCR,two positive PCR,one positive GM and two positive GM were 87.0％,79.3％ ; 58.3％,97.8％ ; 78.3％,63.2％ ; and 58.3％,82.6％,respectively.When one positive PCR was considered as the diagnostic criterion of IA,Real-time PCR was able to diagnose 100％ and 84.2％ of proven and probable IA cases,respectively.The Sp of one/two positive PCR were statistically higher than one/two positive GM (P ＜ 0.05),respectively.The Sp of two positive PCR was statistically higher than one positive PCR (P ＜0.05).The Se and Sp were 65.2％,89.7％ and 100％,52.3％ for one positive PCR combined one positive GM and one PCR or GM positive,respectively.Conclusions Real-time PCR assays have better sensitivities and specificities than GM in the diagnosis of invasive aspergillosis.When two PCR positive were considered,better specificity and positive predictive value were achieved.

Objective To study the diterpene alkaloids from the roots and processed products of Aconitum pendulum.Methods The chemical constituents were isolated and purified using silica gel column chromatography.Their structures were determined on the basis of NMR and mass spectra.ResultsTwelve compounds were isolated and identified as deoxyaconitine(1),3-acetylaconitine(2),aconitine(3),15?-OH-neoline(4),8-acetyl-15-hydroxyneoline(5),neoline(6),14-benzoyl-8-O-methylaconine(7),benzoylaconine(8),polyschistine D(9),benzoyldeoxyaconine(10),polyschistine A(11),and aconine(12).Conclusion Diterpene alkaloids are the main chemical constituents of A.pendulum and compounds 4—8 are found in this plant for the first time.Compared to raw materials,some boiled processed products change into new components:polyschistine D(9),benzoyldeoxyaconine(10),polyschistine A(11),and aconine(12).Identification of these components provides basis for the processing principles.