Objective To explore the application of mini-clinical evaluation exercise (Mini-CEX) in training the diagnostic thinking ability for clinical interns.Methods 83 interns who came to the First People's Hospital of Lianyungang for clinical practice in June 2015 were divided into the experimental group (45 interns) and the control group (38 interns) according to their schools.The two groups received the same clinical teaching according to internship program of five-year clinical medicine,while the experimental group had to take a weekly Mini-CEX training in chnical sections.The diagnostic thinking ability of the two groups was measured by the Diagnostic Thinking Inventory in Chinese version at the beginning and the end of the internship respectively.SPSS 21.0 was applied to processing the data.Measurement data were expressed as mean plus or minus standard deviation,and t test was used in the comparison between groups.Results At the end of the internship,the total score of diagnostic thinking,the score of knowledge structure in memory and the score of flexibility in thinking of the experimental group were higher than scores at the beginning statistically,and the experimental group had a statistically higher score than the control groups in knowledge structure in memory [(69.36 ± 4.28) vs.(66.95 ± 4.78),P=0.018].Conclusion Mini-CEX training can enhance the clinical diagnostic thinking ability of interns by improving their knowledge structure in memory.

Objective To study CD64 expression in neutrophilic granulocyte and its clinical effect in neonatal infection disease. Methods CD64 was detected among 59 neonatal patients(septicemia group 34 patients, local infection group 25 patients)hospitalized in our neonatal department diagnosed as neonatal infection disease in 48 h after hospitalized,2 weeks after therapy, then the results were compared with 27 patients as non - infection disease during the same period. Results CD64 in septicemia group was (6156. 21?3643. 32) molecula per cell,in local infection group was (2176.19 ? 946. 32)molecula per cell, in non- infection group was (2176. 19 ? 946. 32) molecula per cell.There were significant differences among three groups (all P0.05). Conclusions CD64 expression increases in bacterium infection disease. It is more obvious in widespread infection desease.and it can be the mark in early diagnosis of neonatal infection disease.

BACKGROUND:There are abundant cel populations in the placenta that attracts more and more attentions because of high content of CD34+cel s. It is expected to become a new source of hematopoietic stem cel s for the treatment of hematologic diseases and other malignant diseases.
OBJECTIVE:To investigate the amount of cel s derived from placenta, their colony forming ability, and their chimerism analysis.
METHODS:Five placentas obtained from five healthy ful-term cesarean women were treated with perfusion method and tissue digestion for the cel col ection. Flow cytometry was used to detect the proportion of CD34+cel s in the placenta and cord blood, fol owed by the culture of cel colonies as wel as regular observation of cel morphology and counting. PCR amplification with sequence-specific primers and sequence-specific oligonucleotide probes were used to examine HLA type of placenta, umbilical cord blood, and maternal peripheral blood;Short tandem repeat PCR was used for chimerism analysis.
RESULTS AND CONCLUSION:There were more CD34+cel s in the placenta than in the umbilical cord blood. The placenta had good ability to form multiple colonies in vitro, and there were maternal source components in the placenta. It is concluded that the amount of cel s in the placenta and their biological functions exhibit the potential use of placenta as a new source of hematopoietic stem cel s.

Objective The goal of this study is to understand the function of FKBP51 in resistant to high fat diet-induced obesity using FKBP51 knockout ( KO) mice and in vitro adipocyte differentiation.Methods Four-week old male FKBP51 KO and wild type ( WT) mice were fed separately with regular or high fat diet for 6 weeks.The body weight and food consumption were recorded weekly, the energy expenditure differences ( O2 consumption, CO2 production, respiratory exchange ratio, and heat production) of each group were monitored using the MM-100 metabolism cages system for 24 hours, then the liver from the above animals were stained with the Oil red-O to detect the lipid accumulation and the expression of metabolic genes.In addition, induction of adipocyte differentiation of immortalized MEF cells from WT and FKBP51 KO mice were used to observe the effect of FKBP51 gene on lipogenesis.Results Compared to WT mice, FKBP51 KO mice has less weight increment, and less lipid accumulation in the liver, but with no difference on food consumption during high-fat diet fed.Moreover, FKBP51 KO mice exhibited more O2 consumption, CO2 production and heated production under both RD and HF diet conditions.The PEPCK, G6Pase and UCP-1 genes up-regulation.In addition, lipid content was reduced in FKBP51 gene deficient MEF cells after adipocyte differentiation.Conclusions The FKBP51 gene plays an important role in high fat diet-induced obesity through the energy metabolism enhancement and lipogenesis inhibition.

