Objective This article elaborates how to improve the medical undergraduates’ study interest from the angle of network course platform. Methods Based on the analysis of characteristic and application of network course platform,it discusses the problems and solutions existing in network course platform. Results The meaning of utilizing interactive platform in Medical College is explained. Conclusion Utilizing interactive platform rationally can stimulate the medical undergraduate’s study interest and improve the teaching result.

OBJECTIVE To study the application of narrow-band imaging in diagnosis of the nasopharyngeal malignant lesions. METHODS A total of 52 cases of nasopharyngeal malignant lesions were examined and diagnosed by white and NBI endoscopy between June 2014 and August 2015, and their diagnosis efficacies were evaluated based on pathological diagnosis as a gold standard. RESULTS Of 52 cases, 46 cases were malignant lesion(88.46%) and 6 were non malignant lesion(11.54%). The diagnostic accuracy by NBI for the nasopharyngeal malignant lesions was 86.54%(45/52), which was significantly higher than that of white light 69.23%(36/52, χ2=4.522, P<0.05). The sensitivity of NBI and white light to detect nasopharyngeal carcinoma was 97.83%(45/46) and 78.26%(36/46) respectively(χ2=8.364, P<0.05). CONCLUSION NBI has high application value in diagnosis of nasopharyngeal carcinoma, and is expected to become one of the important means to diagnosis of the nasopharyngeal carcinoma.

OBJECTIVE: To estimate the clinical significance of target biopsy in clinical diagnosis, and accurate pathologic specimen acquisition of laryngeal lesion by using narrow band imaging (NBI) endoscopy. METHOD: A total of 156 cases of patients with laryngeal lesions were collected from the department of Otolaryngology Head and Neck Surgery of Tianjin Union Medical Center from Aug 2012 to Dec 2014. All patients were randomly divided into regular biopsy group and NBI target biopsy group. Image data were recorded and the patients' samples were biopsied. The pathologic diagnosis was used to evaluate the accuracy of regular biopsy and target biopsy. RESULT: Based on the pathologic diagnosis, the correct accurate pathologic specimen acquisition rates in NBI target pathology group at stage 0 (Tis), stage I and stage II laryngeal cancer diagnosis compliance rate were higher than those in regular biopsy group, stage 0 (Tis) (χ² = 22.00, P < 0.05), stage I (χ² = 8.33, P < 0.05) and stage II (χ² = 4.55, P < 0.05). CONCLUSION NBI endoscopy plays an important role in the clinical diagnosis and accurate pathologic specimen acquisition of laryngeal carcinoma and can be a regular means to detect laryngeal lesions in clinical.
Biopsy ; methods ; Endoscopy ; methods ; Humans ; Laryngeal Neoplasms ; diagnosis ; Larynx ; pathology ; Narrow Band Imaging ; Neoplasm Staging

Objective To investigate the expressions of vascular endothelial growth factor-C (VEGF-C) and vascular endothelial growth factor-D (VEGF-D) and their relationship with lymph node metastasis in gastric cancer. Methods Eighty patients with gastric cancer had been admitted to our department from January 2005 to December 2005, including 48 with local lymph node metastasis and 32 without local lymph node metastasis. Ten specimens of normal gastric mucosa from patients with gastric ulcer were used as control. The expression of VEGF-C and VEGF-D in serum and tissues were detected. Results The senun levels of VEGF-C and VEGF-D in patients with gastric cancer were significantly higher than those in the control group (χ2= 8.39, P < 0.05). The positive rate of the VEGF-C expression in the sermn of patients with gastric cancer was influenced by the lymph node metastasis (χ2 = 7.01, P < 0.05). The positive rates of the expressions of VEGF-C and VEGF-D in the gastric cancer tissue were 53% (42/80) and 63% (50/80), which were significantly higher than those in the normal gastric mucosa (χ2 =6.44, 6.58, P <0.05). The positive rate of the VEGF-C expression in the tissue of patients with gastric cancer was influenced by the lymph node metastasis (χ2=11.25, P <0.05). Conclusions The expression of VEGF-C is closely related to lymph node metastasis of gastric cancer. The serum levels of VEGF-C can be used as biologic markers in detecting lymph node metastasis of gastric cancer preoperatively.

