Efficacy and safety of lenvatinib in patients with unresectable hepatocellular carcinoma previously treated with tyrosine kinase inhibitor / 临床肝胆病杂志

Objective To investigate the efficacy and safety of lenvatinib in patients with unresectable hepatocellular carcinoma (HCC) previously treated with tyrosine kinase inhibitor (TKI). Methods A retrospective analysis was performed for the clinical data of 76 patients with unresectable HCC who were treated with lenvatinib in Beijing Ditan Hospital, Capital Medical University, from January 2019 to January 2020, and according to the treatment method, they were divided into TKI previously untreated group with 49 patients and TKI treatment-experienced group with 27 patients. The patients were observed till one year after enrollment, adjustment of treatment regimen, tumor progression, or death. The two groups were compared in terms of progression-free survival (PFS) time, objective response rate (ORR), disease control rate (DCR), and incidence rate of adverse events. The t -test or the Wilcoxon rank-sum test was used for comparison of continuous data between two groups, and the chi-square test or the Wilcoxon rank-sum test was used for comparison of categorical data between two groups; the Kaplan-Meier method was used for survival analysis, and the log-rank test was used for comparison between groups. Results There were no significant differences between the TKI previously untreated group and the TKI treatment-experienced group in median PFS time (115 days vs 72 days, P =0.148), ORR (36.7% vs 18.5%, P =0.098), DCR (65.3% vs 55.6%, P =0.402), and incidence rates of grade ≥3 adverse events (24.5% vs 18.5%, P =0.550). Conclusion Patients with unresectable HCC previously treated with TKI can benefit from lenvatinib and have good safety, with similar results to those treated with TKI for the first time.

Generated SecPen_NY-ESO-1_ubiquitin-pulsed dendritic cell cancer vaccine elicits stronger and specific T cell immune responses

Dendritic cell-based cancer vaccines (DC vaccines) have been proved efficient and safe in immunotherapy of various cancers, including melanoma, ovarian and prostate cancer. However, the clinical responses were not always satisfied. Here we proposed a novel strategy to prepare DC vaccines. In the present study, a fusion protein SNU containing a secretin-penetratin (SecPen) peptide, NY-ESO-1 and ubiquitin was designed and expressed. To establish the DC vaccine (DC-SNU), the mouse bone marrow-derived DCs (BMDCs) were isolated, pulsed with SNU and maturated with cytokine cocktail. Then peripheral blood mononuclear cells (PBMCs) from C57BL/6 mice inoculated intraperitoneally with DC-SNU were separated and cocultured with MC38/MC38

Echocardiographic diagnosis of anomalous origin of right pulmonary artery / 中国医学影像技术

Objective To explore the diagnostic value of transthoracic echocardiography (TTE) for anomalous origin of right pulmonary artery (AORPA).Methods Echocardiographic data of 26 patients with AORPA proved by surgical operation were analyzed retrospectively.Results TTE showed that the pulmonary trunk and the left pulmonary artery were displayed normally,and the right pulmonary artery originated from the ascending aorta.AORPA in all 26 patients were diagnosed,and the coincidence rate was 100％.Among 26 patients,9 associated with Berry's syndrome,1 combined with coarctation of aorta,22 combined with patent ductus arteriosus,23 combined with atrial septal defect or patent foramen ovale,25 were found with severe pulmonary artery hypertension,and the diagnostic accuracy rate of TTE was 100％ (26/26),100％ (26/26),96.15％ (25/26),92.31％ (24/26) and 100％ (26/26),respectively.Conclusion TTE can early and accurately diagnose AORPA,also has high accuracy in diagnosis of other concomitant malformations.Multi-section scan can reduce misdiagnosis.TTE can be taken as the preferred inspection method for diagnosing AORPA.

Clinical characteristics and mid-term follow-up of Kawasaki disease in infants under 3 months / 临床儿科杂志

Objective To summarize the clinical characteristics, follow-up and prognosis of Kawasaki disease (KD) in infants under 3 months. Method The clinical data of infants under 3 months diagnosed with KD during January 2009 to December 2013 were analyzed retrospectively. Results In a total of 1504 cases diagnosed with KD during during the study period, there were 40 (2.66%) infants under 3 months (30 males and 10 females). Except for fever, the frequencies of the other 5 main clinical manifestations were less than 50%. Laboratory tests suggested inflammatory reactions, thrombocytosis, anemia, and so on. Coronary artery disease was found in 32 cases (80%), including 24 cases of coronary artery dilatation, 8 cases of coronary artery aneurysm and 3 cases of coronary giant aneurysm. By the end of the follow-up period, there were no myocardial ischemia, myocardial infarction and death in all the patients; coronary artery diameter was normal in 37 cases (92.5%); 3 cases of giant coronary artery aneurysm still had coronary artery aneurysm and thrombosis. Conclusion The clinical manifestations of KD in little infants were atypical, the incidence of coronary artery disease is high, and color doppler echocardiography should be performed in time.

