The phenomenon of recessive absence was initiated by many malpractices in current medical educational system.In this article we try to analyze this phenomenon,speculate the subjective and objective reasons,propose countermeasures such as improving teachers quality,reforming traditional teaching mode,strengthening medical ethics education,enriching teaching means and addressing student-centered lectures.

Adult ; Endocarditis ; complications ; microbiology ; Female ; Humans ; Pulmonary Embolism ; etiology ; Pulmonary Valve ; microbiology

Child, Preschool ; Coffin-Lowry Syndrome ; diagnosis ; psychology ; Diagnosis, Differential ; Humans ; Male

Objective:To evaluate the therapeutic effects of capsule of Biqi Capsule and VitB on lubar intervertebral disc protrusion(LIDP).Methods:78 Patients with LIDP were divided randomly into 2 groups:treatment and control group.39 Patients in treatment group were treated with Biqi Capsule and FENG's bone-setting manipulation,39 patients in control group were treated with vitamine B and FENG's bone-setting manipulation.All patients were followed up for 1 month after treatment for 2 weeks and therapeutic effects were evaluated.Results:In treatment group,24 patients were cured,6 patients had remarkable effects,5 effective,4 ineffective.In control group,the data were 16,8,8,7 correspondly.The therapeutic effects in treatment group were obviously better than those of control group(P

Adult ; Brain Neoplasms ; metabolism ; pathology ; surgery ; Female ; Ganglioglioma ; metabolism ; pathology ; surgery ; Glial Fibrillary Acidic Protein ; metabolism ; Humans ; Magnetic Resonance Imaging ; Phosphopyruvate Hydratase ; metabolism ; Synaptophysin ; metabolism

OBJECTIVETo study the overexpression of Sox9 gene on rabbit bone marrow mesenchymal stem cells for repairing articular cartilage injury in vivo.

METHODSRabbit bone marrow mesenchymal stem cells (BMSCs) were transduced with lentivirus vector containing Sox9 gene and then cartilage specific molecule was detected by RT-PCR in vitro. Total 48 knee joints of 24 mature New Zealand white rabbits were randomly divided into 3 groups according to different defect treatment. After animals anesthesia,a full-thickness cylindrical cartilage defect of 4 mm diameter and 3 mm deep was created in the patellar groove using a stainlesssteel punch. Meanwhile, the transfected cells were implanted to repair the rabbit model with full-thickness cartilage defects. Cartilage defects tissue was observed with light microscope, electron microscope, HE and immunohistochemistry staining to assess the repair of defects by the complex at 6 weeks or 12 weeks after the implantation.

RESULTSAt 3 days after the transfection, Sox9 gene expression was highest and Sox9 gene expression decreased with the increase of time. At 3 days after the transfection, the expression of collagen type II began and reached the peak at 14 days. It showed that the bone marrow mesenchymal stem cells went into chondrogenic differentiation after transfected by Sox9 gene. Histological observation showed that at 6 weeks after the operation, the defects in the experimental group was filled with hyaline like cartilage tissue, 12 weeks after operation,the defects of cartilage and subchondral bone had satisfactory healing. Both at 6 and 12 weeks postoperatively, the defects were filled with fibrous tissues in control groups. Meanwhile, immunohistochemical staining of sections with type II collagen antibodies showed the proteins in the regenerated tissue stained positive for type II collagen and stronger than the control groups. The histological scoring system indicated that the cartilage repair of experiment groups were better than the two control groups with statistical significances.

CONCLUSIONOverexpression of Sox9 gene on rabbit bone marrow mesenchymal stem cells (BMSCs) promote the repair of cartilage defect.

Animals ; Bone Marrow Cells ; metabolism ; Bone Marrow Transplantation ; Cartilage, Articular ; injuries ; metabolism ; Cell- and Tissue-Based Therapy ; Female ; Genetic Vectors ; genetics ; metabolism ; Humans ; Lentivirus ; genetics ; metabolism ; Male ; Mesenchymal Stem Cell Transplantation ; Mesenchymal Stromal Cells ; metabolism ; Osteoarthritis ; genetics ; metabolism ; therapy ; Rabbits ; SOX9 Transcription Factor ; genetics ; metabolism ; Tissue Engineering

