Analysis of discrepancies between clinical and autopsy diagnoses in 188 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To analyze the discrepancies between clinical and autopsy diagnoses in hospitals of different grades and with respect to duration of hospitalization.</p><p><b>METHODS</b>A total of 188 autopsy cases collected from hospitals of different grades were retrospectively reviewed and the discrepancies between clinical and autopsy diagnoses were analyzed.</p><p><b>RESULTS</b>The overall rate of misdiagnosis was 48.9% (92/188). The misdiagnosis rate in grade I hospitals (75.8%, 25/33) was significantly higher than that in grade III (39.6%, 38/96; chi(2) = 12.861, P = 0.000) and grade II hospitals (49.2%, 29/59; chi(2) = 6.179, P = 0.016 ). The misdiagnosis rate of patients beyond 24 hours of admission was lower than that admitted within 24 hours (chi(2) = 20.991, P = 0.000). The overall rate of missed diagnosis was 34.6% (65/188). The rate of missed diagnosis in grade I hospitals was remarkably higher than that of the grade III hospitals (chi(2) = 8.241, P = 0.006). There was no difference between grades I and III hospitals on the rate of missed diagnosis within 24 hours of admission, however, this rate was lower in grade III hospitals in comparing with that of grade I hospitals in patients admitted beyond 24 hours (chi(2) = 5.181, P = 0.047). The distribution of disease entities commonly encountered in patients of both misdiagnosis and missed diagnosis were heart problems, infections, arterial diseases and pulmonary embolism.</p><p><b>CONCLUSIONS</b>The rate of discrepancies between clinical and autopsy diagnoses is relatively high. The misdiagnosis and missed diagnosis rate in grade I hospitals was significantly higher than that in grade III hospitals and was closely related with the duration of hospitalization. Autopsy study thus still remains an important measure in clinical audit.</p>

Expression of epithelial Na+ channel in human nasal polyp / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the expression of epithelial sodium channel in nasal polyps and normal nasal mucosa and to characterize the ENaC-mediated Na(+) absorption and the mechanism of the liquid transport in human upper airway epithelia.</p><p><b>METHODS</b>The tissue from 12 patients with nasal polyps (NP) and the normal ethmoid cornu mucosa (ECM) from 5 patients were obtained through endoscopic surgery. The expression of ENaC was detected by Immunofluorescence and the concentration of ENaC alpha, beta, gamma-mRNA were detected by RT real-time PCR.</p><p><b>RESULTS</b>The ENaC in NP group (35.79 +/- 5.47) was higher than that in ECM group (22.17 +/- 5.43, t = 4.687, P < 0.01). The expression of ENaC-alpha, beta, gamma mRNA in NP group (respectively 2.06 +/- 0.42, 1.97 +/- 0.32, 1.96 +/- 0.54) was higher than that in ECM group (respectively 1.01 +/- 0.10, 0.98 +/- 0.08, 0.97 +/- 0.06; t = 5.482, 6.659, 4.036, all P < 0.01). The mRNA expression of three subunits of ENaC was as follows: alpha > beta > gamma in both groups. The mRNA expression of alpha, beta, gamma subunit of ENaC in NP group was higher than that in ECM group(P < 0.01). The expression of three subunits of ENaC was correlated respectively with that of mRNA in NP group.</p><p><b>CONCLUSIONS</b>The up-regulation of ENaC in human NP was associated with the expression of ENaC mRNA, that made hydrops and might be one of the most important cause of the develop of nasal polyp.</p>

Training model construction and education reform exploration of eight-year medical education / 上海第二医科大学学报

Objective To construct and implement the training model of eight-year medical education with characteristics of Shanghai Jiaotong University. Methods Based on survey,discussion and consultation,the experiences of long schooling medical education in Shanghai Jiaotong University School of Medicine were summarized.Training plan and education reform scheme were established. Results Training objective,guideline and major reform measures had been clarified.The training plan and reform scheme were under process of implementation. Conclusion The training objective of eight-year medical education should be further confirmed.The curriculum should be in accordance with the training objective,and education reform is important and necessary for the eight-year medical education.

Preliminary achievements of 4+4 program in medical education in Shanghai Jiaotong University School of Medicine / 上海第二医科大学学报

Objective To explore and evaluate the implementation process and prelimnary achievements of 4+4 medical education program in Shanghai Jaiotong University School of Medicine. Methods The data of student background,curriculum,exam grades and graduate employment of class 2002 and 2003 were collected and analysed. Results The data showed that this program has enrolled high quality students,teaching hours of key courses of medicine has been reduce to 70%,while the average grades of the comprehensive examination were higher than those of the 5 year students,and the employment prospects for 4+4 program has been optimistic. Conclusion The 4+4 program has achieved preliminary success,and the experiences is beneficial for the further reform of medical educational system.