Ultrasound Cardiogram in Diagnosis of Pediatric Congenital Unilateral Absence of Pulmonary Artery / 中国医学影像学杂志

Purpose Unilateral absence of pulmonary artery is a rare congenital pulmonary arterydysplasia whose untypical symptom often leads to missed diagnosis or misdiagnosis.Diagnostic and follow-up values of ultrasound cardiogram to pediatric congenital unilateral absence of pulmonary artery (UAPA) are explored in this paper.Materials and Methods Ultrasound cardiogram images of 35 UAPA patients confirmed by surgery or CT angiography in Guangzhou Women and Children's Medical Center from May 2009 to July 2016 were analyzed retrospectively,and images characteristics of the correctly diagnosed and missed diagnosis or misdiagnosed ultrasound cardiogram were analyzed.Results Among these 35 UAPA patients,21 cases were on the right side,14 cases on the left side,16 cases single UAPA and 19 cases combined with other intracardiac malformations.27 cases were initially diagnosed by ultrasound cardiogram,7 cases were missed diagnosed and 1 case misdiagnosed,with 77.1％ diagnosis accuracy.UAPA ultrasound cardiogram showed that normal bifurcation structure of pulmonary artery disappears.Main pulmonary artery continued to be one-side pulmonary artery,running to left or right and forming left branch or right branch of pulmonary artery.Pulmonary artery of the one-side absence of pulmonary segment supplied blood through aorta or other branches or vessels on the other side.After receiving unilateral pulmonary artery reconstruction surgery,ultrasound cardiogram of 8 patients of one month indicated that average flow rate of close-end anastomosis was (1.22± 0.17) m/s and far-end (2.17± 0.56) m/s.Conclusion Ultrasound cardiogram is efficient for UAPA preoperative diagnosis.Meanwhile,it is convenient,noninvasive and efficient in assessing anastomosis and pressure of pulmonary artery after surgery.

Infantile hepatic hemangioendothelioma with heart failure as the main manifestation: a report of 4 cases and literature review / 中华实用儿科临床杂志

Objective To summarize the clinical features,treatment and prognosis of infantile hepatic hemangioendothelioma(IHHE) combined with congestive heart failure(CHF) in children.Methods A retrospective analysis was made with the clinical data from 4 children with IHHE combined with CHF in Department of Pediatric Cardiology,Affiliated Guangzhou Women and Children's Medical Center of Guangzhou Medical University from May 2013 to December 2015.Results Among 4 infants,there were 3 male and 1 female,mean aged of 109 days (21-219 days),the average weight of 4 350 g (2 750-6 500 g),and 1 case was admitted because of abdominal swelling and respiratory distress,1 case of abdominal swelling,jaundice,shortness of breath admission,1 case of fever and shortness of breath admission,and 1 case of cyanosis and shortness of breath admission.Two patients were associated with hemangioma and Kasabach-Merritt syndrome.Three cases had multiple liver hemangioma scattered in the left lobe and right lobe of the liver,and 1 case had solitary liver hemangioma scattered in the right lobe.Tumor size diameters were ranged from 2-10 mm.Four children had been used Prednisone [1-2 mg/(kg · d)] and Digoxin,Dopamine,Furosemide,Spironolactone.Two cases responsed well to the therapy and were followed up for 2 years or 1 year and 6 months respectively,whose heart size,heart function and pulmonary hypertension became normal.One case with Kasabach-Merritt syndrome responsed poorly to the therapy.Two cases experienced transcatheter hepatic arteriovenous fistula embolization by using coil occlusion of hepatic artery-venous fistula.The postoperative hepatic tumor volume was significantly decreased,and the heart function was improved.One patient was followed up for 1 year and 6 months,and the heart size,pulmonary hypertension and heart function returned to normal.One case was still under follow-up.One case with Kasabach-Merritt syndrome died from heart failure and severe infection before surgery.The mortality rate was 25％ (1/4 cases).Conclusions IHHE is a rare cause of CHF in children.If heart failure is found unexplained in children,abdominal ultrasound or CT examination should be done immediatey in order to confirm the presence or absence of IHHE.The mortality rate in IHHE associated with CHF is very high.Early identification,early intervention,especially Prednisone combined with transcatheter hepatic arteriovenous fistula embolization can significantly improve heart function,reduce the mortality and improve the prognosis of IHHE associated with CHF in children.

