English training is important for young doctors＇ career development in general hospital.The stagewise English training mode of Beijing Tiantan Hospital of Capital Medical University was introduced.By summarizing the experience of five years trial,viewpoints were brought forward that hospital English training in radiological department of general hospital should adopt a stagewise mode,create an English communication atmosphere,show the special feature of department and combine with clinical daily work.

OBJECTIVE The antagonism of obidoxi me on sarin induced miosis and visual impair-ment was evaluated and its antagonistic mechanism was investigated.METHODS ① 30 min after sarin (2 μg /0.1 mL per eye)was given as an eyedrop,the ability of the 2.5%,5.0%,7.5% obidoxi me and 1 .0% atropine to reverse effects of sarin on pupil dia meter and light reflex were evaluated at different ti mes.② Another 36 rabbits received sarin and at 30 min afer sarin exposure,the drugs above were ad-ministrated and their effects on pupillary light reflex,as well as the AChE activity of cornea,iris and reti-na were recorded 4h after the treatment.RESULTS ① Miosis and impaired pupillary light reflex oc-curred soon after sarin exposure but the abnormal pupil width and pupillary light reflex had disappeared by 48 h after sarin exposure;Subcequent to 1 .0% atropine treatment,the pupil dilatedinstead while the impaired light reflex did not i mprove significantly;unlike atropine,soon after ad ministration of 2.5%, 5.0%,7.5% obidoxi me,the pupil dia meter and light reflex were significantly increased(P <0.01 )and then had beco me normal totally by 24 h post-dose,much faster than those of the control and atropine treatment group.However,there was no significant difference in the recovery ti me between the different dose groups of obidoxi me.② 4h after treatment,the AChE activity in cornea and irisof sarin-treated group were (42 ±4)%,(26 ±2)%,respectively;the AChE activity in cornea of 2.5%,5.0%,7.5%obidoxi me were (74 ±1 1 )%,(81 ±10)% and (74 ±7)%,respectively,and the AChE activity in iris were(39 ±10)%,(43 ±8)% and (43 ±8)%,respectively ,co mpared with sarin-treated group,AChE activities of cornea and iris as well as light reflex of the obidoxi me-treated group were significantly increased(P<0.01 ).But there was no difference in light reflex and AChE activity between the sarin-treated and atropine-treated groups.CONCLUSION Obidoxi me showed better antagonism of sarin-induced ocular effects than that of the commonly used drug,atropine;the antagonistic mechanism is likely closely related to its rapid reactivation of the inhibited AChE in the cornea and iris.

OBJECTIVETo compare the advantages and disadvantages of the Foley catheter draining method versus the urethral stent plus gastric tube draining method for urine drainage following urethroplasty for hypospadias.

METHODSWe retrospectively analyzed the clinical data of 361 cases of hypospadias treated by urethroplasty. After operation, 91 of the cases received urine drainage with the Foley catheter (group A) and 270 with a urethral stent plus a gastric tube (group B). We compared the incidence rates of bladder irritation, fistula, urethral stricture, and urethral diverticulum between the two groups of patients.

RESULTSNo statistically significant differences were found between groups A and B in the incidences of bladder irritation (9.89% vs 10.70%, P > 0.05) and urethral diverticulum (1.09% vs 2.22%, P > 0.05). The incidence rate of fistula was markedly higher in group A than in B (20.80% vs 13.30%, P < 0.05), and so was that of urethral stricture (10.90% vs 5.55%, P < 0.05).

CONCLUSIONThe urethral stent plus gastric tube draining method is more effective than the Foley catheter draining method for urine drainage following urethroplasty.

Aged ; Child ; Diverticulum ; etiology ; Drainage ; methods ; Humans ; Hypospadias ; surgery ; Incidence ; Male ; Retrospective Studies ; Stents ; Urethra ; surgery ; Urethral Stricture ; etiology ; Urinary Catheterization ; instrumentation ; methods

AIMTo study the relationship between changes of learning, memory and orphanin FQ (OFQ) in hippocampus of rats in acute hypobaric hypoxia at two different altitude levels of 4 500 m(moderate) and 7 500 m(serious).

METHODSHypobaric chamber, Morris water maze training method and RT-PCR technique were used in the experiment.

