OBJECTIVETo illustrate the morphological characteristics of atherosclerotic lesions of the internal carotid artery.

METHODSThe morphological characteristics of cervicocerebral atherosclerotic lesions in digital subtracted angiography were retrospectively reviewed in 120 cases.

RESULTSTotally 217 atherosclerotic lesions were detected. Of all the lesions, moderately and severely stenosed lesions accounted for 62.21% and mild stenosed lesions for 37.79%; long lesions were found in 18.89% and short ones in 81.11%; 37.33% of the lesions were ulcerated while 62.67% were non-ulcerated; 13.36% were angulated lesions and 86.64% non-angulated; 50.23% were eccentric lesions and 49.77% were concentric; lesions with adjacent artery dilation were found in 9.22%, and lesions without with adjacent artery dilation in 90.78%.

CONCLUSIONThe atherosclerotic lesions are characterized by moderate to severe stenosis and non-ulcerated, non-angulated, eccentric lesions without adjacent artery dilation.

Adult ; Aged ; Aged, 80 and over ; Angiography, Digital Subtraction ; methods ; Atherosclerosis ; diagnostic imaging ; pathology ; Carotid Artery, Internal ; diagnostic imaging ; pathology ; Carotid Stenosis ; diagnostic imaging ; pathology ; China ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVESTo investigate the relationship between the epithelial growth factor receptor (EGFR) mutation status and clinicopathological factors, and to analyze the mutation on the effect in non-small cell lung cancer (NSCLC) after surgery.

METHODSThe NSCLC patients who were resected and detected EGFR gene from March 2009 to March 2011 were retrospectively reviewed. The relationship between EGFR mutation status and clinicopathological factors, tumor markers, prognostic was analyzed.

RESULTSThe mutation and the wild group had 169 and 214 patients respectively. EGFR mutation in female, non-smoking, adenocarcinoma and less than 60 years old accounted for 63.91%, 61.54%, 88.76% and 62.13% with statistical significance compared with male (χ(2) = 53.490, P = 0.000), smoking (χ(2) = 48.568, P = 0.000), non-adenocarcinoma (χ(2) = 105.560, P = 0.000) and more than 60 years old (χ(2) = 6.057, P = 0.017). Disease free survival (DFS) of the wild group was better than mutation group (χ(2) = 11.329, P = 0.001). In addition, there were some relations between mutation status and excision repair cross complementing (ERCC1) protein, carcinoembryonic antigen (CEA), squamous cell carcinoma (SCC) and Cyfra21-1. ERCC1(+) (χ(2) = 6.739, P = 0.012), SCC(χ(2) = 16.839, P = 0.000) and Cyfra21-1(χ(2) = 6.638, P = 0.013) more than normal value was common in wild group. Increased CEA was common in mutation group (χ(2) = 5.436, P = 0.023).

CONCLUSIONSEGFR mutation is commonly found in female, non-smoking, adenocarcinoma and less than 60 years old NSCLC patients. The wild group obtains better DFS than mutation group. Tumor markers may predict the mutation status, which need further research.

Carcinoma, Non-Small-Cell Lung ; genetics ; mortality ; pathology ; Disease-Free Survival ; Female ; Humans ; Lung Neoplasms ; genetics ; pathology ; surgery ; Male ; Middle Aged ; Mutation ; Prognosis ; Receptor, Epidermal Growth Factor ; genetics ; Retrospective Studies

