A patient diagnosed with myoepithelial carcinoma was recently treated in our department. The neoplasm was huge, located in the left maxillofacial region, blocking both eyes, impeding feeding. About one month before admission, the tumor began to bleed frequently, about 100 ml each time, causing headache, dizziness, fatigue, and cold sweats. CT showed the maximum diameter of the tumor was about 23 cm, with uneven density, and maxillofacial bone destruction. MRI revealed internal bleeding and necrosis inside the tumor. After admission, blood routine test showed erythrocyte count 3.64 x 10(12)/L(↓), hemoglobin 106 g/L(↓), hematocrit 0.320 (↓), serum iron 6.2 μmol/L(↓). After surgery, the patient recovered smoothly.
Carcinoma ; diagnosis ; surgery ; Humans ; Magnetic Resonance Imaging ; Myoepithelioma ; diagnosis ; surgery ; Nasal Cavity ; pathology ; Paranasal Sinus Neoplasms ; diagnosis ; surgery ; Paranasal Sinuses ; pathology

Objective To investigate and analyze the effect of current doctor-patient relationship on profession recognition of medical students and to make some accommodations for medical education. Methods Questionnaire was conducted among 800 medical students in North Sichuan Medical College concerning the aspects of recognition of doctor-patient relationship,profession recognition and effect of current doctor-patient relationship on profession recognition . Data statistics was done by SPSS 19 . 0 . Differences were analyzed by frequency,chi-square test by α=0.05 standard and Spearman correlation analysis. Results 67.6%(536/793)of the surveyed students thought that the current doctor-patient re-lationship exerted effect on their job concepts. According to the results of Spearman correlation analysis between current doctor-patient relationship(X)and effect of current doctor-patient relationship on future job con-cepts(Y),correlation coefficient was 0 . 088 ,P=0 . 013<0 . 05 . Conclusions Effect of current doctor-patient relationship on profession recognition of medical students results from health care policy, school education and society,therefore,university should improve related education .

Objective To investigate the diagnostic value of JAK2V617F mutation detection in the diagnosis of polycythemia vera,and screen a more simple method for clinic laboratory to detect the mutation of JAK2V617F.Method DNA was extracted by standard procedures after isolating total leukocytes from peripheral blood mononuclear cells by density gradient centrifugation over Histopaque 1077.DNA samples were amplified,and single-stranded biotinylated PCR products were prepared for sequencing.At the same time,in order to testify the reliability of the allele-specific PCR,two forward primer and one common reverse primers were applied for identifying the mutation.Result In 32 of 38 patients with polycythemia vera,JAK2V617F mutation was determined by conventional DNA sequencing.35 JAK2V617F mutations were detected by the allele-specific PCR.and these mutations were confirmed by DNA sequencing.None mutation was found in secondary polycythemia and normal control.Conclusion JAK2V617F function mutation occuis in nearly all patients with PV,and JAK2V617F mutation should be a molecular marker in the diagnosis of polycythemia vera.Allele-specific PCR is a very sensitive and specific method for detecting JAK2V617F mutation.

Objective To analyze the differences of video laryngoscope, direct laryngoscopy and fibreoptic bron﹣choscope nasal intubation on hemodynamics, inflammatory and stress response. Methods 117 patients underwent surgery from November 2013 to March 2015 were chose as research subjects and randomly divided into video laryn﹣goscope group, direct laryngoscopy group, fiberoptic bronchoscope group based on different cannula enrolled way. Then compared the hemodynamics, inflammation, stress level after intubation among the three groups. Results Com﹣pared with the T0, the three groups patients' systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), C-reactive protein (CRP), interleukin -6 (IL-6), tumor necrosis factor (TNF-α), norepinephrine (NE), plasma cortisol (Cor), angiotensinⅡ(ATⅡ) differences had no significant difference (P>0.05);compared with direct laryn﹣goscopy group, video laryngoscope group, fiberoptic bronchoscope group patients' T1, T2, T3 SBP, DBP, HR, CRP, TNF-α, IL-6, NE, Cor, ATⅡ levels were lower; compared with the video laryngoscope group, optical fiber bron﹣choscopy group patients SBP, DBP, HR, CRP, TNF-α, IL-6, NE, Cor, ATⅡ low levels at T1, T2, T3 were lower (P<0.05). Conclusions Fibreoptic bronchoscope nasal intubation has less influence on patients, will not cause severe stress and inflammatory response, it is one of the ideal instrument anesthesia induction intubation.

