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Yu Weihan, academician of the Chinese Academy of Engineering, devoted his whole life to the prevention and control of endemic diseases and basically eradicated the epidemic of Keshan disease. Academician Yu Weihan’s struggle experience has left us with valuable spiritual wealth. His spiritual strength is manifested in many aspects, such as the spirit of bearing hardships first, the spirit of innovative daring to be the first, the spirit of craftsmen striving for perfection, the patriotic spirit of caring for the people, and the dedication of being indifferent to fame and wealth. His great medical feelings of bravely shouldering the mission, caring for the people and taking root in the grass-roots have forcefully answered the three important questions: what kind of doctor to be, who to be and how to be a good doctor in the learning and working career of doctors in the new era. He set an model for doctors in later generations and highlighted the value of this spiritual strength for the time.
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The purpose of medicine is to preserve and develop the treatment in the process of saving lives and helping injuries. Medical professionalism is a comprehensive expression of physician’s clinical abilities, relationships and values between different subjects. In practice, white robed doctors utilize high standards of professionalism to practice the medical purpose and goals of "always centering on the interests of the patient" in specific diagnosis and treatment behaviors. At the same time, fulfilling the promises and expectations of medicine to the public. For these reasons, selfless dedication, self-sacrifice, and one-way pure altruism are all internalized into the basic requirements of medical professionalism: doctors should not only have the skill to revive the dead, but also have the benevolence of evangelists; they not only need to achieve maximum efficiency in technology, but also achieve the highest truth, goodness, and beauty in virtue. When these qualities are exaggerated or unattainable due to uncontrollable reasons, there will be a rift between the entrenched value systems and practical needs. In recent years, the global epidemic has had a huge impact on the medical system and medical staff, and the moral beliefs, role expectations, and value systems of doctors have also been impacted unprecedentedly, resulting in moral injury. The international research on moral injury in medical field has also received attention. China is currently in the adjustment period of epidemic related policies, with medical personnel bearing the brunt. Therefore, referring to relevant international research on moral injury to re-examine the relationship between the medical professionalism, which emphasizes one-way pure altruism, dedication and weakening or even neglecting personal well-being, and current medical practices. And constructing a moral injury early warning-repair system that focuses on doctors, patients, medical teams, medical institutions, medical environments, health systems, and other stakeholders, and ensuring its healthy operation. Not only in extreme periods, but also in ordinary daily diagnosis and treatment, it can support doctors to actively, safely, and healthily fulfill their mission of saving lives and helping injuries.
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Mycosis fungoides (MF) and Sézary syndrome (SS) are the most common subtypes of cutaneous T-cell lymphomas (CTCLs). Most cases of MF display an indolent course during its early stage. However, in some patients, it can progress to the tumor stage with potential systematic involvement and a poor prognosis. SS is defined as an erythrodermic CTCL with leukemic involvements. The pathogenesis of MF and SS is still not fully understood, but recent data have found that the development of MF and SS is related to genetic alterations and possibly to environmental influences. In CTCL, many components interacting with tumor cells, such as tumor-associated macrophages, fibroblasts, dendritic cells, mast cells, and myeloid‐derived suppressor cells, as well as with chemokines, cytokines and other key players, establish the tumor microenvironment (TME). In turn, the TME regulates tumor cell migration and proliferation directly and indirectly and may play a critical role in the progression of MF and SS. The TME of MF and SS appear to show features of a Th2 phenotype, thus dampening tumorrelated immune responses. Recently, several studies have been published on the immunological characteristics of MF and SS, but a full understanding of the CTCL-related TME remains to be determined. This review focuses on the role of the TME in MF and SS, aiming to further demonstrate the pathogenesis of the disease and to provide new ideas for potential treatments targeted at the microenvironment components of the tumor.
