A case-control study of minimally invasive transforaminal interbody fusion with the assistance of robot and traditional fluoroscopy in the treatment of single-space lumbar disc herniation / 中国骨伤

OBJECTIVE@#To compare the safety and nail placement accuracy of fluoroscopy-assisted and robot-assisted minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in the treatment of single-space lumbar disc herniation.@*METHODS@#The clinical data of 52 patients with single-space lumbar disc herniation treated by MIS-TLIF from March 2019 to February 2020 were retrospectively analyzed. Among them, 24 patients were treated by robot-assisted MIS-TLIF(group A) and 28 patients were treated by fluoroscopy-assisted MIS-TLIF (group B). The intraoperative blood loss, operation time, intraoperative fluoroscopy times, preoperative and postoperative visual analogue scale(VAS), Japanese Orthopaedic Association(JOA) scores and operation-related complications were recorded in two groups. Gertzbein-Robbins grade according to CT scan was used to evaluate the nail placement after operation. Grade A and B were evaluated as satisfactory nail placement, and grade C, D, and E were evaluated as error placement. Babu's method was used to evaluate the screw's invasion to the superior articular process.@*RESULTS@#The operation time, intraoperative blood loss and intraoperative fluoroscopy times in group A were less than those in group B(P<0.05).VAS and JOA scores of all patients at the final follow-up were significantly improved compared with those before operation(P<0.05), but there was no statistically significant difference between the groups(P>0.05). There were 96 and 112 screws in group A and group B, respectively. Three days after operation, according to the Gertzbein-Robbins grade to evaluate the nail placement accuracy, there were 90 screws of grade A, 5 of grade B, 1 of grade C, no grade D and E in group A;there were 84 screws of grade A, 16 of grade B, 8 of grade C, 4 of grade D, no grade E in group B;the difference between two groups was statistically significant(Z=-3.709, P=0.000). The satisfactory rate of screw placement in group A was 98.96% (95/96), and that of group B was 89.29% (100/112), the difference between two groups was statistically significant (χ2=8.254, P=0.004). Three days after operation, the invasion of superior facet joints by pedicle screws was evaluated according to Babu's method, including 90 screws in grade 0, 4 in grade 1, 2 in grade 2, and 0 in grade 3 in group A;86 in grade 0, 12 in grade 1, 10 in grade 2 and 4 in grade 3 in group B, and the difference was statistically significant(Z=-3.433, P=0.001). There were no serious spinal cord, nerve and vascular injuries and other operation-related complications caused by screw implantation failure in both groups. All patients were followed up from 6 to 12(9.06±1.60) months. The neurological symptoms improved well after operation. During the follow-up period, there was no recurrence of symptoms, loosening or breakage of the internal fixation.@*CONCLUSION@#Compared with the traditional fluoroscopy-assisted MIS-TLIF, the spinal robot-assisted MIS-TLIF not only has more minimally invasive and safer, but also has higher accuracy in nail placement, lower incidence of upper articular process invasion, and more accurate decompression targets, which can be used for minimally invasive treatment of single-space lumbar disc herniation.

Oleanolic Acid Inhibits Neuronal Pyroptosis in Ischaemic Stroke by Inhibiting miR-186-5p Expression

