Objective To investigate the clinical features of small bowel Crohn's disease(CD).Methods From January 2009 to September 2012,a total of 138 patients diagnosed as CD who underwent examinations of colonoscopy,digestive tract radiography,capsule endoscopy,double-balloon enteroscopy and computed tomography (CT) enterography were enrolled.According to the Montreal Classification criteria,the disease was typed by the age at diagnosis,location of the lesions and behavior of the disease.The clinical symptoms,laboratory examinations,diagnostic methods and recurrence condition were also evaluated.Through the comparison of the clinical features of ileocolonic and colonic CD,the clinical features of small bowel CD were analyzed.Measurement data were analyzed with t-test,analysis of variance or non parametric test.Chi square test was performed for count data.Spearman's correlation analysis was used for correlation analysis and multivariate Logistic regression analysis was used for risk factors screening.Results A total of 62 (44.9％) cases were simple small bowel CD.Fifty-three patients (85.5％) were male,and the mean age at diagnosis was 35.3 years old.The age of 67.7％(42/62) of small bowel CD patients were less than 40 years old when diagnosed.The ratio of stricture in small bowel CD group (35.5％,22/62) was significantly higher than that of ileocolonic (18.8％,6/32) and colonic CD group (13.9％,5/36) (x2=6.594,P=0.037).Jejunal involvement was an independent risk factor for structure in CD (OR=3.481,95％ CI:1.250 to 9.693).The patients with obstructive symptoms as primary symptom in small bowel CD (38.7％,24/62) were more than those with colonic CD (16.7％,6/36) (x2 =5.210,P=0.022).However,patients with diarrhea as primary symptom in small bowel CD (21.0％,13/62) were less than those with ileocolonic (37.5％,12/32) and colonic CD (44.4％,16/36) (x2=6.512,P=0.039).Patients with two or more extraintestinal manifestations in small bowel CD (3.2％,2/62) were also significantly less than those with ileocolonic (15.6％,5/32) and colonic CD (19.4％,7/36) (x2=7.957,P=0.019).The score of CD activity index was generally low,and with no statistical correlation to serum inflammation markers such as C reaction protein.The average time duration between induction of remission and clinical recurrence of small bowel CD ((23.64 ± 17.08) months) was shorter than that of ileocolonic type ((35.07±29.84) months,t=-4.285,P=0.002) and colonic CD ((32.35 ± 28.46) months,t =-3.700,P =0.004).However,there was no significant difference in the rate of clinical recurrence between small bowel CD and ileocolonic,colonic CD.Conclusions Patients with small bowel CD account for a large proportion in patients with CD,especially in males.Stricture is more common in jejunum CD.The time duration between induction of remission and clinical recurrence of small bowel CD is short.

Objective To explore the Chinese medical students′attitudes towards communication skills learning .And their communication skills are assessed by themselves in this study .Methods The cross-sectional survey of 127 undergraduates was completed in Sichuan University .Students were evaluated using Communication Skills Attitude Scale(CSAS) and Scale of medical student′s doctor-patient communication behavior which had been published at home or abroad .Results The mean PAS score of 127 students was 51 .43 ,which was 18 .50 points higher statistically significant than the mean NAS score 32 .94 .And there were no difference between undergraduates and eight-year medical students ,also between female and male .95 .28% students agree that“learning the doctor-patient communication skills and learning clinical skills are equally important” .Concerning Scale of medical student′s doctor-patient communication behavior ,the mean score for 127 students was 104 .93(total score is 150) .The mean scores for male was higher than male(P=0 .008) ,but the mean score for undergraduates and eight-year students had no statistic differ-ences .Conclusion Medical students have positive attitudes towards communication skills and have low self-assessments ,and we should enhance the communication skills training .

Cervical cancer is one of the leading causes of death in women with malignancies worldwide.Brachytherapy plays an essential role in the radiation therapy for cervical cancer, and its combination with external beam radiation is indicated for previously untreated or recurrent cervical cancer at various stages without distant metastasis.Magnetic resonance imaging (MRI) has superior resolution of soft tissue, which allows for accurate delineation of target volume, protects organs at risk (OARs), and thus improves treatment outcomes.In recent years, many studies have demonstrated the feasibility and superiority of three-dimensional MRI-guided brachytherapy for cervical cancer.This article aims to elaborate on relevant MRI techniques, selection of applicators, delineation of target volume and OARs, evaluation of treatment plans, and the clinical effect of three-dimensional MRI-guided brachytherapy.

