Humans ; Neck Dissection ; methods ; Tongue Neoplasms ; surgery

Organic phosphorus pesticide poisoning is a common disease in emergency.Compared with other clinical disease teaching,the basic concepts and theories of this unit are relatively less and more fixed,which is conducive to the case-based learning(CBL).The CBL teaching curriculum of organic phosphorus pesticide poisoning includes three aspects:pre-class teaching design,classroom teaching,after-class teaching evaluation and feedback.Pre-class teaching requires teachers to carefully read the syllabus,choose the teaching content,and design typical cases and problems.Classroom teaching emphasizes a lively and relaxed atmosphere,Teachers should guide students to think about questions and find answers themselves,and cultivated the correct clinic ideation through the combination of their theoretical knowledge and clinical practice in a classroom environment.Teaching evaluation and feedback help teachers to summarize what they are teaching and promote the teaching,which benefits both the teachers and students.

Objective:To assess the effectiveness and safety of radiotherapy combined with surgery for gastric cancer compared with single surgery. Methods:We retrieved relevant randomized controlled trails in Cochrane Library (Issue 2, 2009), PubMed (Jan 1966-Jun 2009), EMBASE (Jan 1974-Jun 2009), Chinese Biomedical Literature Database (Jan 1978-Jun 2009), Chinese Science and Technology Periodicals Database (Jan 1989-Jun 2009) ,China National Knowledge Infrastructure (Jan 1994 to Jun 2009) and Wanfang database (Jan 1997-Jun 2009). Two researchers assessed the quality of included randomized controlled trials (RCT) and extracted data independently. The RevMan 5.0 software was used for Meta-analysis. Results:Nine RCTs including 1 548 patients were selected for Meta analysis. Five RCTs were related with comparison of preoperative radiotherapy plus surgery with single surgery. Two RCTs were about the comparison of surgery plus perioperative radiotherapy with single surgery. Two RCTs were the comparative studies between surgery plus postoperative radiotherapy and single surgery. The Meta analysis results showed that: (1)compared with surgery alone, preoperative radiotherapy combined with surgery can increase 3 years [OR = 1.78, 95% confidence interal (CI):1.14-2.78], 5 years (OR = 1.67, 95%CI :1.22-2.29),and 10 years (OR = 1.64, 95%CI 1.03-2.60) survival rate,and reduce the tumor recurrent rate(OR = 0.59, 95%CI :0.37-0.92) and metastasis rate (OR= 0.44, 95%CI :0.27-0.73); (2) The tumor recurrent rates (OR = 0.19,95%CI :0.03-1.14 )and tumor metastasis rates (OR = 0.09, 95%CI :0.00-1.77)had no difference between single surgery group and peri-operative radiotherapy plus surgery group;(3) Postoperative radiotherapy compared with surgery had no significant effects on 1 year (OR = 0.83, 95%CI :0.60-1.15) and 3 years (OR = 0.75, 95%CI :0.51-1.11) survival rate compared with single surgery, but the 5 years (OR = 0.57,95%CI :0.34-0.95) survival rate of the patients who received surgery alone was higher than those who received combined therapy. No difference of the tumor recurrence rate(OR=0.59,95%CI :0.33-1.05) and tumor metastasis rate (OR=0.90,95%CI:0.51-1.59) were observed between the two groups. Conclusion:Preoperative radiotherapy combined with surgery is more rational and effective than surgery alone in the treatment of gastric cancer. However in terms of the clinical effects of perioperative or postoperative radiotherapy combined with surgery, more RCTs with larger samples and higher quality need to be carried out to make further verification.

Objective To compare the impact of anterior and inferior-posterior regional wall motion abnormalities on the vortex in systolic phase by vector flow map(VFM) technique.Methods Sixty patients with myocardial infarction were divided into 2 groups:the left anterior descending artery single branch lesion group (LAD group) and the left circumflex artery and/or right coronary artery lesion group (LCX/RCA group).By VFM technique,left ventricular systolic blood flow field was observed.Parameters such as the vortex duration were calculated and compared between two patient groups and also with healthy control group.Results LAD group did not show significant difference from the control group in isovolumic systolic vortex,this group was characterized with large size of vortex and usually forming local vortex at the apex in early ejection.On the contrary,LCX/RCA group had small isovolumic systolic vortex,the early ejection vortex of this group was significantly smaller than that of LAD group and larger than that of control group.The phenomenon was usually observed in the center of the lumen.Both LAD and LCX/RCA group had longer total vortex duration and vortex collapse time than the healthy control group,these differences were not significant between LAD and LCX/RCA group.There were no significant differences in isovolumic vortex duration among the three groups.Conclusions Anterior wall infarction had more impact on systolic blood flow field than inferior-posterior wall infarction.The VFM technique could be applied for observation and evaluation of the changes in vortex characteristics.

