Objective To investigate the characteristics of HBV replication in HepG2.2. 15 cells treated with LAM alone or sequentially treated with LAM and IFN-α, and to further explore the different suppressive effect on HBV replication by LAM and IFN-α in vitro. Methods Untreated HepG2. 2. 15 cells were used as control group, HepG2. 2. 15 cells treated with 1 000 IU/ml of IFN-α alone for 10 d were served as IFN-α group. The HepG2.2. 15 cells treated with 0.2,1,5,20,100 μmol/L of LAM were used as LAM groups. HepG2. 2. 15 cells treated with 0. 04,0. 2,5,25,125,200 μmol/L of LAM for 7 d, then combined with 1 000 IU/ml of IFN-α for another 3 d. Afterwards, the cells were treated with 1 000 IU/ml of IFN-α only for another 10 d. These cells were served as LAM/IFN-α sequential treatment group. The ELISA was used for analyzing the secreted HBV antigens, while the Dot blot, Southern blot were applied for analyzing the extracellular HBV DNA and intracellular HBV replicative intermediate DNA in HepG2. 2. 15 cells of different treatment groups. Results The secreted HBsAg in the LAM group were 1. 77 ± 0. 22, 1.65 ±0.25, 1.95 ±0. 19, 1.34 ±0. 11, 1.07 ±0.05, respectively, and the secretion of HBeAg were 1.41 ±0. 13, 1.37 ± 0. 09, 1.63 ± 0. 07, 1.26 ± 0. 12, 1.05 ± 0. 09. The secreted HBsAg and HBeAg in control group were 3. 34 ± 0. 15 and 3.33 ± 0. 05. Statistical analysis showed that HBsAg and HBeAg secretion in the LAM group were significantly reduced by treatment with LAM. The t values of HBsAg were 10. 21,10.04, 9.94, 18.62, 24.86, and the t values of HBeAg were 23.87, 32.97, 34.22, 27.57, 38.35,respectively, all P values were ＜ 0.05. Dot blot, Northern blot hybridization analysis indicated that the extracellular HBV DNA and intracellular HBV replicative intermediate DNA could not be detected in the LAM group after cells treated by LAM for 10 days. When LAM was replaced with treatment of 1 000 IU/ml of IFN-α alone, it could not suppress the HBV replication effectively. Moreover, the intracellular HBV replicative intermediate DNA still existed in almost all groups, accompanied with the recovered expression of HBV antigens as well as extracellular HBV DNA, which suggested that the HBV particles restored replication again and secreted extracellular in HepG2. 2. 15 cells, although the sequential treatment lasted for 10 days.Conclusion The effect of viral suppression by LAM and IFN-α in vitro were different, which attributed to the different HBV replicative characteristcs in HepG2. 2. 15 cells.

Objective To apply a complete evaluation system for clinical teaching quality and improve the objective and method of the quality control of clinical teaching procedure. Methods Clinical teachers and staff from four clinical medical colleges(Ruijin,the Sixth,the Ninth,and Tongji) were investigated.The data of their cognition about clinical teaching,weakness in teaching procedure,situation,and quantity and quality control of clinical teaching were collected and analyzed. Results The appraisal system for clinical teaching quality was established in all four clinical medical colleges.The improvement was required in evaluation of executive supervision of the present system.The quality control about clinical ability teaching was the key point to perfect the system. Conclusion It is necessary to further discuss consummation of system,establishment of evaluation method and standard so as to perfect the evaluation system of clinical teaching.We should begin with the weakest procedure,and then improve the present condition step by step.

@@

OBJECTIVETo investigate the expression of zinc finger E-box binding homebox 1 (ZEB1) in the prepuce of hypospadias children and its relationship to the incidence of hypospadias.

METHODSPrepuce tissues were collected from 37 children aged 6-15 months undergoing hypospadias repair and 11 age-matched controls receiving circumcision. Based on the position of the urethral meatus, the hypospadias cases were classified as severe (n = 13) and mild-moderate (n = 24). The mRNA and protein expressions of ZEB1 were determined by immunohistochemistry and RT-PCR.

RESULTSThe expression of the ZEB1 protein was remarkably higher in the severe (100% [13/13]) and mild-moderate hypospadias patients (75.0% [18/24]) than in the controls (9.1% [1/11]), with statistically significant differences between any two groups (P < 0.05). RT-PCR showed the integrated density value (IDV) of the ZEB1 mRNA expression to be (0.67 ± 0.21), (0.81 ± 0.24), and (1.55 ± 0.29) in the control, mild-moderate, and severe hypospadias patients, respectively, significantly higher in the severe hypospadias than in the control and mild-moderate hypospadias groups (P < 0.05), but with no significant difference between the latter two (P = 0.64).

