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This project starts with the teaching of clinical anatomy for eight-year medical students, selects specialists to enter the courses according to the content of clinical anatomy, and explores the deep integration of basic and clinical education. This study used the self-made questionnaire to evaluate the effect of the integrated teaching model, and Likert scale was used to score. Meanwhile, the correlation between the scores of each question and total points was analyzed with the item analysis. Moreover, we assessed the principal components through the exploratory factor analysis. The results showed that more than 95% questioned students thought the preclinical education integrated with clinical medicine teaching model is necessary and practical, which can assist medical students in the anatomical structure learning combined with clinical disease, and meanwhile cultivate students' clinical thinking. Only fewer than 10% thought it can connect the basic knowledge and clinical cases effectively, and over 35% thought there are difficulties. Additionally, more than half students (54%) hold the negative attitude which clinicians can't completely replace basic teachers in teaching. Our finding suggests that the integrated teaching model is attractive and feasible. Nonetheless, clinicians can’t replace preclinical teachers completely in the clinical anatomy education yet.
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"The Expert Group on Tumor Ablation Therapy of Chinese Medical Doctor Association, The Tumor Ablation Committee of Chinese College of Interventionalists, The Society of Tumor Ablation Therapy of Chinese Anti-Cancer Association and The Ablation Expert Committee of the Chinese Society of Clinical Oncology" have organized multidisciplinary experts to formulate the consensus for thermal ablation of pulmonary subsolid nodules or ground-glass nodule (GGN). The expert consensus reviews current literatures and provides clinical practices for thermal ablation of GGN. The main contents include: (1) clinical evaluation of GGN, (2) procedures, indications, contraindications, outcomes evaluation and related complications of thermal ablation for GGN and (3) future development directions. .
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Objective To evaluate two methods of selecting region of interest (ROI)to measure the apparent diffusion coefficient (ADC)of breast lesions on diffusion-weighted imaging (DWI).Methods MRI findings (including plain MRI,dynamic contrast-en-hanced MRI and DWI)of 5 3 cases with breast mass confirmed by pathology were analyzed retrospectively.Two observers independ-ently measured the ADC of breast lesions by the method of fixed ROI with the size of 10 mm2 ±2 mm2 and the routine method.The mean ADCs of benign and malignant breast lesions were compared between two methods and two observers by using paired samples T-test.The values of ADC diagnosing breast cancer were compared between the two methods by using the receiver operating charac-teristic (ROC)curve.Results Among 62 lesions of 53 cases,33 lesions were malignant,and 29 lesions were benign.For the first observer,the mean ADCs of benign and malignant lesions were (1.647±0.359)×10-3 mm2/s and (1.136±0.227)×10-3 mm2/s measured by the fixed ROI method,respectively.The area under the ROC was 0.897.The mean ADCs of benign and malignant le-sions were (1.603±0.415)×10-3mm2/s and (1.251±0.237)×10-3 mm2/s measured by the routine method,respectively.The area under the ROC was 0.768.For another observer,the mean ADCs of benign and malignant lesions were (1.647±0.357)× 10-3 mm2/s and (1.130±0.250)×10-3 mm2/s measured by the fixed ROI method,respectively.The mean ADCs of benign and malignant lesions were (1.590± 0.390)×10-3 mm2/s and (1.250±0.237)×10-3 mm2/s measured by the routine method,respec-tively.There was no significant difference for the mean ADC of benign lesions between the two methods.However,there was sig-nificant difference for the mean ADC of malignant lesions between the two methods.The diagnostic value of ADC measured by the fixing method was better than that of the routine method (P=0.008).There were no significant differences for ADCs of benign and malignant lesions between the two observers.Conclusion DWI has an important value for differential diagnosis of benign and malignant breast lesions.The measurement of ADC by the fixed and smaller ROI is better than that by the routine ROI for dis-tinguishing malignant from benign breast lesions.
