Development and evaluation of a training model for paracentetic suprapubic cystostomy and catheterization

OBJECTIVES: Minimally invasive paracentetic suprapubic cystostomy is a technique that should be learned by all surgical trainees and residents. This study aimed to develop a self-made training model for paracentetic suprapubic cystostomy and placement of the suprapubic catheter and then to evaluate its effectiveness in training fourth-year medical students. METHODS: Medical students were divided into an experimental group receiving comprehensive training involving literature, video, and model use and a control group receiving all the same training protocols as the experimental group except without hands-on practice using the model. Each student's performance was video-recorded, followed by subjective and objective evaluations by urology experts and statistical analysis. RESULTS: All students completed the surgical procedures successfully. The experimental group's performance scores were significantly higher than those of the control group (median final performance scores of 91.0 vs. 86.8, respectively). Excellent scores were achieved by more students in the experimental group than in the control group (55% vs. 20%), and fewer poor scores were observed in the experimental group than in the control group (5% vs. 30%). CONCLUSIONS: Based on its cost-effectiveness, reusability, and training effectiveness, this paracentetic suprapubic cystostomy training model is able to achieve goals in teaching practice quickly and easily. Use of the model should be encouraged for training senior medical students and resident physicians who may be expected to perform emergent suprapubic catheter insertion at some time.

The relationship between the thrombospondin-1 and the carotid atherosclerosis in patients with type 2 diabetic / 天津医药

Objective To investigate the relationship between the thrombospondin-1 (TSP-1) and carotid atherosclerosis and its related indicators in patients with type 2 diabetes mellitus (T2DM). Methods A total of 101 T2DM patients were divided into T2DM group (A group, n=52) and T2DM with carotid artery atherosclerosis group (B group, n=49) according to whether complicated with carotid artery atherosclerosis, and 50 normal healthy persons were used as the normal group (C group , n=50). The TSP-1 and other clinical indicators were detected including fasting blood sugar (FPG), fasting insulin (FINS), glycosylated hemoglobin (HbA1c), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), fibrinogen (Fib) and homocysteine (homocysteine). The differences between TSP-1 and other related indicators were analyzed. Results There were no significant differences in diastolic blood pressure (DBP) and body mass index (BMI) between the 3 groups (P>0.05). The level of systolic blood pressure (SBP) was significantly higher in group B than that of group A and group C (P<0.01), but there was no significant difference between group A and group C (P>0.05). There were no significant differences in TC, TG and HDL-C between three groups (P>0.05). The values of TSP-1 and Hcy were increased sequentially in group B, group A and group C (P <0.05). There were significant differences in FPG, HbA1c, Fib, FINS and LDL-C between three groups (P<0.05). TSP-1 was positively correlated with FPG, FINS, HbA1c, Fib and Hcy (r= 0.585, 0.341, 0.701, 0.409 and 0.351, P < 0.05). Linear regression analysis showed that TSP-1 was affected by FINS, HbA1c and Fib, and HbA1c was more important. Conclusion TSP-1 is associated with the occurrence and development of diabetic macrovascular complications. It has good clinical value for early detection, early treatment and delaying the progress of diabetic macrovascular diseases.

Host protein Snapin interacts with human cytomegalovirus pUL130 and affects viral DNA replication.

The interplay between the host and Human cytomegalovirus (HCMV) plays a pivotal role in the outcome of an infection. HCMV growth in endothelial and epithelial cells requires expression of viral proteins UL128, UL130, and UL131 proteins (UL128-131), of which UL130 is the largest gene and the only one that is not interrupted by introns.Mutation of the C terminus of the UL130 protein causes reduced tropism of endothelial cells (EC). However, very few host factors have been identified that interact with the UL130 protein. In this study, HCMV UL130 protein was shown to directly interact with the human protein Snapin in human embryonic kidney HEK293 cells by Yeast two-hybrid screening, in vitro glutathione S-transferase (GST) pull-down, and co-immunoprecipitation. Additionally, heterologous expression of protein UL130 revealed co-localization with Snapin in the cell membrane and cytoplasm of HEK293 cells using fluorescence confocal microscopy. Furthermore, decreasing the level of Snapin via specific small interfering RNAs decreased the number of viral DNA copies and titer inHCMV-infected U373-S cells. Taken together, these results suggest that Snapin, the pUL130 interacting protein, has a role in modulating HCMV DNA synthesis.

Interaction between human cytomegalovirus UL136 protein and ATP1B1 protein

Interplay between the host and human cytomegalovirus (HCMV) has a pivotal role in the outcome of infection. A region (referred to as UL/b’) present in the Toledo strain of HCMV and low passage clinical isolates contains 19 additional genes, which are absent in the highly passaged laboratory strain AD169. Products of the UL/b’ genes may determine the manifestations of HCMV infection in vivo. However, little is known about the host factors, which interact with UL/b’ proteins. This study was conducted to investigate the function of the HCMV UL136 protein. By yeast two-hybrid screening, the β1 subunit of the host Na+/K+-ATPase (ATP1B1) was identified to be a candidate protein, which interacts with the HCMV UL136 protein. The interaction was further evaluated both in vitro by pull-down assay and in vivo by immunofluorescent co-localization. The results showed that the UL136 protein can interact with ATP1B1 in vitro. Co-localization of UL136-EGFP and ATP1B1-DsRed in cell membranes suggests that ATP1B1 was a partner of the UL136 protein. It can be proposed that the HCMV UL136 protein may have important roles in processes such as cell-to-cell spread, and in maintaining cell osmotic pressure and intracellular ion homeostasis during HCMV infection.

Tissue injury observation caused by thermal effects of microwave endometrial ablation / 中华妇产科杂志

Objective To investigate the thermal effects on tissue structures during microwave endometrial ablation(MEA)and seek a feasible method of endometrial thinning and a fitting mode of applicator radiating microwaves.Methods Operations were performed between the group of thorough uterine curettage and the group of early follicular phase in in vitro or in vivo uterus.The former was treated with MEA after thorough uterine curettage;while the latter was treated with MEA in the early follicular phase directly.The applicator radiating microwaves were moved in "Z" or "Z+W" shape inside uterine cavity.At the same time the serosal temperature was measured in the uterine fundus,tael cornua uteri,the posterior wall and the lower part of anterior wall.After operations the uterine specimens were stained by hematoxylin- eosin,and respiratory enzyme dehydronicotinamide adenine dinucleotide phosphate diaphorase(NADH-d) methods.The morphologic changes and the depth of tissue thermal damage were evaluated using an optical microscope and electron microscope.Results(1)Under the optical microscope the endometrial glands became distorted,the cell boundaries disappeared,the nucleoli turned condensed and were stained darker. A large number of acute inflammatory cells appeared in fibrous tissue.In the shallow muscle layer cells were arrayed thickly,nucleoli were solidified and condensed,and cellular plasm were concentrated.The endometrial and the superficial muscle layers were damaged and colorless with NADH-d staining.The scope of the tissue thermal damage was clearly seen.Under an electron microscope,some smooth muscle ceils, chromatin,karyotheca and cellular membranes were destroyed.The mitochondria were swollen,membranes were ruptured,and the crista disappeared.Many organelles were destroyed.The chromatin was lightly wrecked in the transitional area between putrescence and the normal smooth muscle tissue.Karyotheca and cellular plasm still existed,the mitochondria were highly edematous and the crista were disappeared,and the granular endoplasmic reticula were slightly expanded and degranulated.(2)The serosal temperature in in vitro uterus was significantly higher than that in in vivo uterus(P0.05).The injury depth of the "Z+ W" radiation group increased significantly than that of the " Z" radiation group(P