Objective:To explore the application effect of small private online course (SPOC) teaching mode in clinical practice teaching of thoracic surgery.Methods:A total of 56 undergraduate students who were internships from May to July 2018 were selected as subjects. They were randomly divided into experimental group and control group. SPOC teaching mode and traditional teaching mode were respectively adopted in the practice teaching, and the teaching effect was evaluated by questionnaires and written examinations. SPSS 22.0 was used for statistical analysis, ttest for independent-sample test, and chi-square test for counting data. There were significant differences when P<0.05. Results:The questionnaire showed that the six teaching effect evaluation indicators of the experimental group were higher than those of the control group ( P<0.01). In terms of written test assessment, the average score of the experimental group was significantly higher than that of the control group, with significant differences ( P<0.05). Conclusion:The SPOC teaching mode can improve the teaching effect of clinical practice in thoracic surgery and improve students' self-learning ability.

Objective To analyze the survival statistics and perioperative parameters of clinical stage Ⅰ non-small cell lung cancer patients who received systemic or selective mediastinal lymphadenectomy,and explore the value of selective mediastinal lymphadenectomy for clinical stage Ⅰ non-small cell lung cancer.Methods The clinical data of 984 patients with clinical stage Ⅰ non-small cell lung cancer who underwent lobectomy and systemic/selective lymph node dissection in Zhongshan Hospital from January 2005 to December 2010 were analyzed retrospectively.There were 581 males and 403 females with an average age of(59.6 ± 10.2) (24-84) years.786 patients received systemic mediastinal lymphadenectomy,and 198 patients received selective mediastinal lymphadenectomy.Results Average operation time of selective mediastinal lymphadenectomy group was(132.3 ±30.3) minutes,and that of systemic mediastinal lymphadenectomy group was(150.7 ±41.8) minutes with significant difference(P ＜ 0.01).Average amount of intraoperative bleeding of selective mediastinal lymphadenectomy group was (96.2 ± 53.5) ml,and that of systemic mediastinal lymphadenectomy group was (124.4 ± 65.4) ml with significant difference(P ＜0.01).There was no significant difference in overall survival rate between two groups(P =0.844).Recurrence rates were 25.3 ％ and 27.5 ％,respectively (P =0.533).Subgroup analysis showed no significant difference of 5-year survival rates between the two groups.Conclusion For patients with clinical stage Ⅰ non-small cell lung cancer,selective mediastinal lymphadenectomy can reduce operation time and amount of intraoperative bleeding.Survival of patients who received selective mediastinal lymphadenectomy was no worse than that of patients who received systemic mediastinal lymphadenectomy.

Objective To analyze the epidemiological characteristics of human brucellosis in Harbin City.Methods Retrospective study was used to collect the information of brucellosis epidemic situation and monitoring data.The information of brucellosis cases was from China disease surveillance information system and from the Harbin surveillance results of brucellosis between 2004 and 2013.According to the results of epidemiological characteristics of brucellosis in Harbin,analysis of regional distribution,time distribution,population distribution and brucellosis serology positive rate were conducted in 18 counties (cities,districts) of Harbin.Data were analyzed using SPSS 13.0 software.Results From 2004 to 2013,2 602 cases of brucellosis were reported.In particular,the largest increase was in 2012,a total of 481 cases was reported,which was 2.11 times that of 2011 (228 cases).The incidence was raised from 2.20/100 000 to 5.98/100 000,and the epidemic range expanded from 15 counties (cities,districts) to 18 counties (cities,districts).Age of onset concentrated in young adults,the 20-59 years old group accounting for 86.47％ (2 250/2 602) of the total incidence.The proportion of male and female was 2.90 ∶ 1.00 (1 936 ∶ 666).The occupation of most new cases was farmers,accounting for 83.55％ (2 174/2 602) of the total incidence.In brucellosis surveillance,4 877 people was undergo serological test,the positive number was 145,and the positive rate was 2.97％.Conclusion Human brucellosis epidemic has an increasing trend in Harbin,age of onset is concentrated in young adults,males are more than females,and the epidemic range expands year by year.