Ischaemic stroke is a common condition leading to human disability and death. Previous studies have shown that oleanolic acid (OA) ameliorates oxidative injury and cerebral ischaemic damage, and miR-186-5p is verified to be elevated in serum from ischaemic stroke patients. Herein, we investigated whether OA regulates miR-186-5p expression to control neuroglobin (Ngb) levels, thereby inhibiting neuronal pyroptosis in ischaemic stroke. Three concentrations of OA (0.5, 2, or 8 μM) were added to primary hippocampal neurons subjected to oxygen–glucose deprivation/ reperfusion (OGD/R), a cell model of ischaemic stroke. We found that OA treatment markedly inhibited pyroptosis. qRT–PCR and western blot revealed that OA suppressed the expression of pyroptosis-associated genes. Furthermore, OA inhibited LDH and proinflammatory cytokine release. In addition, miR-186-5p was downregulated while Ngb was upregulated in OA-treated OGD/R neurons. MiR-186-5p knockdown repressed OGD/R-induced pyroptosis and suppressed LDH and inflammatory cytokine release. In addition, a dual luciferase reporter assay confirmed that miR-186-5p directly targeted Ngb. OA reduced miR-186-5p to regulate Ngb levels, thereby inhibiting pyroptosis in both OGD/R-treated neurons and MCAO mice. In conclusion, OA alleviates pyroptosis in vivo and in vitro by downregulating miR-186-5p and upregulating Ngb expression, which provides a novel theoretical basis illustrating that OA can be considered a drug for ischaemic stroke.

Inhibitory Effect of Sangsuyin on Airway Inflammation in Asthmatic Rats by Regulating TLR4 Pathway / 中国实验方剂学杂志

Objective:To investigate the inhibitory effect of Sangsuyin on airway inflammation in asthmatic rats by regulating the Toll-like receptor 4 （TLR4） pathway. Method:Forty-eight SD rats were randomly divided into a normal group （<italic>n</italic>=8） and an experimental group （<italic>n</italic>=40）. Asthma model was induced in the rats of the experimental group which were further divided into the following five groups according to a random number table： a model group， a dexamethasone group （0.005 g·kg^-1），and low- （2.1 g·kg^-1）， medium- （4.2 g·kg^-1）， and high-dose （8.4 g·kg^-1） Sangsuyin groups. The drugs were all dissolved in normal saline at 0.01 L·kg^-1. The rats in the model group and the normal group received normal saline （<italic>ig</italic>） at 0.01 L·kg^-1. The drug treatment was carried out once per day， for a total of 7 days. The grades of allergic reactions were compared among the groups after intervention. The levels of interleukin-1<italic>β</italic> （IL-1<italic>β</italic>），tumor necrosis factor-<italic>α</italic>（TNF-<italic>α</italic>）， and interferon-<italic>γ</italic>（IFN-<italic>γ</italic>） in serum and bronchoalveolar lavage fluid （BALF） were detected by enzyme-linked immunosorbent assay （ELISA）. Hematoxylin-eosin （HE） staining was used to observe the pathological changes of lung tissues，and the inflammatory cell infiltration scores of lung tissues were compared. The mRNA expression of TLR4 and nuclear factor-<italic>κ</italic>B （NF-<italic>κ</italic>B） was detected by quantitative real-time fluorescence-based reverse-transcription polymerase chain reaction （Real-time PCR）. The expression of TLR4，NF-<italic>κ</italic>B， and the level of phosphorylated NF-<italic>κ</italic>B （p-NF-<italic>κ</italic>B） were detected by Western blot. Result:The success rate of modeling was 95.00%. Compared with the normal group， the model group showed a higher grade of allergic reaction and more severe pathological changes of lung tissues，and the groups with drug intervention exhibited relieved conditions. The levels of IL-1<italic>β</italic> and TNF-<italic>α</italic> in the serum and BALF were higher in the model group than in the normal group，and lower in the groups with drug intervention than in the model group （<italic>P</italic><0.01）. The level of IFN-<italic>γ</italic> in the serum and BALF was lower in the model group than in the normal group，and higher in the groups with drug intervention than in the model group （<italic>P</italic><0.05，<italic>P</italic><0.01）. The inflammatory cell infiltration score，mRNA and protein expression of TLR4 and NF-<italic>κ</italic>B，and the mRNA level of p-NF-<italic>κ</italic>B were higher in the model group than in the normal group，and lower in the groups with drug intervention than in the model group （<italic>P</italic><0.01）. Conclusion:Sangsuyin could inhibit allergic reactions，lung tissue lesions， and airway inflammation in asthmatic rats. It is speculated that this effect is achieved by inhibiting the TLR4 pathway，down-regulating the mRNA and protein expression of TLR4 and NF-<italic>κ</italic>B，and reducing the level of p-NF-<italic>κ</italic>B.angsuyin can inhibit allergic reaction，lung tissue lesions and airway inflammation in asthmatic rats. It is speculated that this effect is achieved by inhibiting TLR4 pathway，down regulating the mRNA and protein expression of TLR4，NF-<italic>κ</italic>B，and reducing the levels of p-NF-<italic>κ</italic>B.

