RESUMO
Objective:To investigate the relationship between the expression of serum exsomal miRNA-155-5p (miR-155-5p) and prognosis in patients with esophageal squamous cell carcinoma (ESCC).Methods:A total of 336 samples from ESCC patients in Fujian Provincial Cancer Hospital from October 2014 to December 2015 were collected. The relative expression levels of serum exsomal miR-155-5p were detected by using real-time fluorescent quantitative polymerase chain reaction (qRT-PCR). Cut-off value of the expression levels of serum exsomal miR-155-5p was determined by using X-tile software. Based on the optimal cut-off value, patients were divided into miR-155-5p low expression group and miR-155-5p high expression group. The survival curve was drawn by using Kaplan-Meier method and Cox proportional hazards regression model was used to make survival analysis.Results:The cut-off value of serum exsomal miR-155-5p expression level was 2.340. According to the cut-off value, patients were divided into miR-155-5p low expression group (<2.340) of 51 cases and miR-155-5p high expression group (≥2.340) of 285 cases. There were no statistical differences in age ( χ2 = 0.020, P = 0.887), gender ( χ2 = 0.283, P = 0.595), tumor location ( χ2 = 0.063, P = 0.977), differentiation grade ( P = 0.474), clinical staging ( χ2 = 3.996, P = 0.136) and surgery treatment ( χ2 = 0.941, P = 0.332) of patients in both groups. ESCC patients in serum exsomal miR-155-5p high expression had a higher risk of death compared with patients in miR-155-5p low expression group ( HR = 1.763, 95% CI 1.049-2.961, P = 0.032). Conclusion:The high expression level of serum exsomal miR-155-5p is associated with poor prognosis in ESCC patients and it could be used as a prognostic new marker in ESCC patients.
RESUMO
Objective:To screen and identify differentially expressed long non-coding RNA (lncRNAs) in peripheral blood of children with sepsis, and to explore the role of lncRNAs in the pathogenesis of sepsis in children.Methods:The peripheral blood samples of 3 children with sepsis admitted to the ICU of Children′s Hospital of Capital Institute of Pediatrics from January to December 2016 and 3 healthy children who underwent physical examination in our hospital during the same period were selected, and the differential expression profiles of lncRNAs and mRNAs were screened by lncRNAs sequencing technology.The target genes of differentially expressed lncRNAs were predicted and the relationship pairs of lncRNA-mRNA related to F 1F O-ATPase activity were constructed according to the results of GO analysis.Further increasing the sample size, we verified the expression of some F 1F O-ATPase activity-related mRNAs and lncRNAs which were differentially expressed in the screening results by real-time fluorescent quantitative polymerase chain reaction(qRT-PCR). Results:Sequencing results showed that there were 252 lncRNAs with significant differential expression in peripheral blood of children with sepsis compared with healthy children, of which 86 were up-regulated and 166 were down-regulated; meanwhile, there were 2 652 mRNAs with significant differential expression, of which 955 were up-regulated and 1 697 were down-regulated.The results of qRT-PCR showed that the expression of lncRNA ENST00000621933.1, ENST00000616950.1 and ENST00000595748.1 in peripheral blood of children with sepsis increased( P<0.05), while the expression of MT-ATP8, ATP5E and ENST00000624705.1, ENST00000615535.1 in peripheral blood of children with sepsis decreased( P<0.05), which was consistent with the sequencing results. Conclusion:lncRNAs are differentially expressed in peripheral blood of children with sepsis compared with healthy children.The expression levels of lncRNA ENST00000621933.1, ENST00000616950.1, ENST00000595748.1, ENST00000624705.1 and ENST00000615535.1 which their target genes are MT-ATP8 and ATP5E may be related to the development of sepsis in children.
RESUMO
Capillary leak syndrome is a disease characterized by high permeability of vascular endo-thelium leading to anasarca,hypotension,hypoalbuminemia and hemoconcentration,It can cause multiple or-gan failure and high mortality in acute stage. Vascular endothelial hyperpermeability is the core of pathogene-sis of capillary leak syndrome. This article reviewed the latest research progress on the pathogenesis of capil-lary leak syndrome from the aspects of serological mechanism,histological changes and genetic factors.
