Application of 3D simulated wound model combined with PBL teaching in the standardized residency training of plastic surgery department / 中华医学教育探索杂志

Objective:To explore the teaching effect of 3D simulated wound model combined with problem -based learning (PBL) teaching in the standardized residency training of plastic surgery department. Methods:Totally 90 residents trained in the plastic surgery department of Changhai Hospital of Naval Medical University from June 2016 to September 2019 as the research objects were divided into control group and experimental group in average. The control group received traditional teaching and the experimental group accepted the 3D simulated wound model combined with PBL teaching. Then the out -department examination results and questionnaires evaluation were compared between the two groups. SPSS 19.0 was used to conduct t test on the experimental data. Results:The theoretical and practical scores of residents in the experimental group [(49.23±7.25) points and (36.38±5.29)] points were significantly better than those in the control group [(44.43±5.57) points and (28.94±6.97)] points ( P<0.05). In the questionnaire, the scores of active learning initiative, practical operation ability and clinical strain capacity of residents in the experimental group were all higher than those in the control group ( P<0.05), and there was no statistically significant difference in teamwork ability between the two groups ( P>0.05). Conclusion:The 3D simulated wound model combined with PBL teaching can be used in the teaching of standardized residency training of plastic surgery. Compared with traditional teaching, this teaching method has significant advantages and is worthy of promotion.

The application of drill hole lateral canthoplasty and canthopexy in correction of lower eyelid malposition / 中华整形外科杂志

Objective@#To investigate the lateral canthoplasty and canthopexy with bone drilling to correct lower eyelid malposition and its benefit.@*Methods@#From January 2014 to January 2019, lateral canthopexy with bone drilling technique was used to repair 56 patients with lower eyelid malposition in Department of Plastic and Reconstructive Surgery of Changhai Hospital. Forty-four patients with lower eyelid ectopic had multiple previous surgeries, and 12 patients had congenital lower eyelid retraction. For patients without lower palpebral margin extension, lateral canthopexy with bone drilling technique was applied. For patients with lower palpebral margin extension, the lateral canthus angle was exposed to shorten the lower eyelid margin. For congenital lower eyelid retraction, the lateral canthus tendon was completely cut off, and then fixed with double armed sutures.@*Results@#Operations were successfully performed on all 56 patients, and the patients were followed up for 1-38 months. Forty-nine patients achieved good eyelid shape and satisfied with the operative effects (87.5%). Malposition was ameliorated in 6 patients (10.7%). One remained uncorrected (1.8%).@*Conclusions@#Lateral canthopexy with bone drilling technique could obtain firm suspension force. For lower eyelid malposition, especially for patients with recurrent malposition or congenital lower eyelid retraction, satisfied function and appearance could be achieved.

Clinical experience of primary neurogenic tumors in mediastinum with surgical treatment in 131 cases / 复旦学报（医学版）

Objective To analyze the clinical features,methods of treatment and prognosis of primary neurogenic tumors of mediastinum in patients taking surgical intervention.Methods A database was maintained retrospectively of all patients undergoing surgery for tumor and pathologically diagnosed with primary neurogenic tumors of mediastinum,managed in the Department of Thoracic Surgery,Zhongshan Hospital,Fudan University,Shanghai between Jan.,2008 and Dec.,2014.This work analyzed retrospectively the information about clinical and imaging features,surgical techniques and outcome extracted from medical records.Results Among the 131 cases,78 cases (59.5％) were males,53 cases (40.5％) were females;72 cases were diagnosed incidentally (55.0％),while the other 59 cases (45.0 ％) suffered from different symptoms.The posterior mediastinum was the most principal location with 61 cases in the left and 69 cases in the right,and 1 case remained in the anterior mediastinum.Total 98 cases (74.8％) underwent surgeries via video-assisted thoracic surgery (VATS),5 cases (3.8％) took VATS surgery with small incision,and 28 cases (21.4％) experienced open thoracotomy,with no mortality during perioperative period.Gross total resection was obtained in 130 patients (99.2％).The remaining patient underwent a palliative resection for malignant schwannomas.Of the patients,98 cases had benign schwannomas (74.8％),24 cases had gangliocytomas (18.3％),2 cases had malignant schwannomas (1.5％),2 cases had neurofibromas (1.5％),2 cases had paragangliomas (1.5％),2 cases hadprimitive neurotodermal tumor (PNET) (1.5％) and 1 case had neuroblastomas (0.8％).All patients were followed up from 12 to 95 months with an average of 53 months.A patient with PNET died of tumor metastasis,a patient with malignant schwannomas died after palliative ectomy,and 2 cases died of other reasons.The rest survived until Jan.,2016 with tumor free.Conclusions Nearly no specific clinical symptoms occur in neurogenic tumors of mediastinum.Most of neurogenic tumors of mediastinum are benign with optimistic prognosis after surgical treatment.While malignant neurogenic tumorsusually come with poor prognosis,which places special emphasis on early diagnose together with surgical treatment.

