Adolescent ; Adult ; Electroacupuncture ; Female ; Garlic ; chemistry ; Humans ; Male ; Middle Aged ; Moxibustion ; Tuberculosis, Gastrointestinal ; therapy ; Young Adult

Hematopoietic Stem Cell Transplantation ; adverse effects ; Humans ; Male ; Middle Aged ; Purpura, Thrombotic Thrombocytopenic ; etiology ; Transplantation, Autologous

Objective To explore and establish a kind of dissertation evaluation system which can fully reflects the characteristics of academic medical doctoral training.Methods 41 medical doctoral dissertation evaluation systems and related literatures were collected,to get the current situation of this dissertation evaluation system in our country and find the key points of various evaluation systems.A questionnaire survey was conducted among 350 doctoral supervisors coming from 6 universities so as to define the framework and connotation of evaluation indicators.Using the Delphi expert consultation method,the connotation of evaluation indicators and composition as well as the weight of various indicators was improved.Results The doctoral supervisors who participated in the research considered that building the dissertation evaluation system should follow the principle of science,innovation and fairness,and the evaluation frame-work should have secondary index and evaluation elements.The evaluation contents concluded choosing topic,literature review,basic theory and professional knowledge,paper writing,innovation,research ability and academic morals and so on.And on the basis of this,the paper explored and developed a more scientific and comparative dissertation quality evaluation system with medical specialty.Conclusion The cultivation units should take the educational goal of evaluation target and the requirements of awarding degree into consideration,seeking opinions fully to the first-line supervisors and combing quantitative and qualitative evaluation effectively with scientific and operable principles when specifying evaluation system.

10.3969/j.issn.2095-4344.2013.25.007

Objective To investigate the epidemiologic features of HIV infections in voluntary blood donors in Zhejiang province.Methods A retrospective study was conducted in 206 cases of HIV-positive blood donors who were found from 2008 to 2010 by blood screening in Zhejiang Province,and the demographic data of those HIV carriers were analyzed using SPSS 16.0 software.Results The HIV-positive rates of voluntary blood donors in 2008,2009 and 2010 were 0.09‰(49/552 585 ),0.11‰( 64/601 639)and 0.15‰(93/600 893),respectively.There were five regions in Zhejiang province where HIV-positive rates exceeded 0.10‰,and the highest one was 0.21‰ in Wenzhou.HIV infection rate of male blood donors was 0.19‰,which was higher than that of female donors (0.02‰,x2 =96.21,P ＜ 0.01 ) ; donors with ages of ＞25-35 had the highest infection rate (0.19‰) among all age groups (x2 =41.94,P ＜0.01 ) ; blood donors with education of junior high school or lower had higher infection rate (0.21‰) than those with education of senior high school and undergraduate or above (0.11‰ and 0.02‰,x2 =78.62,P ＜0.01 ).Infection rate of first-time blood donors in 2008 was 0.12‰,higher than that of repeated donors (0.05‰,x2 =7.26,P＜0.01); while in 2009 and 2010,there was no difference between two groups (x2 =0.16 and 1.35,P ＞ 0.05 ).Blood donors who used mobile donation sites had higher infection rate than those using institutional donation (x2 =18.5,22.0 and 16.8 for 2008,2009 and 2010,P ＜0.01 ).Conclusions The risk of HIV infection is gradually increasing among voluntary blood donors in Zhejiang province.To ensure the blood safety,blood agencies should establish pre-donation health consultation for high-risk blood donors such as young men with low education.