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Objective To explore the effect of ParidissaponinⅠ (PSⅠ) on the proliferation of coronary artery endothelial cells (CAECs).Methods CAECs were cultured with PSⅠ.CAEC growth rate was calculated by using blood cell counting plate.Cell viability was measured by MTT.The expressions of cadherin and caspase3 mRNA were detected by RT-PCR.Results PSⅠ slowed down growth rate of CAECs,reduced cell viability of CAECs,decreased the expression of cadherin mRNA and increased the expression of caspase3 mRNA in CAECs.Conclusion PSⅠ inhibits the proliferation of CAECs and induces CAECs apoptosis.
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Objective To explore the expression and clinical significance of microRNA (miR)-155 and miR -222 in plasma of patients with ventricular septal defect(VSD),and to analyze the possible mechanism.Methods A total of 20 children with VSD who received treatment at the Department of Cardiovascular Surgery from August 2012 to June 2013 were enrolled (the VSD group)and 15 patients with fracture (the control group).The plasma miR -155 and miR -222 expression levels were measured by real -time quantitative reverse transcription -polymerase chain reaction (RT -qPCR).The potential target genes of miR -155 and miR -222 were predicted by using 3 current-ly available prediction programs,including TargetScan,mirbase and Miranda,and the signaling pathway of miRNA was predicted by Pathway -express analysis.Results Compared with the control group,the expression levels of miR -155 (P =0.033)and miR -222(P <0.001)in the VSD group decreased significantly;miR -155 and miR -222 predic-ted target genes included 74 and 50,respectively.The Pathway -express analysis indicated that 7 signaling pathways played important roles in the occurrence of fetal VSD,including signaling pathways for heart development,such as:mito-gen -activated protein kinase(MAPK)signaling pathway.Conclusions The expression levels of plasma miR -155 and miR -222 in VSD were significantly decreased.The target genes were related to signaling pathways for heart deve-lopment (MAPK signaling pathway),which indicates that miR -155 and miR -222 may be involved in the pathological process of VSD,and may serve as an independent evaluation indicator for the diagnosis of VSD.
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Objective To explore the effect and mechanism of fragile site WWOX gene on regulating proliferation of gallbladder cancer cells in vitro. Methods The pcDNA3.0 - WWOX recombinant plasmid which was previous successfully built was transfected to GBC-SD cells and empty carrier by liposome medium. Liposome and GBC-SD were served as the negative control and the blank control,respectively. After 48 hours transfection, inverted microscope was used to observe the changes of gallbladder cancer cells' morphology,MTT and BrdU were used to detect the proliferation level of gallbladder cancer cells,and flow cytometry instrument was used to detect the change of the cell proliferation cycle. Results The results of inverted microscope shown: the number of GBC-SD cells in pcDNA3.0-WWOX group decreased significantly,the suspension cells and cell debris increased,while cells in the vector control,NC and Mock groups were in normal proliferation state. MTT test showed the proliferation levels of GBC-SD cells in pcDNA3.0-WWOX group was lower than those in the control group in 24 h,48 h,72 h,96 h and 120 h,and the differences were statistically significant(P 0.05). Conclusion The overexpression of WWOX gene in vitro could effectively inhibit the proliferation activity of gallbladder cancer cells. WWOX might participate in the development of the malignant biological behavior of gallbladder cancer cells. It is expected to become a new potential target for the gene therapy to gallbladder cancer.