Background Biomaterials for corneal tissue engineering must demonstrate several critical features for potentialutility invivo, includingtransparency, mechanicalintegrity, biocompatibilityand slow biodegradation. Silk film biomaterial had been characterized to meet these functional requirements. ObjectiveThis study was to investigate the feasibility of physico-crosslink regenerated silk fibroin film as tissue engineered corneal scaffold. MethodsHuman corneal epithelial cells(CECs) links were cultured by regular method and CECs in logarithmic phase were than incubated on physico-crosslink regenerated silk fibroin film membrane. The shape of cultured human CECs was observed after 24,48 and 72 hours under the inverted microscope and scanning electron microscope( SEM ) ,and the CECs were cultured on culture plates as controls. The growth state of CECs on regenerated silk fibroin film was observed daily for 7 days by MTT, and cell cycle analysis and the presence of apoptosis of human CECs were examined by flow cytometry after incubation on regenerated silk fibroin film. Regenerated silk fibroin filmCECs (4 mm×3 mm) were implanted into the corneal stroma of the right eyes of New Zealand white rabbits. At the end of 4 and 8 weeks after implantation, the appearance of the ocular surface was examined using slit lamp and corneal neovascular area was measured. Corneal histopathological examination was carried out to assess the degradation of graft materials and immunohistochemistry was performed to detect the expression of CD34 in the corneal tissue after operation. ResultsThe morphology and structure of CECs were identical using the two cultured Methods when observed under the inverted microscope and SEM after 24,48 and 72 hours. No significant difference was found in the A490 value 1,2,3,4,5,6 or 7 days after incubation on regenerated silk membrane and in culture plates ( Fmethod =0. 641 ,P＞0.05 ). The apoptosis rates of CECs on regenerated silk membrane or culture plates were 1.8％ and 2.0％ and the amount of cells in G2/G1 phase was 1. 956 and 1. 945, respectively. Histopathological examination showed that the regenerated silk membrane material degraded and was replaced by regular collagen tissue 2 months after implantation,and the presence of neovascular area and inflammatory cells were less prominent in 2 months than 1 month post-implantation. The expression level of CD34 in corneal tissue was evidently lower 1 and 2 months after operation than the Ad-VEGF165-induced positive control group (P＜0. 05), and no significant differences were seen when compared with normal CECs(P＞0.05). ConclusionsPhysico- crosslink regenerated silk fibroin film is an excellent biomaterial for tissue engineered corneal scaffold with good biocompatibility.

OBJECTIVETo compare the biomechanical performances of different wires and cable fixation devices in posterior instrumentation for atlantoaxial instability, and test the effect of different fixation strengths and fixation approaches on the surgical outcomes.

METHODSSix specimens of the atlantoaxial complex (C0-C3) were used to establish models of the normal complex, unstable complex (type II odontoid fracture) and fixed complex. On the wd-5 mechanical testing machine, the parameters including the strength and rigidity of anti-rotation, change and strength of stress, and stability were measured for the normal complex, atlantoaxial instability complex, the new type titanium cable fixation system, Atlas titanium cable, Songer titanium cable, and stainless wire.

RESULTSThe strength and rigidity of anti-rotation, change and strength of stress, stability of flexion, extension and lateral bending of the unstable atlantoaxial complex fixed by the new double locking titanium cable fixation system were superior to those of the Songer or Atlas titanium cable (P<0.05) and medical stainless wire (P<0.05). Simultaneous cable fastening on both sides resulted in better fixation effect than successive cable fastening (P<0.05). Better fixation effect was achieved by fastening the specimen following a rest (P<0.05).

CONCLUSIONSThe fixation effects can be enhanced by increased fastening strengths. The new type double locking titanium cable fixation system has better biomechanical performance than the conventional Songer and Atlas titanium cables. Fastening the unstable specimens after a rest following simultaneous fastening of the specimen on both sides produces better fixation effect.

Atlanto-Axial Joint ; physiopathology ; surgery ; Biomechanical Phenomena ; Bone Wires ; Cadaver ; Humans ; Internal Fixators ; Joint Instability ; physiopathology ; surgery ; Orthopedic Fixation Devices

The gene xynA encoding xylanase was cloned from Streptomyces olivaceoviridis A1. The xynA with and without origin signal peptide sequence were fused behind pel B signal peptide in the plasmid pET-22b(+) respectively, then transfered into the host E. coli. The xylanase expressed in E. coli had normal bioactivity. Further, the xynA without origin signal peptide sequence was cloned into the plasmid pPIC9 under the control of AOX1 promoter and introduced into the host Pichia pastoris by electroporation. The results of SDS-PAGE and activity assay of the xylanase expressed by recombinant P. pastoris showed that the xynA had been overexpressed and secreted, and the xylanase expressed had normal bioactivity. The expression level of xylanase in recombinant P. pastoris exceeded 0.2mg/mL in shake culture.
Bacterial Proteins ; genetics ; metabolism ; Electrophoresis, Polyacrylamide Gel ; Electroporation ; Endo-1,4-beta Xylanases ; genetics ; metabolism ; Escherichia coli ; genetics ; metabolism ; Models, Genetic ; Pichia ; genetics ; metabolism ; Promoter Regions, Genetic ; genetics ; Streptomyces ; enzymology ; genetics