BACKGROUND:Many scholars have experimental y confirmed the obvious effect of mesenchymal stem cells to repair radiation injury. OBJECTIVE:To preliminarily investigate the mechanism of human umbilical cord mesenchymal stem cells promoting the healing of combined radiation-wound skin injury and whether they possess tumorigenicity in vitro. METHODS:Fifteen Sprague-Dawley rats were randomly divided into three groups, five rats in each group. The right buttock of rats (2.5 cm×2.0 cm) was irradiated with 40 Gyβ-rays produced by a linear accelerator, in which a round wound with a diameter of 1.5 cm was made. After 12 hours of modeling, human umbilical cord mesenchymal stem cells at three concentrations (5.0×106, 1.0×107 and 2.0×107 ) were injected through tail vein of rats, and luciferin (20 mg/kg) was injected intraperitoneal y. celldistribution in vivo was traced using IVIS in vivo imaging system. The ability of human umbilical cord mesenchymal stem cells to form colonies was observed using the colony formation assay with soft agar. RESULTS AND CONCLUSION:Human umbilical cord mesenchymal stem cells injected through tail vein of rats were mostly gathered in the lungs. cells were accumulated in the injured site of rats injected with 2.0×10 7 human umbilical cord mesenchymal stem cells;however, the fluorescence signal was not observed in the injured site of rats injected with 5.0×106 and 1.0×107 human umbilical cord mesenchymal stem cells. The other results indicated human umbilical cord mesenchymal stem cells of low dose, medium dose and high dose had no colony formation on soft agar, but the tumor cells had a great ability to form colony. These findings indicate that human umbilical cord mesenchymal stem cells promote healing combined radiation-wound skin injury by local migration and exhibit no tumorigenicity in vitro in a short period.

OBJECTIVETo study the characteristics of the strains of Salmonella enterica (S. enterica) serovar Senftenberg lacking Salmonella pathogenicity island 1 (SPI-1).

METHODSA total of 10 strains of S. enterica serovar Senftenberg were isolated from 10 cases of diarrhea patients. Pulsed field gel electrophoresis (PFGE), PCR, sequencing techniques and cell invasion test were adapted to study the molecular types and invasiveness of the genes and cells; and made a comparison between the 10 strains and the strains (C02013) isolated in Shenzhen in 2002.

RESULTSThe 10 Senftenberg isolated (S09007-S09012, S09014-S09017) in Shanghai showed three PFGE patterns, which were significantly different from the strains isolated in Shenzhen. PCR-amplified results indicated the invasion gene (invA), secreted effector protein gene (sipA) and gene fragments as fhlA-hilA, hilA-spaP and spaP-invH in the 10 strains of SPI-1 were all negative. The sequencing results revealed that the 10 strains isolated in Shanghai lacked most parts of SPI-1 genes, as fragments from orgA to invH and parts of orgA gene itself; however, compared with strains isolated in Shenzhen, the sprB-orgC gene existed. The missing parts of genes were replaced by a simple insertion sequence (IS) of 1000 bp in the strains isolated both in Shenzhen in 2002 and in Shanghai in 2006. The invasiveness rates of the 10 strains (S09007-S09012, S09014-S09017) towards Hela cells were (0.0053 ± 0.0024)%, (0.0046 ± 0.0006)%, (0.0047 ± 0.0003)%, (0.0064 ± 0.0012)%, (0.0065 ± 0.0011)%, (0.0070 ± 0.0020)%, (0.0115 ± 0.0030)%, (0.0099 ± 0.0039)%, (0.0180 ± 0.0135)% and (0.0031 ± 0.0012)%, respectively; which were all significantly lower than the rate of invA-positive control strain STM1344 ((5.0800 ± 0.6333)%); lower or close to the rate of invA-lacked artificial-mutated strain STMinvA-((0.0193 ± 0.0045)%).

