Medicine is a practical application subject,so medical students should conduct numerous clinical practice to improve operation skills and clinical diagnosis ability The ability of clinical practice is one of most important indicators to evaluate medical education quality.In recent years,medical students have been affected by many kinds of adverse factors,such as new doctor-patient relationship,the medical reform and employment pressure and so on.All these adverse factors will bring a great challenge to the dental clinical teaching.In the new medical situation we need urgently to solve the problems to guide students to improve clinical practice ability and cultivate qualified dental professionals

The hepatocellular carcinoma (HCC) is one of the most common malignant tumors.Patients with hepatobiliary cancer suffer from multiple symptoms,such as physical symptoms and psychology symptoms.In recent years,along with the further research of symptoms,the concept of symptom clusters occurred.Those two issues have always been the hot topics in recent years.Through the efforts of experts at home and abroad,there has been a part of progress in this area.However,the results are not the same.There are lots of disputes in the numbers、sequence、incidences of the symptom clusters.The paper will discuss this issue from symptom experience and symptom clusters in order to provide the reference and basis for symptom management.

Objective:To investigate the expression and clinical significance of Ang-2 and MMP-7 protein in laryngeal carcinoma tissue.Method:Immunohistochemical technique was used to detect the expression of Ang-2 and MMP-7 protein in 65 tissues of laryngeal carcinoma and 34 biopsies of adjacent non-cancerous tissue. The relationship between the expression of Ang-2 and MMP-7 and invasion, metastasis or prognosis in laryngeal carcinoma tissue was analyzed.Result:The positive rates of Ang-2 and MMP-7 were significantly higher in laryngeal carcinoma tissue than those in adjacent non-cancerous tissue(P＜0.05).The level of Ang-2 and MMP-7 expression had no significant correlations with the age and course as well as the smoking, drinking, histological differentiation of carcinoma and clinical classification (P＞0.05).While the expression of Ang-2 significantly differed between patients with different T stage and clinical stage(P＜0.05), and the expression of MMP-7 was notably correlated with the T stage,clinical stage and lymph node metastases (P＜0.05).There was a correlation between the expression of Ang-2 and MMP-7 (P＜0.05).The Kaplan-Meier survival analysis showed that patients with positive expression of Ang-2 had worse overall survival(P＜0.05).However,MMP-7 expression was not related to overall survival or disease-free survival (all P＞0.05).Cox regression analysis indicated that Ang-2 and MMP-7 expression were independent prognostic factors of laryngeal carcinoma.Conclusion:Overexpression of Ang-2 and MMP-7 was observed in laryngeal carcinoma and they might be served as an objective indicator for biological behaviour and prognosis.

Objective:To explore the expression of cyclooxygenase-2(COX-2) and S-100 positive dendritic cell in laryngeal carcinoma tissue and their clinical significance.Method:Sixty-five samples of laryngeal carcinoma and thirty-four biopsies of adjacent noncancerous tissue were obtained. Immunohistochemical technique(SP method) was used to detect the expression of COX-2 and S-100 positive dendritic cell, and the relationship of their expression with clinical pathological parameters and prognosis was analyzed.Result:The rates of COX-2 expression were 63.08%(41/65)and 14.70%(5/34)in laryngeal carcinoma and control group, respectively. The difference was significant(P＜0.05).The positive expression of COX-2 was correlated with T and clinical stage in laryngeal carcinoma(all P＜0.05).The rates of S-100 positive dendritic cell expression were 61.54%(40/65)and 0 in laryngeal carcinoma and control group, respectively. The difference was significant(P＜0.05).S-100 positive dendritic cells showed significant differences between early and late clinical stage and lymph node metastasis (all P＜0.05).Kaplan-Meier survival analysis showed that patients with positive expression of COX-2 and S-100 positive dendritic cell had worse disease-free and overall survival(P＜0.05).Cox regression analysis showed that S-100 positive dendritic cell was indicated as an independent prognostic factor for survival(P＜0.05).Conclusion:COX-2 and S-100 positive dendritic cell are highly expressed in laryngeal carcinoma tissue. It suggests that the expression of COX-2 and S-100 positive dendritic cell is related to the process of carcinogenesis and may be the important indicators in laryngeal carcinoma for prognosis.

BACKGROUND:Major abdominal vascular injury is a seldom serious complication during lumbar discectomy. Once occurring, it wil cause critical condition, and incorrect rescue and operation wil lead to patient’s death or functional disorder of the limbs. ＜br> OBJECTIVE:To explore the cause, diagnosis, prevention and treatment action for major abdominal vascular injury caused by lumbar discectomy. ＜br> METHODS:One case of common iliac artery injury caused by lumbar discectomy was reviewed in the aspects of diagnosis, prevention and treatment action. ＜br> RESULTS AND CONCLUSION:The case suffered from common iliac artery injury caused by lumbar discectomy of right L 4-5 vertebrae, and achieved successful rescue by timely diagnosis, surgical intervention and artificial blood vessel transplantation. Injury of the vessels is relevant with many factors, including surgical operation, anatomy, pathology, etc. Unexplained intervertebral hemorrhage accompanied with sudden drop of blood pressure during surgery hints the possible occurrence of major vascular injury. Accurate diagnosis and instant surgical intervention is the key to rescue the patient’s life.

