Objective:To explore the role of PDCA cycle in the standardized residency training in the department of hematology.Methods:Thirty residents trained in the department of hematology of Peking University Third Hospital from January 2019 to September 2019 were enrolled into experimental group, and 36 residents trained from January 2018 to December 2018 were enrolled into control group. Experimental group received the PDCA cycle teaching method and control group did the traditional one. At the end of the training, the results of theory examination and practical operation skills examination of the two groups were compared. The statistical significance was analyzed on the assessment scores and teaching satisfaction between the two groups. SPSS 20.0 was used for t test. Results:Compared with the control group, the examination scores and teaching satisfaction of the residents in the experimental group were higher than those in the control group ( P < 0.05). Conclusion:The teaching mode of PDCA cycle is conducive to improving the effect of standardized residency training in the department of hematology.

Objective To observe the basic rhythm of myoelectrie activities of sphcter of Oddi (SO)and explore its biological significance.Methods Healthy adult rabbits(n=32)were randomized into 4 groups with 8 in each.The first group was for recording of myoelectric activities of SO after keeping fast for 18 hours.The second group was manipulated to observe the myoelectric activities of SO after food infusion through the stoma in stomach.The myoelectric activities of SO in the third group were monitored after the classical Nardi test was performed on these rabbits.The fourth group was used to observe the myoelectric activities of SO after the cholinergic receptors had been blocked.Using the double claw metal electrodes which were put into SO and duodenum through the plasma membrance,the myoelectric signal were recorded with RM6240 multi-channel physiologic recording and signal processing system and non-stop recording was conducted for 120-150 mins.Results 1)Spike Potentials of SO with the frequency was observed in rabbits that had been fasting.2)Myoelectronic activity of SO was observed in rabbits infused with 50 ml milk through stoma.3)After the administration of 1 mg morphine and 1 mg neostigmine i.v,the myoelectric activities of SO were noted as long-lasting persistent MASO.4)Administration of anisodamine 1 mg(i.v.)in the empty abdomen group dismissed SPSO and MASO.This state lasted for 120 min before SPSO gradually reconverted to the state of empty abdomen.Conclusion There are four patterns of myoelectric activities of SO,i.e,tensional waves under empty abdomen indicating a state in which the SO kept a basic tension level.Peristaltic waves under intake of food.Spastic waves under the stimulation of drugs and relaxant waves under the post-ganglionic block of cholinergic receptors were observed in the present study.Correspondingly,their mechanic locomotion is inferred as the basic tensional state to faciliate the deposition and condensation of bile,the peristalsis for the entry of bile into duodenum,the spasmus so that the bile can not be released into duodenum under pathological situation or the effect of drugs.the long lasting relaxant state after effective inhibition of post-ganglionic cholinergic receptors,respectively.The above results indicate that there are more than two states that is ON or OFF in SO and the concepts of contract and peristalsis of SO should be distinguished.

AIM: to assess the effectiveness of a combined procedure ( pars plana vitrectomy with temporary keratoprosthesis, vitreoretinal surgery, and penetrating keratoplasty). in the complicated cases and the risk factors for the surgical failure.METHODS: Restrospectively reviewed charts of patients who underwent penetrating keratoplasty in combination with vitreoretinal surgery between 1990 and 2005, with a follow-up of 3mo to 9a. Analysis was focused on ocular history, indications for surgery, visual acuity (VA), anatomic results, and complications.RESULTS: 18 eyes had light perception or VA of hand motions only. The best-corrected VA improved during the first 3mo, increased in 72.2% of all eyes, remained unchanged in 27.78%, and no decreased. In 3 of 18 eyes (16.67%), VA was better than finger counting and hand motions, and nine eyes(50%) showed useful vision (0.05) postoperatively. 10 eyes showed a clear corneal graft (55.56%). 2 eyes needs the second keratoplasty, Bullous corneal edema was evident in 3 eyes, band keratopathy was evident in a 3 eyes. 10 patients were observed for more than 2a;6 had a clear graft (60%). Two eyes (11.11%) had silicone oil-corneal endothelium contact and all of these grafts failed.CONCLUSION: Although the functional outcome of a combined procedure is limited by primary and secondary tissue destruction, preserving ambulatory vision is possible and thus improves the quality of life, at least in patients with single remaining eyes.

