For the current situation of the time background and the cultivation of innovation ability of undergraduates, the problems of fracture classification, function evaluation and postoperative rehabilitation were realized by a software research team which mainly consisted of medical undergrad-uates. We put the project into practice in forms of software production and software promotion trial separately in the field of teaching and clinical practice to encourage students to be involved in learn-ing in the process of software production of professional knowledge. The implementation of the project worked well, and developed the well-designed relevant mobile software which was convenient in clini-cal practice and acquired computer software copyright, indicating that it can effectively motivate the undergraduates' innovation interest and consciousness through participating in the various links and the software production process, and it can also contribute to the cultivation of the comprehensive practical and innovation ability of medical undergraduates.

Objective To evaluate the surgical approaches, surgical timing and materials for cranial defect repair in children. Methods From the year 2002 to 2006, 4 children with cranial defect received cranial reconstruction using absorbable poly-L-lactic acid (PLA) material and hydroxyapatite. Results The 3-year follow-up showed that the cranial defect was successfully repaired using the absorbable material in 3 patients and failure of repair occurred in 1 patient. Conclusion Cranial defect in children can be effectively repaired using absorbable materials and hydroxyapatite without obviously affecting the skull development. This approach provides an important option for cranial defect repair in children.

OBJECTIVETo explore the influence of inhibition of hypoxia-inducible factor-1 alpha (HIF-1 alpha) by RNA interference (RNAi) on tumorigenesis of human myeloma cell line (HMCL) RPMI8226 cells in nude mice.

METHODRNAi vector of HIF-1 alpha was constructed with commercial shRNA expression vector pSilencer 2. 1-U6 hygro. RT-PCR and western blot were used to detect HIF-1 alpha mRNA and protein expression respectively. Vascular endothelial growth factor (VEGF) secretion and cell cycle changes were detected by ELISA and flow cytometry respectively. Expression of target gene of HIF-1 alpha, VEGF and Glut-1 were tested under hypoxia condition. Tumorigenesis was observed after transfected cells were injected subcutaneously in nude mice.

RESULTSAfter interference, expression of HIF-1 alpha decreased significantly at both mRNA and protein level. Under normoxia condition, VEGF concentrations in HIF-la inhibited cells (RPMI8226-il and RPMI8226-i2) and non-inhibited cells (RPMI8226-c and RPMI8226) showed no differences. While under hypoxia condition, VEGF concentration in the above four cells was (506.0 +/- 53.2), (494.7 +/- 63.1), (984.4 +/- 61.9) and (938.2 +/- 62.2) pg/ml, respectively, being significantly lower in RPMI8226-il and RPMI8226-i2 cells than in RPMI8226-c and RPMI8226 cells (P <0.05). HIF-1 alpha interference was found to suppress the cells shift from S-phase to G1 induced by hypoxia. VEGF and Glut-1 expressions were markedly attenuated (P <0.05). The growth rate of HIF-1 alpha inhibition tumors in subcutaneous xenograft model decreased drastically.

CONCLUSIONSRNAi inhibits HIF-1 alpha expression. Reduced tumor growth by HIF-1 alpha inhibition may partly through inhibiton of angiogenesis and glycolysis metabolism.

Animals ; Cell Cycle ; Cell Line, Tumor ; Genetic Vectors ; Glucose Transporter Type 1 ; metabolism ; Humans ; Hypoxia-Inducible Factor 1, alpha Subunit ; genetics ; metabolism ; Mice ; Mice, Nude ; Multiple Myeloma ; metabolism ; pathology ; RNA Interference ; Vascular Endothelial Growth Factor A ; metabolism ; Xenograft Model Antitumor Assays

OBJECTIVETo apply single nucleotide polymorphism array (SNP-array) for the diagnosis of Williams-Beuren syndrome (WBS) in a patient.

METHODSChromosome G-banding and SNP-array were used to analyze a girl featuring mental retardation.

RESULTSThe karyotypes of the child and her parents were all normal, but SNP-array showed a 1.9 Mb deletion at 7q11.23 in the patient. The same deletion was not found in her parents.

