Objective To compare the efficacy of mechanical ventilation (MV) with low tidal volume (LTV) plus positive expiratory end pressure (PEEP) and conventioal MV in the treatment of traumatic acute respiratory distress syndrome(ARDS). Methods From Oct 1997 to Oct 2003, 26 cases of traumatic ARDS patients were treated by conventioal MV(group A, n=11) or MV with LTV plus PEEP(group B,n=15), and clinical data of the patients were recorded and compared. Results There were no statistical difference in the PaO 2 of blood gas analysis and hemodynamic indices between the two groups, while the PaCO 2 was higher in group B than that in group A(P

This article shared opinions on how to effective educate clinical type postgraduates in department of neurosurgery based on the teaching models in the first affiliated hospital of Chongqing medical university. In the proposed training program,medical ethics education and comprehensive training including clinical thinking and practical skills training should be emphasized.Scientific inquisitiveness of the neurological research and the writing and oral communication in English should also be promoted.This training program will be fully committed to produce highly qualified,ethical and caring neurosurgeons for future needs of the society.

Objective To examine the iron content and the expression of hepcidin in early period after subarach-noid hemorrhage (SAH) in rats, and to explore the role of hepcidin in dysregulation of brain iron metabolism after SAH. Methods Totally 90 adult male SD rats were randomly divided into two groups:the sham-operation group and SAH group. The SAH model was established by single blood injection to prechiasmatic cistern. Immunohistochemical and Western Blotting were used to examine the expression of hepcidin at 12, 24, 48 and 72h after SAH. Meanwhile, Atomic Absorption Spectrometer was used to detect the iron content. Results Immunochemistry showed that hepcidin expression in rats in SAH group began to rise at 12 h(0.30±0.06)and gradually increased over time until 72 h(0.56±0.07)compared with the sham group(0.19±0.05). The expression of hepcidin was significantly higher in SAH group than in the sham group(F=31.911, P<0.05). Western blot showed that hepcidin expression in rats in SAH group began to rise at 12h(0.481±0.065) and gradually increased over time until 72h(1.627±0.143)Compared with the sham group(0.238±0.047). The expression of hepcidin was significantly higher in SAH group than in the sham group after SAH(F=147.314,P<0.05). Iron content in SAH group began to rise at 12h after SAH(58.50±9.19)and gradually increased until 72 h(99.34±7.68). The iron con-tents in SAH group were higher at every time points than those in sham group(43.51±4.59)(F=28.799,P﹤0.05). The ex-pression of hepcidin was correlated with the iron content in SAH group(r=0.914,P﹤0.01). Conclusion The increase in iron content following SAH is associated with the increased hepcidin expression.

AIM: To determine EGF contents in human milk, frech cow's milk and cow's milk-based infant formulas and the relationship between EGF content of human milk and neonatal maturity.METHODS: EGF contents in 57 human colostrum from mothers delivering prematurely and at term, 4 different fresh cow's milk and 8 different cow's-milk-based infant formulas with hydrolyzed and non-hydrolyzed proteins were determined by radioimmunoassay (RIA). RESULTS: Human milk from mothers of premature infants had higher EGF content compared to that from mothers of term infants[(28.2?10.3) nmol/L vs(17.3?9.6) nmol/L]. There was a negative correlation between EGF content of human milk and gestational age, birth weight of neonates. The values in fresh cow's milk [(16.6?3.8) nmol/L]were similar to that in human term milk. The contents in non-hydrolyzed protein formulas[(7.5?1.9) nmol/L]were much lower than that in human milk and fresh cow's milk. No immunoreactive EGF was detected in all hydrolyzed protein formulas. CONCLUSION: The occurrence of high EGF concentration in premature milk may represent a maternal compensatory mechanism to accelerate the growth and maturation in immature infants. Lack of EGF in formulas suggests that they may not suitable for those newborns with immature or damaged gastrointestinal tract.

