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Objective:To explore the effects of prenatal dexamethasone (DEX), postnatal pulmonary surfactant (PS) and respiratory support on the lung fluid clearance in premature rabbits at gestational age (GA) of 25-28 d (full term: 31 d) and their relationship with dynamic compliance of respiratory system (Cdyn), pulmonary morphology and other parameters.Methods:In our previous publications, premature rabbits were divided into four groups according to the intervention strategy: control group, PS-only group, DEX-only group and DEX+PS group in which data of several parameters including wet-to-dry lung weight ratio (W/D), Cdyn and volume density of alveoli (Vv) were retrieved and the lung tissue sections were scanned to recalculate the ratio of perivascular sheath to vascular sectional area (S/V) and lung injury scores-edema (LIS-E). W/D, LIS-E, S/V and Vv were adjusted for birth weight (BW) (divided by BW, represented as W/D/BW, LIS-E/BW, S/V/BW and Vv/BW) and mean Cdyn (Cdyn-m) was adopted. Based on the grouping of previous studies, the intervention groups in this study were divided as DEX group and non-DEX group, and PS group and non-PS group to analyze the influence of DEX and PS on the above parameters. Two independent samples t-test, one-way analysis of variance, LSD test, Kruskal-Wallis H test, Mann-Whitney U test and Pearson correlation analysis were used for statistical analysis. Results:A total of 196 newborn rabbits receiving mechanical ventilation after birth were included in this study. (1) Effects of DEX: compared with the non-DEX group, the DEX group showed increased W/D/BW (489±69 vs 421±113, t=－2.09), LIS-E/BW (188±57 vs 138±55, t=－2.61) and Vv/BW (20.1±4.9 vs 14.2±4.7, t=－3.60), but decreased S/V (0.33±0.23 vs 0.51±0.25, t=2.23) and S/V/W/D (0.05±0.03 vs 0.07±0.04, t=2.22) at 25 d of gestation; at 26 d of gestation, W/D/BW (472±76 vs 303±44, t=－8.75), LIS-E/BW (189±63 vs 106±36, t=－5.23), Cdyn-m [(0.16±0.07) vs (0.05±0.03) ml/(kg?cmH 2O), 1 cmH 2O=0.098 kPa; t=－7.29] and Vv/BW increased (22.4±5.0 vs 12.2±3.8, t=－7.46), while S/V (0.23±0.19 vs 0.62±0.38, t=4.10), S/V/BW (15.7±12.4 vs 25.7±17.3, t=2.20), S/V/W/D (0.03±0.03 vs 0.08±0.05, t=3.92) and propensity scores decreased [(12.5±1.2) vs (15.1±1.2) scores, t=7.00]; at 27 d of gestation, Cdyn-m increased [(0.23±0.12) vs (0.16±0.07) ml/(kg?cmH 2O), t=－2.43], but S/V (0.32±0.23 vs 0.57±0.39, t=2.57) and S/V/W/D decreased (0.05±0.04 vs 0.09±0.06, t=2.55); at 28 d of gestation, W/D/BW (270±64 vs 162±33, t=－8.09), LIS-E/BW (72±32 vs 35±20, t=－5.17), S/V (0.90±0.60 vs 0.59±0.48, t=－2.81), S/V/BW (34.0±23.6 vs 15.2±12.7, t=－3.77) and Vv/BW increased (16.9±4.3 vs 9.2±2.9, t=－8.04); the differences were all statistically significant (all P<0.05). (2) Effects of PS: compared with the non-PS group, the PS group had decreased LIS-E/BW at 25, 26 and 27 d of gestation, increased Cdyn-m and Vv/BW at 25 and 27 d of gestation and higher propensity scores at 25 d of gestation (all P<0.05). (3) The correlation between gestational age and each index: gestational age was positively correlated with S/V ( r=0.31, P<0.05), but negatively correlated with W/D/BW and LIS-E/BW ( r=－0.73 and－0.63, both P<0.05). Conclusions:The pharmacological action of prenatal DEX on lung fluid clearance is mainly confined to preterm rabbits at the GA of 28 d which is supported by mechanical ventilation. Prenatal treatment with DEX and/or postnatal PS can improve the early respiratory function in preterm rabbits between GA of 25-27 d, but had no substantial impact on lung fluid clearance. The GA-related lung maturation appears to play a crucial role, in comparison with medications, in lung fluid clearance.
