Objective Through the design of comprehensive experiments, the precise medical philo-sophy was put into the medical molecular biology experimental teaching, and to explore its effect. Methods Eight-year medical students of Grade 2012 and Grade 2013 in the Fourth Military Medical University were chosen as the teaching subjects. Experimental group consisted of 36 students of Grade 2013, while control group consisted of 30 students of Grade 2012. Precision medicine-based learning was applied in experimental group while traditional learning method was adopted by the control group. At the end of the course, students of two groups were implemented theoretical and experimental skills assessment; through questionnaire students were required to evaluate the effect of teaching methods and the number of two groups of students who asked questions after class greater than or equal to 1 times was counted to evaluate the students' learning enthusiasm. SPSS 15.0 software was used to make t test and Chi-square analysis for the data of the students. Results The assessment results showed that the experimental group was better than control group, especially in the section of comprehensive experimental design [(16.7 ± 2.04) vs. (13.9 ± 2.87), P=0.000]. The results from questionnaire showed that the satisfaction degree of experimental group was also higher than that of control group in many respects, including learning interests, innovation capability, knowledge mastery, cognition of precision medicine and clinical research, satisfaction with the teaching method (P<0.05). And students' learning enthusiasm and the proportion of the number of students asking questions in the experimental group were higher than the control group (P=0.000). Conclusions Precision medicine-based learning not only changes the situation of slavish imitation and passive acceptance in traditional learning, but also arouses students' interest in study and helps students to cultivate clinical thinking, which is com-mensurate to the characteristics of precision-medicine era.

Purpose: We evaluated the therapeutic effects on overactive bladder (OAB) symptoms and sexual function of behavioral therapy with or without mirabegron in sexually active male patients with OAB. Mirabegron, a selective β3 adrenoceptor agonist for the treatment of OAB, has been shown to induce corpus cavernosum relaxation. Methods: In this 4-site, randomized controlled trial, 150 sexually active men with OAB were enrolled between June 2020 and May 2022. Participants were randomly allocated (1:2) into 2 treatment groups: (1) behavioral therapy alone (n = 50) and (2) a combination of mirabegron 50 mg daily and behavioral therapy (n = 100). The evaluation was based on the overactive bladder symptoms score (OABSS), the International Index of Erectile Function, the ejaculatory domain short form, the International Prostate Symptom Score, patient perception of bladder condition, quality of life, and urodynamic parameters. The therapeutic outcomes were assessed at baseline, 4 weeks, and 12 weeks. Results: There were 65 patients (65%) in the combination subgroup and 36 patients in the behavioral therapy who completed all 12 weeks of treatment. Both groups had a statistically significant improvement in OABSS after 12 weeks of treatment. The combination therapy group achieved a statistically significant improvement in all 4 subscores of OABSS, however, the urinary frequency (P = 0.120) and urinary incontinence (P = 0.234) subscores in the behavioral therapy only group did not show a significant change. Additionally, the combination group had a significant improvement in functional bladder capacity, which was not seen in the behavioral therapy group. However, both groups did not have a significant change in erectile or ejaculatory function. Conclusions Behavioral therapy combined with mirabegron had more significant impact on the improvement of OAB than behavior therapy alone. However, both groups did not have significant changes in erectile or ejaculatory function.

PURPOSE: The aim of this study was to analyze patterns of sensory protein expression and urothelial dysfunction in ketamine-related cystitis (KC) in humans. METHODS: Biopsies of bladder mucosa were performed in 29 KC patients during cystoscopy. Then specimens were analyzed for tryptase, zonula occludens-1 (ZO-1), E-cadherin, and terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) with immunofluorescence staining and quantification. In addition, 10 healthy control bladder specimens were analyzed and compared with the KC specimens. Another 16 whole bladder specimens obtained from partial cystectomy were also analyzed for the muscarinic receptors M2 and M3, endothelial nitric oxide synthase (eNOS), inducible nitric oxide synthase (iNOS), β-3 adrenergic receptors (β3-ARs), and the P2X₃ receptor by western blotting. In addition, 3 normal control bladder specimens were analyzed and compared with the KC specimens. RESULTS: The KC bladder mucosa revealed significantly less expression of ZO-1 and E-cadherin, and greater expression of TUNEL and tryptase activity than the control samples. The expression of M3 and β3-AR in the KC specimens was significantly greater than in the controls. The expression of iNOS, eNOS, M2, and P2X3 was not significantly different between the KC and control specimens. CONCLUSIONS: The bladder tissue of KC patients revealed significant urothelial dysfunction, which was associated with mast-cell mediated inflammation, increased urothelial cell apoptosis, and increased expression of the M3 and β3-AR.
Apoptosis ; Biopsy ; Blotting, Western ; Cadherins ; Cystectomy ; Cystitis* ; Cystoscopy ; Fluorescent Antibody Technique ; Humans* ; In Situ Nick-End Labeling ; Inflammation ; Ketamine ; Mucous Membrane ; Nitric Oxide Synthase Type II ; Nitric Oxide Synthase Type III ; Receptor, Muscarinic M2 ; Receptors, Adrenergic ; Tryptases ; Urinary Bladder ; Urothelium