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Objective To investigate the associated risk factors of postoperative complications after rad?ical resecting of colorectal cancer. Methods The clinical data of 237 patients with colorectal cancer performed radical resection in the Second Affiliated Hospital of Kunming Medical University from January 2011 to Decem?ber 2014 were analyzed retrospectively. The incidence of postoperative complications was analyzed,and the relat?ed factors were analyzed by single factor and multi factor correlation analysis. Results The postoperative com?plications occurred in 114 cases of 237 patients( 48. 1%) . Univariate analysis showed that the age more than 70 years old,preoperative comorbidity,intraoperative blood loss,surgeon’ s experience,combined evisceration or en?larged evisceration were related to postoperative complications ( P = 0. 033, 0. 014, 0. 045, 0. 028, 0. 040 ) . Compared with the patients without complications,the postoperative anal exhaust time,length of stay was longer of the patients with complications((3. 7±1. 6) d vs. (3. 2±1. 4) d,P=0. 035;(21. 3±6. 5) d vs. (12. 1 ±2. 4) d,P=0. 001). Logistic regression analysis showed that depth of tumor invasion(P=0. 001),preoperative comorbidity including NRS>3 points (χ2 =8. 903, P=0. 003 ) , anemia and hypoproteinemia (χ2 =3. 494, P=0. 048) ,hypertension complicated with type 2 diabetes mellitus(χ2=5. 418,P=0. 026) ,not complete intesti?nal obstruction(χ2=8. 376,P=0. 003),mild and severe ventilation dysfunction(χ2=6. 331,P=0. 011) and WBC0. 05) . Conclusion Age>70 years old,preoperative comorbidity,intraoperative blood loss,surgeon`s experience,combined evisceration or enlarged evisceration are main risk factors for patients per?formed colorectal cancer radical resection,but laparoscopy?assisted radical resection is not the risk factor.
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Objective To explore the application value of endoscopic thyroidectomy via breast approach without transection anterior cervical muscle group .Methods The clinical data of 130 patients which treated by thyroidectomy without transection ante‐rior cervical muscle group were analyzed ,retrospectively .There were 68 cases treated by endoscopic thyroidectomy via breast ap‐proach and 62 cases treated by conventional thyroidectomy .Results 68 patients underwent endoscopic thyroidectomy ,the mean time of operation was(127 .66 ± 29 .56)min ,which was longer than that in conventional group (89 .06 ± 24 .25)min(P0 .05 ,the nerve dysfunction had no significant difference .Conclusion Endoscopic thyroidectomy via breast approach without transection anterior cervical muscle group has less blood loss ,lower neck pain induration rate ,hidden incisions and excellent cosmetic benefits .The method is safe and feasible .
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Objective Via targeted inhibition of oncogene Bmi-1 expression by RNAi interfering technology in vitro, to observe its effect on the proliferation and cell cycle of gallbladder cancer cells. Methods Four miRNABmi-1 recombinant plasmids were constructed according to different Bmi-1 sites. RT-PCR and Western blot were used to mRNA and protein expression of Bmi-1 in gallbladder cancer cells were measured by RT-PCR and Western blot. mRNA and protein expression of Bmi-1 in gallbladder cancer cells. The most effective interfering plasmids in the miRNABmi-1 groups were transfected into GBC-SD cells. Cell proliferation and cell cycle were analyzed 48 h after transfection by BrdU and flow cytometry. Results Bmi-1mRNA expression in miRNAbmi1-1,-3 and-4 was significantly lower than the control group (P<0.05);and Bmi-1 protein expression in miRNAbmi1-2,-3 and-4 was significantly lower than the control group (P<0.05). The recombinant plasmid in miRNAbmi1-4, with the strongest inhibitive effect of Bmi-1mRNA and protein expression, was transfected into GBC-SD cells,then the cell proliferation rate (46.63 ± 5.31) was significantly lower in mRNABmi1-4 group than the control groups (P<0.05);G0/G1 phase cells increased (72.20 ± 1.71) and G2/M and S phase cells decreased (18.30 ± 7.21, 9.50 ± 6.01) in miRNABmi1-4 group. Both were significantly different from the control groups (P<0.05). Conclusions Targeting and silencing Bmi-1 expression can effectively inhibit the proliferation of GBC-SD cells and restrain the cell cycle atin G0/G1 phase. Bmi-1 gene may be a novel target for geneic therapy of gallbladder carcinoma.
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Medical has the dual attributes essentially , which is not only a science but also a humanology . Therefore , it needs to be nourished by rich humanistic spirit .At present , the generalization of medical technology , the abnormal development of medicine socialization and the less care from humanities to medical and many other reasons lead to the lack of humanistic spirit of medicine .To correct the phenomenon of the disorder, we should explore the effective means actively to provide powerful support for the returning of the medical humanism .There-fore, using an appropriate method to strengthen the humanities education of medical students and attention in the classroom will be regarded as good path in medical humanities spirit returning .
