0.05). The corresponding 1-, 2- and 3-year loca l r ecurrence rates were 4.4%, 8.9%, 13.3% and 9.8%, 26.8%, 32.6% (P 0.05). Conclusions Simultaneous small-field boosting radiotherapy can obviously reduce t he local recurrence and improve the survival without causing more toxicities in the treatment of soft tissue sarcoma in extremities.

Objective To observe the effects of rehabilitation training combined with health education on quality of life and psychological state of elderly patients with chronic obstructive pulmonary disease (COPD).Methods A total of 108 elderly inpatients with moderate to severe COPD in stable conditions were randomly divided into an intervention group and a control group,with 54 patients in each group.The patients in both groups received general respiratory medical therapy.The patients in intervention group also received additional comprehensive rehabilitation training consisting of individualized exercise instructions and health education,while the patients in control group only received online telephone health education and rehabilitation training instruction.Patients in both groups were assessed by using St.George's respiratory questionnaire (SGRQ) and symptom checklist 90 (SCL-90) before and after one year of treatment.Results After treatment,the control group's scores for various SGRQ items were similar to the scores within the group before treatment (P ＞ 0.05).The intervention group's SGRQ scores for symptoms,mobility and impact on life and the total score were (42.12 ± 11.32),(45.17 ± 10.23),(29.98 ± 6.54) and (41.02±9.92),respectively,significantly different from their baseline values and those of the control group after treatment (P ＜ 0.01).After treatment,the intervention group's SCL-90 scores were significantly improved from baseline values and were also significantly different from the control group (P ＜ 0.05).Comparison between the two groups showed that throughout the treatment period,the number of patients with acute attacks and the number of patients' hospitalization due to acute attacks were statistically significantly lower in the intervention group (P ＜ 0.05).Conclusions Rehabilitation training combined with health education can significantly improve quality of life and psychological health of COPD patients.

Objective To investigate primarily the correlation between depression and prognosis in patients with coronary heart disease(CHD).Methods 246 CHD patients were divided into the depression group and non-depression group.The relation between depression and incidence of short term cardiovascular events was compared.Results The incidence of angina pectoris,ST-segment elevated myocardial infarction,non ST-segment elevated myocardial infarction,congestive heart failure,ventricular tarchycardia,ventricular fibrillation and sudden death in the near future were 75.6%,11.1%,17.8%,26.7%,12.2%,8.9% and 7.8% respectively.Depression was an independent predictive factor of all cardiovascular events.Conclusion CHD patients complicated by depression have a high incidence of cardiovascular events,and the depression is an independent predictive factor of all cardiovascular events.

OBJECTIVETo explore the molecular genetic relationship between chromosome 1 and quantitative trait loci for familial schizophrenia.

METHODSA series of assessment scales included positive and negative syndrome scale (PANSS), global assessment of functional scale (GAFS), premorbid schizoid and schizotypal traits scale (PSST), premorbid social adjustment scale (PSA) were applied to quantify the phenotypes of schizophrenia. Non-parametric linkage analysis of quantitative traits was conducted in 32 multiplex pedigrees with schizophrenia by using 29 microsatellite makers on chromosome 1.

RESULTSHaseman-Elston quantitative trait analysis detected a maximum Traditional H-E Lods of 1.73 and a maximum EH H-E Lods of 1.65 of negative symptoms (PANSS-N ) at 147.64 cM, which was overlapped to the positive region of 1q21-23 in qualitative linkage analysis.

CONCLUSIONThe results suggest there might be an independent quantitative trait locus of negative symptoms on 1q21-23 for familial schizophrenia.

Chromosomes, Human, Pair 1 ; genetics ; Family Health ; Genetic Linkage ; Humans ; Lod Score ; Microsatellite Repeats ; Quantitative Trait, Heritable ; Schizophrenia ; genetics

OBJECTIVETo explore the molecular genetic relationship between chromosome 1 and susceptibility genes for familial schizophrenia in Chinese population.

METHODSA genome scanning was conducted in 32 multiplex pedigrees from Chinese population by using 29 microsatellite markers on chromosome 1.

RESULTSMultipoint parametric analysis detected a maximum heterogenicity Lod of 1.70 at 262.52 cM under a recessive model; multipoint non-parametric analysis detected a maximum non-parameter linkage (NPL) of 1.71 (P=0.046) at 262.52 cM, then 1.37 (P=0.086) at 149.70 cM, corresponding to marker D1S206 and D1S425 respectively.

CONCLUSIONThese results give further supports to the presence of susceptibility genes on chromosome 1q for familial schizophrenia.