Breast metastases from extramammary neoplasms are very rare. We presented a 66 year-old female with metastasis of small cell lung carcinoma to the breast. She presented with consolidation over the left upper lobe of her lung undetermined after endobronchial or video-assisted thoracoscopic surgery (VATS) biopsy, and this was treated effectively after antibiotic therapy at initial stage. The left breast lumps were noted 4 months later, and she underwent a modified radical mastectomy under the impression of primary breast carcinoma. However, the subsequent chest imaging revealed re-growing mass over the left mediastinum and hilum, and cells with the same morphological and staining features were found from specimens of transbronchial brushing and biopsy. An accurate diagnosis to distinguish a primary breast carcinoma from metastatic one is very important because the therapeutic planning and the outcome between them are different.
Aged ; Breast Neoplasms ; secondary ; Bronchoscopy ; Carcinoma, Small Cell ; pathology ; Female ; Humans ; Lung Neoplasms ; pathology

OBJECTIVETo investigate the association of SOX9 expression and clinicopathologic factors and prognosis of gastric cancer.

METHODSA retrospective cohort study including 112 gastric cancer patients admitted to the Zhejiang Provincial People's Hospital from 2004 to 2006 was performed. Immunohistochemical analysis was used to evaluate the expression of SOX9 in the 112 specimens of gastric cancer tissues and 70 non-cancerous tissues adjacent to the tumor.

RESULTSLow expression of SOX9 was seen in 5(7.1%) tissues out of 70 non-cancerous tissues adjacent to the tumor. A total of 94(83.9%) patients had varying expression of SOX9, of whom 51(45.4%) had overexpression. Univariate analysis demonstrated that the expression of SOX9 was significantly associated with Lauren classification (P<0.05), tumor invasion(P<0.01), lymph node metastasis(P<0.05), distant metastasis(P<0.05) and tumor stage(P<0.05), however there was no significant association between SOX9 expression and sex, age, histological type, histology differentiation or tumor size. Kaplan-Meier analysis showed that the 5-year survival rate of patients with SOX9 over-expression was significantly lower than that of patients with low expression(29.4% vs. 49.2%, P=0.031). Multivariate Cox regression analysis showed that histology differentiation(P=0.046), tumor invasion(P=0.001), and distant metastasis(P<0.01) were independent prognostic factors for gastric cancer, however the over-expression of SOX9 was not significant(P=0.948).

CONCLUSIONSThe expression SOX9 is associated with the growth, invasion, and metastasis of gastric cancer, as well as the prognosis. However, SOX9 expression is not an independent factor for the prognosis in patients with gastric cancer.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; SOX9 Transcription Factor ; metabolism ; Stomach Neoplasms ; metabolism ; pathology

Objective To investigate the effect of mangiferin on the apoptosis of rat primary cardiomyocytes induced by hypoxia. Methods Rat primary cardiomyocytes were separated and cultured under aseptic condition. Cardiomyocytes were treated with hypoxia of 2, 4, 8 and 12 h, and then the time of hypoxia of cardiomyocyte apoptosis model was determined according to the apoptosis outcome.The cardiomyocytes were divided into normal group, hypoxia group and mangiferin intervention group, each group was subjected to 3 batches in parallel, and 3 holes were done in parallel with each batch. After the experiment, cardiomyocytes apoptosis was deteced by flow cytometry;apoptosis protease caspase-3 and caspase-9 activity in cell lysates was detected by spectrophotometry;the protein expression of Bax and Bcl-2 was detected by Western blot. Results After treated with hypoxia for 12 h, the cardio-myocytes apoptosis rate was significantly increased (P < 0.05), the apoptosis protease caspase-3 and caspase-9 activity was increased markedly (P＜0.05), the protein expression of proapoptotic protease Bax was increased notablely (P＜ 0.05 ) , and the protein expression of anti apoptotic protease Bcl-2 was decrease memorably (P＜0.05) in hypoxia group as compared with those in the control group. After mangiferin intervention, above indexes in mangiferin group can be significantly relieved as compared with those in the hypoxia group. Conclusions Mangiferin can significantly inhibit the apoptosis of rat primary cardiomyocytes induced by hypoxia.