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<p><b>OBJECTIVE</b>To investigate the microsurgical tchniques and effects for the resection of anterior clinoid meningioma (ACM).</p><p><b>METHODS</b>Between January 2003 and March 2013, a total of 46 ACM patients were operated on via the pterion approach or lateral subfrontal approach. There were 16 male patients and 30 female patients, their mean age was 48.5 (16-69) years. Symptoms lasted from 1 month to 9 years(average 24.7 months). Preoperative CT and MRI examination showed that the tumors were located in the anterior clinoid process (25 cases on the right side, 21 cases on the left side). The average maximal tumor diameter was 4.4 cm (1.9-7.4 cm). The patients were peroidly followed-up on outpatient on 3 months to 6 months, then every year postoperativelly. The clinical data, radiological findings, surgical records and outcome of patients were retrospectively analyzed, and the prognostic factors were ananlyzed by using of the unpaired data χ(2) test with continuity correction.</p><p><b>RESULTS</b>Of fourty-six patients operated on, apparently complete removal was achieved in 36 patients (78.3%), 10 patients (21.7%) had minimal residual tumors, 5 of which had gamma knife radiosurgery. Preexisting visual deficit improved in 21 of 41 patients (51.2%), unchanged in 16(35.6%), and worsened in 9(20.0%). At 3-6 months after discharge, 37(80.4%) patients had a good recovery, 7(15.6%) patients were moderately disabled, 1(2.2%) presented with severe disability, and 1 (2.2%) patient died of surgery-related causes. The tumor wrapping blood vessels (χ(2) = 4.676, P = 0.031) and violating cavernous sinus(χ(2) = 4.973, P = 0.026) were causes of unfavorable prognosis. During the mean follow-up of 35.1 months (range, 4-107 months) for 40 patients, the average Karnofsky score was 83.2. Tumor recurred in 4 cases: 2 of which required reoperation, and 2 had gamma knife radiosurgery.</p><p><b>CONCLUSIONS</b>Tumor wrapped vessels and invasion of the cavernous sinus are important unfavorable prognostic factors for ACM resection. By using appropriate surgical strategies and techniques, ACM can be removed safely via the pterion approach or lateral subfrontal approach with relatively low morbidity and mortality.</p>
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Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Estudios de Seguimiento , Neoplasias Meníngeas , Cirugía General , Meningioma , Cirugía General , Microcirugia , Procedimientos Neuroquirúrgicos , Métodos , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
Objective:This work aimed to compare the three-year results, prognostic analysis, and adverse reactions of intensi-ty-modulated radiation therapy (IMRT) positioned by PET-CT and conventional radiotherapy in locally advanced non-small cell lung cancer (NSCLC) patients who underwent concurrent chemotherapy. Methods:A clinical trial was carried out in Qingdao Cancer Hospi-tal. The patients who joined our study were divided into IMRT and conventional radiotherapy (CRT) groups. A total of 48 patients were in the IMRT group and another 40 were in the CRT group. The total dose was 60 Gy throughout the 6-week treatment. The plati-num-based concurrent chemotherapy, combined with regimens such as docetaxel, navelbine, and pemetrexed, was conducted for two cy-cles followed by two to four cycles of consolidation chemotherapy. Results:Significant differences were observed between the curative ratio of the IMRT (77.1%) and CRT (52.5%) groups (P=0.015). No significant difference existed between the short-term survival rates of the two groups. The 1-, 2-and 3-year survival rates were 77.1%, 54.2%, and 22.9%in the IMRT group, as well as 65.0%, 47.5%, and 17.5%in the CRT group, respectively. Significant differences existed in some adverse reactions between the two groups, such as radia-tion gastrointestinal reactions, esophagitis, and pneumonia. More patients died of local recurrence and radiation pneumonia in the CRT group than in the IMRT group. The local recurrence rate was also lower in the IMRT group than in the CRT group. Conclusion:IMRT has obvious advantages in improving the short-term curative effect and reducing adverse reactions. Regarding the survival rate, a long-term follow-up of the two groups is required in the future.
