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Objective:To compare the biomechanical characteristics of screw only spatial weaving fixation and calcaneal plate fixation in calcaneal fractures.Methods:Sanders type III calcaneus fracture model was established by using calcaneus model specimens: the physiological model group were the normal calcaneal models; the steel plate group were conventional steel plate fixation fracture models; the metal screw group were fracture models with only metal screw weaving fixation; seven and nine absorbable screw spatial weaving groups (seven absorbable screw group, nine absorbable screw group) were used to weave and fix fracture models with seven and nine absorbable screws. Cyclic test and mechanical compression test were carried out, and load-displacement curves were recorded. The material properties of metal screw spatial weaving and calcaneal anatomical plate system were replicated, finite element fracture models were established, and the calcaneal internal fixation models of plate screw group and spatial weaving screw group were completed by reverse processing. The changes of biomechanical characteristics of calcaneal bone in human (70 kg) standing on one foot were simulated, and the distribution of structural strength was analyzed by Von Mises equivalent stress cloud diagram and displacement cloud diagram.Results:In the cyclic test of 20-200 N load, the physiological model group, the plate group, the metal screw group, the absorbable 7 screw group, the absorbable 9 screw group were 0.87±0.22, 0.82±0.08, 0.70±0.12, 1.04±0.13 and 0.83±1.76 mm, the difference in model gap was statistically significant ( F=3.16, P=0.037). Among them, the absorbable 7 screws group was larger than the metal screws group ( t=4.28, P=0.003), and the other pin-two comparisons were not statistically significant ( P>0.05). The deformation of the five groups was 0.37±0.06, 0.38±0.07, 0.38±0.06, 0.52±0.07 and 0.42±0.07 mm, and the difference was statistically significant ( F=4.39, P=0.010). The deformation of absorbable 7 screws group was greater than that of physiological model group, the plate group and metal screw group ( t=3.69, P=0.006; t=3.25, P=0.012; t=3.51, P=0.008). In static test, compression displacement was 7.14±0.79, 7.30±0.66, 6.95±0.28, 8.19±0.61 and 7.16±0.55 mm, the difference was statistically significant ( F=3.28, P=0.032). The displacement of the absorbable 7 screws group was greater than that of the metal screws group ( t=4.13, P=0.003). The stiffness changes were 570.60±122.62, 512.86±80.77, 497.40±66.50, 456.21±58.19 and 560.39±94.40 N/mm, respectively, with no statistical significance ( F=1.44, P=0.258). The results of finite element analysis showed that under 3 500 N axial pressure load, the maximum compression displacement and stiffness of the plate and screw set were 6.47 mm, 540.96 N/mm, and the Von Mises equivalent stress peaks were 450.31 and 353.15 MPa, respectively. The maximum compression displacement and stiffness of the braided screw group were 5.25 mm, 666.67 N/mm, and the peak Von Mises equivalent stress of the screw was 396.20 MPa. Conclusion:Compared with lateral plate fixation, spatial weaving fixation can provide sufficient biomechanical stability for calcaneal healing and is superior to plate fixation in terms of structural stability, which may help to improve the effectiveness of calcaneal fracture fixation.
