BACKGROUND:Absorbable suture with good biocompatibility and mechanical strength has been extensively used in the clinic. OBJECTIVE: To explorein vitro degradation of different absorbable sutures, to analyze the clinical superiority of absorbable sutures and the influential factors for itsin vitro degradation. METHODS: After retrieval of related literatures concerning degradation and application of absorbable suture material, we retrospectively analyzed relevant articles addressing influential factors for performance and degradation of absorbable suture materials, and comparison of clinical absorbable and nonabsorbable sutures, thereby providing theoretical evidence for clinical application. RESULTS AND CONCLUSION: Absorbable sutures can be completely degraded and absorbed by the body, with no adverse reaction and no scars after wound healing. Absorbable sutures overcome the shortcomings of nonabsorbable sutures that cannot break down in the body. The absorption of its degradation products in vivo has two pathways: one is the phagocytosis of giant cels and phagocytes in the body, and the other is that the degradation products enter the body fluids and blood. For example, lactic acid is absorbed and excretedvia the systemic circulation. There is a very complicated physiological environment in the human body, and various factors can affect material properties. In addition, the different kinds of materials have different degradation mannersin vivo. Therefore, it is necessary to design, synthesize and process biodegradable polymer materialswith special properties within a certain range to meet the clinical needs.

Objective To understand and explore the personality characteristic of patients with migraine .To prevent and solve the health problems and provide scientific basis .Methods 100 patients with migraineurs were examined by self -edited question-naier and the Chinese version of the Minnesota Multiphasic Personality Inventory .86 effective questionnaiers which made up by 30 males and 56 females(aged from 18 to 65 ,46 years in average) were collected and analyzed .The subjects were grouped according to the gender ,and compared with the Chinese normal .Results In the male patients ,the measured scales of L ,HS ,D ,Hy ,Pd ,Pt and Ma appeared significantly higher than those in the normal males (P<0 .05) ,while in the female ,the measured scales of F ,Hs ,D , Hy ,Pa ,Pt and Ma appeared significantly higher than those in the normal females (P<0 .05) .Conclusion Patients with migraine have some changes in personality .Male patients and female patients were different .Eealy screening and intervention in the treatment of personality will help to improve the treatment of migraine effect .

The concentrations and distributions of trace metals and rare earth elements (REE) in sediment and mussel samples collected from the India Ocean hydrothermal area were analyzed.The metal correlation between organisms and sediments was investigated, and the ecological and chemical characteristics of REE were also explored.The results showed that, the trace metals in sediments were mainly Fe (96.6 mg/kg), Mn (1.14 mg/kg) and Zn (322.6 μg/kg), and Fe had high ratio of 98.15% by normalized calculation, which indicated that the available sediments in this studying hydrothermal area mainly consisted of iron ore substances.Trace metals and REE distributions all had good correlation between deep-sea sediments and deep-sea mussels, and the correlation coefficients were 0.991 for trace metals and 0.996 for REE.The contents and distributions of metal elements in deep-sea mussels were different from those in offshore mussels.The REE distributions in sediments and mussels showed obvious fractionation phenomenon, and the enrichment of LREE in mussels was significant.Through the REE patterns, Eu and Gd in sediments and mussels all showed anomalies, and Eu had a significant abnormal phenomenon in deep-sea sediments and deep-sea mussels.Besides, δEu values were 9.50, 10.68 and 0.23 in deep-sea sediments, deep-sea mussels and offshore mussels, respectively, and δCe were 2.21, 2.71 and 4.38, which showed that the enrichment sources of REE in offshore mussels and deep-sea mussels were different, and the REE in sediments and mussels from the India Ocean were homologous.

A microwave digestion system was preparation for the digestion of the sediment samples of 16 stations in the Southe mid_Atlantic ridge by using HNO3_H2 O2_HF as the digestion reagent. The rare earth elements ( RE ) in sediments were determined by inductively coupled plasma mass spectrometry, and distribution characteristics of rare earth elements were studied. The microwave digestion_ICP_MS method was used for the determination of rare earth elements with a good linear relationship ( r=0 . 9997-1 . 0000 ) for each element. The detection limit reached ng/L level, the relative standard deviation ( RSD, n=3 ) was less than 3% and the relative error was 6%. The total amount of rare earth elements (ΣRE) in sediment samples from 16 stations varied in the range of 37. 25-134. 77 μg/g, the ratio range of light RE/heavy RE ( LRE/HRE) was 0 . 61-1 . 70 , the average value was 1 . 27 , and the enrichment of light rare earth elements in sediments was slightly obvious. The RE distribution patterns were basically the same in each station with obvious fractionation between LRE and HRE. The RE distribution patterns were also similar in sediments from different sources with slightly difference between terrestrial and marine sediments. The δEu and δCe in the sediments had negative anomaly which showed that the rare earth elements in sediments came from the seawater. This study first analyzed the content and distribution of rare earth elements in the southern Atlantic, providing data and technical support for further study of the distribution of rare earth elements in the Atlantic.

