Objective To explore the teaching effect of acute poisoning course among students majoring in rescue medicine. Methods From March to June 2013, 30 students majoring in rescue medicine were randomly divided into two groups for the clinical practice. Case-based learning was used in experimental group and cases was tracked from one department to another in chronological order or in reverse order to explore the cause of poisoning and the development of disease and to ob-tain the complete medical records of patients. Traditional rotating internship was used in control group. Poisoning cases in the department were taken as the starting point and end point and the medical records of patients were obtained. The clinical teaching effect was compared between the two groups through questionnaire survey and final examination. The data were calculated by SAS 9.2 software, mean comparison between the two groups was conducted by t test and enumeration data were analyzed by chi-square test. P<0.05 stands for statistically significant difference. Results The number of cases in the experimental group was more than that in the control group during the same internship period ((15±3) vs. (9±5),P<0.01). Skill score of experimental group was significantly higher than that of the control group((79.1±6.9) vs. (66.2±6.7), P<0.01). Theory examination results between two groups had no obvious difference((88.4±5.7) vs. (87.8±6.3),P>0.05),however, theory examination results were increased significantly in this year compared with those of previous year((88.1±6.0) vs. (79.3±12.8), P<0.01). Questionnaire survey demonstrated that teachers and students' satisfaction were 95.3%(143/150) and 93.3%(140/150) respectively regarding the ten advantages of the track-ing type internship. Conclusions Tracking type internship with poisoning case-based learning is a good combination of lecture-based learning and problem-based learning. It is helpful to cultivate and exercise students' ability to apply the knowledge.

BACKGROUND:Previous research has demonstrated that preoperative hormone therapy relieved clinicaI and pathological stages of prostatic carcinoma patients,reduced positive ratio of incisaI margin:however,it did not increase disease-free surviva J rate.Worth of preoperative hormone therapy for prostatic carcinoma remains unclear.OBJECTIVE:To assess the role of preoperative hormone therapy in localised prostate cancer.METHODS:Articles were searched from PubMed,Embase.Cochrane Library(No.4,2009),Chinese biomedicaf literature database,Chinese Scientific Journals full_text database,and Chinese Journal full-text database(published before October,2009).Randomized controlled trials which were diagnosed as Iocalised prostate cancer using pathology and cytology were included The sex and nationality were not limited.and patients did not have severe heart and lung diseases Prostatic carcinoma which occurred Later or repeatedly was excluded.Otherwise.randomized controlled trails which were coincidence with the inclusion criteria were also included.Review Manager 5.0 published by Cochrane was used for stafistical analysis.Overall survival rate.disease-free survivaI rate,positive surgical margin rate,positive lymph node rate.and seminal vesicle invasion rate were evaluated.RESULTS AND CONCLUSlON:Six randomized controlled trials totaling 1 027 padicipants were included.The result of meta analysis showed that there was no significant difference in overall surviva J rate[RR=0.94,95%C,(0.86,1.02)],disease-free survival rate[RR=1.02,95%CI(0.89,1.17)],positive lymph node rate IRR=0.86,95%CI(0.47,1.57)],and seminal vesicle invasion rate[RR=1.09,95%CI(0.74,1.59)]between single prostatectomy and preoperative hormone therapy plus prostatectomy,while there was significant difference in positive surgical margin rate[RR=0.46,95%CI(0.32,0.66)]This suggested that preoperative hormonal therapy prior to prostatectomy did not improve survival rate,positive lymph nodes rate and seminaI vesicle invasion rate:however.there was a significant reduction in the positive surgicaI margin rate.

BACKGROUND: Traditional open surgery will do great damage to the patients with thoracolumbar fractures, and easily induces local degeneration. In contrast, the novel method is minimally invasive, which contributes to the functional recovery of the spine.OBJECTIVE: To discuss the essential procedures and precautions in the treatment of thoracolumbar fractures with percutaneous pedicle screw fixation.METHODS: Twenty-seven cases of single-level thoracolumbar fractures without spinal neurological deficits treated with percutaneous pedicle screw fixation were selected. The operation time and intraoperative blood loss were observed. The Visual Analogue Scale scores during axial turning at baseline and 3 days postoperatively, and the Visual Analogue Scale scores of the operation region at 1 and 3 days postoperatively were detected, respectively.RESULTS AND CONCLUSION: (1) Twenty-seven patients with 108 vertebrae underwent percutaneous pedicle screw fixation under the guidance of the needle, the puncture was smooth, 98 vertebrae was punctured successfully once, and 10 vertebrae were punctured successfully twice. (2) The Visual Analogue Scale scores during axial turning at 3 days postoperatively were significantly lower than those at baseline, and the scores of the operation region at 3 days postoperatively were significantly lower than those at 1 day postoperatively (P < 0.001). (3) The mean operation time was (109±18) minutes, and the mean intraoperative blood loss was (60±16) mL. (4) There were no nerve root injury and other complications. (5) Our results indicate that percutaneou pedicle screw fixation is a minimally invasive and safe method to treat the patients suffering single-level thoracolumbar fractures without spinal neurological deficits.