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Objective:To compare dose distributions of hypofractionated radiotherapy for pancreatic cancer between IMPT and VMAT.Methods:Ten pancreatic cancer cases were included in this retrospective study. Photon (Edge) and proton (Proteus?PLUS) plans were designed by Eclipse and RayStation TPS, respectively. All plans were transferred to MIM system for extraction of parameters, which included Dmin, Dmean and Dmax of PTV, conformity index (CI), new conformity index (nCI), homogeneity index (HI), gradient index (GI), coverage, Dmax and dose-volume of the organs at risk (OARs). Results:There was no significant difference in CI between the two groups. The higher PTV Dmin, Dmean, Dmax, D98%, D2%, HI, coverage and the better GI, D2 cmwere found in VMAT ( t/ Z=-4.63-5.32, P<0.05). The lower 10%_PD was found in IMPT ( t=-7.47, P<0.05). Regarding the OARs, Dmax of the intestine, stomach, and duodenum and Dmean of the left kidney were similar between two groups without significant difference ( P>0.05). The D5 cm 3 of the intestine, D10 cm 3 of the stomach, D5 cm 3 and D10 cm 3 of the duodenum, D2/3 of the left kidney, Dmean and D2/3 of the right kidney were lower in IMPT than those in VMAT ( t/ Z=-8.12--2.60, P<0.05). However, the Dmax and D0.35 cm 3 of the spinal cord were higher in IMPT than those in VMAT ( t=7.30, 6.77, P<0.05). Conclusions:Both of hypofractionated radiotherapy plans of pancreatic cancer designed by VMAT and IMPT could meet clinical needs. No significant difference was found in Dmax of the adjacent gastrointestinal tracts between the two groups. While IMPT had the advantage over VMAT in the case of lower dose-volumes of the gastrointestinal tracts. Nevertheless, less protections of the OARs in front of the tumor volume could be provided by IMPT compared with VMAT.
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Objective:To investigate the predictive efficacy of the established prognostic nomogram of rituximab in treatment of diffuse large B-cell lymphoma (DLBCL) patients with bone marrow infiltration.Methods:The clinicopathological data of 71 DLBCL patients with bone marrow infiltration who received first-line treatment with rituximab between January 2014 and June 2016 in Shanxi Province Cancer Hospital were retrospectively analyzed. Progression-free survival (PFS) analysis was performed by using Kaplan-Meier method, and influencing factors of PFS were analyzed by using univariate and multivariate Cox proportional hazards models. The nomogram was drawn with R software based on independent influencing factors of PFS from Cox regression analysis. Receiver operating characteristic (ROC) curve was applied to evaluate the effects of nomogram models predicting the PFS of patients; Bootstrap method was used for internal validation of the model. A nomogram calibration curve was plotted to compare the consistency between the nomogram model prediction and the actual PFS.Results:The median follow-up time of all patients was 48 months (12-84 months), and the 3-year and 5-year PFS rates were 39.44% and 26.76%, respectively. Age > 60 years ( HR = 1.593, 95% CI 1.379-1.840, P < 0.001), Ann-Arbor staging Ⅲ-Ⅳ ( HR = 1.444, 95% CI 1.092-1.910, P = 0.010), international prognostic index (IPI) score 3-5 ( HR = 1.648, 95% CI 1.249-2.333, P < 0.001), complicated with type 2 diabetes ( HR = 5.880, 95% CI 1.645-21.023, P = 0.006) were independent influencing factors of PFS in DLBCL patients with bone marrow infiltration. The independent influencing factors of PFS were included to establish the prognostic nomogram model. Bootstrap method internal validation showed that the consistency index of the prediction model was 0.71 (95% CI 0.69-0.78), and the ROC curve showed that the area under the curve (AUC) of 3-year PFS predicted by nomogram model was 0.708, 5-year PFS predicted by nomogram model was 0.716, indicating that nomogram model had a good degree of differentiation; and the calibration curve results showed that the 3-year and 5-year PFS rates predicted by nomogram model had a good consistency with the actual 3-year and 5-year PFS rates. Conclusions:The nomogram model constructed by age, Ann-Arbor staging, IPI score, complicated with or without type 2 diabetes could be used to predict the prognosis of DLBCL patients with bone marrow infiltration treated with rituximab, which is helpful for clinicians to implement treatment strategies.