Adult ; China ; Chromosome Mapping ; Chromosomes, Human, Pair 1 ; genetics ; Family Health ; Female ; Genetic Linkage ; Genetic Predisposition to Disease ; genetics ; Humans ; Lod Score ; Male ; Microsatellite Repeats ; Middle Aged ; Models, Genetic ; Pedigree ; Schizophrenia ; genetics

Objective:To explore the effect of rapamycin on 1-methyl-4-phenylpyridinium iodide (MPP+ )-induced activation of Nod-like receptor protein 3 (NLRP3) inflammasome in microglia.Methods:The BV2 microglia cells were divided into control group, model group and rapamycin group.The model group and rapamycin group were treated by MPP+ to activate NLRP3 inflammasome, and rapamycin group was pretreated with rapamycin.Quantitative real-time PCR (RT-qPCR) was used to detect the mRNA levels of NLRP3, apoptosis-associated speck-like protein (ASC) and caspase-1.Immunofluorescence was used to detect the protein expression of NLRP3 and interleukin-1β (IL-1β). Western blot was carried out to assess the protein expression of NLRP3, ASC, caspase-1, beclin1 and microtubule-associated protein 1 light chain 3 (LC3).Results:The mRNA levels of NLRP3, ASC and caspase-1 in model group were higher than those in control group ( t=4.825, 3.015, 5.853, all P<0.05). The mRNA levels of NLRP3 and caspase-1 in rapamycin group were lower than those in model group ( t=2.75, 2.89, both P<0.05). In model group, the protein expressions of NLRP3 (1.54±0.22), ASC (1.02±0.13) and caspase-1 (1.42±0.30) were higher than NLRP3 (0.66±0.15), ASC (0.41±0.14) and caspase-1 (0.70±0.10) in control group ( t=5.653, 5.602, 3.964, all P<0.01), while the protein expression of beclin1 (0.28±0.09) and LC3II/LC3I ratio(0.69±0.14) were lower than beclin1 (0.60±0.11) and LC3II/LC3I (1.29±0.23) in control group ( t=4.010, 3.982, both P<0.01). The protein expressions of NLRP3 (0.80±0.18) and ASC (0.68±0.14) in rapamycin group were lower than those in model group ( t=4.413, 3.077, both P<0.05), while the protein expression of beclin1 (0.65±0.20) and LC3II/LC3I ratio(1.42±0.36) were higher than those in model group ( t=2.965, 3.278, both P<0.05). Conclusion:MPP+ activates NLRP3 inflammasome and impairs autophagic function in microglia.Rapamycin inhibits MPP+ -induced activation of NLRP3 inflammasome by restoring autophagic impairment in microglia.

Objective:To investigate the characteristics of primary catheter malposition (PCM) following totally implantable venous access port (TIVAP) implantation via the internal jugular vein (IJV) and management strategies.Methods:Clinical data of 587 consecutive breast cancer patients undergoing TIVAP implantation via the IJV performed by single team at the Department of Breast Surgery, the First Affiliated Hospital of Zhengzhou University from Aug 2017 to Aug 2022 was retrospectively analyzed.Results:A total of 593 TIVAP were implanted and PCM was found in 18 cases (3.0%). Four hundred and twenty five TIVAP were implanted via the right IJV with one PCM case (0.2%). One hundred and sixty eight TIVAP implantations were performed via the left IJV and PCM occurred in 17 cases (10.1%). The interventional management with a pigtail catheter was performed as a first-line strategy in 11 of the 18 PCM cases, with a success in 10 cases and failure in one. Three cases were successfully managed with the digital subtraction angiography (DSA)-guided open approach. Four cases underwent blind open procedure firstly and 2 suffered a failure.Conclusions:A higher incidence of PCM is found in TIVAP implantations via the left IJV than the right one. The interventional management with a pigtail catheter or the DSA-guided open procedure proves to be feasible for the correction of PCM.