Objective To observe the effects of Atorvastatin on matrix matalloproteiases-2 (MMP-2) level in patients with stable an ginapectoris(SAP) and acute coronary syndrome(ACS).Methods Sixty SAP and sixty ACS patients were randomly divided into either the Atorvastatin group or the control group.The levels of MMP-2 before and after treatment were detected.Results After treatment with Atorvastatin,the levels of MMP-2 in both two groups significantly de- creased(P

Objective To study bacteria-blocking effect of surgical gowns with new material.Methods Semi-quantitative and qualitative testing methods were used to detect bacteria-blocking rates of key sites of surgical gowns(chest and forearm), the detected samples included sample A (composite material, unused), sample B (composite material, after washing 100 times), and sample C (monolayer material, unused).Results In semi-quantitative testing,the average bacteria-blocking rates of three samples were 75.47%, 70.78%, and 73.73% respectively.In qualitative testing,three samples could effectively block the penetration of Staphylococcus aureus under wet condition and Bacillus subtilis var.niger spores under dry condition.Conclusion In semi-quantitative testing, all three kinds of samples had bacteria-blocking effect, and the average bacteria-blocking rate was> 70%;in qualitative testing, three samples all meet requirements of bacteria-blocking effect under wet and dry condition.

Objective To explore radiographic and MRI features of the hemangiomas and vascular malformation in the deep soft-tissue of the extremities.Methods 89 cases confirmed by surgical pathology and angiography were analyzed retrospectively with clinical data and radiological findings.Imaging exams included plain X-ray performed in all patients,and MRI scan in 33 patients.Results On X-ray plain film,there was normal bone and soft tissue in 54 cases(60.7%),soft tissue abnormalities in 14 cases(1 5.7%),and phleboliths in 30 cases(33.7%).Also,plain X-ray film studies demonstrated bone changes adjacent to the deep soft tissue in 32 cases(36.0%), including periosteal reactions(13 cases),cortical erosion (1 6 cases),involvement of the bone marrow (10 cases)and 7 diffuse lesions with all above changes.On MRI,lesions were similar to honeycomb or sponge,and T1 WI showed isohypointense signal in 25 cases (75.8%),hypointense in 5 cases (1 5.2%),inhomogeneous slightly hyperintense in 3 cases (9.0%).On T2 WI,all lesions were well defined and showed hyperintense signals with hypointense septation,of which there were 9 cases with nodular hypointense areas and vascular flow effect.Hypointense phleboliths were showed in 10 cases(30.3%).Following injection of the contrast medium,all lesions had heterogeneous enhancement patterns.Of the 33 patients studies with MRI,lesions of 18 cases(54.5%)had bone changes which were adjacent to or partially or fully wrapped by neighbouring soft tissue lesions,in which lesions of 12 cases showed abnormal signal within bone marrow and lesions of 3 cases with vascular flow void phenomenon.In 15 cases (45.5%)without osseous change,lesions of 3 cases were adjacent to bone,and lesions of 12 cases were with fat and muscle septum between the bone and lesions.Conclusion The hemangiomas and vascular malformation in the deep soft-tissue of the extremities may cause changes in adjacent bones.Familiarity with the performance of reactive bone changes on X-ray and MRI may help to improve the diagnosis and avoid misdiagnosis.

Objective To investigate the expression of scaffold protein palladin in pancreatic ductal adenocarcinoma (PDAC) tissues and to discuss its clinicopathological significance.Methods 56 samples of PDAC and corresponding adjacent normal pancreas (NP) tissues were collected.Another 10 samples of chronic pancreatitis (CP) tissues were collected.Western blot analysis and immunohistochemistry assay were performed to detect the expression of protein palladin.The correlation of palladin expression with clinicopathological factors of PDAC was analyzed.Results Western blot analysis revealed that the expression of palladin in PDAC,CP and NP tissues were respectively 0.93±0.07,0.41±0.07 and 0.20±0.06,and the expression of palladin was significantly increased in PDAC tissues compared with NP and CP tissues (P ＜ 0.05),and its expression was significantly increased in CP tissues compared with NP tissues (P ＜ 0.05).Immunohistochemical staining showed that palladin was mainly expressed in activated myofibroblasts in PDAC tissues.The rate of palladin expression was 79 ％ (44/56),which was higher than that in NP tissues (2/10) and CP tissues (4/10),and its expression was found to be correlated with the degree of tumor differentiation,lymph node metastasis and clinical TNM classification (P ＜ 0.05),and it had no correlation with patient' s sex,age,tumor location and distant metastasis (P ＞ 0.05).Conclusions Scaffold protein palladin is highly expressed in PDAC tissues,and it is expressed in the activated myofibroblasts within tumor microenvironment.Scaffold protein palladin may be involved in the invasion and metastasis of PDAC.

