ObjectiveTo summarize the research progress in the surgical treatment of sternoclavicular joint dislocation. MethodThe literature on the treatment of sternoclavicular joint dislocation was reviewed, summarized, and analyzed. ResultsAt present, the main therapy of sternoclavicular joint dislocation is operation, including the sternoclavicular joint reconstruction, the inner end of the clavicle resection, and internal fixation of the sternoclavicular joint. The internal fixation surgery is the preferred way, which is reliable fixation and in favor of early functional exercise. ConclusionsIt is the current focus of attention to select a reliable fixation that is accord with sternoclavicular joint anatomy and biomechanics.
ObjectiveTo explore and hypothesize the potential mechanisms of cancer stem cell(CSC) in peritoneal metastasis of gastric cancer. MethodsThe databases of PubMed and CNKI were searched, and relevant literatures were reviewed to draw out systematic hypotheses. ResultsMetastatic cancer stem cell(MCSC) was the subpopulation of CSC with the capacity of metastasis, had still not been well investigated. MCSC transfer was the tendency of migration and planting to specific target tissue by multi-steps of "homing" process. Peritoneal metastasis of gastric cancer was a simplified "homing" process, and we thinked that the key steps were adhesion, migration, and niche establishment of MCSC in peritoneum. That capturing human MCSC of peritoneal metastases in gastric cancer and identifying its stemness feature to determine high tumorigenicity and high invasive ability of it were the important research fields. ConclusionMCSC might play certain role in multiple processes in peritoneal metastasis of gastric cancer, but currently it's lack of relevant researches.
ObjectiveTo observe the changes of left atrial geometry before and after mitral valve replacement in patients with different types of mitral valve disease and different heart rhythm, and to identify factors determining left atrial remodeling after mitral valve replacement. MethodsA total of 215 consecutive patients of mitral valve replacement in Department of Thoracic and Cardiovascular Surgery of West China Hospital, Sichuan University from January 2003 to March 2008 were selected and followed up for this study. There were 52 male and 163 female patients with their age of 40.58±10.54 years (ranged, 18-67 years). St. Jude Medical mechanical valves were used. According to the type of mitral valve diseases (mitral stenosis (MS) or mitral regurgitation (MR)) and heart rhythm (atrial fibrillation (AF) or sinus rhythm (SR)), patients were divided into 4 groups. There were 54 patients with MS and SR (including 13 male and 41 female patients with their age of 39.31±9.46 years), 56 patients with MS and AF (including 14 male and 42 female patients with their age of 41.12±10.72 years), 52 patients with MR and SR (including 12 male and 40 female patients with their age of 39.71±10.09 years), 53 patients with MR and AF (including 13 male and 40 female patients with their age of 40.19±11.87 years). All patients had routine examinations and echocardiogram preoperatively and two years after surgery. Left atrial anteroposterior diameter (LAD), left atrial area (LAA), left atrial volume (LAV) and left atrial volume index (LAVi) were used to analyze the changes of left atrial geometry. ResultsThere was no in-hospital death. Major postoperative complications included low cardiac output syndrome in 5 patients, pneumonia in 6 patients. LAVi were lower in mitral stenosis patients than that in mitral regurgitation patients (P<0.05), LAVi were lower in patients with sinus rhythm than that in patients with atrial fibrillation (P<0.05). Two years after mitral valve replacement, the extent of left atrial reverse remodeling were significantly greater in mitral regurgitation patients than in mitral stenosis patients (P<0.05), and the extent of left atrial reverse remodeling were significantly greater in patients with sinus rhythm than that in patients with atrial fibrillation (P<0.05). ConclusionsAge, atrial fibrillation, preoperative left atrial volume, mitral regurgitation, left ventricle end-diastolic diameter are important influencing factors of left atrial reverse remodeling after mitral valve replacement.
Modern medicine is being transferring from traditional "empirical medicine" to more scientific "evidence-based medicine", which embodies the idea that clinical research is a primary motive that keeps medical practice continuously developing. Therefore, the contemporary aim of medical education should focus on attaching great importance to and strengthen the training of medical students' clinical scientific research ability. Based on clinical departments, we have built an open research project platform for volunteers for medical students before engaging in medical practice. Through a spirally-progressing teaching mode of "Training-Practice-Assessment-Retraining" for medical students before engaging in medical practice, the platform provides training on the knowledge and skills of evidence-based medicine and clinical scientific research. Through the volunteers' active and omnibearing practice, this project achieves some good outcomes in teaching and learning experience. This extracurricular teaching mode provides a platform for scientific research volunteers with the capacity for more knowledge before engaging in medical practice, which is recommended to empower the students with ability of scientific research.