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Objective:To explore the evaluation dimensions and indicators of research hospital, provide empirical evidence for the construction of research hospital.Methods:Non-probability sampling was adopted, physicians from 9 hospitals in Shanghai that have a National Clinical Medical Research Center or Shanghai Clinical Medical Research Center were invited as survey participants. The physician participants were divided into senior and junior groups. For senior group, a questionnaire including 5 dimensions and 21 indicators was provided. The survey participants were consulted to determine whether the indicators can be used to measure this dimension, and also invited to propose additional dimensions and indicators for improvement.For junior group, two open questions were proposed to explore their needs of support in both clinical service and research.Results:Based on suggestions from the research participants, the research team, and other expert consultant, this article tried to propose 5 dimensions and 21 indicators for evaluating research hospitals. Among them, 11 were indicators compiled by the research team based on the literature review and agreed by more than 2/3 of senior physicians surveyed, while others were proposed based on the survey results. The research team planned to use the entropy method to determine the weights of different indicators, thus, the participants were not required to make judgments on the weights of dimensions and indicators.Conclusions:The evaluation of research hospitals has not yet formed a systematic consensus. Through the exploration and establishment of evaluation dimensions and indicators, identify hospitals that are closer to the development goals of research hospitals can provide a basis for future next-step practices.
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Objective:To introduce the scientific research management strategies and measurements of T. H. Chan School of Public Health, Harvard, and explore possible reflections for the research management of Chinese medical universities.Methods:Identify the administrative measurements of scientific research management of Harvard School of Public Health by typical case analysis.Results:Harvard School of Public Health used strategic management tools to draw long-term vision for the development of public health, formulate strategic objectives and implementation paths, different functional departments of scientific research management conducted concerted work to provide high-quality scientific research management services which aimed to serve the institutional strategic development.Conclusions:In order to improve the scientific research management in medical universities in China, it is important to develop appropriate strategy of scientific research development, cooperation among related departments, as well as professional support and training for scientific research management personnel.
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Objective:To investigate the influence of string-overalls-suture pancreaticojejunostomy on the incidence of postoperative pancreatic fistula (POPF) in pancreaticoduodenectomy (PD) .Methods:Clinical data of 70 cases receiving PD in the Affiliated Zhongshan Hospital of Dalian University from Jan. 2011 to Dec. 2018 were retrospectively studied. All cases were divided into experimental group and control group according to the different ways of pancreaticojejunostomy. Patients in experimental group received string-overalls-suture pancreaticojejunostomy, and those in control group received pancreatic duct jejunal mucosa pancreaticojejunostomy. The 70 cases were performed by the same team. Operative time and the incidence of postoperative complications between the two groups were compared and analyzed.Results:There was no statistical differences between the two groups in general data and intraoperative observations. The total operative time was (4.28±1.10) hours in the control group and (3.62±0.76) hours in the experimental group. It was significantly different between the two groups ( t=2.942, P=0.004) . There were 7 (28.0%) cases of POPF including 6 cases of grade B, and 1 case of grade C in the control group, and 3 (6.7%) cases of grade B in the experimental group. 6 (24.0%) cases had postoperative bleeding in the control group, 7 (15.6%) cases in the experimental group, 8 (32.0%) cases with abdominal infection in control group, and 8 (17.8%) cases in the experimental group. Delayed gastric emptying occurred in 3 (12.0%) cases in the control group, and 4 (8.9%) cases in the experimental group. It was significantly different for POPF between the two groups (χ 2=4.358, P=0.037) . And there were no significant differences for other postoperative complications between the two groups (all P>0.05) . Conclusion:The string-overalls-suture pancreaticojejunostomy has the advantages of simple and quick manipulation, wide indication, safe and reliable pancreaticojejunostomy, and has certain superiorities in shortening operation times and reducing POPF.
