ABSTRACT
Objective To investigate the feasibility and practical value of the integration of humanistic concern into clinical problem-based learning ( PBL ) teaching . Methods A total of 112 undergraduate medical interns in Department of Colorectal Surgery were enrolled and randomly divided into experimental group receiving PBL teaching integrated with humanistic concern and control group receiving PBL teaching alone. Theoretical examination, operation examination, and patient satisfaction survey were performed after practice training to evaluate the teaching effect of the two groups . GraphPad Prism 6 software was used for statistical analysis of data, and the t-test was used for comparison of continuous data between the two groups. Results Compared with the control group, the experimental group had significantly higher scores of medical history collection (22.57±2.63 vs 20.87±3.08, t=3.124, P=0.002) and operation skills (31.42±2.89 vs 29.87±4.72, t=2.107, P=0.037), but there were no significant differences between the two groups in the scores of theoretical examination (90.60±3.19 vs 90.52±3.38, t=0.129, P=0.898) and medical record writing (20.78±2.79 vs 20.65±3.51, t=0.215, P=0.830). Compared with the control group, the experimental group had a significantly higher degree of patient satisfaction with service attitude (3.94±1.07 vs 3.22±1.09, t=3.256, P=0.002), trust (3.85±1.16 vs 3.22±1.05, t=2.759, P=0.007), and communication skills (3.92±1.03 vs 3.16±1.03, t=3.652, P=0.000), but there were no significant differences between the two groups in the scores of operating skills (3.60±1.09 vs 3.67±1.10, t=0.281, P=0.779) and arrangement of medical procedures (2.74 ±1.10 vs 3.02 ±1.02, t=1.312, P=0.193). Conclusion The integration of humanistic concern into PBL teaching of anorectal surgery can improve students' clinical operation ability and degree of patient satisfaction.
ABSTRACT
OBJECTIVE: To exploit material decomposition analysis in dual-energy spectral computed tomography (CT) to assess the blood supply status of the ground-glass opacity (GGO) in lungs. MATERIALS AND METHODS: This retrospective study included 48 patients with lung adenocarcinoma, who underwent a contrast-enhanced dual-energy spectral CT scan before treatment (53 GGOs in total). The iodine concentration (IC) and water content (WC) of the GGO, the contralateral and ipsilateral normal lung tissues were measured in the arterial phase (AP) and their differences were analyzed. IC, normalized IC (NIC), and WC values were compared between the pure ground-glass opacity (pGGO) and the mixed ground-glass opacity (mGGO), and between the group of preinvasive lesions and the minimally invasive adenocarcinoma (MIA) and invasive adenocarcinoma (IA) groups. RESULTS: The values of pGGO (IC = 20.9 ± 6.2 mg/mL and WC = 345.1 ± 87.1 mg/mL) and mGGO (IC = 23.8 ± 8.3 mg/mL and WC = 606.8 ± 124.5 mg/mL) in the AP were significantly higher than those of the contralateral normal lung tissues (IC = 15.0 ± 4.9 mg/mL and WC = 156.4 ± 36.8 mg/mL; IC = 16.2 ± 5.7 mg/mL and WC = 169.4 ± 41.0 mg/mL) and ipsilateral normal lung tissues (IC = 15.1 ± 6.2 mg/mL and WC = 156.3 ± 38.8 mg/mL; IC = 15.9 ± 6.0 mg/mL and WC = 174.7 ± 39.2 mg/mL; all p < 0.001). After normalizing the data according to the values of the artery, pGGO (NIC = 0.1 and WC = 345.1 ± 87.1 mg/mL) and mGGO (NIC = 0.2 and WC = 606.8 ± 124.5 mg/mL) were statistically different (p = 0.049 and p < 0.001, respectively), but not for the IC value (p = 0.161). The WC values of the group with preinvasive lesions and MIA (345.4 ± 96.1 mg/mL) and IA (550.1 ± 158.2 mg/mL) were statistically different (p < 0.001). CONCLUSION: Using dual-energy spectral CT and material decomposition analysis, the IC in GGO can be quantitatively measured which can be an indicator of the blood supply status in the GGO.