Objective To reconstitute hair follicles in mice using graft chambers,and to study the effect of different cell types on hair follicle regeneration.Methods Full-thickness skin was obtained from the back of C57BL/6 neonatal mice.Then,epidermal cell suspensions were prepared by shredding epidermis after trypsinization,hair follicles and dermal cells were collected by filtration,low-speed centrifugation and density gradient centrifugation,and hair follicle epithelial cells were obtained via trypsinization of hair follicles followed by filtration.Nude mice were classified into four groups to be transplanted with epidermal cells + follicular buds,dermal cells alone,epidermal cells + follicular buds + dermal cells,follicular epithelial cells + dermal cells,respectively.The cells were implanted into the dorsal skin of nude mice using fold chambers.After the grafting,the growth of skin and hairs was observed at the grafted sites on week 1,2,4 and 8,and skin specimens were obtained on week 2,4,and 8 for histological study of hair follicles using hematoxylin-eosin staining.Results After grafting,the chambers on the back of nude mice began to shed with crust formation on week 1; stunted hairs came out and follicle-like structures were seen under the microscope on week 2 at the grafted sites,normal hairs were observed on week 4 and 8 in all the mice except for those transplanted with epidermal cells + follicular buds,and the growth of hairs in mice grafted with epidermal cells + follicular buds + dermal cells and mice grafted with follicular epithelial cells +dermal cells was superior to that in mice grafted with dermal cells alone.Conclusions Hair follicles can regenerate after hair follicle cell transplantation into dorsal chambers in nude mice.Both epidermal cells and dermal cells play indispensable roles in hair follicle reconstitution.

Objective To investigate the genetic diversity of variable number tandem repeats (VNTR) of Mycobacterium tuberculosis (M,ib) isolates and their impact factors on transmission.Methods A total of 1 310 patients with smear-positive pulmonary tuberculosis registered during 2013 from 30 counties of drug-resistance monitoring sites in Guangxi were enrolled.The VNTR genotyping technique was used to identify and analyze M.tb genotypes.Count data was analyzed by Chi-square test using descriptive statistical method,unconditioned Logistic regression was used to analyze the characteristics of gene clusters.Results A total of 1 310 strains of M.tb were classified into 964 genotypes,of which 779 strains were classified into a single gene cluster,531 strains were classified into 185 clusters.Each cluster contained 2 to 40 strains (mean 6.6).Patients aged between 41 and 60 years old had a highest gene cluster proportion (45.5％).Seven hundred and forty-six strains were Beijing genotype,while 564 were nonBeijing genotype,among which 7.4％ was original Beijing genotype.The estimated recent infection (cluster rate) was 26.41％.The cluster rate was higher in sensitive strains (24.40％) than in drugresistant strains (9.55 ％,x2 =23.621,P =0.000) and multi-drug resistant (MDR) strains (8.97 ％,x2=-9.675,P=0.002),and that was higher in Beijing genotype (28.69％) than Non-Beijing genotype (23.40％,x2 =4.610,P=0.032).The clusters proportion in sensitive strain (37.43％) was higher than drug-resistant strains (14.09％) and MDR strains (15.38％),and that was higher in Beijing genotype (40.88％) than Non-Beijing genotype (37.77％).Conclusions M.tb genetic polymorphisms display highly diversity in Guangxi region.Sensitive strains and Beijing genotype strains are the main epidemic strains.

