Developing enterprise education in medical colleges and universities must have the following basic conditions:renewing medical educationconcept;establishing a teacher troop on teaching enterprise;building a good enterprise education atmosphere and strengthening practice teaching.

Chronic rhinosinusitis with nasal polyps (CRSwNP) and asthma is a common clinical refractory airway disease. Comprehensive treatment of nasal endoscopic surgery including nasal endoscopic surgery and medication, which can significantly improve nose-pulmonary symptoms and make sinusitis and asthma easier to be controlled by medication, has certain superiority. But the existence of disease heterogeneity of CRSwNP with asthma causes different reactions to the current treatment, which manifests as parts of polyps and asthma easy to recur and difficult to control. According to the research recently, the study of the heterogeneity of airway diseases, for example endotype, is a hot area of research. Endotype is a subtype of a condition, which is defined by a distinct functional or pathobiological mechanism. This is distinct from a phenotype, which is any observable characteristic or trait of a disease. Different Inflammatory subtypes often represent different pathophysiology and even different pathogenesis. The concept of inflammatory subtypes of airway diseases provides a new perspective for studies of airway diseases of endotype and the mechanism of combined airway diseases. This review summarizes recent advances in the clinical characterization and treatment of the CRSwNP with asthma. On this basis, we analyze and summarize the heterogeneity of CRSwNP and asthma separately from the perspective of inflammatory subtypes. Then according to the concept of the combined airway diseases and the common pathogenesis, we put forward the definition of inflammatory subtypes of the CRSwNP with asthma and preliminarily discuss the method of the definition.
Asthma ; complications ; Chronic Disease ; Endoscopy ; Humans ; Nasal Polyps ; complications ; Rhinitis ; complications ; diagnosis ; Sinusitis ; complications ; diagnosis

Chronic rhinosinusitis (CRS) can be controlled by a combination of conservative treatment and surgical procedures. However, there is one group of CRS endotypes, refractory CRS, such as eosinophilic chronic rhinosinusitis with nasal polyp (ECRSwNP), for which the current treatment strategies of anti-inflammatory and/or antibiotic therapy or surgical removal of the lesion to improve sinus drainage are less effective. This lack of treatment efficacy highlights the need for further fundamental and clinical research to improve or restore nasal mucosal function of CRS. The role of the immune response in the pathogenesis of mucosal remodeling, which is a key problem in refractory CRS, is of particular current interest. ECRSwNP characterized by Th17/Treg imbalance in- duced by IL-6 has a different mucosal remodeling pattern. This review intends to illustrate the role of the imbalance between Th17 (T helper 17) and Treg (regulatory T) cells in the mucosal remodeling of ECRSwNP and to suggest a novel therapeutic target on treating ECRSwNP.
Chronic Disease ; Humans ; Nasal Mucosa ; Nasal Polyps ; metabolism ; Rhinitis ; metabolism ; Sinusitis ; metabolism ; T-Lymphocytes, Regulatory ; Th17 Cells

OBJECTIVE: To investigate the therapeutic effects of 768 coblation treatment in children with obstructive sleep apnea-hypopnea syndrome. METHOD: A review of 768 coblation treatment in children with obstructive sleep apnea-hypopnea syndrome was presented with respect to the sleep monitoring results, therapeutic effects and complications. RESULT: The time of pseudomembrane ablate was 10-14 d after operation. There were 11 patients occurred Secondarily bleeding within 1 week and 21 patients lymphatic tissue hyperplasia compensatorily within half a year after operation. After operation 3 months, the sleep Monitoring results were improved remarkably (P < 0.01) and the symptoms of snore and choke improved. CONCLUSION Coblation treatment in children with obstructive sleep apnea-hypopnea syndrome can reduce bleeding volume and improve obstruct syndrome apparently. The treatments of tonsils and adenoids differ with the characteristics of children and tympanotomy was fit for chil dren with secretory otitis media.
Catheter Ablation ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Male ; Retrospective Studies ; Sleep Apnea, Obstructive ; surgery