CONCLUSIONThe expression of ZEB1 is significantly increased in hypospadias patients, and its upregulation is positively correlated with the severity of hypospadias, which suggests that the overexpression of ZEB1 may contribute to the development of hypospadias.

Biomarkers ; metabolism ; Case-Control Studies ; Circumcision, Male ; Foreskin ; metabolism ; Homeodomain Proteins ; genetics ; metabolism ; Humans ; Hypospadias ; classification ; etiology ; metabolism ; Immunohistochemistry ; Infant ; Male ; Penis ; RNA, Messenger ; metabolism ; Transcription Factors ; genetics ; metabolism ; Up-Regulation ; Urethra ; Zinc Finger E-box-Binding Homeobox 1

Objective Acute renal failure (ARF) requiring renal replacement therapy (RRT) was reported in 0.33％to 9.5％ patients after cardiac surgery.This study was designed to assess the clinical usefulness and accuracy of 3 clinical tools for the prediction of ARF after cardiac surgery in Chinese patients.Methods Five hundred and four eligible patients with complete clinical data in our institution received prospective assessment for RRT and acute kidney injury (AKI) between June,2009 and November,2010.The clinical tools used were Cleveland ARF Score,acute kidney injury prediction following elective cardiac surgery(AKICS) and Simplified Renal Index(SRI).Hosmer—Lemeshow goodness-of-fit test was used to estimate the calibration.Discrimination was determined with receiver operating characteristic (ROC) curves and area under a ROC curve (AUC).Results Follow-up was completed in all 504 patients.The overall incidence of postoperative RRT was 3.17％(16/504) with a mortality of 37.5％,and the incidence of AKI was 5.36％ ( 27/504 ).Discrimination for the prediction of RRT and AKI was good for SRI measured with AUROCs:0.759 (95％ CI,0.643-0.874) for RRT and 0.773 (95％ CI,0.677-0.868 ) for AKI.SRI score performed better in terms of discrimination than Cleveland ARF score and AKICS in our study,which did not consist with results reported by other centers.Conclusion SRI scoring system is the most useful among three tools for predicting postoperative RRT and should be the first choice in Chinese patients for whom a cardiac surgery is planned.It can also be used in predicting the composite end point of AKI with an extended application in patients at risk for postoperative kidney dysfunction.

Objective To evaluate short-term curative effect of endovascular abdominal aortic aneurysm repair. Methods Twelve cases of infra-renal abdominal aortic aneurysms were checked. Results The av-erage bleeding in the operation was 245 millimeter, the avenage hospitalization time was 8.6 days, and the average abrosia time was 1.5 days. White blood cell, hemoglobin, thrombocyte, hepatic function, and renal function were in the normal limits. Prothrombin time and activated partial thromboplastin time were post-poned after operation, and recovered normally within one week. Complications of operations were as follows:1 case of pulmonary infection, 2 cases of abdominal distention, and 1 case of intraoperafive endoleak. The former two kinds of complications alleviated after conventional treatment, and the latter disappeared naturally after 3 months. Conclusion Endovascular abdominal aortic aneurysm repair is safe, mini-invasive, and has little disturbance for body internal environment.

Objective To explore the prognosis of patients with BCLC-B hepatocellular carcinoma (HCC) receiving LR + MCT vs TACE.Methods BCLC-B HCC patients undergoing LR + MCT (107 cases) and TACE (65 cases) were retrospectively evaluated,in terms of 30-day mortality rate,the median survival,early and long term survival rate and complications.Results The hospital mortality rate was similar between the two groups (x2 =0.285,P =0.593).However,the LR + MCT group were with a significantly higher postoperative complication rate than the TACE group (x2 =4.694,P =0.03).At the same time,the LR + MCT group had significantly higher median Survival rates (x2 =9.135,P =0.003),but,there was no statistical difference for five-year survival (x2 =4.767,P =0.434).Conclusions LR + MCT are as safe as TACE for patients with BCLC-B HCC,and it provides longer median survival rates.