Exploration and practice of applying discussion-based film and television appreciation to the cultivation of medical professionalism / 中华医学教育探索杂志

In view of the lack of teaching methods in the cultivation of medical professionalism, this paper puts forward some important strategies for improving medical students' professionalism through discussion-based film and television appreciation. High-quality discussion-based film and television appreciation can be designed according to the four links of film selection, concentrated viewing, independent discussion and summary feedback. At the same time, in practice, attention should be paid to three key issues: selecting appropriate films, ensuring the quality and depth of discussion, and paying attention to feedback and evaluation. Practice has proved that discussion-based film and television appreciation makes the cultivation of professionalism more attractive, and can promote the professional knowledge and professional spirit, enhance students' professional enthusiasm, promote the understanding of the connotation of professionalism and reflection on related issues. Medical colleges should continue to improve the design of film viewing in practice, so as to help students better absorb humanistic nutrients from the discussion and enhance the teaching effect of professionalism.

Comparison of the clinical efficacy of different fixation systems for the treatment of transverse patellar fractures / 中华创伤杂志(英文版)

PURPOSE@#This study was designed to compare the clinical efficacy of "8" and "0" wire fixation systems combined with double-head cannulated compression screws or Kirschner wires for the treatment of transverse patellar fractures.@*METHODS@#From September 2011 to September 2018, patients with closed transverse patellar fractures treated with a double-head compression screw or Kirschner wire were included and analyzed retrospectively. Patients with patellar fractures combined with distal femoral fractures, tibial plateau fracture or preoperative lower limb dysfunction were excluded. The patients treated with the "8" tension band wire fixation system and Kirschner wire were taken as Group A; those treated with the "0" fixation system and Kirschner wire were taken as Group B; those treated with the "8" fixation system and double-head cannulated compression screw were taken as group C; and those treated with the "0" fixation system and double-head cannulated compression screw were taken as group D. Six weeks and one year after the operation and every month from the third month after the operation until the fractures healed, an X-ray examination was performed to identify fracture healing. The time of fracture healing and postoperative complications of the four groups were compared. One year after the operation, knee function was evaluated by Bostman's score.@*RESULTS@#During the study period, 168 patients with patellar fractures were treated by operations, and 88 patients were excluded because the fracture type did not meet the requirements or because there were combined fractures of the distal femur or tibial plateau. As a result, 80 patients were included in this study, 20 in each group. All the patients were followed up for an average period of 12.2 months. Compared with Group A, patients in Group D presented less postoperative discomfort in the prepatellar region, quicker fracture healing, less fixation failure and better postoperative knee function scores (all p 0.05).@*CONCLUSION@#The "0" wire fixation system combined with a double-head cannulated compression screw seems to be more beneficial than the other three fixation systems for the treatment of transverse patellar fractures.

Exploration on integrated medical education reform in comprehensive universities / 中华医学教育探索杂志

After years of exploration, Central South University has comprehensively reformed and upgraded the curriculum in both horizontal and vertical integration, including optimizing and constructing a basic clinical core curriculum system with organ system integration as the main line, utilizing the advantages of comprehensive universities to further advance the cross-teaching reform of science, engineering, arts and medicine, strengthening pre-medical education with the goal of early exposure to medicine, promoting the reform of early contact clinical integrated teaching according to the concept of "early, multiple and repeated clinical practice", and accelerating the integration of clinical skills training courses with the support of clinical skills simulation teaching. After the integration, the faculty team has gradually matured and the teaching quality has been significantly improved, which has strengthened the students' medical thinking and overall literacy.

