Objective To probe into application of clinical pathway on clinical practice teach-ing in thoracic surgery , and evaluate its effect . Methods 76 students were randomized into two groups: 35 students who accepted clinical pathway teaching were the experimental group, they were asked to carry out clinical practice in accordance with the teaching pathway;and the other 41 students were control group. The final examination included four parts: ①theoretical examination account for 20%of the total score. The test paper was randomly combined from the standardized question bank of Xinjiang Medical University, and this test included single choice questions and fill-in questions; ②clinical operational skills test account for 30%of the total score. This part included pleural puncture, dressing change, stitches remove, incision disinfection and surgical draping, and all of these opera-tions were carried out on medical patient simulators; ③clinical case analysis account for 50% of the total score. This part involved history collection, physical examination, humanistic care, case writing, diagnosis and treatment planning for new admission patients. T-test of independent samples was used to analyze all the scores of the two groups. Results The clinical case analysis score and the total score in experimental group [(42.26 ±3.93) points and (81.69 ±6.16) points, respectively]were obviously higher than that in control group[(38.88±4.76) points and(77.39±6.83) points, respectively];There were significant differences between the two groups(P values was 0.001 and 0.006, respectively). Conclusion Application of clinical pathway in clinical practice teaching may improve the effect of clinical teaching. The pathway contents and evaluation methods should be constantly improved accord-ing to teaching practice.

Adult ; Female ; Hematologic Tests ; Hexanes ; adverse effects ; Humans ; Male ; Occupational Exposure ; adverse effects ; Young Adult

Objective To explore the temporal expressions of interleukin-10(IL-10)and interleukin-4(IL-4)and their relationship with the wound age during skin incised wound healing in mice.Methods Immunohistochemical and image-analysis techniques were employed in vital skin wounds 0.5h～168h after incision and postmortem incision 0.5h～6h after death.Results Weak expression of IL-10 was detected at 0.5h after incision,which increased subsequently,and peaked at 3h post-injury.Then decreased to the pre-incision level at 24h,but peaked again at 72h after injury.Immunostaining revealed that epidermal cells and infiltrating mononuclear cells were the major source of IL-10.IL-4-positive cells were observed in the dermis at 24h,and reached the maximum level at 96h,which maintained until 168h post-injury.IL-4 was mainly expressed in the fibroblast-like cells of the granulation tissue and dermis.In addition,faint IL-10-positive cells were merely identified in the epidermal cells in the postmortem incision skin within 1～3h after incision.No IL-4-postitive cells were found in the postmortem incision skin.Conclusion The time-dependent expressions of IL-10 and IL-4 during cutaneous wound healing may be used for the estimation of wound age.

Purpose To investigate the expression and clinical significance of miR-100 in hepatocellular carcinoma ( HCC) . Methods LNA-modified miR-100 fluorescent probe was used to detect the formalin-fixed and paraffin-embedded tissues of 29 cases of HCC, while 10 cases of normal human liver tissues were used as the control group. Results Analysis of fluorescence in situ hybridization ( FISH) showed that, in all normal tissues miR-100 expression were positive, fluorescence signal located in the cytoplasm, while only 11 cases of HCC were positive, and there was a significant difference between both positive rates (100% vs 37. 9%, P<0. 01). In addition, with the degree of differentiation of HCC decreased, the expression of miR-100 showed a decreasing trend, positive rate of the well differentiation group and moderate differentiation group was significantly higher than the poor differentiation group ( P<0. 05 ) . Conclusion Detection of miR-100 expression in HCC tissue might be helpful to evaluate the pathologic grade of the tumors.

Objective:To study the effects of adhesive peptide arginlie-glycine-aspartic acid(RGD) on the attachment and spreading of osteoblast on the surface of dental implant materials. Methods: RGDC peptides were covalently immobilized on the surface of dental implant materials by SAMs. Rat osteoblasts were isolated and cultured on the materials. The attachment and spreading behavior of the cells were analyzed by cell counting and FITC-conjugated immunofluorsescent assay. Results: On the RGD coated surface, cell attachment was increased by 50% (P

Aim To prepare insulin powder for inhalation by spray-drying technology, determine the deposition of the insulin powder formulation in vitro and preliminarily investigate hypoglycemic response of the dry powder with/without absorption promoters. Methods The depositions of the insulin powder for inhalation were determined by the China Pharmacopoeia 2000 version addenda XH and hypoglycemic effects were evaluated by testing serum glucose with glucose oxidase-peroxidase (GOD-PAP) method.Results The depositions of the spray-dried insulin powder for inhalation were more than 40% under significantly greater decline in blood glucose levels, while coadministration with 1% sodium caprylate, 1%effect ( P ＞ 0. 05 ). Conclusion Insulin powder for inhalation was relatively stable under various humidity pulmonary route.