Objective:To compare the differences in surgical safety and postoperative cosmetic effects between endoscopic nipple-sparing mastectomy with immediate prepectoral prosthesis breast reconstruction and conventional nipple-sparing mastectomy with immediate subpectoral prosthesis breast reconstruction.Methods:The clinical data of early breast cancer patients admitted to the Department of Breast Surgery of Peking University Peoples Hospital from Oct 1, 2022 to Sep 13, 2023 was retrospectively analyzed.Results:According to the surgical method, the patients were divided into endoscopic surgery group (30 cases) and traditional surgery group (46 cases). There were no significant differences in the basic clinicopathological data, and the number of sentinel lymph nodes taken and axillary lymph nodes dissected between the patients in two groups (all P>0.05). Compared with that in traditional surgery group, the patients in endoscopic surgery group had longer operation time and more wound drainage volumes 3 days after surgery (all P<0.05). There was no significant differences in the probability of postoperative complications between the patients in two groups (all P>0.05), however, the proportion of nipple-areola complex necrosis in patients of endoscopic surgery group (10.0%) was lower than that of traditional surgery group (26.1%). Conclusions:The single-port insufflation technique-assisted endoscopic nipple-sparing mastectomy with immediate prepectoral prosthesis breast reconstruction maximize the cosmetic effect. Under the premise of strict selection of indications, it can be an optional surgical method.

Objective To evaluate the long-term safety of sentinel lymph node biopsy mapped by combination of indocyanine green and methylene blue in breast cancer patients.Methods 198 breast cancer patients with clinical negative axillary lymph node received sentinel lymph node biopsy mapped by combination of indocyanine green and methylene blue.Patients were followed up and regional lymph node recurrence,disease free survival(DFS) and overall survival(OS) were analyzed.Results After a median follow-up of 70 months,2 patients had ipsilateral lymph node recurrence with a regional lymph node recurrence rate of 1％ (2/198).14 patient had recurrence or metastasis and 6 patients died of distant metastasis.The estimated 6 years DFS was 94.4％ and OS was 96.5％.The incidence of arm lymphoedema within patients who received axillary lymph node dissection was 4.5％ and it was 2.5％ in patients who received sentinel lymph node biopsy.Conclusions The sentinel lymph node biopsy mapped by combination of indocyanine green and methylene blue was safe and reliable method for further staging axillary lymph node stastus.

Objective:To examine treatment outcomes of breast phyllodes tumors and the prognosis factors of local recurrence.Methods:This retrospective cohort study included 276 patients who underwent surgical resection at Breast Center, Peking University People′s Hospital from January 2011 to December 2019. Tumor subtype and histopathological features were determined from pathology reports, and the deadline of follow-up was September 30 th, 2020. All 276 patients underwent open surgery, including 17 patients of mastectomy, and 259 patients of lumpectomy. The enrolled patients were all female, with age of (41.5±11.3) years (rang: 11 to 76 years), and tumor diameter of 35(28) mm ( M( Q R)). The Kaplan-Meier method and Log-rank test were used for survival analysis. The multivariate analysis was implemented using the Cox proportional hazard model. Results:According the pathologic test, there were 191 patients of benign phyllodes tumor, 67 patients of borderline tumor and 18 patients of malignant tumor. There were 249 patients with a follow-up of more than 6 months, and 14.1% (35/249) had local recurrence. The time-to-recurrence was (28.6±22.2) months (range: 2 to 96 months), (29.1±18.1) months (range: 2 to 80 months), (32.1±30.1) months (range: 5 to 96 months) and (12.0±6.9) months (range: 8 to 20 months) for benign, borderline and malignant phyllodes tumors. Tumor diameter (≥100 mm vs.<50 mm, HR=3.968, 95%CI: 1.550 to 10.158, P=0.004) and malignant heterologous element (yes vs. no, HR=26.933, 95%CI: 3.105 to 233.600, P=0.003) were prognosis factors of local recurrence. One death from malignant phyllodes occurred after distant metastasis. The 3-year disease-free survival rates of benign, borderline and malignant phyllodes tumor were 88.2%, 81.7% and 81.4% ( P=0.300). Conclusion:Phyllodes tumors have a considerable local recurrence rate, which may be associated with tumor diameter and malignant heterologous element.

