Objective To explore the culturing strategies,curiculum provision,courses conferring methods,teaching effects as well as the associated managerial evaluations on the basis of Sino-French cooperation on medical education with the hope of summarizing helpful suggestions to Sino-Foreign cooperation on medical education. Methods The achievements of our Sino-French cooperation on medical education were analyzed and compared in the teaching models,culturing strategies along with courses conferring processes among seven-year medical students from both English-teaching and French-teaching classes. Results Our Sino-French cooperation on medical education was featured in its distinct culturing purposes and effective teaching model.Its scientifically formulated culturing strategy found its full expression in French-teaching atmosphere.The Sino-French cooperation on medical education was consistently welcomed and favorably recommended by both faculties and students. Conclusion The Sino-French cooperation on medical education has not only gained precious experience in culturing the cutting-edge medical talents with the international visions but also conduced to fulfill the goal to establish a modernized and internationalized medical school.

Objective To evaluated the clinical efficacy and safety of valsartan or benazepril combined with atorvastatin in the treatment of chronic cardiac failure in elderly patients.Methods Eighty-six cases with chronic cardiac failure were recruited in this study and randomly divided into treatment group ( n =42 ) and control group ( n =44 ).Patients in treatment group were received valsartan 80 mg · d-1 orally plus atorvastatin 10 mg · d-1 orally, patients in control group received benazepril 10 mg · d-1 orally plus atorvastatin 10 mg · d-1 orally.The course was 3 months.After treatment , the clinical efficacy , serum level of brain natriuretic peptide and adverse event were compared between the two groups.Results The total clinical efficacy of treatment group and control group were 90.48% and 86.36% respectively with no statistical difference ( P>0.05 ).The serum level of brain natriuretic peptide sig-nificant decreased in the both groups ( P<0.05 ) after treatment.And the serum level of brain natriuretic peptide in treatment group was significant lower compared with that in control group after treatment ( P<0.05 ).There were no statistical difference on adverse drug reactions between two groups ( P>0.05 ).Conclusion The clinical efficacy and safety were not significantly different for valsartan or benazepril combined with atorvastatin in the treatment of chronic cardiac failure in elderly patients .

This study was purposed to investigate the ratio of Th17 cells and CD4(+)CD25(+)Foxp3(+) regulatory T (Treg) cells in peripheral blood of patients with chronic lymphocytic leukemia (CLL) and to explore their roles in the pathogenesis and clinical diagnosis. Based on the number of peripheral lymphocytes and treatment condition, the CLL patients were divided into 2 groups: untreated group (n = 30) and remission group (n = 15), the healthy control group (n = 20) was set up as well. The frequencies of Th17 and Treg cells of all cases were detected by flow cytometry (FCM). The results showed that frequencies of CD3(+)CD4(+)T cells and Th17 cells were significantly higher in untreated group than that in healthy control group (P < 0.05), the frequencies of CD3(+)CD8(+)T cells and Treg cells were significantly lower in untreated group than that in healthy control group (P < 0.05), the ratio of Th17/Treg was significantly higher in untreated group than that in healthy control group (P < 0.05). The frequencies of Th17 were not statistically different between remission and healthy control groups, the frequencies of Treg cells were significantly lower in remission group than that in healthy control group (P < 0.05), the ratio of Th17/Treg was significantly higher in remission group than that in healthy control group (P < 0.05), frequencies of Th17 cells were markedly lower in remission group than that in untreated group (P < 0.05). It is concluded that Th17/Treg imbalance exists in patients with CLL, which may play a key role in pathogenesis and development of CLL.
Aged ; Case-Control Studies ; Female ; Flow Cytometry ; Humans ; Leukemia, Lymphocytic, Chronic, B-Cell ; pathology ; Lymphocyte Count ; Male ; Middle Aged ; T-Lymphocytes, Regulatory ; cytology ; Th17 Cells ; cytology

