Objective To explore the advantage of transection the cervical muscles at sternal end and flip fixed in therapeutic bilateral huge thyroid surgery. Methods The transection of the cervical muscles at sternal end and flip fixed in 53 cases was observation group， 44 cases of the neck white line incision thyroid surgery completed for the control group. The completion of the surgery by the same group of physicians. The operative time， operation field of exposing effect， amount of bleeding in operation， postoperative complications， and postoperative drainage volume were compared between two groups. Results There was no statistically differences of sex， age， disease composition， and tumor size between two groups （P＞0.05）. Operative time， amount of bleeding， and postoperative drainage volume in observation group were shorter （less） than that in control group （P＜0.01）. The postoperative complication rate in observation group was lower than that in control group（P=0.04）. Surgical field exposure in observation group was better than that in control group （P＜0.01）. Conclusions The huge bilateral thyroid surgery with the sternal end approach is feasible and simple. The operation field exposure is better than the white line neck incision， complications after operation is less. It is worthy of clinical application.
【Abstract】Objective The effects of tumor infiltrating lymphocytes (TIL) on cellular immunologic function of patients with breast cancer were studied. Methods Twenty five patients with breast cancer were treated by the TIL that were isolated from tissue of tumor. T cell subgroups and natural killer cell (NK cell) activity of peripheral blood, the levels of serum soluble interleukin-2 receptor (sIL-2R) were assayed before and after treatment. Results CD3, CD4, CD4/CD8 and NK cell activity were ascended obviously, and CD8, sIL-2R were descended obviously after the treatment of TIL. Conclusion TIL can enhance the cellular immunologic function of patients with breast cancer.
Objective To investigate the expression of high mobility group protein-B1( HMGB1)and α-smooth muscle actin( α-SMA) in Bleomycin induced pulmonary fibrosis in mice. Methods Twenty C57BL/ 6 male mice were randomly divided into a Bleomycin group and a control group. The Bleomycin group was treated with Bleomycin( 3 mg/kg) by endotracheally injection to induce pulmonary fibrosis. The control group were treated with normal saline( NS) . Then they were sacrificed by abdominal aortic bleeding 10 days after the injection. The right lung was stained with hematoxylin-eosin and Masson trichrome respectively for pathological examination. Immunohistochemistry and RT-PCR were performed to identify the protein and mRNA levels of α-SMA and HMGB1 respectively. Results The mRNA( 0. 89 ±0. 12, 0. 61 ±0. 08) and protein( 13. 66 ±1. 01, 13. 12 ±1. 33) expressions of α-SMA and HMGB1 in the Bleomycin group were all significantly higher than those of the control group( mRNA: 0. 60 ±0. 07, 0. 15 ±0. 02; protein: 8. 18 ±1. 33,7. 92 ±1. 10; all P lt; 0. 01) . Conclusions The expressions of HMGB1 and α-SMA are increased in Bleomycin induced pulmonary fibrosis. HMGB1 participates in the pathological process of pulmonary fibrosis probably by activation of the α-SMA expression.
Objective To identify the effects of single immunoglobin IL-1 receptor related protein （SIGIRR） on inflammation induced by high mobility group box 1 （HMGB1） in A549 derived from human alveolar epithelial cells. Methods Eukaryotic expression vectors pCDNA3.1（+） constructed with SIGIRR cDNA were transiently transfected into A549 cells，in which SIGIRR was forced to be over-expressed. Western blot and RT-PCR were applied to detect the expression level of SIGIRR after transfection. After the stimulation by HMGB1，the transcriptional activity of NF-κB in A549 cells was detected by dual-luciferase reporter assay system，and the protein levels of inflammatory cytokine TNF-α and IL-1β were measured by ELISA. Results The expression level of SIGIRR increased significantly in A549 cells transfected with SIGIRR vectors. The transcriptional activity of NF-κB was enhanced obviously after HMGB1 treatment in A549 cells by dual-luciferase reporter assay system，while the transfection of SIGIRR vectors decreased the activity. The protein levels of TNF-α and IL-1β were down-regulated in A549 cells over-expressing SIGIRR after HMGB1 stimulation compared with the non-transfected cells. Conclusions Up-regulated SIGIRR expression can inhibit HMGB1-induced proinlammatory cytokine release in A549 cells such as TNF-α and IL-1β. The transcriptional activity of NF-κB is dampened by SIGIRR transfection，implying that the anti-inflammatory effects of SIGIRR may be involved in the regulation of NF-κB.
