Objective To evaluate the expression of serum vascular endothelial growth factor ( VEGF ) on recurrence and/or metastasis following surgery in patients with differentiated thyroid carcinoma,and to ana1yze the relationship between serum VEGF and serum thyroglobulin levels.Methods The serum samples were obtained from 25 patients with pulmonary metastasis, 43 cases with locoregional recurrence, 30 cases without recurrence and/or metastasis and 30 normal subjects were selected as control.The levels of serum VEGF were analyzed by enzyme-linked immunosorbent assay( ELISA) ,the levels of serum thyroglobulin were analyzed by chemiluminescence method. Results The level of serum VEGF[(864.3 ±200.3)ng/L] in patients with pulmonary metastasis were significantly higher than that in patients with locoregional recurrence[(393.3 ±96.3)ng/L],without recurrence and /or metasta-sis[(276.6 ±47.7)ng/L] and normal subjects[(268.6 ±36.9)ng/L](t=11.04,14.34,14.66,all P<0.05), while there was no significant difference of serum VEGF level between without recurrence and /or metastasis and normal subjects (t=0.73,P>0.05).It showed linear correlation between serum VEGF and thyroglobulin levels on recurrence and/or metastasis following surgery in patients with differentiated thyroid carcinoma ( r=0.902 2, P<0.001) .Conclusion The serum VEGF level was significantly elevated in patients with locoregional recurrence and pulmonary metastases, the serum VEGF can be used as a auxiliary index to predict recurrence and /or metastasis following surgery in patients with differentiated thyroid carcinoma.

Objective To analyze retrospectively long term follow up of inferior vena cava filters in conjunction with thrombolysis and anti coagulant therapy in prevention and treatment of pulmonary embolism (PE) in 24 patients with deep vein thrombosis (DVT) Methods This study included 13 males and 11 females with an average age of 52 4 years (14-86 years) Percutaneous implantation of inferior vena cava filters was performed via a femoral vein in 24 patients with acute or subacute DVT, of whom two were given conjunctive catheter based urokinase thrombolysis After the procedure, 20 patients underwent intravenous urokinase thrombolysis with subcutaneous low weight molecular heparin for 10 days and subsequent oral warfarin for six months Results All patients underwent a successful interventional procedure with an average 15 month (10-48 months) follow up One week after the procedure, relief of symptoms related to DVT was achieved in all the 24 patients Neither filter migration and thrombolic occlusion of filter nor PE and major hemorrhage were observed in this series Conclusion The use of inferior vena cava filters in conjunction with thrombolysis and anti coagulant therapy is a safe and effective treatment modality in patients with DVT, which can be used to prevent subsequent PE

On the basis of ‘ cooperation between schools and hospitals’,teaching of specialized course of clinical medicine in the second academic year was arranged in affiliated hospitals and teaching hospitals.According to the teaching content and features of specialized courses,flexible teaching methods were adopted,including theoretical instruction,bedside teaching,case studies,situational teaching,integration of teaching,practicing and studying and clinical internships etc.Through selecting and training qualified teachers,establishing practical training base and strengthening teaching management and quality control,the quality of teaching was effectively guaranteed and satisfactory teaching effect was received.

OBJECTIVE　To study the pharmacokinetics of levofloxacin-methane sulfonic acid (LF-MSA)in 8 patients with pulmonary tuberculosis after administration 400 mg orally.METHODS　The concentrations of LF-MSA in serum were measured by HPLC.The pharmacokinetic paramters were obtained using 3P97 program.RESULTS　The results showed that a one-compartment model with 1 st order absorption were fitted for LF-MSA.The average values of tmax was 1.22 h.The concentrations of LF-SA in serum was (4.52±0.72) mg*L-1.The mininal concentrations of LF-AS at 24 hr after a single dose was (0.52±0.26) mg*L-1.The average area under the curve was (48.35±5.38) mg*h*L-1.The elimination half-life was (6.49±1.70) h.The apparent volume of distribution was (77.48±8.33)L.CONCLUSION　According to our study,it was suggested that 400 mg twice daily may be given in order to maintain the concentrations of LF-SA in serum around 24 hours above the minimal concentrations of bactericide.

AIM:To develop a HPLC method for determining scutellarin and geniposide in Yinshanlian Granules(Herba Artemisiae scopariae,Herba Scutellariae barbatae, Fructus Gardemiae,etc). METHODS: The analysis was performed on Diamonsil C_(18)(200 mm?4.6 mm,5 ?m) with mixture of acetonitrile(A) and 0.1% phosphoric acid solution as mobile phase in gradient mode.The concentration of solvent A were 5%,33%,5% and 5% at 0,30,31 and 35 min,respectively.The detection wavelength was set at 240 nm and the column temperature was at 30 ℃.(RESULTS:)The linear calibration curves were obtained in the concentration range of 0.032-0.288 mg/mL for scutellarin and 0.009 6-0.086 4 mg/mL for geniposide.The average recoveries of scutellarin and geniposide were 100.6%(RSD=0.80%,n=9),102.6%(RSD=1.1%,n=9),respectively.CONCLUSION: The method is quick,simple,and reproducible,which can be used to control the quality of Yinshanlian Granules.

