The clinical internship is an important transitional period for humanistic spirit cultivation of the medical students.But in this period there are some problems exposed.For example,there is the lack of transitional link in management; the clinical instruction doctors lack educational consciousness or guidance ability,the medical students pay little attention to enhancing the individual humanistic spirit level and there is a gap between theory and practice of humanistic spirit for them.Strengthening training for students,attaching importance to training,selection and incentive of clinical instruction doctors and revising handbook of clinical internship will help to solve the problems.

This study examined the association of expression of vascular endothelial growth factor (VEGF), a promoter of angiogenesis, with endothelium dysfunction in preeclampsia. The level of VEGF protein and mRNA in the placenta and peripheral blood samples of 30 preeclampsia patients and 30 normotensive pregnant women was measured by immunohistochemistry, real-time reverse transcriptase-polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA), respectively. VEGF expression in the human umbilical vein endothelial cells (HUVECs) was blocked by small interfering RNAs (siRNAs). The monolayer barrier function of HUVECs was determined by measuring the fluorescence intensity of BSA that crossed the HUVEC monolayers. The cell proliferation and cell-secreted nitric oxide (NO) level were detected by MTT method and nitrate reductase assay, respectively. The results showed that VEGF was expressed in the syncytiotrophoblasts and endothelial cells of vessels and capillaries in the placenta tissue. The serum level of VEGF in the preeclampsia patients was significantly decreased as compared with that in normal pregnant subjects, although VEGF mRNA expression in the placenta tissue of preeclampsia patients remained still high. Moreover, VEGF deficit could lead to endothelium cell dysfunction, and the administration of VEGF could protect endothelium cells from injury. It was concluded that lack of VEGF contributes to endothelium dysfunction, which may lead to the occurrence and development of preeclampsia.

Objective To explore the causes and preventive measures of symptomatic intracranial hemorrhage in 217 patients with acute cerebral ischemic stroke treated with local intra-arterial urokinase. Methods From February1999 to June 2004, 217 patients were treated for acute ischemic stroke with local intra-arterial urokinase in our hospital. Factors associated with symptomatic intracranial hemorrhage of intra-arterial thrombolysis were analyzed by Stepwise logistic regression to identify some factors relating the prediction symptomatic intracranial hemorrhage. Results Symptomatic intracranial hemorrhage occurred in 8 cases (3.7%). Predictors of the symptomatic intracranial hemorrhage were the elevated systolic blood pressure before therapy (odds ratio, 1.096; 95% CI, 1.006 to 1.194) and urokinase (UK) treatment (odds ratio , 1.068; 95% CL, 1.053 to 1.247). Risk of secondary symptomatic intracranial hemorrhage was increased with elevated systolic blood pressure. Other factors like age, initial treating time, NIHSS, diabetes and collateral circulation did not predict the symptomatic intracranial hemorrhage respectively. Conclusions Predictors of symptomatic intracranial hemorrhage after local intra-arterial infusion of urokinase for acute ischemic stroke were the elevated systolic blood pressure before therapy and urokinase (UK) treatment.

Objective To explore the protective effect of brain-derived neurotrophic factor (BDNF) on cultured rat cortical neurons against glutamate (Glu)-induced injury and its mechanism. Methods Cortical neurons were primarily cultured from 1-day-old newborn Sprague-Dawley rats and then cultured for 7 d. The cortical neurons were divided randomly into 3 groups: control group,Glu group and BDNF group after identified with neuron-specific enolase (NSE) immunostaining. The cells of BDNF were treated with 50 ng/ml BDNF on day 6 for 24 h followed by cultured with 50 ?mol/L Glu for 0.5 h. While,the cells of Glu group were cultured with 50 ?mol/L Glu for 0.5 h on day 7. The control cells received no such treatments. On day 8,cell viability were determined by the colorimetric MTT assay. The morphological features of the neuron cells were observed under AO/EB fluorescence microscopy. Expressions of p75NTR,JNK and ERK were observed using Western blot analysis. Results On day 8,the primary cortical neurons grew well. BDNF protected cortical neural cells from Glu injury. Cell viability of BDNF group was (1.14?0.06),significantly higher than that of Glu group (0.72?0.10,P

Near infrared chemical imaging (NIR-CI) is an emerging technology for rapidly analyzing the critical quality attribute of Chinese materia medica (CMM). It integrates NIR spectroscopy with chemical imaging. In this paper, it provided a systematic introduction to NIR-CI, such as the core part of instrument, the reliability, transformation, analysis and application of high-dimensional data acquisition. In addition, current studies of NIR-CI application in pharmaceutical field were analyzed. Finally, future opportunities and challenges of NIR -CI applications in the quality control of CMM preparation were prospected.