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Objective:To evaluate and summarize the best evidence for early rehabilitation of adults with veno-venous extracorporeal membrane oxygenation (VV-ECMO).Methods:Evidence on early rehabilitation of adult VV-ECMO patients was searched by computer from 7 English literature databases [PubMed database, cumulative index to nursing and allied health literature (CINAHL), Embase database, Cochrane library database, UpToDate clinical consultant, BMJ best clinical practice, JBI database], 5 Chinese literature databases (China biomedical literature database, China Yimai Tong, China national knowledge infrastructure, Wanfang data, VIP database), 5 guideline networks [National Institute for Health and Care Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), National Guideline Clearinghouse (NGC), Guidelines International Network (GIN), China Guide Network] and 2 professional association websites [Extracorporeal Life Support Organization (ELSO), Chinese Association of Rehabilitation Medicine]. The search period is from January 2011 to December 2021. The appraisal of guidelines for research and evaluation Ⅱ (AGREE ) and JBI 2014 quality assessment tools were used to evaluate the quality of inclusion guidelines, systematic reviews, expert consensus and original studies, respectively, and to extract and summarize the best evidence for early rehabilitation of adults with VV-ECMO.Results:A total of 2 guidelines, 2 expert consensuses, 2 systematic reviews and 8 original studies [including 1 randomized controlled trial (RCT), 1 non-randomized controlled study, 3 cohort studies and 3 case reports] were included. The evidence was summarized from 9 aspects including the necessity of early rehabilitation, rehabilitation initiation time, rehabilitation location, pre-rehabilitation preparation, pre-rehabilitation assessment, rehabilitation method, rehabilitation frequency and duration, rehabilitation process monitoring and effect evaluation,and finally 24 pieces of the best evidence were summarized.Conclusion:Early rehabilitation of adults with VV-ECMO is safe and feasible. The summary of the best evidence can provide evidence-based guidance for clinical medical staff to reasonably carry out early rehabilitation.
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Cancer stem cells (CSCs) are a class of cells with self-renewal, differentiation, and tumorigenic potential in tumors. It is currently believed that the resistance of CSCs to chemotherapy and radiotherapy is an important cause of tumor recurrence and metastasis. Researchers have found that related factors in many signaling pathways endow CSCs with the ability to adapt to changes in the microenvironment, including inflammatory factors, hypoxia, low pH, and a lack of nutrients. In recent years, the mechanism of CSCs' resistance to therapy has been studied, mainly including the drug efflux mediated by the ATP-binding cassette transporter, the effect of aldehyde dehydrogenase 1 (ALDH1) activity on tumor stem cells, the enhancement of DNA damage repair and degradation of reactive oxygen species, autophagy, activation of development-related pathways, stimulation of the microenvironment, and EMT. The targeting strategies for CSCs include targeting signaling pathway inhibitors, targeting multidrug resistance, DNA damage repair, ALDH, targeting the tumor microenvironment, immunotherapy, etc. In this review, the research progress in CSCs treatment resistance and related treatment strategies was reviewed.
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Objective:To compare the dose distribution among CyberKnife, Tomotherapy, Edge, Triology and γ-knife in stereotactic body radiation therapy (SBRT) for pancreatic cancer.Methods:Clinical data of 10 panreatic cancer patients receiving CyberKinife treatment were retrospectively analyzed. The treatment plans were designed by five apparatuses from five centers according to the uniform requirement. All plans were transferred to MIM system for the extraction of parameters, which mainly included D min, D mean and D max of PTV, conformity index (CI), new conformity index (nCI), homogeneity index (HI), gradient index (GI), coverage, D max and dose-volume of the stomach and bowel. Results:The best CI and nCI were obtained in Triology ( P<0.001), and the worst HI was found in γ-knife ( P<0.001). The best GI was found in CyberKnife, followed by γ-knife and Tomotherapy, and Edge showed the worst GI ( P<0.001). The highest D min of PTV was found in both Edge and Triology, while lower D min of PTV was found in CyberKnife and Tomotherapy ( P<0.001). Additionally, γ-knife provided the highest D mean and D max of PTV ( P<0.001). Regarding the organs at risk, the lowest D max and D 5cm 3 of the bowel ( P<0.001), D max of the stomach ( P=0.003), D max( P=0.001), D 5cm 3 ( P<0.001) and D 10cm 3 ( P=0.005) of the duodenum, D max( P<0.001) and D 0.35cm 3 ( P<0.001) of the spinal cord were found in CyberKnife. The highest D max of the bowel was found in γ-knife. Furthermore, the highest D 5cm 3 of the duodenum was demonstrated in Edge ( P<0.001) and Tomotherapy provided the highest D max( P<0.001) and D 0.35cm 3 of the spinal cord ( P<0.001). Conclusions:All five radiotherapy apparatuses can meet the requirement of SBRT for pancreatic cancer. More rapid dose fall-off could be obtained via CyberKnife and γ-knife. Triology and Edge provide better target conformity. CyberKnife can better protect the gastrointestinal tract.