RESUMO
In order to improve the quality of medical records written by interns of clinical medicine in hematology department,we evaluated and analyzed 100 medical records written by the interns.The main reasons that affect the quality of medical record written by interns are the writing defects that are history of present illness,past history,personal history,the record of the clinical operation,blood transfusion and chemotherapy.There are other reasons for affecting the quality of medical records,such as students in clinical practice not paying attention to the writing of medical records,the relative lag of teaching management,the particularity of the diseases in the department of hematology and the weak legal consciousness.Therefore,we should strengthen the teaching management,improve the comprehensive quality of the clinical teaching teachers,carry out the pre job training of the medical records for the interns,train the interns' inquiries and the ability to communicate with the doctors and patients,and make use of the typical medical records of the Department of Hematology to combine the discussion and other ways,so as to strengthen the interns' clinical disease writing skills and legal consciousness as well as the quality of their writing medical records.
RESUMO
Objectives Toexplorethe effect of the Balint group on improving the empathy and doctorpatient communication skills among medical students in clinical practice.Methods We investigated 500 clinicalmedicalstudentsin fourth grade by JSE-HP and SEGUE framework scalein Shanghai Jiao Tong university school of medicine between July 2016 and December 2016.60 students with insufficientempathy and doctor-patient communication skills were selected randomly.These students were thanrandomly divided into the Balint group (experimental group) and the routine clinical practice group(control group).The experimental group participated inthe Balint group activitiesin addition to routine clinical practice,whilethe control group only participated in routine clinical practice.After 20 weeks of the Balintgroup intervention,the two groups were invited to assess theempathy and doctor-patient communication skills again to analyze the effect of the Balintgroup on improving the empathy and doctor-patient communication ability among intern students.The evaluation result was analyzed by SPSS 22.0 software.Data comparison was conducted using pair t test,independent sample t test and x2 testing.Results There were no statistically significant differences in age,sex,whether only child or class leader and previous year theoretical exam scoresbetween the two groups (all P＞0.05).For empathy,there was no statistically significant difference in terms of opinion,emotional care,empathy,and total scorebefore the routine clinical practicebetween the two groups (P＞0.05) and they all improvedsignificantly after the routine clinical practice (all P＜0.05).But the experimental group had higher scoresin all above scalesthan the control group (all P＜0.05).For communication skills with patients,there were no statistically significant differencesbetween the two groupsin communication initiation,information collection,understanding of patients,information giving,end questioning,and SEGUE scoresbefore the routine clinical practice (all P＞0.05),and they allimprovedsignificantly in all above 5 scales after the routine clinical practice (all P＜0.05).While except for understanding of patients,the experimental group had higher gains in other scales than the control group (all P＜0.05).Conclusion Use of the Barring group activities on the basis of routine clinical practice canimprove the empathy andthedoctor-patientcommunication skills in medical students.
RESUMO
Objectives Aiming at the current health management mode of chronic disease preven-tion and control as the focus of work, this paper was to evaluate the effect of chronic disease management-based education on clinical teaching and training in cardiovascular medicine. Methods Totally 54 students participating in internship training in Department of Cardiology, the Shanghai Ninth People’s Hospital be-tween July 2013 and Aug 2014 were enrolled. Twenty-eight students were taught by chronic disease man-agement-based method while twenty-six students were taught by traditional method. After the internship training in cardiology, final examination (theoretical exam, skill appraisal and case analysis) were compared between the two groups to assess the teaching efficacy. Questionnaire survey was employed to investigate student satisfaction with chronic disease management-based teaching method. Data were analyzed by SPSS 13.0 software. Quantitative data or enumeration data between two groups were compared by t-test or chi-square test respectively. Results There was no significant difference in the theoretical exam score between two groups (P=0.422). However, the scores of skill appraisal and case analysis in students taught by chronic disease management-based method were significantly higher than those in students taught by traditional method (P<0.05). Most students taught by chronic disease management-based method were satisfied with the novel teaching method. Conclusion In the course of clinical medicine education, the emphasis on the management of chronic diseases can not only significantly improve the quality of clinical teaching in car-diovascular medicine, but also lay the foundation for the implementation of the concept of chronic disease management.