AIM: To obtain a McAb that can inhibit the function of matrix metalloproteinase-2 (MMP-2), we expressed the fibronectin-like domain of MMP-2 (MFD) in vitro and prepared a McAb against MMP-2. METHODS: The purified MFD protein was used to immunize BALB/C mouse three times. Then the spleen of mouse was taken out and hybridized with hybridoma cells SP2/0. The positive cell clones were screened with ELISA method. The subtype and tissue specificity of the McAb were identified and its effect on endothelial cell migration and tube-formation was analyzed. RESULTS: After the spleen cells of the mouse and hybridoma cells SP2/0 were hybridized, a piece of cells that continuously secreted McAb against MMP-2 was obtained and named SZ-117. The titers of this McAb in culture supernatants and ascites were 2?10~-3 and 2?10~-5 , respectively. The heavy chain of the McAb belongs to IgG1 subclass. The McAb identified native MMP-2. MMP-2 existed in the stromal tissue of stomach, cholecystis, spleen, ovarian, prostate, salping and lymph node. It inhibited the invasion behavior of endothelial cells Eahy926 and pancreatic carcinoma cells 1990 and inhibited the tube-formation of Eahy926 cells. CONCLUSION: A useful tool for testing MMP-2 is obtained and it will be helpful to look for a kind of new anti-tumor material.

Objective To evaluate the value of low concentration of isotonic contrast agent combined with 80 kV and adaptive statistical itera-tive reconstruction (ASiR)technique for bronchial artery with CT angiography (CTA).Methods 40 patients (18.5 kg/m2 ≤ body mass index(BMI)≤25 kg/m2 )with lung cancer were randomly divided into two groups and performed enhanced chest CT examina-tion.20 patients (low concentration group)were scanned with Visipaque 270mg I/mL,scanning protocol of (80 kV,260 mA)and other 20 patients (high concentration group)were scanned with Ultravist 370 mg I/mL,scanning protocol of (120 kV,1 50 mA). The CT value,signal noise (SD),signal-to-noise ratio (SNR),contrast-to-noise ratio (CNR)and effective dose (ED)of the two groups were compared and analyzed statistically.Differences between the two groups were determined with t test(P <0.05).Results The mean CT value of the low concentration group (31 7.33 HU±70.44 HU)was higher than that of the high concentration group (256.39 HU±37.38 HU)(P <0.05).SD,ED and dose length product (DLP)of the low concentration group (SD:7.55 ±1.51 HU;ED:1.74±0.14 mSv;DLP:124.94±9.9 mGy/cm)were lower than those of the high concentration group (SD:9.36±1.26 HU;ED:3.20±0.35 mSv;DLP:228.82±25.13 mGy/cm)(P <0.05).CNR and SNR of the low concentration group (CNR:59.71± 17.36;SNR:44.01±14.71)were higher than those of the high concentration group (CNR:37.61±6.16;SNR:27.75±4.72)(P <0.05).The subjective scores of the two groups were (3.73±0.66)and (3.81±0.59),respectively,with no statistical difference.Conclusion For the patients with normal body mass index ,it can reduce 47% radiation dose and 27% iodine dosage using low concentration of isotonic contrast agent combined with 80kV and ASiR technique for bronchial artery CTA,while maintaining similar excellent image quality.

Objective To establish a rat model of liver metabolism profile in chronic heart failure (CHF), to explore the dynamics of liver metabolism in CHF from the point of view of metabolism, and to find the characteristic metabolites valuable for the molecular mechanism and management of CHF.Methods Twenty male Wistar rats were assigned to the CHF group to receive aortic coarctation or to the control group to receive sham surgery, and were bred for 24 weeks following surgery.The metabolic profiling of the rat liver tissues was analyzed on a metabonomics research platform. Orthogonal partial least squares-discriminant analysis ( OPLS-DA) model and principal component analysis ( PCA) model were established for liver tissues of the CHF rats, and the characteristic metabolites were finally derived by data processing with SPSS 19.0 software.Results The PAC and OPLS-DA models were established successfully.Ten characteristic metabolites with significant differences between the CHF and control groups, including lysophosphatidyl choline, lysophosphatidyl ethanolamine, oleic acid, glycocholic acid, and dehydroepiandrosterone sulfate, were screened and identified from the models.Conclusions The metabolic disorders in CHF rats are well fitted to the established metabolic profile models, and these identified characteristic metabolites may provide reference for the pathophysiological molecular mechanism and management, etc., of chronic heart failure.