Subject(s)
Humans , Adenocarcinoma , Arteries , Iodine , Lung , Multidetector Computed Tomography , Retrospective Studies , Tomography, X-Ray Computed , WaterABSTRACT
[Abstrict]Objective To explore the key points and clinical value of combined direct and indirect extracranial-in?tracranial (EC-IC) bypass in patients with adult moyamoya disease. Methods Retrospective analysis of combined revas?cularization surgery in 25 adult patients with moyamoya disease. The frontal branch and parietal branch of the superficial temporal artery (STA) were dissected. Combined revascularization surgery consisted of direct (anastomosis between the su?perficial temporal artery and cortical branch of the middle cerebral artery) and indirect (encephalodurogaleosynan-giosis EDAS) surgeries. Clinical status was evaluated using the modified Rankin Scale and NIHSS score at 1 day before, 1 week and 3 months after surgery. Results Thirty lateralities were successfully performed on 25 patients. Postoperative angiogra?phy or CTA and cranial computer tomography perfusion imaging(CTP) were conducted to examine the patency of the di?rect anastomosis and cerebral blood flow in 23 patientswithin 1 weeks after surgery . The results showed that the anasto?motic vascular patency was excellent and the cerebral blood flow increased in parallel to the relief of the patients’s isch?emic symptoms. The median mRS scores were 3 (1,3) before surgery, 2 (1,3) 1 week and 1 (0,3) 1 month after surgery.The median mRS scores were significantly improved (Z=15.14, P<0.01). The median NIHSS scores was 5 (4,8) preopera?tively and 4(2,7) postoperation 1 week and 3(1,4) 3 months. The median NIHSS scores were also significantly improved (Z=11.36, P<0.01). Unfortunately, two patients had complication and left hemiparesis. One patient complicated with con?tralateral hemisphere infarction and the another one complicated with ipsilateral hemispheric hemorrhage after operation. Conclusions Combined revascularization surgery may result in satisfying improvement in clinical, angiographic, and he?modynamic states and prevention of recurrent stroke. The stabilized hemodynamic is the key point in peroperative period for moyamoya patients.
ABSTRACT
Objective To study the effects of berberine (BBR) on the gene mRNA expression of fat-specific protein 27 (FSP27) and PR domain containing 16 (PRDM16) signal pathway in visceral white adipose tissues (VWAT) from type 2 dia? betic (T2DM) Chinese hamsters, and explore the related mechanisms. Methods The obese insulin-resistant (OIR) hamster model was induced by high-fat diet, and T2DM hamster model was created by OIR hamster model injected with low-dose streptozotocin. The control group was fed with standard laboratory chow. After the induction, the hamsters were randomly di?vided into control, OIR, obese T2DM and BBR-treated T2DM groups. After nine-week BBR treatment, real-time quantita?tive PCR was used to measure the gene mRNA expression changes of VWAT FSP27 and PRDM16 signal pathway and their target genes from different groups. Results Compared with control group, the gene mRNA expressions of PRDM16, CtBP-1, CtBP-2, C/EBPβ, PPARγ, PGC1α, PGC-1β and brown adipose tissue-specific genes such as UCP-1, Cidea, Elovl3, PPARα, and Acox, Cpt1 and Acadm were decreased and that of FSP27 and white adipose tissue-specific genes including Resistin, MEST and Serpina3k were increased in VWAT in OIR and obese T2DM groups. BBR treatment down-regulated FSP27 expression, enhanced PRDM16 signal pathway, and induced the gene mRNA expression of brown adipose tissue-spe?cific genes in VWAT of obese T2DM group to develop browning gene phenotype of VWAT, and then improved fat-induced insulin resistance. Conclusion The decreased FSP27 expression and increased PRDM16 expression are involved in the molecular mechanisms of browning of visceral white adipose tissues induced by BBR, and which contributes to improve ab?normal lipids metabolism and fat-induced insulin resistance in VWAT by enhancing consumption of energy as heat to re?store VWAT function.
