Physician-patient communication skill is the core clinical capability,and its im-portance is more and more recognized by educationists.Introducing the communication skill education into the standardized resident training can improve the residents'clinical and communicative ability and train them to be the comprehensive quality talents.

Objective To investigate the expression and significance of Periostin,VEGF and MMP-9 in breast invasive ductal carcinoma.Methods Immunohistochemistry was employed to detect the expression of Periostin,VEGF and MMP-9 in breast invasive ductal carcinoma and normal breast tissue.Results In breast invasive ductal carcinoma and normal breast tissue,the positive rates of Periostin were 63.8 ％ (37/58) and 0 (x2 =24.272,P =0.000).The figures were 69 ％ (40/58) and 8 ％ (2/25) for the positive rates of VEGF (x2 =25.977,P =0.000),respectively,as well as 70.69 ％ (41/58) and 16.0 ％ (4/25) for the positive rates of MMP-9 (x2 =21.050,P =0.000),respectively.There were significant differences among the groups (P ＜ 0.05).In breast invasive ductal carcinoma,the expression of Periostin was correlated with clinical stage (x2 =4.835,P =0.028),whereas not correlated with age (x2 =1.155,P=0.282),histological grade (x2 =0.05,P =0.972),lymphatic metastasis (x2 =1.660,P =0.198).The expression of VEGF was correlated with clinical stage (x2 =4.230,P =0.040),lymphatic metastasis (x2 =9.667,P =0.002),whereas not correlated with age (x2 =0.506,P =0.477),histological grade (x2 =0.532,P =0.767).The expression of MMP-9 was correlated with clinical stage (x2 =8.456,P =0.004),lymphatic metastasis (x2 =5.494,P =0.019),whereas not correlated with age (x2 =0.153,P =0.695),histological grade (x2 =0.224,P =0.894).The expression of Periostin,VEGF and MMP-9 were positively correlated with each other in breast invasive ductal carcinoma (r =0.348,P =0.001; r =0.303,P =0.021; r =0.469,P =0.000).Conclusion Periostin,VEGF and MMP-9 are correlated closely with the occurrence and development of breast invasive ductal carcinoma,which might be valuable in evaluating the invasiveness,metastasis and prognosis.

The natural history of 383 patients of schistosomal cirrhosis, discovered from 1960-1990 in Donjing township Shanghai suburb, where schistosomiasis had been controlled for more than 10 years, was studied. The cumulative survival rate in 243 patients who had splenecto-my 11-30 years previously (group I ) was much higher than that of 140 patients without splenectomy (group II ), and the time for 75% survival rate of these 2 groups were 18 and 4 years respectively, being much longer in the splenectomized patients without ascites and those operated before age of 30 than those complicated with ascites and those operated between the age of 31 - 50 or after 51 years of age.The complications and mortality rate of group I were significantly lower than that of group I , indicating that splenectomy not only prevented the complication of portal hypertension but improved the general health and resistance of the patients against other pathogens as well.There was no significant difference between group I and group II in the ratio of the avarage death age of the deceased patients to the life expectancy of the general population, suggesting that the life span of a number of patients without splenectomy are not substantially shortened in an area where schistosomiasis had been controlled.

Objective To investigate the reliable parameters of the efficacy of CRT on patients with CHF evaluated by 3D-STI. Methods Thirty-six patients with CHF were performed by three-dimensional speckle tracking imaging (3D-STI) before and at one week, one month and three months after CRT, respectively. The left ventricular end systolic volume (3D-LVESV), the left ventricular ejection fraction (3D-LVEF) and the left ventricular dys-synchrony parameters which include the standard deviation of time to peak (AT-SD) and the maximum difference of time to peak (AT-Dif) of radial strain, circumferential strain and area tracking in the 16 left ventricular segments and the changes of 3D-LVESV, 3D-LVEF (ΔLVEF), AT-SD (ΔAT-SD) and AT-Dif (ΔAT-Dif) at 3 months after CRT were determined. Forty normal volunteers as the controls were performed 3D-STI only once. Results AT-SD, AT-Dif of three kinds of strain, LVESV of the patients in both effective and non-effective groups were significantly higher than those in the control group before CRT (P < 0.05). AT-SD, AT-Dif of three kinds of strain in the CRT effective group were significantly higher than those in the CRT non-effective group , whereas 3D-LVESV and 3D-LVEF were not significantly different between these two groups before CRT. For the CRT effective group, one week after CRT, all of the left ventricular dyssynchrony parameters were decreased (P < 0.05, respectively). For the CRT non-effective group, the changes of total assessment parameters after CRT were not significant (P > 0.05). ΔAT-SD and ΔAT-Dif were negatively correlated with ΔLVEF. Conclusion 3D-STI can efficiently evaluate the short-term efficacy of CRT , and the area tracking is a reliable parameter to predict and assess CRT efficacy.