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Objective:To explore the best negative pressure standard of sputum aspiration in patients with severe craniocerebral injury, so as to achieve the best sputum aspiration effect and maintain relatively stable intracranial pressure.Methods:Totally 120 patients with severe craniocerebral injury admitted to the Department of Neurosurgery of Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from January to December 2019 were selected by convenience sampling method. According to the random number table method, patients were divided into 4 different negative pressure sputum aspiration groups: 75 mmHg (1 mmHg=0.133 kPa) group, 100 mmHg group, 150 mmHg group, 200 mmHg group, with 30 patients in each group. The levels of intracranial pressure and SpO 2, sputum cleaning time and mucosal injury were observed and compared in 4 groups: 1 min before sputum aspiration, 1 min after sputum aspiration and during sputum aspiration. Results:Comparison of intracranial pressure and SpO 2 in sputum aspiration among the four groups: intracranial pressure in 200 mmHg group was (22.23 ± 4.80) mmHg, which was higher than 75 mmHg group (16.33 ± 2.71) mmHg, 100 mmHg group (17.70 ± 2.32) mmHg, 150 mmHg group (17.20 ± 2.11) mmHg ( q=8.29, 6.58, 7.23), and SpO 2 was 0.906 ± 0.048, which was lower than 0.956 ± 0.013, 0.946 ± 0.018, 0.952 ± 0.023 in the other three groups ( q=7.81, 6.08, 6.69), with statistical significance (all P<0.01). There were statistically significant differences in intracranial pressure ( F=10.55) and SpO 2 ( F=36.57) among the four groups 1 min after sputum aspiration ( P<0.01);the 200 mmHg group had the highest intracranial pressure (15.63 ± 3.64) mmHg; the 100 mmHg group was (12.50 ± 1.48) mmHg and 150 mmHg group was (12.60 ± 1.00) mmHg, which had lower intracranial pressure than the 75 mmHg group (14.03 ± 2.86) mmHg. The sputum cleaning time was (35.53 ± 5.71) s in 75 mmHg group which was the longest and the shortest in 200 mmHg group (24.27 ± 3.22) s, with statistical significance among the four groups ( F=47.81, P<0.01). The incidence of airway mucosal injury in 200 mmHg group was 33.33% (10/30),which was higher than that in the other three groups, and the difference was statistically significant ( χ2=15.41, P<0.01). Conclusions:For patients with severe craniocerebral injury, artificial airway sputum viscosityⅠ-Ⅱ degree, suction negative pressure of 100-150 mmHg can better maintain the stability of intracranial pressure, control the decline of SpO 2 and prevent the damage of airway mucosa, and effectively reduce the adverse effects of sputum aspiration on patients with severe craniocerebral injury.
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Objective:To investigate the short-term and medium-term changes of the left ventricular ejection fraction (LVEF) and the predictive value of relevant electrocardiogram (ECG) indexes in children with dilated cardiomyopathy (DCM) complicated with complete left bundle branch block (CLBBB).Methods:Children clinically diagnosed with DCM in the Department of Heart Center, Women and Children′s Hospital, Qingdao University and Beijing Anzhen Hospital, Capital Medical University between November 2011 and August 2020 were retrospectively recruited.According to the combination of CLBBB, they were divided into CLBBB group and non-CLBBB group.Echocardiogram and ECG were regularly performed.Short-term and medium-term changes of LVEF based on the 1-5-year follow-up data were compared between groups.COX proportional hazards model and Kaplan-Meier multiplicative limit method were used to analyze the predictive value of ECG indexes of LVEF changes in children with DCM combined with CLBBB.Results:Ninety-four children with DCM were enrolled, including 35 cases in CLBBB group and 59 cases in non-CLBBB group.There was no difference in baseline LVEF between groups.However, significant differences were found in QRS duration, corre-cted QT interval(QTc), R peak time in lead V 5 (T V5R) and QRS notching or slurring between groups ( P<0.05). LVEF of all children showed an upward trend within one year after onset, while the Z value of eft ventricular end diastolic diameter(LVEDd) showed a downward trend, and the two indexes tended to be stable within 1 - 5 years.The Z value of LVEDd in CLBBB group was significantly higher than that of non-CLBBB group, while LVEF was significantly lower (all P<0.05). The mean LVEF of CLBBB group slightly fluctuated around 50%, that of LVEF in non-CLBBB group was 60%.The multivariate COX regression analysis showed that QRS duration ( HR=0.979; 95% CI: 0.960-0.999, P<0.05) and QTc ( HR=0.988; 95% CI: 0.979-0.998, P<0.05) were independent predictors of LVEF recovery in children with DCM.Kaplan-Meier method showed a significant difference of LVEF normalization between DCM children with different QRS durations ( P<0.05), which was also detected in those with QTc interval ( P<0.05). Conclusions:LVEF of children with DCM combined with CLBBB increases in the short term after standard treatment, and then being stable.CLBBB can affect the recovery of left ventricular systolic function in children with DCM.Moreover, QRS duration and QTc interval are independent predictors of LVEF recovery in DCM children.