Value of color Doppler echocardiography in diagnosis of scimitar syndrome / 中华超声影像学杂志

Objective To discuss the value of color Doppler echocardiography in diagnosis of scimitar syndrome .Methods The echocardiographic results of 6 patients with a diagnosis of scimitar syndrome were reviewed retrospectively .Their sonographic and hemodynamic characteristics were also analyzed connected with the reports in the literature .Results Three cases had dextrocardia and the others had mesocardia .All cases got right ventricular dimension enlargement .Total or partial of right pulmonary venous connection to the inferior vena cava were 3 cases respectively .All cases had right pulmonary artery hypoplasia .All of 6 cases echocardiographic results were in accordance with the findings by CT angiography and 4 cases were confirmed by operation .Conclusions The sonographic features of scimitar syndrome were obvious ,and echocardiography was contribute to early diagnosis of scimitar syndrome .

Follow up and review of patients with Kawasaki disease complicated with giant coronary artery aneurysms for a decade: a single-institution experience / 中华儿科杂志

<p><b>OBJECTIVE</b>To evaluate the prognosis and clinical features of patients with giant coronary artery aneurysm (GCAA) caused by Kawasaki disease (KD).</p><p><b>METHOD</b>KD complicated with GCAA was diagnosed in 55 patients between January 2003 and December 2012 in Guangzhou Women and Children's Medical Center.Of the 55 patients, 48 were studied(43 boys, 5 girls). According to the follow-up time, these patients were divided into four groups: ≤ 1 year follow-up group, > 1-3 years follow-up group, > 3-5 years follow-up group, and > 5-10 years follow-up group. These patients were investigated at the acute stage, and were followed up respectively at two weeks, one month, three months, six months, and one year after hospitalization and every 3 to 6 months after a year. All patients regularly accepted echocardiography and electrocardiographic examination, while some cases accepted CT coronary angiography (CTA) examination and coronary angiography (CAG) examination to confirm the condition of GCAA.</p><p><b>RESULT</b>(1) The age of 48 patients ranged from 2 months to 10 years. Twenty cases were less than 1 age (42%), 30 cases were under 3 years of age (62%) and follow-up time was (4.0 ± 3.1) years. Age at endpoint was 1.5 to 19 years, mean (6.8 ± 4.2) years respectively. (2) In ≤ 1 year follow-up group, the proportions of no significant changes, retraction, and stenosis were 48%, 48% and 4% respectively. In > 1-3 years follow-up group, the proportions of no significant changes, retraction, and stenosis were 39%, 39% and 22% respectively. In > 3-5 years follow-up group, the proportions of no significant changes, retraction, and stenosis were 30%, 35% and 35% respectively. In > 5-10 years follow-up group, the proportions of no significant changes, retraction, stenosis were 30%, 20% and 50% respectively. Compared with the ≤ 1 year group, a significant increase in the proportion of coronary artery stenosis occurred at the other three groups.Significant difference in the stenosis rate could be found between the ≤ 1 year group and the other three groups respectively (χ(2)=6.026, 11.121, 15.652; P=0.019, 0.002, 0.001). (3) The rate of retraction in bilateral GCAA group (20 cases) was lower than unilateral GCAA group (28 cases ); bilateral GCAA group had lower rate than the unilateral group(15% (3/20) vs. 36% (10/28)). There was no significant difference in coronary artery outcome between two groups (P > 0.05) . (4) There were six severe ischemic heart disease in 48 cases including 2 deaths. (5) CTA showed coronary artery wall thickening, mural thrombus and calcification, the CAG could display coronary artery occlusion and recanalization and collateral vessels formation.</p><p><b>CONCLUSION</b>KD complicated with GCAA may occur in infants under one year of age, especially infants under 6 months of age. A significant increase in the proportion of coronary artery stenosis occurred with the follow-up time extended. The proportion of bilateral GCAA patients who had ischemic heart disease and died was higher than the unilateral cases. The combined application of echocardiography, CTA and CAG may greatly help to discover coronary thrombosis, stenosis and occlusion.</p>

