Objective: To investigate the combined examination of plasma levels of troponin T (TnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP) for predicting the risk of peri-operative cardiovascular events in elder coronary artery disease (CAD) patients with non-cardiac surgery. Methods: A total of 200 patients from (60-82) years of age with elective non-cardiac surgery were enrolled. The patients were divided into 2 groups: CAD group,n=118 and Non-CAD group,n=82. Plasma levels of TnT and NT-proBNP were examined at 1 day before and 2 days after the operation respectively. The cardiovascular events were recorded in both groups and the best cut-off values for TnT and NT-proBNP in risk prediction were evaluated by receiver operating characteristic (ROC) analysis. Results:①CAD group had the higher levels of post-operative TnT and NT-proBNP than pre-operative; both TnT and NT-proBNP levels were higher in CAD group than those in Non-CAD group at the same time points, allP<0.05.②The total cardiovascular events in CAD group was higher than those in non-CAD group (χ2=5.85,P=0.016) and the individual event was similar between 2 groups.③In CAD group, the best cut-off value for pre-operative TnT in predicting peri-operative cardiovascular events was 18.5 ng/L with the sensitivity at 72% and speciifcity at 69.6%; for NT-proBNP was 98.0 pg/ml with the sensitivity at 90.8% and speciifcity at 74.6%.④The patients with the higher level of pre-operative TnT had the increased risk of total cardiovascular events than those with normal TnT (χ2=4.56,P=0.043), and the same as NT-proBNP (χ2=4.08, P=0.036). Likewise, the patients with higher levels of both pre-operative TnT and NT-proBNP had the increased risk of total cardiovascular events than those with normal TnT and NT-proBNP (χ2=13.32,P=0.000). Conclusion:Either plasma levels of TnT or NT-proBNP could be used as the biomarker for predicting the risk of peri-operative cardiovascular events in elder CAD patients with non-cardiac surgery, the combined examination would have the better predictive value.

Objective To evaluate the safety and efficacy of percutaneous sclerotherapy through pig tail drainage tube for giant hepatic and renal cysts under CT guidance. Methods Seventeen cases of giant hepatic and renal cyst were percutaneously implanted with 7 F pig tail drainage tube under CT guidance, together with daily injection of dehydrated ethanol or acetic acid. The drainage tube should be clamped after injection of sclerosing agent for cystic fluid 500 ml, immediate reopening of the drainage tube should be taken sright after the sclerotherapy. The withdrawal of drainage tube should be taken after resclerotherapy for all patients with

BACKGROUND: Calcium sulfate/poly amino acid compound materials carrying triple anti-tuberculosis drugs have been proved to have excellent slow release performance based on our preliminary studies on the physical and chemical properties and the release properties of the compound materials.OBJECTIVE: To observe the slow release performance of the calcium sulfate/poly(amino acid) compound material carrying triple anti-tuberculosis drugs in a rabbit model of spinal tuberculosis.METHODS: Twenty-four New Zealand white rabbits were used to make L4-5 spinal tuberculosis models and divided into two groups in a random way following removal of tuberculosis lesions. Calcium sulfate/poly amino acid compound material carrying isoniazide, rifampicin, pyrazinamide or calcium sulfate/poly(amino acid)compound material with no drugs was implanted into the defect in the experimental or control group,respectively. At 2, 4, 6 and 8 weeks after implantation, the concentrations of isoniazid, rifampicin and pyrazinamide in the defect region, including the bone tissue, adjacent psoas major and inferior vena cava,were measured.RESULTS AND CONCLUSION: In the experimental group, the isoniazid levels in the damaged bone tissue and psoas major were kept in minimum bactericidal concentration (MBC) at 8 weeks after implantation and in the minimum inhibitory concentration (MIC) at the end of 12 weeks after implantation, while its level in the vein was kept in MBC at 2 weeks and in MIC at 8 weeks. The rifampicin levels in the bone tissue and psoas major were kept in MBC at 4 weeks after implantation and in the MIC at 8 weeks after implantation, while its level in the vein was kept MIC at 4 weeks.The pyrazinamide levels in the damaged bone tissue and psoas major were kept in MBC at 8 weeks after implantation and in the MIC until 8 weeks after implantation, while its level in the vein was kept MIC at 8 weeks. In the control group,there were no levels of isoniazid, rifampicin and pyrazinamide in the damaged bone tissue, adjacent psoas major and inferior vena cava in comparison with the baseline. These results show that isoniazid, rifampicin and pyrazinamide in the defect region can achieve sustained slow release in the rabbit model of spinal tuberculosis after implantation of the calcium sulfate/poly(amino acid) compound material carrying triple anti-tuberculosis drugs. In addition, the local drug concentration and duration in the defect region are better than those in the blood.