Objective To investigate the clinical efficacy of complete mesogaster excision in the radical gastrectomy for gastric cancer.Methods The clinical data of 100 patients with distal gastric cancer who were admitted to the First Affiliated Hospital of Harbin Medical University from January 2011 to December 2012 were retrospectively analyzed.All the patients underwent complete mesogaster excision in D2 radical gastrectomy for gastric cancer.The operation quality was evaluated according to operation time,volume of intraoperative blood loss,mean number of lymph nodes dissected,time to flatus,volume of drainage and duration of postoperative hospital stay.Patients were followed up by outpatient examination and telephone interview till May 2014.Results Complete mesogaster excision in the radical gastrectomy for gastric cancer was successfully carried out on all the 100 patients.The operation time,volume of intraoperative blood loss,mean number of lymph nodes dissected,time to flatus,volume of drainage and duration of postoperative hospital stay were (118 ± 34) minutes (range,90-160 minutes),(80±25)mL (range,45-135 mL),38± 10 (range,25-52),(3.0 ± 1.2)days (range,1.5-4.5 days),(62±15)mL (range,15-85 mL) and (7.0±1.5)days (range,4.0-11.5 days),respectively.According to the postoperative pathological results,there were 36 patients with high differentiated gastric carcinoma,38 with moderate and/or low differentiated gastric carcinoma,17 with low differentiated gastric carcinoma and 9 with signet ring cell carcinoma.After operation,3 patients had gastroplegia,2 with poor healing of abdominal incision,2 with duodenal stump fistula,1 with pancreatic fistula,and all of them were cured by conservative treatment.All the 100 patients were followed up for a mean time of 25.6 months (range,17.6-39.2 months).There was no tumor recurrence.Conclusions Complete mesogaster excision in the radical gastrectomy for gastric cancer is safe and feasible,with the advantage of minimal trauma,low morbidity and quick recovery during the follow up.

ObjectiveThe purpose of this study was to investigate the clinical significance of HMGB1 and Smac/DIABLO protein expression in epithelial ovarian cancer.MethodsImmunohistochemistry (IHC) and terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) staining were used to detect the protein expression of HMGB1,Smac/DIABLO and cell apoptosis in 45 epithelial ovarian cancers by tissue microarray.ResultsThe protein expression of HMGB1 in epithelial ovarian cancers was significant higher than benign cancers and normal ovarian tissues( P ＜0.05).The protein expression of HMGB1 was related to the lymph node metastasis,which had a negative correlation with the cell apoptosis index ( rs =-0.583,P =0.000).The protein expression of Smac/DIABLO in epithelial ovarian cancers was significantly lower than benign cancers and normal ovarian tissues( P ＜0.05) ; the protein expression of HMGB1 in epithelial ovarian cancers had a negative relationship with protein expression of Smac/DIABLO( rs =-0.40,P =0.006).ConclusionsThe over-expression of HMGB1 in epithelial ovarian cancers may play an important part in the metastasis of the epithelial ovarian cancers.The over-expression of HMGB1 and the low-expression of Smac/DIABLO may take part in the occurrence and development of the epithelial ovarian cancers through abnormal cell apoptosis.

