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The scaffolding teaching is a kind of "student-centered" teaching desgin. In this study, the teacher breaks down complex content into simply conceptual framework so as to enable students to define their learning objectives, provide help for students' learning, and guide students to think independently and explore cooperatively to construct their own knowledge system. Clinical Microbiology Laboratory Technology is a specialized course with very complicated theoretical contents, which can break up the whole into parts by scaffolding instruction, combined with the learning strategies of cooperation, exploration and mind mapping. Finally, "installment fixed deposit" is realized by induction and summary. The scaffolding teaching model promotes students' ability of autonomous learning, analytical reasoning and innovation.
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Objective:To observe the efficacy and safety of albumin paclitaxel in patients with advanced breast cancer.Methods:A retrospective analysis was performed on 138 patients with advanced breast cancer admitted to Xiangyang Central Hospital from June 2018 to June 2021. The patients were divided into groups according to molecular type, number of treatment lines for albumin paclitaxel, number of metastatic sites, specific metastatic sites, past use of docetaxel and paclitaxel and combination therapy of albumin paclitaxel. Median progression-free survival (mPFS) and treatment-related adverse reactions in different subgroups treated with albumin paclitaxel were investigated. Survival curves were plotted by Kaplan-Meier method and log-rank test was performed, and multivariate analysis was performed by Cox model.Results:The mPFS of the overall population was 8.2 months. The mPFS of triple negative breast cancer, human epidermal growth factor receptor-2 (HER-2) positive breast cancer and Luminal breast cancer were 6.4 months, 11.2 months and 8.1 months respectively, with a statistically significant difference (χ 2=7.42, P=0.025) . The mPFS of patients treated with first- and second-line albumin paclitaxel was 9.5 months, and the mPFS of patients treated with third- to seventh-line was 6.3 months (χ 2=3.86, P=0.049) . The mPFS of patients with ≤3 metastatic sites was 8.1 months, and the mPFS of patients with >3 metastatic sites was 7.0 months (χ 2=0.38, P=0.535) . The mPFS of patients with liver and brain metastases was 6.8 months, and the mPFS of patients with extrahepatic and extracerebral metastases was 9.6 months (χ 2=7.53, P=0.006) . The mPFS of patients who had previously treated with docetaxel and paclitaxel was 8.2 months, and the mPFS of patients who had not previously received docetaxel or paclitaxel was 9.6 months (χ 2=0.03, P=0.862) . The mPFS of patients with albumin paclitaxel combined with targeted therapy, combined with immunotherapy, combined with chemotherapy and monotherapy were 12.1, 7.8, 9.0 and 7.1 months respectively, with a statistically significant difference (χ 2=8.96, P=0.030) . Multivariate analysis showed that molecular type (triple negative breast cancer RR=1.87, 95% CI: 1.24-4.22, P=0.008; HER-2 positive breast cancer RR=0.63, 95% CI: 0.52-0.94, P=0.042) , number of treatment lines ( RR=0.67, 95% CI: 0.32-0.86, P=0.011) , specific metastatic sites ( RR=1.26, 95% CI: 1.12-2.75, P=0.014) and combination therapy (combined with targeted therapy RR=0.74, 95% CI: 0.16-0.86, P=0.021; combined with chemotherapy RR=0.93, 95% CI: 0.48-0.96, P=0.045; combined with immunotherapy RR=0.81, 95% CI: 0.17-0.78, P=0.032) were independent factors for prognosis. The main adverse reactions were alopecia, neutropenia, peripheral neurotoxicity and rash, and there was no death caused by adverse reactions. Conclusion:Albumin paclitaxel is effective in the treatment of advanced breast cancer with controllable adverse reactions.
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Objective:To investigate the causes and prognosis of salvage cholecystectomy for relapsing cholecystolithiasis after gallbladder-preserving gall stones removal surgery.Methods:From Jul 2015 to Dec 2019, 24 referral patients with gallstone recurrence after gallbladder-preserving cholelithotomy surgery received salvage cholecystectomy. The clinical data was analyzed to explore the causes for re-operation and the prognosis.Results:Twenty-two cases had definite gallstone recurrence, among them 19 cases were symptomatic, 2 cases were operated on suspected gallbladder tumor and common bile duct stones induced acute cholangitis. Laparoscopic cholecystectomy was successfully performed in 23 cases and 1 case was converted to open surgery. No severe complication were observed in all the patients.Conclusions:Symptomatic gallstone recurrence is the most common causes of salvage cholecystectomy after gallbladder-preserving cholelithotomy. Laparoscopic surgery procedure is still highly successful.