Objective To study the application value of modified urine nucleoside's detection in prognosis of patients with bladder cancer. Methods We enrolled 85 patients with bladder transitional cell carcinoma confirmed by pathological examination.The 85 patients fulfilled one-year follow-up visit after TUR-BT and were reviewed every three months.The 85 patients did not relapse in the first third month after operation.At the sixth month after operation,20 cases relapsed.18 cases and 19 cases relapsed at the ninth month and the twelfth month after operation.Patients with recurrence added up to 57 cases as the recurrent group.The remaining 28 cases did not relapse at one year after operation as the no recurrent group.Of the 85 cases,55 cases were in T(is) - T1,while 30 cases were in T2 - T4.Of the 85 cases,27 cases were with G1,40 cases were with G2 and 18 cases were with G3.In T(is) -T1,there were 35 cases in recurrent group,while there were 20 cases in the no recurrent group.In T2 -T4,there were 22 cases in recurrent group,while there were 8 cases in the no recurrent group.There were 50 normal people in the control group.Highperformance liquid chromatography/electrospray ionization-quadrupole-time-of-flight mass spectromerry was used to measure the levels of change of two urine modified nucleosides (M1A,1-MeI) which the patients with bladder cancer had different pathology grades,clinical stages,before or after operation and recurrence or no recurrence. Results The levels at third month after operation in no recurrent group ( M1A:3.24 ± 0.40,1 -MeI:5.73 ± 0.67 ) were significantly lower than that before operation ( M 1A:4.34 ± 0.98,1-MeI:14.22 ± 4.05,P ＜ 0.005 ),and remained in low status at another time points after operation.The levels at the third month after operation in recurrent group (M1A:3.31 ±0.33,1-MeI:5.67 ±0.55) were significantly lower than that before operation ( M1A:4.32 ± 1.19,1-MeI:14.31 ± 4.12,P ＜ 0.005 ),which was on the rise and indicating a high level approaching the condition before operation.According to the time point before the operation,recurrent group and no recurrent group were higher than control group (M1A:2.91 ±0.84,1-MeI:5.56 ± 1.25,P ＜ 0.01 ).The levels at the sixth month,ninth month and twelfth month after operation in recurrent group ( M 1A referring to 4.04 ± 0.48,4.11 ± 0.47,4.09 ± 0.53 ;1-MeI referring to1 1.46 ± 1.34,12.14 ± 1.22,12.33 ± 1.27) were the highest (P ＜ 0.01 ).The levels of change of two urine modified nucleosides between pathology grade and clinical stage had no statistical difference ( P ＞ 0.01 ).The levels in recurrence group in T(is) - T1 ( M1 A:5.92 ± 1.28,1-MeI:20.01 ± 8.53 )were higher than the levels in no recurrent group ( M1A:4.02 ±1.22,1 -MeI:11.21 ± 6.45,P ＜ 0.05 ),which was the same in T2 - T4. Conclusion Urine modified nucleosides detection offer a certain clinical value the prognostic of operated bladder cancer patients.

Objective: To establish a method for the determination of 1-methoxy-2-propanol in urine using headspace solid phase micro-extraction coupled with gas chromatography. Methods: The 1-methoxy-2-propanol was enriched by headspace solid phase micro-extraction fiber coated with carbene/polydimethylsiloxane (CAR/PDMS) . Single factor rotation method was used to optimize the conditions of extraction temperature, salt amount, and extraction time. The separation was performed on DB-5 (30 m×0.32 mm×0.25 μm) capillary column and detected with flame ionization detector. The quantification was based on the standard curve. Results: The concentration of 1-methoxy-2-propanol in urine was linear in the range of 0.50-10.0 mg/L, and the linear correlation coefficient was 0.9993. The detection limit of the method was 0.14 mg/L, and the limit of quantification was 0.45 mg/L. The recovery was 85.8% to 104.7%, and the RSD of intra- and inter-batch precision were 3.25%-6.65% and 0.81%-3.96%, respectively. Conclusion The method is high sensitivity and simple operation, and is suitable for the determination of 1-methoxy-2-propanol in urine of occupational exposure population.