Objective To evaluate the dynamic changes of left ventricular systolic blood flow hemodynamics in patients with acute myocardial infarction(AMI) before percutaneous coronary intervention (PCI) and short-term after PCI by vector flow mapping (VFM).MethodsTwenty-five patients with AMI were examined by color Doppler two-dimensional echocardiography respectively before PCI and three days and one month after PCI.The standard apical three-chamber color images in three sequent cardiac cycles were acquired and analyzed on off-line by VFM.In systole,the parameters of vortex including horizontal length,longitudinal length,transverse position,vertical position,and maximum vector velocity were measured respectively,and all parameters three days and one month after PCI were compared with those before PCI respectively.Results In systole,there were not statistically significant differences between parameters three days after PCI and those before PCI( P ＞0.05).Compared parameters one month after PCI with those before PCI,horizontal length was longer( P ＜0.05),longitudinal length was shorter (P ＜0.05),the transverse position was closer to anterior ventricular septum( P ＜0.05),and the maximum vector velocity of vortex was increased ( P ＜ 0.05).Conclusions VFM may serve as an ideal tool to quantitatively evaluate the blood flow hemodynamics of left ventricle in patients with AMI after short-term therapy by PCI.

Objective To investigate variations in bFGF,NGF,and brain-derived neurotrophic factor(BDNF) following sciatic nerve injury in rabbits and the optimum time to perform stem cell transplantation.Methods Sixteen New Zealand rabbits were divided into control group and groups at 3,7,and 14 days postinjury according to the random number table,with 4 rabbits per group.Rabbit models of the sciatic nerve injury were induced by forceps.Structural change of the injured nerve tissues were observed with HE staining.Contents of NGF,bFGF,and BDNF in supernatants of homogenated sciatic nerves were detected by ELISA test.Results Level of bFGF increased slowly postinjury,reached the peak at day 7 (P ＜ 0.05),and then restored to the normal level at day 14 (P ＞ 0.05).Level of BDNF raised quickly postinjury,reached the peak at day 7 (P ＜ 0.05),and then restored to the normal level at day 14 (P ＞ 0.05).Level of NGF increased rapidly postinjury,reached the peak at day 3 (P ＜ 0.05),and then restored to the normal level at day 7 (P ＞ 0.05).Conclusions In the early recovery process after peripheral nerve injury,the nerve tissues regulate the secretion of NGF,bFGF,and BDNF immediately and secretions of these growth factors correlate with the time of injury.Early period (3-7 days) after injury is the best time to perform nerve repairing,nerve transplantation,and stem cell transplantation.

· AIM :To investigate the role of pericytes in growth of retinal microvascular endothelial cells with a co-culture system in order to understand some mechanism of angiogenesis in hypoxia induced retinal neovascular disorders.(RMECs) were isolated by a modified protocol using CD31 coated Dynabeads, and identified by immunocytochemical staining with anti-Factor Ⅷ and CD31 antibodies. Rat retinal pericytes were isolated and characterized by immunofluorescent staining with PDGFR-β; and desmin antibodies. Pericytes and RMECs were cultured in a contact co-culture system both under normoxia and hypoxia by Millicell chamber. RMECs proliferation was evaluated by MTT and cell cycle assay with flow cytometry. RT-PCR was used to detect the alteration of KDR/Flk-1 mRNA level in RMECs under normoxia or hypoxia in the co-culture system.harvested with the modified isolating method. The two cell types were identified by positive Factor Ⅷ, CD31 and PDGFR-β, desmin cytochemical staining respectively.RMECs proliferated significantly under hypoxia from 3 to 9d with a maximal rate on day 6 (24.9%, P ＜ 0.01) by MTT. In the co-culture system, the proliferation of RMECs was inhibited by pericytes. After 6d exposure to hypoxia,the fraction of S-phase RMECs number was greatly increased by 43.9% (P ＜ 0.01). In the co-culture system,RMECs proliferation was inhibited by pericytes through decreasing the fraction of S-phase cell number both under normoxia (3.6%, P＜0.05) and under hypoxia (15.1%,P＜0.01). KDR/Flk-1 mRNA level in single cultured RMECs was shown to increase approximately 1.3-fold when exposed to hypoxia. Compared with single cultured RMECs, co-culture with pericytes could decrease KDR/Flk-1 mRNA by 45.1% (P＜0.05) and 27.7% (P ＜ 0.05) under normoxia and hypoxia condition respectively.pericytes could inhibit proliferation of RMECs under both normoxia and hypoxia. The inhibition effects of pericytes maybe, at least in part, due to downregulation of KDR/Flk-1 of RMECs. These findings confirm that pericytes could be a potential inhibitor in the pathogenesis of retinal neovascularization.