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Objective To compare the function and influence of magnetic resonance cholangiopancreatography (MRCP) and T tube cholangiography before pulling out T tube after biliary tract surgery. Methods Clinical data from 248 patients with T tube drainage after biliary tract surgery bewteen January 2009 and June 2011 were retrospectively analyzed.Among them, the T tube cholangiography group was 195 cases, and MRCP group was 53 cases.Analyzed the function, the toxic side reaction and effect of prolonged hospitalization time of T tube cholangiography group and MRCP group,and discussed the diagnostic effect of MRCP before pulling out T tube after biliary tract surgery.Results Two groups of patients got distinct and integrated image of the bile ducts all.Compared with T tube cholangiography group, all 53 cases patients of MRCP group got accurate of diagnosis results, no fake positive results and adverse reaction occurred, and no prolonged hospitalization. Conclusion MRCP can replace T tube cholangiography as a means of diagnosis before removal of T tube.
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Objective To investigate the efficacy and side-effect of docetaxel and cisplatin induction chemotherapy followed by concurrent chemoradiotherapy in locally advanced non-small cell lung cancer (NSCLC).MethodsEighty-six patients with histologically confirmed locally advanced NSCLC were randomized into induction chemotherapy followed by concurrent chemoradiotherapy (ICCRT)arm or concurrent chemoradiotherapy (CCRT) arm. Both arms were treated with intensity-modulated radiation therapy. Induction and concurrent chemotherapy regimen consist of docetaxel and cisplatin. Results Follow-up rate of the whole group is 100％.The response rate in the CCRT arm and ICCRT arm is 70％ and 80％ ( χ2 =1.26,P =0.261 ),respectively; and 1-,2-,3-year survival rate is 65％ and 85％,40％ and 50％,33％ and 44％ (χ2 =3.90,P=0.048),respectively; the median survival time and time to progression is 17.5 and 22.0 months and 14.0 and 19.0 months respectively.Major adverse effects are leukopenia (43 and 32 cases,χ2 =3.48,P =0.062),radiation esophagutis (26 and 20 cases,χ2 =0.12,P =0.730),anemia (26 and 16 cases,χ2 =2.34,P =0.126) and radiation pneumonitis (13 and 9 cases,χ2 =0.37,P =0.541 ).ConclusionsICCRT for locally advanced NSCLC can improve the overall survival rate and time to progression,induction chemotherapy did not increase side-effects.There was no difference in response rate between CCRT and ICCRT arm.
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<p><b>OBJECTIVE</b>To investigate the appearance and moisture, ash content, extract, volatile oil of Panax ginseng and its processed products from different producing areas of northeast China, and thus provide the useful reference data for its quality standard establishment and standardized cultivation.</p><p><b>METHOD</b>Base on the Chinese Pharmacopoeia and literatures relating to P. ginseng, the content of moisture, ash, extract, volatile oil in P. ginseng and its processed products from northeast 10 different producing areas were measured, and data analysis of these various indicators was carried out by DTOPSIS.</p><p><b>RESULT</b>The samples from Changbai, Jian Kangmei and Fusong reached the standard of Chinese pharmacopoeia and national standard, and in addition comprehensive evaluation indicators of them were higher than others samples.</p><p><b>CONCLUSION</b>The quality of ginseng from different producing areas appears very different. Some samples failed to reach the standard of Chinese pharmacopoeia and national standard. Ginseng samples from those 3 producing areas of GAP planting bases showed good quality, which reflects the importance of GAP for ginseng cultivation.</p>
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China , Medicamentos Herbarios Chinos , Química , Aceites Volátiles , Química , Panax , Química , Raíces de Plantas , QuímicaRESUMEN
Tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL) can be induced in ischemia and other pathological states and mediate neuronal apoptosis after cerebral ischemia.Understanding the upregulation mechanism of TRAIL in ischemic brain tissue is promising to develop new treatment for stroke.
