The present residents training for ultrasound departments depends mostly on poorlyscheduled rotation and clinical clerkship,with repeated and obsolete subjects in their training.The authors identified these setbacks and such characteristics as complication of ultrasound medicine,complex and variable ultrasonic scan technique,and the high threshold for beginners.In view of this,the authors adopted the tutorial system training mode for cultivating the residents in their medical care,teaching,research and foreign language competencies.A questionnaire survey of 44 residents so trained evaluated outcomes of the mode,with constructive suggestions raised on expansion of the training base,improvement of teachers’competency and reduction of trainees' workload.

Abstract: Objective　To analyze the epidemiological characteristics of 151 cases of melioidosis and the drug resistance of Burkholderia pseudomallei (BP), in order to provide the basis for diagnosis, treatment and reasonable prevention of melioidosis. Methods　A total of 151 inpatients and outpatients from the Second Affiliated Hospital of Hainan Medical University from January 1, 2013 to August 31, 2022 were collected, and clinical specimens were submitted for examination to isolate and identify BP strains. The clinical data of 151cases of melioidosis and the drug resistance characteristics of pathogenic bacteria were retrospectively analyzed, and using SPSS26.0 software for statistical analysis. Results　Among 151 cases with BP infection, there were 138 males (91.4%) and 13 females (8.6%); the most patients were aged from 45-<60 years old, accounting for 74 cases (49.0%); melioidosis incidence was concentrated in October (19.2%), November (19.2%), August (9.9%) and July (8.6%), and; the number of confirmed cases showed an increasing trend and the time for confirmation was <10 d; Internal medicine system (31.1%), surgery system (26.5%) and intensive care department (20.5%) were the common departments for treating melioidosis; blood (49.0%), sputum (9.9%) and wound secretion (8.6%) were the main clinical specimens for detecting BP; pulmonary infection (68.2%), sepsis (35.1%) and local suppurative infection (23.8%) were the top clinical manifestations in patients with BP infection; the effective rate of treating melioidosis was 74.8%; abnormal liver function was a risk factor for the curative effect of melioidosis (χ2=5.010, P<0.05); the sensitivity rates of BP strains to sulfamethoxazole-trimethoprim (SXT), doxycycline (DOX), imipenem(IPM), ceftazidime (CAZ), amoxicillin/clavulanate (AMC) and tetracycline (TCY) were generally more than 90%, with sensitivities of 98.7%, 97.2%, 96.7%, 94.0%, 93.2% and 90.7%, respectively. Conclusions　It can be concluded that misdiagnosis or missed diagnosis of melioidosis is easy to occur, and the understanding of the epidemiological characteristics and risk factors in this area should be strengthened. The sensitivity of BP to commonly used antibiotics has shown a certain downward trend, clinical use should be standardized, and drug resistance monitoring should be strengthened to improve the efficacy of melioidosis treatment.

Objective To explore the relationship between free fatty acid(FFA)composition and other glucose and lipid metabolic parameters in patients with metabolic syndrome(MS)in community. Methods Serum FFA profile was measured with gas chromatography and mass spectrometry in 158 patients with varied metabolic syndrome components(MSC),including 61 with MS and 97 at high-risk for MS,and 43 control subjects,with diagnostic criteria by the International Diabetes Federation(IDF).Results Patients with MS had higher parameters of polyunsaturated fatty acid(PUFA)and n6PUFA,as compared to the patients at high risk and normal subjects(P0.05). Among the high-risk group,those with diabetes had increased linoleic acid,n6PUFA and total fatty acid (TFA),and decreased saturated fatty acid(SFA)/TFA,as compared to those without diabetes(P

OBJECTIVETo evaluate the usefulness of contrast-enhanced ultrasonography (CEUS) in the diagnosis of biliary diseases.

METHODSCEUS was performed in 57 patients with biliary diseases. The contrast enhancement characteristics and the morphologic features were observed. The ultrasonographic results were compared with those obtained through conventional 2-D ultrasound (2D-US), color Doppler flow ultrasound (CDFI), and clinical, surgical, and laboratory findings. In some cases, the ultrasonographic results were also compared with those obtained from contrast-enhanced computed tomography (CECT).