ABSTRACT
Objective To conduct a Meta?analysis to compare the safety and short?term efficacy of laparoscopic assisted distal gastrectomy (LADG)and open distal gastrectomy(ODG)in D2 radical surgeries for locally advanced distal gastric cancer. Methods The literatures from Janurary,1990 to August,2014 on the evaluation of safety and short?term efficacy of LADG versus ODG in D2 radical surgeries for locally advanced distal gastric cancer were collected. The quality of the enrolled articles was evaluated and the software Revman 5.2 was adopted to analyze the cura?tive effect. Results Totally 25 articles met the inclusion criteria,including 5 044 patients with treatment of D2 radical surgeries for locally advanced distal gastric cancer. There was no significant difference in the cleaning number of lymph nodes between LADG and ODG in patients undergoing D2 radical surgeries for locally advanced distal gastric cancer. The operation time was longer for LADG than ODG,but the postoperative evaluation in?dexes such as the intraoperative blood loss and the short?term efficacy of LADG were superior to ODG. Conclusion In the treatment of locally ad?vanced distal gastric cancer,there were differences in the safety and short?term efficacy between LADG and ODG,and surgeons should give concern to these differences in clinical practice to select appropriate surgical approaches. Further research is still needed to explore the long?term efficacy.
ABSTRACT
BACKGROUND:Extreme lateral lumbar disc herniation is a rare type of lumbar disc herniation, there are a variety of treatment methods, but the therapeutic efficacy and recurrence rate are controversial. OBJECTIVE:To investigate the availability of lumbar pedicle screw fixation combined with interbody fusion cage for treating extreme lateral lumbar disc herniation. METHODWe retrospectively analyzed 19 patients with extreme lateral lumbar disc herniation after treatment with lumbar pedicle screw fixation combining with interbody fusion cage from March 2006 to January 2009. The outcomes were evaluated depending on VAS scoring standard and Macnab scoring standard, lumbar stability were observed postoperatively. We analyzed the spinal stability in recurrent lumbar disc herniation patients after lumbar pedicle screw fixation combined with interbody fusion cage depending on literature search. RESULTS AND CONCLUSION:Al the 19 patients were fol owed up for 13 months to 3 years, the leg and lumbar pain of al the patients were relieved to varying degrees. Preoperative VAS score was 7.3±1.28 points and postoperative VAS score was 2.1±0.8 points, showing significant difference between two groups (P<0.05). The excellent and good rate was up to 95%with 15 excellent results, 3 good results and 1 acceptable result depending on Macnab evaluation standard. There was no pedicle screw loosening, broken, non-fusion phenomenon. Al the lumbar interbody fusions were good. No one occurred secondary lumbar spinal stenosis. Experimental findings indicate that, lumbar pedicle screw fixation combined with interbody fusion cage for extremely lateral lumbar disc herniation, is characterized as fast symptom relief, strong fixation and good lumbar stability.
ABSTRACT
Objective To investigate the expression and significance of caveolin-1 in breast carcinoma.Methods Using immunohistochemical method the protein expression of caveolin-1 were analyzed in 105 cases of breast carcinoma and 50 cases of non-cancerous breast tissues.The relationship between caveolin-1 expression and CK5/6,EGFR,and E-cadherin expression was investigated.Clinical data of 105 cases of breast carcinoma were retrospectively analyzed.Results Among 105 cases of breast carcinoma,there were 20 cases of basal-like subtype,22 cases of luminal subtype A,23 cases of luminal subtype B,23 cases of HER2 over-expressing subtype,17 cases of normal breast-like subtype.Positive rate of caveolin-1 was significantly lower in breast carcinoma than in non-cancerous breast tissues (24.8％ vs.88.0％,P ＜ 0.05).Positive rate of caveolin-1 (75.0％) was higher in breast carcinoma than in luminal subtype A ( 4.8％ ),luminal subtype B ( 17.4％ ),HER2 over-expressing subtype ( 17.4％ ) or normal breast-like subtype( 11.8％ ),all P ＜0.05.Caveolin-1 expression was associated with expression of CK5/6 and EGFR(P ＜0.01 ).In univariate analysis,positive caveolin-1 was associated with higher lymph node metastasis rate (18/26,69.2％ )than negative (37/79,46.8％ ),P =0.047,and shorter 5-year-disease-free survival (38.46％ vs.74.68％,P =0.0004 ),but in multivariate analysis caveolin-1 was not an independent predictor of 5-year- disease-free survival (P ＞ 0.05).Conclusions Caveolin-1 can be seen as a screening mark of basal-like breast carcinoma,it may promote the invasiveness of breast cancer cells,but it is not an independent prognostic predictor of breast cancer patients.