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YKL-40 (human cartilage glycoprotein 39) is a newly discovered inflammatory cytokine, which belongs to the member of 18 glycosyl hydrolase of mammal family. Previous studies have indicated that YKL-40 is associated with the acute or chronic inflammatory diseases and tumors. Studies in recent years have suggested that YKL-40 may be involved in the occurrence and development of atherosclerotic plaques, and it is correlated with the plaque instability. The physiological function and the mechanisms of YKL-40 are not fully understood. It may have the roes of promoting vascular smooth muscle migration and proliferation, promoting cell adhesion and proliferation, as well as regulating extracellular matrix remodeling The detection of YKL-40 may have some significance in the aided diagnosis, predicting prognosis, prevention of cardiocerebrovascular diseases, and even the establishment of new therapeutic strategies.
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Objective To investigate the correlation among expression of serum VEGF without operation between pre-and post-chemoradiotherapy in non-small cell lung cancer (NSCLC) patients, to explore the correlation of markers on prognosis and effect. Methods The serum vascular endothelial growth factor (VEGF) were detected in 50 patients without operation between pre-and post-chemoradiotherapy with NSCLC by ELISA method. The group t-test was played into before concurrent chemoradiotherapy and normal control. The paired t-test was played into before and after concurrent chemoradiotherapy. Results The prechemoradiotherapy serum VEGF ( 241.09 ± 52.45 ) ng/L in NSCLC patients was significantly higher than those in normal control patients (103.72 ± 39. 22) ng/L (t = 2. 50,P ＜0. 05 ). The pre-chemoradiotherapy serum VEGF in NSCLC patients was closely related to pTNM stage, distant metastasis, grade of cell differentiation and the size of the primary tumors ( t = 9. 61 - 14. 94, all P ＜ 0. 05 ), but not to the histological classification, type of the tumor, lymph node status, age, gender of the patients or smoking or not (t =0. 58 - 1.84, all P ＞ 0. 05 ). The pre-chemoradiotherapy serum VEGF ( 24 1.09 ± 52. 45 ) ng/L was significantly higher than that of the post-chemoradiotherapy ( 133.64 ± 33.62) ng/L ( t = 12. 20, P ＜ 0. 01 ). The post-chemoradiotherapy serum VEGF decreases to the pre-was the biggest in the CR patients (( 92.35 ± 37.48ng/L) ,t =3.79,P ＜0. 01 ) ,the smallest in the PA patients ( (276.32 ±47.98) ng/L,t = 1.32,P ＞0. 05) ) ,and bigger in the PR patients and the NC patientspatients ( ( 113.10 ± 39. 20) ng/L,t = 13.58,P ＜0. 01 and ( 198.10 ± 42.68 ) ng/L, t = 4. 78, P ＜ 0. 05 ) ), respectively. Conclusions Elevation of serum VEGF exists in patients with NSCLC . The serum VEGF in patients with NSCLC might be helpful to evaluate the biological behavior of lung cancer. Detection of VEGF expression maybe helpful for predicting the prognosis of NSCLC patients.
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<p><b>OBJECTIVE</b>Prunalla vulgaris was used as the experimental material to study the effects of water stress on the related quality charaters of spadix in P. vulgaris.</p><p><b>METHOD</b>By weighting method to experiment the relative characteristics in vegetative period and reproductive period respectively were studied under timing and quantitative water stress conditions everyday with the method of statistics to compared, including biological characteristics and content of ursolic acid and oleanolic acid.</p><p><b>RESULT AND CONCLUSION</b>It is true that the better water range of growth in vegetative period of P. vulgaris is 80% -85%; The 65%-70% field leakage coefficient maximum was the best and the proper water range which would promote the growth, but the best range of active component is 80% -85%.</p>