Effect of GLP-1 on the expression of PDX-1 gene in islet beta cells of type 2 diabetes rats / 实用医学杂志

Objective To observe the effect of liraglutide, an analogue of glucagon like peptide-1 (GLP-1), on the expression of PDX-1 gene in the islet beta cells of type 2 diabetes rats. Methods Sixty male SD rats were divided into 3 groups:normal control group, diabetic model group and GLP-1 group. Normal control group was given normal diet and diabetic model group and GLP-1 group were given high fat diet. After the eighth weekend, the high fat diet group was intraperitoneally injected with streptozotocin (STZ) 30 mg/(kg·bw), and the GLP-1 group was subcutaneously injected with liraglutide 200μg/kg with 2 times per day for 8 weeks. The other groups were treated with normal saline by subcutaneous injection. Real-time fluorescent quantitative reverse transcription polymerase chain reaction (Real-Time RT-PCR) was used to detect the expression of PDX-1 gene in rat pancreatic islet cells. Results The expressions of PDX-1 mRNA in the GLP-1 group and untreated group were significantly lower (P <0.001) than that in the normal control group, but significantly higher than that after GLP-1treatment (P < 0.001). Conclusion GLP-1 can upregulate the expression of PDX-1 gene in the islet beta cells of type 2 diabetes rats.

The keystone design perforator island flap in reconstructive surgery / 中华整形外科杂志

<p><b>OBJECTIVE</b>To introduce the experience in skin defects reconstruction using keystone design perforator island flap.</p><p><b>METHODS</b>Since June 2012 to June 2013, the flaps have been used in 14 patients. The size of defects ranged from 1 cm x 1 cm to 5 cm x 9 cm at the extremities, trunk and facial region. The trapezoidal shaped flap has the same width as the defect. The flap is designed along the edge of the defect with 90 degree angle at the ends of the island flap. This curvilinear- and trapezoidal-shaped flap essentially consists of two conjoined V-Y advancement flaps at the proximal and distal end. The vascular supply is supported by the subcutaneous vascular network and fascial/muscular perforators. Perforators should be detected by Doppler techniques when large size flaps are used.</p><p><b>RESULTS</b>Primary wound healing and satisfactory result was achieved in 13 patients except for one with partial flap necrosis.</p><p><b>CONCLUSION</b>The technique offers a simple and effective method of wound closure in situations that would otherwise have required complex flap closure or skin grafting.</p>

Clinical appliance of cone-beam computed tomography and dental operating microscope in treating maxillary molars containing bifurcative canals buccally / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the effect of using cone-beam computed tomography (CBCT) and dental operating microscope (DOM) in treating maxillary molars containing bifurcative canals buccally.</p><p><b>METHODS</b>304 endodontically treated maxillary molars (159 maxillary first molars and 145 maxillary second molars) were included. After preparing access to pulp chamber, the number of canal orifices and location in the pulp chamber floor of each tooth were recorded. For those teeth with bifurcative canals buccally confirmed by preoperative radiographs, the root canals were negotiated by naked eyes firstly, then under DOM according CBCT results. Following working length determination, the root canals were prepared by step-down technique and obturated with cold lateral condensation technique. The efficiency was evaluated with radiographs before, during and after operation.</p><p><b>RESULTS</b>In 304 maxillary molars, 51 molars were found to have two canal orifices (buccal one and palatal one) in the pulp floor, 30 bifurcative canals buccally (8 upper first molars and 22 upper second molars) were found. CBCT information indicated the level of bifurcation in buccal canals were 3-8 mm under the pulp chamber floors. In 30 maxillary molars, 7 teeth treated by X-rays and eyes could be negotiated, 22 teeth treated by CBCT and DOM could be negotiated and were well instrumented and filled by evaluating with radiographs during and after operation, 8 teeth with deep divergent MB2 canals or calcified canal could not be negotiated.</p><p><b>CONCLUSION</b>Operative field can be located precisely by CBCT and dental operating microscope that could be effective method in treating these sort of canals.</p>

Studies on chemical constituents from herbs of Botrychium lanuginosum / 中国中药杂志

<p><b>OBJECTIVE</b>To study the chemical constituents of Botrychium lanuginosum.</p><p><b>METHOD</b>Various chromatographic techniques were used to isolate and purify the constituents. The structures were elucidated by chemical evidence and spectroscopic methods.</p><p><b>RESULT</b>Ten compounds were isolated from the 95% ethanol extract of the herb of B. lanuginosum and their structures were elucidated as 30-nor-21beta-hopan-22-one (1), beta-sitosterol (2), luteolin (3), thunberginol A (4), apigenin (5), (6'-O-palmitoyl)-sitosterol-3-O-beta-D-glucoside (6), daucosterol (7), 1-O-beta-D-glucopyranosyl-(2S, 3R, 4E, 8Z)-2-[(2R-hydroxy hexadecanoyl) amino]-4, 8-octadecadiene-1, 3-diol (8), luteolin-7-O-glucoside (9), sucrose (10).</p><p><b>CONCLUSION</b>Compounds 1-10 were isolated from this genus for the first time.</p>

Active constituents from Aloe arborescens as BACE inhibitors / 药学学报

<p><b>AIM</b>To seek for new components as BACE inhibitors from Aloe arborescens.</p><p><b>METHODS</b>The chemical constituents were isolated by chromatographic methods and their structures were elucidated on the basis of spectral analysis.</p><p><b>RESULTS</b>Eight compounds were isolated and their structures identified as 6'-O-isobutyryl aloenin A (1), aloenin A (2), aloe-emodin (3), (E)-2-acetonyl-8-(2'-O-feruloxyl)-beta-D-glucopyranosyl-7-methoxy-5-methyl-chromone (4), 7-O-methylaloeresin A (5), babarloin A (6), elgonica-dimer A (7), and elgonica-dimer B (8), separately.</p><p><b>CONCLUSION</b>Compound 1 is a new compound, and compound 4 was isolated from A. arborescens for the first time. Pharmacological tests indicated that 2, 4, 5 and 6 have moderate inhibitory active on BACE.</p>