Application of 320-detector row dynamic volume CT angiography in follow up of coronary artery aneurysms caused by Kawasaki disease / 临床儿科杂志

ObjectiveTo assess the values of 320-detector row dynamic volume CT angiography (CTA) and transthoracic echocardiography (TTE) in follow up of coronary artery aneurysm (CAA) caused by Kawasaki disease (KD).Methods320-de-tector row CTA and TTE were applied in long-term follow-up of 8 patients with CAA caused by KD.ResultsIn 8 patients, the mean age at onset was 41.63±22.70 months and the mean follow up time was 43.50±10.99 months. In acute phase, 3 cases of giant coronary artery aneurysms (GCAA) and 5 cases of mid-small CAA were diagnosed by TTE. A total of 16/32 arteries (50%) were involved. At the end of follow-up, 3 cases of GCAA and 2 cases of mid-small CAA were still diagnosed by TTE, and small CAAs were regressed in another 3 cases. A total of 6/32 arteries (18.75%) were involved. Simultaneously at the end of follow-up, a total of 7/32 arteries (21.9%) were involved by 320-detector row CTA. The distribution was consistent with that of TTE. Mean-while, there were one case of left circumlfex artery, one case of GCAA at distal of the right coronary artery, 2 cases of thrombus, 1 case of coronary stenosis and 2 cases of calciifcation.ConclusionsCAA caused by KD may be persistent for a long time. The thrombus, stenosis, and calciifcation of coronary can occurr at late phase in GCAA. TTE is sensitive and reliable to detect proxi-mal and middle segment of coronary lesions, but has limitations in detection of distal segment of coronary arteries. 320-detector row CTA has more comprehensively view of each coronary artery lesions and is especially sensitive and reliable to detect coro-nary thrombosis, calciifcation and narrowing in proximal and distal coronary arteries after acute phase.

Recurrent Müllerian adenofibroma of uterus: a clinicopathologic study of 7 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features and differential diagnosis of recurrent Müllerian adenofibroma (MAF) of the uterus.</p><p><b>METHODS</b>Clinicopathologic information of 7 cases of recurrent MAF of uterus was retrieved from January 1992 to April 2006 and compared with 12 cases of MAF without recurrence and 14 cases of low-grade Müllerian adenosarcoma (MAS). EnVision immunohistochemistry of estrogen receptor (ER), progesterone receptor (PR), smooth muscle actin (SMA), CD10, Ki-67 and p53 were performed in all cases.</p><p><b>RESULTS</b>All cases of recurrent MAF of the uterus were polypoid, lobulated, and broad based mass arising from the corpus or cervix. Microscopically, the tumor consisted of benign epithelial and mesenchymal components with low mitotic activity ( ≤ 1/10 HPF). The clinical and pathologic features of 3 recurrent tumors were similar to their primary tumors, while 4 cases of recurrent tumor presented with focally higher cellularity and mitotic activity, meeting the diagnostic criteria of adenosarcoma. The stromal expression patterns of ER, PR, SMA and p53 in recurrent MAF were similar to those of clinically benign MAF and low-grade MAS. Negative or focally positive stromal cell expression of CD10 was seen infrequently in recurrent MAF (1/7) and clinically benign MAF (1/12). In contrast, a moderate to strong CD10 staining was frequently seen in MAS (9/14, P < 0.05). The difference of Ki-67-labeling index between MAF and MAS did not reach a statistical significance (P > 0.05). Ki-67-labeling index increased in areas of periglandular stromal cuffing as compared with interglandular areas in all MAS cases, but it was not observed in either recurrent MAF or clinically benign MAF cases.</p><p><b>CONCLUSIONS</b>Recurrent MAF may be associated with aggressive behavior. It is difficult to distinguish MAF from low-grade MAS. CD10 and Ki-67 staining pattern in stromal cells may be helpful for the differential diagnosis.</p>

Echocardiography diagnosis of coronary artery lesion in Kawasaki disease / 中华实用儿科临床杂志

The main complications of Kawasaki diseases(KD) is relative to cardiovascular,especially coronary artery.Coronary artery lesions can be showed as arteritis,artery dilatation,aneurysm,arterial stenosis and so on.As a noninvasive,convenient,fast and well reproducible inspection method,echocardiography can offer dynamically observa tion of the evolution process of coronary artery lesions in each stage,accurately measure the coronary artery diameter,evaluate heart function in children,find other cardiac complications and which has become a standard diagnosis technics.With upgrades and new technology,the echocardiography plays a more and more important role in the diagnosis of acute period of KD and observation of curative effect,prognosis and long-term follow-up of recovery period of KD.