Objective To investigate the expression of Foxo3a and p27kip1 in lumbar dorsal root ganglia (DRG) after injury of sciatic nerve in rats. Methods Adult rats were randomly divided into control group and experimental group. The rats in experimental group were subjected to sciatic nerve clamp.Expression and distribution of Foxo3a and p27kip1 and cellular proliferation and axon regeneration in DRG was detected by western blot and immunohistochemistry. Results Foxo3a protein levels begined to reduce at 1 day (7.0 ± 3.5), reached valley at 2 day (6.0 ± 3.8) after injury, and following Foxo3a downregulation, p27kip1 protein levels begined to decrease at 2 day (29.0 ± 3.5), reached valley at 7 day (21.0± 3.0) after injury. Down-regulation of Foxo3a and p27kip1 was expressed predominantly in neurons and glial cells by double immunolabelling. Foxo3a and p27kip1 were expressed in neurons [(37.8 ± 5.7)%, (43.3 ±4.3)%] and glial [(22.4 ± 3.9)%, (13.8 ± 3.2)%] cells in sections of DRG at 2 day after injury less than neurons [(73.6 ± 2.5)%, (84.1 ± 3.7)%] and glial [(61.3 ± 4.4)%, (68.7 ± 5.6)%] cells in sections of normal DRG. Proliferating cell nuclear antigen (PCNA) and GAP-43 were up-regulation from 2 day, and PCNA reached peak at 7 day after injury.The glial cells were the main type of cellular proliferation.Conclusion Down-regulation of Foxo3a and p27kip1 in lumbar DRG is correlated with the proliferation of glial cells and axonal regeneration after sciatic nerve injury.

BACKGROUND:So far the positive or negative effects of mesenchymal stem cel s on tumor growth and metastasis are under discussion. OBJECTIVE:To explore the mechanism of bone marrow mesenchymal cel s in promoting lung cancer metastasis. METHODS:Primary rat bone marrow mesenchymal stem cel s were obtained by direct adherence method of the whole bone marrow, and differential adherence combined with digestion control method was performed to purify cel s. Lung cancer cel lines were cultured, and the effects of bone marrow mesenchymal stem cel s on the migration, invasion and metastasis of lung cancer cel s were observed by scratch test, cel invasion and migration assays. Orthotopic lung cancer models were established in rats and bone marrow mesenchymal stem cel s were seeded onto the left lung of rats. Then, pathological changes of lung tissues were observed at 14 days after transplannation. RESULTS AND CONCLUSION:After the scratch test, the migration rate of lung cancer cel s became higher, and the scratches healed with time. And after cel transplantation, the number of migrated lung cancer cel s increased, as wel as the ability of lung cancer cel s penetrating the Matrigel was strengthened. Besides, fibrous connective tissues could be found around the lung cancer tissues, and necrosis with distinct boundary and large tumor nuclei;the metastatic tissues showed obvious infiltration and necrosis with large tumor nuclei. These results suggest that bone marrow mesenchymal stem cel s can promote the invasion, migration and metastasis of lung cancer cel lines.

BACKGROUND:Mesenchymalstem cels have pluripotent differentiation, and can promote cel engraftment and immune regulation. Therefore,we attempt to use human umbilical cord mesenchymal stem cels as anew source for treatment of lung cancer by exploringcelisolation, identification and transplantation combined with chemotherapyforlung cancer in mice.
OBJECTIVE:To investigate the isolation and identification of human umbilical cord mesenchymal stem cels and its transplantation combined with chemotherapy for lung cancer inmice.
METHODS:Human umbilical cord mesenchymal stem cels were isolated from fresh umbilical cord of newborns and identified using tissue culture and enzyme digestion. Twenty Balb/C nude mouse models of lung cancer were randomly divided into two groups:mice in chemotherapy group were given chemotherapy, and those incombinedgroup given combination of chemotherapy with human umbilical cord mesenchymal stem cel transplantation.
RESULTS AND CONCLUSION:Compared with the chemotherapy group, the gastrointestinal tract was rosy and shiny, intestinal mucosa was smooth and complete, and tumor mass and blood indexes significantly decreased in thecombinedgroup (P< 0.05). To conclude, mature human umbilical cord mesenchymal stem cels can be obtained by tissueculture and enzyme digestion, andthecel transplantation combinedwith chemotherapy can significantly reduce gastrointestinal tract damage and themake peripheral hemogram in a stable level.

