Objective:To study the clinical value of detecting estrogen receptor(ER),progesterone receptor(PR) and p53 gene,DNA ploidy in colorectal cancer.Methods:Combined with clinical data,286 specimens of colorectal cancer were detected with ER,PR,p53 gene and DNA ploidy analysis by radiobioassay(RBA),immunohistochemistry and flow cytometry.Results:The expressions of ER,PR,p53 gene and of DNA ploidy analysis correlated with the prognosis of colorectal cancer patient(P

Since Guglielmi detachable coils used in the clinical practice, endovascular embolization of cerebral aneurysms is increasingly being accepted by doctors and patients.However, the relatively higher recurrence rate is still a matter of concern in the interventional treatment, The development and application of new coils have made some progress. This paper reviews the new coated coils and their advances in clinical application.

AIM:To investigate the relationship of autophagy and reactive oxygen species ( ROS) in multiple myeloma cell line RPMI-8226 stimulated with doxorubicin.METHODS:The RPMI-8226 cells were stimulated with doxo-rubicin at different doses, and untreated cells were used as control.The protein expression of beclin 1 and LC3 was detec-ted by Western blot.ROS production was analyzed by DCFH-DA fluorescence staining.After treated with or without 3-methyladenine (3-MA), the ROS production and apoptosis in RPMI-8226 cells were determined by DCFH-DA and flow cy-tometry, respectively.After treated with or without antioxidants tempol and N-acetyl-L-cysteine ( NAC) , the expression of beclin 1 and LC3 in RPMI-8226 cells was determined by Western blot.RESULTS:The protein levels of beclin 1 and LC3Ⅱ/LC3Ⅰwere increased in the RPMI-8226 cells stimulated with doxorubicin compared with untreated group.The ROS production was increased in the RPMI-8226 cells stimulated with 2 mg/L doxorubicin compared with untreated group.After treated with 3-MA, the ROS production and apoptosis in the RPMI-8226 cells stimulated with doxorubicin were increased compared with doxorubicin group.After treated with antioxidant NAC or tempol, the expression of beclin 1 and LC3 II/I in the RPMI-8226 cells stimulated with doxorubicin was decreased compared with doxorubicin group.CONCLUSION:The autophagy and ROS levels are increased in RPMI-8226 cells stimulated with doxorubicin.Inhibition of autophagy increases the ROS production and apoptosis of RPMI-8226 cells stimulated with doxorubicin.Inhibition of ROS production reduces doxorubicin-induced autophagy in multiple myeloma cells.

Barriers to doctor-patient communication induced medical disputes easily.Operation is one of the main means for surgical treatment.Surgery has a high incidence of medical disputes for its invasive and high-risk nature in operative treatments.In the course of surgical treatment,we place patients at the center of medical services and carry out the communicating model of "empathy" in doctor-patient communication to reduce the somatopsychic suffering of patients and promote mutual understanding and support between doctors and patients.It proves to help build a harmonious relationship between doctors and patients,reduce medical disputes,advance the quality of medical services and put the relationship between doctors and patients in a win-win situation.

Objective To investigate the role of transcription factor Ets-1 involved in premature rupture of membranes(PROM) by detecting its expression and location in human fetal membranes. Methods Between Feb. and Nov. 2007, 100 pregnant women who delivered in the First Affiliated Hospital, Chongqing Medical University were enrolled in this study. According to gestational weeks, rupture of amuiochorionic membranes and delivery mode, those women were classified into preterm labor group, preterm premature rupture of membranes (PPROM) group, term labor group and term premature rupture of membranes (TPROM) group, matched with elective term cesarean sections women as control group. There were 20 pregnant women in every group. The expression and distribution of Ets-1 protein in fetal membranes were detected by immunohistochemical streptravidin-biotin peroxidase(SP) method and histoscore. In the mean time, 6 cases were chosen from each group randomly and reverse transcription-PCR was used to measure the Ets-1 mRNA expression. Results (1) The expression of Ets-1 mRNA in fetal membranes were 0.342±0.016 in preterm labor group,0.603±0.027 in PPROM group,0.325±0.013 in term labor group, 0.582±0.075 in TPROM group,0.139±0.012 in control group, respectively. When compared with that in control group, Ets-1 mRNA expression were significantly increased in both PPROM and TPROM group(P< 0.05). However, it did not show remarkably difference between preterm group and term labor group, as well as between PPROM and TPROM group (P>0.05). (2) Ets-1 was in stromal layers of amniochorionic membranes and in both cytoplasm and nuclei of trophoblast, which were shown with diffuse intracellular positive granularities (brown-yellow) clearly. No expression of Ets-1 was observed in amniotic epithelial cells. (3) The expression of Ets-1 protein was 0.552±0.018 in preterm labor group, 2.853±0.174 in PPROM group, 0.538±0.042 in term labor group, 2.731±0.090 in TPROM group and 0.214±0.013 in control group, respectively. Ets-1 protein was significantly increased in the stroma of both PPROM and TPROM group than that in control group(P<0.05). However, no remarkable different expression of Ets-1 was observed between preterm and term labor group,so was that between PPROM and TPROM group(P> 0.05). Conclusion Transcription factor Ets-1 is expressed in human amniochorionic membranes and it could be up-regulated in PROM.

