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Under the combination of postgraduate education and standardized medical residents training, via exploring current situation, we put forward the limitations of routine rotation training, disconnection of theory and practice, inefficient of scientific ability. We arouse a new model by improving teaching model, enriching teaching content, optimizing teaching method, making better arrangement of rotations and cultivating scientific ability to provide references for enhancing the ability of clinical thinking, practice, scientific research and communication.
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Major depressive disorder is a mental illness characterized by depressed mood, lack of engagement in pleasurable activities, anhedonia, and cognitive-behavioral disorders. Currently, traditional pharmacological treatments for depression have a delayed therapeutic onset and low treatment effectiveness. (2R, 6R)-HNK, as a key metabolite of ketamine, can not only exert rapid and lasting antidepressant effects but also has no side effects such as hallucination and addiction caused by ketamine, which has potential clinical application values. Studies have found that the antidepressant effect of (2R, 6R)-HNK is closely related to the regulation mechanism of glutamate receptor and synaptic plasticity. Besides, the changes of downstream signaling pathways include the upregulation of brain-derived neurotrophic factor (BDNF) expression, dephosphorylation of eukaryotic elongation factor 2 (eEF2), and activation of the mammalian target of rapamycin (mTOR) play a key role in the antidepressant process of the drug. Understanding the molecular mechanisms underpinning (2R, 6R)-HNK's antidepressant effects will be invaluable for the identification of targets, which will drive the development of novel, effective, next-generation pharmacotherapies for the treatment of depression.
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Objective To reveal pathogenesis and etiology in adrenal incidentaloma. Methods The clinical data of 116 patients with adrenal incidentaloma from January 1, 2015 to January 1, 2017 were retrospectively analyzed. Results In 116 patients with adrenal incidentaloma, 49 cases (42.2％) were male and 67 cases (57.7％) were female; there were 14 cases (12.1％) aged from 20 to 40, 63 cases (54.3％) aged from 40 to 60, and 39 cases (33.6％) > 60 years. Forty-three patients (37.1％) were found by health examination, 26 patients (22.4％) were found because of hypertension, 27 patients (23.3％) were found by CT detection because of other diseases, and 20 cases (17.2％ ) were found because of other reasons. The result of endocrine function examination showed that nonfunctioning adrenal tumor was in 56 cases (48.3％); functional adrenal tumor was in 44 cases (37.9％), among whom primary aldosteronism was in 27 cases, Cushing syndrome was in 10 cases, and pheochromocytoma was in 7 cases;nonfunctioning non- adenoma was in 16 cases (13.8％ ). Conclusions It is frequent that the adrenal incidentaloma is found by health examination. The patients with adrenal incidentaloma should examine the endocrine function and identify the benign or malignant. And if necessary, surgical treatment should be performed.
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Objective To study the effects of task-oriented training combined with electromyographic biofeedback on wrist and finger extension after stroke.Methods Thirty-eight stroke patients were assigned randomly into either an experimental group (18 cases) or a control group (18 cases).Both groups received routine rehabilitation treatment and electromyographic biofeedback training.In addition,the experimental group was given task-oriented training in wrist and finger extension.Myoelectricity values,the active range of wrist dorsiflexion and the FuglMeyer upper extremity assessment (FMA) were assessed before and after 8 weeks of training.Results All of the patients showed significant improvements after 8 weeks of training,but compared with the controls,the patients in the experimental group improved significantly more in terms of all of the measures.Conclusion Task-oriented training with electromyographic biofeedback can improve upper extremity function,particularly wrist extension,among hemiplegic stroke survivors.
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Objective To observe the diagnosis and surgical treatment of substemal goiter. Methods The clinical data of 26 cases with substemal goiter underwent thyroidresection were retrospectively analyzed. Results All the 26 cases were treated by operation. 20 cases were operated by Lower collar incision. 6 cases were operated by ster-notomy. The pathological results showed nodular goiter in 18 cases,follicular adenoma in 6 cases,and papillary carcinoma in 2 cases. Conclusions Surgery via cervical collar incision was fit for most of retrostemal thyroid nodules,and sternotomy or thoracotoray were safely fit for large or carcinomatous substemal goiter. Most cases of retrostemal goiter could be removed by Lower collar incision.
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Objective To investigate the therapeutic efficacy of Video-assisted thoracoscopic surgery (VATS)in treating hemopneumothorax. Methods 83 cases of hemopneumothorax treated with exploratory thoracotomy with the help of VATS were retrospectively analyzed. Results All the 83 cases were completed successfully by the VATS.22 cases were treated with bunamiody resection,42 eases were treated with lung repair operation,12 cases were treated with pleuropexy,5 cases were treated with albumingel injection,2 cases were treated with thoracotomy because of serious injury.All patients were followed up 1 year and were found in good condition. Conclusion VATS could treat bunamiody resection and lung repair operation,can stop the bleeding effectively, cause less injury,good therapeutic effect and quickly recovery.
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Objective To investigate the effects of adiponectin on the development of atherosclerosis.Methods The in vivo role of adiponectin on the development of atherosclerosis in rabbits was investigated mainly using adiponectin-producing adenovirus(Ad-APN)and intravascular ultrasound(IVUS).On day 14 after Ad-APN local transfer to the intima of abdominal aortas,abdominal IVUS images were recorded and then rabbits were sacrificed.Abdominal aortas were collected and performed histochemical analysis.Results Ultrasonography revealed a significantly reduced atherosclerotic area,in abdominal aortas of rabbits infected through intima with Ad-APN,by 36.39% compared with the area in adenovirus expressing β galactosidase gene(Ad-βgal)treated rabbits(P＜0.01),and by 37.50% compared with that before treatment(P＜0.01).The lumen area stenosis was also reduced by 23.37%(P＜0.05)and 33.15%(P＜0.01),respectively.In rabbits with Ad-APN infection,the atherosclerotic plaque area as seen on Oil Red O staining was reduced significantly,by 30.70%(P＜0.05)and the greatest thickness of plaque was reduced,by 20.83%(P＜0.05)as compared with those in Ad-βgal-treated rabbits,respectively.Conclusions Intravascular ultrasound analysis is a valuable method in the in vivo study about the effects of adiponectin on the development of atherosclerosis.
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With the development of CT technique and clinical application of mutiple-detector helical CT,it is possible to reconstruct the structure of organs under the help of 3-dimention CT technique.The blood supply of normal liver and that of hepatic cancer come from hepatic artery and portal vein,with 25% and 75% respectively for the former and just neverse for the latter and sometimes having correlation with presure inside ,the biliary system.Therefore,a full knowledge of intrahepatic vasculo-ductal system is not only crucial for hepatic cancer diagnosis but also for treatment interventionally.(J Intervent Radiol,2007,16:280-283)