Objective To explore and solve the key technologies of the three dimensional (3D) visual ization reconstruction of functional fascicular groups inside long segmented peri pheral nerve. Methods A 20 cm ulnar nerve from upper arm of fresh adult dead body was embedded by OCT with four pieces of woman’s hair which was used as locating material, then the samples were serially horizontally sl iced into 400 sl ices with 15 μm thickness and 0.5 mm interval. All sl iceswere stained with acetylcholinesterase (AchE) histochemical staining. After that, the 2D panorama images of the same sl ice were obtained with Olympus stereomicroscope and MSHOT MD90 micro figure image device before and after AchE staining. Using the layer processing technique of Photoshop image processing software, the recomposition images including complete 4 location pots were obtained, based on which the algorithm of optimized least square support vector machine (Optimized LS-SVM) and space transformation method was used to fulfill automatic registration. Finally, with artificial assistant outline obtaining, the 3D visual ization reconstruction model of functional fascicular groups of 20 cm ulnar nerve was made using Amira 4.1, and the effects of reverse reduction and the suitabil ity of 3D reconstruction software were evaluated. Results The two-time imaging technique based on the layer process of Photoshop image processing software had the advantages: the image outline had high goodness of fit; the locating pots of merging image was accurate; and the whole procedure was simple and fast. The algorithm of Optimized LS-SVM had high degree of accuracy, and the error rate was only 8.250%. The 3D reconstruction could display the changes of the chiastopic fusion of different nerve functional fascicular groups directly. It could extract alone, merge and combine arbitrarily, and revolve at any angles. Furthermore, the reverse reduction on arbitrarily level dissection of the 3D model was very accurately. Conclusion Based on the two-time imaging technique and computer image layer processing technology, the compute algorithm of auto-registration can be developed and appl ied to 3D visual ization reconstruction of long segmented peripheral nerve. The technological processes is fast, and the reconstruction effect is good.
Objective To investigate the morbidity of ocular fundus diseases in Tibetan above 40 in Maqin county, Qinghai Province. Methods A total of 2511 Tibetan above 40 in Maqin county, Qinghai Province were seelected by cluster sampling method. The sampling survey of ocular fundus diseases was performed on the individuals with indirect ophthalmoscope, and the results were compared with the domestic existing epidemiological data. Results Two hundred and thirty five (9.35%) cases were found to have abnormal ocular fundus, and the blindness rate due to the abnormal ocular fundus was 20.5% (80/391 eyes) which was lower than the blindness rate due to cataract (52.5%). Low vision and blindness led by ocular fundus diseases were found in 155 eyes (65.96%)，including 74(47.74%) with age-related macular degeneration (AMD) and 23 (9.79%) with retinoangiopathy. Conclusions The morbidity of ocular fundus disorder is higher in high plateau than that in backland; AMD and retinoangiopathy are the main diseases leading to blindness. (Chin J Ocul Fundus Dis, 2006, 22: 321-323)
Objective To observe the suppressive effect of co mbi nation of tissue plasminogen activator (t-PA), heparin and homoharringtonine on the formation of proliferative vitreoretinopathy (PVR) after vitreoretinal surgery. Methods Forty-three cases (44 eyes )of complicated retinal detachment who received vitreoretinal surgery were divided into 2 g roup s.Twenty cases(20 eyes)in group A were treated by intravitreal injection of abo ve mentioned drugs at the end of operation,while no intraocular injection of drugs given in 23cases(24 eyes)in group B.The mean follow-up period was 7.9 months. Result The rate of recurrent PVR in group A was 15.8%(3 of 19),and 45.5%(10 of 22) in group B (P＜0.05). The rate of recurrent retinal detachment was 5.5%(1 of 18) in group A,an d 33.3%(7 of 21) in group B，in group B(P＜0.05). Conclusion Combination use of the above mentioned drugs can effectively suppress the post operative recurrent PVR and lower the rate of subsequent recurrent retinal detac hment. (Chin J Ocul Fundus Dis, 2001,17:24-25)
The main approaches to medical education reform that have been introduced elsewhere in the world, including the integration of basic and clinical sciences into organ-based model, the establishment of a Center for Faculty Development and problem-based learning (PBL) have been introduced to the College of Medicine, Chung Shan Medical University (CSMU) since the mid 1990s. The process of developing the PBL approach can be divided into the following stages: Observation (1994-2000): In this stage, CSMU observed the practice and effectiveness of PBL programs in other domestic and foreign medical schools. At the same time, we assessed the possibility of introducing PBL to Chung Shan. When the authority decided to introduce PBL, a PBL committee was inaugurated. Preparation (2000-2002): In this stage, tutor training took place, as well as PBL case writing workshops to reach consensus among the faculty. To reduce the total amount of curricula and traditional teaching hours, we combined and simplified related curricula, so that one and half weekdays were reserved for PBL tutorials and students’ self-study. A preliminary course about how to learn well, including the philosophy and methodology of learning as well as evidence-based medicine (EBM), was integrated into premedical curricula. Practice (2002-2004): In light of the number of trained tutors and written cases that have been prepared, and the desire that the PBL would be successful from the start, CSMU chose to introduce PBL to the clinical curricula first in a hybrid curriculum design. This meant that the traditional teaching was retained at the beginning. Evaluation of PBL by the students was done at the end of each semester. Tutor meetings were held twice per semester. Advancement (2004-2006): In this stage, PBL was introduced to the basic medical curricula as well as to the premedical general curricula. Based on our experience and comprehensive evaluation, a PBL guidebook for tutors and students has been published and delivered to both groups. We also developed an on-line evaluation system containing the evaluation forms for students and tutors. Excellence (2006 onwards): In this stage, the PBL website and learning resources will be further developed, and we are designing the system for on-line PBL practice.In conclusion, the introduction to PBL for medical education is reasonable and feasible. It requires b administrative support, a long-standing and high commitment of the PBL committee, consensus among the faculty and an appropriate planning and evaluation mechanism.