Chondrosarcomas has low morbidity in China,but we should pay more attention to the results it contributed to.Patients usually have poor prognosis because of defect of surgical resection and resistance to con-ventional chemotherapy and radiotherapy.Chemotherapy is a significant method to the chondrosarcoma treatment. If we overcome the difficulty of chemoresistance,chemotherapy will kill the sarcoma cells efficiently and inhibit the capacity of metastasis and invasion.The patients will have better prognosis.Finding the mechanisms of che-moresistance in chondrosarcomas is the key, now we review sevaral recent mechanisms of chemoresistance in chondrosarcoma.

Objective To explore the expression and significance of CD44 gastric cancer stem cell biomarker positive circulating tumor cells (CTC ) in peripheral blood of patients with gastric cancer . Methods From March 2010 to December 2012 ,45 patients with gastric cancer and 20 healthy individuals were enrolled .Peripheral blood samples of all the subjects were collected .The expression of CTC and CD44 postive CTC were detected by density gradient centrifugation method and double immunofluorescent staining .Chi‐square test and t‐test were performed for statistical analysis .Results CTC in peripheral blood of healthy controls were not detected .Among 45 patients with gastric cancer ,CTC were detected in 27 patients and 19 of them were CD44‐positive .The difference in positive rate of CTC expression was statistically significant between two groups (χ2 =10 .986 , P<0 .05) .Among 27 CTC‐positive patients , 19 were proximal gastric cancer and 16 of them were CD44‐positive;16 patients had lymph node metastasis and 14 of them were CD44‐positive;13 patients had distant metastasis and 12 of them were CD44‐positive;14 patients had recurrence and 13 of them were CD44‐positive .The CD44 positive CTC was correlated with tumor location ,lymph node metastasis ,distant metastasis and recurrence (χ2=5 .891 ,5 .527 ,5 .787 and 7 .052 ,respectively ,all P<0 .05) .Furthermore ,in 13 patients with recurrence and CD44 positive CTC ,the recurrence time was (10 .54 ± 5 .55) months which was shorter than that of one patients with CD44 negative CTC (19 months) ,and the difference was statistically significant (t= -3 .654 , P=0 .004) .Conclusions CTC which express cancer stem cell marker may be associated with recurrence and metastasis of gastric cancer .It has more important clinical significance to detect this subtype of CTC .

Objective To examine the application value of reticulocyte hemoglobin content (CHr)for diagnosing iron deficiency in premenopausal women.Methods The levels of CHr,hemoglobin (Hb), mean cellular volume(MCV),red cell distribution width (RDW) were measured on the ADVIA 120 (Bayer Diagnostics) automated hematology analyzer.Transferrin saturation (TS) and ferritin (SF) were measured on chemistry analyzer.Results CHr in iron deficiency without anemia group were significantly lower than that in the healthy control group (P＜0.01)and significantly higher than that in iron deficiency anemia group(P＜0.01).CHr in anemia of chronic disease group were significantly higher than that in iron deficiency anemia group(P＜0.01).Receiver operator characteristic curve (ROC) analysis in diagnosis of iron dificiency without anemia demonstrated that the area under the curve for CHr,SF,RDW,MCV,Hb were 0.872,0.798,0.721,0.713,0.677,respectively (P＜0.01).So CHr has a better overall sensitivity than SF,Hb,MCV and RDW in the diagnosis of iron deficiency without anemia.ROC also showed that the area under the curve for Hb,RDW,CHr,SF and MCV was 1.000,0.969,0.958,0.953 and 0.926,respectively (P＜0.01) in iron deficiency anemia.Conclusion CHr is the early and sensitive predictor of iron deficiency in premenopausal women,especially for the diagnosis of iron deficiency without anemia.

The theoretical basis, significance and feasibility of tutor system for undergraduates in medical informa-tion education were studied.It was considered that the tutor system for undergraduates is an effective means for training medical information talents as it can help the undergraduates to know what role they will play in itheir future po-sition and the professional knowledge they should master, ncrease their study interests and stimulate their study motives by providing the professional skill education service in an order form.The management model of tutor system for under-graduates was put forward according to the significant features of undergraduate course education and cross subjects, the various requirements of professional skills, and the low study motives in domestic medical information education.The problems to which attention should be paid in implementing the tutor system for undergraduates were elaborated .