Objective To compare the long-term prognosis of patients with stage Ⅰ endometrial cancer (EMC) after laparoscopic surgery or open laparotomy. Methods Totally 83 patients with stage Ⅰ EMC who underwent laparoscopic surgery or open laparotomy between 1993 and 2008 were enrolled in this study. The clinical data were analyzed retrospectively to compare the survival time during long-term follow-up between the two groups. Results The total survival rate was 95.2% (79/83) in the 83 cases. The median survival time was 77,51,and 31 months respectively in stages Ⅰa,Ⅰb,and Ⅰc EMC patients. No significant difference was found in the survival rate between open and laparoscopy groups [94.2% (49/52) vs 96.8% (30/31),Z=0.028,P=0.978]. For the stage Ⅰa,stages Ⅰb and Ⅰc,and G2 and G3 patients,the median survival time was similar between the open and laparoscopy groups (80 month vs 63 months,P=0.483; 49 months vs 48 months,P=0.781; and 51 months vs 49 months,P=0.635). However,in the G1 patients,significantly difference was detected in the median survival time between the two groups (77 vs 51 months,P=0.037). Conclusion Laparoscopic surgery should be used as a routine surgical approach for patients with stage Ⅰ EMC considering its minimal invasiveness and promising prognosis.

ObjectiveTo investigate the association between the FCRL5 gene (rs6427384 and rs12036228) single nucleotide polymorphism(SNP) and patients with ankylosing spondylitis (AS). Methods SNP of FCRL5 gene (rs6427384 and rs12036228) was analyzed in 169 patients with AS and 184 healthy controls by ligase detection reaction based on high temperature(LDR)-PCR. The distribution of FCRL5 genotypes and allele frequencies were detected between the two groups. Chi-square test, one-way ANOVA were used for statistical analysis. ResultsSignificant differences were found in the distribution of allele frequencies of FCRL5 gene between AS patients and health controls(P＜0.05). The C allele frequencies of FCRL5 gene at positions of rs6427384 and rs12036228 were 17.3％, 92.3％ and 25.0％, 87.2％ respectively in the AS group and the control group. And the T allele frequencies of rs6427384 and rs12036228 were 82.7％, 7.7％ and 75.0％, 12.8％ in the AS group and the control group. The percentages of CC, CT and TT genotype(rs6427384) were 3.7％, 27.2％, and 69.1％ in the AS group, which were significantly different from those of the control group(3.9％, 42.2％ and 53.9％ ) (x2=8.7637, P=0.0125 ). Staging of sacroiliitis in X ray were significantly different during AS patients whose genotype represented as CC, CT and TT (rs6427384)(x2=34.159, P=0.0001 ). Incidences of the initial symptoms (low back pain or inflammation of periphery joint)in the AS group were obviously differed among patients with different genotypes (rs6427384) (x2=7.254, P=0.027), so did the mean duration of morning stiffness (F=4.159, P=0.018) and the average scores of BASDAI (F=4.461, P=0.014). Incidences of the initial symptoms in the AS group were also conspicuously different between the AS patients with different genotypes (rs 12036228 ) (x2=6.640, P=0.036 ). ConclusionOur study suggests that the SNP(rs6427384 and rs12036228) of FCRL5 may be a susceptibility factor for AS in Anhui Han population and the genotype may influence the clinical phenotype of AS.

Objective To investigate the role and possible mechanism of caveolin-1 (CAV1) in the forming of cholesterol gallstone in mice fed with lithogenic diet.Methods Cholesterol gallstone susceptible C57BL/6 mice were study objects.The mice of control group (n=6) and experiment group (n=6) were fed with normal diet and lithogenic diet for four weeks respectively.The condition of cholesterol gallstone forming,changes of serum lipid and bile composition were measured,and the expressions of CAV1 and scavenger receptor classB member Ⅰ (SR-BⅠ) at mRNA and protein level in the liver and gallbladder were detected by realtime-polymerase chain reaction and Western blot,respectively.The t test was performed for mean comparsion between the two groups.Results The incidence rate of gallstone in experimental group was 100％ after fed with lithogenic diet for four weeks,the lipid level significantly increased,and the proportion of cholesterol in bile raised and bile salt decreased.Compared with those of control group,the expressions of CAV1 at mRNA and protein level in the liver and gallbladder tissues siginificantly decreased (in liver tissue,mRNA 0.53 ± 0.13 vs 1.00 ± 0.32,t =3.330,protein level 0.39 ± 0.07vs 0.92±0.06,t=10.280; in gallbladder tissue,mRNA 0.40±0.22 vs 1.00±0.22,t=3.823,protein level 1.04±0.07 vs 1.34 ± 0.04,t =6.367,all P＜0.01).There was no significant difference in the relative expression of SR-BⅠ at mRNA and protein level in the liver and gallbladder tissues between the mice of experiment group and control group.Conclusion The changes of CAV 1 expression at mRNA and protein level in liver and gallbladder tissues may affect lipids metabolism and cholesterol transportation in liver and gallbladder tissues of experiment mice,which might play an important role in the formation of cholesterol gallstone.