Objective To assess right ventricular(RV) regional and global function in patients with repaired tetralogy of Fallot (TOF) by speckle tracking imaging (STI).Methods 36 asymptomatic patients with repaired TOF whose postoperative period is more than one year and 35 healthy controls were studied.RV longitudinal peak systolic strain (ε),strain rate (SRs) were measured in RV free wall and interventricular septum(IVS) for basal,mid and apical segments by STI from the apical 4-chamber view,RV global longitudinal peak systolic strain (GLS),strain rate (GLSRs),early diastolic strain rate (GLSRe) and late diastolic strain rate (GLSRa) were measured from the above view.The correlations between RV systolic functional parameters and the postoperative period,degree of pulmonary regurgitation (PR) and QRS duration were explored.Results ①Compared with controls,εand SRs of RV free wall and IVS for most segments,GLS,GLSRs,GLSRe,and GLSRa were significantly impaired in patients with repaired TOF (P ＜ 0.05 for all).Both GLS and GLSRs were lower in postoperative patients with transannular patch than in those with RV out tract patch.②In comparison with controls,GLS,GLSRs,GLSRe and GLSRa were decreased in postoperative patients with mild,mid and severe PR,Whereas,there was no difference in RV global function among the patients with varying degree of PR.③GLSRs of RV was correlated inversely with postoperative period and QRS duration(r1--0.431,P1 =0.009 ; r2 ==-0.469,P2-0.004),RV GLS and GLSRs had no correlation with PR.Conclusions RV regional and global function in patients with late repaired TOF are decreased,STI can early detect right ventricular dysfunction in asymptomatic patients with repaired TOF.The type of operation impacts on late prognosis,RV abnormal deformations are associated with electrical depolarization abnormalities.

Objective To probe into the clinical value of left atrial(LA) volme tracking method (LAVT) on the assessment of left atrial function in patients with hypertension. Methods Thirty-one patients with hypertension and 31 control subjects were involved. Images of apical two-chamber and four-chamber views were obtained by two-dimensional echocardiography. LA maximal volume (LAVmax), LA minimal volume (LAVmin), LA presystolic volume (LAVpre), systolic LA filling rate (dv/dtS), early diastolic LA emptying rate (dv/dtE) and late diastolic LA emptying rate (dv/dtA) were derived using LAVT. LA passive emptying volume(LAVp), LA passive emptying fraction(LAVpEF), LA active emptying volume(LAVa), LA active emptying fraction (LAVaEF), LA total emptying volume (LAVt), LA total emptying fraction(LAVtEF) were calculated. All volume measurements were corrected to body surface area (LAVI). Results There were significant differences in the LAVImax, LAVImin, LAVIpre, LAVpEF, LAVIa, LAVIt,dv/dtS, dv/dtA between hypertensive patients and control subjects(P <0.05~0.001), but no significant differences were found in the LAVp, LAVaEF, LAVtEF,dv/dtE between the two groups. The LAVImax has shown significant positive correlation with LAVIp, LAVIa and LAVIt(r = 0.588~0.812, P <0.001). LAVaEF has shown positive correlation with the LAVtEF(r = 0.833, P<0.001), whereas LAVpEF has not(r = 0.420, P <0.01). There was a significant positive correlation with LAVImax and LAVIpre(r = 0.908, P <0.001), LAVIpre and LAVIa(r = 0.689, P <0.001) ,dv/dtE and LAVIp(r = 0.690, P <0.001),dv/dtA and LAVIa(r = 0.600, P <0.001). Conclusions In hypertensive patients,left atrial reservoir function and booster pump function increase, while left atrial conduit function decreases. LAVT has a potential ability to evaluate left atrial function.