Objective Anthrax is an anthropozoonosis caused by the bacterium Bacillus anthracis .Bacillus anthracis is an aerobic ,spore-forming ,rod-shaped bacterium ,which infects human through ingestion or inhalation of the spores .The exos-porium of spores of Bacillus anthracis contains tetrasaccharide antigen with specific chemical structure ,which can be used in preparation of glycoconjugates vaccines ,inducing an immune response .This paper reviewed articles in the last decade that re-ported research advances in chemical synthesis of anthrax tetrasaccharide ,presented the methods for synthesis ,and compared the advantages and limitations among different methods .

Glycosylation is the key step of the synthesis of GM3 ,its reaction conditions are very harsh ,the stereoselec‐tivities are usually poor ,and the configuration of anomeric carbon is difficult to control .Whetherαglycosidic bond can be con‐structed efficiently in sialylation reactions is an important criteria used to evaluate the reaction quality .Studies of GM3 and de‐rivatives methods generally relates to following areas :the choice of the donor compounds and receptor compounds ,the control of stereoselectivity ,and the development of some new glycosidic reaction catalyst .In recent years ,important progress has been made in this research area .Now ,we predominately make a summary and review on the progress of methods for the synthesis of GM3 and derivatives .

Human diphyllobothriasis is a parasitic disease caused by ingestion of larvae (plerocercoids) in raw or undercooked fish and commonly found in temperate areas. Rare cases were reported in tropical or subtropical areas especially in children. The first documented case of pediatric diphyllobothriasis in Taiwan had been reported 11 years ago. Here, we report another 8-year-old girl case who presented with a live noodle-like worm hanging down from her anus, with no other detectable symptoms. We pulled the worm out and found the strobila being 260 cm in length. Examination of gravid proglottids showed that they were wider than their lengths, containing an ovoid cirrus sac in the anterior side and the rosette-shaped uterus. Eggs extracted from the uterus were ovoid and operculated. Diphyllobothrium latum was confirmed by molecular analysis of the mitochondrial DNA cytochrome c oxidase subunit 1 (cox1) gene. The girl was treated with a single oral dose of praziquantel, and no eggs or proglottids were observed from her stool in the subsequent 3 months. The reemergence of human diphyllobothriasis in non-endemic countries is probably due to prevalent habit of eating imported raw fish from endemic areas. This pediatric case raised our concern that human diphyllobothriasis is likely underestimated because of unremarkable symptoms.
Anal Canal ; Child ; Diphyllobothriasis ; Diphyllobothrium* ; DNA, Mitochondrial ; Eating ; Eggs ; Electron Transport Complex IV ; Female ; Humans ; Larva ; Ovum ; Parasitic Diseases ; Praziquantel ; Taiwan* ; Uterus

BACKGROUND AND OBJECTIVES: Age is a traditional risk factor for open-heart surgery. The efficacy and safety of transcatheter edge-to-edge mitral valve repair, using MitraClip (Abbott Vascular), has been demonstrated in patients with severe mitral regurgitation (MR). Since octogenarians or older patients are usually deferred to receive open-heart surgery, the main interest of this study is to elucidate the procedural safety and long-term clinical impact of MitraClip in elderly patients. METHODS: Patients with symptomatic severe MR were evaluated by the heart team. For those with high or prohibitive surgical risks, transcatheter mitral valve repair was performed in hybrid operation room. Transthoracic echocardiography (TTE), blood tests, and six-minute walk test (6MWT) were performed before, 1-month, 6-months, and 1 year after index procedure. RESULTS: A total of 46 consecutive patients receiving MitraClip procedure were enrolled. Nineteen patients (84.2±4.0 years) were over 80-year-old and 27 (73.4±11.1 years) were younger than 80. Compare to baseline, the significant reduction in MR severity was achieved after the procedure and sustained. All the patients benefited from significant improvement in New York Heart Association functional class. The 6-minute walk test (6MWT) increased from 259±114 to 319±92 meters (p=0.03) at 1 year. The overall 1-year survival rate was 80% in the elderly and 88% in those <80 years, p=0.590. Baseline 6MWT was a predictor for all-cause mortality (odds ratio, 0.99; 95% confidence interval, 0.982–0.999; p=0.026) after the MitraClip procedure. CONCLUSIONS Trans-catheter edge-to-edge mitral valve repairs are safe and have positive clinical impact in subjects with severe MR, even in advanced age.