Based on the first hand cardiothoracic surgical training experiences in Australia, the author introduced the Australian surgical training system's objective, structure, outline and specific training methods as well as its contents in detail. Its overall characters can be summarized as high standard, strict requirement and equal stress on both theory and practice. Hopefully, this introduction and reflection may shed some light on the improvement and evolvement of the resident training system in China.

Objective To discuss the imaging features of the localized fibrous tumor of pleura(LFTP).Methods 10 cases of LFTPproved patholgically were underwent CT scanning,while MRI scanning was performed in 3 cases.The imaging findings of LFTP wereanalysed.Results 9 cases were benign tumors and 1 case was malignant tumor.The main CT manifestations were single soft tissue massadhering to the pleural surface,clearly boundary,homogeneous or unhomogeneous density,obvious homogeneous or non-uniformityenhancement."Pleura mass hat"was characteristic appearance located the pleura mass.The mass formed acute angle or obtuse angle with the adjacent pleura,which was related to mass size and shape.MRI manifestations were hypointense or isointense on T_1WI and T_2WI,non-uniformity signal.1 case of giant LFTP showed scattered in disorder and clutter signal on T_2WI.Inside tumor peduncle of the giant LFTP was connected with the pericardium.Conclusion CT is a main imaging diagnostic technique for LFTP,while MRI is commonly superior to CT in localizing the mass and showing inner characteristics for the bigger pleural masses.The appearance of pleuraL tumor peduncle is an important sign in diagnosis of LFTP.

OBJECTIVE: By studying the MRI apperances of postcricoid area invaded by laryngeal carcinoma, to identify the characteristic appearances of the invaded postcricoid area and to provide information on the early detection of the lesions. METHOD: Eighteen cases of MRI images of postcricoid area invaded by laryngeal carcinoma were included in this study. To find out the characteristic manifestation of the lesions, the destructions of surrounding structures and layers, and the invaded extent were observed. RESULT: In 18 cases the invaded lesions of postcricoid area include the mucous layer, submucous fat layer and the mucous layer of anterior wall. In 14 cases the invaded lesions of postcricoid area include the mucous layer, submucous fat layer and the mucous layer of the posterior wall. The soft tissue mass was found in 15 cases, and disappeared hypopharynx cavity in 16 cases. In 14 cases, the full-thickness of both anterior and posterior walls were invaded, accompanied with soft tissue mass and disappeared hypopharynx cavity. CONCLUSION The postcricoid area invaded by laryngeal carcinoma usually shows the destruction of normal structures, signal change in MRI and soft tissue mass. Being familiar with the imaging of the invaded postcricoid area is extremely important to early detect laryngeal carcinomas invading postcricoid area.
Cricoid Cartilage ; pathology ; Humans ; Hypopharyngeal Neoplasms ; diagnosis ; Hypopharynx ; pathology ; Laryngeal Neoplasms ; diagnosis ; Larynx ; pathology ; Magnetic Resonance Imaging

Objective To investigate the adjustment of miRNA-155 on CD4+ CD25+ Treg regulative T cell in peripheral blood in patients with acute cerebral infarction (ACI) and its pathogenesis. Methods Sixty patients with ACI were divided into three groups according to clinical neurological deficit score. Twenty healthy volunteers were enrolled into the control group. The expression levels of plasma miR-155 mRNA and Foxp3 mRNA were detected by real-time quantitative PCR(qRT-PCR). IL-10 levels in plasma were detected by ELISA. Results Expression of miR-155, Treg, Foxp3 mRNA and levels of IL-10 were significantly increased in patients with ACI compared with normal control group, with statistical differences; Expression of miR-155, Treg, Foxp3 mRNA and levels of IL-10 were gradually increased. The values showed significant statistical difference among the mild, moderate and severe ACI groups (P < 0.01). Among the patients,the levels of miR-155, Treg, Foxp3 mRNA and levels of IL-10 in the survival group were obviously lower than those in the non (P<0.05 or P<0.01). There was a positive correlation between miR-155 and Treg, Foxp3 mRNA (P < 0.01). Conclusion This study suggests that miR-155 is involved in the cell proliferation regulation of CD4+ CD25+ Treg cells,and plays some role in the immunological dissonance with ACI.

Objective To introduce the construction of clinical research information system of a tertiary grade A comprehensive hospital in Shanghai.Methods Based on the database construction,the structured inpatient medical records,surgical records and ancillary diagnostic report are designed and the application terminal is developed.Results A full-link normalized clinical research information system for research-based cases covering all aspects of clinical research is developed,which can provide customized and structured data.Conclusions The clinical research information system provides convenience for clinical medical research,and its practice has certain reference significance.