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Objective:To investigate the value of SFRP1 gene promoter methylation in PTC tissues, to eanalyze its correlation with clinical characteristics and biochemical indicators and its effect on mRNA expression, and to explore its value in clinical applications.Methods:97 patients with first-onset PTC were selected as the research subjects, and the patients’ PTC tissues (observation group) and adjacent tissues (control group) were taken. Methylation-specific PCR (MSR) was used to detect the methylation status of the SFRP1 gene promoter region, and mRNA expression was measured by fluorescent quantitative PCR. The methyltransferase inhibitor 5-Azacytidine was used to treat thyroid papillary cancer cell lines, detection of biochemical indicators and collection of clinical characteristics.Results:The positive rate of methylation of SFRP1 gene promoter region (70.1%) in PTC tissues was significantly higher than that of adjacent tissues (33.0%) ( χ2=26.747, P<0.001) ; the expression of SFRP1 gene mRNA in PTC tissues was significant MRNA expression in tissues adjacent to cancer ( t=2.886, P=0.007) , mRNA expression in methylated positive PTC tissues was also significantly lower than that in methylated negative PTC tissues ( t=2.065, P=0.038) ; with the concentration of 5-Azacytidine increased, the expression of SFRP1 gene mRNA in CGTHW-3 cells also gradually increased. In addition, the positive methylation rate in PTC tissues was related to the TNM stage ( χ2=5.487, P=0.019) and whether there was lymph node metastasis ( χ2=4.659, P=0.031) . The levels of TSH and TGAb in the methylation group were higher than those in the unmethylated group (TSH: t=2.234, P=0.023; TGAb: t=2.312, P=0.021) . Conclusion:High DNA methylation in the promoter region of SFRP1 gene can participate in the occurrence and development of PTC by down-regulating the mRNA expression of genes.
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Objective To assess the preoperative detection of hepatic arterial anomalies in patients undergoing pancreaticoduodenectomy using multi-slice computed tomographic angiography (MSCTA).Methods Between January 2014 and December 2017,60 patients who underwent pancreaticoduodenectomy were included in this retrospective study.The clinical and imaging data were analyzed.The types of hepatic artery found by preoperative MSCTA based on the Michels classification were compared with the actual hepatic arterial anatomy detected during surgery.Results Hepatic arterial anomalies were detected by MSCTA in 12 of 60 patients (20.0％).Using the Michels classification,there were 3 patients with type Ⅱ (25.0％),6 patients with type Ⅲ (50.0％),1 patient with type Ⅵ (8.3％),and 1 patient with type Ⅸ (8.3％).One patient (8.3％,1/12) had an anomaly which was not included in the Michels typing.All the hepatic arterial anomalies detected by MSCTA corresponded to those found in surgery (12 patients).The rates of accuracy,sensitivity,and specificity of MSCTA were all 100％.Conclusions MSCTA provided a high accuracy in diagnosing hepatic arterial anomalies.MSCTA should be routinely used before pancreaticoduodenectomy.
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Objective To investigate the expression of peroxisome proliferator-activated receptor γ (PPARγ) and uncoupling protein-1 (UCP-1) after sleeve gastrectomy in Zucker rats and to discuss the weight loss mechanisms.Metbods 30 male Zucker rats aged 10 weeks were randomly divided into 3 groups:the operation group (10 rats),the sham operation group(10 rats) and the diet-pairing group (10 rats).The rats were decapitated to retrieve the retroperitoneal adipose.mRNA and protein expressions of PPARγ and UCP-1 were detected by RT-PCR and Western blot.Results As for the operation group,the weight decreased significantly after the operation compared to the other two groups((250±5.8) g,(370±10.0) g,(310±9.6) g,respectively,P＜0.05).The expressions of PPARγ and UCP-1 gene of mRNA and protein were all significantly higher in the operation group (P＜0.05).Conclusions SG can up-regulate the expressions of thermogenic gene PPARγand UCP-1 in adipose in Zucker rats,browning the white adipose tissue,which was one of the important mechanisms of weight loss.
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Objective To investigate the effect of sleeve gastrectomy (SG) on the distal ileum apical sodium-dependent bile acid transporter (ASBT) and ileum bile acid binding protein (IBABP)in obese type 2 diabetic rats.Methods Thirty 8-week-old male Sprague-Dawley rats were divided into groups O,F and N according to the random number table method.Among them,groups O and F were given high-sugar and high-fat diets,and group N were fed with normal diets before and after surgery.After 1,2 and 4 weeks,the body weight,blood glucose and plasma total bile acid levels were measured.The experimental animals were sacrificed 4 weeksafter operation and the terminal ileum tissue was harvested.Two types of ASBT and IABAP were detected by Western blot and immunohistochemistry.Bile acid transporters were tested.Results Blood glucose in group O was significantly lower than that in group F at 4 weeks postoperatively,(5.8±1.77) and (19.55±2.16) mmol/L,respectively (P＜0.05).Body weight in group O was significantly lower than that in group F at 4 weeks postoperatively,(182±10.66) g and (362±23.54) g,respectively (P＜0.05).Plasma total bile acid levels in group O were significantly higher than those in group F and N at 4 weeks after operation (52±18.48),(6.39±1.18),(5.89±1.21)μmol/L,respectively(P＜0.05).At the end of the 4th postoperative period,the expression of ASBT and IBABP in the distal ileum of group O increased,but there was no significant change in group F and group N.Conclusions The effect of SG on the hypoglycemic and weight-loss of obese T2DM rats is definite.The level of bile acid in plasma increases significantly after SG,and the expression of bile acid transporter in the terminal ileum of rats is one of the mechanisms.