RESUMO
Objective To explore the effecr of problem-based leaming(PBL) in emergency clinic skill training.Methods Totally 65 students participating in emergency clinical skill training in The Ninth People's Hospital of Shanghai Jiao Tong University were enrolled.Thirty-three 2008 grade five-year clinic majors as control group were taught by traditional teaching method while Thirty-two 2009 grade five-year clinic majors as experimental group were taught by PBL.After the courses,final examinations (theoretical exam,case analysis and skill appraisal) and questionnaire smvey were used to evaluate the teaching effectiveness between the two groups.Data were managed by SPSS 13.0 software package.Quantitative data between two groups were compared by t-test.Enumeration data between two groups were compared by chi-square test.Results There was no difference in theoretical score between two groups(P=0.212).Scores of case analysis and skill appraisal in experimental group were higher than those in control group (P＜0.05).There were significant differences between experimental group and control group in arousing students' learning interest,promoting understanding of knowledge,cultivating clinical comprehensive ability,increasing communication skills,improving team cooperation ability and clinical operating ability(P＜0.05).Conclusions PBL mode is better than traditional teaching methods in emergency clinical skill training.PBL can improve students' clinical comprehensive ability and emergency operations can be perfectly applied in clinic typical cases.
RESUMO
<p><b>OBJECTIVE</b>To evaluate the safety and efficacy of laparoscopy-assisted surgery for Siewert I adenocarcinoma of the esophagogastric junction (AEJ).</p><p><b>METHODS</b>Clinical data of 36 patients who underwent left transthoracic dissection of lower mediastinal lymph node followed by laparoscopy D2 lymph node dissection for Siewert I AEJ in the Fujian Provincial Cancer Hospital between March 2008 and March 2013 were analyzed retrospectively. A left thoracic-abdominal single incision was used without transection of costal arch. Celiac lymph nodes dissection was performed laparoscopically followed by left transthoracic dissection of lower mediastinal lymph node. Digestive tract reconstruction was carried out by esophagus-gastric posterior wall end-to-side anastomosis.</p><p><b>RESULTS</b>Laparoscopy-assisted surgery was successfully achieved in all the 36 patients and there were no in-hospital deaths. The mean operation time, blood loss and number of harvested lymph node were (216.4±46.0) min, (252.1±41.1) ml and 30.7±3.2 respectively. All the procedures were R0 resections. The complication rate was 16.7% (6/36). All the complications were managed by conservative treatment, and there were no re-operations. The lymphatic metastasis rate was 50.0% (18/36), and the lymph node groups with high metastatic rate (all >10.0%) were groups 1, 2, 3, 7, 9, 110 and 111. The median follow-up was 25 months. The overall 3-year survival was 48.0%.</p><p><b>CONCLUSION</b>Laparoscopy-assisted surgery for Siewert I AEJ is safe and feasible.</p>
Assuntos
Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adenocarcinoma , Cirurgia Geral , Neoplasias Esofágicas , Cirurgia Geral , Esofagectomia , Métodos , Seguimentos , Gastrectomia , Métodos , Laparoscopia , Métodos , Excisão de Linfonodo , Métodos , Estudos Retrospectivos , Neoplasias Gástricas , Cirurgia Geral , Resultado do TratamentoRESUMO
Objective To analyze the possible prognostic factors of thoracic-esophageal cancer patients with lymph node (LN) metastasis after esophagectomy plus three-field lymphadenectomy.Methods 590 esophageal cancer patients with LN metastasis after esophagectomy plus three-field lymphadenectomy were recruited from Jan.1993 to Mar.2007,and the prognostic factors and causes of postoperative failure were analyzed.Results Five-year survival in the whole sample was 29.6％.While the 5-year survival in different subgroups with 1-2,3-6 or ＞ 7 metastatic LNs were 41.2％,22.2％ and 7.0％ (x2 =62.158,P ＜0.0001),respectively.Univariate analysis showed that tumor site,disease length,T stage,number of metastatic LN and the seventh edition of AJCC staging system were prognostic factors.Multivariate analysis indicated that tumor site and number of metastatic LN were two independent prognostic factors.Conclusion Tumor site and number of metastatic LN were independent prognostic factors influencing the outcome of esophageal cancer.
RESUMO
The curriculum construction of medical students' occupational career planning has its own character. Principles of curriculum construction siuh as practical object, professional content and target-oriented organization should be sticked to and four aspects of curriculum construction such as target,content, organization and evaluation. are discussed in detail.