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Taking case discussion of clinical treatment options of primary liver cancer during clinical internship as an example, the course design of basic elements of case-based learning (CBL) was discussed. The purpose of clinical practice is to cultivate the clinical thinking ability of "selecting the best one from multiple treatment options", which is suitable for taking CBL teaching method. The design of CBL course includes 8 elements: teaching object, purpose, objectives, course content, implementation plan, key points for assessment, course evaluation and reference materials. The core points of the design of CBL course are that: ①The teaching objectives include knowledge, ability and professionalism; ②The course content should includes the training of decision-making organizations and clinical thinking ability of selecting the best one from multiple treatment options; ③The general CBL teaching procedure can be adopted in the implementation of the scheme that focuses on the decision-making issues defined in each decision-making step. The teaching practice of CBL on primary liver cancer cases discussion shows the basic design of CBL course is universal, which is helpful for teachers to design and implement CBL course on clinical treatment options.
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Objective@#To explore the selection method and technology of laparoscopic surgery for gallbladder stones and common bile duct stones(GCBDS).@*Methods@#Data was collected from 318 in-patients of GCBDS at Department of General Surgery,Xuanwu Hospital of Capital Medical University from January 2013 to December 2017, and 298 in-patients acceptedlaparoscopic cholecystectomy(LC) and choledocholithotomy were recruited into final analysis.There were 138 males and 160 females,aged (60.4±18.6)years (range:25-89 years).Retrospective analysis was done on method distribution,effect and safety of laproscopic surgery.Comparisons of basic characters and therapeutic effects were performed betweenlaparoscopic common bile duct exploration (LCBDE) combined with primary closure and T tube drainage(TTD).@*Results@#Among therecruited in-patients,LC combined with common bile duct exploration was performed in 7 cases(2.3%, 7/298), LC combined with LCBDE was performed in 291 cases(97.7%,291/298).There were 133 cases (45.7%,133/291) who treated by LCBDE combined with TTD and 158 cases(54.3%,158/291) who treated by LCBDE combined with primary closure.In LCBDE combined with primary closure group,18 cases (11.4%,18/158)had intraoperative biliary manometry.All patients were followed up for 6 months at least and there no death.Postoperative complications rate was 10.0% (29/291).There were no significant differences in sex ratio,age,American Society of Anesthesiologists score,concomitant diseases and previous abdominal surgery history between LCBDE combined with primary closure and LCBDE combined with TTD group.Patients in LCBDE combined with primary closure group were accompanied with less acute cholangitis than TTD group (43.3% vs.76.7%; χ2=9.061, P=0.002).There were no significant differences in the diameter of common bile duct, the number of stones, hospitalization expenses and the incidence of complications between the two groups(all P>0.05).LCBDE combined with primary closure had shorter operation time ((134.2±28.3)minutes vs.(148.3±19.6)minutes; t=-1.830, P=0.011)and post-operative hospitalization time ((5.6±2.6)days vs. (7.2±2.4)days; t=-1.847,P=0.014).Bile duct leakage rate was higher in primary closure group(6.3% vs.0.8%, χ2=3.934, P=0.047) and TTD group had higher residual stones rate(6.8% vs.1.3%; χ2=6.008, P=0.014).@*Conclusion@#Strategy for treating GCBDS by laparoscopic surgery should be considered preoperative evaluation and intraoperative exploration to select appropriate minimally invasive surgical methods and techniques.
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Hilar cholangiocarcinoma (HCCA) is a common malignant tumor of the biliary system with great difficulties in surgery, and there are still controversies over the standardized diagnosis and treatment system of HCCA. This article reviews the research advances in perioperative management of HCCA, including preoperative diagnosis and evaluation, clinical stage, preoperative preparation, surgical approach, and postoperative management.