Case-based teaching (CBT) on the basis of treatment guidelines was carried out to develop standard medical behavior, improve learning efficiency and students' ability of solving clini-cal problems. In clinical internship teaching, guidelines for common and frequently-occurring respira-tory diseases and CBT were organically combined. Cases were carefully selected and questions were meticulously set. Guidelines were thoroughly analyzed and teaching was reasonably evaluated. There-fore, students' learning interests were initiated and learning efficiency was improved. It not only trained evidence-based medicine thinking of intern students, but also improved the teaching ability of clinical teachers.

Objective To report a randomized trial in comparing the clinical outcomes of three-port LC versus standard four-port LC. Methods From March 2001 to August 2004, four hundred consecutive patients who underwent elective LC were randomized to receive either the three-port or the four-port technique. All patients were blinded to the type of operation they underwent. Postoperative overall pain and incisional pain at different sites were assessed on the first day after surgery using the Prince-Henry scale. Other outcome measures included length and success of the operation, analgesia requirements, postoperative complications, postoperative stay, and the cosmetic results. Results There was no difference between the two groups in age, sex, weight or other diseases. In terms of outcome, patients in the three-port group had less pain at individual subcostal port sites and better cosmetic results. Success rate, mean operative time, complications, subxiphoid port and overall pain score, analgesia requirements, and postoperative hospital stay were similar between these two groups. Conclusion Three-port LC resulted in less individual port-site pain and similar clinical outcomes but fewer surgical scars compared to four-port LC. The three-port technique is as safe as the standard four-port procedure for LC. Thus, it can be recommended as a routine procedure in elective LC.

Objective To probe the prevention and management of complications after laparoscopic cholecystectomy (LC). Methods Retrospective study was performed on 13 000 patients, who underwent LCs from September 1991 to February 2005 at our department. Results The complication rate was 1. 66% (216 patients) including intraabdominal hemorrhage in 21 patients (0. 16%),bile duct injury in 11 (0. 08% ),gastrointestinal perforation in 7(0. 05% ) , bile leakage in 26(0. 20% ) , retained abdominal tumor in 10(0. 08% ) , retained common bile duct stones in 47(0. 36% ) , intraabdominal abscess in 4(0. 03% ) , upper gastrointestinal hemorrhage in 2(0. 02% ) , extensive subcutaneous emphysema in 32 (0. 25% ) , port wound infection in 46(0. 35% ) , incisional hernia in 1 (0. 01% ) and deep vein thrombosis in 9 (0.07%). Six patients died postoperatively. Conclusions LC is a safe technique when up-to-date equipment and meticulous dissection techniques are employed. With the routine procedure, LC can be performed more safely.

Objective To explore the effect and significance of clinical pathway guided teaching in the residency standard training program of respiratory medicine. Methods Total 47 resident physicians were selected and divided into clinical pathway group and control group from March 2014 to November 2014. The pathway group (n=24) was introduced into the teaching guided by clinical pathway management. The control group (n=23) was taught by traditional teaching method. All physicians were tested for the basic theory and the ability of case analysis after 4 weeks training. The ability of chemotherapy strategy ordered by residents independently and correctly was assessed each week during training. A satisfaction questionnaire survey was conducted to evaluate the effectiveness and satisfaction of teaching guided by clinical pathway. GraphPad Prism 5.0 was used and T test was done for comparison of data between groups. Results The medical records about basic theory and case analysis in the pathway group was higher than those in the control group with significant statistical difference (P<0.05). The records of resident physicians who could issue orders for chemotherapy independently and correctly were (70.75±2.79), (81.43±1.91), (85.23±1.3), (90.62±2.34) in the pathway group and (69.65±2.06), (77.11±2.21), (80.3±1.96), (87.78±2.21) in the control group at each week time point. There was statistical increase of the records in the pathway group than in the control group since the second week time point (P<0.05) The overall satisfaction of the pathway group was 95.84%(23/24), and the teaching satisfaction was higher than that of the control group(91.29%, 21/23). Pathway group doctors believe that the relevant teaching effectively improve the level of their knowledge , experience and ability. Conclusions The teaching method guided by clinical pathway is help-ful to standardize the teaching behavior, develop the standardized medical behavior of resident physicians, improve their clinical working ability efficiently, promote the relationship between teaching and studying, which is worth application in the residency standard training program of respiratory medicine.

BACKGROUNDSmoking is related with insulin resistance and type 2 diabetes mellitus. Retinol-binding protein-4 is a new adipocytokine associated with insulin resistance. We investigated the serum levels of a series of adipocytokines including retinol-binding protein-4 in smokers and non-smokers to explore the possible roles of adipocytokines on smoking induced insulin resistance.