Objective To determine whether it could enhance gene delivery and tumor transfection in vivo by combination of ultrasound-targeted microbubble destruction(UTMD)with polyethylenimine(PEI)in tumor xenografts.Methods Two different reporter plasmid[lueiferase(pCMV-LUC)and red fluorescent protein(RFP)]were incubated with PEI to prepare cationic compound(PEI/DNA)in various nitrogen:phosphate ratios(N/P ratios,nmol of nitrogen in the PEI/nmol of phosphate in DNA).Formation of PEI/DNA complexes were confirmed by the gel retardation assay.Human cervical carcinoma(Hela)tumors were planted subcutaneously in both flanks of female nude mice.Tumor-bearing mice were administered by tail vein with PBS,plasmid,plasmid and Sono Vue microbubble,PEI/DNA and Sono Vue microbubble.One tumor was exposed to ultrasound irradiation (3 MHz,2 W/cm2,2 min exposure,duty cycle 20%),while the other served as control.The feasibility of targeted delivery and tissue specificity facilitated by UTMD and PEI was investigated.The mice were sacrificed 3 days after ultrasound exposure.Tissue specimens were viewed with microscopy to determine the presence of RFP expression.The efficiencies of luciferase transgene expression were determined.Histology analysis was detected.Results Electrophoresis experiment revealed that PEI was mixed with plasmid to condense DNA efficiently.The application of UTMD significantly increases the tissue transfection in vivo compared to plasmid alone.RFP expression was present in all sections of tumors that received ultrasound exposure but not in control tumors.Results of luciferase activity showed that the expression of luciferase was to be 14 times greater in ultrasound-exposed tumors(P＜0.01).More importantly,the increase in transgene expresgion was related to UTMD with the presence of PEI dramatically.At least 10-fold increase of luciferase gene transfer was obtained in irradiated tumors compared to non-irradiated controls(P＜0.01),111-fold increase compared to UTMD alone(P＜0.01).There was not significantly gene expression in other organs or tissues regardless of US exposure(P＞0.05).No tissue damage was seen histologically.Conclusions The combination of UTMD with PEI can enhance targeted delivery and expression of reporter gene to tumors at intravenous administration.It is a promising new and safe method for gene delivery in vivo.

Objective To investigate the diagnostic value of contrast-enhanced ultrasound (CEUS), and compare it with contrast-enhanced CT(CECT). Methods Eighty-one focal liver lesions were evaluated with CEUS and CECT, diagnostic value of two modalities were calculated, vaseularity manifestations of two modalities in arterial phase were compared. Results The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CEUS were 96.6 %, 86.9 %, 94.9 %, 90.9 %, 93. 80%, respectively, and the diagnostic value of CECT were 98.3%, 82. 6%, 93.4%, 95.0%, 93.8%, respectively. Among all the metastasis, hypervascular manifestation lesions in arterial phase of CEUS and CECT were 72% (18/25) and 32% (8/25)( P <0.05). Conclusions The diagnostic value of CEUS and CECT in focal liver lesions are comparably satisfying,and there is no significant difference between them, the combination use of two modalities would improve the diagnosis performance. CEUS can show more hypervaseular metastasis than CECT in arterial phase.

Objective To explore the optimal dose-effect relationship of gene transfer according to the expression of pEGFP in tumor cells under different parameters mediated by microbubble contrast agent and ultrasound in vivo.Methods C57BL/6J mice were inoculated subcutaneously in the middle of the right flank with hepal-6 tumor cells.The mixture of SonoVue and enhanced green fluorescent protein(EGFP)plasmid was injected into the tail vein of each mouse, groups were randomly established according to different output intensity( 1 W/cm2, 2 W/cm2, 3 W/cm2 ), exposure time ( 1 min, 5 min, 10 min) and volume of SonoVue(30 μl,60 μl,90 μl), the expression of EGFP in tumor cells under different parameter was examined by flow cytometry and fluorescence microscopy.Results The expression of pEGFP in tumor cells was significantly higher with the increase of exposure time,output intensity and volume of SonoVue (1 min vs 5 min, P＜0.05; 1 W/cm2 vs 2 W/cm2, P＜0.05 ; 30/μl vs 60 μl, P＜0.05).However, the transfection efficiency of EGFP can not be enhanced continuously with the increasing exposure time,output intensity and volume of SonoVue (5 min vs 10 min, P＞0.05; 2 W/cm2 vs 3 W/cm2, P＞0.05; 60 μl vs 90 μl, P＞0.05).The highest transfection effieieney was achieved under intensities was 2 W/cm2 [(21.02±1.45)%]with 5 min[(23.22±1.91)%] exposed to ultrasound, and 60 /μl SonoVue [ (21.02±1.45) % ].Conclusions Gene transfeetion efficiency changded with the difference parameters.2 W/cm2,5 min and 60 μl SonoVue led to the optimum dose-effect relationship of gene transfer in vivo .