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Objective To investigate the correlations between expression of CASC2 and hepatocellular carcinoma(HCC) prognosis.Methods A total of 129 patients including 80 males and 49 females with HCC were includedin this study,ranging from 21 to 73 years in Xuanwu Hospital of Capital Medical University and Beijing You'an Hospital were retrospectively analyzed from September 2007 to January 2014.Expression of CASC2 was assessed using reverse transcription quantitative-polymerase chain reaction in HCC tissue and the adjacent normal tissue.The correlations between CASC2 mRNA level and clinicopathological parameters was investigated.The relationship between the expression of CASC2 and the prognosis of patients with HCC was analyzed by Kaplan-Meier method.A log-rank analysis was performed to identify group differences.Univariate and multivariate Cox analysis were used to analyze the variables affecting the patient's prognosis.Results In 129 HCC samples,the level of CASC2 expression (0.84 ± 0.05) was lower than (3.35 ± 0.11) adjacent normal tissue (P ＜ 0.05).There were significant differences between CASC2 expression and tumor size,histological differentiation,and tumor stage in 129 HCC speciments.The median expression level of CACS2 in HCC tissues,0.84-fold,was used as the cut-off value to divide the 129 patients into two groups:low-expression group (n =72) and high-expression group (n =57).Overall survival rate of HCC patients with high CACS2 expression was significantly higher than those of patients with low CACS2 expression(P ＜0.05).Multivariate analysis indicated that histological differentiation (HR =0.20,95％ CI:0.05 ～ 0.59),tumor stage (HR =1.71,95％ CI:1.02 ～ 2.99) and CACS2 expression (HR =O.51,95％ CI:O.08 ～0.92) were an independent predictor of overall survival.Conclusion Low expression of CACS2 might be associated with the occurrence and development of HCC.
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Objective To compare the clinical efficacy of primary closure versus T-tube drainage after laparoscopic common bile duct exploration in acute cholangitis cases.Methods The clinical data of 100 patients with acute cholangitis undergoing laparoscopic common bile duct exploration from January 2012 to December 2014 were reviewed.54patients received primary closure of the common bile duct and 46 patients were subjected to T-tube drainage after choledochotomy.Results One hundred patients underwent the surgery successfully.Compared with the T-tube group,the operation time(96.72 min vs 123.00 min,P =0.001),intraoperative blood loss(27.13 ml vs 38.48 ml,P =0.009),postoperative gastrointestinal function recovery time(1.57 d vs 2.33 d,P=0.003) and postoperative hospital stay(6.19 d vs 9.20 d,P=0.000) were significantly less in the primary closure group.There were no statistical differences in the incidence of postoperative drainage (309.22 ml vs 212.46 ml,P =0.070),drainage time (3.96 d vs 4.02 d,P =0.875),incidence of bile leakage(9.3％ vs 0,P =0.060) and postoperative bleeding rate(5.1％ vs 2.2％,P =0.622) between these two groups.Conclusion Laparoscopic common bile duct exploration with primary closure of the common bile duct is an effective and safe procedure in acute cholangitis cases compared with T-tube drainage.
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Objective:To explore the effects of voriconazole on the proliferation and morphology of Acanthamoeba cultivated in vitro,and to clarify the killing effects of voriconazole against the trophozoites and cysts of Acanthamoeba.Methods:The Acanthamoeba polyphaga at logarithmic phase were selected and divided into control group and experiment groups(2.5 and 25.0 mg·L-1).The Acanthamoeba in each group was collected at 24,48,72,and 96 h after drug administration,respectively.Then the concentrations of Acanthamoeba were calculated and the proliferation curves were drawn;inverted microscope was used to observe the morphology,activity and adherence of Acanthamoeba;the ultrastructures of Acanthamoeba were observed under electron microscope.Results:Compared with control group,the numbers of Acanthamoeba polyphaga in experiment groups were significantly decreased(P<0.01).The morphology of Acanthamoeba changed significantly under inverted microscope,and the shape of Acanthamoeba transformed from the trophozoites with irregular spiny filopodia to circular cysts.Even a large number of cell debris was observed.Different degrees of damage and even necrosis of Acanthamoeba in experiment groups were found under electron micro scope.Conclusion:Certain concentration of voriconazole can effectively inhibit the proliferation of Acanthamoeba and change the morphology and ultrastructure and kill the trophozoites and cysts of Acanthamoeba cultivated in vitro.