Objective:To evaluate the efficiency of thoracic endovascular aortic repair (TEVAR) in dealing with abdominal aortic branch malperfusion based on the analysis of aortic computed tomography angiography (CTA) images in pre-and post-TEVAR.Methods:Retrospective analysis from September 2015 to March 2016 in single institution to 32 patients,diagnosed as Stanford B aortic dissection with abdominal aortic branch malperfusion,CTA images in pre-and post-TEVAR were collected.Based on the aortic branch malperfusion pattern redefined by Nagamine,we identified and characterized branch malperfusion pattern for four abdominal aortic branches (celiac trunk,superior mesenteric artery,bilateral renal artery) in statistical analysis.Results:In the four abdominal aortic branches (total 128 branches),86 branches (67.2％) expressed with Class Ⅰ patterns,in which subtype Ⅰ-b presented with 0.8％,subtype Ⅰ-c with 5.5％;14 branches (10.9％) expressed with Class Ⅱ patterns,in which subtype Ⅱ-b-1 with 3.9％,subtype Ⅱ-b-2 with 3.1％;16 branches (12.5％) expressed with Class Ⅲ patterns,all with subtype Ⅲ-a,no subtype Ⅲ-b and Ⅲ-c presented.The remaining 12 branches were normal.The 100％ successful rate of TEVAR obtained in 32 patients performed.The mean following-up was 4 months.Aortic CTA showed that among the 14 "high-risk" abdominal aortic branch malperfusion,13 (92.9％) with obvious branch malperfusion in post-TEVAR were observed to improve,and the remaining one branch malperfusion (7.1％) was observed to change from subtype Ⅰ-b to Ⅰ-c.Conclusion:Few ratios in abdominal aortic branches suffered with obvious malperfusion complicated by Stanford B aortic dissection.For branches with "high-risk" malperfusion pattern,optimal changes were observed in abdominal aortic branch without revascularization in post-TEVAR,as well other branches with non-" high-risk" pattern perfusion were mostly stable in post-TEVAR.It could be of profound benefit to extend branch malperfusion patterns redefined by Nagamine in clinical practice to assess aortic dissection and in further guide for revascularization or not.

Objective To explore application on improving basic knowledge of clinical scientific research based on PDCA circle in the standardized training of pediatrics residents and to provide scientific basis for improving the capability of clinical scientific research in standardized training of pediatrics residents. Methods Based on previous research results, the training courses of improving the capability of clinical scientific research based on conception of PDCA were practiced . The examination of basic knowledge of clinical scientific research before and after training and satisfaction questionnaire in pattern, contents , time arrangements as well as effect of training courses were conducted among 22 pediatrics residents from April to July, 2017. Data were analyzed using Mean, Standard deviation and proportion for description and the data before and after training were given a independent-sample t test. The training courses were taken for 3 months. Results ①Compared with the training courses before, the average scores of basic knowledge in capability of clinical scientific research were improved after training [(54.14±23.06) vs. (73.63±21.05)]. ②Insufficiency of some basic clinical scientific research knowledge still existed and there was no statistical difference between the results before and after the training in those areas. ③ In the standardized training, pediatrics residents were satisfied with the pattern, contents and results of training courses, except for the time arrangement. Conclusion The training courses based on PDCA circle can significantly improve the capability of clinical scientific research in the standardized training of pediatrics residents.