CONCLUSIONThe mental retardation and special facies of the girl were probably due to the 7q11.23 microdeletion. SNP-array has an important value for the diagnosis of mental retardation.

Child ; Chromosome Deletion ; Chromosomes, Human, Pair 7 ; Female ; Humans ; Oligonucleotide Array Sequence Analysis ; Polymorphism, Single Nucleotide ; Williams Syndrome ; genetics

OBJECTIVETo observe the promoting consciousness effect of electroacupuncture combined with routine western medicine therapy on the patient with coma caused by craniocerebral trauma.

METHODSThirty-two cases were randomly divided into an acupuncture-medication group treated with electroacupuncture at Neiguan (PC 6) and Quze (PC 3) and routine western medicine, and a control group treated with routine western medicine, 16 cases in each group. Glasgow (GCS) scores were assessed after treatment for 7 sessions and 30 sessions respectively and the promoting consciousness rate was observed.

RESULTSAfter treatment of 7 sessions, GCS score was 6.88 +/- 1.63 in the acupuncture-medication group and 5.25-1.65 in the control group with a significant difference between the two groups (P < 0.05); after treatment of 7 sessions, the promoting consciousness rate was 25.0% in the acupuncture-medication group and 0 in the western medicine group, and after treatment for 30 sessions, the promoting conscious ness rate was 81. 3% in the acupuncture-medication group and 43.8% in the western medicine group with a signifi cant difference between the two groups (P < 0.05).

CONCLUSIONElectroacupuncture at Neiguan (PC 6) and Quze (PC 3) combined with western medicine has a good promoting consciousness effect in the patient with coma caused by craniocerebral trauma, which is better than that of simple western medicine.

Adolescent ; Adult ; Aged ; Coma ; drug therapy ; etiology ; therapy ; Combined Modality Therapy ; Craniocerebral Trauma ; complications ; Electroacupuncture ; Female ; Humans ; Male ; Middle Aged ; Young Adult

OBJECTIVETo study the risk factors associated with lymphatic metastasis of T2 rectal carcinoma.

METHODSA consecutive series of 122 patients with T2 rectal cancer who underwent radical surgery in the First Affiliated Hospital of Fujian Medical University from 2006 to 2011 were included for retrospective analysis. Risk factors associated with lymphatic metastasis were investigated.

RESULTSThe rate of lymph node metastasis was 21.3% (26/122). Distance to anal verge(P<0.05), morphological type(P<0.05), histological type(P<0.05), tumor differentiation(P<0.05), and depth of invasion(P<0.05) were risk factors for lymph node metastasis in T2 rectal cancer by univariate analysis. The depth of invasion remained statistically significant by multivariate analysis. The rate of lymph node metastasis was 13%(7/54) in patients with shallow muscularis propria involvement, and 28%(19/68) in those with deep muscularis involvement.

CONCLUSIONFor T2 rectal cancer with shallow muscularis involvement, the risk of lymph node metastasis is low and transanal excision should be considered.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; pathology ; Male ; Middle Aged ; Rectal Neoplasms ; pathology ; surgery ; Retrospective Studies ; Risk Factors

OBJECTIVETo investigate the impact of timing of nasojejunal feeding tube placement and enteral nutrition on clinical outcomes in children with acute pancreatitis.

METHODSA retrospective analysis was performed on the clinical data of 31 children with acute pancreatitis, who received nasojejunal feeding between January 2008 and July 2013, to investigate the relationship of abdominal symptoms/signs and serum amylase level with the tolerability of catheterization and success rate of enteral nutrition. The treatment outcome and incidence of adverse reactions and complications were compared between the early enteral nutrition group ( ≤7 days from the onset of the disease) and late enteral nutrition group (>7 days from the onset of the disease).