BACKGROUND:To optimize the oral implant design in the abutment angle has an important effect on bone resorption, and meanwhile, the high bite force from patients is also crucial to rebuild bone absorption.
OBJECTIVE:To optimize the model design of the maxilary anterior teeth using Ansys Workbench 13.0 software and to investigate the stress size on the cortical and cancelous bone from different angled abutments and different loads of the central incisor.
METHODS:A three-dimensional finite element model of the V-shaped cylindrical threaded implants in the maxilary bone. Abutment angle was set as 0°, 5°, 10°, 15°, 20°, 25°, 30°, and the load stress was set as 90, 105, 120, 135, 150, 165, 180, 195, 210 N. Occlusion of the central incisor was simulated on the implants, and then, buccolingual mechanical loads were loaded on the center of prostheses to observe the effects of different abutment angles and loads on the Von Mises peak stress of the maxila and mandible.
RESULTS AND CONCLUSION:Under the influence of a single factor, when the abutment angles acted as variables, the Von Mises peak stress of the cortical and cancelous bone was respectively increased by 60.60% and 69.30% under labial or palatal loads; when the loading stress acted as variables, the Von Mises peak stress of the cortical and cancelous bone was increased by 68.74% and 69.30% under buccolingual loads. When the loading stress was less than 150 N and the abutment angle was less than 25°, the slop of tangent for the mandible Von Mises stress response curve was-1 to 0. It seems from the mechanical analysis that the stress of cancelous bone is more susceptible to abutment angle and load stress; the optimal abutment of screwed implant should be designed to an angle less than 25° and an bite force less than 150 N.

Drug addiction is a chronic relapsing brain disease that is characterized by compulsive drug use and persistence of drug craving. Drug abuse can lead to changes in the neuron structure and function of plasticity,alterations in molecules and cells,and ultimately to individual abnormal behavior. Current studies have found that epigenetic changes leading to the sustainability of gene expression is an important mechanism of drug addiction. In this review,we will systematically summarize the latest advances in epigenetic mechanisms of drug addiction. This review is expected to provide robust evidence that repeated exposure to drugs of abuse induces changes within the brain′s reward regions in three major modes of epigenetic regulation-histone modifications such as acetylation and methylation , DNA methylation,and non-coding RNAs. It promises a new perspective from which to gain insights into the genetic and epigenetic mechanisms of drug addiction and a new area for epigenetic research on clinical drug addiction treatment.

Objective There is still controversy over the effect of hyperglycemia on the tolerance of heart to ischemia/reperfusion(I/R)injury in patients with diabetes mellitus. The aim of this study was to evaluate the effect of hyperglycemia on I/R-induced ventricular arrythmia in isolated diabetic rat hearts. Methods Twenty-four healthy male SD rats weighing 210-250g were randomly divided into two groups: control group(C, n=10) and diabetes mellitus group(DM, n=14). Diabetes mellitus was induced by intraperitoneal injection of streptozotocin 60 mg?kg~(-1). Blood glucose was measured 72h later and every week thereafter. Diabetes mellitus was defined as persistent hyperglycemia(blood glucose≥16.7 mmol/L after meal). The diabeticrats received no insulin. The rats were anesthetized with pentobarbital 60mg?kg~(-1). The hearts were immediately removed and perfused with oxygenated(95% O_2, 5% CO_2)Krebs-Henseleit buffer(KHB)in a Langendorff apparatus at a constant perfusion pressure of 80 mm Hg. The 14 diabetic rats were further divided randomly into 2 subgroups: (1)DM+KHB (n=7) and (2) DM+GLU(n=7) in which glucose 3.6 g was added to KHB 1000ml. After 20 min equilibration all hearts were subjected to 30 min global ischemia followed by 40 min reperfusion. Epicardial electrocardiogram was monitored. The incidence of ventricular tachycardia(VT) and ventricular fibrillation(VF) and their duration were measured. The severity of arrhythmia was quantified by arrythmia score(AS). Coronary outflow was collected for determination of creatine kinase(CK) release. Results The incidence of ischemia-induced arrythmia was significantly lowered in diabetic hearts. The incidence of VT was 14.3% and VF 28.6% in DM+KHB subgroup as compared to 60%(VT) and 100%(VF) in the control group. The CK release was significantly lower in diabetes group(DM) than in control group(C); furthermore the CK release in DM=KHB subgroup was lower than that in DM=GLU subgroup. Conclusion Diabetic rat hearts are less susceptible to I/R induced arrythmia. Hyperglycemic perfusion reduces to some extent the increased tolerance to I/R injury in diabetic rat hearts as shown by increased CK release in DM+GLU subgroup but hyperglycemic perfusion has anti-arrhythmic action as shown by 0% incidence of VT and VF in DM+GLU subgroup.