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Objective To investigate the related mechanism of Slug inhibiting the proliferation of cervical cancer cell through CDH3/β-catenin/C-myc. Methods SiHa cells with stable Slug expression were screened. The expression of CDH3 in Slug-overexpressed SiHa cell was detected by RNA-sequence, Real-time PCR, Western blot and immunocytochemistry. The expression of CDH3 in SiHa and HeLa cells were detected by Western blot and immunocytochemistry. The protein level of CDH3 was up-regulated in HeLa cells or rescued in SiHa-Slug cells by transient transfection of CDH3 expression vector. The protein levels of β-catenin and C-myc were detected by Western blot, the cell growth was detected by cell counting and CCK-8 assays. Luciferase reporter assay and chromatin immunoprecipitation assay (ChIP) were performed to detect the effect of Slug on regulating the promoter region of CDH3. Results SiHa cell line with stable Slug expression was successfully constructed. Slug overexpression inhibited CDH3 expression in SiHa cells. CDH3 promoted cell proliferation and up-regulated the protein level of β-catenin and C-myc in HeLa and SiHa-Slug cells. Slug could recognize and bind to the E-boxes in the CDH3 promoter region and inhibited the transcription of CDH3 in SiHa cells. Conclusion Slug could inhibit the expression of β-catenin and C-myc by inhibiting CDH3 transcription in SiHa cells, and then attenuate the growth of SiHa cells.
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Objective:To evaluate the clinical significance of the coincidence test with 3D mirror image of unaffected side in the treatment of contralateral calcaneal fracture.Methods:A retrospective analysis was performed of the 35 patients who had been treated for single calcaneal fracture by coincidence test with 3D mirror image of unaffected side from January 2016 to June 2018 at Department of Trauma Orthopedics, The Sixth Hospital of Ningbo. They were 29 males and 6 females with an average age of 44 years (from 18 to 71 years). By Sanders classification, 19 cases were type Ⅱ and 16 cases type Ⅲ. CT scan and reconstruction of both calcaneuses was performed. The image of unaffected calcaneus was mirrored by Mimics software to guide virtual treatment of contralateral calcaneal fracture. Preoperatively the virtual bilateral calcaneuses and the reduced calcaneus were 3D printed to guide the actual operation. The coincidence test with 3D mirror image of unaffected side was used to evaluate fracture reduction after operation. Postoperative parameters such as B?hler Angle, Gissane Angle, calcaneal width, and coincidence of the affected calcaneal bone were recorded at 12 months after surgery. The clinical outcomes were assessed by American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and visual analogue scale (VAS) score.Results:In this cohort, operation time averaged 43.9 min (from 30 to 55 min), time from admission to operation 3.6 d (from 0 to 14 d), and hospital stay 6.3 d (from 3 to 11 d). The patients were followed up for an average of 18.8 months (from 13 to 24 months). All patients achieved bone union after an average of 17 weeks (from 12 to 26 weeks). Re-collapse of subtalar articular surface, talocalcaneal joint fusion, loss of calcaneal height or length, and calcaneal width increase were observed in none of the patients. The VAS scores averaged 2 (from 0 to 4), and the AOFAS scores 93.3 (from 76 to 98). The total coincidence was 95.2%±3.5%. Spearman test indicated a positive correlation between postoperative total coincidence and AOFAS score ( ρ=0.588, P<0.05). Conclusion:The coincidence test with 3D mirror image of unaffected side can be used to treat contralateral calcaneal fracture, with advantages of reduced surgical time, increased surgical accuracy and fine clinical outcomes.