RESULTSAbdominal symptoms/signs and serum amylase level were independent of the tolerable rate of catheterization and success rate of enteral nutrition. Compared with the late enteral nutrition group, the early enteral nutrition group had a shortened time to normal serum amylase level, significantly reduced incidence of systemic complications, length of hospital stay, and hospitalization expenses, and less weight gain. The tolerable rate of catheterization and success rate of enteral nutrition showed no significant difference between the two groups. Similarly, no significant differences were found in the increase in albumin level after enteral nutrition, duration of enteral nutrition, incidence of adverse reactions, and incidence of local complications.

CONCLUSIONSAbdominal symptoms/signs and serum amylase level cannot be used as a measure of whether nasojejunal feeding tube placement and enteral nutrition can be performed. Early enteral nutrition can better improve clinical outcomes in children with acute pancreatitis, and it is feasible.

Acute Disease ; Adolescent ; Child ; Child, Preschool ; Enteral Nutrition ; Female ; Humans ; Intubation, Gastrointestinal ; Male ; Pancreatitis ; therapy ; Retrospective Studies ; Time Factors

OBJECTIVETo evaluate the possible side-effects after injecting hydrophilic polyacrylamide gel for augmentation of the soft-tissue.

METHODSFifteen patients with some side-effects after injecting the hydrophilic polyacrylamide gel had been undergoing for the treatment in our unit from 2000 to 2001. Their symptoms were analyzed and the specimen of the tissue was also removed for pathologic examination.

RESULTSThe major complaints of the patients after injecting hydrophilic polyacrylamide gel were feeling pain(60.00%), uncomfortable (13.33%), no cosmetic improvement results (33.33%), secondary deformity (20.00%), long-lasting swelling (6.67%), and nodules (80.00%). The pathologic examination was showing the capsule formation (53.33%), macrophagocyte infiltration (60.00%) and granuloma producing (20.00%).

CONCLUSIONClinical application of the hydrophilic polyacrylamide gel may result in some serious side-effects. It should be cautious to the physicians who may apply the product for clinic use.

Acrylic Resins ; adverse effects ; Adult ; Breast ; drug effects ; pathology ; Female ; Humans ; Injections ; Male ; Middle Aged ; Surgery, Plastic ; adverse effects

BACKGROUNDIt has been recently reported that inflammatory mechanisms play an important role in in-stent restenosis (ISR) processes. Inflammatory factors after percutaneous coronary intervention (PCI) for dynamic monitoring can probably predict ISR. Functional polymorphisms in the promoter region of genes coding for inflammatory factors might be important for determining the magnitude of the inflammatory response. Thus, in the present study, we aimed to investigate the serial changes in serum interleukin-6 (IL-6) levels before and after PCI and the relationship between the -572C/G polymorphism in the promoter region of the IL-6 gene and ISR. We also discussed genetic polymorphisms in the inflammatory response to PCI.

METHODSA total of 437 patients who successfully underwent bare metal stent (BMS) implantation with a follow-up angiography were divided into an ISR group (n = 166) and a non-ISR (NISR) group (n = 271). The IL-6 gene promoter polymorphism at position -572 was determined by restricted fragment length polymorphism using the polymerase chain reaction (PCR-RFLP) method. The serum IL-6 levels before and one day, five days and 180 days after PCI were determined by the radioimmunoassay method.

RESULTSISR patients showed higher IL-6 serum levels than NISR patients before PCI ((324.42 ± 28.14) ng/L vs. (283.22 ± 47.30) ng/L, P < 0.001), and one day post-PCI IL-6 serum levels in the ISR group also showed a significantly higher level than in the NISR group (P < 0.001). Increased IL-6 after PCI persisted at a statistically significant level throughout the study in ISR patients, whereas IL-6 levels had normalized five days after the procedure in NISR patients. One day post-PCI serum IL-6 level was the most accurate marker for diagnosis of ISR, the area under the ROC curve being 0.927 (95%CI 0.878 - 0.977). The cut-off value for IL-6 to predict ISR was over 355.50 ng/L, with a sensitivity of 0.968 and a specificity of 0.865. There were no significant differences in frequencies of -572 genotype and allele between the two groups (P > 0.05). One day post-PCI IL-6 serum levels in patients with the G allele was significantly higher than in patients without the G allele ((366.99 ± 49.37) ng/L vs. (347.20 ± 55.30) ng/L, P < 0.05). In the ISR group, one day post-PCI serum levels of IL-6 in patients with the G allele was also significantly higher than that in patients without the G allele ((405.67 ± 26.56) ng/L vs. (375.69 ± 38.81) ng/L, P < 0.05). Multivariate Logistic regression analysis revealed positive correlations between male gender, one day post-PCI serum levels of IL-6, the pre-PCI degree of stenosis, the length of the target lesion stenosis, and restenosis; and there were negative correlations between the stent diameter, the diameter of the reference vessel before stent implantation and restenosis.