RESULTSThe diagnostic accuracy of 2D-US combined with CEUS was significantly higher than that of 2D-US combined with CDFI 87.7% vs 71.9%; chi(2) = 4.41, P < 0.05). CEUS clearly showed the presence/absence of blood supply in biliary lesions and offered real-time imaging of the microcirculation perfusion in the lesions. It also offered useful information to differentiate biliary tumors from stones, bile mud, and/or blood clots. It distinctly displayed the size and contour of the lesions as well as the infiltrated range, depth, and the involved area. However, CEUS is most useful in reflecting blood perfusion patterns; it had limited value in differentiating the malignancies of polypoid lesions. The diagnostic accuracy (87.0% vs 91.3%;chi(2) = 0. 45, P > 0.05) and the size and range of the lesions displayed (0.4-6.2 cm vs 0.4-6.0 cm, P = 0.721) were not significantly different between CEUS and CECT.

CONCLUSIONCEUS is a useful tool in the routine ultrasonography of biliary diseases.

Adult ; Aged ; Aged, 80 and over ; Biliary Tract Diseases ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Sensitivity and Specificity ; Ultrasonography ; Young Adult

Objective:To investigate the immunomodulation of CCK8 on the Coxsackievirus B ( CVB )-attacked human peripheral blood plasmacytoid dendritic cells(pDC). Methods:Peripheral blood mononuclear cells of healthy volunteers were separated by Ficoll-Hypaque gradient density centrifugation. The pDC was separated and divided into five groups,which were the control group, CVB attacked group,the group of CCK8 treated after CVB attack,the group of PGE2 treated after CVB attack and the group of CCK8+PGE2 treated after CVB attack. 100-time TCID50 of CVB was applied for the attack on pDC. Real-time PCR and Immunofluorescence technique were employed to detect the expression of CCK1R/CCK2R mRNA and protein. Then,the expression levels of costimulatory molecules such as CD80,CD86,HLA-DR ligand,and the chemokine receptor CCR7 were evaluated by Flow Cytometry Analysis. The supernatants of pDCs were collected, and the content of IFN-α was determined by Enzyme-linked Immunosorbent Assay. Results:CCK1R and CCK2R were co-expressed in human peripheral blood pDC,and both were significantly upregulated after CVB attack in vitro. Expression of CD80,CD86,HLA-DR and IFN-α were decreased in the CVB+CCK8 group compared with the CVB group,which suggested that CCK8 may reduce the CVB activation of pDC. Whereas expression of CD80,CD86,HLA-DR,CCR7 and IFN-α were increased in the CVB+PGE2 group compared with the CVB group,which suggested that PGE2 may increase the CVB activation of pDC in vitro. Conclusion:CCK8 repressed the CVB-attacked pDC,while PGE2 activated the CVB-attacked pDC.

OBJECTIVENoncystic fibrosis (non-CF) bronchiectasis remains as a common health problem in Asia. Pathogens' distribution in airways of patients with non-CF bronchiectasis is important for doctors to make right decision.

DATA SOURCESWe performed this systematic review on the English language literatures from 1966 to July 2014, using various search terms included "pathogens" or "bacteria" or "microbiology" and "bronchiectasis" or "non-cystic fibrosis bronchiectasis" or "non-CF bronchiectasis" or "NCFB."

STUDY SELECTIONWe included studies of patients with the confirmed non-CF bronchiectasis for which culture methods were required to sputum or bronchoalveolar lavage fluid (BALF). Weighted mean isolation rates for Haemophilus influenzae, Pseudomonas aeruginosa, Streptococcus pneumoniae, Stapylococcus aureus, Moxarella catarrhails were compared according to different methodology.

RESULTSThe total mean bacterial culture positive rates were 63%. For studies using sputum samples, the mean positive culture rates were 74%. For studies using BALF alone or BALF and sputum, it was 48%. The distributions of main bacterial strains were 29% for H. influenzae, 28% for P. aeruginosa, 11% for S. pneumoniae, 12% for S. aureus, and 8% for M. catarrhails with methodology of sputum. Meanwhile, the bacterial distributions were 37% for H. influenzae, 8% for P. aeruginosa, 14% for S. pneumoniae, 5% for S. aureus, and 10% for M. catarrhails with methodology of BALF alone or BALF and sputum. Analysis of the effect of different methodology on the isolation rates revealed some statistically significant differences.