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Objective To evaluate the curative effect and complications of percutaneous puncture kyphoplasty in the treatment of vertebral compression fracture in the elderly. Methods 19 cases of vertebral compression fracture in the elderly patients with disc 25 PKP technology applications were diagnosed with the accurate positioning,local anesthesia a small incision of about 0. 3cm later puncture path through vertebral pedicle to the wound vertebra,After perspective is the accurate lateral, putting into high-pressure balloon, injecting the contrast agent into the balloon with high-pressure syringe gradually. The wound vertebra is blackmai until a high degree of vertebral distraction to the recovery basis under the C-arm, and then taking the balloon out after pumping the contrast agent out. Bone cement is mixed well and injected into the cavity of the wound vertebra slowly which is the result of balloon dilation,during that time under the control of bone cement inside the wound vertebra,then puting the working column out and surgery completed. Results The low back pain of 19 patients immediately disappeared or significantly reduced after the operation, and 8 postoperative patients is up that day, 11 cases is up the following day. The degree of the wound vertebra is recovered by X-ray examination, and the bone cement evenly distributed within the wound vertebra, no spills. This group of patients are followed up for an average of 18 months(1 ～24 months) ,using visual analog and digital method to determine changes in Iow back pain. The data are paired t test,P ＜ 0.01. It have significant difference of views.Conclusion Percutaneous kyphoplasty accurate cervical disc herniation and effective disarmament of the symptoms and signs, with trauma and rapid recovery, fewer complications, shorter course of treatment and so on, and it is a safe and effective way in the treatment of vertebral compression fracture in the elderly.
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Objective To analyze the causes of the complications of one-stage surgical management for spinal tuberculosis and its countermeasures.Methods From May 1997 to December 2008,116 patients with spinal tuberculosis underwent operations.Among them,6 were in cervical vertebra,3 in cervicothoracie vertebra,29 in thoracic vertebra,37 in thoracolumbar vertebra.29 in lumbar vertebra and 12 in hmbrosacrum vertebra.All cases underwent the anterior and/or radical debridement,decompression,autogenous bone grafting or radical debridement,decompression,autogenous bone grafting and internal fixation.The causes of the complications of surgical management and the countermeasures were analyzed.Results One hundred and ehven cases were followed upfor an average of(3.86±2.16)years(range 6 months to 12 years).The rate of complication was 13.5%(15/111).Recurrent spinal tuberculosis occarred in 5 cases,internal fixation loosened in 1 case,rupture of the external iliac vein occurred in 2 cases,lateral ventral syndrome in 1 case,venous embolism of the lower extremity in 1 csse,reactional psychosis in 2 cases,pneumatothorax in 2 cases and femoral nerve irritating syndrome in 1 case.Among the recurrent cages,2cases with anterior debridement and 2 cases with posterior debridement underwent anterior operation again andgot good results, 1 case with anterior debridement gave up the reoperafion.Other cases relieved after conservative therapy.Conclusions Standardized anti-tuberculosis thempy is fundamental for preventing the recurrence of tuberculosis.Correct approach for the operation and thorough radical debddement are the key points for preventing the recurrence of tuberculosis.Good and effective therapy surround the operation is helpful for preventing the recurrence of tuberculosis.
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Objective To explore the indications of anterior and posterior approach operations for unstable thoraco-lumbar fractures coupled with neurologic deficits and prevention of intraoperative and postoperative complications. Methods We investigated 107 consecutive eases of thoraco-lumbar fractures coupled with spinal cord injury who had been operated on from January 2000 to December 2006.Their average age was 37.8(range.17 to 78) years old. They were 71 males and 36 females. Anterior approach was selected for 46 cases and posterior approach for 61 cases according to their McCormack grades. By the Frankle system for neurologie deficits, 7 cases were graded as A,16 as B,39 as C and 45 as D. Fracture height vecoveries before and after surgery were analyzed statistically. Kyphotic deformity was assessed on lateraJ radiographs using the Cobb method. Results The mean follow-up of 97 cases was 2.8(range,0.5 to 6) years. In both groups. All the cases gained at least 1 grade improvement except those with Frankle grade A. The mean kyphotic angles before operation, after operation and at the latest follow-up were 23.7°,10.6°and13.1°respectively, with significant differences(P＜0.01),in the anterior approach group, while 16.3°,8.4°and 11.7°respectively, with significant differences(P＜0.01),in the posterior approach group. Some complications, such as deficit of cutaneous nerve of thigh, appeared in the 2 groups. Conclusions In treatment of unstable thoraco-lumbar fractures coupled with neurologic deficits, the anterior approach may be better than the posterior approach. The posterior approach can be applied for the cases with less than 7 points in McCormack index. Correct selection of operative approach, careful operation and good rehabilitation after operation are necessary for the prevention of complications.