Objective To investigate the clinic technique and effect of treating lumbar disc herniation (LDH) with decompressor and ozone injection combined lumbar traction after surgery.Methods 110 contained LDH patients were randomly divided into two group:decompressor and ozone group,decompressor and ozone combined lumbar traction after surgery group.Under the guidance of CT,fifty-five patients in group A were treated by disc decompression with Decompressor through poster olateral approach,then ozone was injected into the lumbar disc or out side the lumbar disc,and the other fifty-five patients in group B were treated by lumbar traction after surgery that disc decompression and ozone injection same as the group A in once a day and one week of treatment.The theraputic effect was evaluated by comparing VAS,effective rate of therapy before and after treatment.Results The VAS score of two groups at 1,3,7 days between pre-and post-treatment had singificantly different(t =2.159,2.163,2.169,2.167,2.173,2.192,all P ＜0.05).110 case were followed up after 6 and 12 months,The good-excellent rate of therapy in B group 12 months were better than those of A group (x2 =74.23,75.11,all P ＜ 0.05).Conclusion Decompressor combined ozone injection and lumbar traction after surgery is an effective menthod for treatment of the central type mbar disc herniation.

Objective:To explore the application value of case three-dimensional teaching method combined with standardized patient (CTTM+SP) in the clinical clerkship teaching reform of gastrointestinal surgery.Methods:A total of 120 students of clinical medicine having clerkship in Binzhou Medical University Hospital were recruited in this study, and they were randomized to the experimental group and the control group, with 60 students in each group. The experimental group took the CTTM+SP teaching method, and the control group adopted the lecture-based learning teaching method. The comprehensive ability of the two groups was evaluated by department graduation examination and satisfaction survey.Results:The examination performance and the satisfaction rate of students in the experimental group were significantly higher than those of the control group ( P < 0.05). Conclusion:CTTM+SP teaching method is helpful for the probationers to master the theoretical knowledge of gastrointestinal surgery systematically, improve the clinical thinking ability and the ability to solve practical problems, mobilize the students' learning motivation and interest, and improve the teaching effect of gastrointestinal surgery clinical clerkship.

OBJECTIVETo construct a recombinant lentiviral vector that stably express hepatocyte nuclear factor 6 (HNF6) in colorectal cancer cell line and examine its effects on the invasive ability of SW620 cells.

METHODSThe lentiviral vector pLeno-DCE-HA-HNF6 was constructed and transfected into 293T cells. The supernatant containing the lentivirus particles was harvested to determine the virus titer. A stable cell line was established by infecting SW620 cells with the lentivirus particles, and the transfection efficiency was examined by fluorescence microscopy and flow cytometry. The invasion ability of the transfected SW620-HNF6 cells was assessed by wound healing and transwell assays.

RESULTSThe recombinant lentiviral vector was correctly constructed and verified by sequencing. SW620-HNF6 cell line with stable HNF6 expression was established successfully, and the transfection efficiency reached 82.3%. Western blotting and quantitative PCR demonstrated significantly upregulated HNF6 expression in SW620-HNF6 cells, which showed obviously suppressed invasive ability in wound healing and transwell assays.

CONCLUSIONWe have successfully established a colorectal cancer cell line SW620-HNF6 stably expressing HNF6, which shows a lowered migration activity in vitro.