Objective To investigate the clinical efficacy and safety of temperature-controlled radiofrequency ablation(TCRF)for treatment of elderly patients with obstructive sleep apnea hypopnea syndrome(OSAHS).Methods From March 2009 to June 2010,52 elderly patients with OSAHS confirmed by polysomnography(PSG)were treated with TCRF under local anesthesia.PSG monitoring was used preoperatively and 6 months postoperatively to determine the therapeutic effect.Apnea hyponea index (AHI),the lowest blood oxygen saturation(LSaO2),sleep apnea quality of life index(SAQLI)and the Epworth sleepiness scale(ESS)were assessed before and 6 months after operation.Results All these cases were reevaluated with PSG by the end of postoperative period lasted for 6 months.Thirteen cases were cured,18 cases were significantly improved,15 cases were improved,6 cases were not improved,with a total effective rate of 88.5％(46/52).No serious complications occurred.After operation,AHI decreased from (47.8 ± 13.7)times/h to(13.5 ± 7.3)times/h,LSaO2 increased from 0.677 ± 0.095 to 0.808 ± 0.056,SAQLI increased from(3.53 ± 0.43)scores to(5.01 ± 0.22)scores and ESS scores decreased from(14.93 ± 3.13)scores to(5.33 ± 2.52)scores,all above index had significant differences(P＜ 0.01).Conclusions TCRF for elderly patients with OSAHS is effective,and can improve their health-related quality of life.This treatment is convenient,simple,minimally invasive,repeatable,without serious complications,and can be especially suitable for surgical treatment of elderly patients with mild and moderate OSAHS.

Aim To investigate the effect of resveratrol on astrocyte activation after cerebral ischemia/reperfusion injury in rats.Methods 45 male Sprague-Dawley rats were divided into sham,control and resveratrol groups, 15 rats in each group.Resveratrol or solvent was intra-peritoneally perfused into the rats for 7 consecutive days after 3h for MCA I /R.Cerebral infarction volume with TTC,neurological function score with Longa score, and pathological change with HE staining,the protein expressions of Caspase-3 with immunohistochemistry at 24h after MCA I /R were examined.The protein ex-pressions of GFAP and NeuN in penumbra were detec-ted with immunohistochemistry and immunofluores-cence at 14d after MCA I /R.Results Resveratrol treatment significantly improved the neurological func-tion score,decreased the infarct volume,reduced neu-ron loss,and inhibited the activation and proliferation of astrocytes,compared with the control group.Con-clusion Resveratrol can inhibit the excessive activa-tion of astrocytes,protect neurons in penumbra and im-prove neurological function.

BACKGROUND:Delayed graft function (DGF) occurs frequently in kidney transplants from donation after cardiac death if creatinine level is high in kidney recipients. OBJECTIVE:To analyze the clinical effects of renal transplantation with kidneys from donors dying of cardiac death in organophosphate poisoning. METHODS:Data were col ected from kidney transplants from two donors dying of cardiac death in organophosphate poisoning. After some donor maintenance, donor organ were obtained and perfused with impulse type machine. Recipients were treated with intervention of immunity induction, anti-rejection drugs and infection prevention drugs during and after renal transplantation. Pathological data of donor kidney zero needle biopsy, DGF after kidney transplantation, complication rate (such as acute rejection), renal al ograft recovery situation, the survival rate of recipients and kidney transplants were col ected and analyzed. RESULTS AND CONCLUSION:Needle biopsy results from four donor kidneys showed that glomerular morphology was normal, but there were edema and degeneration in kidney tubules in some degree. Donor DGF rate was 75%(3/4), acute rejection rate was 0%(0/4), perioperative period donor kidney and recipient survival rate were 100%(4/4). Al recipients showed a good result of transplanted kidney, their creatinine and urea nitrogen were at low level, and had no proteinuria. One recipient died of severe pulmonary infection 4 months after surgery. For some organophosphate poisoning donors dying of cardiac death, donor kidney quality can be improved by suitable donor maintenance and high-quality donor kidney preservation using machine perfusion. Kidney transplants from donors dying of cardiac death in organophosphate poisoning who receive the maintenance of organ function may be a promising candidate for renal transplantation due to a severe lack of kidney donor sources.