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[Objective]To study the stresses value and distribution of the facet joint of the normal L4、5 segment model and that of the denucleated lumbar segment model. [Method]A finite element model of the intact L4、5 segment was developed through Ansys software.The property of nucleus pulposus was changed to be negligible to model lumbar discectomy through anterior approach.Then the finite element model of the denucleated lumbar spine segment was created.The inferior end plate of L5 was fixed.Models were subjected to 6 Nm flexion,extension or right rotation moment in combination with 400 N axial compression preload.Forces were applied to the superior L4 end plate.Stresses value and distribution of the lumbar facet joint were analyzed under different loading conditions.[Result]Finite element models of the intact L4、5 segment and the denucleated lumbar spine segment were created.The facet joint was treated as a three dimensional contact,linear frictionless problem.The facet joint was composed of the inferior and superior facet surface and ligamentous structure.Both facet joints,especially the left of the intact model produced larger stresses in right rotation.Comparing with that of the intact model,stresses of the facet joint of the denucleated model increased in flexion,extension and right rotation.[Conclusion]The region of contact of each facet joint varies according to different loading conditions.So does the stresses value and distribution.The facet stresses of the lumbar segment increase in flexion,extension and rotation after discectomy.
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[Objective]To study the relationship between trauma and the lumbar disc degeneration and to detect the expression of the fibronectin splicing variants in the degenerated lumbar intervertebral disc,and study the expression of EDA.[Method]The human lumbar intervertebral disc tissues were collected to extract total RNA which was then amplified by RT-PCR technique.[Result]EDA~+ Fn of normal lumbar intervertebral disc were not expressed,whereas EDA~+ Fn of degenerated lumbar intervertebral disc were expressed abundantly.The defference between different groups has statistical significance.[Conclusion]EDA~+ Fn has very strongly expression in the lumbar degenerated intervertebral disc,and the trauma is one of prerequisite factors in the disc degenerated process probablely.
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Objective To study a new method of kyphoplasty( Sky bone expander system) used to treat the osteoporotic compression fractures of vertebral body. Methods 74 patients with 87 vertebrae were retrospectively analyzed who had been treated with the Sky bone expander system. Based on the Genant' s grading system, 29 vertebrae were rated as Grade One, 41 Grade Two and 17 Grade Three. Both kyphoplasty and posterior internal fixation were done for 16 cases. Of all the cases, 46 were fresh fractures and 28 old. Their average VAS score was 8.7 before operation. Results The mean follow- up time was 8.6 months. All the patients reported significant pain relief. Their average VAS score was 1.4 at the third day after operation (P
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Aim To introduce and apply artificial lumbar interverte-brai disc replacement for the treatment of lumbar disc degenerative diseasesand lumbar disc herniation accompanying evident disc space narrowing andinvestigate the regulation of its recovering spinal motion and carrying a-bility. Methods Thirty-one cases (37 discs) of artificial lumbar disc re-placement were performed using SB Charite Ⅲ from April 1998 to April2000. Among them, disc degenerative diseases were in 16 cases (18discs), disc herniation accompanying evident disc space narrowing in 13cases ( 17 discs), rec urrent dise herniation in 2 cases. The rehabilitationtraining was done under postoperative instructions. Results All the caseswere followed up from 17 to 41 months (averagely 26 months) untilSeptember 2001. The clinical outcomes were excellent in 23 cases, goodin 6 cases, fair in 2 cases. The mobility of the operated level had 4.0°anterior flexion and 5. 1° posterior extension after operation and 9.1° ontotal mobility. Meanwhile, the operated intervertebral space got an average4. 2 mm higher than that before. Because of technical problem, a slightdisplacement of the core occurred in one case without any clinical symp-toms and signs. Conclusion Artificial lumbar disc replacement can re-covery spinal motion and carrying capacity and provides a new kind ofoperation for the treatment of lumbar disc degenerative diseases and discherniation accompanying evident disc space narrowing.