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To design teaching course of problem-based learning (PBL) combined with case-based learning (CBL) for standardized training of clinicians based on clinical decision thinking mode (CDTM) of diagnosis and treatment process for primary liver cancer. The CDTM of treatment choice for primary liver cancer is multi-scheme selection model. The general decision rule includes decision condition, action plan and decision tree. For the theoretical study of clinical decision rules, it is suitable to design PBL teaching, but it is suitable to design CBL teaching course for clinical decision-making practice. The teaching course of PBL combined with CBL is conducive to improving the ability of clinicians' clinical decision thinking step by step.
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Objective To conduct concordance test on Life Event Scale reported by different informants and the suicide-attempters themselves in Chinese suicide research. Methods In this retrospective study, 104 attempted suicide cases and 147 suicide cases were included. Each case had two informants. One was family member, and the other was associate (friends, neighbors, etc.). Suicide attempters (only for attempted suicide cases) were also interviewed by qualified psychiatrists. Life Event Scale was administered to each respondent to obtain life events experienced by the case before the suicidal behavior. Kappa and Intraclass Correlation Coefficient (ICC) were used to compare the suicide attempters' self-reports with two informants' reports, and to present the concordance of two informants' reports for suicides. Results For attempted suicide group, agreements were nearly moderate or better for life events on marital relation, physical illness, family relation, love, birth or death of family members (Kappa≥0.39); Proxy-based chronic stress and acute stress scores were significantly lower than subject-reports (ICC:0.11~0.24, P<0.01).For suicide group, the agreements between the two informants' reports were moderate or better on death of spouse, work/study or physical illness (Kappa≥0.49); The agreement for chronic stress score was fair (ICC=0.47). Conclusions The results have demonstrated that proxy-based data on life events are valid if structured and objective scales are used.
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We investigated the correlation between toxin gene exoS,exoU and fluoroquinolone resistance in lower respiratory tract infection with P.aeruginosa so as to provide guidance for reasonable treatment of clinical infections.We collected P.aeruginosa of sputum samples in hospitalized patients from October 2015 to March 2016.The antimicrobial susceptibility was tested by liquid dilution method.The exoS and exoU genes were detected by PCR technique.Results showed that forty-six P.aeruginosa strains were identified from sputum.The exoS and exoU gene positive rate were 86.96 ％ (40/46) and 69.57 ％ (32/ 46) respectively,and the highest proportion of genotype was exoS+/exoU+ (60.87％,28/46).Among them,36.96％ (17/ 46) were multiple drug-resistant bacteria(MDR).Fluoroquinolone non-sensitive (FQ-NS) strain were 78.95％ (15/19) for MDR and 89.47 ％ (17/19) exoU gene were positive,which was significantly higher than the fluoroquinolone sensitive strains (FQ-S).Compared with the FQ-S strain,FQ-NS strains were serious drug resistance.The drug resistant rate of eefepime and aztreonam were more than 70％,and then meropenem and imipenem were more than 50％.The drugs of lower resistance rate in FQ-NS strain had polymyxin B(10.53％,2/19),amikacin(10.53％,2/19),ceftazidime (15.79％,3/19) and gentamicin (21.05％,4/19).P.aeruginosa of lower respiratory infection carried toxin genes exoS and exoU were higher,the main genetpy was exoS+/exoU+.FQ-NS strains were higher drug resistance rate and a higher proportion of exoU+ strains than FQ-S strains.We should strengthen virulence genes test and drug resistance monitoring in clinical practice.
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Aim To investigate the effects and possible mechanisms of kaemperol in the rats with chronic cere-bral ischemia.Methods Chronic cerebral hypoperfu-sion model was produced by permanent occlusion of bi-lateral common carotid arteries (2VO)in rats.After KAE treatment,the rats underwent Morris water maze and prehensile traction test.Neuronal morphology was observed using Nissl and HE staining.The activity of SOD and the content of MDA in brain tissue were de-termined.The DJ-1 protein expression was assayed by Western blot.Results Compared with 2VO model group,KAE significantly improved learning and memo-ry and the grasping ability.In addition,KAE signifi-cantly reduced brain tissue pathological injury induced by 2VO. Furthermore, KAE significantly increased SOD activity and enhanced antioxidant protein DJ-1 ex-pression in brain tissue.Conclusions KAE could sig-nificantly attenuate the cognitive impairment,limb bal-ance dysfunction and pathological injury in rats with chronic cerebral ischemia.The mechanism may be re-lated to improving the antioxidant system in vivo.
