Condoms ; standards ; supply & distribution ; Humans ; Quality Control ; Sexually Transmitted Diseases ; prevention & control

Acromioclavicular Joint ; anatomy & histology ; injuries ; surgery ; Fracture Fixation ; instrumentation ; methods ; Humans ; Male ; Shoulder Dislocation ; surgery

Bile Duct Neoplasms ; surgery ; Bile Ducts ; pathology ; surgery ; Bile Ducts, Intrahepatic ; pathology ; surgery ; Biliary Tract Diseases ; surgery ; Biliary Tract Surgical Procedures ; methods ; trends ; Cholecystectomy, Laparoscopic ; methods ; trends ; Cholelithiasis ; surgery ; Humans

In the medical field, the innovation education is to cultivate residents in China, which is an important way to senior medical elite. By analyzing competency-based neurosurgery residency training mode, the training methods for innovative ability of competency-based neurosurgeon are further discussed, for the purpose of reforming the training mode of neurosurgeon, improving creative ability and scientific clinical thinking ability.

Objective To explore the effect of gamma-aminobutyric acid (GABA) on the growth, apoptosis and telomerase activity of Cholangiocarcinoma cell line QBC939. Methods Cholangiocarcinoma cell line QBC939 was cultured by routine method, and then treated with different concentrations of GABA (1-1000 μmmol/L). The proliferation, apoptosis and cell cycle of QBC939 cells was investigated by MTT, Flow cytometry and transmission electron microscopy. The telomer-ase activity of QBC939 cells was examined by modified PCR-ELISA assay. Radioimmunoassay was used to measure the intracellular cyclic adenosine monophosphate(cAMP) content. Results The dif-ferent concentrations of GABA inhibited the growth of QBC939 cells and promoted the apoptosis. The apop-totic rate of QBC939 cells was increased from 4. 8% to 28. 03%, which had significant difference (P<0.05). It had no effect for distribution of cell cycle. Cell nuclear condensation and apoptotic bodies were seen by transmission electron microscopy. Telomerase activity was inhibited by GABA(0. 82±0. 048 vs 0.56±0. 054, P<0.05). The content of intracellular cAMP was increased with the increase of GABA concentration in a dose-dependent manner [(0. 59±0. 049) nmol/L vs (0. 82±0. 033)nmol/L, P<0. 05]. Conclusion GABA can inhibit the proliferation of QBC939 cells by promoting apoptosis and inhibiting telomerase activi-ty, which may be mediated by the information transmission of post-receptor.

Objective To investigate the changes of clinical symptoms and liver or lung functions after inferior vena cava stent implantation in Budd Chiari syndrome patients. Methods 35 cases of Budd Chiari syndrome patients were enrolled and retrospective analysized, such as ascites, edema of lower limbs, abdomen wall of varicose veins and serum total bilirubin, serum albumin, prothrombin time, FVC, MVV, PEF, FEV1.0, FEV1.0/FVC and other pulmonary functional changes were analyzed before and 1 months after inferior vena cava stent implantation. Results Ascites, edema of lower limbs, abdominal varicose veins and other clinical symptoms were significantly reduced or disappeared, the total serum bilirubin significantly decreased, serum albumin significantly increased, and prothrombin time significantly reduced 1 month after surgery in patients with Budd Chiari syndrome, (t = 1.95, 2.31, 2.07, P < 0.01). FVC, MVV, PEF, FEV1, the indexes of FEV1/FVC improved obviously after surgery (t = 1.83, 2.69, 1.47, 1.69, 1, 97, P = 0.041, 0.029,0.046, 0.043, 0.043, 0.038). Conclusion Inferior vena cava stent implantation could effectively improve the clinical symptoms of patients with Budd Chiari syndrome.