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Objective:To explore and analyze the influence of thoracic types and symmetry methods on the treatment effect before operation for the breast cancer patients undergoing immediate breast reconstruction.Methods:From January to October 2018, 30 female patients with unilateral breast cancer, aged 33-48 (39.6±4.6) years, were treated in the Breast Center of Qingdao University Affiliated Hospital. Thoracic CT was used to analyze thoracic types and symmetry. The measurement indexes included the maximum transverse diameter of thorax, the maximum longitudinal diameter of left and right sides, the ratio of the maximum transverse longitudinal diameter of left and right sides, the anterior chest angle of left and right sides, the posterior chest angle and the external chest angle, and the type and symmetry of thorax were analyzed, and the choice of prosthesis was adjusted according to the measurement results.Results:All the 30 patients recovered smoothly, and no complications such as infection and prosthesis removal occurred. Anatomical prostheses were selected in 22 patients, including 12 cases with medium high protrusion prosthesis, 10 cases with low protrusion prosthesis and 8 cases with round low protrusion prosthesis. The average follow-up time was 15 months after operation. The postoperative follow-up photos were evaluated aesthetically by using the BRAST-Q questionnaire and 3 non-operative doctors, among which 22 cases were excellent, 4 cases were good, 3 cases passed and 1 case was poor. Excellent and good rate was 86.7%. Among them, 3 cases were satisfactory, 1 case was scar hyperplasia of local incision, 2 cases were mild capsular contracture, and 1 case was subject to prosthesis displacement.Conclusions:The measurement and analysis of thoracic type and symmetry before operation can help to adjust the choice of prosthesis, check the obvious thoracic deformity and avoid affecting the surgical results.
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Objective:To systematically evaluate the relationship between sedentary behavior (SB) and the risk of developing gestational diabetes mellitus (GDM).Methods:PubMed, Medline, EMBASE, CINAHL, the Cochrane Library, the Rehabilitation & Sports Medicine Source, the Sedentary Behavior Research Database (SBRD), Wanfang Database, the China Journal full-text database, and the China Biomedical Literature Database were searched for cohort studies, case-control studies, and cross-sectional studies concerning the risk of SB and GDM from the establishment of the database to January 2021. Two researchers screened the literature, extracted data, evaluated the quality of the data according to the inclusion and exclusion criteria, and, finally, produced a descriptive analysis of the results.Results:A total of 11 studies were included, including eight cohort studies, two cross-sectional studies, and one case-control study. The overall quality of the studies was moderate. The prevalence of GDM was 5.04%-26.81%, and the prevalence of SB before and during pregnancy was 39.47%-40.21% and 28.86%-93.50%, respectively. In terms of the prevalence of SB before pregnancy, four moderate-quality studies reported no association with GDM risk. In terms of SB during pregnancy, four moderate-quality studies reported no association with GDM risks, and four studies (one of high quality and three of moderate quality) reported an association with GDM risks, two of which focused on the second trimester. There was considerable heterogeneity between studies on the diagnosis of GDM and SB.Conclusion:SB before pregnancy is not associated with the risk of GDM, while the relationship between SB and the risk of GDM is unclear, but the level of SB in the second trimester of pregnancy may be positively associated with the risk of GDM.