Objective To explore the postgraduate tutor assessment system in order to provide suggestions to improve the quality of postgraduate education. Methods Assessment indexes of post-graduate tutor were screened and assigned by methods of questionnaire investigation, interview, kruskal wallis H-test, taking a total of 109 students and professors in medical colleges in the south-western part as research objects. Results Different populations had different cognitions on the important degree of each index, P<0.05. Primary indexes of assessment system were determined based on the importance of indicators and the influence of different cognitive levels, including tutor personal accom-plishment, teaching ability, scientific research quality and guiding ability (P<0.05). Conclusions Assessment system and method fined by this study covers majority aspects of tutors and can provide feasible suggestions for tutor evaluation.

OBJECTIVE: To investigate the significance and relationship between the expression of FOXC1 and clinicopathological features, and to explore its correlation with E-cadherin. METHOD: Immunohistochemical SP method was used to detected the expression of FOXC1 in nasopharyngeal carcinoma tissues and nasopharyngitis tissues. RESULT: (1) Immunoreaction to FOXC1 was mainly located in nucleus of nasopharyngeal carcinoma cells. The positive expression rate of FOXC1 in nasopharyngeal carcinoma tissues was 85.3% (81/95), which was significantly higher than that in nasopharyngitis tissues (59.4%) (P < 0.05). (2) The expression of FOXC1 was not related to patients' age and gender, clinical stage of cancer and lymph node metastasis (P > 0.05). (3) There was a correlation between the expression of FOXC1 and down-regulated expression of E-cadherin in nasopharyngeal carcinoma tissues (P < 0.05). CONCLUSION FOXC1 may play an important role in generation and progression of nasopharyngeal carcinoma, there may be a correlation between the expression of FOXC1 and down-regulated expression of E-cadherin, also FOXC1 may play an important role in the process of EMT in nasopharyngeal carcinoma by regulating E-cadherin.
Adolescent ; Adult ; Aged ; Antigens, CD ; Cadherins ; metabolism ; Carcinoma ; Female ; Forkhead Transcription Factors ; metabolism ; Humans ; Male ; Middle Aged ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; metabolism ; pathology ; Nasopharyngitis ; metabolism ; Young Adult

OBJECTIVETo explore the value of 3D printing technique in the surgical management and strategy of rehabilitation therapy of acetabular fracture.

METHODSFor a patient with acetabular fracture, the pelvis model was printed preoperatively by 3D printing technique for surgical simulation to determine the optimal position of the screw, measure the screw length, and design the route of screw entry. Laparoscopic assisted internal fixation was performed, and a gradual and systematic rehabilitation plan was carried out after the surgery based on the results of simulation.

RESULTSThe operation was completed successfully with a shortened postoperative recovery time.

CONCLUSIONSThe application of 3D printing allows more accurate and safer surgical management of acetabular fracture to promote postoperative recovery of the patient and lower the medical costs.

Adult ; Bone Screws ; Fracture Fixation, Internal ; methods ; Hip Fractures ; rehabilitation ; Humans ; Imaging, Three-Dimensional ; Male ; Postoperative Period ; Printing, Three-Dimensional ; Rehabilitation ; instrumentation ; methods

Objective To compare the clinical efficacy and safety of nilotinib and imatinib as frontline therapy in newly diagnosed patients with chronic myeloid leukemia in chronic phase ( CML-CP ) . Methods Until December 31st 2016, 18 patients using nilotinib and 83 using imatinib were recruited in our study.The efficacy and safety of two groups were evaluated .Results A total of 101 patients with CML-CP included 18 receiving nilotinib and 83 imatinib.The optimal response rates at 3, 6, 12 and 18 months in nilotinib and imatinib group were 88.9%(16/18) vs 57.3%(47/82) (P=0.012), 82.4%(14/17) vs 55.7%(44/79) (P=0.041), 9/12 vs 63.9% (39/61) (P=0.460), 6/9 vs 68.9% (31/45) (P=0.896) respectively.The optimal response rates by 3 months in low sokal risk group on nilotinib and imatinib were 9/9 vs 76.5%(26/34) (P=0.107), in intermediate and high sokal risk group were 7/8 vs 45.2%(14/31) (P=0.032).At the end of follow-up, the rate of major molecular response (MMR) in nilotinib group was 72.2%, which was higher than 56.6% in imatinib group (P=0.021).The rate of complete cytogenetic response ( CCyR ) in nilotinib group was 100%, which was higher than 71.1% in imatinib group (P =0.002).Progression free survival (PFS) rates in nilotinib and imatinib groups were 94.4%and 98.8%(P=0.019) respectively; whereas event free survival (EFS) rates were 88.9% and 48.2%(P=0.045).The incidence of drug related adverse reactions in nilotinib and imatinib was similar with only minor proportion of grade 3/4 adverse reactions .Conclusions Nilotinib achieves a deeper molecular response in a shorter time than imatinib in newly diagnosed patients with CML-CP, especially in patients with high risk outcome .Good safety is obtained in both groups so as to ensure a long-term administration and improving prognosis .