Preparation of evodiamine-glycyrrhizic acid micelles with glycyrrhizic acid as carrier and their anti-hepatic fibrosis activity / 中国中药杂志

This study aimed to prepare evodiamine-glycyrrhizic acid(EVO-GL) micelles to enhance the anti-hepatic fibrosis activity of evodiamine. Firstly, EVO-GL micelles were prepared with use of thin film dispersion method. With particle size, encapsulation efficiency, loading capacity of micelles and the solubility of evodiamine as the indexes, the effect of different factors on micelles was observed to screen the optimal preparation methods and process. Then the pharmaceutical properties and the therapeutic effects of EVO-GL micelles prepared by optimal process were evaluated on CCl_4-induced hepatic fibrosis. The results showed that the micelles prepared by the thin film dispersion method had an even size, with an average particle size of(130.80±12.40)nm, Zeta potential of(-41.61±3.12) mV, encapsulation efficiency of 91.23%±1.22%, drug loading of 8.42%±0.71%, high storage stability at 4 ℃ in 3 months, and slow in vitro release. Experimental results in the treatment of CCl_4-induced hepatic fibrosis in rats showed that EVO-GL micelles had a synergistic anti-hepatic fibrosis effect, which significantly reduced the liver function index of hepatic fibrosis rats. In conclusion, the EVO-GL micelles prepared with glycyrrhizic acid as a carrier would have a potential application prospect for the treatment of hepatic fibrosis.

SWOT analysis of medical online teaching in X hospital during COVID-19 epidemic / 中华医学教育探索杂志

SWOT theory can be used to analyze the internal and external competitive environment and conditions of online teaching in teaching hospitals during the epidemic prevention and control. Conducting online education of clinical medicine courses in a hospital affiliated toa hospital affiliated to a comprehensive university has advantages in resources, administrations and platforms. However, disadvantages of online medical education lie in the professionalism, specificity of doctors as teacher and request of special teaching tools, all of which may not be available online. Online education meets the need of constructing top level courses national wide, carrying out the dominant role of ideological work in medical education field, and promoting the autonomous learning. Meanwhile, online education also challenges the future reform of teaching mode, management, and space. Based on this, it's proposed to promote the informatization construction of hospital medical education, improve IT literacy of all teachers, build an educational informatization platform matching the hospital management, construct a multiple evaluation system based on intelligent teaching space, build an online and offline mixed curriculum system based on multi-disciplinary, and take it as a breakthrough to promote the construction of "new medicine".

Analysis and reflection on the current construction of massive open online course of medical humanities under the epidemic situation / 中华医学教育探索杂志

This study aims to analyze the current construction of massive open online course (MOOC) of medical humanities in China, promote the sharing of high-quality curriculum resources, and provide information reference for curriculum design and planning. Mathematical statistics and mind map analysis were used to analyze 42 medical humanities MOOCs on 17 online course platforms during the epidemic, and the results showed that: ①the scale and quantity of medical humanities MOOCs need to be expanded; ②there is regional imbalance in MOOCs construction, with the largest number in East China; ③most of the courses are taught by teachers in a team, teachers with senior professional titles are the main force of the team, and some teams have multidisciplinary backgrounds; ④there are rich teaching contents related to humanistic knowledge and ability, but the content related to medical humanistic spirit cognition needs to be added appropriately. According to the above analysis, it's suggested that the construction of MOOC should focus on systematism and standardization, equip a team of teachers with multidisciplinary backgrounds, value curriculum design and planning, and pay full attention to the feedback and evaluation of learners to find out deficiencies.