CONCLUSIONSPI-1 genes are not essential for the diarrhea caused by S. enterica serovar Senftenberg.

Adult ; Aged ; Bacterial Typing Techniques ; Diarrhea ; microbiology ; Feces ; microbiology ; Female ; Genes, Bacterial ; Genomic Islands ; HeLa Cells ; Humans ; Male ; Middle Aged ; Salmonella enterica ; genetics ; isolation & purification ; pathogenicity

ObjectiveTo evaluate the long term outcomes, toxicities and prognostic factors of the patients in Northwest China with nasopharyngealcarcinoma (NPC)treated by intensity-modulated radiotherapy (IMRT). MethodsFrom January 2006 to December 2009, 133 NPC Patients were treated by IMRT in Xijing Hospital, the Fourth Military Medical University. There were 22 treated by radiotherapy alone, 111 treated by platinum-based current chemo-radiothreapy. The prescription dose to the gross tumor volume was 66 - 76. 6 Gy/30 - 33 fractions, positive lymph nodes was 66. 0 - 72. 4 Gy/30 - 33 fractions.The higher and lower risk clinical target volume were irradiated with 56. 0 - 63. 5 Gy/28 - 33 fractions and 50. 4 -53. 2 Gy/28 fractions respectively. ResultsThe follow-up rate was 97. 7％. Follow-up time more than 2years,3years were 37cases ,44cases. The l-,2-and 3-year overall survival (OS) were 93. 8％, 88. 3％and 83.2％ ; local control rate were 99. 2％ ,95.4％ and 95.4％ ; regional control rate ( RC ) were 99. 2％,96. 8％ and 96.8％ ; and distant metastasis-free rate (DMFR) were 82. 8％, 79. 8％ and 79. 8％ ; the disease-free survival (DFS) were 84. 3％ ,76. 7％ and 76. 7％, respectively. Multivariate analyses revealed that N stage, age and anemia before radiotherapy were independent predietors for OS (x2 =5.56,9. 10,4.89,P=0. 018,0.003,0.027), and N stage was also independent predictors for DFS (x2 =8.98,P=0.003).Thegrade 3acutetoxicitiesweremueositis(34.7％),xerostomia(20. 1％ ), skin reaction ( 1.4 ％ ) and leucocytopenia ( 1. 4 ％ ). No grade4 acute and late toxieities were detected. Conclusions IMRT with or without chemotherapy achieved good long term survival in nasopharyngeal carcinoma treated by intensity-modulated radiotherapy, especially in LC and RC. Distant metastasis becomes the main treatment failure.N stage, age, and anemia before radiotherapy were the main prognostic factors in nasopharyngeal cancer patients.

OBJECTIVETo analyze the related factors of neck recurrence and regularity of cervical lymph nodes metastasis of pathologically node positive (pN+) tongue squamous cell carcinoma(SCC) and explore the neck treatment strategy for pN+ tongue SCC.

METHODSClinical and follow-up data of 138 patients with pN+ oral tongue SCC from Jan. 1991 to Dec. 2008 were reviewed. Distribution of neck metastatic and recurrent lymph nodes were analyzed. The influencing factors of neck recurrence of pN+ tongue SCC were analyzed.

RESULTSAll patients were followed over two years or until death. Using Kaplan-Meier method, the 3-year and 5-year overall survival rates were 46.4% and 36.2% respectively. Two hundred and three levels of 138 patients had metastasis and the involvement frequency of ipsilateral I, II, III reached to 94.6%. Sixty-six levels of 47 patients had neck recurrences and the involvement frequency of ipsilateral I, II, III reached to 77.3%. pT stage, pN stage, pTNM stage, extracapsular spread (ECS) of cervical lymph nodes were relevant to the neck recurrence of pN+ tongue SCC (all P < 0.05). When ECS of cervical lymph nodes was present, the neck recurrence rate of patients with postoperative radiation was lower than patients without postoperative radiation, but P value failed to demonstrate significant difference (P = 0.076). There were no significant difference of neck recurrence rates between different neck dissection methods (P > 0.05). Multivariate Cox analysis showed that pTNM stage and ECS of cervical lymph nodes were the independent prognostic factors of pN+ oral tongue SCC.