ObjectiveTo evaluate nipple-areola complex sparing modified radical mastectomy for breast cancer.MethodsClinical data of 159 breast cancer cases undergoing NAC sparing modified radical mastectomy from Jan 1998 to Dec 2009 were retrospectively analyzed.ResultsNAC sparing modified radical mastectomy was successfully carried out in 141 out of the 159 cases ( 88.68％ ).In 14 cases (8. 81％ ) the original operative protocol was changed to modified radical mastectomy or radical mastectomy during the operations because NAC ischemia in 4 (2. 52％ )cases, NAC occult involvement or dysplasia in 5 cases (3. 14％ ), Ⅲ level lymph node metastasis was found in 3 cases (1.89％). Postoperative complete nipple necrosis occurred in 4 (2. 52％ ) cases. Other significant postoperative complications included nipple necrosis in 20 cases ( 12. 58％ ), skin flap necrosis and infection in 11 cases ( 6.92％ ), subcutaneous hydrops in 10 cases (6. 29％ ). All patients got follow-up ranging from 15 to 96 months,median follow-up was 51 months. Local region recurrences were observed in 5 cases (3. 14％ ), distant metastasis in 2 cases ( 1.26％ ). There was no recurrence in the region of NAC.ConclusionsNipple-areola complex sparing modified radical mastectomy is oncologically safe by strict preoperative selection criteria and strict operative procedure.

Response evaluation criteria in solid tumors is widely used for assessing tumor response to radiotherapy in clinical practice.However,it is clearly insufficient.Currently there is no ideal method for early evaluation of tumor radiation response.This paper reviews studies on early evaluation of radiotherapy efficacy by positron emission tomography-computed tomography (CT),magnetic resonance imaging,and CT.This paper also further explores the necessity and feasibility of CT values of megavoltage CT scans in early evaluation of the radiosensitivity of tumor during tomotherapy.