The new amplatzer ductal occluder for transcatheter arterial duct occlusion in children / 中华实用儿科临床杂志

Objective To describe early clinical experience with the new amplatzer ductal occluder Ⅱ (ADO Ⅱ) for transcatheter patent ductus arteriosus(PDA) in children.Methods Twelve children were diagnosed as PDA from Jan.2013 to Apr.2014 in Guangzhou Children and Women's Hospital.All the children who were treated with the ADO Ⅱ had the indication of a successful interventional therapy successfully.The size of device was chosen according to aortographic and transthoracic echocardiography(TTE) results and pulmonary pressure.The device was delivered in a consequent or reverse way depending on the type of PDA,the minimal diameter of PDA and the size of duct ampulla.The device was delivered in a reverse way in ten patients,and two in a consequent way before detaching the device.Another aortogram was performed in order to check the position and form of the device,the velocities of blood flow in left pulmonary artery and the descending aorta though TTE and whether there was a residual shunt.All patients were examined by TTE in 24 hours after surgery and discharged without any complications 2 days later.The patients were programmed for the cardiologic consult including an TTE and electrocardiogram in 1,3,6 and 12 months after discharge.Results Twelve patients(7 male,5 female) with a median age of(1.59 ± 1.10) years(range 0.53-4.47 years),a median weight of (9.52 ± 3.41) kg(range 5.5-18.3 kg),a median pulmonary blood flow/systemic blood flow (Qp/ Qs) of 1.64 ± 0.45 (range 1.33-2.85),a median pulmonary artery systolic pressure (32.50 ± 10.05) mmHg (range 23-58 mmHg,1 mmHg =0.133 kPa),and the minimum (2.40 ±0.68) mm (1.6-3.8 mm),underwent transcatheter ductal closure with the ADO Ⅱ.Device sizes used were 3 mm ×4 mm(n =7),3 mm ×6 mm(n =3),6 mm ×6 mm (n =2),respectively and delivered with 4 or 5 F delivery catheters.The median fluoroscopy time was (6.39 ± 4.16) min(range 3.2-18.2 min).Complete ductal occlusion was achieved by the end of the procedure in 10 patients.The TTE showed good position of the occlusion and the velocities of blood flow in left pulmonary artery and the descending aorta were in a normal range.There was a trivial residual shunt after the surgery of 2 patients.No residual shunt was found after 24 hours in all 12 patients.In 1 case,the patient had a descending aortic obstruction with pressure gradient of 11 mmHg.Three months after surgery,the pressure descended to 10 mmHg by TTE.Complete ductal occlusion without aortic arch or left pulmonary artery stenosis had been identified in other 11 remaining patients on TTE follow-up of 6 months of 3 patients and 12 months of 6 patients.Conclusions The ADO Ⅱ achieves excellent ductal closure rates through low profile delivery systems in small infants and children with moderate and small PDA or morphologically varied PDAs.It is simple in use with few complications.Occlusion design allows closure with arterial or venous approach and delivery with 4 or 5 F delivery catheters.The children who used arterial approach,transthoracic echocardiography TTE is recommended to replace aortic angiography,so as to avoid puncturing the aorta and reduce vascular injury.

PEG-conjugated hemoglobin with chemotherapy down regulate the EPO/EPOR expression in tumor xenograft model / 国际生物医学工程杂志