Objective:To explore the feasibility of applying BOPPPS (B-bridge in, O-objective, P-pre-assessment, P-participatory learning, P-post-assessment, S-summary) course design mode in the teaching of internal medicine practice for nursing undergraduates.Methods:A total of 73 nursing interns of Kunming Medical University were selected as subjects and divided into the experimental group ( n=30) and the control group ( n=43). The experimental group adopted the practice teaching method based on BOPPPS model, while the control group adopted the traditional teaching method. Students' evaluation was collected by questionnaire. The students' comprehensive reasoning ability, holistic nursing skills ability and clinical nursing evaluation ability were evaluated by taking out questions from the question bank. And the results of teachers' evaluation on the participation of case study and problem solving in the process of students' internship were collected. SPSS 20.0 was used for t-test. Results:The students' evaluation of the practice process in the experimental group (86.81±2.85) was significantly better than that in the control group (82.61±3.82) ( P<0.001). The experimental group was significantly better than the control group in comprehensive reasoning of clinical thinking and assessment of holistic nursing ability ( P <0.001). Teachers' evaluation in the experimental group was better than that in the control group ( P <0.05). The overall effect of the experimental group (20.60±1.73) was significantly better than that of the control group (17.84±1.70) ( P <0.001). Conclusion:BOPPPS mode is helpful for teachers to carry out and demonstrate holistic nursing teaching with symptoms as the core according to the overall teaching objectives of nursing internal medicine, optimize the time arrangement and knowledge structure, improve the practice efficiency, and promote the establishment of holistic nursing thinking mode of students.

Objective:To investigate the clinical diagnostic value of MRI retention enema cannula enhanced scanning in the high complex anal fistula.Methods:The clinical data of 60 anal fistula patients underwent surgery treatment from May 2020 to May 2022 in Affiliated Hospital of Shanxi University of Traditional Chinese Medicine were retrospectively analyzed. All patients underwent MRI plain scanning and enhanced scanning before operation. Compared with the surgical results, the difference between MRI plain scanning and enhanced scanning in the diagnosis of high complex anal fistula was compared.Results:All of the 60 patients successfully completed surgical treatment, and 58 cases internal orifices, 55 cases complex anal fistulas and 53 cases high anal fistulas were found intraoperatively. MRI plain scanning results showed 32 cases internal orifices, 46 cases complex anal fistulas and 42 cases high anal fistulas were found. MRI enhanced scanning results showed 54 cases internal orifices, 53 cases complex anal fistulas and 50 cases high anal fistulas were found. Based on surgical results, the coincidence rates of internal orifice, complex anal fistula and high anal fistula in MRI enhanced scanning were significantly higher than those in MRI plain scanning: 93.10% (54/58) vs. 55.17% (32/58), 96.36% (53/55) vs. 83.64% (46/55) and 94.34% (50/53) vs. 79.25% (42/53), and there were statistical differences ( χ2 = 21.76, 4.95 and 5.27; P<0.01 or <0.05). Conclusions:The MRI retention enema cannula enhanced scanning has obvious advantages in the diagnosis of high complex anal fistula, which provides scientific reference value for the diagnosis and operation of high complex anal fistula in clinic.

PURPOSE: Mismatch repair (MMR) deficiency plays a critical role in rectal cancer. This study aimed to explore the associations between genetic variations in seven MMR genes and adverse events (AEs) and survival of patients with rectal cancer treated with postoperative chemoradiotherapy (CRT). MATERIALS AND METHODS: Fifty single nucleotide polymorphisms in seven MMR (MLH1, MLH3, MSH2, MSH3, MSH6, PMS1 and PMS2) genes were genotyped by Sequenom MassARRAY method in 365 patients with locally advanced rectal cancer receiving postoperative CRT. The associations between genotypes and AEs were measured by odds ratios and 95% confidence intervals (CIs) by unconditional logistic regression model. The associations between genetic variations and survival were computed by the hazard ratios and 95% CIs by Cox proportional regression model. RESULTS: The most common grade ≥ 2 AEs in those 365 patients, in decreasing order, were diarrhea (44.1%), leukopenia (29.6%), and dermatitis (18.9%). Except 38 cases missing, 61 patients (18.7%) died during the follow-up period. We found MSH3 rs12513549, rs33013 and rs6151627 significantly associated with the risk of grade ≥ 2 diarrhea. PMS1 rs1233255 had an impact on the occurrence of grade ≥2 dermatitis. Meanwhile, PMS1 rs4920657, rs5743030, and rs5743100 were associated with overall survival (OS) time of rectal cancer. CONCLUSION: These results suggest that MSH3 and PMS1 polymorphisms may play important roles in AEs prediction and prognosis of rectal cancer patients receiving postoperative CRT, which can be potential genetic biomarkers for rectal cancer personalized treatment.
Biomarkers ; Chemoradiotherapy ; Dermatitis ; Diarrhea ; DNA Mismatch Repair ; Follow-Up Studies ; Genetic Variation ; Genotype ; Humans ; Leukopenia ; Logistic Models ; Methods ; Odds Ratio ; Polymorphism, Single Nucleotide ; Prognosis ; Rectal Neoplasms