CONCLUSIONSH. influenzae accounted for the highest percentage in different methodology. Our results suggested that the total positive culture rates and the proportion of P. aeruginosa from sputum and BALF specimens had significant differences, which can be used in further appropriate recommendations for the treatment of non-CF bronchiectasis.

Bronchiectasis ; microbiology ; Bronchoalveolar Lavage Fluid ; microbiology ; Haemophilus influenzae ; pathogenicity ; Humans ; Pseudomonas aeruginosa ; pathogenicity ; Sputum ; microbiology

AIM: To investigate the synergistic antitumor effect of sinomenine(SIN)and cisplatin(DDP) against human fibrosarcoma HT-1080 cells and its possible mechanism.METHODS:CCK-8 assay was used to detect the cytotoxic effect of SIN and DDP in HT-1080 cells,and the combination index(CI)of SIN and DDP was analyzed by Chou-Talalay method.The apoptosis was analyzed by flow cytometry.The protein levels of copper transporter 1(CTR1),gluta-thione S-transferase-π(GST-π),Bcl-2 and Bax were determined by Western blot.RESULTS: At 48 h after treatment with SIN or DDP at various concentrations,the cell viability was remarkably reduced(P<0.05), and the IC50values of DDP and SIN were 6.50 μmol/L and 1.06 mmol/L, respectively.When the inhibition rate of HT-1080 cells exceeded 25%, SIN in combination with DDP produced a synergistic effect(CI<1).Combination treatment of SIN with DDP signi-ficantly induced apoptosis of HT-1080 cells.SIN up-regulated the protein levels of CTR1 and Bax,and down-regulated the protein levels of GST-πand Bcl-2(P<0.05).CONCLUSION:SIN synergistic induces apoptosis with DDP in human fi-brosarcoma HT-1080 cells by up-regulating the protein levels of CTR1 and Bax, and down-regulating the protein levels of GST-πand Bcl-2.

OBJECTIVETo screen the high risk factors for relapse after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in acute lymphocytic leukemia (ALL), acute myeloid leukemia (AML) and chronic myeloid leukemia (CML) respectively, then to compare the contribution of each risk factor to relapse and investigate the relevant mechanisms.

METHODSA retrospective study from single center involved in 262 evaluable cases of leukemia received allo-HSCT over the past 8 years, of them 69 cases with ALL, 90 AML (except APL) and 103 CML. Cox proportional hazard regression model was used for univariate and multivariate analysis to screen the high risk factors.

RESULTSThe risk factors significantly affecting relapse in ALL included: Cytogenetic risk classification, the cycles of initial induction chemotherapy; AML: Cytogenetic risk classification, minimal residual disease (MRD) level before transplant, reconstitution of WBC, and CD4(+)/CD8(+) lymphocyte ratio in the graft; CML: disease stage before transplant.

CONCLUSIONSThe relapse risk after HSCT of ALL mainly depends on the grade of malignancies, and the relapse risk of AML is closely related to the course of transplant. Chronic phase of CML favors a good prognosis after HSCT. Cytogenetic risk classification is the most relevant predictor of relapse after HSCT.

Adolescent ; Adult ; Child ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; Leukemia ; pathology ; surgery ; Male ; Middle Aged ; Recurrence ; Retrospective Studies ; Risk Factors ; Transplantation, Homologous ; Young Adult

OBJECTIVETo investigate the protective effects of hypothermia combined with dexamethasone on the testis of rats after testicular torsion reduction and on the expression of eNOS and apoptosis of spermatogenic cells.

METHODSWe made unilateral testicular torsion models in 80 adolescent male Sprague-Dawley rats by 720 degrees torsion of the left testis, and then randomly divided them into four groups of equal number to be treated with normal temperature + physiological saline (group A), hypothermia + physiological saline (group B), hypothermia + dexamethasone (group C), and normal temperature + dexamethasone (group D). After 48 hours, we collected the testes, observed pathological changes of the testicular tissue by HE staining under the light microscope, determined the expression of eNOS by immunohistochemistry, and detected the apoptosis of spermatogenic cells by TUNEL.