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Objective:To search, evaluate and summarize the evidence on prediabetes management in high-risk population with gestational diabetes mellitus (GDM).Methods:Two researchers independently screened the evidence according to the inclusion criteria and exclusion criteria. The quality of the included evidence was evaluated by the clinical guideline research and evaluation system (AGREE Ⅱ). The quality of the evidence and the strength of recommendation were graded by the GRADE system. According to the clinical nursing practice guidelines for gestational diabetes mellitus, the recommendations for GDM high-risk groups were extracted.Results:A total of 14 pieces of evidence were included, including 4 guidelines, 2 consensus, 5 practice guidelines and 3 diagnosis and treatment standards. 29 pieces of recommendations for prediabetes management of high-risk population with gestational diabetes mellitus were summarized from five aspects, including disease risk assessment, prenatal examination guidance, management objectives of gestational weight and blood glucose, diet guidance and exercise guidance.Conclusion:The evidence of prediabetes management of high-risk population with gestational diabetes mellitus is scientific and reliable.
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Objective:To summarize the establishment and management experience of extracorporeal membrane oxygenation (ECMO) rapid response team, and explore a more efficient rescue mode.Methods:From January 2015 to September 2020, 85 patients treated with ECMO in Affiliated Hospital of Qingdao University were selected as the research objects. Thirty-eight patients treated with conventional ECMO from January 2015 to December 2019 were selected as the control group, and 47 patients treated with ECMO rapid response team from January 2020 to September 2020 were selected as the experimental group. The differences in team preparation time, catheterization time, treatment success rate, incidence of complications and equipment failure frequency between the two groups were compared.Results:There were no significant differences in gender, age or disease types between the two groups. The team preparation time and catheterization time of the experimental group were significantly shorter than those of the control group [team preparation time (minutes): 31.79±6.10 vs. 67.16±30.49, catheterization time (minutes): 40.62±7.13 vs. 84.89±19.29], and the incidence of complications was significantly lower than that of the control group [4.3% (2/47) vs. 21.1% (8/38)], and the differences were statistically significant (all P < 0.05). Conclusion:ECMO rapid response team can shorten the rescue preparation time, reduce the occurrence of complications, improve the team treatment efficiency, and provide ideas for emergency and critical patients.
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Objective:To discuss and analyze the clinical efficacy and application value of transperineal ultrasound dynamic monitoring for the contraction function of pelvic floor muscle to guide training based on its feedback in the treatment of stress incontinence of female.Methods: 169 female patients with stress incontinence were enrolled this study. And all of them were treated by using the Koegel physical training of pelvic floor muscle under the guidance of doctor, at the same time, the relative contraction function indicators of pelvic floor muscle before and after treatment were observed and compared by applied transperineal ultrasound dynamic monitoring.Results: The differences between before and after treatment of physical training on pelvic floor muscle about the length of the levator hiatus, the acreage of pelvic diaphragm hiatus, and the perimeter of pelvic diaphragm hiatus in contraction and silent period were significant (t=-2.858,t=-2.949,t=-4.899,P<0.05), and that of after treatment was higher than that of before treatment. The horizontal distance of pubis combined with margo inferior, vertical distance and thickness of viscera on pubis of after treatment were significant higher than that of before treatment (t=3.674, t=-4.899,t=4.230,P<0.05). The posterior urethra intersection angle and the intersection angle of left and right levator after treatment were significantly higher than that of before treatment (t=-4.087,t=6.584, P<0.05).Conclusion: Transperineal ultrasound dynamic monitoring can correctly evaluate the clinical efficacy of the contraction function of pelvic floor muscle to guide training based on its feedback in the treatment of stress incontinence of female. And this method has important clinical value.
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Resident standardization training of dentists is a very important program for the dental students , during which they are trained to be capable of analyzing cases logically and carrying out the treatment suitably. The students who study in this period always have a certain level of basic knowledge and with the full passion for clinical practice, so it's important for them to develop the correct clinical thinking method and form a life-long learning habit. However, the traditional teaching models can't catch up with today's more and more divergent and complicated demands of teaching and learning. The new ori-ented teaching models of PBL and CBL may offer us new ways to carry out the resident standardization training more efficiently, simulate the student's passion of learning and gain wider experience in short time, for their student-centered and clinical cases-guided characteristics.
