This paper argues that the core idea of evidence-based medicine is to “follow the evidence”,whose essence is a model of clinical medical service,and a guiding ideology for the clinical practice.It has become a proper noun nowadays.The wording “evidence-based medicine teaching method”needs discussion, because “evidence-based medicine” and “teaching method” are lack of logical internal relations in concept.The teaching method of scientific sense has its own characteristics and requirements.To name a teaching method,it is necessary to define its peculiar connotation in teaching method,with specific procedures and steps to form a complete set of scientific method of teaching.

Objective To investigate the efficacy of heparin plus low-dose aspirin on pregnant women with primary antiphospholipid syndrome(APS). Methods Three hundred and twenty women with unexplained pregnant failure were reviewed and anticardiolipin (aCL) immunoglobulin antibody G and M were tested. Heparin plus low-dose aspirin was given to 36 women with positive results. Results One fetal death and one embryo loss occured. The live birth rate was 94.4%(34/36) and the mean gestational week was (35.7?3.2) wks. The average birth weight was (2960?458) g which was significantly higher than the normal pregnancies (2684?324)g ( P

Clinical obstetrics practice is a very important process. According to our exploration on it on 7-year-systemmedical students in our hospital for nine years, we think that if you want high quality 7-year-system medical students,five concepts should be emphasized besides traditional basic knowledge, basic theory and basic skill, which are familyplanning and eugenics, loving infants, whole concept, new medical model and renewing knowledge.

Objective To study the value of SCCAg,CYFRA21-1 and TPS in the diagnosis and prognostic evaluation of patients with cell cervical cancer (SCC).Methods The levels of serum SCCAg,CYFRA21-1and TPS from 160 SCC patients and 60 health women were detected by means of ELISA.Results ( 1 ) The levels of serum SCCAg,CYFRA21-1and TPS in SCC were significantly higher than those of normal group ( P ＜0.001 ).The median values of normal group:0.43 μg/L,0.43 μg/L,26 U/L,the median values of cervical cancer group:1.96 μg/L,2.29 μg/L,149.1 U/L ( 2 ) The specificity of SCCAg,CYFRA21-1 and TPS in diagnosing SCC were both 100％.The sensitivity of SCCAg,CYFRA21-1 and TPS in diagnosing SCC was 53.42％,40.68％ and 83.95％,respectively.The sensitivity of TPS was obviously different from SCCAg and CYFRA21-1 ( P ＜0.001 ).The sensitivity of SCCAg plus CYFRA21-1 and three markers together were 69.23％and 92.31％,respectively.(3)The expressing of SCCAg,CYFRA21 -1 and TPS in FIGO stages Ⅲ plus Ⅳ was significantly higher than in stages Ⅰ plus Ⅱ (P ＜ 0.05 ),and all markers were not related to the degree of histological differentiation.SCCAg was correlated strongly with tumor size,growth type,lymph node metastasis and age( P ＜ 0.05 ),but CYFRA21-1 was not correlated with all these factors.TPS level was significantly associated with tumor size and lymph node metastasis( P ＜0.05 ),but not with growth type and age.(4)A total of 78 patients were followed up.The pretreatmental serum levels of SCCAg and CYFRA21-1 in patients with recurrence were significantly higher than those without recurrence( P ＜0.05 ).The same trend was not found for TPS.Compared with the normal control,the patients with elevated SCCAg before treatment has shorter intervals before recurrence and metastasis occurred.Also,the survival of patients with elevated SCCAg before treatment was shorter than the normal control ( P ＜ 0.05 ).Conclusion SCCAg,CYFRA21-1 and TPS serum levels are valuable markers for the diagnosis of SCC.Meanwhile,SCCAg and CYFRA21-1 are chnically significant pridictors for the prognosis of SCC.

Objective To investigate the expressions of Transforming Growth Factorβ2 (TGF-β2) and Smad3 in human gliomas associated with pathologic grading. Methods The expressions of TGFβ2 and Smad3 protein were detected with SP immunhistochemistry in 80 human glioma specimens. The Kapan-Meier survival curves of progression-free survival time and overall survival time in different expression levels was compared with log-rank. Results The expression of TGFβ2 and Smad3 correlated with the pathological grading (r=0.545, r=0.570, P<0.01). Both progression-free survival time and overall survival time were significantly different between low expression group and high expression group (P<0.05). Conclusion Both TGF-β2 and Smad3 correlate well with the occurrence and differentiation of human gliomas,which help for the diagnosis, treatment and prognosis judgment．

OBJECTIVETo explore the role of the hydatidiform mole-related gene F10 in the tumorigenicity of choriocarcinoma cell lines JEG-3 in nude mice.

METHODSChoriocarcinoma JEG-3 cell lines with stable F10 gene over-expression and F10 gene silencing were established using cell transfection and RNA interference techniques, respectively. Thirty SPF nude mice (4-5 weeks old) were equally randomized into F10 over-expression group, control group, and F10 gene-silenced group for subcutaneous injection of 0.2 ml cell suspension (5 × 10⁷ cells) of F10 gene over-expressing JEG-3 cells, non-treated JEG-3 cells, and F10 gene-silenced JEG-3 cells, respectively. The mice were observed and weighed every 3-4 days, and the tumor formation time was recorded to draw the tumor growth curve and calculate the tumor formation rate.