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Aim To explore the protective effect of ac-tive components of Xiaoxuming decoction ( XXMD ) on focal cerebral ischemia/reperfusion injury in rats dur-ing early recovery period .Methods The ischemia and reperfusion of middle cerebral artery model rats were established by nylon wire with 2 hours ischemic time on healthy male SD rats .The models of MCAO were eval-uated by Zea-Longa′s standard score .The model rats were randomly divided into sham operation group , the ischemia/reperfusion model group , the active compo-nents group of Xiaoxuming decoction and the positive group (extract of ginkgo biloba leaves EGb 761).Rats were orally administrated with different drugs 24 h after operation for up to 14 days, once a day.The effect of active components of Xiaoxuming decoction on behavior changes of MCAO rats in different recovery period was evaluated by a series of behavioral assessent methods such as modified neurological severity scores and cor-ner test.The infarct volume was observed by TTC stai-ning.Moreover, the contents of MDA and the activities of GSH-Px, SOD and NOS in the penumbra and core tissues of rat brain were detected by spectrophotometric method.Results Compared with the I/R model group, the active components group of XXMD could significantly alleviate the neurological deficit scores with prolonged administration . The motion function tended to be normal , stayed longer on the balance beam, sensory function gradually restored sensitivity , reduced the radio of turning to the right .Among them , compared with model group , the active components of XXMD could effectively improve the neurological dys-function after five days of administration ( P<0.05, P<0.01).Meanwhile, the active components of Xiaox-uming decoction could significantly reduce the infarct volume percentage in the cerebral tissue on post opera-tion day 5 and 14(P<0.01).In addition, the active components of XXMD could reduce the content of MDA and the activity of NOS , increase the activity of SOD and GSH-Px.Conclusion The active components of XXMD can generate neuroprotective effect in early stage of recovery and may play a major role in regula-ting the level of oxidative stress in rat brain .
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Aim To explore the therapeutical effect and mechanism of baicalein on two 6-hydroxydopamine (6-OHDA ) induced Parkinson′s disease (PD ) rat models,which received unilateral lesions of the left medial forebrain bundle (MFB ) or caudate putamen (CPu ) made by stereotaxic injection of 6-OHDA (MFB-M,CPu-M).Methods PD rat models were established by microinjection of 6-OHDA into MFB or CPu.The anti-tremor effect of baicalein on PD rat models was examined.Spontaneous activity was recor-ded. Dopamine (DA ), dihydroxyphenylacetic acid (DOPAC)and homovanilic acid (HVA)in striatum were quantified by HPLC-ECD.The tyrosine hydroxy-lase (TH)and OX-42 positive cells were detected by immunohistochemical method.The morphological vari-ation of the neurons was confirmed by analysis at an ul-trastructural level.Results Baicalein significantly in-creased the spontaneous activity in CPu-M.The elec-tromyography (EMG ) recordings revealed that com-pared with 6-OHDA group,the tremor frequency in ba-icalein group was decreased by 55% in MFB-M,and by 60% in CPu-M.6-OHDA treatment decreased DA levels in the striatum,while treatment with baicalein attenuated the DA decreases in CPu-M.Moreover,ba-icalein treatment could increase TH-positive neurons and decrease OX-42-postive microglia compared with 6-OHDA group in both MFB-M and CPu-M.Conclu-sions In the present study,it is illustrated that ①microinjection of 6-OHDA into the MFB and the CPu could cause different pathological changes of PD, which is important for efficacy evaluation;②baicalein showed the ability to alleviate the behavior symptoms in PD-rats at different stages by improving motor function and attenuating muscle tremor;③therapeutic effect of baicalein was produced by inhibiting the inflammatory medium production and release,anti-apoptosis,chan-ging dopamine catabolism, and inhibiting dopamine turnover.
