From the perspective of institute of medical higher education, a set of index system which include three first level indicators has been constructed, for medical academic postgraduate ed-ucation internal evaluation with the method of expert advice as well as in-depth interview, and then through Delphi consulting, the weight of every indicator has been calculated. The weight of three first level indicators are 0.28 (educational condition), 0.42 (educational process), 0.30 (educational results) respectively. Finally, how to carry out internal evaluation and how to apply the results effec-tively have been discussed.

Objective To investigate the proportion of follicular fluid CD56~+ natural killer (NK) cells to the total lymphocytes and the ac-tivated CD56~+ NK cells to the total CD56~+ NK cells. To provide an evidence for improving the clinical pregnancy rate in in vitro fertilization (IVF) treatment by regulating the function of NK cells. Methods Triple color flow cytometry was used to analyze the proportion of CD56~+ NK cells and activated CD56~+ NK cells in mature follicular fluid. The IVF treatment outcome was closely followed up. The relationship be-tween the proportion of CD56~+ NK cells and activated CD56~+ NK cells and the IVF treatment outcome was analyzed statistically. Results The proportion of CD56~+ NK cells and activated CD56* NK cells in mature follicular fluid of women who got pregnancy by IVF treatment was (15.57±3.10)% and (2.63±0.94)% respectively,while the proportion of the women who didn't get pregnancy was (19.12±5.37)% and (4.06±2.08)% respectively,which was significantly higher than the pregnant group(P< 0.05). Conclusion The women with lower propor-tion of CD56~+ NK cells and activated CD56~+ NK cells in mature follicular fluid of is easier to get pregnancy by IVF. An altered NK cells pro-file in follicular fluid could therefore influence fertility in IVF treatment outcome.

BACKGROUNDTo study the diagnostic significance of detecting p53 gene mutation in peripheral blood of lung cancer patients.

METHODSPCR-SSCP was used to detect p53 gene mutation in peripheral blood of 46 samples (lung cancer 28, benign lung diseases 8, healthy people 10).

RESULTSOf the 28 lung cancer patients, 4 cases (squamous cell carcinoma 1, adenocarcinoma 1, small cell lung cancer 2) had p53 gene mutation. The positive rate was 14.29%. Of the 4 positive lung cancer patients, one patient was in stage II, one in stage III, and the other two in stage IV. No p53 mutation was found in peripheral blood of 8 benign lung disease patients and 10 healthy persons.

CONCLUSIONSDetection of p53 gene mutation in peripheral blood cells may be helpful to the diagnosis of lung cancer, especially to the accurate staging of lung cancer.

Objective To evaluate the clinical outcome of Osteoset artificial bone mixed Rifampicin for injection after radical debridement in the treatment of sacroiliac joint tuberculosis,and compare with debridement alone.Methods From May 2005 to August 2010,48 patients with sacroiliac joint tuberculosis patients underwent two different surgical methods were selected as analysis subjects in the Orthopedics Department of Chest Hospital of Hebei Province.Among them,27 cases underwent radical debridement and fusion with Osteoset artificial bone combined with Rifampicin for injection (Grafting group),and 21 case were treated with radical debridement only(Control group).The local wound healing,adverse reactions and regular imaging examination (pelvic X-ray and CT scan) were observed,and the surgical time,the intraoperative blood loss,postoperative 6 months and 12 months,18 months bone graft fusion rate,and Majeed scoring results of the patients were recorded and statistically analyzed.Results All patients were followed up from 20 to 30 months with an average of 24 months.There was no significant difference in terms of surgical time and operative bleeding between the two groups(P＞0.05).The rate of bone fusion in grafting group was 33.33％ (9/27) of 6 months after operation,88.9％(24/27) of 12 months after operation,and 96.3％ (26/27) of 18 months after operation.While that in control group was 4.76％ (1/21) of 6 months after operation,42.85 ％ (9/21) of 12 months after operation,and 42.85％ (9/21) of 18 months after operation.The differences of these parameters between the two groups were significant(x2 =5.85,20.92,15.90;P＜0.05).According to Majeed scoring system,the excellent and good rates were 100％ (27/27) in grafting group,76.19％ (16/21) in control group,the difference was statistically significant(x2=7.18 P＜0.05).Conclusion With Rifampicin loaded Osteoset artificial bone can recruit bone graft mass during the bone fusion for sacroiliac joint tuberculosis,and reduce the adverse reactions,achieve bone fusion earlier than the control group.

Objective To investigate the influence of nerve growth factor (NGF) on the ability of differentiation and proliferation of regulatory T cells (Tregs) induced by mesenchymal stem cells (MSCs).Methods The MSCs were stimulated directly by NGF.IL-10,TGF-β and HLA-G were tested.The expression of CD4 and CD25 was detected by flow cytometry after co-culture.The expression of CD4,CD25 and Foxp3 was detected by flow cytometry after Transwell co-culture.Results As compared with control group,the expression of IL-10,TGF-β and HLA-G in NGF group was increased (P＜0.05 for all).The number of Tregs was increased after the co-culture (P＜0.05).The reduction in IL-10 and TGF-β could block the inducing function of NGF (P＜0.05).Conclusion NGF can enhance the ability of differentiation and proliferation of Tregs induced by MSC,which is possibly associated with the increases in the expression of IL-10 and TGF-β.