Objective    To investigate the feasibility, safety and effectiveness of radiofrequency ablation of atrial fibrillation with mitral valve replacement under totally thoracoscopic surgery. Methods    The clinical data of 107 patients with rheumatic mitral disease and atrial fibrillation who underwent mitral valve replacement and radiofrequency ablation at the same time in our hospital from January 2014 to October 2018 were retrospectively analyzed. The patients were divided into two groups: a totally thoracoscopic surgery group (n=51, including 20 males and 31 females, aged 50.57±5.24 years) and a median sternotomy group (n=56, including 21 males and 35 females, aged 52.12±5.59 years) according to the surgical methods. The preoperative, intraoperative and postoperative data of the patients were compared. Results    All operations were successfully completed without death. In terms of bleeding volume, drainage volume, ventilator-assisted breathing time, hospital stay and incision length, the totally thoracoscopic surgery group was better than the median sternotomy group, and the difference was statistically significant (P<0.05). The cardiopulmonary bypass time and radiofrequency ablation time in the totally thoracoscopic surgery group were longer than those in the median sternotomy group (P<0.05). There was no significant difference in the operation time, aortic occlusion time, postoperative complications, left ventricular ejection fraction, left atrial diameter and sinus rhythm maintenance between the two groups (P>0.05). There was no atrioventricular block, pulmonary vein stenosis, atrioesophageal fistula, coronary artery injury, stroke or hemorrhage during the follow-up. Conclusion    Radiofrequency ablation of atrial fibrillation with mitral valve replacement under totally thoracoscopic surgery is safe and effective, and it is worthy of clinical application.

PURPOSE: Four polymorphisms, -765G>C, -1195G>A, 8473T>C, and Val511Ala, in the cyclooxygenase-2 (COX-2) gene were identified to be associated with colorectal cancer (CRC) risk. However, the results are inconsistent. The objective of this meta-analysis was to evaluate the association between these four polymorphisms and the risk of CRC. MATERIALS AND METHODS: All eligible case-control studies published up to December 2012 on the association between the four polymorphisms of COX-2 and CRC risk were identified by searching PubMed and Web of Science. The CRC risk associated with the four polymorphisms of the COX-2 gene was estimated for each study by odds ratio (OR) together with its 95 % confidence interval (CI), respectively. RESULTS: A total of 15 case-control studies were included. Overall, no evidence has indicated that the -1195A allele, -765C allele, 8473C allele, and 511Ala allele are associated with susceptibility to CRC (-1195G>A: OR=1.11, 95 % CI: 0.82-1.51, p=0.78; -765G>C: OR=1.08, 95 % CI: 0.96-1.21, p=0.07; 8473T>C: OR=1.03, 95 % CI: 0.89-1.18, p=0.91; Val511Ala: OR=0.71, 95 % CI: 0.46-1.09, p=0.94). However, stratified analysis with ethnicity indicated that individuals with -765GC or GC/CC genotypes had an increased risk of CRC among Asian populations (GC vs. GG: OR=1.05, 95 % CI: 0.87-1.28, p=0.03; GC+CC vs. GG: OR=1.08, 95 % CI: 0.96-1.21, p=0.07). CONCLUSION: This meta-analysis indicated that -765G>C polymorphism was significantly associated with susceptibility to CRC in Asian populations.
Asian Continental Ancestry Group ; Case-Control Studies ; Colorectal Neoplasms/*genetics ; Cyclooxygenase 2/*genetics ; Genetic Predisposition to Disease/genetics ; Humans ; Polymorphism, Genetic/*genetics

Objective To explore the scan technique and image quality of coronary artery imaging with dual-source CT without oral Betaloc preparation.Methods Plain and enhanced dual-source CT coronary artery imaging without oral Betaloc preparation was performed in 215 patients with clinically suspected coronary heart disease or early-stage coronary lesions.Calcium scoring with plain scan images and multi-planar reconstruction(MPR),maximum intensity projection(MIP)and volume rendering technique (VRT)reconstruction with enhanced scan images were made in all cases.The scan technique and post reconstruction experience was summarized.The image quality was classified as three grades,and coronary segments classified according to AHA standards were evaluated.Results The median of calcium score of the 215 cases was 82.2(2.3—1827.9).The average heart rate of the enhanced scan was(80.6?15.3) (57—139)bpm.The post reconstruction methods with which coronary segments could be shown as best as possible consisted of(1)multiphases screening methods,(2)bi-phase or multiple-phase complement method,and(3)premature beat removing or arrhythmia shifting method.Altogether 3026 coronary segments were evaluated,among them 97.5% were evaluated as grade 1 image quality,2.0% were evaluated as grade 2 and 0.5% were evaluated as grade 3.The coronary segments in 91 cases were completely normal, while 112 segments with