Resident doctor standardization training is the base of dermatologist training. We set up the specialist standardization training system according to our hospital's training practice. The dermatolo-gist standardization training mode was set up through tutor responsibility rule , internet learning platform and problem-based learning methods. The teaching level for dermatologists was upgraded by using above methods.

Objective To investigate the effects of leflunomide(A77 1726) on the proliferation and apoptosis of human keratinocytes. Methods Proliferating cell nuclear antigen (PCNA) of HaCaT cells was analyzed with crystal violet staining and immunohistochemistry. The moiphological change was assessed with hematoxylin and eosin staining. The changes of cell cycle and apoptosis rate were measured by flow cytome-try. Result Epidermal proliferation was inhibited by leflunomide, at concentration 5 ?mol/L or more, which was begun after 24 hrs and manifested by PCNA positive cell decreasing. With the increasing of time or dosage, the anti- proliferation effect of leflunomide was significant. Meanwhile, the PCNA positive cell de-creased respectively. There was no PCNA positive cell while the drug concentration achieved 200 ?mol/L. Therefore, leflunomide significantly inhibited the proliferation of HaCaT cells in a dose-dependent and time-dependent manner. The morphological change and cell cycle change was found but no change of apoptosis rate was measured. Conclusion Leflunmide can inhibit the proliferation of HaCaT cell, without the effect on its apoptosis.

BACKGROUND: Recently biodegradable hydrogel has been extensively used to delivery anticancer drug and bioactive macromolecule. However, to protect the activity of the bioactive macromolecule, we need to obtain series of hydrogel which have milder hydrogelation conditions and shorter hydroglation time.OBJECTIVE: To prepare enantiomeric poly(L-Lactic acid) (PLLA)-poly(ethylene glycol (PEG)-PLLA/ poly(D-Lactic acid) (PDLA)-PEG-PDLA stereocomplex hydrogel which has shorter hydroglation time, to physically encapsulate a model drug-lysozyme and sustained release it from the hydrogel. METHODS: Triblock copolymers of PLLA-PEG-PLLA and PDLA-PEG-PDLA were synthesized by ring-opening polymerization of L(D)-lactide using PEG as the initiator and Sn(Oct)2 as the catalyst. The triblock copolymers were characterized by 1H nuclear magnetic resonance, FT-IR and X-Ray diffractometry. A hydrogel was prepared from an aqueous mixture of PLLA20-PEG227-PLLA20 and PDLA21-PEG227-PDLA21 (10 wt% concentration) at room temperature for 12 hours. X-Ray diffractometry test was used to research the gelation mechanism. The release profile of the lysozyme as a model drug from the hydrogel was tested. The morphology of the freeze-dried hydrogel was investigated by scanning electron microscope. The cytotoxicity of the hydrogel was evaluated by 3-(4,5-dimethylthiazol-2-yl-2,5-diphenyl tetrazolium bromide) assay.RESULTS AND CONCLUSION: Triblock copolymers of PLLA-PEG-PLLA and PDLA-PEG-PDLA were obtained. Both the PEG and PLA blocks in the copolymers could crystallize, but the crystallization of the PEG block was predominant. The stereocomplex formation between the PLLA and PDLA blocks within the hydrogel was confirmed by the X-Ray diffractometry analysis. The release profile of the lysozyme from the hydrogel exhibited a sustained-release pattern with a duration period of 7 days. The hydrogel exhibited a 3D interconnected porous structure with 50-100 μm pore size after being freeze-dried. The mouse fibroblast cell viability percentage was 99.3% after the cells contacted with the 100% extracted liquid for 72 hours.

Objective To screen, analyze and predict microRNAs (miRNAs) related to systemic scle-roderma (SSc). Methods Differentially expressed miRNAs between tissue samples from 3 patients with SSc and 3 normal human controls were screened with a gene chip including 924 miRNAs. Target genes regulated by differentially expressed miRNAs were searched with bioinformatics method. Finally, miRNAs related to SSc were predicted. Results There were 24 miRNAs differentially expressed between tissue samples of SSc and normal controls, including 9 up-regulated miRNAs and 15 down-regulated miRNAs. Literature review disclosed that SSc was associated with target genes regulated by hsa-miR-206, has-let-7g, hsa-miR-133a, hsa-miR-125b, hsa-miR-40-5p and hsa-miR-23b. In particular, 15 target genes regulated by hsa-miR-206 were closely correlated with the pathogenesis of SSc. Conclusions In lesions of SSc, there is an expression of miRNAs related to the pathogenesis of SSc, which may include hsa-miR-206 as well as 5 other miRNAs.