RESULTSHE staining showed different degrees of testicular tissue injury in all the four groups of rats, most obvious in group A, while protective effect was observed in the other three groups. Immunohistochemistry revealed significantly more positive cells and higher positive staining intensity in the torsion (left) testis in group A than in B (P < 0.05), C (P < 0.01) and D (P < 0.01). The nuclei were deep brown or brown. Lots of apoptotic spermatogenic cells were seen in the torsion testis of group A, with a significantly higher apoptosis index (31.12 +/- 4.68) than in B (16.58 +/- 6.22) (P < 0.05), C (8.60 +/- 1.15) (P < 0.01) and D (13.52 +/- 3.06) (P < 0.01).

CONCLUSIONIschemia-reperfusion injury after testicular torsion reduction can increase the apoptosis of spermatogenic cells and decrease testicular reproductivity. Hypothermia combined with dexamethasone can protect the testis from injury as well as the reproductive function of the testis after testicular torsion reduction.

Animals ; Apoptosis ; Dexamethasone ; pharmacology ; Germ Cells ; cytology ; metabolism ; Hypothermia, Induced ; Male ; Nitric Oxide Synthase Type III ; metabolism ; Rats ; Rats, Sprague-Dawley ; Spermatic Cord Torsion ; metabolism ; pathology ; Spermatogenesis ; Testis ; metabolism ; pathology

OBJECTIVETriple-negative [estrogen receptor (ER)-/progesterone receptor (PR)-/HER2-] breast cancer (TNBC) accounts for ∼ 15% of overall breast cancer and associated with a poor prognosis. There is a short of standard adjuvant chemotherapy regimens for TNBC. A number of studies have shown that TNBC might be sensitive to cisplatin and carboplatin on the basis that dysfunction of BRCA1 and its pathway is associated with a specific DNA-repair defect, but data of adjuvant setting about this is limited.

METHODSFrom January 2010 to September 2011, 95 early triple-negative breast cancer patients confirmed by pathology were randomly assigned to receive TP (docetaxel 75 mg/m², carboplatin AUC = 5, day 1, 21 days a cycle for 6 cycles) or EC-T (epirubicin 90 mg/m², cyclophosphamide 600 mg/m², d1, 21 days a cycle for 4 cycles, followed by docetaxel 80 mg/m², d1, 21 days a cycle for 4 cycles) chemotherapy. Adjuvant radiation therapy was given selectively after chemotherapy. Here we report a preliminary safety analysis with the chi-square test.

RESULTSSeventy-six out of the 95 patients had completed the chemotherapy and could be assessed for the safety profiles of the regimens. Thirty-seven of them were in the EC-T group with a median age of 47 years, and 21 out of these 37 patients were premenopausal (56.8%). Another 39 patients came from the TP group with a median age of 46 years, and 22 out of these 39 patients were premenopausal (56.4%). All of the 37 patients in EC-T group completed the planned treatment whereas 2 patients of the 39 cases in TP group did not because of bone marrow suppression. During the treatments, 9 patients had dose adjustment in each group. Adverse events of grade 1/2 were common. Specific incidence of adverse events with grade 3/4 in each group was as follows: alopecia, 29.7% vs. 10.3% (P = 0.033), vomiting 21.6% vs. 7.7% (P = 0.085), leukopenia 54.1% vs.25.6% (P = 0.011) and neutropenia 51.4% vs. 35.9% (P = 0.174). Other grade 3/4 toxicities were rare. All the adverse events (except peripheral neuropathy and pigmentation) recovered within 1 month after the chemotherapy.

CONCLUSIONBoth EC-T and TP regimens as adjuvant chemotherapy are safe and tolerable for the treatment of triple-negative breast cancer patients, while the TP regimen has advantages with less grade III/IV alopecia and leukopenia.

Adult ; Aged ; Alopecia ; chemically induced ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Breast Neoplasms ; drug therapy ; metabolism ; pathology ; radiotherapy ; surgery ; Carboplatin ; administration & dosage ; Carcinoma, Ductal, Breast ; drug therapy ; metabolism ; pathology ; radiotherapy ; surgery ; Chemotherapy, Adjuvant ; Cyclophosphamide ; administration & dosage ; Epirubicin ; administration & dosage ; Female ; Humans ; Leukopenia ; chemically induced ; Middle Aged ; Neoplasm Staging ; Neutropenia ; chemically induced ; Premenopause ; Radiotherapy, Adjuvant ; Receptor, ErbB-2 ; metabolism ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism ; Taxoids ; administration & dosage ; Vomiting ; chemically induced