OBJECTIVE To compare the clinical characteristics between eosinophilic and noneosinophilic CRSwNP and identify the predictors of eosinophilic CRSwNP. The impact of comorbidity (allergic rhinitis-AR, bronchial asthma-BA) on the predictors was also studied. METHODS Histologic characteristics of surgical samples were analyzed in 182 CRSwNP patients, who were classified into eosinophilic CRSwNP (ECRSwNP) group and noneosinophilic CRSwNP (non-ECRSwNP) group. Factors associated with ECRSwNP were selected by correlation analyses. The optimal cutoff points of the predictors were determined by a receiver operating characteristic curve. Based upon the different comorbidity, four groups were divided to study the impact of comorbidity on the optimal cutoff points of the predictors. RESULTS Patients with ECRSwNP had significant higher rate of revision FESS, significant higher concurrent rate of allergic rhinitis and bronchial asthma than non-ECRSwNP patients (all P<0.05). There were significant differences in Ratio of Lund-Mackay scores, peripheral blood eosinophil percentage and serum total IgE between ECRSwNP group and non-ECRSwNP group except the peripheral blood neutrophilic percentage (U value were 1028.00, 1143.50, 800.00 respectively, all P<0.05). Peripheral blood eosinophilic percentage had the highest significant correlation with degree of infiltration of eosinophils in nasal polyps (r =0.538, 0.568, both P<0.05) and there also existed significant correlation between degree of infiltration of eosinophils in nasal polyps and Lun-Mackay score (r =0.419, P<0.05). Comorbidity of AR and BA could impact the peripheral blood eosinophil percentage. According to the different combination of comorbidity, the range of the optimal cutoff points of peripheral blood eosinophil percentage was 3.05%-4.8%. CONCLUSION ECRSwNP and non-ECRSwNP displayed significant differences in certain clinical features. Comorbidity of AR and BA could increase the peripheral blood eosinophil percentage, that may impact the diagnosis of the subtype of ECRSwNP.

Objective To understand websites of public hospitals in China.Methods Website search and appraisal were called into play to analyze the percentage and present conditions of websites built by public hospitals in Shanghai,Hubei Province and Gansu Province.Rusults The study found websites in less than 55％ of the public hospitals in these three areas.Those websites in operation provide instant information on hospitals and medical services,yet their online service functions are less satisfactory and website levels vary sharply.Conclusion The authors recommend the Chinese government encourage public hospitals to build websites and enhance their online services.

Objective To demonstrate the spectrum of multi-detector spiral CT (MSCT) findings of drug-induced liver injury (DILI). Methods From May 2008 to January 2010, DILI was identified in 10 cases based on their clinical and pathological results. The spectrum of CT findings was analyzed retrospectively. Results According to the CT features, DILI were divided into three types. ( 1 ) Two cases presented diffuse hepatic injury, which appeared as homogeneous hypo-attenuation in precontrast CT scan and mild enhancement after contrast injection. The histopathological findings of the involved 1ivers include hepatocellular steatosis, neutrophil and eosinophil infiltration, punctiform necrosis and canalicular cholestasis. (2) Six cases presented focal hepatic injury, including massive wedge-shaped necrosis in 4,multiple small necroses in 1 and multiple regenerated nodules in 1. In precontrast CT scan, hepatic necroses were seen as inhomogeneous hypo-attenuation areas, which turned to hyper-attenuation after contrast injection and presented "flip-flop" sign between precontrast CT scan and portal venous phase scan. In the case with regenerated nodules, slight hyper-attenuation lesions were detected with diffuse distribution in liver in precontrast CT scan, which showed enhancement in hepatic arterial phase and turned to iso-attenuation in portal venous phase and equilibrium phase. The histopathological changes included massive necrosis or bridging necrosis with abundant neutrophil and eosinophil infiltration in 5 cases, nodular regeneration with cholestasis and feathery degeneratin in 1 case. (3) Two cases presented liver cirrhosis. CT displayed obvious nodularity of liver, which complicated with splenomegaly, ascites and collateral veins. The histopathological changes of these two cases included punctiform necrosis, canalicular cholestasis and pseudolobular formation. Conclusion CT signs of DILl have certain characteristics, which may help in detecting and determining the severity of liver damage.