Objective To evaluate the efficacy of preoperative biliary drainage (PBD) in the pancreaticoduodenectomy for malignant obstructive jaundice.Methods Database including PubMed,EMBASE,Cochrane Central Register of Controlled Trials,Academic Degree Dissertation Database and Conference Database were searched with malignant obstructive jaundice,pancreaticoduodenectomy,preoperative biliary drainage,comparative study.Literatures about the randomized controlled trials of PBD (PBD group) and efficacy of early surgery (ES group) in the pancreaticoduodenectomy were retrieved from January 2001 to December 2013,and then a Meta analysis was carried out based on the data.The count data were analyzed using the odds ratio (OR),relative risk (RR) and 95％ confidence interval (95％ CI),and the measurement data were analyzed using mean difference (MD) and 95％ CI.The heterogeneity of the data was analyzed using the I2 test.Data were integrated by fixed or random effect model.Results Twelve literatures including 1 982 patients were selected.There were 1 029 patients in the PBD group and 953 in the ES group.The results of Meta analysis showed that the operation time,volume of blood loss and rate of postoperative wound infection in the PBD group were significantly different from those in the ES group (MD =10.50,107.92,95％ CI:6.34-14.66,16.43-199.42;RR =1.62,95％CI:1.19-2.21,P ＜0.05).There were no significant differences in the postoperative mortality,incidence of pancreatic fistula,incidence of bile leakage,incidence of delayed gastric emptying and duration of hospital stay between the 2 groups (RR=0.69,95％CI:0.52-0.92;OR =0.68,1.35,95％CI:0.38-1.21,0.93-1.95;MD =0.69,95％CI:-0.67-2.05;RR =0.00,95％ CI:-0.02-0.01,P ＞0.05).Conclusion PBD in the pancreaticoduodenectomy for malignant obstructive jaundice cannot reduce postoperative mortality and incidence of complications in patients,and should not be used as the conventional management in the perioperative period.

Objective To estimate the efficacy of Xiaoyin decoction combined with calcipotriol ointment in patients with mild to moderate vulgaris psoriasis of blood heat type as well as their effects on the expression of interleukin (IL)-17,-22 and tumor necrosis factor (TNF) α.Methods Sixty patients with mild to moderate vulgaris psoriasis of blood heat type were enrolled in this study,and equally divided into 2 groups to be treated with Xiaoyin decoction and placebo respectively for 12 weeks.Calcipotriol ointment was applied in both groups of patients.Thirty healthy volunteers served as the controls.Bicolor flow cytometry was conducted to determine the proportion of peripheral blood Th17 cells,and enzyme linked immunosorbent assay (ELISA) to measure the serum levels of IL-17,IL-22 and TNF-α,in the controls and patients before and after treatment.Clinical efficacy was evaluated by psoriasis area and severity index (PASI) score.Results Increased proportion of Th17 cells and serum levels of IL-17,IL-22 and TNF-α were observed in the patients with psoriasis before treatment compared with the controls (all P ＜ 0.05).After treatment,a significant decrease was noted in the proportion of Th17 cells ((8.32 ± 1.28)％ vs.(14.24 ± 1.97)％,P ＜ 0.05) and serum levels of IL-17,IL-22 and TNF-α in the Xiaoyin decoction group (all P ＜ 0.05 ),but not in the placebo group.The PASI score was significantly different between the Xiaoyin decoction and placebo group after treatment (1.83 ± 1.28 vs.2.91 ± 1.42,P ＜ 0.05).The total response rate was 93.33％ in the Xiaoyin decoction group,significantly higher than that in the placebo group (73.33％,P ＜ 0.05).Conclusions There is an abnormality in the proportion of Th17 cells and serum levels of IL-17,IL-22 and TNF-α,which may be ameliorated by the combined treatment with Xiaoyin decoction and calcipotriol ointment.

Objective To reduce the management risk of operational narcotics in the operation room .Methods System of in-formation management for RFID turnover box was developed with RFID technology based on the establishment of narcotic operation pharmacy;system function was achieved through applying the response of RFID to the process of obtaining and employing modular med -icine cabinet for anesthesia connecting fingerprint door-lock system.Results Narcotic operation pharmacy was equipped with 6 kinds of medicine cabinet .A total medicine cabinets of 62 can meet the demands of 120 operations per day .Conclusion Modular medicine cabinet for operation based on the response of RFID technology decreases the cost of drug management and promote the efficiency and management standardization .