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Objective To investigate the epidermal growth factor receptor (EGFR),KRAS and BRAF mutations and their correlation with clinicopathological characteristics in non-small-cell lung cancer (NSCLC).Methods The mutations of exon 18,exon 19,exon 20 and exon 21 of the EGFR,codon 12,codon 13 of the KRAS and codon 600 of the BRAF gene in 143 cases of NSCLC were detected by gene sequencing.The relationship between the mutations and clinicopathological features was analyzed by SPSS 16.0.Results EGFR mutation was detected in 57 cases (39.9 ％),including 2 mutations in exon 18,25 in exon 19,3 in exon 20,24 in exon 21 and 3 multiple point mutations.KRAS mutation was found in 25 cases (17.5 ％),including 23 in codon 12 and 2 in codon 13.BRAF V600E mutation was detected only in 2 cases (1.4 ％).No patient harboring multiple EGFR,KRAS and BRAF mutations was found.EGFR mutation rate was related to gender,smoking history,histological types,differentiation and tumor size (P ＜ 0.05).However,no relationship was found among lymph node metastasis,pTNM stage and EGFR mutation (P ＞ 0.05).There was no association between KRAS mutation and clinicopathological features including gender,smoking history,histological types,differentiation,tumor size,lymph node metastasis and pTNM stage (P ＞ 0.05).Conclusions The frequency of EGFR mutation in NSCLC is high,and usually occurs in female,non-smokers,smaller tumors,better differentiation and adenocarcinomas.The frequency of KRAS mutation is not associated with the clinicolpathological features.The frequency of BRAF mutation is very low,and EGFR,KRAS and BRAF gene mutations do not occur at the same time.These results contribute to the target therapy of NSCLC.
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Objective To find an easy and proper way to differentiate metastatic breast cancer from second primary breast cancer by analyzing the histopathological characteristics of 40 patients with bilateral breast cancer.Methods According to the Chaudary histological criteria,the histopathological and biological characteristics of 16 cases of synchronous bilateral breast cancer and 24 cases of metachronous bilateral breast cancer were evaluated.The histopathological and biological characteristics included Nottingham histological grade,immunohistochemistry (IHC) results of the estrogen receptor,progesterone receptor and expression of Her-2.Results The average age of the 40 patients at first diagnosis was 41 years old (range,26-68 years old).The average time interval between first and second diagnosis of tumors was 34 months (range,7-209 months) in metachronous cancer.The concordant histopathological type was found in 93.8 ％ (15/16) of synchronous cancer patients and 58.3 ％ (14/24) of metachronous cancer patients (P =0.02).The concordance rates of tumor stage was 68.8 ％ (11/16) in synchronous cancer patients,while it was 25.0 ％ (6/24) in metachronous cancer patients (P =0.03).For progesterone receptor status,the concordance rates were 87.5 ％ (14/16) and 54.2 ％ (13/24) in synchronous and metachronous cancer patients respectively (P =0.03).There was no statistically significant difference in terms of estrogen receptor status and Her-2 expression (P ＞ 0.05).Conclusions Without considering the limitation of Chaudary criteria and the number of patients,it seems to be an easy and proper way to differentiate metastatic cancer from second primary cancer in the patients with bilateral breast cancer by combining the histopathological type,tumor stage and progesterone receptor status.The synchronous cancer is closer to same clonal lesion (metastatic lesion).
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Objective To study the therapeutic effect of the complex mixture of luteolin and rutin ( MLR) on 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridin ( MPTP) induced Parkinson’ s disease ( PD) mouse model. Methods Seventy-two C57BL/6 mice were divided into six groups randomly ( n=12 in each group): the normal control , model control , madopar (50 mg·kg-1) group, MLR at low (140 mg·kg-1), middle (280 mg·kg-1) and high (560 mg·kg-1) dose groups. PD mouse models were established by intraperitoneal injection of MPTP ( 30 mg · kg-1 ) . Pole test and traction performance were recorded to access the body coordinate capability and strength. The tyrosine hydroxylase (TH), dopamine transport protein ( DAT) , and glial fibrillary acidic protein ( GFAP ) positive cells were detected by immunohistochemical method. Dopamine ( DA ) , dihydroxyphenylacetic acid ( DOPAC ) , homovanilic acid ( HVA ) , 5-hydroxytryptamine ( 5-HT ) and 5-hydroxyindoleacetic acid (5-HIAA) in striatum were quantified by HPLC-ECD. Results MLR significantly ameliorated mouse motor coordination ability (P<0. 01 or P<0. 05). MLR at 280 and 560 mg·kg-1 could increase TH-positive neurons by 69. 00%and 77. 95% compared with the normal control group (P<0. 01) and DAT-positive neurons by 68. 53% and 70. 40% compared with the normal control group(P<0. 05), and decrease GFAP-postive astrocyte reactivity. The treatment with MLR at three doses attenuated the monoamine neurotransmitter disorder. Conclusion MLR markedly improves MPTP caused movement coordinate ability injury in mice and exerts therapeutic action on PD by regulating neurotransmitters in brain, inhibiting the inflammatory reaction and alleviating the neuron injury.