Objective To identify the antibiotic resistance, homology of imipenem-resistant Pseudomonas aeruginosa strains isolated from older in Zhejiang Hospital and the carbapenemases determinants of imipenem-resistant strains. MethodsTwo hundred and sixty-two strains of Pseudomonas aeruginosa were isolated through May 2006 to May 2009 from older in Zhejiang Hospitals. K-B method was used to determine the 16 antimicrobial agents resistance of these 262 strains. The MICs of strains to 14 antimicrobial agents were determined by agar dilution and E test method. The coding sequence of Metallo-β-lactamases (MBL) were amplified, PCR products were purified, cloned and sequenced. The homology of these isolates was analyzed by pulse-field gel electrophoresis(PFGE). ResultsOne hundred and four strains of imipenem-resistant Pseudomonas aeruginosa were screened from 262 strains. The resistant rates of 104 isolates of Pseudomonas aeruginosa to ampicillin/sulbactam and cefoperazone/sulbactam were 78.9％ and 35.9％ ; polymyxin E had a minimal resistance of 6.0％ ; minocycline had a resistance rate of 58.3％. The resistant rates to other antimicrobial agents were more than 70.0％. Twelve imipenem-resistant Pseudomonas aeruginosa strains contained MBL gene and two kinds of integron were detected from 10 of these 12 strains. Twelve strains of Pseudomonas aeruginosa belonged to 5 epidemic PFGE-clone. ConclusionAll of the imipenem-resistant Pseudomonas aeruginosa which had cause outbreaks in Zhejiang Hospital. MBL were not the most popular gene type. All of the MBL gene types were VIM-2. The blaVIM-2 gene cassettes located in diflerent class 1 integrons. The integrons dissemination was the most important style of strains spread.

Objective:To investigate the clinical features, operative approach and method of petrous apex chol-esteatoma, to improve the effect of operation and to reduce surgical complications. Method:Two cases of patients with giant petrous apex cholesteatoma were treated by trans labyrinth approach,one of which was successfully operated with oto-endoscope-assisted surgery. Result; No cerebrospinal fluid leakage, infection, vertigo or disequilibrium was found in the two cases after operation. Conclusion:Temporal CT and MRI are of great importance in clinical diagnosis and choice of surgical approach. Surgery by trans-labyrinth approach paves way for removing cholesteatoma thoroughly, dealing with facial nerve and repairing cerebrospinal fluid leakage. Surgery is considered to be the only way to cure petrous apex cholesteatoma, while the key procedure to prevent recurrence lies in complete removal of lesion, long-time strict follow up and regular clearance of the surgical field.

BACKGROUND: Thyroid cancer stem cells are essential to the recurrence and metastasis of thyroid carcinoma. Leukemia inhibitory factor receptor (LIFR) shows a downward trend in a variety of malignant tumors, and its overexpression can inhibit the recurrence and metastasis of malignant tumors. OBJECTIVE:To explore the effect of LIFR on the stemness maintenance and lung metastasis of thyroid cancer stem cells in vivo. METHODS: Primary thyroid cancer cells TCLM were isolated from the lung metastases of a metastatic thyroid cancer patient. Serum-free suspension culture was used to form tumor cell balls. Flow cytometry was used to screen CD133+phenotype of metastatic thyroid cancer stem cell subpopulation TCLM-S. The overexpressed recombinant lentiviral plasmid containing LIFR and its negative control containing the empty plasmid were infected into thyroid cancer stem cells TCLM-S at the ratio of virus/cell number=20, and screened with 2.0 mg/L puromycin to construct TCLM-SLIFRand TCLM-Scontrolstem cells which stably expressed LIFR and its control. Real-time quantitative PCR (qRT-PCR) was used to detect the expression of LIFR in TCLM-SLIFRand TCLM-Scontrolstem cells. Flow cytometry was used to detect the percentage of CD133+phenotype cell subsets, western blot assay was used to detect the expression of tumor stemness related factors SOX2, Oct4, Nanog and tumor invasion and metastasis related proteins E-cadherin, matrix metalloproteinase (MMP)-2, MMP-7 in TCLM-SLIFRand TCLM-Scontrol stem cells. TCLM-SLIFRand TCLM-Scontrolstem cells were respectively injected into BALB/c nude mice by tail vein, and the lung metastasis model of thyroid cancer stem cells was constructed. The effect of LIFR overexpression on lung metastasis was observed. RESULTS AND CONCLUSION: Compared with TCLM-Scontrolcells, the expression of LIFR in TCLM-SLIFRcells was significantly increased, the proportion of CD133+phenotype stem cell subsets was significantly decreased, the expression of SOX2, Oct4 and Nanog were significantly decreased, the expression of E-cadherin was significantly increased, and the expression of MMP-2 and MMP-7 was significantly decreased. Moreover, the number of lung metastasis in nude mice given TCLM-SLIFRcells was significantly decreased as compared with those given TCLM-Scontrol cells.To conclude,LIFR overexpression can decrease the stemness and ability of lung metastasis in vivo.