METHODSA total of 136 healthy male subjects (92 smokers and 44 non-smokers) with normal glucose tolerance were enrolled in the study. Adipocytokines including retinol-binding protein-4, visfatin, leptin, resistin, adiponectin were measured for the comparison between the two groups. Serum lipid profile, glucose, true insulin and proinsulin levels were measured as well in both groups. Food intake spectrum was also investigated.

RESULTSBoth groups had similar profile of food consumption; visfatin, leptin, resistin and adiponectin, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, alanine aminotransferase, aspartate aminotransferase, as well as blood pressure and body mass index, were similar in both groups. Triglycerides, retinol-binding protein-4 and homeostatic model assessment index for insulin resistance were higher in smoker group ((2.58 ± 2.53) vs. (1.60 ± 0.94) mmol/L, (26.05 ± 8.50) vs. (21.83 ± 8.40) µg/ml, and 2.25 ± 2.08 vs. 1.58 ± 1.15, respectively).

CONCLUSIONSmoking may have effect on insulin sensitivity, which is correlated with retinol-binding protein-4.

Adiponectin ; blood ; Adult ; Alanine Transaminase ; blood ; Aspartate Aminotransferases ; blood ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Humans ; Leptin ; blood ; Male ; Middle Aged ; Nicotinamide Phosphoribosyltransferase ; blood ; Resistin ; blood ; Retinol-Binding Proteins ; metabolism ; Smoking ; blood ; physiopathology ; Triglycerides ; blood

Background: Signal transducer and activator of transcription 3 (STAT3) was strongly expressed and activated in psoriatic keratinocytes (KCs) and correlated with the severity of psoriasis. The study aimed to investigate the effects of STAT3 small interfering RNA (siRNA) combined with ultrasonic irradiation and SonoVue microbubbles on the proliferation and apoptosis in KCs of psoriatic lesions and the relative mechanisms. Methods: Psoriatic KCs were transfected under four experimental conditions: (1) STAT3 siRNA carried by Lipofectamine 3000 combined with ultrasonic irradiation and SonoVue microbubbles (LUS group); (2) STAT3 siRNA only carried by Lipofectamine 3000 (L group); (3) the negative control of siRNA carried by Lipofectamine 3000 combined with ultrasonic irradiation and SonoVue microbubbles (siRNA-NC); (4) not treated as Blank. Cell Counting Kit-8 assay was used to evaluate the cell proliferation. Cell cycle analysis was detected with cycle test Plus DNA reagent kit associated with flow cytometer. FITC Annexin V apoptosis detection kit associated with flow cytometer was applied for apoptosis analysis. Fluo calcium indicator associated with flow cytometer was used to analyze intracellular free calcium concentration ([Ca]). The expressions of cyclin D1 and Bcl-xL were detected both at the mRNA level by real-time reverse transcription-polymerase chain reaction (RT-PCR) and at the protein level by Western blotting. The obtained data were statistically evaluated by two-way analysis of variance. Results: STAT3 siRNA inhibited the growth of KCs in a time-dependent manner showing the highest proliferation inhibition in LUS group with proliferation ratio of 45.38% ± 5.85% at 72h (P < 0.05 vs. L group, siRNA-NC, or Blank). STAT3 siRNA induced an altered cell cycle distribution of KCs showing the highest increases in G2/M-phase population up to 18.06% ± 0.36% in LUS group (P < 0.05 vs. L group, siRNA-NC, or Blank). STAT3 siRNA induced late apoptosis of KCs with the highest late apoptosis percentage of 22.87% ± 1.28% in LUS group (P < 0.05 vs. L group, siRNA-NC, or Blank). STAT3 siRNA induced the elevation of [Ca]of KCs with the highest calcium fluorescence intensity mean of 1213.67 ± 60.51 in LUS group (P < 0.05 vs. L group, siRNA-NC, or Blank). STAT3 siRNA induced the downregulation of cyclin D1 and Bcl-xL expressions of KCs at mRNA and protein levels with the lowest expressions in LUS group with cyclin D1 expression of 51.81% ± 9.58% and 70.17% ± 4.22% at mRNA level and at protein level, respectively, and with Bcl-xL expression of 37.58% ± 4.92% and 64.06% ± 7.78% at mRNA level and at protein level, respectively (P < 0.05 vs. L group, siRNA-NC, or Blank). Conclusions STAT3 siRNA inhibited the growth and induced the apoptosis in psoriatic KCs likely partly through altering cell cycle distribution, elevating [Ca], and downregulating cyclin D1 and Bcl-xL expressions. Silencing the target gene STAT3 in psoriatic KCs with siRNA combined with ultrasonic irradiation and microbubbles would contribute to a significant innovation as a new clinical therapy for psoriasis.
Apoptosis ; Cell Line, Tumor ; Cell Proliferation ; Humans ; Keratinocytes ; Microbubbles ; Phospholipids ; Psoriasis ; therapy ; RNA Interference ; RNA, Small Interfering ; STAT3 Transcription Factor ; metabolism ; Sulfur Hexafluoride ; Ultrasonics