Humans ; Nephritis ; etiology ; therapy ; Prognosis ; Purpura, Schoenlein-Henoch ; complications ; therapy ; Sjogren's Syndrome ; etiology ; therapy

Current reform of higher medical education focuses on curriculum integration and corresponding reconstruction of teaching system. Chongqing Medical University has carried out the reform of medical personnel training mode from basic to clinical, which has achieved certain results. Three aspects including teaching content, teaching methods and appraisal system of the urogenital system curriculum integration are introduced in the paper. In the teaching content, the parts related to urogenital system in basic subjects and clinical subjects are extracted and integrated. In the process of teaching implementation, a teaching team is set up across departments and multidisciplinary joint teaching is carried out. In order to arouse the enthusiasm of students, inspire and cultivate students' scientific research thinking by improving teaching methods, several teaching methods such as case introduction teaching method, question discussion and debate meeting are used. Scientific evaluation system is used to observe and record the whole process of students' learning. Meanwhile, some existing problems and solutions of curriculum integration are discussed in the paper to provide references for peers in relevant colleges and universities.

Animals ; Base Sequence ; Gene Expression Regulation ; Humans ; MicroRNAs ; genetics ; metabolism ; Molecular Sequence Data ; RNA, Viral ; genetics ; Virus Diseases ; genetics ; metabolism ; virology ; Virus Physiological Phenomena ; Viruses ; genetics ; metabolism

Objective To summarize the clinical and pathological characteristics of primary gallbladder carcinoma, analyze factors such as surgical procedures, tumor stages that associated with prognosis, and standardize the diagnosis and treatment strategy for primary gallbladder carcinoma.Methods From January 1986 to October 2009, 197 patients of primary gallbladder carcinoma were treated in Peking Union Medical College Hospital (PUMCH). A retrospective study was performed basing on clinical data of these patients, statistical analysis carried out using SPSS version 13.0, Kaplan-Meier estimate employed for the survival analysis and Log-rank test for the group comparisons. Results One hundred and ninety-seven patients were enrolled (73 male and 124 female) with the mean age of 64.4±1.1years. Abdominal pain (77.3%) , obstructive jaundice (33.6%) and fever (19.5%) were the main symptoms of primary gallbladder carcinoma, with accompanying cholecystolithiasis in 99 cases. B-mode ultrasonic examination and CT scan were important for preoperative diagnosis. Nevin stages and surgical modalities were independent prognosis factors. For stage Ⅰ and Ⅱ patients the survival terms were not different between those receiving radical cholecystectomy and simple cholecystectomy. However, for stage Ⅲ, Ⅳ and Ⅴ patients the survival terms were of statistically different between those in radical cholecystectomy group and simple cholecystectomy group. Conclusions For stage Ⅰ and Ⅱ patients, simple cholecystectomy is a good surgical procedure. For those at more advanced stages, radical cholecystectomy is the choice of therapy, while simple cholecystectomy also improves the prognosis compared with laparotomy only.

Objective To summarize the clinicopathological features of ampullary cancer,and investigate the diagnosis and treatment strategy for ampullary cancer.Methods The clinical data of 187 patients with ampullary cancer who were admitted to the Peking Union Hospital from January 2000 to December 2010 were retrospectively analyzed.According to different surgical procedures applied,patients were divided into pancreaticeduodenectomy (PD) group (162 patients) and local resection group (25 patients).Survival curve was drawn by using Kaplan-Meier method,and the difference in survival rate between the 2 groups was compared by using Log-rank test.All data were analyzed by using t test or chi-square test.Results The positive diagnostic rates of B-ultrasound,computed tomography (CT),magnetic resonance imaging (MRI) and endoscopic retrograde cholangiopancreatography (ERCP) were 9.3％ ( 15/161 ),43.9％ (65/148),21.3％ (19/89) and 83.9％ ( 135/161 ),respectively.There were 87 patients with well differentiated adenocarcinoma,64 with moderate differentiated adenocarcinoma,27 with low differentiated adenocarcinoma and 9 with tubular canceration.There were no significant differences in survival rate between patients with ampullary cancer in T1 or T2 stage who received PD or local resection ( x2 =3.163,P ＞0.05).The prognosis of patients with ampullary cancer in T3 or T4 stage who received PD were superior to those who received local resection ( x2 =6.309,P ＜ 0.05 ).Conclusions Most of the ampullary cancer is well differentiated adenocarcinoma,and ERCP has a higher diagnostic rate than B-ultrasound,CT and MRI.Local resection is an ideal treatment for patients with ampullary cancer in T1 or T2 stage,while for patients with ampullary cancer in T3 or T4 stage,PD is the first choice of treatment.

In recent years,with the increasing of immunocompromised patients in clinical practice,invasive candidiasis has been increased accordingly. Although several antifungal drugs,including polyenes,azoles,5-flucytosine,and echinocandins,have been used widely to treat invasive candidiasis,the treatment failure that caused by the resistance of Candida albicans to these antifungal drugs have been reported widely. Here,we reviewed the molecular mechanisms of resistance to azoles,polyenes,5-flucytosine,and echinocandins,such that to provide an update on these issues.

