We analyzed the special characteristics of postgraduate education for anesthesiology majors based on the current situation of medical postgraduate education.Next,we introduced the ‘ sandwich' teaching method and discussed how it can promote students' subjective initiative by transforming various learning patterns.Finally,the effectiveness of study was elevated by ‘sandwich' teaching method.

Aged, 80 and over ; Blood Vessel Prosthesis Implantation ; adverse effects ; methods ; Humans ; Male ; Pacemaker, Artificial ; Subclavian Artery ; surgery

Objective To access the diagnostic value of Prostate Imaging Reporting and Data System (PIRADS version 2)for prostate cancer (PCa) in prostate specific antigen (PSA) grey zone(4-10 ng/mL).Methods Treatment naive PCa and BPH patients with an increase of PSA 4-10 ng/mL from 2200 patients underwent prostate MRI from 2012 to 2016 were included,multiparameter magnetic resonance imaging (mp-MRI) prior biopsy or prostatectomy and clinical data were obtained,mp-MRI were retrospectively analyzed quantitatively by a radiology expert with 15 years experience in urogenital system imaging diagnosis and a doctor with 5 years experience in radiology diagnosis blind to the pathology results according to PIRADS v2,PIRADS v2 score and lesion zone were recorded respectively,in case of disagreement,dicision was made through discuss.TRUS guided biopsy or prostatectomy pathology serves as gold reference.Diagnostic value of PIRADS v2 for PSA grey zone PCa was calculated by receiver operating characteristic (ROC) curve,logistic regression analysis was used to access the risk factors of PCa.Results 15 PCa and 30 BPH patients were in eluded.There was no significant difference between these two groups in age,tPSA,fPSA,f/tPSA,prostate volume and PSA density.The area under ROC curve of PIRADS v2 in diagnosing PCa was 0.932[95 ％ CI 0.822-0.984],P＜0.01.Using a cutoff PIRADS＞4,the diagnosis sensitivity was 88.89 ％,specificity 87.10 ％,and positive predictive value 80 ％,negative predictive value 93.10％,respectively.Logistic regression analysis showed that PIRADS v2 score was an independent risk factor for predicting PCa,with a hazard ratio 17.847[3.745-85.078],P＜0.01.There was a positive correlation between PIRADS v2score and gleason score,r=0.585,P=0.022.Conclusion PIRADS v2 has a significantly high diagnosis value in diagnosing PSA grey zone PCa and a good correlation with pathology results.

Traditional Chinese medicine thinking is the core method of diagnosis and treatment of traditional Chinese medicine. Thus, cultivating the clinical thinking of traditional Chinese medicine in the orthopeadics department has become the importance. TCM tendon and muscle injuries were well characterised by the TCM, becoming an important part of TCM orthopedics., The tendon and muscle injuries were used to explore the application and cultivation of traditional Chinese medicine thinking. This will help to improve the clinical curative effect, complement the modern Chinese medicine.

Objective The purpose of this study was to compare the image quality of readout-segmented EPI (RS-EPI) and that of standard single-shot echo-planar imaging (SS-EPI) in patients with scrotal diseases. Methods Initial diagnosis of scrotal diseases were included in the prospective study, all patients underwent scrotum routine MRI and RS-EPI, SS-EPI sequence at 3.0 T. A total of 38 patients were recruited qualitative assessment ,and 29 patients proved by operation and pathology (malignant 21 cases and benign 8 cases) were included quantitative analysis.For qualitative comparison of image quality, two readers independently assessed the two sets of DWI, which consisted of identification of structure and geometric distortion of scrotum (epididymis,testes, lesion) using a 5-point Likert scale. For assessment of image parameters, signal-to-noise ratio (SNR), contrast, contrast-to-noise ratio (CNR),apparent diffusion coefficient value of normal testis and testis distortion ratio of anatomical(T2WI)/DWI fusion image were calculated. Inter-observer agreement was assessed with the Kappa statistics, the differences of scores of
RS-EPI and SS-EPI were compared by using Wilcoxon rank-sum test, and image parameters were compared by using paired sample t test. Results There was good reader agreement in the scores, the Kappa value were 0.77, 0.74, 0.80, 0.87. The difference of identification of structure and geometric distortion on RS-EPI and SS-EPI had statistic significance, the RS-EPI was superior to SS-EPI in image quality (all P<0.05).The SNR, contrast of benign lesion for two sequences had no statistic significance(P values were 0.352, 0.124, respectively), but the difference of CNR had statistic significance(P<0.05). The SNR,contrast and CNR of malignant lesion for two sequences had statistic significance (all P<0.05). The mean size of the testis was (35.61 ± 9.78)mm, the mean distance in fusion image of RS-EPI or SS-EPI with T2WI were (3.80 ± 1.32)mm and (7.54 ± 2.62)mm, and the mean distortion ratios of the two set were (11.1 ± 0.6)% and (22.4 ± 19.2)%, respectively, the difference of two sets had statistic significance(P<0.05). There was no significant difference in the ADC obtained by using either DWI method(t=0.396,P=0.796), the mean ADC values of normal testes for RS-EPI and SS-EPI, respectively, were (1.18 ± 0.06) × 10-3mm2/s, (1.24 ± 0.11) × 10-3mm2/s.Conclusion RS-EPI DWI images is a feasible technique in the scrotum for producing high-resolution DWI with reduced geometric distortion and offers potentially superior image quality compared to SS-EPI at 3.0 T.