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<p><b>OBJECTIVE</b>This work was conducted to investigate the expression of matrix metalloproteinase 9 (MMP 9) gene in cancer cells by fibronectin adhesion and the underlying mechanism of cell invasion.</p><p><b>METHODS</b>Following adhesion of ovarian cancer cells A2780 to fibronectin, mRNA expression of MMP cells were assayed by reverse transcription-polymerase chain reaction (RT-PCR). MMP9 promoter was cloned from genomic DNA of HT1080 cells with PCR. The MMP-9-pGL2 reporter gene vector was constructed and then transiently transfected into A2780 cells.</p><p><b>RESULTS</b>Adhesion induced the increase of cellular MMP9 mRNA content in A2780 cells, not affecting the expression of MMP2 or TIMP-1 gene. The stimulation was enhanced with the increase adhesion time. When the transfected cells were allowed to adhere and spread on FN-coated surface, the promoter activity of MMP9 gene was also enhanced dramatically.</p><p><b>CONCLUSION</b>Cell-ECM adhesion may stimulate the expression of MMP9 gene through stimulating the promoter activity, thereby enhancing cancer cell invasion and metastasis.</p>
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Female , Humans , Cell Adhesion , Physiology , Gene Expression , Matrix Metalloproteinase 9 , Genetics , Ovarian Neoplasms , Genetics , Pathology , Reverse Transcriptase Polymerase Chain Reaction , Tumor Cells, CulturedABSTRACT
Objective To investigate the mitochondrion DNA (mtDNA) mutation in tumor tissues of gynecologic oncology patients and their relationship to tumorigenesis and tumor development Methods The samples of tumor tissue and their proximal normal tissue of 32 gynecological malignant tumor patients as well as 8 gynecological benign tumor patients were taken The malignants were 5 squamous cervical carcinomas, 10 endometrial carcinomas and 17 epithelial ovarian cancers(EOC) The benign tumors were 4 ovarian epithelial tumors and 4 uterine myomas Polymerase chain reaction single strain conformation polymorphism(PCR SSCP) and DNA sequencing were done to examine mtDNA mutation Results The mtDNA mutation rate and polymorphism rate were 68 8% and 56 3% respectively in 32 cases of malignants The mtDNA mutation rate and polymorphism rate were 2/8 and 4/8 respectively in 8 cases of benigns The difference between malignants and benigns was significant ( P
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Clinical significance of ovarian cancer marker COX 1 was studied . The data were colected from 97 cases of ovarian benign and malignant orarian tumors diagnosed by pathology . A sandwich enzyme immunoassay procedure was designed for quantitative determinations of COX 1, and CA125 was detected. 52 78% of COX 1 was found to be positive in ovarian cancer group ( P
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Objective To study a simple?minimally invasive?safe?effective and economical therapy for osteoportic vertebrae compression fracture. Methods 9 patients with 14 vertebrae (13 lumbar, 1 thoracic) suffered from osteoportic compression fractures were treated with percutaneous vertebrolasty from March to September in 2001. The patients included 8 women and 1 man aged from 33 to 85 years with a mean of 72 years. Results All patients had marked to complete pain relief at 1～2 postoperative days, and could get up to move at 2～3 postoperative days. During 1-6 months follow-up period, no pain reoccurred. No severe comlication occurred. Conclusions Percutaneous vertebroplasty provided significant pain relief in the patients with osteoportic vertebrae compression fractures. It is a promising therapy for patients with osteoportic vertebrae compression fracture.
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Objective To investigate the angioarchitecture and the efficacy of endovascular embolization of uterine fibroids. Methods Bilateral internal iliac and uterine arteriography were performed to domonstrate the angioarchitecture in uterine fibroids with Seldinger technique. The feeding arteries of uterine fibroids were super-selectively embolized. Results The uterine arteries of 30 patients all originated from the iliac arteries of the ipsilateral side. The feeding arteries of uterine fibroids showed bilateral dominance in 16 cases (53%), unilateral dominance in 11 (37%) and unilateral feeding in only 3(10%). All symptoms disappeared after embolization. The fibroids masses decreased averagely by 40% in size at 3-month with ultrasound follow-up, by 55% at 6 months and by 60% at 12 months with a total clinical efficacy of 100%. Conclusions The key to efficacy and prevention of relapse is to understand the angioarchitecture in order to occlude all the pathological vessels in uterine fibroids.