Technique of detection of hepatitis C core antigen used in safety blood transfusion / 中国实验血液学杂志

This study was purposed to investigate the feasibility to screen donor with HCV infection by means of HCV-cAg ELISA. The first and repeat assays were performed for detection of serum anti-HCV in 8677 donor's serum specimens from January 2003 to December 2005. All serum anti-HCV specimens with positive anti-HCV from first and repeat assays were finally identified by using HCV-cAg ELISA and HCV RT-PCR methods. The results showed that only 5 serum specimens were positive anti-HCV by HCV-cAg ELISA identification in 29 specimens including 15 specimens with positive ant-HCV in first assays and 14 specimens with positive anti-HCV in repeat assays, the positive rate detected by HCV cAg ELISA was 17.24%. 5 serum specimens were positive anti-HCV by HCV RT-PCR detection also in 29 specimens mentioned above, the positive rate detected by HCV RT-PCR was 17.24% too. It is concluded that sensitivity of HCVcAg ELISA is similar to HCV RT-PCR and may be useful for the early diagnosis of hepatitic C or used as a reliable method to screen donor with HCV infection in blood transfusion medicine.

Inhibition of pathogenic Leptospira on phagocytosis of peritoneal macrophages of guinea pigs / 上海第二医科大学学报

Objective To investigate the effects of different Leptospira strains on phagocytosis of peritoneal macrophages of guinea pigs,and explore the role of innate immune in the pathogenesis of leptospirosis. Methods Peritoneal macrophages of guinea pigs were infected in vitro by three different Leptospira strains,the virulent Leptospira interrogans serovar Lai type strain Lai,the avirulent L.interrogans serovar Lai type strain IPAV,and the nonpathogenic L.biflexa serovar Patoc type strain PatocⅠ,respectively,and heat inactivated Staphylococcus epidermidis was added 0.5,1.5,3 and 6 h after infection and incubated for 30 min.The effect of Leptospira on the phagocytosis of macrophage was evaluated by the inactivated Staphylococcus epidermidis phagocytosis rate and phagocytosis index.Phagocytosis and ultrastructure of peritoneal macrophages were observed by transmission electron microscopy 3 h after infection,and changes of cytoskeleton of the macrophages were observed by laser scanning confocal microscopy. Results The phagocytic rates and phagocytic indexes of strain Lai,strain IPAV and strain PatocⅠinfection groups were significantly lower than those of control group 3 h and 6 h after infection(P

Effects of hVEGF genetically engineering membrane on the expression of flt-1 and TSP-1 during the healing process of full-thickness cutaneous defect / 上海第二医科大学学报

Objective To study the effects of hVEGF on the expression of fms-like tyrosine kinase-1(flt-1)and thrombospondin 1(TSP-1)during the healing process of rats' full-thickness cutaneous defect which covered by genetically membrane planted by fibroblast integrated with hVEGF recombinant.Methods Wounds with full-thickness cutaneous defect were produced on the dorsum of the SD rats.Eighty rats were divided into four groups at random,20 rats each.For the rats in the experimented group A,the wounds were covered with hVEGF genetically engineering membrane and Tegaderm membrane.In the control group B,the wounds were covered with membrane planted by the fibroblasts integrated with blank plasmid and Tegaderm membrane.In the control group C,the wounds were covered with blank membrane and Tegaderm membrane.In control group D,the wounds were only covered with Tegadern membrane.Specimens were obtained at the 3,7,14 and 29 days after injury,immunohistochemistry and image analysis were used to observe the expression of flt-1 and TSP-1.Results The expression of flt-1 in vascular endothelial cells was increased obviously in the experimental group.There was significant difference between the experimental group and other groups at 3,7 and 14d after injury(P

Design and validation of bone marrow histological scoring system for myelodysplastic syndrome / 上海第二医科大学学报

Objective To design a bone marrow histological scoring system for myelodysplastic syndrome(MDS) in order to provide an objective evaluation of clinical diagnosis,disease development and outcome prediction. Methods HE and Gomori staining were used to observe the morphological alterations in 149 bone marrow biopsies.Immunohistochemical staining for MPO,CD235,F8,CD42b,CD61 and CD34 was performed.The scores of distinct morphological changes of MDS were valued. Results The bone marrow histological scoring system for MDS was established and validated.The scoring system comprised 8 distinct histological features of MDS in bone marrow biopsy.When the score was ≥5,there was significant difference between normal bone marrow biopsy and bone marrow biopsy with MDS(P

Expression of CDK4 and cyclin D1 proteins in gastric carcinoma / 上海第二医科大学学报

Objective To investigate the expression and significance of CDK4 and cyclin D1 in gastric carcinoma,and to discuss their correlation with WHO histological classification,TNM stages and lymph node metastasis.Methods Forty paraffin wax specimens from patients with gastric carcinoma were collected and expression of CDK4 and cyclin D1 proteins were detected by immunohistochemistry.Results Immunohistochemistry demonstrated that the positive rates for CDK4 and cyclin D1 protein were 65% and 55%,respectively.There was positive correlation between CDK4 and cyclin D1 proteins(P0.05).Conclusion CDK4 and cyclin D1 proteins are frequently overexpressed in gastric carcinoma and there is a positive relationship between the two proteins,which may be involved in the development of gastric carcinoma.