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Objective To investigate mRNA expression of hepatic phosphoenolpyruvate carboxykinase (PEPCK) after gastric bypass surgery (GBS) in rats with type 2 diabetes mellitus (T2DM).Methods 36 male Goto-Kakizaki rats,aged 12 weeks,were randomly divided into GBS,sham operation with diet restriction (SO),and sham operation alone(control) groups(n=12 per group).The blood lipid levels and fasting plasma glucose (FPG)levels in rats before and 8 weeks after surgery were measured and compared.The insulin sensitivity index (ISI)was calculated.Real-time polymerase chain reaction (RT-PCR) and Western blot were used to detect the expression of PEPCK mRNA and protein in hepatocytes at 8 weeks after operation.Results 8 weeks after operation,the blood lipid levels [TC(1.25±0.08) mmol/L,TG (0.93±0.10) mmol/L,FFA(0.88±0.12) mmoUL] in GBS group were significantly lower than those before operation [TC (2.31 ±0.52) mmol/L,TG(1.44±0.27) mmol/L,FFA (1.08±0.06) mmol/L] (P＜0.05).The fasting blood glucose levels in GBS decreased from (11.73±0.37) mmol/L to (5.13±0.22) mmol/L (P＜0.05),and ISI in GBS group increased from (-5.78±0.10) to (-4.64±0.15) (P＜0.05).PEPCKmR-NA (3.97±0.30) and protein (1.60±0.31) expression significantly reduced (P＜0.05).Conclusion GBS can reduce blood glucose in T2DM rats while improving glucose tolerance and hyperglycemia,and the mechanism appears to be associated with a decrease of hepatic PEPCK mRNA and protein expression.
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Objective To investigate the expression of hormone sensitive lipase (HSL) and carnitine acyl transferase-1 (CAT-1) in Zucker rats after sleeve gastrectomy and to discuss the weight loss mechanism.Methods 30 male Zucker rats aging 10 weeks were randomly divided into 3 groups:the operation group (10 rats),the sham operation group (10 rats) and the diet-pairing group (10 rats).The rats were decapitated to retrieve the retroperitoneal adipose,mRNA and protein expression of HSL and CAT-1 gene of were detected by RTPCR and Western blot.Results As for the operation group,the weight decreased significantly after the operation comparing to the other two groups ((250±5.8) g,(370±10.0) g,(310±9.6) g,P＜0.05).mRNA and protein expressions of HSL and CAT-1 gene were all significantly higher in the operation group (P＜0.05).Conclusion SG can up-regulate the expressions of lipolysis gene HSL and CAT-1 in adipose in Zucker rats,promoting fat hydrolysis and increasing the energy expenditure,which is one of the important mechanisms of weight loss.
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<p><b>OBJECTIVE</b>To investigate the expressions of adipic insulin receptor β(IR-β) and insulin receptor substrate-1 (IRS-1) after gastric bypass (GBP) operation in spontaneous rats with type 2 diabetes mellitus(GK rats) and to elucidate the mechanisms of GBP in improving insulin resistance.</p><p><b>METHODS</b>Thirty male GK rats aged 8 weeks were randomly divided into 3 groups according to the table of random number: the operation group (GBP, 10 rats), the sham operation group (the same sites were cut off as GBP and end to end anastomosis was performed in site, 10 rats) and the diet pairing group (the same kind and weight dieting as the operation group, 10 rats), besides 10 male SD rats aged 8 weeks were used as blank control group (free eating and drinking). Four weeks before and after operation, levels of fasting blood glucose(FPG) and fasting insulin(FINS) were measured, HOMA-IR was calculated respectively, and compared among 4 groups. Then rats were decapitated to retrieve the omentum. Expressions of adipic IR-β and IRS-1 protein were detected by Western blot.</p><p><b>RESULTS</b>Compared with the preoperative levels, the FPG and HOMA-IR decreased significantly 4 weeks after surgery in operation group [(5.13±0.22) vs. (11.73±0.37) mmol/L, 2.16±0.18 vs. 5.10±0.29, P<0.05), reaching the level of blank control group(P>0.05). FINS showed no obvious change in these 4 groups after operation(all P>0.05). Expressions of IR-β and IRS-1 were significantly higher in operation group than those in other 3 groups 4 weeks after the operation(all P<0.05).</p><p><b>CONCLUSIONS</b>Expressions of adipic IR-β and IRS-1 in insulin signal transmission of rats with type 2 diabetes mellitus after GBP are up-regulated, meanwhile insulin resistance can be improved and insulin sensibility increases.</p>
Assuntos
Animais , Masculino , Ratos , Peso Corporal , Diabetes Mellitus Tipo 2 , Derivação Gástrica , Insulina , Proteínas Substratos do Receptor de Insulina , Resistência à Insulina , Receptor de Insulina , Regulação para CimaRESUMO