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Objective:To explore the effect of different head elevation angle on intracranial pressure and cerebral blood flow of patients with hypertensive cerebral hemorrhage in a resting state, to provide scientific basis for nursing development.Methods:A total of 72 hypertensive cerebral hemorrhage patients were selected as research subject, at the resting state, head elevation was raised up with 0°, 5°, 10°, 15°, 20°, 25°, 30° in the supine position with 5 minutes interval between different positions. The levels of intracranial pressure, cerebral perfusion pressure, regional oxygen saturation, blood pressure, heart rate, pulse oxygen saturation were recorded.Results:With head elevation from 0° to 5°, 10°, 15°, 20°, 25°, 30°, the levels of intracranial pressure were (12.39±3.32), (10.64±3.19), (9.84±2.58), (9.09±1.76), (8.33±2.51), (7.13±1.81), (6.81±1.67) mmHg(1 mmHg=0.133 kPa); mean arterial pressure were (106.06±10.17), (104.45±10.77), (105.87±6.73), (106.82±10.36), (105.78±10.27), (106.77±6.15), (100.30±10.92) mmHg; cerebral perfusion pressure were (93.67±10.36), (93.82±10.81), (96.03±7.26), (97.73±10.63), (97.45±10.38), (99.65±6.62), (93.49±10.99) mmHg; regional oxygen saturation were (65.91±6.70)%, (66.89±6.52)%, (67.12±8.04)%, (69.33±13.26)%, (69.31±8.47)%, (68.94±9.82)%, (66.12±6.78)%. Intracranial pressure was increased gradually with head elevation from 0° to 5°, 10°, 15°, 20°, 25°, 30°, the difference was statistically significant ( F value was 45.380, P<0.01). Mean arterial pressure was significantly decreased at 30° head elevation compared to the 0°, 5°, 10°, 15°, 20°, 25° head elevation ( t values were 2.331-2.997, P<0.05). Cerebral perfusion pressure and regional oxygen saturation showed an increased trend, however, those index was decreased at 30° head elevation, the levels of cerebral perfusion pressure and regional oxygen saturation was significantly increased at 15°, 20°, 25° head elevation compared to the 0° and 30° head elevation ( t values were 2.554-3.331 and 2.378-3.091, P<0.05). However, there was no significant difference between 0°, 5°, 10°, 15°, 20°, 25°, 30° head elevation in systolic pressure, diastolic pressure, heart rate, pulse oxygen saturation ( P>0.05). Conclusions:15°-25° head elevation is a relatively appropriate position in patients with hypertensive cerebral hemorrhage.
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Objective@#To compare the sensitivity of 8-color panels and next generation flow cytometry (NGF) for detecting minimal residual disease of multiple myeloma patients.@*Methods@#8-color-membrane antigens (8C-Mem) panel was built including CD45, CD38, CD138, CD19, CD56, CD81, CD27 and CD117 to identify the plasma cells, while 8-color-cytoplasmic antigens (8C-Cyto) panel was built including CD45, CD38, CD138, CD19, CD56, CD81, cKappa (cK) and cLambda (cλ) , and 8-color-two-tubes (8C-2tubes) panel were built including 8C-Mem and 8C-Cyto panels, the data of three groups was analyzed by Diva software. NGF uses Infinicyt software to fuse 8C-2tubes data to further analyze the expression of plasma antigens. Bone marrow aspiration obtained from 20 controls and 76 multiple myeloma patients who achieved complete remission were measured and analyzed.@*Results@#Positive MRD samples were discriminated in 88.2% of the specimen evaluated through either abnormal plasma cells (aPCs) or clonal plasma cells (cPCs) by NGF antigens panel, Among of them, consistency was 94.7%. The median percentage of cPCs was 0.3530%, The lowest sensitivity of NGF was 0.0003%. In 8-color panels, the positive MRD rates of 8C-Mem, 8C-Cyto and 8C-2tubes panels were 84.2%, 85.5% and 86.8%, respectively, which lower than that of NGF (P<0.001) . The positive MRD rate of 8C-Mem and 8C-Cyto panels were lower than that of 8C-2tubes panel (P<0.001) , and the positive MRD rate of 8C-Mem panel was lower than that of 8C-Cyto panel (P<0.001) . Sensitivity and specificity of NGF was higher than that of 8-color panels. 8C-2tubes panel has the best sensitivity, accuracy, negative predicted value, positive predicted value and specificity than other 8-color panels. However, huge data and low efficiency for analysis is the disadvantage. 8C-Cyto panel was the second choice, and 8C-Mem panel was the last.@*Conclusions@#Membrane and cytoplasmic light chain is a better method for multiple myeloma-MRD detection and NGF panel is an ideal approach. 8C-Cyto panel is recommended in 8-MFC groups.
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Objective@#To investigate the relationship between neglect , physical abuse and non-suicidal self-injury (NSSI) behaviors among middle school students in rural China.@*Methods@#A total of 14 162 adolescents in Anhui, Guangdong, Yunnan, Heilongjiang and Hubei provinces were selected by multi-stage cluster random sampling method. Data were obtained on demographic information, neglect, physical abuse and non-suicidal self-injury from questionnaire survey.@*Results@#During the past year before survey, 13.5% of participants engaged in self-injury 5 times or more, 15.4% of participants engaged in self-injury 1 to 4 times. Both neglect and physical abuse were significantly associated with self-injury in adolescents(P<0.01). After adjusted for gender, ethnicity, the only-one child, family structure, family economic status, and other variables, multinomial logistic regression showed that neglect and physical abuse were positively associated with self-injury behavior(OR=1.43-3.23). There was a potential dose-response relationship of accumulating physical abuse types and self-injury, with more physical abuse types, the higher risk of self-injury behavior.@*Conclusion@#Neglect and physical abuse experience should be considered as a risk factor for NSSI among adolescents in rural China. Specific intervention targeting neglect and physical abuse should be strengthened to reduce the occurrence of NSSI.