Background The optic quality of Toric intraocular lens (IOL)-implanted eye is affected by the residual astigmatism and individual difference of corneal spherical aberration and different magnification from steep and flat axis refraction.Whether correcting Toric IOL spherical aberration can effectively improve the image quality of individual patient is a question to be studied.Objective This study attempted to collect eye parameters of cataract patients to reconstruct the customized vision model by using Zemax optical software,and to evaluate the image performance with different Toric IOL spherical aberration.Methods A prospective study was performed.Forty-five eyes of 45 cataract patients were included in Second Hospital of Hebei Medical University from August 2012 to October 2013.Several relevant parameters were measured by Pentacam,including anterior and posterior surface height of cornea,corneal thickness,curvature radius of flat and steep meridians of anterior surface astigmatism,refractive diopter and curvature radius of posterior surface.The astigmatism of anterior and posterior corneal surface was described by Matlab 4.5 software.Corneal astigmatism model were set as aspheric state,and the effective position of Toric IOL was calculated using Holladay Ⅰ formula.Customized individual model eyes were constructed by Zemax software.The contrast sensitivity function (CSF) of different spherical Toric IOLs at different spatial frequencies were calculated and compared between 300 Td light environment with 3 mm pupil diameter (photopia light) and 0.3-1.0 Td light environment with 5 mm pupil diameter (mesopia light).This study was approved by Second Hospital of Hebei Medical University ethics committee,all the patients signed the informed consent.Results The mean astigmatism power was (1.51 ± 0.36) D and (1.49 ± 0.37) D,and the mean astigmatism meridian was (101.5 ± 59.8) ° and (101.9±58.5) ° in the model eyes and cataract eyes,respectively,without significant differences between them (t=0.886,0.652;both at P＞0.05).Bland-Altman test showed a good agreement in astigmatism power and astigmatism meridian between model eyes and cataract eyes.The LogCSF values at 1.5,3.0,6.0,12.0 and 18.0 c/d spatial frequencies were significantly higher in the aspherical Toric IOL model eyes than those in the spherical Toric IOL model eyes,and the LogCSF values at various spatial frequencies were significantly higher in the Toric IOLs with spherical aberrations of-0.13 μm and-0.26 μm than those in the zero spherical aberrations in both photopia light and mesopia light (all at P＜0.05).Conclusions A precise corneal astigmatism model based on cornea high data of cataract eyes was successfully constructed through special formulas with Zemax software.Aspherical Toric IOL can compensate for spherical aberration of cornea and enhance the optic quality in individual model eye.

Objective To analyze the monitoring results of human and animal plague in Zhangye city from 1982 to 2011,and further explore the prevention and control policies and measures to control the spread of the disease.Methods The trends of human and animal plague were studied by retrospective survey in Zhangye city.Information of animal and human plague epidemic and prevention and control measures were collcoted and assessed with epidemiology methods,and the density of rodents,the rodents infected with flea,flea index and other indicators were calculated.Results 1982-2011,there were 6 cases of human plague incidence of 6 cases,of which 2 cases cured,4 cases died,the mortality rate was 67％; detection of Yersinia pestis from the captured 5167 animals was 93 strains from 1982 to 2011,the detection rate was 1.80％; 29 840 various vector insects were collected from the body surface of the 5167 animals captured,21 206 hole dries,and three marmot dens.A total of 7050 groups of Marmota parasites and hole stem fleas were inspected,52 strains of Yersinia pestis were isolated,and the average detection rate was 0.74％; 3912 marmot serums were detected,178 were positive,and the positive rate was 4.55％.Conclusions The prevention and control of plague is still very grim in Zhangye city.It is recommended to take publicity,education and active surveillance measures in the future to deal with emergencies and other.