Construction of a hybrid curriculum system for standardized residency training based on the concept of outcome-based education / 中华医学教育探索杂志

Based on the in-depth analysis of the status quo of the curriculum system for standardized residency training, this paper introduces a hybrid curriculum system for standardized residency training in Xiangya Hospital of Central South University, which is guided by the concept of outcome-based education (OBE) and based on three outcome objectives of "task, attitude and occupational characteristics". The paper also analyzes the construction process of the curriculum system from five aspects: outcome design, curriculum design, curriculum implementation, results record and outcomes evaluation, which is of great reference value for further improving the objectives, contents, models and methods of standardized residency training.

Effect of Sulfur Fumigation on Content of Chemical Constituents in Panacis Quinquefolii Radix and Preliminary Study on Its Identification Method / 中国实验方剂学杂志

Objective: To elucidate the effect of sulfur fumigation on the content of chemical composition and quality of Panacis Quinquefolii Radix, and to discuss the identification method of sulfur fumigated Panacis Quinquefolii Radix. Method: The content changes of ginsenoside Rb1, Re, Rg1 in Panacis Quinquefolii Radix were determined by HPLC-DAD before and after sulfur fumigation. The content changes of 11 inorganic elements in Panacis Quinquefolii Radix before and after sulfur fumigation were detected by microwave digestion method and inductively coupled plasma emission spectrometry tandem mass spectrometry (ICP-MS). The quality difference of Panacis Quinquefolii Radix before and after sulfur fumigation was qualitatively distinguished combined with the principal component analysis. Result: Three ginsenosides were well separated and showed good linearity with R2 ≥ 0.999.Before sulfur fumigation, the contents of ginsenoside Rg1, Re and Rb1 in Panacis Quinquefolii Radix were (0.897±0.045), (13.092±0.639), (12.896±0.430) g ·kg-1, respectively. After sulfur fumigation, the contents of these three components in Panacis Quinquefolii Radix were (0.807±0.032), (11.968±0.627), (11.752±0.696) g ·kg-1, respectively. After fumigation, the contents of inorganic elements (Cr, Mn, Co, Cu, As, Se, Ag, Cd, Sb, Pb and Fe) from Panacis Quinquefolii Radix increased in varying degrees. According to the distribution results of three-dimensional (3D) scattered points, sulfur and non-sulfur fumigation products of Panacis Quinquefolii Radix could be effectively distinguished. Conclusion: After sulfur fumigation, the contents of ginsenoside Re and Rb1 in Panacis Quinquefolii Radix decrease significantly, but the contents of 11 inorganic elements increase, suggesting that sulfur fumigation may have a great influence on the quality of Panacis Quinquefolii Radix.

Fixation versus Excision of Osteochondral Fractures after Patellar Dislocations in Adolescent Patients: A Retrospective Cohort Study / 中华医学杂志(英文版)

<p><b>Background</b>Patellar dislocation is one of the most common knee injuries in the adolescent population. It is often combined with osteochondral fracture. The purpose of this study was to compare the outcomes between fixation and excision of osteochondral fractures not involving the bearing surface in adolescent patients with patellar dislocations.</p><p><b>Methods</b>Patients who underwent surgery for osteochondral fracture following patellar dislocation in our institution from 2007 to 2014 were retrospectively evaluated. Visual analog scale (VAS) of pain and the International Knee Documentation Committee (IKDC) form were used to assess knee pain and function at follow-up. Patient satisfaction was evaluated. Differences in the values of variables among groups were assessed using t-test if equal variance or Mann-Whitney U-test if not equal variance. The Pearson's Chi-square test was applied for dichotomous variables if expected frequency was >5 or Fisher's exact test was applied if not. A value of P < 0.05 was considered statistically significant.</p><p><b>Results</b>Forty-three patients were included, with the average age of 14.1 ± 2.3 (range, 9.0-17.0) years. Nineteen underwent fixation of osteochondral fractures and 24 did not. The average follow-up time was 28 ± 10 months. There was no significant difference in age, gender, follow-up time, causes of injury, times of dislocation, and location of osteochondral fracture between fixation and excision groups. The fixation group had a significantly longer surgery time (82 ± 14 min) and larger size of osteochondral fracture (2.30 ± 0.70 cm) than the excision group (43 ± 10 min, 1.88 ± 0.62 cm, respectively, t = 10.77, P < 0.01 and t = 0.84, P < 0.05). At the last follow-up, the average IKDC score in the fixation group (82.52 ± 8.71) was significantly lower than that in the excision group (89.51 ± 7.19, t = 2.65, P < 0.01). There was no significant difference in VAS of pain and patients' satisfaction. There were 7 (16%) patients with recurrent dislocation.</p><p><b>Conclusion</b>Excision of osteochondral fractures has equivalent or better outcomes compared to fixation in adolescent patients with patellar dislocations when these fractures do not involve the bearing surface.</p>

