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This study uses "virtual implant" technology combined with PBL and CBL teaching methods to carry out oral implantology teaching with "restoration as the goal". By instructing students to collect preoperative data and compare actual postoperative data, the continuous cycle verification between problems, objectives, methods, and results is performed. The continuous cycle verification can improve the enthusiasm and initiative of students to learn oral implantology. At the same time, it can allow students to develop the thinking habit of understanding oral implantology with a holistic and whole-process concept and provide strong educational guidance for clinical medical students.
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Objective@#To investigate the clinicopathological features, diagnosis and differential diagnosis of gastrointestinal glomus tumors (GIGT).@*Methods@#Totally 15 cases of GIGT were collected at the First Affiliated Hospital, Zhengzhou University, from January 2011 to June 2018. The clinicopathological features, immunophenotype, BRAF V600E mutation and prognosis were retrospectively analyzed.@*Results@#The 15 patients′ age ranged from 37 to 59 years(median 49 years, mean 50 years). Eleven patients presented with intermittent abdominal pain and distention, three showed antral space-occupying lesions at physical examination, and one had abdominal pain accompanied by fecal blood. Fourteen tumors were located in the stomach, and one was in the ileum. Imaging showed the gastric glomus tumors were located in the submucosal layer with obvious enhancement in the arterial phase, and the ileum glomus tumor involved the whole layer of intestinal wall causing luminal obstruction. The maximum diameters of the tumors ranged from 1.5 to 3.0 cm (mean 2.3 cm). Grossly, the gastric glomus tumors were solid. Microscopically, the gastric glomus tumors were mostly located in the muscularispropria layer and were vascular. The tumor boundary was distinct but without capsule formation. The tumor cells were round or oval, and showed perivascular hemangiopericytoma-like or solid nest-like structures. The tumor cells were mildly pleomorphic, with rare mitosis and no necrosis. Two tumors had focal calcification, two showed mucosal invasion, two showed vascular invasion and five showed perineural invasion. The ileum glomus tumor was cellular, with prominent cellular atypia, and the mitotic count in hot spots was about 5-6/HPF. Immunohistochemistry showed that SMA and collage Ⅳ were strongly expressed in all the tumor cells; caldesmon and calponin were moderately expressed in some regions, and syn was weakly expressed in 12 cases. The Ki-67 proliferation index in the gastric glomus tumors ranged from 1% to 30% (mean 6%); and that in the ileum glomus tumor was about 70%. BRAF V600E mutations were not detected in any of 15 GIGTs. All patients did not receive radiotherapy or chemotherapy post operatively. Thirteen patients were followed up by telephone for 18-90 months (mean 42 months). Twelve patients with gastric glomus tumors survived without recurrence and metastasis, and the patient with ileum glomus tumor had liver metastasis 15 months after operation.@*Conclusions@#Glomus tumors is a rare mesenchymal tumor of the gastrointestinal tract. It should be differentiated from gastrointestinal stromal tumors, neuroendocrine tumor, leiomyoma, solitary fibrous tumor and paraganglioma. Most GIGTs are benign and have good prognosis. More experience is needed to understand the biologic behavior and prognostication of GIGTs.
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Medical record writing is an important part of clinical practice for stomatology undergraduates. The application of electronic medical record system has been used under the guidance of teachers in the practice of stomatology undergraduates in our hospital. This paper investigates the use of electronic medical records of undergraduates in practice through questionnaires, and analyzes the quality of electronic medical records by spot checking. It's found that electronic medical records can guide interns to improve their clinical abilities in all aspects, but there are still some shortcomings such as dependence on medical record templates and inadequate mobilization of clinical thinking ability. This paper puts forward some measures to promote the application of electronic medical records and the quality of practice teaching by strengthening pre-job education and mobilizing students' subjective initiative.
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Objective@#To investigate the clinicopathological features of gangliocytic paraganglioma(GP).@*Methods@#Clinical data and pathological diagnosis of the 4 cases of GP were obtained through the medical record inquiry from January 2011 to December 2017 at the First Affiliated Hospital of Zhengzhou University. Routine HE staining and immunohistochemistry of CKpan, Syn, CgA, CD56, NSE and NF were performed. Clinical follow-up of the patients was obtained through telephone communication.@*Results@#All 4 patients, including 2 male and 2 female patients, presented with intermittent abdominal pain and distention. The median age was 56 years. Preoperative CT showed local thickening of the duodenum wall with slight enhancement in all four cases. Endoscopic ultrasonography showed low level echo in the mucous layer and submucosa involved by the tumor in 3 of 4 cases. The maximal diameter of the tumor ranged from 0.6 to 1.8 cm with an average of 1.2 cm. Microscopically, the tumors consisted of epithelioid, spindle and ganglion-like cells, and the proportion of the three cell types was different among cases. Epithelioid cells expressed CKpan, Syn, CgA and CD56. Spindle cells expressed S-100 protein and SOX-10 and ganglion-like cells expressed NF, Syn, CgA and CD56.All tumour cells expressed NSE. All 4 patients had no recurrence a post-surgery follow-up period of 3 to 30 months.@*Conclusions@#GP of the duodenum is a benign tumor with excellent prognosis after endoscopic excision. Although its incidence is very low, its diagnosis should be considered for any mass lesion of the duodenum, especially involving mucosa and submucosa of the second dudenal segment.