Objective:To evaluate the effects of smart stethoscope on the monitoring childhood asthma exacerbation, so as to assist family management in childhood asthma.Methods:A prospective randomized controlled study was carried out.A total of 80 children with asthma who were treated at Department of Pediatric Respiratory, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine and Shanghai Tonxin Pediatric Clinic from November 2020 to May 2021 were enrolled and randomly divided into a test group of 40 cases (used the smart stethoscope) and a control group of 40 cases(not used the smart stethoscope). Medical history data were collected.The control group received monthly routine follow-up, while the test group was followed up both routinely and by smart stethoscope.In the test group, hearing wheezing sound was regarded as asthma exacerbation, and in the control group, the asthma exacerbation was reported by the parents themselves.The frequency of asthma exacerbation, asthma control level and quality of life were compared between the two groups.The recognition, diagnosis, treatment and outcomes of acute asthma exacerbation in two groups of children were described and analyzed.Measurement data were analyzed by t test or Mann- Whitney U test.Numeration data were analyzed by χ2 test. Results:Respiratory sounds collected by smart stethoscope in the test group were assessed by 3 specialist physicians.There were 12 wheezing rales (42.86%), 1 moist rale (3.57%) and 1 rhonchi rale (3.57%). Besides, 12 files (42.86%) were difficult to distinguish, and 2 files (7.14%) induced inconsistent identification.The number of asthma exacerbation was 12 in the test group and 5 in the control group.In the test group, 12 were recognized by the smart stethoscope, and only 6 were recognized by the parents.Comparing the diagnosis and treatment measures between two groups, it was found that there were more children in the test group (38.1%) receiving home treatment through telemedicine than those in the control group (20.0%). Besides, there were less children (61.9%) in the test group receiving unplanned hospital treatment (including unplanned outpatient, emergency and hospitalization) than those in the control group (80.0%). There was no statistically significant difference between the two groups of children during acute asthma exacerbation ( χ2=4.67, P=0.097). Parents were satisfied with the common functions, convenience and stability of smart stethoscope. Conclusions:Smart stethoscope can acquire the respiratory sounds of children with asthma in real time, achieving timely detection, diagnosis and treatment of asthma exacerbation in children.What′s more, smart stethoscope reduces the incidence of unplanned hospital diagnosis and treatment, and assists parents with better family management of children asthma.

Objective : To analyze the effects of transglutaminase 2(TGM2) gene interference on the malignant proliferation and movement of lung cancer cells . Methods : A549 cells in logarithmic growth phase were divided into control group , shRNA⁃NC group and TGM2⁃shRNA1 group . After transfection , expression levels of TGM2 mRNA A549 cells in logarithmic growth phase were divided into control group , shRNA⁃NC group and TGM2⁃shRNA1 group . After transfection , expression levels of TGM2 mRNA clone formation assay . The proliferation activity of cells was detected by CCK⁃8 . The apoptosis rate was detected by flow cytometer. The invasion of cells was detected by Transwell . The number of tubule formation in each group was observed under microscope . The expression of E ⁃cadherin (E⁃cad) , N ⁃cadherin (N⁃cad) , fibronectin (FN) and vascular endothelial growth factor (VEGF) in each group was detected by Western blot . Results : Compared with shRNA⁃NC group , the mRNA level and protein expression of TGM2 in TGM2⁃shRNA1 group were decreased (P <0. 05) , and the rate of clone formation , proliferation activity , number of invasive cells and number of tubules formation were decreased ( P < 0. 05) . The apoptosis rate and the expression of E ⁃cad protein were increased ( P <0. 05) , while the expression of N ⁃cad , FN and VEGF protein were decreased (P < 0. 05) . Conclusion TGM2 gene silencing can inhibit the expression of VEGF protein , inhibit the malignant proliferation and invasion of A549 cells , and promote apoptosis .

Objective : To analyze the effects of miR⁃346 on alleviating cardiac function damage and oxidative stress in rats undergoing myocardial ischemia/reperfusion (I/R) . Methods : A total of 48 rats were randomly divided into control group , I/R group , I/R + agomiR⁃NC group and I/R + agomiR⁃346 group. I/R model was replicated by the ligation of left anterior descending coronary artery. The recombinant adeno⁃associated virus miR⁃346 was injected through the tail vein for overexpression intervention. After 120 minutes of reperfusion , heart rate (HR) , left ventricular ejection fraction (LVEF) , fractional shortening (FS) and left ventricular wall thickness (LVWT) , levels of serum creatine kinase MB (CK⁃MB) , myoglobin (Mb) , lactate dehydrogenase (LDH) and cardiac troponin I (cTnI) , and levels of superoxide dismutase ( SOD) , glutathion peroxidase ( GSH⁃Px ) and malondialdehyde (MDA) in myocardial tissues were detected. The apoptosis of myocardial tissue cells was detected by TUNEL staining. The expression of B⁃cell lymphoma/leukemia⁃2 (Bcl⁃2) gene , Bcl⁃associated x protein (Bax) , cysteine protease 3 ( Cas⁃3 ) and Cas⁃9 in myocardial tissues was detected by Western blot. Results : HR , LVEF , FS and LVWT in I/R group were lower than those in control group , the levels of serum CK⁃MB , LDH , Mb and cTnI were higher than those in control group , the expression of MDA , Bax/Bcl⁃2 , cleaved Cas⁃3/Cas⁃3 and cleaved Cas⁃9/Cas⁃9 proteins in myocardial tissues was higher than that in control group , the levels of SOD and GSH⁃px were lower than those in control group , and the apoptosis rate of myocardial tissue cells was higher than that in control group (P < 0. 05) . HR , LVEF , FS and LVWT in I/R + agomiR⁃346 group were higher than those in I/R + agomiR⁃NC group , the levels of serum CK⁃MB , LDH , Mb and cTnI were lower than those in I/R + agomiR⁃NC group , the expression of MDA , Bax/Bcl⁃2 , cleaved Cas⁃3/Cas⁃3 and cleaved Cas⁃9/Cas⁃9 proteins in myocardial tissues was lower than that in I/R + agomiR⁃NC group , the levels of SOD and GSH⁃px were higher than those in I/R + agomiR⁃NC group , and the apoptosis rate of myocardial tissue cells was lower than that in I/R + agomiR⁃NC group ( P <0. 05) . Conclusion The miR⁃346 overexpression can reduce oxidative stress level in I/R rats , alleviate myocardial tissue damage , and improve cardiac function.