An Exploration of the development of medical simulation teaching center / 中华医学教育探索杂志

Medical simulation teaching is an emerging and developing teaching method in our coun-try. At present, the simulation teaching centers are developing rapidly in higher education institutions, but how to improve the effectiveness in the operation of the centers is still a subject that needs to be discussed. Based on our own experience, this paper analyzes the related factors in developing medical simulation teach-ing centers, making summary and demonstrations from aspects of team building, teacher training, docking needs, staffing and so on, so as to provide references and suggestions for the construction of medical simu-lation center higher education institutions.

Interleukin-20 targets podocytes and is upregulated in experimental murine diabetic nephropathy

Interleukin (IL)-20, a proinflammatory cytokine of the IL-10 family, is involved in acute and chronic renal failure. The aim of this study was to elucidate the role of IL-20 during diabetic nephropathy development. We found that IL-20 and its receptor IL-20R1 were upregulated in the kidneys of mice and rats with STZ-induced diabetes. In vitro, IL-20 induced MMP-9, MCP-1, TGF-β1 and VEGF expression in podocytes. IL-20 was upregulated by hydrogen peroxide, high-dose glucose and TGF-β1. In addition, IL-20 induced apoptosis in podocytes by activating caspase-8. In STZ-induced early diabetic nephropathy, IL-20R1-deficient mice had lower blood glucose and serum BUN levels and a smaller glomerular area than did wild-type controls. Anti-IL-20 monoclonal antibody (7E) treatment reduced blood glucose and the glomerular area and improved renal functions in mice in the early stage of STZ-induced diabetic nephropathy. ELISA showed that the serum IL-20 level was higher in patients with diabetes mellitus than in healthy controls. The findings of this study suggest that IL-20 induces cell apoptosis of podocytes and plays a role in the pathogenesis of early diabetic nephropathy.

Lentivirus-mediated silencing of the PTC1 and PTC2 genes promotes recovery from spinal cord injury by activating the Hedgehog signaling pathway in a rat model

This study aimed to investigate the effect of Patched-1 (PTC1) and PTC2 silencing in a rat model, on Hedgehog (Hh) pathway-mediated recovery from spinal cord injury (SCI). An analytical emphasis on the relationship between the sonic hedgehog (Shh) pathway and nerve regeneration was explored. A total of 126 rats were divided into normal, sham, SCI, negative control (NC), PTC1-RNAi, PTC2-RNAi and PTC1/PTC2-RNAi groups. The Basso, Beattie and Bresnahan (BBB) scale was employed to assess hind limb motor function. Quantitative real-time polymerase chain reaction and western blotting were performed to examine the mRNA and protein levels of PTC1, PTC2, Shh, glioma-associated oncogene homolog 1 (Gli-1), Smo and Nestin. Tissue morphology was analyzed using immunohistochemistry, and immunofluorescent staining was conducted to detect neurofilament protein 200 (NF-200) and glial fibrillary acidic protein (GFAP). The PTC1/PTC2-RNAi group displayed higher BBB scores than the SCI and NC groups. Shh, Gli-1, Smo and Nestin expression levels were elevated in the PTC1/PTC2-RNAi group. PTC1 and PTC2 mRNA and protein expression was lower in the PTC1/PTC2-RNAi group than in the normal, sham and SCI groups. Among the seven groups, the PTC1/PTC2-RNAi group had the largest positive area of NF-200 staining, whereas the SCI group exhibited a larger GFAP-positive area than both the normal and the sham groups. The Shh pathway may provide new insights into therapeutic indications and regenerative recovery tools for the treatment of SCI. Activation of the Hh signaling pathway by silencing PTC1 and PTC2 may reduce inflammation and may ultimately promote SCI recovery.