BACKGROUND:Studies have shown that mesenchymsi stem cells (MSCs) participate in tumor stroma remodeling,but the mechanism is not clear.However,myofibroblast is related with tumor strema remodeling.OBJECTIVE:To investigate whether MSCs can differentiate into myofibroblast under the induction of tumor microenvironment.DESIGN,TIME AND SETING:This in vitro observation and in vivo transplantation cytology experiment was performed at institute of Low Temperature Medicine,Qilu Hospital of Shandong University from June 2006 to December 2007.MATERIALS:Twelve male New Zealand white rabbits,with 3-month-old,were purchased from Shandong Academy of Agricultural Sciences.METHODS:MSCs were obtained through bone marrow aspirates in male New Zealand rabbits and cultured by density gradient method.The 2~(nd) passage of MSCs were labeled with DAPI,and adjusted cell density to 5×10~(10) /L.The cells were assigned into experimental and control groups.For the experimental group,the passage two MSCs were cultured in low-glucose DMEM containing 10% fetal bovine serum and 30% VX2-cultured supernatant.For the control group,passage two MSCs were cultured in low-glucose DMEM containing 10% fetal bovine serum.Also,DAPI labeled self passage 2 MSCs of avery animal were delivered uniformly via direct surgical intratumoral injection to observe the differentiation of MSCs in tumor tissue.MAIN OUTCOME MEASURES:Immunofluorescense and RT-PCR were used to test the expression of α-SMA and Vimentin in MSCs of both groups 14 days later.At 3 weeks after VX2.intratumoral injection,Immunofluorescence was used to observe the distribution and differentiation of MSCs in tumor tissue.RESULTS:After stimulated with 30% VX2-cultured supematant for 2 weeks,Cy3 immunofluorescance showed that the expressions of α-SMA and Vimentin were strongly expressed in the experimental group,which was weakly expressed in the control group.Compared to the control group,the levels of α-SMA and Vimentin mRNA were obviously increased in the experimental group (P ＜ 0.01,P ＜ 0.05).At 3 weeks after MSCs intratumoral injection,these MSCs mainly distributed in tumor stroma and the expression of α-SMA and Vimentin in MSCs were also obviously increased,which demonstrated that the MSCs had differentiated into myofibroblasts.CONCLUSIONS:Under the induction of tumor microenivironment,MSCs can differentiate into myofibroblast,accordingly,accelerate the growth of tumor.

Objective To observe critical patients with thrombocytopenia,and exam their coagulation function,so as to diagnose disseminated intravascular coagulation(DIC)in the early stage.Methods Totally 56 critical patients complicated with thrombocytopenia were enrolled in the investigation;complete set of DIC tests were performed.A total of 26 cases were diagnosed as DIC according to the criteria from the International Society of Thrombosis Haemostasis(ISTH).The sensitivity,specificity,accuracy,likelihood ratio,predictive value of prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(Fg),antithrombin Ⅲ and bleeding signs(including petechia and ecchymosia)were calculated by applying fourfold table.Results The specificity of PT prolongation and Fg reduction was 87.0%;the sensitivity of ATⅢ decrease,and each of PT prolongation,Fg reduction,and bleeding(including petechia and ecchymosis)were as high as 96.0%.Conclusion Multi-markers based on thrombocytopenia are likely to improve sensitivity and specificity of DIC diagnosis.

Objective To build a scientific,rational and practical evaluation index system for medical tutors.Methods Evaluation framework was initially constructed on the basis of literature analysis.Two rounds questionnaires investigation were conducted soon using Delphi method and the data were analyzed using descriptive analysis,independent samples of non-parametric test (Kreskas-Wallis test),expert reliability analysis,analytic hierarchy process and other methods.Results The results of two rounds of expert questionnaires showed that both recovery rate and acceptance rate of the questionnaires were more than 90％ and overall expert coefficient was 0.8957.The coordinate coefficient of the second-class index was 0.181,x2 =27.148,P ＜ 0.001,and that of the third-class index was 0.157,x2 =127.03,P ＜ 0.001.Experts' opinions were highly consistent.Conclusions Evaluation index system including three first-class indexes,seven second-class indexes and twenty-eight third-class indexes was established for medical tutors.The evaluation index system is of great importance in safeguarding postgraduate culturing quality and strengthening teaching staff construction.

The goal of medical education is to train good doctors.Only by understanding the trend of medical education development,call medical schools effectively promote educational reform and improve the quality of medical education.In this paper,we analyze the trend of course plans,teaching content,teaching strategies and the evaluation mode of the domestic and international medical education reform and development,introduce the ideas and practices in reform of management system,training pattern,course plans and assessment methods based on the education platform of"mutual promotion of teaching and research,mutual integration of medicine and humanities and simultaneous improvement of knowledge and ability"in Chongqing Medical University.