Objective:To investigate preliminary results of chest wall reconstruction with local kiss flap following mastectomy for locally advanced breast cancer (LABC).Methods:Clinical data of the LABC patients receiving treatment at the Department of Breast Surgery, the First Affiliated Hospital of Zhengzhou University between June 2020 and July 2021 was retrospectively analyzed. All patients underwent modified radical mastectomy after neoadjuvant chemotherapy. And the local kiss flap was used for reconstruction of the secondary chest wall soft tissue defects. Two small local flaps were designed intraoperatively and harvested from inferior (flap A) and lateral (flap B) to the defect, respectively, resurfacing a large chest wall soft tissue defect side by side with primary closure of both two donor sites. The flap perfusion was routinely monitored postoperatively. Adjuvant systemic therapies were implemented based on both pre- and post-operative pathological results. And the adjuvant radiotherapy was started immediately after wound healed completely. All cases were followed up regularly.Results:A total of five female patients were included, with an average age of 53.4 (ranging from 41 to 71). Stage Ⅲ (T 3-4N 2-3M 0) breast cancer was diagnosed in all cases. After mastectomy, chest wall soft tissue defect was presented in all cases, ranging from 12.0 cm × 12.0 cm to 22.0 cm × 20.0 cm. The flap A measured from 7.0 cm × 7.0 cm to 14.0 cm × 13.0 cm and the flap B from 5.0 cm × 4.0 cm to 11.0 cm × 7.0 cm. Only 1 flap A suffered tip necrosis and the remnant flaps survived totally. All donor sites recovered uneventfully and no donor-site morbidity was noted. The mean post-operative follow-up period was 15.8 months (ranging from 13 to 20 months). No tumor recurrence or metastasis was noted in all patients, except one patient, who did not receive radiotherapy, suffered local recurrence 4 months after surgery. Conclusion:Given its simplicity and satisfying results, the local kiss flap is a feasible and reliable reconstructive option for chest wall soft tissue defect reconstruction after mastectomy in selected LABC patients.

Objective:To investigate preliminary results of chest wall reconstruction with local kiss flap following mastectomy for locally advanced breast cancer (LABC).Methods:Clinical data of the LABC patients receiving treatment at the Department of Breast Surgery, the First Affiliated Hospital of Zhengzhou University between June 2020 and July 2021 was retrospectively analyzed. All patients underwent modified radical mastectomy after neoadjuvant chemotherapy. And the local kiss flap was used for reconstruction of the secondary chest wall soft tissue defects. Two small local flaps were designed intraoperatively and harvested from inferior (flap A) and lateral (flap B) to the defect, respectively, resurfacing a large chest wall soft tissue defect side by side with primary closure of both two donor sites. The flap perfusion was routinely monitored postoperatively. Adjuvant systemic therapies were implemented based on both pre- and post-operative pathological results. And the adjuvant radiotherapy was started immediately after wound healed completely. All cases were followed up regularly.Results:A total of five female patients were included, with an average age of 53.4 (ranging from 41 to 71). Stage Ⅲ (T 3-4N 2-3M 0) breast cancer was diagnosed in all cases. After mastectomy, chest wall soft tissue defect was presented in all cases, ranging from 12.0 cm × 12.0 cm to 22.0 cm × 20.0 cm. The flap A measured from 7.0 cm × 7.0 cm to 14.0 cm × 13.0 cm and the flap B from 5.0 cm × 4.0 cm to 11.0 cm × 7.0 cm. Only 1 flap A suffered tip necrosis and the remnant flaps survived totally. All donor sites recovered uneventfully and no donor-site morbidity was noted. The mean post-operative follow-up period was 15.8 months (ranging from 13 to 20 months). No tumor recurrence or metastasis was noted in all patients, except one patient, who did not receive radiotherapy, suffered local recurrence 4 months after surgery. Conclusion:Given its simplicity and satisfying results, the local kiss flap is a feasible and reliable reconstructive option for chest wall soft tissue defect reconstruction after mastectomy in selected LABC patients.

Objective:To evaluate the effect of tutorial system for medical undergraduates in a non-affiliated hospital of a medical university in Jiangsu.Methods:32 senior medical undergraduates in non-affiliated hospitals were divided into two groups. The experimental group adopted tutor-guided teaching, and the control group adopted traditional teaching. Professional theoretical knowledge, clinical ability, operational ability, foreign language level, basic research ability and participation of scientific research activities of students in the two groups were evaluated. SPSS 19.0 was used for t test, chi-square test and U test. Results:The results of operational ability ( t=3.537, P=0.000), the number of papers that had been read ( t=6.961, P=0.000), quality of these ( U=68.000, P=0.017), the number of literature reviews that had been written and reading notes ( χ2=4.747, P=0.000), participation in scientific research activities ( t=6.788, P=0.009) of students in the experimental group were better and higher than those in the control group. In the same period, there was no significant difference between the two groups in the scores of theoretical exam, clinical competence and foreign language tests. Conclusion:The implementation of tutorial system for medical students in non-affiliated hospitals is an effective measure to improve the quality of training. We should make full use of the short intership, to improve the comprehensive quality of students by establishing perfect rules, regulations and teaching evaluation system, and educate students in accordance with their own ability.