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Objective To evaluate the variation of the blood flow in anterolateral femoral head by ligating different amount of extracapsular arteries. Methods Thirty six hips of 18 mongrel puppies were divided into A、 B、 C、 D and E groups. In group A, only one peripheral artery was ligated randomly. In groups B, C, D,and E, 2, 3, 4, and 5 peripheral arteries were respectively ligated. The blood flow in anterolateral femoral head in 18 mongrel puppies was measured before and after the ligation of the arteries by using of Hydrogen clearance technique. Results 1) The average blood flow in anterolateral femoral head was (0.1397?0.0515) ml?min-1?ml-1. 2) The mean blood flow in the anterolateral femoral head was slightly decreased after one to two of the extracapsular main arteries were ligated but there was no statistical difference. However, the mean blood flow was decreased significantly after more than three arteries were ligated. Conclusion 1) Hydrogen clearance technique is a quite simple, economic and reliable method for estimation of blood flow perfusion in various tissue. 2) The efficiency of blood supply of the anterolateral femoral head in puppies depends at least upon three of the major extracapsular arteries.
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Objective To screen related gene of endometrial cancer by mRNA differential display (DD) polymerase chain reaction (PCR). Methods Individual mRNA from normal and neoplastic endometrium obtained from the same patient were comparatively studied by DD methodology.The mRNAs were isolated from the tissues, reverse transcribed to cDNA, and then amplified by PCR. The PCR products were displayed on a polyacrylamid gel by silver staining, and the differentially expressed bands were retrieved and reamplified. Subsequently we selected four bands for sequencing and making further investigation. Results cDNA homology was analysed by searching through GenBank sequence databases and indicated that tumor fragment (T1 7) has no significant sequence homology with any sequence of known function. Acession number is AF315581. Further study showed that T1 7 expressed more abundantly in endometrial cancer than hyperplasia endometrium, but not expressed in normal endometrium. Conclusions T1.7 is a new expressed sequence tag. It may be related gene fragment of endometrial cancer.
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Objective: To investigate whether bcl-2 directly contributes to the development of drug resistance and apoptosis in o- varian cancer cell lines cells OC3. Methods: Retrovirus expression cector pLXSN-bcl-2 was constructed and was transfected to ovarian cancer cell line cells OC3 using Lipofectin,with empty vector pLXSN as a control. bcl-2 expession of transfected cells was analyzed by FACS and Western blot and Adr-induced cytotoxicity was measured by MTT assay. Apoptosis was also detected by PI DNA staining and DNA Ladder analysis.Results:pLXSN/bcl-2 transfected cells OC3/bcl-2 overexpressed bcl-2 and were resistant to Adr-induced cytotoxicity.The ability against Adr-induced apoptosis was increased. Conclusion: bcl-2 may play an important role in the resistance to Adr-inducing apoptosis, thereby increasing resistance of OC3/bcl-2 cells to chemotherapy.
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Objective To study the expression of the extracellular fragment of P glycoprotein in the bacteria. Methods According to the P glycoprotein antigen analyses and mdr1 gene structure, a couple of primers were designed to amplify the extracellular DNA fragment of the protein with PCR. The product was inserted into pGEM T vector followed by sequencing. The sequencing verified vectors were cloned into pGEX 2T to get a highly expression recombinant vector pGEX Pgp. The recombinant was transferred into E. coli DH5?, and its expression, identification and purification were studied. Results The highest level of recombinant expression was achieved at 4 h after IPTG induction. SDS PAGE analysis indicated that the expressed protein was about 30?10 3. Conclusion The target gene fragment expression at high level is established for the preparation of its antibody and biospanning of its specific peptide by using random phage library, founding a basis for the targeting treatment of multidrug resistance.
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Expression of the GST-? in 51 cases of lung cancer was researched by quantitative RT-PCR. The results suggested that the expression of GST-? was significantly higher in lung cancer than in normal tissues adjacent to cancer, and tumoral native resistance might be dominant in tumoral resistance to chemotherapeutic drugs. No relationship was found between GST-? expression and clinicopathological parameters including tumor class, stage and differentiation. The study of GST-? expression is of importance in the evaluation of tumoral resistance to anticancer drugs.