RESULTS(1) Compared with the control, the OFQ mRNA expression of hippocampus increased significantly after exposure to acute serious hypobaric hypoxia (8 h/d for 6 d in succession), but obviously decreased after Morris water maze training (6 times/d for 6 d in succession, the latency of place navigation was shortened). (2) After exposure to acute hypobaric hypoxia, the latency of place navigation was markedly elongated, but the OFQ mRNA of hippocampus was significantly higher than that of learning and memory group.

CONCLUSIONThe hippocampal OFQ was involved in the mechanism of decrease in spatial learning and memory induced by acute hypobaric hypoxia.

Altitude ; Animals ; Hippocampus ; metabolism ; Hypoxia ; Maze Learning ; Memory ; Opioid Peptides ; physiology ; RNA, Messenger ; genetics ; Rats ; Rats, Wistar

Objective To evaluate the clinical value of total hemihepatic vascular exclusion (THHVE) for liver resection in hepatocellular carcinoma (HCC) patients and its effect on tumor recurrence, metastasis and patient survival. Methods Consecutive patients who were scheduled for elective hepatic resection were screened and allocated randomly to THHVE and Pringle maneuver groups. The total intraoperative blood loss, blood loss during transection, blood transfusion rate, operation time, vascular clamping time, complication, mortality, postoperative hospital stay, postoperative liver function index, overall survival time and diseasefree survival time were analyzed and compared between the two groups. Results From Aug. 2011 to Aug. 2013, 143 patients were eligible and were analyzed, with 71 in THHVE group and 72 in Pringle group. Baseline data were similar between the two groups. Total blood loss (250. 0 [150. 0-400. 0] mL vs 350. 0 [200. 0-637. 5] mL,P<0. 001) and blood loss during hepatic transection (100. 0 [50. 0-200. 0] mL vs 215. 0 [100. 0-380. 0] mL, P<0. 001) in the THHVE group were significantly less than those in the Pringle group. The vascular clamping time in THHVE group was significantly longer than that in Pringle group (27. 0 [20. 0-31. 0] min vs 20. 0 [16. 0-24. 0] min, P<0. 001); the serum ALT levels (P<0. 05) on postoperative day 1, 3, 7 and the serum total bilirubin levels (P = 0. 013) on postoperative day 7 in the THHVE group were significantly lower than those in the Pringle group, and the serum pre-albumin level was significantly higher in the THHVE group than that in the Pringle group on postoperative day 7 (P = 0. 038). The incidence rate of postoperative complication in THHVE group was significantly lower than that in Pringle group (21. 1% vs 37. 5%,P = 0. 032). The overall survival time in THHVE group was significantly longer than that in Pringle group (P = 0. 036). Multivariate analysis by the Cox proportional hazard regressionmodel showed that THHVE was one of the independent factors affecting overall survival, and the death risk of the patients in THHVE group was 47. 6% that of the patients in Pringle group. Conclusion THHVE is a safe and effective method in liver resection for patients with HCC, and the method is associated with less intraoperative bleeding, better postoperative liver function recovery, lower incidence rate of complication and better overall survival compared with Pringle maneuver.

OBJECTIVE Based on different drug loading models,three types of nanoparticulated HI-6 were prepared and their reactivations on inhibited acetylcholinesterase (AChE)in peripheral and central nervous syste ms were evaluated and compared in so man-intoxicated mice.METHODS Three kinds of nano-reactivators including HI-6 loaded human serum albunin nanoparticle (HSA-HI-6 NP),HI-6 absorptive mesoporous silica nanoparticle(MSN-HI-6),polylactico-glycolic acid nanoparticle coated HI-6 (PLGA-HI-6 NP)were prepared.The characteristic of all blank nanocarriers was observed through elec-tron microscope.HI-6 release rate of nano-reactivators was also determined in vitro.Then the reactiva-tion rate of nano-reactivators at a constant HI-6 dosage(22 mg·kg -1 )on so man-inhabited AChE both in blood and brain was assessed the so man intoxicated mice(120 μg·kg -1 ,sc).RESULTS All the syn-thetic nanocarriers met the de mand for nanodrug use in vivo.The rate of HI-6 release of nano-reactiva-tors was HI-6 >HSA-HI-6 NPs >MSN-HI-6 >PLGA-HI-6 NP in vitro.On the reactivations of so man-inhibited mice blood AChE,the free HI-6 and HSA-HI-6 NPs,as well as MSN-HI-6 showed co mparable reactivation rates(20% -30%)but were greater than that of PLGA-HI-6 NPs (6.2%)(P <0.01 ). However on the reactivations of so man-inhibited mice brain AChE,the reactivation rate of HSA-HI-6 NP (15.3%)was significantly higher than that of PLGA-HI-6 NP(3.3%)and free HI-6(6.3)(P<0.01 ).In addition,MSN-HI-6 group had a significant reactivation rate compared to PLGA-HI-6 NPs(P <0.01 ). But there was no statistic difference between MSN-HI-6 and free HI-6.CONCLUSION The reactivation potency changed obviously with different drug loading models and HSA-HI-6 NPs had the most potent reactivation on so man-inhibited AChE in both blood and brain.