Objective To investigate the expression of hepatic glucose transporter-2 ( GLUT-2 ) and glu-cokinase(GCK)after gastric bypass(GBP)in type 2 diabetes mellitus(T2DM)GK rats and to discuss the mecha-nism of GBP improving insulin resistance .Methods 30 male GK rats aged 8 weeks were randomly divided into 3 groups:the operation group(10 rats), the sham operation group(10 rats)and the diet control group(10 rats), and 10 male SD rats aged 8 weeks were made as blank control group .The levels of fasting plasma glucose ( FPG) and fasting insulin(FINS)were measured and compared among the 4 groups before and 1,2 and 4 weeks after the operation and then the rats were sacrificed to retrieve the liver .The expressions of GLUT-2 and GCK mRNA and protein were detected by PT-PCR and Western blot respectively .Results As for GK operation group ,FPG levels at the 1st, 2nd,and 4th week after surgery ((11.06 ±0.52) mmol/L,(7.49 ±0.34) mmol/L,(5.20 ±0.08) mmol/L)respectively)were all lower than that before surgery (all P<0.05),and FINS level at the 4th week after surgery increased from(11.90 ±0.75)mmol/L to(14.20 ±1.23)mmol/L(P<0.05).The expressions of GLUT-2 and GCK mRNA and protein significantly increased in GK operation group 4 weeks after surgery ( P<0.01 ) . Conclusion The expressions of hepatic GLUT-2 and GCK in insulin signal transmission in T2DM rats are up-regu-lated after GBP , which enhance the signal transmission of insulin receptor , and improves the insulin sensibility .
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Objective To study the significance of c-met mRNA in axillary drainage after operations for breast cancer. Methods RT-PCR assay was used to examine c-met mRNA in axillary drainage after operations in 52 cases of breast cancer. The relationships between the expression of c-met and the tumor size, metastatic lymph nodes, the expressions of estrogen receptor (ER), progesterone receptor (PR) and c-erbB-2 were analyzed, respectively. In addition, the effect of douching operative field with 5-FU and distilled water on the expression of c-met mRNA was also analyzed. Results ①The proto-oncogene c-met mRNA could be detected in axillary drainage after operations for breast cancer by RT-PCR, and its positive rate was higher than that in routine pathological detection for micrometastasis in the axillary lymph nodes (P
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Objective To study the effects of aminoguanidine (AG), a selective inhibitor of inducible nitric oxide synthase (iNOS) on the pathological changes of liver tissues and ultrastructural changes of liver cells in rodent model of endotoxic shock. Methods Twenty-four male Wistar rats were randomly divided into normal control group,lipopolysaccharide (LPS) control group and AG treatment group, each group had 8 rats. Rats were challenged by E.coli LPS to set up the model of endotoxic shock, AG group were treated by aminoguanidine. The pathological and ultrastructural changes of liver tissues and plasma NO contents of three groups were observed and compared. Results Light microscopy revealed that many tiny abscesses scattered in liver tissue in LPS group, accompanied by necrosis of liver cells and neutrophils infiltration, while liver injuries of AG group were much slighter than that in LPS group. Electron microscopy revealed that there were dissolved plaques in hepatocyte nuclears, swelling of mitochondria, decreasing in number of mitochondrial ridges, while AG play a protective role to nuclears and mitochondria of hepatocytes. The plasma NO levels of LPS control group were higher than that of normal control group, and plasma NO levels decreased significantly after AG treatment, but still higher than that of normal control group. Conclusion Aminoguanidine selectively inhibits iNOS activity and prevents the overproduction of NO induced by iNOS, thus attenuates the damages of liver structure induced by NO. This method has potential value in clinical application, which deserves more deep research.
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Objective To study the correlation between postoperative tumor recurrence and VEGF expression in preoperative biopsy specimens of early gastric carcinoma together with p53 gene abnormality and tumor cell proliferation. Methods Sixty-eight endoscopically biopsied specimens obtained preoperativelly from patients with early gastric carcinoma were studied immunohistochemically. Date was processed by computer image analysis system. Result The rate of VEGF positivity was significantly higher in patients (n=5) with postoperative tumor recurrence than in those (n=63) without (5/5 vs. 14/63, P