According to the goal of promoting all-round ability and the core idea of PRICE,the Medical School of Shanghai Jiao Tong University improves the curriculum,teaching method,experimental teaching,multidimensional examination to explore the new system of teaching reform for eight-year clinical medical education.

The immunoregulatory effects of mescenchymal stem cell (MSC) and its application have become a focused research topic in recent years. This article reviews the up-to-date research advances in the features and mechanisms of immune regulation of MSC and its application.

The immunoregulatory effects of mescenchymal stem cell (MSC) and its application have become a focused research topic in recent years.This article reviews the up-to-date research advances in the features and mechanisms of immune regulation of MSC and its application.

Objective To investigate the technical feasibility and clinical significance of non-vascular contrast-enhanced ultrasound(NVCEUS) in screening pyelogenie cyst out of simple renal cysts so as to avoid damage to the urinary tract from absolute ethanol while undergoing percutaneous aspiration and ethanol sclerotherapy(PAEST). Methods Following an inclusion criteria 23 patients with renal cysts were selected to receive NVCEUS scanning by means of administrating SonoVue contrast agents through puncture needle into their renal cyst lumen prior to the injection of absolute ethanol for sclerosing treatment. By the demonstration of hyperechoic contrast agents leaving from intra cyst into renal collecting system,a pyelogenic cyst was defined. The patients with this kind of cyst was not allowed for further ethanol sclerotherapy. Results NVCEUS made 3 patients with pyelogenic cyst resembling simple ones free from ethanol selerotherapy,and 4 patients suspicious of pyelogenic cyst due to weird cyst configuration remain in the list of simple cyst for further selerotherapy. Conclusions NVCEUS of renal cyst is highly capable of differentiating pyelogenie cyst from simple cyst and highly valuable in increasing the safety for the procedure of PAEST.

Objective To represent the high-resolution ultrasonic profiles of diffuse sclerosing variant of papillary thyroid carcinoma (DSVPTC) and highlight the importance of ultrasound examination for detecting this rare entity. Methods The document of clinical presentations and thyroid ultrasound imaging information leading to correct diagnosis were reviewed in association with the microscopic findings of excised thyroid specimen. Results The average age of the eight patients was (18.88 ± 3.59) years(range from 12 to 24) with a gender ratio of 2 males to 6 females. Their predominant clinical presentations were enlargement (8/8) and hardening(6/8) of the involved thyroid lobes. The ultrasound imaging features were increase in the width and thickness of involved thyroids, hypoechoic and heterogeneous internal echoes, containing multiple,diffuse,and fine hyperechoic spots but without formation of any masses, and multiple enlarged lymph nodes in the bilateral jugular chains due to cancer cell metastasis. Ultrasound diagnosis of the first case was malignant thyroid tumor, but the following consecutive 7 patients were all definitely interpreted as DSVPTC. Conclusions The clinical presentations alone is less valuable in diagnosis of DSVPTC, but the characteristic features on high-resolution ultrasonography are highly sensitive and indicative.

Objective To study the clinical characterics of 139 patients with wide QRS complex tachycardia.Methods Retrospective analysis was performed on 139 patients with QRS wave tachycardia treated by radiofrequency ablation at TEDA International Cardiovascular Hospital.The patients were divided into supra-ventricular tachycardia with intra-ventricular aberrany group (group A,n =84) and ventricular tachycardia (group B,n =55).The clinical data,electrocardiogram (ECG) and echocardiographic features between the two groups were compared.Results There was no statistical significance between the two groups in terms of gender,height,weight and ventricular rate (P ＞ 0.05).The difference in the course of disease,blood pressure,age,QRS duration,left ventricular diameter by echocardiography and ejection fraction was statistically significant (P ＜ 0.05).Radiofrequency ablation result showed that 81 (96.4％) cases were successful in group A,and 37 (67.3％) cases were successful in group B.The difference in the success rate was statistically significant (P ＜0.05).After 1 year of follow-up,4 (2.9％) cases in group A were recurred,13 (23.6％) cases in group B were recurred.The difference in the recurrence rate was statistically significant.Conclusion The wide QRS wave tachycardia is often accompanied with left ventricular diameter enlargement and left ventricular ejection fraction reduction,The success rate of radiofrequency ablation is low,and the recurrence rate is high when diagnosis is ventricular tachycardia.