ObjectiveTo observe the influence of polyethylene glycol-conjugated hemoglobin (PEG-Hb) solution combined with cisplatin on the expression of erythropoietin/erythropoietin receptor (EPO/EPOR) and tumor angiogenesis in cancer treatment.MethodsHeLa cells were injected subcutaneously into the right oxter of 3-4 weeks old BALB/c nude mice to establish cervical tumor xenograft model.Then animals were randomly assigned to 4 groups (n=10) and treated respectively:group 1(control); group 2,cisplatin (5 mg/kg); group 3,PEG-Hb (0.6 g/kg); group 4 cisplatin (5 mg/kg) plus PEG-Hb (0.6 g/kg).The volume oftumors in each groups were measured in 4 weeks treatment period.Efficacy was measured as percent tumor growth inhibition (TGI) relative to salinetreated group.CD31 was detected by immunohistochemistry and its expression was identified as microvascular density (MVD).Expressions of hypoxia inducible factor-1α(HIF-1α) and EPO/EPOR in tumor tissues were analyzed by irnmunohistochemistry.EPOR protein level was tested by western blot.ELISA method was used in measuring EPO concentration in serum.ResultsTumor volume was significantly decreased in group 4 compared with other groups.Immunoreactivity data demonstrated lower expression of CD31,HIF-1α and EPO/EPOR in group 4.The expression of EPOR in the endothelial cells was also significantly decreased in group 4.Western-blot data indicated lower EPOR protein level in group 4.Serum level of EPO was also decreased in group 4.ConclusionPEG-Hb plus cisplatin is benefit to tumor tissue oxygenation,therefore it can inhibit the tumor angiogenesis and down regulate the erythropoietin/erythropoietin receptor system.The result can provide more evidence for the enhanced sensitivity effect of the artificial oxygen carrier in cancer therapy.

PI3K-like kinases restrain Pim gene expression in endothelial cells / 华中科技大学学报（医学）（英德文版）

Pim kinases contribute to tumor formation and development of lymphoma, which shows enhanced DNA replication, DNA recombination and repair. Endothelial cells

Changes and prognostic significance of bone marrow oil drop and megakaryocyte counts of the bone marrow in acute myeloid leukemia patients (non-M3) / 白血病·淋巴瘤

Objective To investigate the changes and prognostic significance of bone marrow(BM) oil drop and megakaryocyte counts after chemotherapy in acute myeloid leukemia (AML) patients (non-M3).Methods Ninty-nine adult patients with denovo AML (non-M3) were retrospectively analyzed to evaluate the change of BM oil drop and megakaryocyte counts and their influences on overall survival(OS) and disease free survival (DFS) during all stages of standardized therapy.Results The median DFS and OS were 21 (2-88);months and 70 (4-89) months,respectively; and 3-year predicted DFS and OS were 47.3 ％ and 55.8 ％,respectively.After AML patients (non-M3) achieving complete remission (CR) by induction therapy,BM oil drop tended to increase along with postremission chemotherapy cycle accumulation, while megakaryocyte counts tended to decrease.The univariate analysis indicated that megakaryocyte counts decreased after the second course of postremission therapy. BM oil drop increased after the first to the third course of postremission therapy.Grade of myelofibrosis in BM biopsy,serum lactate dehydrogenase (LDH) level at diagnosis,flow cytometric immunophenotyping, the percentage of BM blast cells at diagnosis and the percentage of residual leukemic cells (RLC) during aplasia (7-10 days after the end of induction therapy) had prognostic significance.Multivariable COX analysis indicated the percentage of BM blast cells at diagnosis and change of BM oil drop after the third postremission therapy were independent prognostic factors for DFS (P =0.010,0.018 respectively),and RLCs during aplasia and change rate of the megakaryocyte counts after the second postremission therapy were independent prognostic factors for OS (P =0.009, 0.038respectively).Conclusion After AML patients (non-M3) achieving CR by induction therapy,BM oil drop tends to increase along with postremission chemotherapy cycles accumulation,while the megakaryocyte counts tend to decrease.Dynamic observations of bone marrow oil drop and megakaryocyte counts are helpful for assessing the prognosis of acute myeloid leukemia (non-M3).

Construction and application of evaluation system of PBL teaching for medical courses / 中华医学教育探索杂志

The evaluation system of PBL teaching was constructed to develop PBL teaching in combination with the characteristics of medical courses. It covered students evaluation system, teacher's evaluation, and teaching pattern system in all aspects of teaching. The present study was carried out through repeated verification in many clinical medicine curriculum and many grades of students, and standardized assessment model, a more mature evaluation system, has been fully applied. All the indices of the evaluation system were comprehensive in contents, scientific, objective, manipulated easily and with good results, which is worth promoting the application of PBL teaching in the future.