Objective:To understand the clinical research knowledge, attitude and practice of pediatrics residents in standardized residency training, and to provide scientific basis for improving their capability of clinical medical scientific research.Methods:A self-complied questionnaire survey including demographic information, knowledge and attitudes toward capability of medical scientific research as well as personal interview was conducted in 22 pediatric residents during the standardized residency training from April to July, 2017. Data were analyzed by (mean±standard deviation) and percentage for description, and qualitative data were analyzed by classification and induction. SPSS 18.0 was used to analyze the data.Results:Firstly, the total score of basic knowledge in clinical scientific research was (54.14±23.06), with the scores between 31 and 60 being the most. Secondly, all these residents believed that capability of clinical medical scientific research was very important for them and clinical research training was necessary for them during the standardized residency training. Thirdly, the residents had the scientific research practices but no article published during the standardized residency training. Fourthly, the residents hoped to improve their capability of clinical scientific research by various means during the training.Conclusion:It is indicated that basic knowledge on capability of clinical medical research is still insufficient in standardized residency training of pediatrics residents, so relevant measures should be taken to cultivate their capability of clinical scientific research.

Male infertility is a common and complex disease in urology and andrology, and for many years there has been no effective surgical treatment. With the emergence of microsurgery and assisted reproductive medicine (IVF/ICSI), rapid development has been achieved in the treatment of male infertility. The Center for Male Reproductive Medicine and Microsurgery at Weill Cornell Medical College of Cornell University has been playing an important leading role in developing microsurgical techniques for the management of male infertility. The development of microsurgical treatment of male infertility in China has experienced the 3 periods of emerging, making, and boosting ever since its systematic introduction from Weill Cornell Medical College 15 years ago. At present, many Chinese hospitals have adopted microsurgery in the management of male infertility, which has contributed to the initial establishment of a microsurgical treatment system for male infertility in China. However, some deficiencies do exist concerning microsurgical treatment of male infertility, as in normalized technical training programs for competent surgeons, unified criteria for evaluation of surgical outcomes, and detailed postoperative follow-up data. This article presents an overview on the 15-year development of microsurgical management of male infertility in China, points out the existing deficiencies, and offers some propositions for the promotion of its development.
China ; Humans ; Infertility, Male ; surgery ; Male ; Microsurgery

OBJECTIVE: To investigate the current status of antibiotic use for very and extremely low birth weight (VLBW/ELBW) infants in neonatal intensive care units (NICUs) of Hunan Province. METHODS: The use of antibiotics was investigated in multiple level 3 NICUs of Hunan Province for VLBW and ELBW infants born between January, 2017 and December, 2017. RESULTS: The clinical data of 1 442 VLBW/ELBW infants were collected from 24 NICUs in 2017. The median antibiotic use duration was 17 days (range: 0-86 days), accounting for 53.0% of the total length of hospital stay. The highest duration of antibiotic use was up to 91.4% of the total length of hospital stay, with the lowest at 14.6%. In 16 out of 24 NICUs, the antibiotic use duration was accounted for more than 50.0% of the hospitalization days. There were 113 cases with positive bacterial culture grown in blood or cerebrospinal fluid, making the positive rate of overall bacterial culture as 7.84%. The positive rate of bacterial culture in different NICUs was significantly different from 0% to 14.9%. The common isolated bacterial pathogens Klebsiella pneumoniae was 29 cases (25.7%); Escherichia coli 12 cases (10.6%); Staphylococcus aureus 3 cases (2.7%). The most commonly used antibiotics were third-generation of cephalosporins, accounting for 41.00% of the total antibiotics, followed by penicillins, accounting for 32.10%, and followed by carbapenems, accounting for 13.15%. The proportion of antibiotic use time was negatively correlated with birth weight Z-score and the change in weight Z-score between birth and hospital discharge (r=-0.095, -0.151 respectively, P<0.01), positively correlated with death/withdrawal of care (r=0.196, P<0.01). CONCLUSIONS Antibiotics used for VLBW/ELBW infants in NICUs of Hunan Province are obviously prolonged in many NICUs. The proportion of routine use of third-generation of cephalosporins and carbapenems antibiotics is high among the NICUs.
Anti-Bacterial Agents ; Birth Weight ; Humans ; Infant ; Infant, Extremely Low Birth Weight ; Infant, Newborn ; Intensive Care Units, Neonatal ; Surveys and Questionnaires