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Objective@#To explore prevalence and associated factors of neglect among left-behind middle school students in undeveloped area of Guangdong, and to provide scientific basis for effective intervention measures.@*Methods@#A total of 1 105 middle school students were selected from Yangjiang and Qingyuan by random cluster sampling, neglect and left-behind was assessed by a self-reported questionnaire.@*Results@#The prevalence of neglect was 70.9% among left-behind middle school students aged 11-17 years in Yangjiang and Qingyuan areas. Univariate analysis suggested that high parental education, democratic and strict parenting, and frequent contacts with parents associated with low rate of neglect (P<0.05). After adjusted for gender, parental education, parenting style, contact frequency, Logistic regression analysis revealed that parenting discipline(rough, cold, capricious)(OR=2.01, 95%CI=1.23-3.26), contact with parents more than once every two weeks (OR=1.75, 95%CI=1.12-2.72) , peer or self-care (OR=1.85, 95%CI=1.04-3.30) were positively associated with neglect, while higher mother education was negatively associated with neglect.@*Conclusion@#The prevalence of neglect is high among left-behind students in Yangjiang and Qingyuan, which deserves further attention from family, community, school and government to promote healthy development.
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Objective@#To explore the relationship between non-suicidal self-injury and Internet addictive behavior in adolescents.@*Methods@#A cross-sectional survey of 15 538 middle school students across 5 provinces in China. Participants reported self- injury behavior during the past year and the Internet addition behaviors were assessed through Young’s Internet Addiction Test(IAT).@*Results@#The prevalence of self-reported 1-year NSSI, Internet addictive behavior and pre-addictive behaviors was 28.7%, 3.3% and 29.9%, respectively. After controlling for potential confounders, the Internet addition was positively correlated with NSSI, and the risk of all types of NSSI was higher in adolescent with Internet addition than those with mild suspected Internet addictive behavior(OR=1.3-2.8).@*Conclusion@#These findings indicate that Internet addition is associated with the incidence of NSSI in adolescents.
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In the practice of building its humanistic environment of a research hospital,Nanjing Drum Tower hospital adheres to such humanistic characteristics of the hospital as humanistic concept,planning, environment,management,service,and quality.Furthermore,the hospital upholds such keys as learning, innovation, cooperation, undertaking, competition and development. High focus, high starting point planning,persistence,and down-to-earth efforts,effectively promoting hospital development.
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After the concept and characteristics of public health emergencies were described , the advantages and possibility of medical library to provide service for public health emergencies were analyzed with suggestions put for-ward for medical library to provide service for public health emergencies,such as perfecting emergency measures and service mechanisms ,cultivating active and advance service awareness ,developing special database ,establishing close communication with related institutions, enforcing network construction and maintenance,and improving librarians'literacy.