摘要:目的: 研究分析特殊饮食结构和生活习惯人群发生上消化道疾病的病种及发生率。 方法 :对1998年11月至2008年11月我院经胃镜检查的3661例患者进行统计,并参考饮食结构和生活习惯进行分析。 结果 :汉族调查2343例,彝族调查1318例:汉族患病率胃溃疡1626%、十二指肠溃疡858%、复合性溃疡098%、糜烂出血性胃炎1434%、胃癌、食道癌089%;彝族患病率胃溃疡2527%、十二指肠溃疡1282%、复合性溃疡25%、糜烂出血性胃炎1988%、胃癌、食道癌152%。 结论 :少数民族地区特殊饮食人群上消化道疾病发病率及胃、十二指肠溃疡的发生率和癌变比率明显增高。Abstract: Objective: To study the structure of the special diet and the lifestyle of people who occurred the upper digestive tract diseases and disease incidence. Methods : From 199811 t0 200811,3661 cases in our hospital carryed out statistics and analysis with reference to diet and lifestyle. Results : Han people with 2343 cases, Yi people with 1318 cases, in Han people, the rate of ulcer was 1626%,858% of duodenal ulcer,098% of compound ulcer,1434% of erosive hemorrhage gastritis,089% of stomach and esophagus; in Yi people,2527% of gastric ulcer,1282% of duodenal ulcer,25% of compound ulcer,1988% of erosive gastritis hemorrhage,152% of stomach and esophageal cancer. Conclusion : The upper digestive tract diseases, the incidence of stomach, duodenal ulcer and cancer incidence rate increased significantly in special diet groups in ethnic minority areas.
Objective To study the effect on expression of high mobility group box-1 （HMGB1） mRNA for the expression of zonula occludens-1 （ZO-1） in ileum tissues， and to explore the possible mechanism of intestinal mucosal barrier injury in rats with acute necrotizing pancreatitis （ANP）. Methods Ninety-six male Wistar rats were divided randomly （random number method） into ANP group， ethyl pyruvate （EP）group， and sham operation group. Eight rats of 3 groups were killed to get abdominal aortic blood and ileal tissues at 6， 12， 24， and 48h after operation， respectively.The levels of plasma amylase （AMY） ， D-lactate acid， and the activity of malonyl dialdehyde （MDA） in the ileum tissues were determined by using automatic biochemical analyzer， improved enzymatic spectrophotometry， and thiobarbituric acid （TAB） colorimetry respectively. The pathological changes of ileum tissues were observed under microscopy by HE staining， the expression of ZO-1 protein in ileum tissues was observed by immunohistochemistry （SP method）， and the expressions of HMGB1 mRNA and ZO-1 mRNA in ileum tissues were detected by reverse transcription-polymerase chain reaction （RT-PCR）. Results Compared with ANP group at the same time， levels of AMY， D-lactate acid， and MDA in ileum tissues of EP group were all significantly lower （P＜0.05）. The expression level of HMGB1 mRNA increased at 6 h while ZO-1 mRNA decreased in ANP group. Compared with ANP group at the same time， the expression level of HMGB1 mRNA of EP group was significantly lower while ZO-1 mRNA was higher （P＜0.05）， and the pathological damage in ileum tissues was lighter. Conclusions The decreased expression of ZO-1 in ileum tissues is one of the vitalcauses for intestinal mucosal barrier injury in ANP， and it probably occurs in case of the excessive expression of HMGB1.