Objective We aimed to explore the difference of dosimetry among intensity modulated radia-tion therapy(IMRT),volumetric modulated arc therapy(VMAT)and helical tomotherapy(TOMO)in the radio-therapy of medulloblastoma.Methods Ten children's patients with the medulloblastoma were selected and de-signed in this study.A clinically feasible radiotherapy plan was designed for IMRT(5 fields),VMAT and TOMO. Conformality index(CI),homogeneity index(HI),V107,maximum dose(Dmax),organ at risk(OAR)dose-volume level,monitor units and treatment time were used to analyze in these groups.Results CI,HI,V107,Dmaxand OAR of target areas were significantly superior to VMAT and IMRT in the TOMO group of target PTV for whole brain full radiotherapy.The organ at risk dose-volume level in the TOMO group was lower than that in VMAT and IM-RT(5 fields)groups(P<0.05).The TOMO group also had the most monitor units and the longest treatment time (P<0.05).Hence,the patients in the TOMO group could irradiate completely the whole brain and full spinal cord without moving treatment couch to avoid the error from the man-made movement in VMAT and IMRT(5 fields)treatments.Conclusion In the radiotherapy of medulloblastoma,the dose distribution of patients in the TOMO group are superior to the VMAT and IMRT groups(5 fields).However,the number of monitor units and treatment time is significantly increased during treatment,and its clinical effect needed to be further studies.

A patient with intermittent right lumbar pain for more than one month and aggravating for one week was reported. The right laparoscopic radical nephrectomy was performed, and fibrosarcoma of the right kidney was diagnosed. The patient refused further radiotherapy or chemotherapy and was discharged on the 11th after surgery. One year after operation, the patient underwent chest CT, and subdural tumor of right lobe of liver was detected. A surgery was performed in another hospital, and liver metastasis from right renal fibrosarcoma was diagnosed. He was alive four months after operation.

A female patient who was admitted to the hospital on March 4, 2020 due to the right kidney mass for 4 days by physical examination. Ultrasound examination revealed a single space-occupying lesion in the right kidney, and further examination of the abdominal enhanced CT and three-dimensional reconstruction showed two lesions in the right kidney. The retroperitoneal laparoscopic partial nephrectomy was carried out. The pathological diagnosis were renal leiomyoma and renal eosinophiloma, respectively. After 1 year follow-up, no recurrence or metastasis was found.

Objective:To improve the accuracy of cone-beam CT (CBCT) image registration by using a dose-guided registration algorithm based on multi-objective optimization.Methods:A total of 28 sets of CBCT images of 6 patients with lung cancer and 5 patients with cervical cancer admitted to Harbin Medical University Cancer Hospital in 2022 were retrospectively analyzed. Using the results of bone-based registration as the starting points for dose registration algorithm, the dose fluence weighted mean square errors of each displacement point in surrounding three-dimensional space were calculated, and the candidate displacement points were selected by unsupervised k-means clustering method. The three-dimensional dose distribution of each candidate displacement point was calculated by using the limited size pencil beam algorithm, and the dose histogram indexes were extracted as the optimization variables of the multi-objective optimization algorithm. After the Pareto optimal solution set obtained using multi-objective genetic algorithm, the optimal unique solution was then determined based on the predetermined objective weight scheme.Results:After dose optimization registration, the values of D 90%, D 95%, D 98%, D mean and conformity index (CI) of planning target volume (PTV) of lung cancer patients were increased by 0.23 Gy, 0.49 Gy, 1.05 Gy, 0.15 Gy, 0.03 compared with conventional registration, respectively, and no significant difference was found for the organs at risk (OAR). For cervical cancer cases, the values of D 90%, D 95%, D 98%, D mean and CI of PTV were increased by 0.72 Gy, 1.15 Gy, 2.53 Gy, 0.24 Gy, 0.05 compared with conventional registration, respectively, whereas the evaluation indexes of partial OAR were decreased by 1.06-1.81 Gy. Conclusion:The proposed dose-guided registration algorithm can improve the dose coverage for the target area, decrease the dose for OAR and reduce residual error of rigid registration algorithm, which can be implemented as part of online adaptive radiotherapy.

OBJECTIVE: To gain an insight into the transplantation with donor kidneys from extended criterion donation after cardiac death (DCD) and to improve the management during and after renal transplantation METHODS: Renal transplantation in 2 patients who used organs from small pediatric donors (<3 years) was performed. The graft kidneys were procured from 1 donor aged 11 months and the other 1 year and 7 months. The 2 donors were diagnosed as brain death caused by serious infantile hepatitis syndrome and severe craniocerebral injury, respectively. After the cardiac death, en bloc organ resection was performed. En bloc kidneys were transplanted to 2 adult recipients who were 37 and 41 years old, respectively. RESULTS: The recipients were followed-up for 6 months. Both of them developed large volume of bloody drainage in the early post-operational period and relieved after relevant treatment. The kidney grafts functioned well and no other surgical complications or acute rejections happened during the follow-up. CONCLUSION Based on modified peri-operative techniques, it is safe to perform renal transplantation with kidneys procured from cardiac death donors who are younger than 3 years old, an important source to increase the number of organs available for transplantation, yet the vascular complications require attention.
Adult ; Graft Survival ; Humans ; Infant ; Kidney ; Kidney Transplantation ; Postoperative Period ; Tissue Donors