Cell Line, Tumor ; Cell Movement ; Colorectal Neoplasms ; metabolism ; pathology ; Genetic Vectors ; genetics ; Hepatocyte Nuclear Factor 6 ; biosynthesis ; genetics ; Humans ; Lentivirus ; genetics ; metabolism ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Recombinant Proteins ; biosynthesis ; genetics ; Transfection

The purpose of this study is to investigate the basic situation of self-regulated learning among clinical medical undergraduates in the stage of professional courses and construct a structural model suitable for them to carry out self-regulated learning . Zimmerman's self-regulated learning concept framework was determined as the theoretical basis of this study. A questionnaire survey was performed to identify five main dimensions affecting self-regulated learning including expression of learning intention, self-efficacy, adjustment of learning behavior, management of curriculum strategies, and adaption of learning environment, and then, Amos 24.0 software was used to construct the structural model and draw the conclusion that self-regulated learning in this group centers on the regulation of learning behavior, with learning intention and self-efficacy as sub-centers.

OBJECTIVE To investigate the effect of amifostine(Amf)on the differentiation of human megakaryocyte cell line-Dami. METHODS Dami cells were treated with Amf 0.01-5.0 mmol · L-1 for 12 d. Dami cells were counted every day for the growth curve:only cells with a diameter>20μm. The platelet demarcation membrane system was observed by transmission electron microscopy. The expression of CD33,CD34,CD41a and DNA ploidy was detected by flow cytometry. RESULTS Amf 0.1-1.0 mmol · L-1 promoted the differentiation of Dami cells ,but inhibited their proliferation at a concentration>1.0 mmol · L-1. When these cells were treated with Amf 1.0 mmol · L-1 for 12 d,the platelet demarcation membrane system was observed,the percentage of cells with a diameter >20 μm was increased by 24.6%(P<0.01),the expression of CD41a was increased by 11.9%,while the expression of CD33 was decreased by 13.6%(P<0.05). Polyploidy cells(16N)were observed,and 4N,8N and 16N cells were increased to 31.56%,8.83% and 3.43%,respectively(P<0.05). CONCLUSION Amf 0.1-1.0 mmol · L-1 can promote the differentiation of Dami cells,but inhibit their proliferation at a high concentration(>1.0 mmol·L-1).

Objective: To explore relationships between the enrichment of ETBF, Fn, Hp in feces, tissues and colorectal cancer. Methods: Feces, lesion tissue and adjacent tissue from 24 patients with colorectal cancer and 31 patients with adenomas were collected, and we collected Feces and tissue of 20 healthy control persons. Then the copy numbers of enterotoxigenic B. fragilis (ETBF), Fusobacterium nucleatum (Fn) and Helicobacter pylori (Hp) were determined by quantitative real-time PCR. Immunohistochemical method was used to examine the expression intensity of EGFR and p53, and the relationships between different expression intensity of EGFR, p53 and the numbers of three bacterias. Results: In the feces, copy numbers of ETBF and Fn were as follous: colorectal cancer group>adenomas group>healthy control group (P<0.05). Copy numbers of Hp were as follous: colorectal cancer group>healthy control group (P<0.01); adenomas group>healthy control group (P<0.01). In the tissue, copy numbers of ETBF, Fn were as follows: colorectal cancer group>adenomas group>healthy control group (P<0.05). Copy numbers of Hp were as follows: colorectal cancer group>healthy control group (P<0.01); adenomas group>healthy control group (P<0.01). Copy numbers of those three bacteria in the lesion tissue and the adjacent tissue had no significant difference. This happened both in colorectal cancer group and adenomas group. The different expression intensity of EGFR, p53 and the number of three bacteria showed no obviously statistical correlation(P>0.05). Conclusion Adenomatous polyp and colorectal cancer patients show high enrichment of ETBF, Fn and Hp in both feces and tissues. ETBF, Fn and Hp probably contribute to the development of adenomatous polyp and colorectal cancer. Trial registration Chinese Clinical Trial Registry, ChiCTR-BOC-17012509.