Objective To investigate the risk factors of post-pancreaticoduodenectomy complications.Methods The clinical data of 207 patients with pancreatic carcinoma or peri-ampullary carcinoma who underwent pancreaticoduodenectomy at the Anhui Provincial Hospital from Dec.2007 to Dec.2012 were studied.Seventeen clinicopathologic factors to correlate with the postoperative mortality and methods were selected for univariate analysis and multivariate analysis using logistic regression.Results Univariate analysis showed the major risk factors of postoperative mortality and morbidity were a history of previous operation,pre-operative drainage,total serum bilirubin level,alanine aminotransferase level,serum albumin level,serum pre-albumin level,parenchyma texture and pancreatic duct diameter (P＜0.05).Multivariate analysis showed alanine aminotransferase level,parenchyma texture and pancreatic duct diameter were independent risk factors of postoperative complications.Pancreatic duct diameter was the independent risk factor of pancreatic fistula.Pancreatic fistula was the independent risk factor of hemorrhage.Conclusion The postoperative complications of pancreaticoduodenectomy was closely related to alanine aminotransferase level,parenchyma texture and pancreatic duct diameter.

The incidence of cervical neoplasms complicated with pregnancy is rising,with delaying of reproouctive age.Because of the prevalence of cytology in pregnancy.eervical neoplasnis complicated with pregnancy are mostly detected early. All patients with cytological abnormalities should undergo colposcopy, and when necessary,they should undergo cervical biopsy.Conization is reserved for patients with suspected invasion.In cases of invasive carcinoma detected up to the 12th week of pregnancy,immediate treatment is prioritized.Regarding diagnoses made during the second trimester,in early-stage invasive cancers,delay of therapy seems to be safe.fetal pulmonary maturity can be awaited.And the use of neoadjuvant chemotherapy to stabilize the disease until the time of delivery appears to be viable.Doctors should draw up personalized program for the patients with cervical neoplasms complicated with pregnancy according to stage of disease, gestational weeks and the patient's desire for continued pregnancy.Cervical neoplasms complicated with pregnancy are mostly early-stageinvasive cancers, so prognosis is good.

Epithelial-mesenchymal transition (EMT) not only can endow cells migration and invasion characteristics,but also can make tumor cells obtain self-renewal ability and have the characteristics of stem cells,which might result in cancer stem cell (CSCs).There are the same molecular mechanism and microenvironment between EMT and CSCs,which have great clinic significances for the diagnosis and treatment of the aggressive cancers.Moreover,many studies show that miR-200 could regulate EMT and CSC,participate in the tumor invasion and metastasi,and promote the research of targeted cancer therapy.

Objective To investigate the pathogenesis of interleukin-21 (IL-21)role in primary biliary cirrhosis (PBC).Meth-ods 38 cases of PBC were selected for the study.35 caeses of healthy subjects were selected as the control group in January 2012 to January 2014 from Shenzhen Fuyong People’s Hospital of Baoan District and the Third People’s Hospital of Shenz-hen.The levels of IL-21,IL-17 of two groups were measured with Enzyme-linked immunosorbent assay (ELISA).The levels of T helper lymphocytes 17 (Th17),regulatory T cells (Treg)cells ratios of two groups were measured with flow cytome-try.The relationship of IL-2 1 and liver function were analyzed with pearson correlation.Another analysis of pyruvate through the establishment of in vitro deaminase complex E2 subunit (PDC-E2)peptides relationship with Th17 and Treg cell.Results The levles of IL-17 (18.23±4.12)ng/L,IL-21 (512.25±18.25)ng/L,Th17 (3.98±0.98)%,Th17/Treg (39.25±3.25)% of PBC group were significantly higher than the control group (7.89±3.26)ng/L,(212.98±21.52)ng/L,(0.92±0.21)% and (12.98±3.12)%,while the PBC group Treg (3.11±0.85)% were lower than the control group (8.36±1.12)%.IL-21 were positive correlation with IL-17,Th17 (t=8.886,7.021,4.448,10.112,5.125,P<0.05).In vitro experiments showed that the addition of IL-21 in the culture system,the levels of Th17 (2.41±0.82)%,Th17/Treg cells(32.98±3.12)% were significantly higher than the control group(0.98±0.21)%,(12.25±3.25)%,while Treg (4.75 ±0.68)% were lower than the control group(11.85±0.96)%,the difference was statistically significant (8.521,6.489, 8.236,P<0.05).Conclusion IL-21 levels increased with the pathogenesis of PBC has a close relationship,which can pro-mote the reaction of PDC-E2 Th1 7/Treg immune imbalance caused thereby occurs mediated by PBC.