BACKGROUND: Repetitive brief and non-lethal cerebral ischemia can produce cumulative neuronal damage and vascular dementia; however, precisely injured patterns and mechanisms are still unclear. Thalamus is an important structure of learning and memory; meanwhile, it is also one of the selectively vulnerable regions of cerebral ischemia.However, there are a few reports about neuronal damage induced by repetitive cerebral ischemia.OBJECTIVE: To investigate the pathological damage and mechanism of neurons induced by repetitive cerebral ischemia in thalamus.DESIGN: Randomized controlled experimental study.SETTING: Department of Neurology, General Hospital of Chengdu Military Area Command of Chinese PLA.MATERIALS: The experiment was carried out at the Animal Central Laboratory of the Third Military Medical University of Chinese PLA from March to December 1999. A total of 72 healthy male Wistar rats were randomly divided into sham operation group, single cerebral ischemic group,repetitive cerebral ischemic group, MK-801 treatment group and saline group.METHODS: Transient global cerebral ischemia models of rats were established with modified Pulsinelli-4 vessel occluing method for single 15-minute ischemia and repetitive three 5-minute ischemia at hourly intervals,followed by 5 hours, 2 days and 4 days of survival. Rats in sham operation group were not treated with burning vertebral artery and clipping common carotid artery. 45Ca autoradiography and light microscopy were used to determine the calcium accumulation and neuronal pathological changes of thalamus following repetitive cerebral ischemia as compared with single cerebral ischemia. The effects of MK-801, a N-methyl-D-aspartate (NMDA)receptor antagonist, were also examined.MAIN OUTCOME MEASURES: Distribution and degree of calcium accumulation and neuronal damage in the thalamus of rats in each group.RESULTS: Sham-operated rats revealed no abnormal calcium accumulation and neuronal damage in the thalamus. At 5 hours following ischemia,slightly abnormal calcium accumulation was found in the partial thalamus of the repeated ischemic group, and the neuronal damage was also relatively severer than that in the single ischemic group (0.98±0.19, 0.60±0.14, P＞ 0.05). At 2 days after ischemia, obviously abnormal calcium accumula tion and neuronal damage were shown in thalamus, and the degree of calcium accumulation and score of neuronal damage in repeated ischemic group were significantly severer than that in single ischemic group (1.62±0.31, 0.88±0.21, P ＜ 0.01). At 4 days, the thalamus calcium accumulation and neuronal damage were further increased, and also that in repeated ischemic group was significantly severer than that in single ischemic group (1.80±0.21, 1.02±0.23, P ＜ 0.01), especially marked calcium accumulation and cumulative damage were shown in the ventral thalamus. MK-801 significantly relieved the abnormal calcium accumulation and neuronal damage in the thalamus in repeated ischemic group, showing significant protection of thalamus neurons as compared with that in saline-treated group (0.20±0.12, 1.80±0.15, P ＜ 0.01).CONCLUSION: Repetitive non-lethal cerebral ischemia results in an intense cumulative damage in the ventral thalamus, and the excitatory amino acid and Ca2+ may play a major role in it.