ABSTRACT
OBJECTIVE: To explore the application of biological patches in tension-free inguinal hernia repair. METHODS: Totally 29 Chinese references and 1 English article regarding tension-free repair for inguinal hernia with biological patches were retrieved from 1999 to 2008. Then the retrieved information was summarized from clinical data, surgical results, complication, and recurrence rate to report the biological patches in tension-free inguinal hernia repair. RESULTS: The biological patch in tension-free inguinal hernia repair was characterized by little trauma, simple operation, rapid recovery and less complication with lower recurrence rate, especially obtained an excellent result in treating recurrent hernia. CONCLUSION: Tension-free repair for inguinal hernia with biological patches is an ideal operative method.
ABSTRACT
To investigate the relationship of bcl-2, p53, proliferating cell nuclear antigen (PCNA) to cell proliferation, apoptosis and pathological parameters, the patterns of cell growth and turnover in renal cell carcinoma (RCC), formalin-fixed and paraffin-embedded tissue blocks from 34 patients with RCC were examined. Cell proliferation activity was detected by PCNA immunostaining and the proliferation index (PI) was expressed as a percentage of the PCNA-positive cells in the tumor cells. Apoptosis was detected by terminal deoxy- nucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL), and the apoptotic index (AI) was expressed as a percentage of the TUNEL-positive cells in the tumor cells. Expressions of bcl-2 and p53 were assessed immunohistochemically. Our results showed that the PI ranged from 6.0% to 24.0% (median 12.3%) and the AI from 2.0% to 8.0% (median 5.4%) in RCC. The expression of the bcl-2 protein was demonstrated in 15 cases (44.1%); the expression of the p53 protein, however, was seen in only 3 case. bcl-2 positivity was not associated with PI or AI or any pathological parameters. There were close associations between PI and tumor grade and stage, and a significant relationship between AI and the tumor grade of RCC, Our study suggests that bcl-2 positivity was not associated with PI or AI or any pathological parameters. There are close associations between PI and AI and tumor grade and stage of RCC. Active cell proliferation may be accompanied by frequent apoptosis in RCC.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Apoptosis , Physiology , Carcinoma, Renal Cell , Metabolism , Pathology , Cell Division , Kidney Neoplasms , Metabolism , Pathology , Proliferating Cell Nuclear Antigen , Genetics , Proto-Oncogene Proteins c-bcl-2 , Genetics , Tumor Cells, Cultured , Tumor Suppressor Protein p53 , GeneticsABSTRACT
A case-control study was performed to investigate the relationship between gallbladder cancer(GCA) and gallbladder stones (GS). 43 patients with GCA confirmed by pathology were included, in which 19 were accompanied by GS, 24 patients without. 88 controls were selected from the data for the periodic health checkup with B-ultrasonography(B-US): cholelithiasis were discovered in 6 controls, but 82 were free from GS. The difference between the case and control group was significant(P
ABSTRACT
The method of under--water weighing was used to measure the body composition of seventeen rhythmicgymnasts and four ordinary women. The average fat percentage was found to be 19. 0% in the gymoasts and26. 4% in the non--gytnnasts. The fat oercentage in the body composition of an athlete is not directly proportional to her body weight.It is inversely proportional to her training level. Therefore, in evaluating the physical condition of an athlete,her fat percentage must be taken into account. An artistic gymnast who is reducing bodyweight shows a negative energy belance of 50. 5% and insuffi-cient intake of protein and vitamins. Reduction of bodyweight should therefore be carried out under medicalsupervision.