The relationship between age and biomechanical properties in porcine common bile duct / 生物医学工程学杂志

The aim of this study was to detect the relationship between age and biomechanical properties in porcine common bile duct (CBD). The CBDs of 50 Hubei white pigs aged 3-12 months were obtained. The experiment of pressure-diameter was conducted on the biomechanical experiment stand for soft tissues, and then the elastic modulus and compliance were calculated. The materials were transversely extracted, refrigerated, and sliced up before HE staining. The diameter and wall thickness of the CBD were measured by a computer image analysis system. The results showed that there was statistically significant difference in regard to the compliance of the porcine CBDs of different months (F = 59.69, P = 0.00). The compliance of the porcine CBD increased gradually with monthly age. However, after the pigs being aged 10 months, the compliance decreased gradually with monthly age. The compliance of the CBD of pigs aged 7-10 months was not significantly different (P > 0.05), but the compliance of the CBDs of pigs' aged 3-6 months and 11-12 months was significantly lower than that of pigs aged 7-10 months (P < 0.01). The changes in elastic modulus of porcine CBD with age were opposed to the changes in compliance. The results of the present study suggests that the in biomechanical properties of pigs' CBDs change with their ages, and the CBDs of pigs aged 7-10 months have good compliance. Thus, for the pig-to-human liver xenotransplantation, the livers of pigs aged 7-10 months, being chosen as donators, may be more conducive to matching.

Influence of chemical hypoxia induced by cobalt chloride on the proliferation and apoptosis of tumor cells / 基础医学与临床

Objective To investigate the effect of cobalt chloride on tumor cell proliferation and apoptosis in vitro, to explore the reasonable strategy of chemical hypoxia induced by CoCl2. Methods Two tumor cell lines (A549 and HeLa) were respectively exposed to CoCl2(0.05～2 mmol/L) for different time period (4～48 h), cells viability、proliferation and apoptosis were maesured by MTT and FCM methods. HIF-1? and related apoptosis proteins expression were detected by Western blot. Results Cells viability was weakly changed in low concentration(≤200 ?mol/L)of CoCl2 within 24 h. However, higher dose or prolonged challenge of CoCl2 significantly decreased cell survival rate (P

Comparison of zero-stress state of ascending aorta and pulmonary trunk between human and swine in vascular tissue reconstruction / 中国组织工程研究

BACKGROUND: Due to the source of conspecific heart transplanted organ is limited and it becomes more and more deficient, and porcine cardiovascular system and haemodynamics are very similar to that of human being, therefore, domestic and foreign scholars have paid more attention on the heterogeneic heart transplantation from swine to human, and there are more and more basic studies about it.OBJECTIVE: To compare the zero-stress state of ascending aorta and pulmonary artery trunk between swine of different months and healthy persons, which provides necessary vascular tissue reconstruction basis for anastomosing vessel of heterogeneic heart transplantation from swine to human being.DESIGN: Open experiment.SETTING: Laboratory of Biomechanics, Yunyang Medical College.MATERIALS: This experiment was carried out at the Laboratory of Biomechanics, Yunyang Medical College from October 2001 to September 2002. Human heart specimens were chosen from 6 male adult corpses who had no visible manifestation of cardiovascular diseases, aged 18 to 30 years. Informed consents were obtained from all the relatives. Totally 42 conspecific swine, aged one month, were also chosen and divided into 7 groups, named as 1,2,3,4,5,6 and ＞ 6 months groups respectively, with 6 in each group. Swine were anesthetized at 1,2,3,4,5,6,＞ 6 months respectively and sacrificed in each group.METHODS: The corresponding ascending aorta and pulmonary artery trunk were dissected and isolated. Each arterial anterior wall was labeled in situ with coloring pen, and then artery was shifted into the oxygen-saturated Kreb's solution. Five isometric vascular rings were divided along the axial direction, then each vascular ring was cut open along the radial direction. Opening angle of each vascular ring at zerostress state was measured and recorded by computer 20 minutes later(The included angel formed through connecting the middle point of inner wall of open vascular plane and two end points of inner wall). The experiment was conducted at room temperature 20-30 ℃. All the procedures of vascular samples were performed within 24 hours after subjects died.MAIN OUTCOME MEASURES: Measuring results of opening angle of ascending aorta and pulmonary trunk at zero-stress state of swine at different months and human being.RESULTS: ①Comparison of measuring results of opening angle of ascending aorta and pulmonary trunk between swine at different months and human being: Opening angle of ascending aorta of human being increased from (100.4±12.8)°at proximal end to (152.8±18.6)°at distal end. Opening angle of swine at different months increased from about 68°at proximal end to about 130°at distal end; Opening angel of pulmonary artery trunk of human being did not changed significantly along axial direction, and opening angel of pulmonary artery trunk of swine at different months increased from about 65° at proximal end to about 125°at distal end. There was significant difference of opening angle of ascending aorta and pulmonary trunk at zero-stress state between human being and swine (P=0.028 ＜ 0.05).But the opening angle of ascending aorta of human being was similar at the second segment to at the fourth and fifth segments of swine of different ages; Opening angle of each segment of pulmonary artery trunk of human being was close to that of proximal end (first and second segments) ofpulmonary artery trunk of swine.② Comparison of measuring results of ascending aorta and pulmonary artery trunk at zero-stress state of swine at different months: Opening angle of ascending aorta and pulmonary artery trunk of swine did not changed with the increase of age (P=-0.063 ＞ 0.05).CONCLUSION: Opening angels of ascending aorta and pulmonary artery trunk at zero-stress state are close in some segments between human being and swine, suggesting that corresponding ascending aorta or pulmonary artery trunk can mutually anastomose in some segments in the heterogeneic heart transplantation from swine to human, and the effect of age is not significant in vascular reconstruction.