Hilar cholangiocarcinoma is one of the most difficult malignant tumors to treat in the biliary system. In Japan, 5-year survival rate of the disease has increased from 32.5% to 67.1% during the past 30 years. The impressive progress reflects the solid efforts in preoperative endoscopic diagnosis, innovation in surgery such as PTPE as well as hepato-pancreatoduodenectomy and perioperative treatment including replacement of the bile and synbiotic treatment, which have finally formed a set of standardized diagnosis and treatment systems. The present review intends to report the history, current status and remaining bottlenecks of the diagnosis and treatment system of hilar cholangiocarcinoma in Japan as follows.

OBJECTIVETo investigate the clinical therapeutic results of allograft tendon for anatomical reconstruction of medial patellofemoral ligament (MPFL) for the treatment of patellar dislocations.

METHODSFrom September 2008 to June 2013, 16 patients with patellar dislocation underwent MPFL reconstructions. There were 2 males and 14 females, aged 11 to 27 years old (16 years old on average). Patellar dislocations occurred in 11 left and 5 right knees. The disease course ranged from 3 to 10 years. The frequency of dislocation ranged from 9 to 33 times (19 times on average). Affected knee joints showed patellar instability; the range of action for patella obviously increased. The X-ray films showed patellar dislocation. The preoperative Q angle was (36 ± 9)°, and the congruence angle was (63 ± 18)°. Reconstruction was performed via allograft tendon. Allograft tendon was fixed through the superomedial pole of the patella, and the other end was fixed at the natural MPFL insertion site near the medial femoral condyle with an interference screw in a bone tunnel. All the patients were evaluated postoperatively; Kujala patellofemoral scores, objective knee function, complications, and reoperations were assessed.

RESULTSPrimary healing was achieved in all cases. No infection or necrosis and absorption of grafts was observed. All the patients were followed up for an average of 16.4 months (ranged, 10 to 24 months) postoperatively. At the latest follow-up, all the patients had no pain, swelling and patellar instability; neither patella redislocation nor fracture occurred. The X-ray films showed good position of tunnel 6 months after operation, and the congruence angle was (5 ± 9)°, showing statistically significant difference when compared with preoperation (P < 0.05). The postoperative Q angle was (17 ± 8)°, the Kujala knee function score improved significantly from 45.20 ± 9.20 to 89.30 ± 6.40 at the latest follow-up, showing statistically significant difference (P < 0.05).

CONCLUSIONMPFL reconstruction improves clinical symptoms. Anatomical MPFL reconstruction is effective for patellar dislocation, and it offers good recovery of the premorbid patella mechanics. The interference screw provides firm fixation. Allograft can avoid the graft harvest site morbidity, but it increases the cost of the surgery.

Adolescent ; Adult ; Allografts ; Child ; Female ; Humans ; Ligaments, Articular ; surgery ; Male ; Patellar Dislocation ; surgery ; Patellofemoral Joint ; surgery ; Reconstructive Surgical Procedures ; methods ; Tendons ; transplantation

ObjectiveTo investigate the condom use of men who have sex with men （MSM） in Shanghai， the information motivation behavioral skills model （IMB） theory was used to introduce psychosocial factors and study the relevant factors of consistent condom use （CCU） in this population. MethodsA cross-sectional study of 547 MSM in four districts of Shanghai was conducted by snowball sampling. The structural equation model based on psychosocial optimization was constructed and validated using the data collected by structured questionnaires. ResultsAmong the 547 respondents， the proportion of CCU in the past six months was 45.5%. Comparing the fitness of the initial model with that of the adjusted model， we found that the fitness of the adjusted model was good. ConclusionThe proportion of CCU among MSM in Shanghai is relatively low； In addition， information and motivation do not directly affect the CCU of this population； Only behavioral skills have a direct effect on CCU. Finally， social psychological measures should be emphasized for this population， and comprehensive and multi-level strategies should be formulated to control the spread of HIV in this population.