Objective To investigate the relationship between the microsatellite polymorphism of cytotoxic T lymphocyte associated antigen-4 (CTLA-4) gene and inflammatory bowel disease(IBD) patients in Zhejiang province. Methods One hundred and eighteen IBD patients without consanguinity (99 patients with ulcerative colitis, 19 patients with Crohn's disease) and 140 healthy controls were studied. The (AT) repeats in the 3' untranslated region of exon 4 of CTLA-4 gene were amplified by allele-specific PCR. The amplified products were electrophoresed with 12% polyacrylamide gel, followed by silver staining. Results Twenty alleles were found in IBD patients and healthy controls. The frequency of 122 bp allele was higher in patients with ulcerative colitis (P=0.0001/Pc=0.0025, OR= 11.393, 95% CI:2.574-50.429) and Crohn's disease (P=0.0003/Pc=0.0050, OR=21.061, 95% CI:3.927-112.94) than that in healthy controls. Conclusion CTLA-4 gene microsatellite polymorphism was obviously associated with IBD in Zhejiang province.

Objective To investigate clinical outcomes and side effects of 103Pd seed brachytherapy for malignant tumors. Methods Twenty patients with residual or recurrent unresectable malignancies were treated with 103Pd seed implantation under the guidance of ultrasonigraphy or CT scans. Three patients were given a local anesthesia and 17 patients, general anesthesia. The match peripheral doses ranged from 97.3 Gy to 182.78 Gy (mean, 123 Gy). The activity of each seed ranged from 1.4 mCi to 1.8 mCi. The planning target volume (PTV) included a 1 cm isotropic expansion margin around the clinical target volume (CTV). The seeds were retrogradely placed with a Mick applicator. External beam radiation was required 3～4 weeks after seed implantation in 6 patients, with a total dose of 45～50 Gy and 2 Gy each fraction. All of the patients received CT scanning after implantation for quality evaluation and underwent routine chest X-ray examination at 24～48 hours for seed observation. Results A complete response was achieved in 5 patients and a partial response in 12 patients. Two patients were assessed as having stable disease. In 1 patient with prostatic cancer, the serum PSA level was decreased significantly. The local control rate was 90% (18/20). The 20 patients were followed for 2～25 months (median,11 months).Two patients were lost to follow-up at 6 and 12 months after operation, respectively. Twelve patients died and 6 patients survived.No severe complications were recorded postoperatively. Conclusions 103Pd brachytherapy for malignant tumors gives a high local control rate and satisfactory reliability.

Objective To investigate the technological feasibility and short-term efficacy of 125I seeds implantation in head and neck cancer. Methods Thirty patients with head and neck recurrent cancer were treated with 125I seeds interstitial brachytherapy. The operation was performed under local anesthesia and the 125I seeds were implanted under the guidance of ultrasonography. The seed needles were implanted parallelly to each other, at 1～1.5 cm apart. The Mick applicator was used to implant seed at 1 cm interval. The radioactive activity per seed ranged 0.40～0.70 mCi, and the matched peripheral dose (MPD) was 90～160 Gy. The number of 125I seed implanted per lesion was 3～84 (median, 24). Ten patients with a seed radioactive dose