To assess right ventricular free wall longitudinal myocardium deformation and examine the changes with normal age by speckle tracking imaging (STI), myocardial systolic peak strain (epsilon), systolic peak strain rate (SRs), early diastolic peak strain rate (SRe), late diastolic peak strain rate (SRa), the ratio of SRe/SRa were measured in the basal, middle and apical segments of right ventricular free wall in 75 healthy volunteers (age range: 21-71 y) by STI from the apical 4-chamber view. RV longitudinal strain and strain rate were highest in the basal segment of the free wall. Older subjects had lower early diastolic strain rate (SRe) than younger subjects, but they had higher late diastolic strain rate (SRa). A negative correlation between age and the ratio of SRe/SRa was found in all RV free wall segments (r=-0.466 - -0.614, P<0.01). It is concluded that RV diastolic strain rate changes with age and STI can be used for the study of RV myocardial deformation.
Age Factors ; Diagnostic Imaging/*methods ; Echocardiography/methods ; Heart/physiology ; Models, Statistical ; Myocardial Contraction ; Myocardium/*pathology ; Reproducibility of Results ; Stress, Mechanical ; Ventricular Dysfunction, Right ; Ventricular Function, Right

Background:Gastric cancer is one of the malignant tumors with highest morbidity and mortality,and the early change of molecular marker in gastric mucosal lesion is the hot spot of gastric cancer study. Aims:To investigate the expressions and clinical significance of trefoil factor 2(TFF2),claudin 18(CLDN18),mucin 5AC(MUC5AC)in gastric mucosal lesions. Methods:Gastroscopy biopsies and surgery specimens from Dec. 2008 to May 2009 at Inner Mongolia People’s Hospital were collected,including 20 normal gastric mucosal tissues,20 intestinal metaplasia tissues,11 dysplasia tissues and 20 gastric cancer tissues. The protein expressions of TFF2, CLDN18, MUC5AC were determined by immunohistochemical SP method. Results:The positive expression rates of TFF2,CLDN18 and MUC5AC in normal gastric mucosal tissues were all 100% ,and were gradually decreased in the order of intestinal metaplasia,dysplasia and gastric cancer tissue,the differences were statistically significant(P < 0. 01). Conclusions:Expressions of TFF2,CLDN18 and MUC5AC protein are closely related to the degree of malignancy of gastric mucosal lesions,and can be considered as a potential biological marker for predicting the development and prognosis of gastric cancer.

Objective To investigate the effect of right ventricular(RV)volume and RV pressure overload on left ventricular(LV)rotation and twist in patients with atrial septal defecl(ASD).Methods Using speckle tracking imaging(STI),the peak rotation of 6 segments in basal and apical short-axises was measured respectively in 35 patients with ASD(18 of which with pulmonary hypertension)and 21 healthy subjects as controls.The average peak rotation and duration time of the 6 segments in basal and apical short-axises in negative direction during early systolic phase were also measured respectively.LV twist versus time profile was drawn and the peak twist and time to peak twist were calculated.LV ejection fraction(EF)was measured by biplane Simpson method.Results Compared to ASD patients without pulmonary hypertension and healthy subjects,the peak rotation of posterior wall,inferior wall and postsept wall in basal was lower(P＜0.05).And at the basal level,the averagepeak rotation of 6 segments in negative direction during early systolic phase was higher(P＜0.05),and the average duration time was delayed(P＜0.05).LV peak twist was also lower(P＜0.05),and had a significant negative correlation with pulmonary arterial systolic pressure(r=-0.57,P=0.001).There were no significant differences in LVEF among 3 groups.Conclusions Although RV volume overload due to ASD has no significant effects on LV rotation and twist,LV peak twist is lower in ASD patients with pulmonary hypertension.Thus LV twist may be a new index which predicting whether ASD patients also has pulmonary hypertension or not.

Objective To investigate the risk factors associated with acute renal failure (ARF)after surgery in patients with simple abdominal trauma. Methods A retrospective case-control study was carried out in patients with simple abdominal trauma after surgery from January 2003 through May 2008 in our hospital. Twenty patients with ARF were set as study group and 68 patients without ARF as control group. Clinical data including age, gender, injury type, number of injured organs, blood transfusion volume, intra-abdominal pressure, abdominal infection, shock and related factors were analyzed by using univariate and Logistic regression to identify the independent risk factors of ARF after surgery in patients with simple abdominal trauma. Results Univariate analysis revealed statistical difference in aspects of blood transfusion volume ( ＞ 1 600 ml), operation timing ( interval between trauma and operation ＞12 h), preoperative shock duration ( ＞6 h), postoperative abdominal infection and intra-abdominal hypertension ( ＞ 12 mm Hg) between two groups ( P ＜ 0. 05 ). Logistic regression analysis showed that these five indices were the independent risk factors of ARF after surgery in patients with simple abdominal trauma ( P ＜ 0. 05 ). Conclusions Massive blood transfusion, delayed operation, long preoperative duration of shock, postoperative abdominal infection or intra-abdominal hypertension are the risk factors of ARF after surgery in patients with simple abdominal trauma. We should pay attention to these factors and take effective measures to prevent occurrence of ARF.