Objective To evaluate the diagnostic value of cerebrospinal lactate for the diagnosis of bacterial meningitis in patients post-neurosurgical operation (PNBM) with blood-contaminated cerebrospinal fluid (CSF). Methods A prospective observational study was conducted. 101 patients underwent neurosurgical operation and clinically suspected PNBM admitted to neurosurgical intensive care unit (NSICU) of the First Affiliated Hospital of Sun Yat-sen University from October 2015 to December 2016 were enrolled. Based on red blood cell quantitative test in CSF, the patients were divided into blood-contaminated and non blood-contaminated CSF groups. According to the PNBM diagnostic criteria of 2008 Centers for Disease Control and Prevention/National Healthcare Safety Network (CDC/NHSN), all patients were divided into PNBM group and non-PNBM group. The biochemical indexes levels in CSF were compared among the groups. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic power of CSF lactate for PNBM in blood-contaminated patients.Results A total of 101 suspected PNBM patients were enrolled. In 77 blood-contaminated CSF patients, 39 patients were diagnosed as PNBM (account for 50.6%); in 24 non-blood-contaminated patients, 12 patients were diagnosed as PNBM (account for 50.0%). ① In non-PNBM patients, the lactate level in blood-contaminated CSF was significantly higher than that of non-blood-contaminated CSF (mmol/L: 3.5±1.3 vs. 2.3±1.1,P < 0.01). In PNBM patients, there was no significant difference in lactate level between blood-contaminated CSF and non blood-contaminated CSF (mmol/L: 6.8±2.1 vs. 6.9±2.5,P > 0.05). ② In both blood-contaminated and non blood-contaminated CSF, white blood cell (WBC), protein and lactate levels in PNBM group were significantly higher than those in non-PNBM group [WBC (×106/L): 660.0 (67.5, 1105.0) vs. 41.0 (15.0, 142.5) in blood-contaminated CSF,168.0 (86.5, 269.5) vs. 34.5 (7.0, 83.5) in non-blood-contaminated CSF; protein (mg/L): 4757.8 (2995.2, 10219.8) vs. 1292.8 (924.2, 1936.2) in blood-contaminated CSF, 39247.3 (14900.6, 62552.2) vs. 1441.6 (977.3, 2963.9) in non blood-contaminated CSF; lactate (mmol/L): 6.8±2.1 vs. 3.5±1.3 in blood-contaminated CSF, 6.9±2.5 vs. 2.3±1.1 in non blood-contaminated CSF, allP < 0.05], and glucose and CSF glucose/blood glucose ratio in PNBM group were significantly lower than those in non-PNBM group [glucose (mmol/L): 2.5±1.2 vs. 4.4±1.6 in blood-contaminated CSF, 1.9±1.4 vs. 3.4±0.9 in non blood-contaminated CSF; CSF glucose/blood glucose ratio: 0.28±0.15 vs. 0.46±0.16 in blood-contaminated CSF, 0.24±0.16 vs. 0.45±0.11 in non blood-contaminated CSF, allP < 0.01]. ③ It was shown by ROC curve analysis that CSF lactate level was a good diagnostic parameter for PNBM both in blood-contaminated and non blood-contaminated CSF, and the area under ROC curve (AUC) was 0.91 and 0.97, respectively. When the cutoff value of lactate in non blood-contaminated CSF was 3.35 mmol/L, the sensitivity was 100%, and the specificity was 91.7%. When the cutoff value of lactate in blood-contaminated CSF was 4.15 mmol/L, the sensitivity was 92.3%, and the specificity was 71.1%, and the combination of CSF lactate and glucose achieved better diagnostic specificity (AUC = 0.96, sensitivity was 97.4%, specificity was 84.2%).Conclusions Blood in CSF led to the elevation of CSF lactate as compared with that in non-blood-contaminated CSF of patients with PNBM. CSF lactate was still a good diagnostic parameter for PNBM both in blood-contaminated patients, and the combination of CSF lactate and glucose achieved better diagnostic specificity.

Objective To determine sonographic features and outcome of fetal lung abnormal lesions. Methods Blood supply of the lesion, fetus hydrops and other extra-lung anomalies should be evaluated by color Doppler flow image(CDFI) when abnormal lesion was detected in fetus lung during routine scanning. The fetus with lung abnormal lesion without hydrops at the first time scanning should be monitored by ultrasound in every four to six weeks. Results Forty cases fetus presented lung abnormal lesions, which included 21 cases with hyperechogenic solid masses,15 cases with cystic-solid mixture masses,4 cases with cystic masses. Lesions of 8 cases were demonstrated systemic arterial blood supply arising from the aorta on CDFI and the diagnosis of pulmonary sequestration (PS) were suggested. Seventeen cases lesion that had small size or decreased or disappeared or remained stable in size with gestational age developing had normal neonate. Conclusions CDFI is very useful in detecting abnormal lesion of the fetal lung and differentiating pathology and evaluating the prognosis. The outcome of isolated lung lesion without hydrops and mediastinal shift that decreased or disappeared or remained stable in size had a good prognosis.