Objective To investigate the roles of theaflavins(TFs) in airway mucus hypersecretion induced by human neutrophil elastase(HNE). Methods Human lung adenocarcinoma cell A549 was stimulated by HNE for mucus hypersecretion,and TF monomers(TF1,TF2 and TF3) were used for intervention.The effects of TF monomers on viability of A549 cells were examined by MTT method.After the effective doses of TFs were determined,A549 cells were divided into 4 groups for experiment.In control group,A549 cells were cultured with serum-free medium.In HNE treatment group,A549 cells were treated with HNE(50 nmol/L) for 24 h.In TF monomer intervention groups,A549 cells were pre-treated with TF1,TF2 or TF3(50,100 or 200 ?g/mL) for 24 h,and were then treated with HNE for another 24 h.In AG1478 intervention group,A549 cells were pre-treated with AG1478(5 ?mol/L),an epidermal growth factor receptor blocker for 30 min,and were then treated with HNE for another 24 h.The changes in mucin(MUC) after treatment by different doses of TF1,TF2 and TF3,and by TF3(200 ?g/mL) for different time(12 h,24 h and 36 h) were detected.The changes in MUC5AC mRNA expression and MUC5AC protein expression were detected by RT-PCR and ELISA,respectively. Results The MUC5AC mRNA expression and protein expression in HNE treatment group were significantly higher than those in control group(P

Objective To explore the effects of chronic disease management in the treatment and quality of life for rheumatoid arthritis (RA).Methods A total of 160 patients with active RA were selected from June 2011 to August 2012 and randomly assigned into experimental and control groups (n =80 each).Based upon oral medication,the experimental group had chronic disease management for 6 months.Before and after therapy,DAS28 score,erythrocyte sedimentation rate (ESR),ACR50 and quality of life score were measured.Results The number of regular medication in experimental group was significantly more than that in the control group (68 vs.37,x2 =26.625,P =0.000).The inter-group difference of DAS28 score reduction was statistically significant (2.46 ± 1.09 vs.3.68 ± 1.65,t =1.655,P =0.002).After intervention,ESR significantly decreased in experimental group (66.09 ± 41.98 vs.21.27 ± 19.61,t =1.655,P =0.029) and the reduction of control group was not statistically significant (t =1.976,P =0.059).The number of ACR50 in experimental group was more than that in control group (60 vs.44,x2 =4.314,P =0.038).The score of life quality of experimental group increased dramatically (56.58 ± 20.24 vs.63.71 ± 18.35,t =1.655,P =0.013) and it was significantly higher than control group (63.71 ± 18.35 vs.48.76 ± 19.88,t =1.906,P =0.020).Conclusion Chronic disease management can improve the life quality and clinical indices of RA patients.Thus it may be widely applied clinically as an adjunct treatment.

Objective To study the effects of parthenolide on osteoclast differentiation of RAW264. 7 cell induced by receptor activator of nuclear factor κB ligand (RANKL). Methods The mouse macrophage RAW264.7 cells induced by RANKL was used alone as the control group, different concentrations of par-thenolide (0.5, 1, 2 μmol/L) were added to culture the RAW264.7 cells. On the third, fifth and seventh day, the tartrate resistant acid phosphatase (TRAP) staining method was used to detect osteodast-like cells and the cell number was count;the contents of tartrate resistant acid phosphatase (TRAP5b) in the Culture supernatant of each groups were detected by enzyme linked immunosorbent assay (ELISA) and the expression of osteodast marker gene alcitonin receptor (CTR) and matrix metalloproteinase (MMP)-9 in each groups were detected by realtime-polymerase chain reaction (PCR) on the seventh day. We use Chi-square test and t test to test the differences between groups by SPSS 17.0. Results In different culture conditions, RANKL could always induce the RAW264.7 cell differentiate into mature osteoclasts. Compared with the control group at the same time control group, on the third, fifth and seventh day, he number of mature osteoclasts induced were obviously decreased in groups adding different concentration of PAR; the number of induced osteoclasts decreased along with the increase of parthenolide concentration, on the seventh day in 0.5, 1, 2 μmol/L concentration PAR groups, the number of mature osteoclasts compared with the control group were descended 36.3%, 40.8%, 49.3%(t=7.758, 8.742, 10.56;P<0.05);the contents of TRAP5b in the culture supernatant were consistent with the cell counting results on the seventh day (P<0.05). The expression of CTR and MMP-9 by TRAP positive osteoclasts decreased along with the increase of parthenolide concentration, and the 2 μmol/L group was the lowest. Compared with the control group, there were statistically significant differences with the different PAR concentration groups 0.5, 1, 2 μmol/L (P<0.05). Conclusion Parthenolide can inhibit RANKL induced RAW264.7 differentiation into osteoclast cells, and the inhibition is dose dependent.