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<p><b>OBJECTIVE</b>The objective of this article was to review the current advances in diagnostic methods for Acanthamoeba keratitis (AK).</p><p><b>DATA SOURCES</b>Data used in this review were retrieved from PubMed (1970-2013). The terms "Acanthamoeba keratitis" and "diagnosis" were used for the literature search.</p><p><b>STUDY SELECTION</b>Data from published articles regarding AK and diagnosis in clinical trials were identified and reviewed.</p><p><b>RESULTS</b>The diagnostic methods for the eight species implicated in AK were reviewed. Among all diagnostic procedures, corneal scraping and smear examination was an essential diagnostic method. Polymerase chain reaction was the most sensitive and accurate detection method. Culturing of Acanthamoeba was a reliable method for final diagnosis of AK. Confocal microscopy to detect Acanthamoeba was also effective, without any invasive procedure, and was helpful in the early diagnosis of AK.</p><p><b>CONCLUSION</b>Clinically, conjunction of various diagnostic methods to diagnose AK was necessary.</p>
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Humans , Acanthamoeba Keratitis , Diagnosis , Visual Acuity , PhysiologyABSTRACT
<p><b>OBJECTIVE</b>To compare the application values of real-time quantitative PCR-Sanger sequencing and TaqMan probe method in the detection of KRAS and BRAF mutations, and to correlate KRAS/BRAF mutations with the clinicopathological characteristics in colorectal carcinomas.</p><p><b>METHODS</b>Genomic DNA of the tumor cells was extracted from formalin fixed paraffin embedded (FFPE) tissue samples of 344 colorectal carcinomas by microdissection. Real-time quantitative PCR-Sanger sequencing and TaqMan probe method were performed to detect the KRAS/BRAF mutations. The frequency and types of KRAS/BRAF mutations, clinicopathological characteristics and survival time were analyzed.</p><p><b>RESULTS</b>KRAS mutations were detected in 39.8% (137/344) and 38.7% (133/344) of 344 colorectal carcinomas by using real-time quantitative PCR-Sanger sequencing and TaqMan probe method, respectively. BRAF mutation was detected in 4.7% (16/344) and 4.1% (14/344), respectively. There was no significant correlation between the two methods. The frequency of the KRAS mutation in female was higher than that in male (P < 0.05). The frequency of the BRAF mutation in colon was higher than that in rectum. The frequency of the BRAF mutation in stage III-IV cases was higher than that in stageI-II cases. The frequency of the BRAF mutation in signet ring cell carcinoma was higher than that in mucinous carcinoma and nonspecific adenocarcinoma had the lowest mutation rate. The frequency of the BRAF mutation in grade III cases was higher than that in grade II cases (P < 0.05). The overall concordance for the two methods of KRAS/BRAF mutation detection was 98.8% (kappa = 0.976). There was statistic significance between BRAF and KRAS mutations for the survival time of colorectal carcinomas (P = 0.039). There were no statistic significance between BRAF mutation type and BRAF/KRAS wild type (P = 0.058).</p><p><b>CONCLUSIONS</b>(1) Compared with real-time quantitative PCR-Sanger sequencing, TaqMan probe method is better with regard to handling time, efficiency, repeatability, cost and equipment. (2) The frequency of the KRAS mutation is correlated with gender. BRAF mutation is correlated with primary tumor site, TNM stage, histological types and histological grades.(3) BRAF gene mutation is an independent prognostic marker for colorectal carcinomas.</p>