Objective:To summarize the surgical treatment of malignant carotid body tumor (MCBT).Methods:A retrospective analysis of 14 MCBT patients admitted at our hospital from Mar 2005 to Nov 2019 was made, and the imaging data, surgical records, perioperative complications and follow-up data were collected.Results:There were 8 males and 6 females, with an average age of (40.8±11.3) years. 10 patients underwent surgical resection of CBT, with one case undergoing tumor enucleation only, nine cases underwent internal carotid artery reconstruction, and all patients underwent intraoperative lymph node biopsy.Tumors were completely removed in all 10 patients. No perioperative death or cerebral infarction occurred. The intraoperative blood loss was (955±658.5) ml. Four patients had permanent nerve injury after surgery. The follow-up time ranged 1-132 months. There were no cases of cerebral infarction or death, and the reconstructed graft remained patent. Apart from the 2 patients who developed tumor metastasis after surgery, other patients recovered uneventfully with no disease progression.Conclusions:Surgery is still the main treatment for MCBT, but MCBT is large and Shamblin class is more advanced. Therefore, complete tumor removal and reconstruction of the carotid arteries are difficult. Surgery should seek to completely remove the tumor and neck lymph node biopsy should be performed to determine the lymph node metastasis.

In grating-based phase contrast imaging,the phase stepping technique is commonly utilized for data acquisition and signal retrieval from acquired intensity data.However,the algorithm efficiency with respect to the dark-field retrieval has yet to be sufficiently evaluated.Herein the algorithm efficiency of dark-field retrieval based on Cramér-Rao lower bound is evaluated.The theoretical analysis and numerical results demonstrates that fully efficient algorithm is currently available only for 3-step phase stepping technique,and other techniques with more phase steps are all sub-optimal.Quantitatively,the dependence of the algorithm efficiency on the phase step number and the visibility is investigated.It is shown that the phase stepping technique can nearly approach its theoretical optimal efficiency in the case of a low visibility.With a phase step greater than 5,the algorithm efficiency is only 77.4%in the case of a high visibility.The study can provide some reference for signal-to-noise ratio improvement and potential dose optimization in X-ray and neutron grating-based dark-field imaging.

Objective:To study the correlation between the acute-phase characteristics of motor evoked potential (MEP) and severities of spinal cord injury in patients with acute cervical hyperextension injury and central cord syndrome (CCS).Methods:Retrospectively analyzed were the data of 45 patients with acute cervical hyperextension injury and CCS (observation group) who had been admitted to Department of Orthopedics, Tongji Hospital Affiliated to Tongji University from December 2018 to July 2021 and 20 healthy controls. Examination of transcranial magnetic stimulation-induced MEP was performed in patients with CCS and healthy controls using a magpro x100 magnetic stimulator, and recording was conducted in bilateral abductor pollicis brevis (APB). The characteristics of MEP waveform latency, amplitude and motor threshold were described and compared between the healthy control and observation groups; the correlations were analyzed between the MEP latency and the severity of spinal cord injury [American Spinal Injury Association (ASIA) total score and motor function of Upper Extremity Motor Subscores (UEMS)] in the observation group. According to different MEP-induced states, the patients in the observation group were divided into a resting group ( n=19), a facilitation group ( n=18), and a no-waveform group ( n=8). The severity of spinal cord injury (ASIA total score) and the functional independence of the spinal cord (SCIM-Ⅲ score) were compared among the 3 groups to analyze the correlation between the MEP-induced state and the severity of spinal cord injury (ASIA total score). Results:The observation group had a significantly longer MEP latency [(30.16±6.32) ms], a significantly smaller amplitude [(0.54±0.30) mV] and a significantly higher motor threshold [(65%±11%)] than the healthy control group (all P<0.05). The MEP latency in the observation group was significantly correlated with ASIA total score ( r=-0.730, P<0.001) and UEMS ( r=-0.740, P<0.001). The ASIA total score and SCIM-Ⅲ score were significantly different among the 3 groups ( P<0.05), and the MEP-induced state was significantly correlated with the severity of spinal cord injury (ASIA total score) ( r=0.668, P<0.001). Conclusions:In patients with acute cervical hyperextension injury and CCS, the MEP latency is prolonged, the amplitude lowered, and the motor threshold enhanced. The MEP latency is strongly correlated with the severity of spinal cord injury and upper limb motor function. The MEP-induced state is also closely related to the severity of spinal cord injury.