OBJECTIVE To investigate the expression of Cyclooxygenase-2(COX-2)andVascular endothelial growth factor(VEGF)in laryngeal carcinoma tissue and its clinical significance. METHODS Sixty-five samples of laryngeal carcinoma and thirty-four biopsies of adjacent noncancerous tissue were immunohistochemically examined for expression of COX-2 and VEGF, whose relationship with clinicopathological parameters was also analysied. RESULTS Percentages of COX-2 and VEGF expression in laryngeal carcinoma tissue were 63.08% and 70.77% respectively, which were higher than those in adjacent noncancerous tissue(P

Objective:To study the inhibitory effect and anti-cancer mechanisms of adenovirus-mediated ING4 gene on the MG-63 osteosarcoma xenografts in nude mice.Methods:Ad-ING4 was transfected into QBI-293 cells and harvested.15 nude mice of the subcutaneous tumor models were established with MG-63 osteosarcoma cells and were randomly divided into PBS,Ad-GFP and Ad-ING4 groups.Then PBS(100 μl),Ad-GFP(100 μl,10~9pfu/ml) and Ad-ING4 (100 μl,10~9pfu/ml) for each one were given respectively QOD for 5 times,with intratumor injections.Tumor volume changes were monitored;and the 15 mice were sacrificed 2 weeks after treatment,the tumors were removed,weighed and ratios of tumor-suppression were calculated.The morphological changes of apoptotic tumor cells were observed under microscope.Bcl-2,Bax,Caspase-3,VEGF,CD34 expression was tested by immumohistochemistry.Results:High titer(10~9pfu/ml)adenoviral vector of ING4 gene were obtained.In nude mice bearing MG-63 osteosarcoma xenografts,the growth of MG-63 tumors treated by intratumoral injecting of Ad-ING4 was significantly suppressed,compared with PBS group and Ad-GFP group.The ratios of tumor weight-suppression of Ad-ING4 group was 59.3%(P＜0.05).Immumohistochemistry displayed that the expression of Bax,Caspase-3 was up-regulated and the expression of Bcl-2,VEGF,CD34 was down-regulated by Ad-ING4.Conclusion:Ad-ING4 can inhibit the growth of MG-63 osteosarcoma xenografts in nude mice,which may be via activating the apoptosis pathway and inhibiting tumor angiogenesis.

Objective To establish Ad-hLIF transgenic feeder cells for the expansion of umbilical cord blood CD34+ HSPC in vitro and study the SCID mice model of hematopoietic stem/progenitor cell (HSPC) transplantation. Methods The expression of objective gene in Ad-hLIF transgenic feeder cells was detected by RT-PCR and ELISA. The purity of umbilical cord blood CD34+ HSPC separated by magnetic-activated cell sorting(MACS) was detected by the flow cytometry. After expanded with various combinant of cytokines and transgenic feeder layer cells for 28 d, the quantity of mono-nuclear cell (MNC) and CD34+ cells rate was detected in different time. MNC after expansion stained by CFDA SE was injected to the sublethally irradiated SCID mice. Humanize gene Alu was detected by RT-PCR and fluorescence microscope. Results The green fluorescence was observed in the transgenic cells infected with 50MOI( multiplicity of infection) Ad-hLIF, and the objective gene was confirmed by RT-PCR and ELISA. The purity of umbilical cord blood CD34+ HSPC separated by MACS could reach 95.60% ±2.58%, Ad-hLIF transgenic feeder cells and various cytokines system increased MNC by 356.95±0.87 fold, and maximal expansion of CD34+ cells was observed during 0-14 d of culture, then down-expansion gradually. Four weeks after transplanted in SCID mice, fluorescently-labeled humanize cells still can be observed. The existence of the humanized gene Alu was confirmed by RT-PCR. Conclusion Ad-hLIF transgenic feeder cells can effectively proliferate umbilical cord blood CD34+ HSPC in vitro and delay it differentiate, what's more, it has high transplant efficacy and haematogenesis activity.

OBJECTIVE: To study the expression and significance of TNF-alpha, MMP-9 and their relationship with the infiltration of eosinophil granulocyte in nasal polyps. METHOD: The expression of TNF-alpha and MMP-9 was determined in tissues of nasal polyps from 30 patients(nasal polyps group) and in inferior turbinate mucosa tissues from 10 patients(control group) by in situ hybridization and immunohistochemical technique, and the number of eosinophil granulocyte was counted in the same tissue by HE staining. Their correlations with each other were also analyzed in the tissue of nasal polyps. RESULT: The number of TNF-alpha and MMP-9 positive cells and TNF-alpha positive blood vessels in nasal polyps were more than that in control group (P < 0.05). The number of both TNF-alpha positive cells and blood vessels had positive relationships with the number of eosinophil granulocyte, but there was only positive relationship between the number of MMP-9 positive cells and eosinophil granulocyte (P < 0.05). At the same time there was a positive relationship between the number of TNF-alpha and MMP-9 positive cells (P < 0.05). CONCLUSION TNF-alpha and MMP-9 may play an important role in the pathological mechanism of nasal polyps. TNF-alpha may induce the expression of MMP-9 and promote the migration of eosinophil granulocyte.
Adult ; Case-Control Studies ; Eosinophils ; pathology ; Female ; Humans ; Male ; Matrix Metalloproteinase 9 ; metabolism ; Middle Aged ; Nasal Mucosa ; metabolism ; pathology ; Nasal Polyps ; metabolism ; pathology ; Tumor Necrosis Factor-alpha ; metabolism

Building a professional clinical research team inside hospitals is in favor improving their research abilities,accelerating the clinical discipline construction,improving their comprehensive influence.Also it fits the objective of general hospital development under gate-keeping system.Now in domestic,the percentage of professional research staff in large hospitals accounts was much less than the international level.The main reasons included the misunderstanding of constructing the research-oriented hospitals,insufficient human resources enrollment,less attractive environment to the highlevel researchers and the absence of relevant degree training programs.To enhance the construction of research-oriented hospitals,it's of key importance to build the professional research team in hospitals.Besides,the hospital has to update management conception,broaden the channels of talent cultivation,grasp the development of the subject accurately and interact with the basic medicine and public health subject,increase the financial investment and perfect the relevant management regulations.