Objective To evaluate the immunogenicity of group A and C meningococcal polysaccharides conjugates using different proteins as carriers. Methods Heat-labile enterotoxin B subunit (LTB)pentamer form was expressed in E. coli. The target protein was identified and purified by cation-exchange chromatography. Then biological activity of rLTB was tested using GM1-ELISA. GCMP was conjugated to rLTB with the chemical method (ADH). Furthermore, the mice were immunized with GAMp-TT/GCMP-TT conjugates and GAMP-TT/GCMP-rLTB conjugates via peritoneal. Finally the anti-polysaccharide antibody was detected. Results The GAMP-TT/GCMP-rLTB conjugate elicits remarkably higher serum antibodies in mice than GAMP-TT/GCMP-TT conjugate. Conclusion These results indicated that polysaccharide conjugates using different proteins as carriers were superior to those using only one protein as carrier.

Objective To investigate the CT manifestations of gastric carcinoma invasion to lesser omentum and to assess the im-pact of lesser omentum on the spreading of gastric carcinoma.Methods We retrospectively reviewed CT findings in 48 patients with gastric carcinoma and lesser omentum involved for primary tumor and the lesser omentum abnormalities.The influence of lesser o-mentum on the extension of gastric carcinoma as well as the accompanied ascites were also analyzed.Results CT manifestations of lesser omentum involvement in gastric carcinoma included the following items:① direct infiltration (35.4%,1 7/48),which was mainly shown as increased density of fatty tissue and the development of mass within the lesser omentum,including spreading into the liver through the lesser omentum directly in two cases;② omental seeding (25.0%,12/48),including smudged appearance (1 1 cases)and omental caking (1 case);③ metastasis of lymph nodes (64.6%,31/48),including enlargement and increase of lymph nodes (27 cases)and cystic mass (4 cases).Ascites was found in 1 1 patients and fluid collection in the lesser sac was shown in 3 of these 1 1 patients.The lesser omentum forms the anterior wall of the lesser sac and separates the fluid collection in the lesser sac from the ascites in the greater peritoneal cavity.Ascites was associated with the omental seeding statistically.Conclusion CT scan is helpful for detecting lesser omentum invasion by gastric carcinoma.The imaging features consist of mass sign,enlargement of lymph nodes,smudged andcakingappearance,and so on.Lesser omentum may also play a certain role in both the extension of gastric carcinoma and the compartmentalization of ascites due to gastric carcinoma.

Objective To evaluate the clinical effectiveness of early-stage keep warm intervention on improving low temperature risk children treated with blood purification (BP). Methods Ninety children were randomized into observation group (46 cases) and control group of (44 cases) from July 2013 to September 2015. Control group were nursed with conventional BP standard operation process, while the observation group were nursed additionally with heat insulation blanket before 30 min of booting machine, and recorded the central body temperature of 0 min,30 min,60 min,90 min,120 min for each 60 min 1 time in the future. Until the end of the blood purification 60 min. Low temperature complications were recorded and judged between the two groups. Results In the observation group, 107 cases of low body temperature occurred during the course of 7 cases of blood purification, occurrence rate of 6.5% (7/107). The control group was 15.8% (16/101). The difference between the 2 groups was statistically significant (χ2=4.569,P<0.05);In the continuous blood purification group, observation group 10.6% (5/47), The incidence rate of control group was 29.3% (12/41), he difference between the 2 groups was statistically significant (χ2=4.876,P<0.05). Conclusions Application of heat insulation blanket at the early-stage may effectively reduce the risk of hypothermia complications in the children treated with blood purification. The continuous blood purification effect is more significant.