Objective To investigate the roles of phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) signaling pathway and its regulatory protein peroxisome proliferator-activated receptor γ (PPAR γ) and phosphatase and tension homologue deleted on chromosome 10 (PTEN) in regulating insulin sensitivity in rats with fetal growth restriction (FGR).Methods Sixteen pregnant rats were randomly divided into two groups including FGR and control groups on the 12th day of pregnancy (eight in each group).The FGR group was given low protein diet (8％ of casein) and restriction diet to establish the neonatal rat model of FGR.All maternal rats after delivery and newborn rats after weaning on 21 days after born were fed with normal diet.Each time blood samples were collected from eight newborn rats of each group to measure levels of fasting plasma glucose (FPG) and fasting insulin(FINS) at the time points of 21 days,two and four months after birth.Then insulin resistance index (IRI) and insulin sensitivity index (ISI) were calculated to evaluate insulin sensitivity.Expression of PI3K,AKT,PPAR γγ,PTEN and glucose transporters 4 (GLUT4) in skeletal muscle at mRNA and protein levels were measured at 21 days,two and four months after birth with real time fluorescence polymerase chain reaction and Western blot,respectively.Relationships between the expression of key molecules of PI3K/AKT signaling pathway and insulin sensitivity were analyzed.T-test,and Pearson's correlation analysis were used for statistical analysis.Results (1) The average birth weight of newborn rats in the FGR group was lower than that of the control group [(4.37± 0.69) vs (7.03±0.55) g,t=-20.75,P＜0.05].The incidence of FGR in the FGR group was 93.33％ (70/75).(2) Compared with normal offspring,those in the FGR group showed significantly increased FPG [two months after birth:(5.53± 0.58) vs (7.49 ± 0.38) mmol/L,t=8.08;four months afterbirth:(6.35±0.66) vs (8.94±0.90) mmol/L,t=6.58],FINS [two months afterbirth:(9.18±0.66) vs (14.67± 1.90) mU/L,t=7.71;four months after birth:(33.08±2.76) vs (56.33±2.81) mU/L,t=16.71] and IR1 (two months after birth:2.25±0.31 vs 4.90±0.81,t=8.63;four months after birth:9.30±0.90 vs 22.44±3.10,t=1 1.51),but decreased ISI (two months after birth:0.020 ± 0.002 vs 0.009± 0.001,t=-10.1 4;four months after birth:0.005±0.000 vs 0.002 ±0.000,t=-14.91) at two and four months after birth (all P＜0.05).(3) Compared with normal offspring,those in the FGR group showed decreased expression of PI3K (21 days after birth:0.082±0.028 vs 0.019±0.004,t=-6.29;two months after birth:0.020±0.003 vs 0.010±0.005,t=-4.78;four months after birth:0.014±0.004 vs 0.003±0.001,t=-7.87) and GLUT4 (21 days after birth:0.132±0.057 vs 0.041 ±0.019,t=-4.32;two months after birth:0.183±0.084 vs 0.069±0.017,t=-3.74;four months after birth:0.248±0.069 vs 0.113±0.040,t=-4.74) at mRNA level at 21 days,two and four months after birth (all P＜0.05).Compared with normal offspring,decreased expression of PPAR γ (two months after birth:0.028±0.002 vs 0.012±0.005,t=-3.70;four months after birth:0.030±0.008 vs 0.012±0.005,t=-3.80) and increased expression of PTEN (two months after birth:0.020±0.004 vs 0.045±0.014,t=5.09;four months after birth:0.023±0.007 vs 0.034±0.009,t=2.57) at mRNA level were observed in offspring of the FGR group at two and four months after birth (all P＜0.05).(4) Compared with normal offspring,expression of PI3K protein (21 days after birth:0.22±0.01 vs 0.17±0.02,t=-6.62;two months after birth:0.27±0.03 vs 0.16±0.02,t=-7.25;four months after birth:0.18±0.01 vs 0.09±0.02,t=-9.79) and GLUT4 protein (21 days after birth:0.21 ±0.01 vs 0.03±0.01,t=-27.29;two months after birth:0.10±0.01 vs 0.06t±0.01,t=-3.90;four months after birth:0.13 ±0.01 vs 0.08± 0.02,t=-8.10) decreased in offspring in the FGR group at 21 days,two and four months after birth (all P＜0.05).Compared with normal offspring,those in the FGR group showed decreased expression of PPAR γ protein (two months after birth:0.10 ± 0.01 vs 0.07± 0.01,t =-7.29;four months after birth:0.09±0.01 vs 0.08±0.01,t=-2.83),but increased expression of PTEN at protein level (two months after birth:0.10±0.01 vs 0.15±0.02,t=6.01;four months after birth:0.09±±0.01 vs 0.13±0.02,t=5.51) at two and four months after birth (all P＜0.05).(5) The IRI levels in offsprings in the FGR group were negatively correlated with the expression of PI3K,GLUT4 and PPAR γ at protein level (two months after birth:r=-0.90,-0.92 and-0.79;four months after birth:r=-0.92,-0.75 and-0.73,all P＜0.05),but positively correlated with the expression of PTEN at protein level (r=0.87 and 0.86,both P＜0.05) at two and four months after birth.Conclusions The abnormal expression of the key molecules of PI3K/AKT signaling pathway precedes the decrease of insulin sensitivity in newborn rats with FGR and the expression regulatory protein PPAR γ and PTEN are also changed,suggesting that these molecules may induce the impairment of insulin sensitivity in rats with FGR and be involved in the development of insulin resistance.

ObjectiveTo investigate the clinicopathological characteristics of nipple-areolar complex (NAC) involvement in patients with operable breast carcinoma and to determine the indications and risk factors of NAC-sparing modified radical mastectomy. Methods407 female patients with primary breast cancer were included in the study.Data like tumor position, tumor size, the distance from the tumor to the margin of areolar (D) were recorded.NAC sample in vitro was collected and routine pathological examination was performed.Statistical methods were employed to analyze the relation between the clinicopathological factors and NAC involvement.ResultsThe rate of NAC involvement was 13.27％ (54/407).NAC involvement had no statistically significant correlation with age or histological type, but had statistical correlation with tumor position, D value, tumor size, TNM stage, clinical manifestation of NAC, and status of axillary lymph nodes(P ＜ 0.05).ConclusionsTumor position, D value, tumor size, TNM stage, clinical manifestation of NAC and status of axillary lymph nodes are the major influential factors for NAC involvement.The indications of NAC-sparing modified mastectomy:1.in Ⅰ or Ⅱa TNM stage; 2.patients have strong will to preserve NAC or breast appearance; 3.noncentric tumor (D≥2 cm) ; 4.the maximum diameter of tumor should be less than 3 cm; 5.no abnormal manifestation like nipple discharge, eczematoid change or nipple inversion happened.6.no occult involvement in subareolar tissues was found by frozen pathology.