Biomechanical properties of relevant blood vessels in the heterogeneic heart transplantation from swine to human / 中国组织工程研究

BACKGROUND: The source of conspecific heart transplantation organ is very limited and deficiency becomes more and more obvious.OBJECTIVE: To observe the mechanical properties of ascending aorta at one-dimensional loading between healthy persons and swine of different months, so as to provide necessary biomechanical experimental basis for anastomosing blood vessel in heterogeneic heart transplantation from swine to human.DESIGN: Open design SETTING: Staff Room of Anatomy, Yunyang Medical College MATERIALS: This experiment was carried out at the Laboratory of Biomechanics, Yunyang Medical College from April 2002 to July 2003.Ascending aortas of human were obtained from the 6 adult male corpses without cardiovascular diseases, aged 18 to 30 years, who died for accident and donated by Yunyang Medical College. Totally 42 conspecific swine of 1 month old, with certification number of QN0202, were provided by Animal Experimental Center of Yunyang Medical College. They were raised with common foodstuff. The 42 swine were butchered respectively at 1,2,3,4,5,6 and 7 months, 6 swine once. After anatomical isolation and in situ measurement of respective in vivo length, ascending aorta from aorta valve ring base plane to initiation part of innominate artery was taken out (Artherosclerosis was not presented in all the samples) and divided into five equal segments, and the second and fourth segments were used for mechanical test of one-dimensional loading.METHODS: Six adult male corpses and ascending aorta of 42 swine of 1 to 7 months were performed mechanical test of one-dimensional loading.All the blood segments were pre-treated ten times with the same strain rate at room temperature 32 ℃(loading range from 0 to 0.5 N). Hysteresis disappeared after blood vessel was given periodic permanent loading and unloading, and repeated force-deformed data were obtained. Blood vessel was given loading and unloading once with the same loading range and strain rate. The recorded force-deformed data were used for computer analysis. Force and displacement were scaled with standard weight and percentage scale at the end of each time. Constant α and elastic modulus Dt/dλ were fitted from experimental data.MAIN OUTCOME MEASURES: ① Comparison of the mechanical characteristic constant of ascending aorta at one-dimensional loading be tween human and swine of different months. ② Comparison of elastic mod ulus of ascending aorta at one -dimensional loading between human and swine of different months .RESULTS: ① Comparison of the mechanical characteristic constant of ascending aorta at one-dimensional loading between human and swine of different months: With the increase of month, although the material con stant of blood vessel of swine had a little increase, there was no significant difference (P ＞ 0.05). The mechanical material constant of ascending aorta at one-dimensional loading of human was basically familiar to that of swine of 1 to 7 months (P ＞ 0.05). ② Comparison of elastic modulus of ascend ing aorta at one -dimensional loading between human and swine of differ ent months: With the increase of months, elastic modulus of ascending aorta was significantly increased in swine of 7 months old in comparison with that in other months old (P ＜ 0.05); there was no significant difference of elastic modulus of corresponding blood vessel between human and swine of different months (P ＞ 0.05).CONCLUSION: There is no significant difference in mechanical characteristic constant and elastic modulus of ascending aorta between human and swine of 1 to 7 months. Mechanical characteristics of corresponding blood vessel were similar in some segments at least. From the mechanical angle, anastomosis of corresponding ascending aorta in the process of heterogeneic heart transplantation from swine to human has certain feasibility.