OBJECTIVETo explore the efficacy and prognosis of first-line autologous hematopoietic stem cell transplantation (ASCT) for newly diagnosed patients with multiple myeloma(MM).

METHODSFrom January 2005 to December 31, 2012, 60 patients with MM were enrolled. All patients received thalidomide or/and bortezomib-based induction therapy, then received high-dose melphalan (200 mg/m²) and autologous stem cell support to get a ≥ partial response (PR), and followed by thalidomide-dexamethasone (TD) ±bortezomib as consolidation or maintenance treatment. With the follow up to December 31, 2012, the overall survival (OS), progression free survival (PFS) and the prognostic factors, including ISS stage, response and fluorescent in situ hybridization (FISH) data of cytogenetics were analyzed.

RESULTSWith a median follow up of 36.8 (12.0-102.5) months, the median OS and PFS estimate were not reached and 86.5 months, respectively. After transplantation, all (100%) patients received very good partial response (VGPR), and 34 (56.7%) patients achieved complete response (CR) after consolidation or maintenance treatment. The patients that achieved CR resulted in long term PFS (P=0.030), with no difference in OS (P=0.942). The univariate analysis showed that the abnormalities, including 13q14 deletion, 1q21 gain, IgH location and p53 deletion had the prognostic impacts. If the t(4;14) or p53 deletion was excluded, there would be no correlation between 13q14 deletion or 1q21 gain with PFS and OS. The patients with p53 deletion had a worst survival.

CONCLUSIONThere has been significant improvement in the outcome for young MM patients by using ASCT and novel drugs. Cytogenetic abnormalities and response to therapy are the main factors affecting the survival of patients.

Adult ; Aged ; Chromosome Aberrations ; Female ; Follow-Up Studies ; Hematopoietic Stem Cell Transplantation ; Humans ; Male ; Middle Aged ; Multiple Myeloma ; diagnosis ; genetics ; therapy ; Prognosis ; Transplantation, Autologous ; Treatment Outcome

OBJECTIVETo study the clinical value of total hemihepatic vascular exclusion (THHVE) in liver resection for patients with hepatocellular carcinoma (HCC) and impaired liver function.

METHODSThe data of 70 patients who underwent liver resection for HCC with impaired liver function between January 2009 and October 2011 were analyzed retrospectively. THHVE was applied in 38 patients (THHVE group), Pringle maneuver in 25 patients (Pringle group) and no vascular occlusion in 7 patients. In the THHVE group, 36 patients were male, 2 were female, average age was (54 ± 9) years. And in Pringle group, 23 patients were male, 2 were female, average age was (53 ± 10) years. Total intraoperative blood loss, blood transfusion rate, clamping time, postoperative complication rate, postoperative hospital stay and postoperative liver function were compared between the THHVE and Pringle group.

RESULTSTotal blood loss ((317 ± 186) ml vs. (506 ± 274) ml, t = -3.025, P = 0.004) and transfusion rate (10.5% vs. 32.0%, χ(2) = 4.509, P = 0.034) were significantly lower in the THHVE group than in the Pringle group. Although the clamping time was longer ((21 ± 5) minutes vs. (17 ± 5) minutes, t = 3.209, P = 0.002), the total bilirubin levels on postoperative day 3 and 7 and ALT levels on postoperative day 1, 3, 7 were significantly lower in the THHVE group than in the Pringle group, and the pre-albumin level on postoperative day 7 was higher in the THHVE group than in the Pringle group. Total complication rate (26.3% vs. 52.0%, χ(2) = 4.291, P = 0.038) and major complication rate (7.9% vs. 28.0%, χ(2) = 4.565, P = 0.033) were lower in the THHVE group than in the Pringle group. And postoperative hospital stay duration was shorter in the THHVE group than in the Pringle group ((14.0 ± 2.6) d vs. (16.4 ± 4.0) d, t = -2.625, P = 0.012).