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<p><b>OBJECTIVE</b>To evaluate the results of autologous hematopoietic stem cell transplantation (auto-HSCT) in adults with Philadelphia chromosome-negative acute lymphoblastic leukemia (Ph-ALL).</p><p><b>METHODS</b>From January 2000 to December 2007, the clinical data of auto-HSCT in adults Ph-ALL with complete remession (CR) 1 according to BDHALL2000/02 protocol were analyzed.</p><p><b>RESULTS</b>A total of 56 patients were enrolled and the probabilities of standard risk, intermediated risk and high-risk group were 41.1%, 33.9%, and 25.0%, respectively. After a median follow-up of 75 months (range 7-177 months), the 5-year overall survival (OS), events free survival (EFS) and relapse free survival (RFS) were (51.8 ± 6.7)%, (51.8 ± 6.7)%, and (60.5 ± 6.9)%, respectively. And the 5-year accumulative relapse rate was (39.1 ± 6.9)%. The 5-year OS of standard risk, intermediate risk, high-risk group were (60.9 ± 10.2)%, (52.6 ± 11.5)%, and (35.7 ± 2.8)%, respectively. The 5-year RFS among three groups were (68.3 ± 9.9)%, (62.5 ± 12.1)%, and (44.9 ± 14.1)%, respectively. The 5-year EFS among three groups were (60.9 ± 10.2)%, (52.6 ± 11.5)%, and (35.7 ± 12.8)%, respectively. The 5-year accumulative relapse rate among three groups were (31.7 ± 9.9)%, (37.5 ± 12.1)%, and (55.1 ± 14.1)%, respectively. There was no statistical significance of any survival rates between standard and intermediate risk groups, just as intermediate and high-risk groups. The OS and EFS in standard risk group were superior to those in high-risk group (P=0.040 and P=0.029, respectively), while there was no statistical significance of RFS and accumulative relapse rate between the two groups. The clinical factors listed below did not influenced the prognosis in the univariate analysis (P>0.05), including more than 5 weeks reaching to CR, WBC count at diagnosis, different immunophenotype (T or B cells), myeloid antigen expression, hyperdiploid chromosome karyotype, complex chromosome abnormality, conditioning regimen with or without TBI, duration between transplantation and diagnosis.</p><p><b>CONCLUSION</b>Ph-ALL adults could achieve a satisfactory CR and better survial according to BDHALL2000/02 protocol followed by auto-HSCT, especially for the standard or intermediate risk group, and no-donors high-risk patients.</p>
Subject(s)
Adult , Humans , Autografts , Disease-Free Survival , Hematopoietic Stem Cell Transplantation , Immunophenotyping , Philadelphia Chromosome , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Prognosis , Recurrence , Survival RateABSTRACT
<p><b>OBJECTIVE</b>To explore the feasibility and diagnostic implication of BRAF V600E mutation identified by high-resolution melting (HRM) assay in patients with hairy cell leukemia (HCL).</p><p><b>METHODS</b>The V600E mutation of BRAF exon 15 in four HCL patients were detected by HRM assay and patients' clinical data were retrospectively analyzed.</p><p><b>RESULTS</b>All four HCL patients were positive for the BRAF V600E mutation, which were identical to the results of DNA sequencing.</p><p><b>CONCLUSION</b>The HRM assay for BRAF V600E mutation provides a useful tool to aid the laboratory diagnosis of HCL with easy operability, accuracy, and low cost.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , DNA Mutational Analysis , Leukemia, Hairy Cell , Diagnosis , Genetics , Mutation , Polymerase Chain Reaction , Methods , Proto-Oncogene Proteins B-raf , GeneticsABSTRACT
Objective:This study aimed to compare the clinical efficacy and prognosis between rituximab plus fludarabine and cyclophosphamide (FCR) and fludarabine and cyclophosphamide (FC) regimens for patients with chronic lymphocytic leukemia (CLL). Methods:The clinical data of 58 patients with CLL treated with FCR or FC regimens from December 2002 to January 2012 were analyzed retrospectively. Therapy efficacy and prognosis were compared between the two groups. Results:Among the 58 pa-tients, 27 (44.4%) experienced complete remission (CR) in the FCR group and 31 patients (19.4%) experienced CR in the FC group (P=0.039). The overall response rate (ORR) of the FCR group was higher than that of the FC group (81.5%and 51.6%, respectively, P=0.017). Fourteen patients achieved MRD-negative rating after therapy. PFS and OS in MRD-negative patients were superior compared with the MRD-positive group (P=0.000, 0.003). The proportion of MRD-negative patients in the FCR group was higher than that in the FC group (37.0%and 12.9%, respectively, P=0.032). PFS in high-risk genetic patients was lower than that in low-risk genetic patients (P=0.011, 0.027). The OS time between the two groups did not exhibit any difference. Conclusion:FCR produced a high CR and ORR in patients with CLL. Many patients in the FCR group were responsive to the treatment. Thus, FCR could be a more effective regimen than FC for patients with CLL.