Objective To investigate the role of heme oxygenase-1(HO-1)in the protective actions of curcumin against ethanol-induced oxidative damage.Methods Microsomal HO-1 enzyme activities were determined in rat primary hepatocytes pretreated by curcumin.AST,LDH release and hepatic oxidative/antioxidant status were measured with or without ZnPPⅨ/Hemin as a classic HO-1 inhibitor/inducer,respectively.Results Curcumin could induce the HO-1 expression and enzyme activity,which was correlated with antioxidant levels in hepatocytes.HO-1 induction reached a peak under administration of 15 μmol/L curcumin for 1 h.Conclusion HO-1 induction by curcumin is contributed to the heptoprotective effects against ethanol-induced oxidative damage.

Objective To investigate the injury caused by hydrogen peroxide (H2O2) on human renal tubular epithelial cell (HKC) and its effect on calcium oxalate (CaOxa) crystal crystallization time before and after the injury. Methods The injury degree of HKC by H2O2 was measured by detecting the cell survival rate and the concentration change of malonaldehyde (MDA). CaOxa crystallization was investigated by scanning electron microscopy (SEM). Results Control cells induced only a small amount of calcium oxalate dihydrate (COD) crystals, while the injured cells not only induced calcium oxalate monohydrate (COM) crystals, but also increased the number and aggregation of CaOxa crystals. After incubating with CaOxa supersaturated solution, the control group HKC cells could be injured as well. Conclusions H2O2 can cause oxidative damage on HKC. The injured HKC promotes the nucleation and aggregation of COM crystals. In the body environment, the long-term presence of crystals in urinary tract is a risk factor for stone formation.

BACKGROUNDLung carcinoma is one of the most common malignant tumors in China.The increasing incidence of lung cancer has been alerted and multimodality treatments including surgery,radiotherapy,chemotherapy etc.have been highly aware.However,the outcome of treatment in lung cancer remains poor,because there is still no definite molecular targeting drug affecting its biological behavior significantly.To find an useful clinical tool,the aims of this study are to explore the effects of a novel monoclonal antibody targeting at the α-strain of insulin-like growth factor 1 receptor(IGF1-αR) on lung adenocarcinoma cell lines.

METHODSThe novel monoclonal antibody targeting at IGF1-αR was exacted by hybrid cell processes and purified by Protein G column.The effects of growth were investigated on SPCA-1 and A549 cell lines by MTT curve lines and the expression of Ki67.

RESULTSThe combination of IGF1 with IGF1-αR could be competitively inhibited by the novel monoclonal antibody significantly.Intervented by the novel monoclonal antibody,SPCA-1 and A549 cell lines proliferated more slowly than that of the respective control,with significant statistic value(P < 0.05).Besides,the expression of Ki67 showed significant downregulation under the invention of the monoclonal antibody.

CONCLUSIONSThe special monoclonal antibody extracted in our laboratory shows good affinity with IGF1-αR,and can inhibit the growth of SPCA-1 and A549 cell lines.

Objective To investigate the outcomes of unselected peripheral T cell lymphoma (PTCL) patients treated with in-tensive first-line chemotherapy with high-dose therapy followed by autologous stem cell transplantation (ASCT).Methods Here a nonrandom study was reported for 23 PTCL patients treated with first-line intensive chemotherapy followed by autologous stem cell trans-plantation and 23 PTCL patients treated with conventional chemotherapy during January in 2000 to 2011 .All patients had received E-CHOP for 6~8 cycles, and autologous stem cell transplantation group was administrated with intensive chemotherapy followed by ASCT after complete remission or partial remission .Results There was no statistically significant difference in short-term therapeutic effect between two groups( P >0.05), but the 5-year overall survival(OS) of autologous stem cell transplantation group( 58%) was higher than conventional chemotherapy group , as well as 5-year disease-free survival time (DFS) (45%in autologous stem cell transplanta-tion group, and 21%in conventional chemotherapy group ) with both statistical significance ( P <0.05).Only the incidence of Ⅳ° myelosuppression in autologous stem cell transplantation group ( 100%) was higher than that in conventional chemotherapy group ( 13%) ( P <0.01 ) .Conclusions First-line intensive chemotherapy followed by autologous stem cell transplantation for peripheral T cell lymphoma was quietly safe utility , it was better than conventional chemotherapy which would be considered as first -line method.