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.

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.

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.

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.

Objective:To investigate the effects of extraction orthodontic treatment on the upper airway dimensions in young adult patients with malocclusion,and to evaluate the relationship between changes in the craniofacial morphology,position of incisor and upper airway dimensions.Methods:26 patients with upper and lower first premolar extraction and 21 patients without extraction were recruited.Cephalometry and dental cast analysis were performed pretreatment and posttreatment.Results:No statistical difference was found in the parameters of the upper airway dimensions in both non-extraction group and extraction group after treatment.In linear correlation analysis,SPAS was positively correlated with cephalometric variables U1-Y and L1-Y.MAS and IAS was positively correlated with cephalometric variables SNB,U1-Y and L1-Y.The multiple regression analysis revealed that the change of U1-Y had a significant positive effect on SPAS and IAS,and the change of L1-Y also had a significant positive effect on SPAS and MAS.Conclusion:The upper airway dimensions can not be altered during extraction orthodontic treatment,while the changes of incisors are significant associated with the change of the upper airway dimensions.

The effects of cyanide poisoning on the contractibility of the cardiac muscle were observed after the dogs were infused intravenously with a lethal dose of NaCN (2.5 mg/kg) within 2 minutes through a cannulated femoral vein. Heart rate (HR) , left ventricular pressure (LVP) , the largest changing rate of LVP (LVP?dp/dtmax), cardiac muscle contractibility (CMC) , the largest changing rate of CMC (CMC?dc/dtmax) , and ECG changes were recorded. It was found that there was an initial excitatory response of cardiac functions in the first minute of NaCN infusion, and then a drastic cardiac failure occurred, which resulted in the rapid death of the dogs within 10 minutes after NaCN administration. The changes of myocardial contractibility were slower than those of .other cardiac parameters, which implies that cyanide can exert an excitation on the myocardium initially. Our results indicate that the effects of cyanide on myocardial contractibility may be one of the important factors to induce serious arrhythmia,which in turn results fatal cardiac failure.

Objective To study the application of debridement with arthroscopy in acetabular dysplasia with osteoarthritis. Methods Thirty-two cases in 48 hips acetabular dysplasia with osteoarthritis debrided under the arthroscopy. In this group, male 9 and female 23, the mean age was 38.1 years old (range, 28-52 years old), the left side for 9, right side for 7 and bilateralis for 16. In the 48 hips, X-ray showed that comparatively large acetabular draw with normal position of femoral head in 21 cases (28 hips), large acetabular draw with femoral head lateral shift slightly but did not exceed 1/3 of femoral head in 11 cases (20 hips).MRI demonstrated that intraarticular fluid in 28 hips, subcartilage anormal signal of acetabular and femoral head at weight loading region in 10 hips, signal interruption of glenoid lip of hip in 10 hips. The procdure which included to remove of osteophyma, loose body and hyperplasia synovial membrane, degenerated cartilage on the stress areas of the hip joint, wear and tear of glenoid lip. Results The perianal skin in 2 patients suffered dysesthesia because of the over traction during operation. They recovered 7 days postoperation. Dysesthesias twenty-eight patients (36 hips) were follow-up with an average of 23 months (range, 6 months-3.5 years). After debridement and lavage, the patients released from pain, restored function and the range of the motion. According to VAS evaluation system for pain, the preoperative score was 5-9, with an average of 6.8; the postoperative score was 4-6, with an average of 2. According to Harris hip joint score evaluation system, preoperative score was 58.8?6.15, postoperative score was 89.6?11.3. The excellent in 20, good in 4, fair in 3 and poor in 1. The excellent and good result was up to 85.7%. Conclusion Selectivity debridement and lavage were effective methods for osteoarthritis hip joint acetabular dysplasia. It can delay the developing of course of disease; improve clinical symptom and elevate quality of life.

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.