Clinical study on ambulatory surgery for thyroid / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the advantages and clinical value regarding the ambulatory surgery for thyroid.
@*METHODS@#A total of 66 patients (including 16 cases of differentiated thyroid cancer, 50 cases of benign thyroid tumors) from June 2014 to April 2015 in Center for Ambulatory Surgery of Xiangya Hospital were enrolled for this study and served as an exprimental group. All patients met pre-established ambulatory surgery criteria for thyroid. According to medical records, 133 patients with similar conditions to the experimental group were chosen as a control group. All of operations in two groups were completed by the same doctors. The time of operation, amount of bleeding during operation, drainage after the operation, operation method, resection range, histological features, surgical complications, average days of hospitalization, average hospitalization cost, the rate of re-admission and the satisfaction of patients were compared between the 2 groups. 
@*RESULTS@#Time of operation and amount of bleeding during operation were not significantly different between the 2 groups (P>0.05). In terms of drainage after operation and resection range, there were obvious differences between the 2 groups (P0.05), but average days of hospitalization and average hospitalization cost were less in the experimental group (P<0.05). Patients were satisfied with ambulatory thyroid surgery (P<0.05).
@*CONCLUSION@#Under certain criteria, ambulatory surgery for thyroid is a new operation method, which is safe, high-efficient, convenient, economy and time-efficient. It can decrease average days of hospitalization and average hospitalization cost obviously, and provide a reasonable choice for certain patients. The selection of endoscopic thyroid surgery was not conflict with selection of ambulatory thyroid surgery.

A study on the comprehensive evaluation index system for national health city / 预防医学

Objective To construct a scientific and reasonable evaluation index system for the national health city. Methods A two -round Delphi consultation method was used.Results The positive coefficient of the first round of consultation of the expert was 90%,and the index system of the authority coefficient was 0.78.A total of 85 index were selected and eventually evaluation system including 5 first level indicators,22 second level indicators and 85 third level indicators were developed.The third level indicators with high weight included compliance rate of centralized drinking water source water quality,average level of regional environmental noise,office expenses,and mass satisfaction.Conclusion The structure of the evaluation index system is reasonable and targeted,and could be used to evaluate the changes of public health,appearance of city,environmental sanitation,economic development and construction investment.

Silencing of CXCR4 Inhibits Tumor Cell Proliferation and Neural Invasion in Human Hilar Cholangiocarcinoma

BACKGROUND/AIMS: To evaluate the expression of CXC motif chemokine receptor 4 (CXCR4) in the tissues of patients with hilar cholangiocarcinoma (hilar-CCA) and to investigate the cell proliferation and frequency of neural invasion (NI) influenced by RNAi-mediated CXCR4 silencing. METHODS: An immunohistochemical technique was used to detect the expression of CXCR4 in 41 clinical tissues, including hilar-CCA, cholangitis, and normal bile duct tissues. The effects of small interference RNA (siRNA)-mediated CXCR4 silencing were detected in the hilar-CCA cell line QBC939. Cell proliferation was determined by MTT. Expression of CXCR4 was monitored by quantitative real time polymerase chain reaction and Western blot analysis. The NI ability of hilar-CCA cells was evaluated using a perineural cell and hilar-CCA cell coculture migration assay. RESULTS: The expression of CXCR4 was significantly induced in clinical hilar-CCA tissue. There was a positive correlation between the expression of CXCR4 and lymph node metastasis/NI in hilar-CCA patients (p<0.05). Silencing of CXCR4 in tumor cell lines by siRNA led to significantly decreased NI (p<0.05) and slightly decreased cell proliferation. CONCLUSIONS: CXCR4 is likely correlated with clinical recurrence of hilar-CCA. CXCR4 is involved in the invasion and proliferation of human hilar-CCA cell line QBC939, indicating that CXCR4 could be a promising therapeutic target for hilar-CCA.