RESULTSThe tumor formation rates were 100% in all the 3 groups. No significant difference was found in the tumor formation time among the F10 over-expression, F10-silenced and control groups (6.2 ± 0.78 vs 7 ± 2.49 vs 6.3 ± 0.67 days; F=0.781, P=0.468). A significantly greater tumor growth rate was noted in the F10 over-expression group compared with the other two groups (P<0.05), and the growth rate was significantly slower in F10-silenced group than in the control group (P<0.05). The subcutaneous tumor weight at 5 weeks after JEG-3 cell injection differed significantly among F10 over-expression, F10-silenced and control groups (571.1 ± 221.10 vs 136.2 ± 66.25 vs 354.5 ± 116.23 mg; F=21.199, P=0.000).

CONCLUSIONF10 gene plays a role in the regulation of choriocarcinoma JEG-3 cell proliferation and might enhance its tumorigenicity in nude mice.

Animals ; Cell Line, Tumor ; Cell Proliferation ; Choriocarcinoma ; pathology ; Female ; Gene Expression ; Gene Expression Regulation, Neoplastic ; Genes, Neoplasm ; Humans ; Hydatidiform Mole ; genetics ; Mice ; Mice, Nude ; Pregnancy ; Transfection ; Uterine Neoplasms ; pathology

OBJECTIVETo evaluate the significance of the serum cystatin C (Cys-C) in assessing renal dysfunction in preeclamptic women.

METHODSNinety-six women with normal pregnancies and 48 with severe preeclampsia were examined for 24-hour creatinine clearance (CrCl), serum creatinine (Scr), Cys-C, uric acid (UA) and beta microglobulin (MG) concentrations during the second and third trimesters and postpartum in severe preeclamptic patients. These indexes were analyzed to estimate the glomerular filtration rate.

RESULTSThe concentrations of Scr, UA and MG were significantly higher in the third trimester than in the second trimester in women with normal pregnancies, where serum Cys-C levels showed no significant variations. Severe preeclamptic patients exhibited significantly higher serum Cys-C levels in the third than in the second trimester. Correlation analyses demonstrated significant negative correlations between Cys-C and 24-hour CrCl in the second and third trimesters in all the 144 pregnant women and in the postpartum period in severe preeclamptic patients.

CONCLUSIONSerum Cys-C can serve as a good indicator for assessing renal function in severe preeclamptic women from antepartum to postpartum periods.

Case-Control Studies ; Creatinine ; blood ; Cystatin C ; blood ; Female ; Humans ; Kidney ; physiopathology ; Pre-Eclampsia ; blood ; physiopathology ; Pregnancy ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Retrospective Studies ; Uric Acid ; blood ; beta 2-Microglobulin ; blood

BACKGROUND: The HELIOS stent is a sirolimus-eluting stent with a biodegradable polymer and titanium oxide film as the tie-layer. The study aimed to evaluate the safety and efficacy of HELIOS stent in a real-world setting. METHODS: The HELIOS registry is a prospective, multicenter, cohort study conducted at 38 centers across China between November 2018 and December 2019. A total of 3060 consecutive patients were enrolled after application of minimal inclusion and exclusion criteria. The primary endpoint was target lesion failure (TLF), defined as a composite of cardiac death, non-fatal target vessel myocardial infarction (MI), and clinically indicated target lesion revascularization (TLR) at 1-year follow-up. Kaplan-Meier methods were used to estimate the cumulative incidence of clinical events and construct survival curves. RESULTS: A total of 2998 (98.0%) patients completed the 1-year follow-up. The 1-year incidence of TLF was 3.10% (94/2998, 95% closed interval: 2.54-3.78%). The rates of cardiac death, non-fatal target vessel MI and clinically indicated TLR were 2.33% (70/2998), 0.20% (6/2998), and 0.70% (21/2998), respectively. The rate of stent thrombosis was 0.33% (10/2998). Age ≥60 years, diabetes mellitus, family history of coronary artery disease, acute myocardial infarction at admission, and device success were independent predictors of TLF at 1 year. CONCLUSION: The 1-year incidence rates of TLF and stent thrombosis were 3.10% and 0.33%, respectively, in patients treated with HELIOS stents. Our results provide clinical evidence for interventional cardiologists and policymakers to evaluate HELIOS stent. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, NCT03916432.
Humans ; Middle Aged ; Sirolimus/therapeutic use* ; Drug-Eluting Stents/adverse effects* ; Prospective Studies ; Cohort Studies ; Treatment Outcome ; Risk Factors ; Time Factors ; Percutaneous Coronary Intervention/adverse effects* ; Cardiovascular Agents/therapeutic use* ; Coronary Artery Disease/therapy* ; Myocardial Infarction/etiology* ; Thrombosis/complications* ; Polymers ; Registries