BACKGROUND: Because of the relatively similar size of organs to human and the physiological and structural similarities, the use of porcine as xenograft donors is progressing very actively. In this study, we analyzed the characteristics of porcine ear cartilage and evaluated its suitability as graft material in reconstructive and cosmetic surgery. METHODS: The auricular cartilage was harvested from two pigs, and subjected to histological examination by immunohistochemical staining. To determine the collagen content, samples were treated with collagenase and weight changes were measured. After sterilization by irradiation, the samples were grafted into rats and stained with Hematoxylin and Eosin and Masson Trichrome to observe inflammation and xenograft rejection. RESULTS: In IHC staining, extracellular matrices were mainly stained with type II collagen (20.69%), keratin sulfate (10.20%), chondroitin sulfate (2.62%), and hyaluronic acid (0.84%). After collagenase treatment, the weight decreased by 68.3%, indicating that about 70% of the porcine ear cartilage was composed of collagen. Upon xenograft of the sterilized cartilages in rats, inflammatory cells were observed for up to 2 months. However, they gradually decreased, and inflammation and reject-response were rarely observed at 5 months. CONCLUSION: The porcine ear cartilage was covered with perichondrium and cellular constituents were found to be composed of chondrocytes and chondroblasts. In addition, the extracellular matrices were mainly composed of collagen. Upon xenograft of irradiated cartilage into rats, there was no specific inflammatory reaction around the transplanted cartilage. These findings suggest that porcine ear cartilage could be a useful alternative implant material for human cosmetic surgery.
Animals ; Cartilage ; Chondrocytes ; Chondroitin Sulfates ; Collagen ; Collagen Type II ; Collagenases ; Ear Cartilage* ; Ear* ; Eosine Yellowish-(YS) ; Extracellular Matrix ; Hematoxylin ; Heterografts* ; Humans ; Hyaluronic Acid ; Inflammation ; Rats ; Sterilization ; Surgery, Plastic ; Swine ; Tissue Donors ; Transplants

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Diarrhea ; virology ; Female ; Humans ; Male ; Middle Aged ; Oligonucleotide Array Sequence Analysis ; methods ; Young Adult

Objective: To explore the effect of histone deacetylase (HDAC) inhibitor valproic acid (VPA) on the epithelial-mesenchymal transition (EMT) of colon cancer. Methods: With four colon carcinoma cell lines (DLD-1, HCT116, SW480 and HT29) as study subjects, the effect of different concentrations of VPA(0.5，5 mmol/L) on cell proliferation was detected by MTT assay. The expression level of EMT-related proteins (E-cadherin and vimentin) was detected by Western blotting; Phenotypic changes of E-cadherin and vimentin were detected by immunofluorescence staining; Cell migration and invasion ability was detected by wound healing and Transwell invasion assay, respectively. Results:After treated with different concentrations of VPAfor 48 h, low concentration of VPAmerely exerted any effect on the cell proliferation rate of four colon cancer cell lines, and thus was chosen as the experiment concentration; The results of Western blotting showed that the expression of E-cadherin was reduced (P<0.05) and vimentin was increased (P<0.05) in colon carcinoma cells by VPAtreatment (0.5 mmol/L); Immunofluorescence staining revealed membranous attenuation or nuclear translocation of E-cadherin and enhanced expression of vimentin after VPA treatment (0.5 mmol/L), and these responses occurred after 6 h and sustained until 24 h; Wound healing and Transwell invasion assay showed increased migration and invasion ability following VPA treatment (0.5 mmol/L). Conclusion: Low concentration VPA could induce the development of EMT in colon cancer cells by nuclear translocation of E-cadherin, and obviously enhance the migration and invasion ability of colon cancer cells; Thus, HDAC inhibitors, as a new type anti-cancer option, shall be carefully considered before their application in colon cancer.