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Objective@#To evaluate the expression of cytokeratin (CK)7, CK8/18, CK19 and p40 in esophageal squamous cell carcinoma (ESCC) and its significances. @*Methods@#One hundred and ninety cases of surgically resected ESCCs and 154 normal esophageal tissues as control were collected at the First Affiliated Hospital of Zhengzhou University in 2012.Of the 190 ESCC cases including 116 male and 74 female, aged 28-82 (60.3±8.6) years, 88 cases <60 years old and 102 cases ≥60 years old. Tissue sections were immunostained for CK7, CK8/18, CK19 and p40, and the expression was evaluated and correlated with the clinicopathologic findings and outcome. @*Results@#CK19 and p40 were expressed in 190 cases of ESCCs; with 147 cases (77.4%) and 151 cases (79.5%) showing high p40 and CK19 expression, respectively; while 43 cases (22.6%) and 39 cases (20.5%) showed low p40 and CK19 expression, respectively. The low expression groups showed more lymph node metastases and higher pTNM stages compared to the high expression groups. The high CK19 expression group showed better prognosis than the low expression group (P<0.01); p40 expression was not correlated with prognosis(P>0.05). In contrast, CK7 and CK8/18 expression was only seen in 29 cases (15.3%) and 59 cases (31.1%) of ESCCs, respectively, and their expression correlated significantly with the degree of tumor differentiation and lymph node metastasis (P<0.05). The prognosis in the CK7 negative group was better than that in the CK7 positive group. Similar results were found in CK8/18 expression. Multivariate analysis revealed that pTNM stages, low CK19 expression and CK8/18 expression were independent prognostic factors. @*Conclusions@#Low p40 expression and the expression of CK7 and CK8/18 cannot exclude poorly-differentiated ESCCs.CK7 and CK8/18 expression and low CK19 and p40 expression in the ESCCs are associated with lymph node metastasis and poor prognosis. Decreased expression of CK19 and positive expression of CK8/18 in ESCCs are independent prognostic markers.
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Objective To evaluate the efficacy and toxicity of the combination of oxaliplatin and S-1 in the treatment of patients with advanced breast cancer.Methods A total of 72 patients with advanced breast cancer after the treatment failuer of anthracycline and taxane were treated with oxaliplatin and S-1.The first day,they were given oxaliplatin,135 mg/m2,with the 5％ glucose injection 500 ml,the time of intravenous drip should be more than 2 hours.And the S-1 was taken after breakfast and dinner,the dose was 40-60 mg,and the time of duration was 2 weeks,then they had 7 days to rest.The cycle was 21 days.Every 2 cycles,we estimated the efficacy.Patients who were effective and stable kept that chemotherapy regimens,the maximum duration was 6 cycles.The efficacy and toxicities were evaluated after cycles of chemotherapy.Results Two cases (2.8％) had complete response (CR),26 cases (36.1％) had partial response (PR).The response rate (RR) was 38.9％ and the disease control rate (DCR) was 69.4％.The median progress free survival (PFS) was 7.7 months and the median overall survival (OS) was 12.3 months.Subgroup analysis showed that the OS of patients who belong to stage Ⅳ,had two or more metastases or with failure treatment after being treated with anthracycline and taxane was notably shorter than the patients who belong to stage Ⅲ C,only one metastasis,with effective treatment after being treated with anthracycline and taxane,and the differences were statistically significant (10.5 months vs.15.0 months,x2 =4.469,P =0.035;9.3 months vs.15.0 months,x2 =8.297,P=0.004;10.0 months vs.14.0 months,x2 =4.077,P=0.043).The main side effects were neutropenia (19.4％),nausea (8.3％) and nerve toxicity (2.8％),mainly 3-4 degree,and could be welltolerated.The others were diarrhea,impaired liver function,stomatitis,anemia and hand-foot syndrome,mainly 1-2 degree.Conclusion Oxaliplatin combined with S-1 is effective and tolerable in treatment of patients with advanced breast cancer,the adverse reactions can be tolerated.
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Objective To investigate the expression of β-catenin and Oct-4 in colonal carcinoma and explore the relationship with recurrence and metastasis after operation. MethodsImmunohistochemical analysis was used to evaluate the expression of β-catenin and Oct-4.The correlation of β-catenin and Oct-4 expression with tumor cell differentiation,T stage,N stage and metastasis was analyzed.The gene expression of Oct-4 was examined by RT-PCR in 20 frozen tumor tissues and normal tissues adjacent to tumor.Results Thirty-five patients had metastasis. The positive rates of β-catenin and Oct-4 expression were significantly higher in metastasis group than in the non-metastasis group (65.71％ vs 31.11％,51.43 ％vs 13.33 ％,x2 =9.843,P =0.002,x2 =13.605,P =0.001).Expression of β-catenin and Oct-4 was not associated with differentiation,T stage or N stage.The positive expression rate of Oct-4 in colonal carcinoma tissues was significantly higher than that in normal tissues.Metastatic rates in patients with positive expression of β-catenin and Oct-4 was higher than that in negative expression.The survival analysis showed that time of metastasis was significantly different in two groups of patients (P ＜0.05).Conclusion The expression of β-catenin and Oct-4 in tumor tissues is related to metastasis of colonal cancer after surgery and might be used to predict metastasis of colonal cancer after operation.
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@#ObjectiveTo observe the effect of Nd∶YAG laser combined with enamel cement on dentine hypersensitiveness (DH).Methods120 DH cases (totally 182 teeth) were randomly divided into two groups. The experiment group (92 teeth) was treated with Nd∶YAG laser and enamel cement. The control group (90 teeth) was only treated with Nd∶YAG laser.ResultsEffective rates of the experiment group at the moment of treatment, 3 months and 6 months after treatment were 97.8%, 96.7% and 90.2 % respectively, and that of the control group were 95.6%, 91.1% and 84.4%. There was a significant difference between two groups (P<0.05).ConclusionNd∶YAG laser combined with enamel cement has an obvious effect on DH.