Objective To investigate the gene expression change of TNF-α,IL-6 and IL-1β at different time points in brain tissues of rats with cerebral ischemia reperfusion injury.Methods A total of 24 adult male SD rats were randomly divided into four groups:sham group and 3 groups with brain ischemia reperfusion of 3h,6h and 12h.Real-Time PCR was used to analyze the gene expression ofTNF-α,IL-6 and IL-1 β at 3h,6h,and 12h after reperfusion.Results In the sham group,the mRNA expression levels of TNF-α,IL-6 and IL-1 β in were low,but increased immediately after brain ischemia injury and decreased gradually thereafter.The gene expression of TNF-α mRNA at 3h after reperfusion was significantly increased and reached the peak (P ＜0.01) then significantly decreased at 12h after reperfusion.The gene expression of IL-6 mRNA was notably increased at 3h after reperfusion and peaked at 6h (P＜0.01),and significantly decreased at 12h compared with 6h (P＜0.01).The gene expression of IL-1 β mRNA at 3h after reperfusion was significantly increased,peaked at 6h (P＜0.01) and significantly decreased at 12h (P ＜0.01).Conclusion The gene expression levels of TNF-α,IL-6 and IL-1β mRNA increased significantly in the early stage of reperfusion and decreased gradually after reaching the peak,which suggested that the gene expression change of TNF-α,IL-6 and IL-1β was involved in the mechanism of cerebral ischemia reperfusion injury.

Objective To evaluate the validity and reliability of multi-slice spiral CT (MSCT) in preoperative TNM staging judgment of rectal carcinoma. Methods Three hundred and one patients with rectal carcinoma were diagnosed and treated consecutively in Colorectal and Anal Surgery Department of Shanxi Province Tumor Hospital from January 2009 to December 2009. The clinical data of these patients were analyzed retrospectively. The diagnosis results were compared between the preoperative MSCT staging and the postoperative pathological staging,the ROC curve and the diagnostic concordance test were analyzed by software Medcalc 11.2. Results The sensitivity, specificity, Kappa value, area under the curve of TNM staging were 64.7% ,96. 8% ,0. 667,0. 808 for T2 staging tumors; 93.8% ,75.0% ,0.709,0.844 for T3 staging tumors;87. 8% ,98. 1% ,0. 859,0. 929 for T4 staging tumors; 72. 0% ,91.2% ,0. 619,0. 816 for N staging tumors;92. 7%, 99. 7%, 0. 925,0. 963 for M staging tumors respectively. Conclusion The diagnostic value of independent use of MSCT in estimating the infiltration degree and lymph node metastasis of rectal cancer is very poor and cannot be used in preoperative staging judgment.

Objective To investigate the mechanism of radiosensitizing effects of endostatin on H-520 human lung squamous cancer cells.Methods H-520 cells was treated with endostatin and/or radiation.Colony-forming assays were used to indicate the radiosensitising effects.Cell cycle distribution and expression of phosphor-p38-MAPK were assayed by FCM,and cyclin D1,cdk2,cdk4 and survivin mRNA leveh were assayed by RT-PCR.Phosphor-Akt was evaluated by Western-blotting.Results Combination of endostatin and irradiation inhibited the proliferation of H-520 cells.According to the colony-forming assays,the D0,Dq,D10 and SF2 values of the combination groups were much lower than those of irradiation groups.The sensitization enhancement ratio(SER)was 1.51.G2/M arrest occurred after 4 Gy irradiation.The gene expression of cyclin D1,cdk2,ckd4 and survivin and phosphor-Akt protein were down-regulated after treatment.The expression of phosphor-p38-MAPK protein was also down-regulated after treatment with 200 μg/ml endostar.Conclusions Endostatin inhibits the growth of H-520 cells and radiosensitizes the cells by induction of G0/G1 arrest,cell apoptosis and down-regulation of gene expression of cyelin D1,cdk2,cdk4 and reduces the phosphorylation of Akt and p38-MAPK.

Cotinus coggygria Scop. is theAnacardiaceae Cotinus L. plant and used for natural drugs in the treatment of acute icteric infectious hepatitis. The pharmacological research showed thatCotinus coggygria Scop. has the effects of reducing jaundice and enzyme, gallbladder Cholagogic and strengthen immune function. The current research onCotinus coggygria Scop. is still not deep enough, the pharmacological effects ofCotinus coggygria Scop. are mostly limited to the anticoagulant, hemolytic and anti liver chemical injury. In order to better study the scientific connotation of antitumor ofCotinus coggygria Scop., the active ingredient ofCotinus coggygria Scop., pharmacological action and clinical application were reviewed.