Objective:To explore the clinical value of T 1 mapping/indexed extracellular volume fraction (iECV) quantified with cardiac MR (CMR) parameters, and its correlation with traditional indicators of myocardial dysfunction in aortic insufficiency (AI) patients. Methods:A total of 36 patients clinically and radiologically diagnosed with chronic AI in our hospital between May 2012 and February 2016 were retrospectively selected. All AI patients underwent conventional CMR protocol, native and post T 1 mapping. CMR parameters, such as aortic regurgitant fraction (RF), late gadolinium enhancement (LGE) mass fraction, myocardial extracellular volume fraction (ECV) and iECV. Based on the values of aortic RF, AI patients were divided into mild AI group (9 cases), moderate AI group (14 cases) and severe AI group (13 cases). The clinical characteristics were teased from the patients′ electronic medical records. Univariate analysis of variance was used to compare the measurement data of native T 1 mapping, post-contrast T 1 mapping, ECV, and iECV. LSD test was used for pair wise comparison between the mild AI, moderate AI and severe AI groups. Data about cardiovascular history, New York Heart Association (NYHA) heart function classification, and LGE were compared by chi-square test or Fisher exact test. The correlation between left ventricle ejection fraction (LVEF) and iECV was evaluated by Spearman correlation analysis. Results:There was no difference in age, sex, cardiovascular history among the three groups. Comparison of patients with different severity of AI in the three groups: (1) There was statistically significant difference in the LGE positive rate among the three groups ( P=0.023), while the myocardial replacement of fibrosis increased with the grade of aortic regurgitation. (2) There was no statistically significant difference in the measurement data of native T 1 mapping, post-contrast T 1 mapping, ECV among the three groups ( H=1.815, 0.929, 2.496, all P values>0.05), while the diffuse myocardial fibrosis tended to increase with the degree of aortic regurgitation. There was statistically significant difference in iECV among the three groups ( H=16.725, P<0.001). The measurement data of iECV in the severe AI group was significantly higher than those in the other two groups ( P<0.05). LVEF value was inversely correlated with iECV ( r=-0.649, P<0.001). Conclusions:Quantitative T 1 mapping/iECV can serve as a parameter to noninvasively identify diffuse myocardial fibrosis in AI patients of different severities. It changes with LVEF and can manifest the reversible stage of left ventricular decompensation.

BACKGROUND: Enophthalmos deformity is the most common complication caused by orbital blow-out fractures, and others are diplopia and worsening of visual acuity. Since the therapeutic result of orbital blow-out is not satisfactory and many complications exist after operation, it is still a dispute to select implantation materials and therapeutic regimens.OBJECTIVE: To observe the therapeutic effect and assess the improvement of visual function by surgical reconstruction with porous high-density polyethylene (Medpor) for the correction of enophthalmos deformity caused by orbital blow-out fractures.DESIGN: A pre-and postoperative controlled study.SETTING: Beauty Center for Trauma Repair,Plastic Surgery Hospital,Peking Union Medical College, Chinese Academy of Medical Science .PARTICIPANTS: Totally 56 patients with orbital blow-out fractures who had enophthalmos deformity caused by fists or traffic accidents, treated at Beauty Center for Trauma Repair,Plastic Surgery Hospital, Peking Union Medical College, Chinese Academy of Medical Science, were selected in this study from December 1996 to March 2004. Final diagnosis were made with case history, X-ray film, two-demensional and three-dimensional CT before operation. 24 cases were accompanied with other areas fractures such as zygoma and nasal bone, 34 cases with diplopia, 35 cases with visual acuity worsening after injured.METHODS: ①Material implantation: Exposure of the orbital floor, inferior and medial walls could be performed through a 2 mm inferior subciliary incision of 3 cm long. To approach the orbital rim via a dissection plane anterior to the orbital septum, sub-periosteal dissection was then performed over the orbital rim, and along the orbital floor to the orbital apex. Mobilized the soft tissue from the bone throughout the entire area of fractures and re-position it to its proper position. Took Medpor (Type 6331) sheets as the implantation materials, trimmed Medpor sheets according to the radian and anatomic form, and 2 mm larger than the defect rim was needed.If other operations were needed during the operation, they could be done.Mannitol and dexamethasone should be used just postoperatively to decrease edema of the orbital contents and reduce inner orbital excessive pressure. ②Functional evaluation standard: Diplopia: completely disappear meant recovered, less diplopia residual meant improvement, no improvement meant inefficacy. Enophthalmos: marked improvement meant the degree of enophthalmos stabilizated at below 2 mm, less improvement meant stabilizated at above 2 mm.MAIN OUTCOME MEASURES: ①Improvement of enophthalmos; ②Improvement of diplopia ; ③Improvement of visual acuity.RESULTS: ①All 56 cases of enophthalmos deformities caused by orbital blow-out fractures improved greatly. ② Of all the 34 patients with diplopia, 27 recovered. ③ 9 patients' visual acuity of 35 improved with different degrees. No diplopia or visual acuity worsening occurred. With a follow-up ranging from 2 months to 5 years, the degree of enophthalmos stabilizated at below 2 mm, and no relapse and other complications occurred.CONCLUTION: Medpor has such advantages as better histocompatibility,fewer complications and better visual function improvement, so it is the preferred implantation material for correcting enophthalmos deformity caused by orbital blow-out fractures.

Abdominal Neoplasms ; secondary ; surgery ; Abdominal Wall ; Antiporters ; metabolism ; Choriocarcinoma ; pathology ; Diagnosis, Differential ; Epithelioid Cells ; pathology ; Female ; Gestational Trophoblastic Disease ; metabolism ; pathology ; secondary ; surgery ; Humans ; Pregnancy ; Uterine Neoplasms ; metabolism ; pathology ; surgery ; Young Adult