OBJECTIVETo investigate the effect of extract of Ginkgo Biloba(EGB) on nerve growth factor(NGF) and Neurotrophin-3(NT-3) expression of hippocampus neurons in streptozotocin-induced type I diabetic rats.

METHODSThirty male SD rats were divided into three groups (n = 10): the control group, diabetic group and EGB-treated group. Strepozotocin were injected intraperitoneally in the later two groups to induce diabetes. EGB-treated group was injected intraperitoneally with EGB, and the same volume of normal saline was injected to the other groups. Concentration of blood glucose and body weight and behaviour were dynamicly monitored. At the end of the 12th week, morphological changes of the hippocampus neurons were observed under microscopy by HE stain. The expression of NGF and NT-3 were assayed by Western blot and RT-PCR respectively.

RESULTSCompared with diabetic group, the behaviour and body weight (P < 0.05) and the concentration of blood glucose (P < 0.05) were significantly improved and the escape latency of Morris water maze test (P < 0.05) was significantly shortened, while the platform searching score was significantly increased (P < 0.01) in EGB treated group; The pathological changes of hippocampus neurons were significantly attenuate by EGB treated; The expression of NGF and NT-3 in hippocampus neurons were significantly increased which assayed by Western blotting and RT-PCR respectively (P < 0.05) in EGB treated group.

CONCLUSIONEGB may improve the learning and memory ability of diabetic rats the mechanism may be attributed to its improvement of the expression of NGF and NT-3 and reducing apoptosis in hippocampus neurons.

Animals ; Diabetes Mellitus, Experimental ; metabolism ; psychology ; Ginkgo biloba ; Hippocampus ; cytology ; Male ; Maze Learning ; drug effects ; Nerve Growth Factor ; metabolism ; Neurons ; drug effects ; metabolism ; Neurotrophin 3 ; metabolism ; Plant Extracts ; pharmacology ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo observe the therapeutic effect of shengxuening (SXN) in treating iron-deficiency anemia (IDA) and to explore its molecular mechanism on iron metabolism balance regulation.

METHODSPatients with IDA were randomly divided into the treated group and the control group, 50 in each group. They were treated with SXN (0.1 g, three times per day) and ferrous gluconate (0.1 g, three times per day) respectively, for 30 days. Levels of serum iron (Fe), total iron binding capacity (TIBC), transferrin saturation (TS), serum ferritin (SF), transferrin (Tf), soluble transferrin receptor (sTfR) and blood routine test, as well as scoring of TCM qi-blood deficiency Syndrome were conducted before and after treatment.

RESULTSThe total effective rate in the treated group reached 92%, it was shown that SXN could improve the iron metabolism, increase levels of Fe, TS, SF and reduce levels of TIBC, Tf, sTfR, it has obvious effect in promoting erythrocyte generation and could promote formation of leucocytes and platelets. The total effective rate in the control group was 32%, which was significantly lower than that in the treated group (P < 0.01).

CONCLUSIONThe effect of SXN in treating IDA and qi-blood deficiency Syndrome is evident, it could improve the iron metabolism, increase levels of Fe, TS, SF and lower levels of TIBC, Tf, sTfR.

Adolescent ; Adult ; Anemia, Iron-Deficiency ; blood ; drug therapy ; Child ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Ferritins ; blood ; Humans ; Iron ; blood ; Male ; Middle Aged ; Phytotherapy ; Receptors, Transferrin ; blood

OBJECTIVETo investigate the inhibitory effects of bcl-xl antisense oligodeoxynucleotides (ASODN) on growth and gene expression of human nasopharyngeal carcinoma (NPC) in nude mice.