Clinical features of 30 cases of primary hyperthyroidism complicated with thyroid cancer / 中华内分泌外科杂志

Objective To study the epidemiological and clinical features of primary hyperthyroidism complicated with thyroid cancer.Methods Clinical data of 30 cases of hyperthyroidism complicated with thyroid cancer(hyperparathyroidism group)were retrospectively analyzed.They were chosen from the 365 cases of primary hyperparathyroidism treated by operation from Jan.2002 to Jun.2011.At the same time,30 cases of thyroid cancer without hyperparathyroidism were randomly taken out as the control group.Results The incidence of thyroid cancer in primary hyperparathyroidism was 8.22％ (30/365).The median course,preoperative diagnostic rate of thyroid cancer,and lymph nodes metastasis rate for hyperparathyroidism group and control group was 875.00 vs 120.00 days(z =-2.501,P ＜0.05),40.0％ (12/30) vs 66.7％ (20/30) (x2 =4.286,P ＜0.05),and 20.0％ (6/30) vs 46.7％ (14/30) (x2 =4.800,P ＜ 0.05) respectively.All patients were followed up with the average of 4.5 years,ranging from 1 month to 9 yeas and a half.1 case(3.3％)in hyperparathyroidism group recurred hyperthyroidism 5 years after surgery.1 case(3.3％)recurred thyroid cancer 1 year after surgery and received operation again,and 1 case(3.3％)died half a year after operation from respiratory failure caused by lung metastasis of thyroid cancer in the control group.Conclusions Hyperthyroidism complicated with thyroid cancer has the characteristics of high incidence rate of thyroid cancer in the hyperthyroidism patients,long course,high preoperative misdiagnosis rate,low lymph node metastasis rate,favorable prognosis and so on.

Clinical analysis of 41 cases of Hashimoto's disease accompanying with thyroid cancer / 中华内分泌外科杂志

Objective To analyze the clinical characteristics of Hashimoto's disease(HD) accompanying with thyroid cancer,and to explore the experience of diagnosis and treatment.Methods Clinical data of 41 cases of HD accompanying with thyroid cancer were retrospectively analyzed.The patients were diagnosed by postoperative paraffin pathological examination from Jan.2002 to July 2011.Results 10 cases of HD,37cases of thyroid cancer,and 8 cases HD accompanying with thyroid cancer were diagnosed before operation.The rate of preoperative diagnosis was only 19.51％.All patients underwent surgical treatment,including 22 cases total thyroidectomy,14 cases subtotal thyroidectomy,and 5 cases lesion side lobe resection.24 cases underwent ipsilateral neck dissection,and 4 cases underwent bilateral neck dissection (ipsilateral radical resection,contralateral selective resection).Postoperative paraffin pathological examination proved that there were 39 cases of HD accompanying with thyroid cancer,1 case of focal cancer and 1 case of B-cell lymphoma of mucosa-associated thyroid.All patients were followed up.Conclusions The preoperative diagnosis rate of HD accompanying with thyroid cancer is low and great attention should be paid to its diagnosis.For HD patients,if carcinoma can not be excluded,surgical exploration is recommended.Appropriate surgical method should be chosen according to intraoperative frozen section results.Postoperative thyroid hormone treatment is usually taken.