CONCLUSIONSTHHVE is a safe and effective technique in liver resection for patients with HCC and impaired liver function. It is associated with less blood loss, lower transfusion requirements, better postoperative liver function recovery, lower postoperative complication rate and shorter postoperative hospital stay.

Adult ; Aged ; Carcinoma, Hepatocellular ; blood supply ; surgery ; Female ; Hepatectomy ; methods ; Humans ; Liver ; blood supply ; physiopathology ; Liver Neoplasms ; blood supply ; surgery ; Male ; Middle Aged ; Retrospective Studies

Objective·To study the effects of Roux-en-Y gastric bypass (RYGB) surgery on hepatic glycolipid metabolism in the rat models with obesity combined with type 2 diabetes mellitus (T2DM) and investigate the molecular mechanisms involved. Methods·The rats were randomly divided into control group, high-fat diet+DM group, sham-operated group and operated group, ten each. The changes of body weights and food intakes, as well as the results of intraperitoneal glucose tolerance test (IPGTT) and insulin tolerance test (ITT) were monitored. The mRNA and protein expressions of farnesoid X receptor (FXR), fibroblast growth factor 21 (FGF21) and glucose-6-phosphatase (G6Pase) were respectively detected. Results·The body weights and food intakes were significantly reduced in operated group, as compared to the high-fat diet+DM group and sham-operated group.The areas under the curve of IPGTT and ITT in operated group were reduced. Meanwhile, red lipid droplets of the operated group were obviously less than those of high-fat diet+DM group and sham-operated group by oil red-O staining. Furthermore, the mRNA expressions of FXR and FGF21 in operated group were significantly higher than those of high-fat diet+DM group and sham-operated group, while G6Pase mRNA expression was reduced. The protein levels of FXR and FGF21 were also higher in operated group than in high-fat diet+DM group and sham-operated group, but G6Pase level was decreased. Conclusion·RYGB could improve the glycolipid metabolism of rats with obesity combined with T2DM by activating FXR-G6Pase pathway.

OBJECTIVETo evaluate the efficacy and safety of Magnesium isoglycyrrhizinate in treatment of chronic liver diseases.

METHODSIt is a randomized, double-blind, multi-doses, active drug controlled, multi-center study. 480 proper patients were randomly divided into group A (180 patients), group B (180 patients) or group C (120 patients). Patients in group A received magnesium isoglycyrrhizinate 100 mg once daily. Patients in group B received magnesium isoglycyrrhizinate 150 mg once daily. Patients in group C received compound glycyrrhizin 120 mg once daily. The treatment course was 4 weeks. Patients were followed up 2 weeks after the treatment. Patients visited once every 2 weeks. Clinical symptoms, ALT, AST were evaluated in all the patients before treatment, at week 2, at week 4 and at 2 weeks later after treatment. The other liver function test was done before treatment and at week 4.

RESULTS412 patients completed the study according to the protocol,152 in group A, 160 in group B and 100 in group C. ALT and AST level were significantly decreased in all groups at week 2 and week 4 (P < 0.05). The degree of ALT decrease is greater in group B than in group C at week 2 (P < 0.01). The degree of ALT decrease was not significant different among three groups at week 4 (P > 0.05). The rates of ALT improvement at week 4 in group A, B, C were 92.59%, 91.76%, 88.29%, respectively (P > 0.05). The rates of symptoms improvement at week 4 in group A, B, C were 90.41%, 89.86%, 86.46% and 72.22%, 73.53%, 68.47%, respectively (P > 0.05). No relapse were found in all three groups after treatment. The rate of adverse event in three groups was similar (P > 0.05).

CONCLUSIONMagnesium isoglycyrrhizinate is an effective and safe treatment for chronic liver diseases.

Alanine Transaminase ; blood ; Anti-Inflammatory Agents ; adverse effects ; pharmacology ; therapeutic use ; Aspartate Aminotransferases ; blood ; Chronic Disease ; Double-Blind Method ; Fatty Liver ; blood ; drug therapy ; Female ; Glycyrrhizic Acid ; adverse effects ; pharmacology ; therapeutic use ; Humans ; Injections, Intravenous ; Liver ; drug effects ; pathology ; Liver Diseases ; blood ; drug therapy ; Liver Diseases, Alcoholic ; blood ; drug therapy ; Male ; Saponins ; adverse effects ; pharmacology ; therapeutic use ; Triterpenes ; adverse effects ; pharmacology ; therapeutic use