METHODSCNE-2Z cell line was implanted subcutaneously into nude mice. Twenty four h after implantation, bcl-xl ASODN and mismatch control oligonucleotides (SCODN) were injected subcutaneously into nude mice, respectively. The tumor volume and weight were measured twice weekly. The histopathological changes of the tumors were observed by HE staining. RT-PCR and Western-blot were performed for bcl-xl gene expression.

RESULTSGrowth of NPC was significantly inhibited in the ASODN therapy group as compared with that in the control group (P < 0.01). The growth inhibitory rate was 41.7% in the ASODN group and 19.0% in the SCODN group. The expression level of bcl-xl mRNA and protein was decreased in the ASODN group, whereas in the SCODN group there was no significant difference in contrast with saline-treated control group.

CONCLUSIONOur findings suggest that bcl-xl antisense oligodeoxynucleotides results in marked inhibition of NPC growth in nude mice. It may be a novel treatment approach for human nasopharyngeal carcinoma.

Animals ; Female ; Humans ; Male ; Mice ; Mice, Inbred BALB C ; Nasopharyngeal Neoplasms ; drug therapy ; pathology ; Neoplasm Transplantation ; Oligonucleotides, Antisense ; therapeutic use ; Proto-Oncogene Proteins c-bcl-2 ; antagonists & inhibitors ; genetics ; RNA, Messenger ; analysis ; Transplantation, Heterologous ; bcl-X Protein

BACKGROUNDCandida albicans (C. albicans) infection, often occurring in genital candidiasis, has increased dramatically recently. Developing an efficient C. albicans typing method may contribute to understanding its epidemiological characteristics and guiding efficient treatment. We used rapid microsatellite genotyping assay for interstrain differentiation of C. albicans isolates and explored some characteristics of its spread.

METHODSDNA was extracted from C. albicans isolates from gentalia, recta and mouths of 39 female cases and 27 male cases of genital candidiasis. Three fluorescent primers for the microsatellite markers in conserved genes (CDC3, EF3 and HIS3) of C. albicans were used to amplify the isolates DNA by PCR. Fluorescent signals were read with an automatic sequencer and analyzed with GeneScan software.

RESULTSAnalysis of the three microsatellites markers showed 18 gene allelic associations in genital C. albicans infected patients: 10 allelic associations in female and 11 allelic associations in male, of which 3 allelic associations shared by both genders covered 71% of infections. The most dominant allele association of pathogenic strains for both genders was 116:124, 122:131, 160:200 that covered about 50% of infection. Gentalia and recta shared the same strains in 80% of female patients, but in only 3.8% of male patients. There were 2.7% female patients, but no males, with same strain in both gentalia and mouths. Five of seven genital C. albicans infected couples had the same allelic associations of which 4 were the dominant pathogenic C. albicans susceptible for both genders.

CONCLUSIONSThe predominant allelic association of the pathogenic strain in genital C. albicans infection is 116:124, 122:131, 160:200. Vaginal pathogenic strains are probably maintained from the rectal reservoir. Pathogenic strains of male patients are probably from frequent sexual intercourse. The aggressiveness of some strains varies with gender.

Adult ; Candida albicans ; classification ; genetics ; Candidiasis ; diagnosis ; Candidiasis, Vulvovaginal ; diagnosis ; Female ; Genital Diseases, Male ; diagnosis ; Genotype ; Humans ; Male ; Microsatellite Repeats ; Rectum ; microbiology ; Sensitivity and Specificity ; Tongue ; microbiology

Three cyclotides were isolated from the whole plant of Viola yedoensis in this study. The two, vary peptide E and cycloviolacin Y5, were previously reported, and a novel cycloviolacin VY1 was characterized according to the interpretation of MS/MS fragmentation of peptides which were produced from the reduced and alkylated parent peptide with the digestion of Endo Lys-C, trypsin and chymotrypsin, separately. The stability of remarkable resistance to proteolytic degradation by trypsin and chymotrypsin, and that of thermal denaturation was confirmed again. Besides, the IC50 value of cycloviolacin VY1 against influenza A H1N1 virus was (2.27 +/- 0.20) microg x mL(-1). It is the first cyclotide reported with anti-influenza A H1N1 virus activity in vitro assay.
Antiviral Agents ; isolation & purification ; pharmacology ; Cyclotides ; pharmacology ; Influenza A Virus, H1N1 Subtype ; drug effects ; Tandem Mass Spectrometry ; Viola ; chemistry