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Objective To evaluate whether recombinant human erythropoietin (rh-EPO) could increase the angiogenic responses in preterm rat models with periventricular white matter damage (PWMD).Methods Three-day postnatal rats were divided into 3 groups randomly:the sham group,the hypoxic-ischemic (HI) group and the recombinant human erythropoietin(rh-EPO)treatment group.Rat pups underwent permanent ligation of the right common carotid artery followed by 60 mL/L O2 for 4 h or sham operation and normoxic exposure.Immediately after the HI,rats received a single intraperitoneal injection of rh-EPO (5 U/g)or saline.Angiogenesis-related cells (CD34 + cells),microvessel density (MVD)and arteriovenous related genes (ephrinB2 and EphB4)were examined at 48 h and 96 h after operation.Results At 48 h after operation,the proteins of CD34 in HI rats increased compared with the sham rats (HI group vs Sham group:0.54 ± 0.05 vs 0.42 ± 0.05,P ＜ 0.05).However,the MVD,the mRNA of ephrinB2 and EphB4 did not change (P ＞ 0.05).The proteins of CD34,the mRNA of ephrinB2 and EphB4 increased after rh-EPO treatment compared with HI rats.However,the MVD did not increase.As the proteins of CD34 increased further at 96 h after operation (HI group vs Sham group:0.85 ± 0.06 vs 0.62 ± 0.06,P ＜ 0.05),the MVD (3.14 ± 1.21 vs 1.50 ± 1.04),ephrinB2 (7.51 ± 1.89 vs 1.28 ± 0.24) and EphB4 (4.58 ± 0.82 vs 1.21 ± 0.22) also increased (all P ＜ 0.05).And the proteins of CD34 increased after administration of rh-EPO(EPO group vs HI group:0.98 ± 0.07 vs 0.85 ± 0.06,P ＜0.05) and MVD(EPO group vs HI group:4.71 ± 1.38 vs 3.14 ± 1.21,P ＜0.05) were increased after administration of rh-EPO.However,the ephrinB2 and EphB4 did not increased after administration of rh-EPO at 96h time point.Conclusion Endogenous regenerative response is triggered in the damaged tissues and rh-EPO increases the angiogenesis in model rats with PWMD.
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The multidisciplinary synthetic therapy for the colorectal liver metastases has been a hot spot in clinical research,which includes operative therapy,tumor local therapy,conversion therapy,chemotherapy, molecular targeted therapy and so on. It is need to choose multiple therapies for the patients and make the whole treatment strategy in accordance with the condition of patients to maximize the survival benefit in clinical prac-tice. So,it is important to comprehend the newest research process of the clinical therapy to make a good choice for the colorectal liver metastases patients.
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Objective To investigate the association of Galectin-3 ( lectin, galactoside-binding soluble , LGALS3)gene-191(rs4644)polymorphism and breast cancer in Chinese female population .Methods Galectin-3 gene rs4644 polymorphisms was genotyped by polymerase chain reaction-restriction fragment length polymor-phism(PCR-RFLP)in 172 breast cancer patients and 17 controls.The experimental results of PCR-RFLP were verified and sample of 10 cases were sequenced randomly .Results The frequency of CC ,CA and AA genotype in breast cancer group and normal control group was 72.7%, 25.0%, 2.3% and 52.9%, 41.2%, 5.9%, respectively .The frequency of C and A allele in breast cancer group and normal control group was 85.2%, 14.8%and 73.5%, 26.5% respectively .The genotype and frequency of allele had no statistical difference between breast cancer patients and the control group .rs4644C allele was more likely to occur in breast cancer patients with T>2 cm (χ2 =8.295,P=0.004) and Ki67<14%(χ2 =3.917,P=0.048).Conclusions There is no significant association between Galectin-3 gene 191 polymorphism rs4644 and susceptibility of breast cancer in Chinese female population .It is closely associated with the size of tumor and Ki 67.
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Objective To evaluate the effect of problem-based learning (PBL)versus tradi-tional methods in medical statistics. Methods Computer retrieval was conducted to search for con-trolled studies comparing PBL and traditional methods. The quality of included studies was critically evaluated and data were analyzed by using the Cochrane Collaboration's RevMan 5.0 software. Results A total of 21 articles were retrieved,but only 7 were included. The results of Meta analysis showed that there was no significant difference between PBL and traditional methods in both the passing rate of student's score (RR=1.09,95%CI=0.98-1.23,P=0.12>0.05)and the exact score (WMD=0.30, 95%CI=-0.06 -0.67,P=0.10>0.05). Conclusion PBL showed no better learning results in medical statistics compared with traditional methods.