Objective To study the relationship between genotypes and phenotypes,geographical distribution,and the sites of infection of Trichophyton rubrum(T.rubrum).Methods The genotypes were determined by Southern blotting with a probe amplified from the small-subunit rDNA and adjacent internal transcribed spacer(ITS)regions.The phenotypes of T.rubrum were determined by conventional method.Results Twenty genotypes(DNA type A to T)and5phenotypes(villous,furrowed,granular,powdery,and woolly)were recognized among49strains of T.rubrum.Genotype A prevailed in all phenotypes except granu-lar type.Type B represented the most common genotype among the strains of villous type and furrowed type.Type A took the first place in powdery type and woolly type.All of the type A strains were from Dalian.Seven of9type B strains were from Nanjing.Six type C strains were all from Nanjing.The majority strains of21strains isolated from tinea unguium were type C,most of the16strains isolated from tinea cruris and tinea corporis were type A,8strains from tinea pedis were type B,and4strains from tinea capitis were type C.Conclusion There are certain possible relationships between genotypes and phenotypes,geographical distri-bution and sites of infection of T.rubrum.

This study investigated whether the curative effect of short-pulse gastric electrical stimulation (GES) on the vasopressin-induced dyspeptic symptoms was mediated by central opioid peptide-producing neurons. Five female beagle dogs implanted with 1 pair of electrodes in gastric serosa were used in a two-experiment study. In experiment one, the brain was scanned by positron emission tomography in 3 dogs with and without short-pulse GES, and the radioactivity in nuclei of solitary tract (NST) and hypothalamus was detected. Experiment two was composed of 4 sessions. In session one, the dogs were injected with vasopressin in the absence of short-pulse GES. With session two, the short-pulse GES was simultaneously given via the electrodes with the injection of vasopressin. In sessions three and four, naloxone and naloxone methiodide was administered respectively in the presence of short-pulse GES. Motion sickness-like symptoms were scored and compared among the different sessions. The results showed that the short-pulse GES significantly increased the radioactivity in NST and hypothalamic nuclei (P<0.05, vs control). The short-pulse GES could ameliorate the vasopressin-induced motion sickness-like symptoms in dogs. Naloxone, but not naloxone methiodide could attenuate the curative effects of short-pulse GES. It is concluded that NST and hypothalamic nuclei may participate in the mediation of the curative effects of short-pulse GES on dyspepsia-like symptoms. Central opioid peptide-containing neurons presumably mediate the therapeutic effect on dyspeptic symptoms of short-pulse GES.

Objective To prospectively investigate the characteristics and correlative influential factors for the changes in pulmonary artery hypertension (PAH)in chronic kidney disease (CKD) patients without end-stage renal disease.Methods Complete clinical and laboratory data of 133 outpatients without ESRD (CKD stage 2,3 and 4)in Beijing Hospital between January 2012 and January 2013 were retrospectively analyzed.Pulmonary artery systolic pressure(PASP)was assessed by echocardiography according to the guideline from the American Society of Echocardiography in 2010,and PASP more than 35 mmHg(1 mmHg=0.133 kPa)was diagnosed as PAH.Results PAH was found in twelve(9.0 ％) patients,including 7 females and 5 males,with mean age(82.9 ± 5.4 years).The prevalence of PAH was 2.3％,10.9％ and 17.6％ in the patients of CKD stage 2,3 and 4(P＜ 0.05) respectively.PASP could be calculated in 67 patients in whom tricuspid regurgitation was present.The mean PASP was (27.1 ± 5.4) mmHg,(31.0 ± 8.3) mmHg and (37.3 ± 13.8) mmHg in patients with CKD stage 2,3 and 4,respectively(P ＜ 0.05).Body mass index(BMI),eGFR and BUN showed significant differences between PAH group and non-PAH group with statistical significance (P＜0.05).Multivariate logistic regression analysis revealed that the lower BMI and the higher stage of CKD were independent risk factors for PAH (P ＜ 0.05).Conclusions PAH is not a rare complication in the CKD patients without end-stage renal disease.The incidence of PAH is significantly associated with lower BMI and the higher stage of CKD.Doppler echocardiography should be performed periodically to detect PAH in CKD patients in order to improve the prognosis of these patients.

This study was aimed to explore brain regions which were closely related to the disease onset of premenstrual syndrome (PMS) with liver-qi depression. The BOLD-functional magnetic resonance imaging (fMRI) was used in the study. The processing of imaging data was based on the SPM 8 software and the REST software of the matlab platform. Each cluster was more than 389 continuous voxel. The brain region with single voxel of P < 0.05 (corrected) was defined as region with statistical significance. The 2 Sample T-Test was applied in the case group and the control group. The results showed that compared with the normal control group, the frontal lobe, occipital lobe, insula, limbic lobe, basal nuclei, and cingulate gyrus were activated in the PMS with liver-qi depression cases. It was concluded that the disease onset of PMS with liver-qi depression cases was related to brain regions such as frontal lobe, occipital lobe, insula, limbic lobe, basal nuclei, and cingulate gyrus.