CONCLUSIONSIL-6 is an early post-PCI inflammatory cytokine, and one day post-PCI serum IL-6 level is an independent risk factor for restenosis. The frequencies of IL-6 gene -572 genotype and allele are not different between patients with and without ISR in a Chinese Tianjin Han population, but carrying the IL-6 -572G allele is likely to increase an individual's susceptibility to ISR by promoting serum IL-6 levels.

Aged ; Angioplasty, Balloon, Coronary ; Coronary Restenosis ; blood ; genetics ; Female ; Genotype ; Humans ; Interleukin-6 ; blood ; genetics ; Male ; Middle Aged ; Polymorphism, Genetic ; genetics ; Promoter Regions, Genetic ; genetics

OBJECTIVETo investigate the relationship of interleukin-10 gene (IL-10) polymorphism and the serum IL-10 level with restenosis after percutaneous coronary intervention (PCI) in Tianjin Chinese Han population and study the effect of IL-10 gene polymorphism on serum IL-10 level.

METHODSFour hundred and thirty-seven patients who successfully underwent PCI with a follow-up angiography were divided into a restenosis group (n = 166) and non-restenosis group (n = 271). The IL-10 gene promoter polymorphism at position -592 was determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Meanwhile their serum IL-10 level before and 24 h after PCI was determined by enzyme-linked immunosorbent assay (ELISA).

RESULTS(1) There was no significant difference in frequencies of -592 genotypes and alleles between the two groups (P > 0.05); (2) The 24 h post-PCI IL-10 serum level of restenosis group was significantly lower than that of the non-restenosis group [(82.67 ± 35.02) ng/L vs. (95.08 ± 32.26) ng/L, P < 0.05]; (3) The serum level of the A allele carriers (AA+AC) was significantly lower than that of the CC carriers [(86.13 ± 34.77) ng/L vs. (102.50 ± 27.52) ng/L, P < 0.05]; (4) In the restenosis group, the 24 h post-PCI serum level of IL-10 in the A allele carriers was also significantly lower than that in those without the A allele [(78.51 ± 34.09) ng/L vs. (102.19 ± 33.66) ng/L, P < 0.05]; (5) Logistic regression analysis revealed positive correlations between acute coronary syndrome patients, pre-PCI degree of stenosis, length of target stenosis lesion and restenosis (OR = 5.90, 1.86, 2.83 respectively); and there were negative correlations between 24 h post-PCI serum level of IL-10, the stent diameter, the diameter of reference vessel before stent implantation and restenosis(OR = 0.99, 0.70, 0.46 respectively).

CONCLUSION(1) The IL-10 gene -592 C/A polymorphism was not associated with restenosis in the Tianjin Chinese Han population; (2) IL-10 is an early post-PCI inflammatory cytokine, 24 h post-PCI serum IL-10 level was an independent predictive factor for restenosis, the IL-10 A allele carriers may have increased incidence of in-stent restenosis (ISR) by reducing the serum IL-10 levels.

Adult ; Aged ; Angioplasty, Balloon, Coronary ; Asian Continental Ancestry Group ; genetics ; Coronary Restenosis ; genetics ; Female ; Genotype ; Humans ; Interleukin-10 ; blood ; genetics ; Male ; Middle Aged ; Polymorphism, Genetic ; Stents