OBJECTIVETo investigate the ratio of Th17 cells and CD4⁺CD25⁺Foxp3⁺ regulatory T (Treg) cells in peripheral blood from patients with multiple myeloma (MM) and explore its pathological effects.

METHODS70 MM patients were divided into three groups: newly diagnosed group (n=30), plateau stage group (n=23) and relapsed/refractory group (n=17). The controls consisted of 20 healthy donors. The frequencies of Th17 and Treg cells were detected by flow cytometry.

RESULTSCompared with controls [(0.72±0.33)%] and plateau stage group [(0.74±0.29)%], frequencies of Th17 cells were higher in newly diagnosed group [(1.62±0.65)%] and relapsed/refractory group [(1.45±0.51)%], respectively (P<0.05). Compared with controls [(2.33±0.90)%] and plateau stage group [(1.69±0.70)%], frequencies of Treg cells were significantly lower in newly diagnosed group [(0.55±0.23)%] and relapsed/refractory group [(0.82±0.54)%], respectively (P<0.05). The ratios of Th17/Treg in newly diagnosed group and relapsed/refractory group were higher than those in controls (P<0.05). There were no differences of the frequencies of CD3⁺CD4⁺ T cells and Th17 cells between plateau stage group and controls. The frequencies of Treg cells were significantly lower in plateau stage group than that in controls (P<0.05), and the ratio of Th17/Treg was significantly higher in plateau stage group than that in controls (P<0.05).

CONCLUSIONThe remarkable abnormality of T cells subsets was reduction of CD4⁺ T cells in MM. Higher frequency of Th17 and lower ratio of Treg could lead to imbalance of Th17/Treg, which may play a critical role in the pathogenesis of MM.

Adult ; Aged ; Female ; Flow Cytometry ; Humans ; Lymphocyte Count ; Male ; Middle Aged ; Multiple Myeloma ; immunology ; pathology ; T-Lymphocytes, Regulatory ; cytology ; Th17 Cells ; cytology

BACKGROUNDAzithromycin can reduce neutrophil accumulation in neutrophilic pulmonary diseases. However, the precise mechanism behind this action remains unknown. Our experiment assessed whether azithromycin inhibits neutrophil accumulation in the airways by affecting interleukin-17 (IL-17) downstream signals.

METHODSMice were pretreated with azithromycin before murine IL-17A (mIL-17) stimulation. After the mIL-17 stimulation, the levels of six neutrophil-mobilizing cytokines were determined by enzyme-linked immunosorbent assay (ELISA) tests in bronchoalveolar lavage (BAL) fluid; IL-6, CXC chemokine ligand-1 (CXCL-1), CXCL-5, macrophage inflammatory protein-2 (MIP-2), granulocyte colony-stimulating factor (G-CSF), and granulocyte macrophage colony-stimulating factor (GM-CSF). The number of neutrophils in BAL fluid were evaluated by cytospin preparations.

RESULTS(1) Azithromycin pretreatment significantly inhibited both the release of three neutrophil-mobilizing cytokines (MIP-2, CXCL-5 and GM-CSF) and the accumulation of neutrophils in airways caused by mIL-17 stimulation. (2) The levels of three neutrophil-mobilizing cytokines (IL-6, MIP-2 and GM-CSF) were positively correlated with the numbers of neutrophil in BAL fluid.

CONCLUSIONSAzithromycin can inhibit neutrophil accumulation in the airways by affecting IL-17 downstream signals. This finding suggests that macrolide antibiotic application might be useful in prevention of neutrophilic pulmonary diseases characterized by high levels of IL-17.