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Objective To investigate and analyze the effect of current doctor-patient relationship on profession recognition of medical students and to make some accommodations for medical education. Methods Questionnaire was conducted among 800 medical students in North Sichuan Medical College concerning the aspects of recognition of doctor-patient relationship,profession recognition and effect of current doctor-patient relationship on profession recognition . Data statistics was done by SPSS 19 . 0 . Differences were analyzed by frequency,chi-square test by α=0.05 standard and Spearman correlation analysis. Results 67.6%(536/793)of the surveyed students thought that the current doctor-patient re-lationship exerted effect on their job concepts. According to the results of Spearman correlation analysis between current doctor-patient relationship(X)and effect of current doctor-patient relationship on future job con-cepts(Y),correlation coefficient was 0 . 088 ,P=0 . 013<0 . 05 . Conclusions Effect of current doctor-patient relationship on profession recognition of medical students results from health care policy, school education and society,therefore,university should improve related education .
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Objective To explore the clinical characteristics of B cell prolymphocytic leukemia (B-PLL).Methods The clinical manifestation,treatment and outcome of a 33-year-old man with B-PLL were reported.Results The young patient had thrombocytopenia and systemic B-symptoms,markedly raised lymphocyte'count,bulky splenomegaly and lymphadenopathy.He refused stem cell transplant,so RFC regimen (fludarabine,cyclophosphomide and rituximab) therapy were administered.After 4 cycles of RFC therapy,the patient achieved a complete immunophenotypical and hematological remission response.Conclusion RFC therapy might be a feasible and useful treatment option for B-PLL.
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LATS2-gene,as one homolog of LATS tumor suppressor family,plays an important role in the control of cell cycles and tumor development through Hippo pathway,p53 gene and Ras-ERK signal transduction.Once an aberrant expression of LATS2 in cell to happen,it may lead to the tumor occurrence.
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Objective To discuss the anatomical and radiographic characteristics of acetabular fossa,and evaluate their value as a reference for achieving the anticipated inclination of the acetabular cup.Methods Sixteen adult normal pelvic specimens were studied.Central axis of acetabular fossa and its intersection with fossa edge and acetabular rim were marked.The radiographic appearance of the two intersections was evaluated.With radiographic templating,the relationship between the top of acetabular fossa and the central axis of acetabular cup at anticipated inclination was identified.Implantation of cementless acetabular cup was performed bilaterally on the pelvic specimens.The acetabular fossa was used as a reference for implantation on one side,and the acetabular positioning device was used on the other side.The discrepancy of acetabular inclination was recorded before and after operation in the two groups.Results Intersection of central axis of acetabular fossa with fossa top edge and acetabular rim corresponded to the most medial and lateral aspect of acetabular sourcil respectively on standard anteroposterior pelvic radiograph.There was close correlation between most medial aspect of acetabular sourcil and central axis of the acetabular cup at anticipated inclination of 40°±5°.For the group of using acetabular fossa as reference,the mean difference of inclination was 0.19°±3.14°(-6°-5°)before and after operation,and the discrepancy was 2.75°±2.89°(-2°-8°)for the control group.The difference between the two groups was statistically significant(t=-2.453,P=0.027).Conclusion In primary total hip replacement,if normal anatomy of acetabulum was found,the anticipated inclination of acetabular cup can be accurately obtained,based on the relationship between the top of acetabular fossa and anticipated inclination of acetabular cup on preoperative templating.
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Objective:To observe the clinical effect of apical barrier and perforation repair with mineral trioxide aggregate.Methods:Selected 23 samples from out-patients of the department of conservative dentistry of oral disease treatment center of 306 Hospital of PLA.Among them,7 samples were with unshaped root apical,6 samples were with lateral perforation from root canal internal absorption or root fracture,10 samples were iatrogenic lateral perforation.The course of the disease was 0.5-24 months.The images of dental films showed that there was shadow around the root or apical area in all the samples.All the samples received regular root canal treatment.Under root canal microscope,the open sites were sealed with MTA.After the barrier formed,filled the root canal with warm gutta-percha vertical compaction technique.Patients were ordered to re-check on 6 months and 12 months respectively.Results:1 sample dropped out.On 6 months visit,1 sample showed enlarged shadow at the apical area,20 samples showed shrinked shadow,1 sample showed no significant change.On 12 months visit,the shadow vanished in 9 samples;the shadow decreased in 5 samples,and there were 2 samples showed no significant changes.Conclusion:The treatment with MTA on apical barrier and perforation shows acceptable effect in short term observation.The use of microscope helps to enhance the accuracy and leak tightness of MTA filling.