Objective To investigate the value of laparoscopy in the diagnosis and treatment of unexplained chronic abdominal pain.Methods From January 2014 to February 2016, clinical data of 56 unexplained chronic abdominal pain undergoing laparoscopic surgery were analyzed retrospectively.Laparoscopic exploration was performed firstly and then the corresponding abnormalities were diagnosed and dealt with accordingly.Results The disease causes were explicit in 48 cases (85.7%), including 25 cases of abdominal adhesions, 8 cases of chronic appendicitis, 2 cases of small intestinal diverticulum, 2 cases of intestinal tuberculosis, 2 cases of lymphoma, 5 cases of endometriosis, 2 cases of tubal adhesions, 1 case of peritoneal metastasis of gastric cancer after surgery, and 1 case of appendiceal mucinous adenocarcinoma.Surgical treatment was performed in 43 cases, 3 of whom were converted to laparotomy.There were no postoperative complications in the 56 cases.The follow-up rate was 92.9% (52/56), and lost of follow-up was in 4 cases.The follow-up duration was from 3 months to 3 years (median, 19.4 months).There was 1 death case (peritoneal carcinomatosis).There were 35 cases (62.5%) of complete relief of abdominal pain (no recurrence of preoperative abdominal pain symptoms) and 12 cases (21.4%) of pain relief (preoperative pain decreased or interval extended).The total effective rate was 83.9% (47/56).Conclusion Laparoscopy is of high value in the diagnosis and treatment of unexplained chronic abdominal pain.

Objective　The effects of endotoxemia on hepatic energy metabolism and hepatic tissue blood flow were studied on the rats with obstructive jaundice.Methods　 After biliary obstructed and decompressed the rats were injected endotoxin,then hepatic tissue blood flow and energy metabolism were determined.Results　Hepatic blood flow decreased and hepatic energy metabolism lowered in rats with obstructive jaundice.Hepatic blood flow decreased markedly and hepatic energy metabolism lowered further due to endotoxemia. Afeter 4 weeks of jaundice hepatic energy metabolism did not recover.Conclusion　The decrease in hepatic tissue blood flow affected notably hepatic energy metabolism in obsturctive jaundice.When obstructive jaundice with endotoxemia happened,hepatic tissue blood flow markedly deceased and energy metabolism lowered further.

Objective To observe the effect of community rehabilitation on the motor function and activities of daily living(ADL)of stroke patients.Methods 155 stroke patients were randomly divided into the exercises group(n=76)and control group(n=79)and evaluated with simple Fugl-Meyer Assessment(FMA),Modified Barthel Index(MBI)and Functional Comprehensive Assessment(FCA)before treatment and 1 and 3 months after treatment.Results The evaluations of FMA,MBI and FCA were not different between two groups before treatment.One month later,the scores of MBI and FCA of the exercises group improved significantly(P<0.01),but simple FMA not improved even to 3 months after treatment(P>0.05).In the control group,the simple FMA score not improved(P>0.05),the scores of MBI and FCA had a declined tendency with disease course prolong.Conclusion The effect of community rehabilitation on the motor function of stroke patients during convalescence is not significant,but community rehabilitation may improve ADL and the quality of life.

Objective Carry out the reform of the online learning mode of prehospital training for refresher doctors , and evaluate the effect of reform in Peking Union Medical College Hospital .Methods An exploration was carried out on the refresher doctors prehospital training mode from traditional classroom teaching to online learning , Estab-lished the online learning system .Evaluated the effect of online learning by the way of questionnaire investigation andreexaminationamong289refresherdoctors.Results 289refresherdoctorshavecompletedthestructuredon-line courses of prehospital training , and the average pass rate of the first test was 42.2%.The questionnaire and retest was conducted , A total of 262 doctors completed the work , The recovery rate was 90.7%, and the average pass rate of retest was 74.9%, showing improvement by 32.7%.Conclusions Online learning mode is an effec-tive tool for knowledge dissemination , and has a better learning effect .

目的探索康复治疗专业学生社区实习基地规范带教方法和教学管理模式。方法对43名康复治疗专业学生进行问卷调查。结果绝大多数学生对社区康复教学的必要性表示肯定。超过半数学生对教学模式、内容比较满意，但教学效果的满意度低于教学模式及内容。社区康复教学在培养学生服务态度、沟通能力、操作能力方面有优势，在培养学生创造性思维能力、分析归纳能力、激发兴趣性存在明显不足。结论需要将三级医院康复的技术力量与社区康复教学纵向整合，摸索社区康复教学模式，不断提高社区康复师资水平。