Objective: To evaluate the diagnostic value and feasibility of narrow-band imaging in detection of recurrent nasopharyngeal carcinoma (NPC). Methods: One thousand three hundred and sixty-four NPC patients who had completed NPC treatment were enrolled. All patients were followed-up with imaging, serological examination of EB virus and nasopharyngeal endoscopy(WL and NBI mode), in which (1) both white light (WL) and NBI modes were done; (2) positive endoscopic patients were given nasopharyngeal biopsy; (3) using histologic finding as criterion standard, the sensitivity, specificity, accuracy and Yonden′s index of two modes were compared. Kappa index was used to evaluate the consistency between the two modes and pathological results respectively; (4) the positive rates of WL and NBI in patients with early recurrent (stage Ⅰ+ Ⅱ) were compared. Results: A total of 265 cases were suspected as having recurrent lesions by endoscopy in WL mode and 68 cases of them were pathologically diagnosed as having NPC; and 82 cases were suspected as having recurrent lesions by endoscopy in NBI mode and 74 cases of them were pathologically diagnosed as having NPC. The sensitivity, specificity, accuracy and Yonden′s index of WL mode were 91.89%, 0, 25.09% and -0.0811, respectively, with a kappa of -0.045; the sensitivity, specificity, accuracy and Yonden′s index of NBI mode were 100.00%, 95.94%, 97.05% and 0.9594, respectively. Conclusion NBI has higher sensitivity, specificity, early diagnosis rate and Yonden′s index than WL.

Objective: To investigate the efficiency and safety of domestic tyrosine kinase inhibitor (TKI) dasatinib (Yinishu) as second-line treatment for patients with chronic myeloid leukemia in chronic phase (CML-CP). Methods: A retrospective analysis of clinical data of CML-CP patients who received domestic dasatinib as second-line treatment in the CML collaborative group hospitals of Hubei province from March 2016 to July 2018 was performed. The optimal response rate, the cumulative complete cytogenetic response (CCyR), the cumulative major molecular responses (MMR), progression free survival (PFS), event free survival (EFS) and adverse effects (AEs) of the patients were assessed at 3, 6 and 12 months of treatment. Results: A total of 83 CML-CP patients were enrolled in this study. The median follow-up time was 23 months. The optimal response rates at 3, 6 and 12 months in 83 CML-CP patients treated with dasatinib were 77.5% (54/71), 72.6% (61/75) and 60.7% (51/69), respectively. By the end of follow-up, the cumulative CCyR and MMR rates were 65.5% (55/80) and 57.1% (48/73), respectively. The median time to achieving CCyR and MMR was 3 months. During follow-up time, the PFS rate was 94.0% (79/83) and the EFS rate was 77.4% (65/83). The most common non-hematological AEs of dasatinib were edema (32.5%), rash itching (18.1%) and fatigue (13.3%). The common hematological AEs of dasatinib were thrombocytopenia (31.3%), leukopenia (19.3%) and anemia (6.0%). Conclusion Domestic dasatinib was effective and safe as the second-line treatment of CML-CP patients and it can be used as an option for CML-CP patients.