Sweet potato is an important food crop that can also be used as an industrial raw material. Sucrose is the main form of long-distance carbohydrate transport in plants, and sucrose transporter (SUT) regulates the transmembrane transport and distribution of sucrose during plant growth and metabolism. Moreover, SUT plays a key role in phloem mediated source-to-sink sucrose transport and physiological activities, supplying sucrose for the sink tissues. In this study, the full-length cDNA sequences of IbSUT₆₂₇₈₈ and IbSUT₈₁₆₁₆ were obtained by rapid amplification of cDNA ends (RACE) cloning according to the transcripts of the two SUT coding genes which were differentially expressed in sweet potato storage roots with different starch properties. Phylogenetic analysis was performed to clarify the classification of IbSUT₆₂₇₈₈ and IbSUT₈₁₆₁₆. The subcellular localization of IbSUT₆₂₇₈₈ and IbSUT₈₁₆₁₆ was determined by transient expression in Nicotiana benthamiana. The function of IbSUT₆₂₇₈₈ and IbSUT₈₁₆₁₆ in sucrose and hexose absorption and transport was identified using yeast functional complementarity system. The expression pattern of IbSUT₆₂₇₈₈ and IbSUT₈₁₆₁₆ in sweet potato organs were analyzed by real-time fluorescence quantitative PCR (RT-qPCR). Arabidopsis plants heterologous expressing IbSUT₆₂₇₈₈ and IbSUT₈₁₆₁₆ genes were obtained using floral dip method. The differences in starch and sugar contents between transgenic and wild-type Arabidopsis were compared. The results showed IbSUT₆₂₇₈₈ and IbSUT₈₁₆₁₆ encoded SUT proteins with a length of 505 and 521 amino acids, respectively, and both proteins belonged to the SUT1 subfamily. IbSUT₆₂₇₈₈ and IbSUT₈₁₆₁₆ were located in the cell membrane and were able to transport sucrose, glucose and fructose in the yeast system. In addition, IbSUT₆₂₇₈₈ was also able to transport mannose. The expression of IbSUT₆₂₇₈₈ was higher in leaves, lateral branches and main stems, and the expression of IbSUT₈₁₆₁₆ was higher in lateral branches, stems and storage roots. After IbSUT₆₂₇₈₈ and IbSUT₈₁₆₁₆ were heterologously expressed in Arabidopsis, the plants grew normally, but the biomass increased. The heterologous expression of IbSUT₆₂₇₈₈ increased the soluble sugar content, leaf size and 1 000-seed weight of Arabidopsis plants. Heterologous expression of IbSUT₈₁₆₁₆ increased starch accumulation in leaves and root tips and 1 000-seed weight of seeds, but decreased soluble sugar content. The results obtained in this study showed that IbSUT₆₂₇₈₈ and IbSUT₈₁₆₁₆ might be important genes regulating sucrose and sugar content traits in sweet potato. They might carry out physiological functions on cell membrane, such as transmembrane transport of sucrose, sucrose into and out of sink tissue, as well as transport and unloading of sucrose into phloem. The changes in traits result from their heterologous expression in Arabidopsis indicates their potential in improving the yield of other plants or crops. The results obtained in this study provide important information for revealing the functions of IbSUT₆₂₇₈₈ and IbSUT₈₁₆₁₆ in starch and glucose metabolism and formation mechanism of important quality traits in sweet potato.
Ipomoea batatas/metabolism* ; Arabidopsis/metabolism* ; Sucrose/metabolism* ; Saccharomyces cerevisiae/metabolism* ; DNA, Complementary ; Phylogeny ; Plants, Genetically Modified/genetics* ; Membrane Transport Proteins/metabolism* ; Starch/metabolism* ; Plant Proteins/metabolism* ; Gene Expression Regulation, Plant

Objective:To examine treatment outcomes of breast phyllodes tumors and the prognosis factors of local recurrence.Methods:This retrospective cohort study included 276 patients who underwent surgical resection at Breast Center, Peking University People′s Hospital from January 2011 to December 2019. Tumor subtype and histopathological features were determined from pathology reports, and the deadline of follow-up was September 30 th, 2020. All 276 patients underwent open surgery, including 17 patients of mastectomy, and 259 patients of lumpectomy. The enrolled patients were all female, with age of (41.5±11.3) years (rang: 11 to 76 years), and tumor diameter of 35(28) mm ( M( Q R)). The Kaplan-Meier method and Log-rank test were used for survival analysis. The multivariate analysis was implemented using the Cox proportional hazard model. Results:According the pathologic test, there were 191 patients of benign phyllodes tumor, 67 patients of borderline tumor and 18 patients of malignant tumor. There were 249 patients with a follow-up of more than 6 months, and 14.1% (35/249) had local recurrence. The time-to-recurrence was (28.6±22.2) months (range: 2 to 96 months), (29.1±18.1) months (range: 2 to 80 months), (32.1±30.1) months (range: 5 to 96 months) and (12.0±6.9) months (range: 8 to 20 months) for benign, borderline and malignant phyllodes tumors. Tumor diameter (≥100 mm vs.<50 mm, HR=3.968, 95%CI: 1.550 to 10.158, P=0.004) and malignant heterologous element (yes vs. no, HR=26.933, 95%CI: 3.105 to 233.600, P=0.003) were prognosis factors of local recurrence. One death from malignant phyllodes occurred after distant metastasis. The 3-year disease-free survival rates of benign, borderline and malignant phyllodes tumor were 88.2%, 81.7% and 81.4% ( P=0.300). Conclusion:Phyllodes tumors have a considerable local recurrence rate, which may be associated with tumor diameter and malignant heterologous element.