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Purpose To study the clinic-pathologic features, differential diagnosis and prognosis of lymphoepithelioma-like carcinoma of cervix. Methods Eight cases of lymphoepithelioma-like carcinoma of cervix were retrieved from our institution. HE staining, im-munohistochemistry and in situ hybridization were perform on those cases. Results Of the 8 cases of lymphoepithelioma-like carcino-ma,the median age was 44 years old ( ranged from 29-67 years) and all of the clinical stage belonged toⅠB. Grossly, 5 cases presen-ted a cauliflower-like appearance, 1 case grew as a polyp protrusion, and the other 2 cases showed a non-specified thicken change of cervix. Histologically, the tumors were composed of undifferentiated large cells, either loosely or closely-packed, with the nested and trabecular growth pattern. The tumor cells were generally oval or polygonal in shape, while the demarcation between the cells was indis-tinct and form the syncytial appearance. The nuclei were vesicular and had one or more prominent nucleoli. There were abundant infil-trates of lymphocyte and plasma cells among the tumor nests. The tumor cells showed positive expression of CK in 100% of cases, p63 in 37. 5% of cases, p16 in 62. 5% of cases, CK5/6 in 75% of cases, Ki-67 in 10% ~30% of cases. The stromal lymphocytes mainly expressed CD3 and CD8. EBER was negative in the entire tumor cells while was weakly positive in the stromal lymphocytes in one case. The follow-up data, which terminated at June 2013, demonstrate 7 cases were alive and 1 case died of the disease. Conclusions Lymphoepithelioma-like carcinoma occurred of cervix is rare. They have distinctive morphologic features and overall favorable prog-nosis. The accurate diagnosis is dependant on the combination of the histologic and immunohistochemical examination.
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<p><b>OBJECTIVE</b>To identify the occupational hazard factors in an accumulator factory, to analyze the status of internal and external lead exposure and evaluate the impact of lead exposure on the health of workers in the accumulator industry, and to provide a theoretical basis for improved lead exposure criteria and technical support for the control of lead contamination in the accumulator industry.</p><p><b>METHODS</b>An on-site investigation was carried out to monitor and evaluate the lead fume and dust in the workplaces of an accumulator factory, and occupational health examination was performed in all workers.</p><p><b>RESULTS</b>The occupational hazard safeguards in the accumulator factory were unadvanced. The contamination of lead fume and dust was serious. The abnormal rate of blood lead was up to 79.80%, and many workers developed anemia and mild peripheral nerve disease.</p><p><b>CONCLUSION</b>Lead contamination is serious in the accumulator factory, leading to poor health of workers. It is essential to take effective control measures, improve the working environment, provide occupational health education, increase workers' self-protection awareness, and periodically conduct occupational hazard monitoring and health surveillance. The government must reinforce occupational health supervision of such enterprises.</p>
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Female , Humans , Male , Industry , Lead , Blood , Lead Poisoning , Occupational Diseases , Epidemiology , Occupational Exposure , Occupational Health , WorkplaceABSTRACT
Objective To investigate the evaluation of medical doctoral students on medical statistics teaching. Methods An investigation was carried out among doctoral students of 2012 using questionnaires in a medical university. A total of 272 doctoral students were investigated and 266 (97.79%)of them had learned medical statistics before enrollment. Statistical description was used to analyze enumeration data by calculating cases and percentages. Results More than 88.00% of them thought that medical statistics was helpful for their future work. More than 60.00% of them thought that the present teaching contents were appropriate and about 93.00% of them thought that examina-tion mode was appropriate. However,65.00% of them thought that the class hours were not enough and some con-tents should be explained more clearly. Conclusions Both basic statistics methods and advanced statistics methods should be given consideration to. Some frontier or hot knowledge of medi-cal statistics should be arranged and the class hours should be increased to expand the content of teaching.
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ObjectiveTo assess the current situation of postgraduates knowledge about medical research design and optimize the curriculum setting of research design.MethodsAn investigation was carried out in the postgraduates of 2011 using questionnaires in a medical university..The questionnaire ineluded basic information of participants and cognition of basic methods of research design.ResultsA total of 473 postgraduates participated in the investigation.Among them,311 systematically learned medical statistics before enrollment,and 275 ( 58.14％ ) once participated in scientific researches.Most of them ( ＞80％ ) knew about the 10 basic methods of research design listed in the questionnaire,but only a few of them were familiar with them,and some even didn't know about the methods.ConclusionWe should pay attention to the culture of scientific research thought in statistical design,strengthen the practice of research design teaching,and the curriculum of research design should be led into undergraduate course.