Animals ; Azithromycin ; pharmacology ; Bronchoalveolar Lavage Fluid ; chemistry ; Chemokine CXCL2 ; metabolism ; Chemokines, CXC ; metabolism ; Enzyme-Linked Immunosorbent Assay ; Granulocyte Colony-Stimulating Factor ; metabolism ; Granulocyte-Macrophage Colony-Stimulating Factor ; metabolism ; Interleukin-17 ; pharmacology ; Interleukin-6 ; metabolism ; Male ; Mice ; Mice, Inbred BALB C ; Neutrophils ; drug effects ; metabolism

OBJECTIVETo assess whether the polymorphisms of CYP17 MspA(1)I are associated with the susceptibility of endometrial cancer.

METHODSThe allelic discrimination of the CYP17A1 gene polymorphisms were assessed with the ABI PRISM 7900 Sequence Detection Systems using TaqMan genotyping assay. Unconditional logistic regression was applied to assess odds ratio and 95% CI and evaluate the association between different genotypes and endometrial cancer development.

RESULTSThe frequencies of wild-type, heterozygote and homozygote for the CYP17 MspA(1)I in control women in Shanghai were 17.8%, 49.3% and 32.9%, respectively. No significant difference was found in the distribution of various genotypes of CYP17 MspA(1)I between patients and controls. Pregnancy was associated with reduced risk of endometrial cancer in pre-menopausal women with A2 allele, OR = 0.66, 95% CI: 0.44 approximately 0.99. In post-menopausal women with A2 allele, more pregnancies ( > 2) and shorter time of menstruation ( < or = 32 yrs) were associated with reduced risk of endometrial cancer.

CONCLUSIONNo significant relationship was found between CYP17 MspA(1)I genotypes and endometrial cancer risk.

Adult ; Aged ; Alleles ; Case-Control Studies ; China ; Endometrial Neoplasms ; enzymology ; genetics ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Humans ; Menopause ; Middle Aged ; Odds Ratio ; Polymorphism, Genetic ; Steroid 17-alpha-Hydroxylase ; genetics

OBJECTIVETo evaluate the clinical value of HER2 overexpression in breast cancer and its prognostic implication in patients with lymph node negative breast carcinoma.

METHODSThe following electronic database were extracted using appropriate inclusive and exclusive standards: Cochrane library, PUBMED, Embase (1984 - 2003), OVID, CMCC and CNKI. Excel and RevMan 4.2 were used for statistical analysis.

RESULTSFifty-six articles were extracted to calculate the positive rate of HER2 overexpression. The pooled positive rate was 23.14% [19.54%, 26.73%], with positive immunohistochemistry (IHC) rate of 23.13% [19.49%, 26.77%] and positive FISH rate of 20.90% [15.54%, 26.25%]. Seven articles were used to evaluate prognostic predication of HER2 expression. It was concluded that in patients with lymph node negative breast carcinoma, HER2 overexpression (both IHC and FISH) independently predicted a poor prognosis based on disease-free survival (DFS) and overall survival (OS) with a P < 0.05. For DFS, the pooled RR was 1.38 [1.07, 1.80] with 1.16 [1.02, 1.31] for IHC and 1.98 [1.56, 2.52] for FISH. For OS, the pooled RR was 1.58 [1.16, 2.14] with 1.37 [1.14 to 1.64] for IHC and 2.33 [1.45 to 3.75] for FISH. HER2 overexpression effectively predicted DFS/OS of patients without adjuvant therapy and OS of patients with the therapy, but not for DFS, with the pooled RR of 1.46 [1.02, 2.09] and 1.11 [0.95, 1.31] for DFS, respectively and the pooled RR of 1.93 [1.44 to 2.58] and 1.25 [1.01, 1.56] for OS, respectively.

CONCLUSIONSIn patients with lymph node negative breast carcinoma, the positive rate of HER2 overexpression is 23.14%. HER2 overexpression indicates a poor prognosis and adjuvant therapy after surgery should be recommended.

Breast Neoplasms ; genetics ; metabolism ; pathology ; therapy ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Female ; Genes, erbB-2 ; Humans ; Lymph Nodes ; pathology ; Mastectomy ; Prognosis ; Receptor, ErbB-2 ; metabolism ; Survival Rate