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The fourth affiliated hospital of Zhejiang university is responsible for training general practitioners in view of the basics of local general practitioners and the characteristics of chronic and frequently-occurring diseases in Yiwu city. This program is carried out relying on the high-quality faculty of medical alliances within Zhejiang university, and funded by the municipal government of Yiwu. The "4+6"training program is designed to elevate the competence of primary general practitioners. Such training fit the overall medical level of general practitioners, enhances people′s trust of general practitioners and the rate of diagnosis at primary level.
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Objective To evaluate the effect of " elite small class" training mode in capacity building for general practitioners in Yiwu city. Methods The Fourth Affiliated Hospital of Zhejiang University School of Medicine worked with Yiwu Health Bureau, and held the first training class for general practitioners from December 6th in 2018 to April 5th in 2019.The mode of " elite small-class" was adopted. Theoretical assessment was carried out for trainees before and after the training and discussion was conducted after the training. Descriptive analysis of quantitative data and thematic analysis of qualitative data were carried out. Results The trainees′theoretical performance had been significantly improved after 4 months of theoretical learning and clinical rotation.The average score of the theoretical performance was increased from 66.94 to 72.59. Conclusions It was preliminarily found that the " elite small-class" training mode was suitable for the training of general practitioners in rural areas.Government support and trainee selection are key to training outcomes.
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Objective To investigate the effect of cyanidin-3-glucopyranoside extracted from Chinese bayberry on proliferation and apoptosis of human gastric cell line SGC7901.Methods After cocultured with C3G on different concentrations,cell proliferation was determined by MTT assay; morphology of apoptosis were observed by laser confocal microscopy; TUNEL assay was applied to measure the apoptoic rate; The expression of Bcl-2,Bax,Caspase-3,ICAD protein were observed by Western blot assay.Results C3G significantly inhibited the proliferation of SGC7901 cells in a concentration-and timedependent manner as measured by MTT method(P < 0.01).After cells were treated with C3G,the presence of typical morphological changes of apoptosis was confirmed with laser confocal microscopy after Hoechst 33258 fluorescence staining.TUNEL assay indicated that the number of apoptotic cells in C3G-treated group was greater than that in the gastric cancer cells group(P < 0.01).The expression level of Bcl-2 was down-regulated while the expression level of Bax was up-regulated by C3G,the ratio of Bcl-2 protein and Bax protein decreased.C3G may accelerate the activation of procaspase-3 and down-regulate the expression of ICAD(P < 0.01).Conclusions C3G inhibits SGC7901 cell growth and induces apoptosis in a concentraion-and time-dependent manner.This action may be mediated by down-regulating Bcl-2/Bax,resulting in Caspase-3 activition and decreased ICAD protein expression.
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Tumor invasion and metastasis are regarded as main reasons for the failure of therpy and the reason of patients death.The mechnism of tumor metastasis is still uncertain.The pre-metastatic niche hypothesis provides us with new ideas to discover the mechnism.Numerous materials are involved in the formation of the pre-metastatic niche according to this hypothesis,including bone marrow-derived cells,microvesicles,exosomes,CD44,and so on.A further research on this hypothesis helps to deeply understand the nature of metastasis and leads clinical doctors to explore novel targets for clinical diagnoses and therapies.
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Objective To investigate the effect of cyanidin-3-glucoside extracted from Chinese bayberry on the proliferation. migration and invasion ability of the gastric cancer cell lines MGC803 and SGC7901 in vitro, and explore the possible mechanism of the preventive effects of C3G on tumor metastasis.Methods After treatment by C3G, the growth inhibiting of C3G on MGC803 and SGC7901 was determined by MTF assay, cell migration and invasion ability was evaluated with transwell chamber. Expression of Matrix metalloproteinase 2( MMP-2 )mRNA and protion on cells were analyzed by RT-PCR and Western blot.Results C3G significantly inhibited the proliferation of MGC803 and SGC7901 cells in a concentration and time-dependent manner as measured by MTT method ( P <0. 01 ), and the IC50 were: MGC803:24 h IC50 =6. 27 μg/ml;SGC7901:24 h IC50 = 5.42 μg/ml. After the cells were treated with C3G, the migration and invasion ability of MGC803 and SGC7901 cells decreased significantly ( P < 0. 01 ) the number of invasive cells in 24 hours of the negative control MGC803, SGC7901 group was ( 207 ± 9 ) and ( 115 ± 9 ),respectively, while in C3G 10 μg/ml group the number of invasive cells decreased to( 24 ± 5 ) , ( 14 ± 6). In addition, the expression of MMP-2 mRNA and protion decreased abviously ( P < 0. 01 ), all that was in a concentration-dependent manner. Conclusions In vitro, C3G has a concentration- and time-dependent growth inhibiting effect on MGC803 and SGC7901 cells, and may prevent metastasis by affecting migration and invasion ability of tumor cells. This action may be mediated by down-regulation of MMP-2mRNA and protein.
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ObjectiveTo evaluate the result of direct parathyroid adenomectomy for the treatment of hyperparathyroidism caused by single parathyroid adenoma. MethodsClinical data of 13 cases were retrospectively analyzed from 1993 to 2000. Preoperative Bus, CT, 99mTc-MIBI localization was suggestive of a single adenoma and direct parathyroid adenomectomy through minimal incision was performed.ResultsHyperparathyroidism was cured in all cases. One case underwent second operation in which the pathology found malignancy, making the success rate of simple adenomectomy of 92.3%.Conclusions Simple parathyroid adenomectomy for primary hyper parathyroidism caused by single adenoma is effective?safe alternative to conventional neck exploration should preoperative diagnostic measures verify a single adenoma as the etiology of hyperparathyroidism.
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Purpose:To investigate the expression of VEGF and its prognostic significance in ampullary carcinoma.Methods:22 resected tumor specimens from patients with ampullary carcinoma were immunohistochemically stained for VEGF and CD34 (surrogate for vessels) by streptavidin-peroxidase (S-P) method. Results:Expression of VEGF in tumor tissue was found in 50% cases of patients with ampullary carcinoma. The mean MVD for the entire group was 26.4?12.8. A significantly higher MVD(35.0?9.6) was observed in the tumors with positive VEGF expression compared with tumors with negative VEGF expression(17.7?9.3)( P
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Objective To study the current management strategy for colorectal injuries. Methods The clinical data of 86 consecutively admitted patients with penetrating colorectal injuries were retrospectively reviewed. Results Most injuries were of closed type. Iatrogenic colon injury accounted for 14%. There were 61 patients (71%) associated with other abdominal organ injuries. Operations were performed in all patients. Seventy six patients were treated with primary repair or resection and anastomosis, and 10 with diverting colostomy. In recent 10 years mortality rate dwindled from 10% to 4%(2/46). Mortality was most often caused by hemorrhagic shock, associated organ injuries or severe secondary infection. Conclusions Most colorectal traumas are blunt closed type in China. Primary repair or resection and anastomosis at the time of initial exploration is most often used for colorectal injuries. Indications for diverting colostomy are severe shock, heavy intra abdominal contamination, poor condition, and rectal injury. Fecal peritonitis should be effectively prevented and treated.