CONCLUSIONSpT stage, pN stage, pTNM stage, ECS of cervical lymph nodes were the influencing factors of neck recurrence of pN+ tongue SCC. Postoperative radiation may reduce the neck recurrence rate when ECS was present. There was no difference of the neck recurrence rate between modified neck dissection (MRND) and radical neck dissection (RND) and when the non-lymphatic structures were not involved, MRND should attempted. Metastatic and recurrent lymph nodes of pN+ tongue SCC were mostly distributed in ipsilateral I, II, III level and selective neck dissection (SND) can be applied to pN+ tongue SCC.

Carcinoma, Squamous Cell ; Humans ; Lymphatic Metastasis ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Retrospective Studies

Objective To provide references for the clinical treatment of patients with periodontal diseases by modeling and analysis based on four software and obtaining stress distributions of the patient's teeth,according to CT data and plaster model of the patient's teeth.Methods The CT data were preliminary processed by using Mimics software to establish three-dimensional (3 D) cloud model.The 3 D surface model of the teeth was then constructed by using Geomagic software to make parameter modeling and reverse engineering.The 3D surface model was imported into SolidWorks to obtain the 3D entity model by entity conversions.Finally,the 3D entity model was imported to ANSYS for analysis.Results The stress distributions on the upper teeth were obtained,and the location of stress concentration points was determined.The stress concentration points of the teeth were analyzed separately,and the maximum stress was 1 774.8 MPa.The occlusal relationship was adjusted based on stress distributions,and the maximum stress after adjustment was reduced to 1 529 MPa.Conclusions This dental modeling and analysis method can simulate various occlusal relationships and calculate tooth stress distribution after amendment,which provides the theoretical basis for clinical treatment of periodontal diseases.

This study was purposed to construct and prepare the recombinant adenovirus vector carrying human thioredoxin (hTRX) and enhanced green fluorescence protein (EGFP), and transfect it into HEK293 cells, so as to lay a foundation for further gene therapy. The PCR-amplified products of hTRX with a pair of primers containing Not I and EcoR V restriction sites were subcloned into shuttle plasmid pDC316-mCMV. HEK293 cells were co-transfected with the constructed recombinant shuttle plasmid pDC316-hTRX-EGFP and large adenovirus-helper plasmid pBHGlox (delta) E1, 3Cre in mediation of liposome. The obtained replication-defective recombinant adenovirus pAd-hTRX-EGFP was co-transfected in HEK293 cells, purified by CsCl gradient centrifugation, counted for virus particles and determined for titer. The recombinant adenovirus was identified by PCR. The HEK293 cells were then transfected with adenoviruses and assayed by flow cytometry. The expression of hTRX was confirmed by Western blot. The results showed that according to PCR and restriction endonuclease assay, the target gene was inserted into recombinant adenovirus vector successfully. The sequence of fusion gene was the same as that of designed fragments. The titer of the purified recombinant adenovirus pAd-hTRX-EGFP was 5.558×10(10) pfu/ml. A transfection efficiency of 92.25% could be achieved at MOI = 100. Western blot further confirmed that hTRX was efficiently expressed in HEK293 cells. It is concluded that recombinant adenovirus vector containing hTRX has been constructed successfully and obtained highly efficient virus that can express efficiently in HEK293 cells, which laid a foundation for further investigation.
Adenoviridae ; genetics ; Genetic Vectors ; Green Fluorescent Proteins ; genetics ; HEK293 Cells ; Humans ; Plasmids ; Recombinant Proteins ; genetics ; Thioredoxins ; genetics ; Transfection