Objective To investigate the periodic variety at the germ form, quantity, flagellar expression and activity of breath enzyme etc during the swarming motility of Proteus mirabilis (PM). Methods The 2, 3, 5-tetraphenyltetrazolium chloride (TTC), as indictor of breath enzyme, was added to the culture medium. Electronic microscope was adopted to observe the germ form and flagellar. Quantity of PM was measured by turbidimetry. Results During the PM growth and migration at LB medium, the germ quantity reduced and form changed from short and small to long and thin, flagellar got more and breath enzyme turned into inactive. Conclusion At the LB medium, PM in growth process appeared varieties in length of germ body, flagellar quantity and germs density, etc. PM in solid medium appeared wave motility, resulting from many factors including the environment, the signal transduction in cells and the density of germ.

Objective To evaluate the role of MR imaging (MRI) and MR cholangiography (MRC) for the diagnosis of hepatic hilar cholangiocarcinoma (HHC) and assessment of tumor resectability. [WT5”HZ]Methods [WT5”BZ] MRI and MRC were performed in 280 patients with obstructive jaundice from Mar.1997 to May.1999. The diagnosis of HHC was proved in 38 cases (13 6%, 38/280) by laparotomy and pathology. Imaging features and classification as related to surgical therapy of the tumor were analyzed. [WT5”HZ]Results [WT5”BZ] Tumor was identified in 24 out of 38 HHC cases. The contrast enhancement scanning further found tumors in 8 out of 14 HHC cases,with a total rate of tumor finding of 84% (32/38). MRI also suggested hepatic metastasis in 4 cases, portal vein invasion in 7 cases. MRC found hilar obstruction and dilatation of the intrahepatic biliary tree in all HHC cases. The surgical resection rate was 24%(9/38) including 4 cases of typeⅠ,3 cases of typeⅡ,1 of type Ⅲa and 1 of typeⅢb. Resection was impossible or not worthwhile in cases with hepatic metastasis, invasion of portal vein and/or hepatic artery. Conclusion [WT5”BZ]MRI and MRC plays an important role in the diagnosis of hepatic hilar cholangiocarcinoma and assessment of tumor resectability.

A strain of P. Aeruginosa,which was seperated from clinical environment ,shows a special characteristic . It keeps normal short rod shape when cultured at 37℃,however,it forms filament without pyocyanin producing when cultured at 25℃ overnight. The filaments will divide and form short rods,simultaneously,produce pyocyanin when culture time is prolonged to over 72h or culture temperature is raised to 37℃. The preliminary study indicates that this phenomenin has nothing to do with nutritive conditions and could the inbluenced by inoculating density and irradiating with ultraviolet rays The absence of pyocyanin was not the cause of filamentous formation by the test results.

Objective To investigate the correlation between bacterial cryptic growth cell(CGC)and irritable bowel syndrome(IBS).Methods The techniques of micro-culture and morphological observation were employed in examination of the CGC in feces specimens of patients suffering from IBS.Furthermore,the animal monitoring tests was applied in the aspects of CGC formation under inducing factors and colonization at local intestinal mucus.Results A great deal of CGC could be observed in the feces of IBS patients and exhibited continuous proliferation characteristics regardless of using or not using antibiotics.And the CGC in feces showed auto-lysis features when the patients suffered from the disease.The monitoring tests demonstrated that the antibiotics often used presently to IBS patients could induce the formation and colonization of intestinal bacterial CGC.Conclusion Based on the experimental and clinical data,we presume that there is a correlation between intestinal bacterial CGC and IBS.

With the development of social economy and the transformation of modern medical models as the background, this paper expounds the importance of improving medical students' doctor-patient communication ability in terms of that doctor-patient communication can be helpful for doctors to deeply understand the illness, make accurate diagnosis, improve doctor-patient relationship, and reduce medical disputes. By analyzing the current situation and existing problems of doctor-patient communication teaching at home and abroad, the paper puts forward some suggestions on strengthening the training of medical students' doctor-patient communication ability from four aspects: cultivating professional communication skills, establishing multi-disciplinary teaching teams, adopting diversified teaching forms and formulating systematic evaluation system.

The construction of hospital administration talent echelon has become a " bottleneck" problem in the core competence construction of county-level public hospitals in ethnic regions. West China-Mabian Medical Alliance has made a preliminary exploration on the cultivation of hospital management talents in county-level public hospitals. The hospital carried out the working principle of " setting up a talent pool by post" , and gradually established a reserve talent pool with suitable scale and dynamic adjustment by providing part-time project management positions for young employees in the hospital. There were three kinds of part-time project management positions: part-time assistant to president, part-time project supervisor and part-time department management assistant. In addition, the hospital strengthened the ideological and political education, medical management theory training and practical training of the reserve talents in a planned way. The practical experience of hospital reserve management personnel training based on West China-Mabian Medical Alliance can be used for reference by other county-level hospitals.

Objective:At present, the modified NIH classification commonly used in clinical practice is still insufficient for assessing the risk of postoperative recurrence in some patients with intermediate-high risk gastrointestinal stromal tumors (GIST). Through exploring risk factors for recurrence of intermediate-high risk GIST, this study establishes a predictive model for recurrence with more convenience and more precision in order to guide adjuvant therapy for intermediate-high risk GIST patients.Methods:A retrospective case-control study was carried out. Clinical and pathological data of 432 GIST patients who did not receive preoperative targeted treatment, underwent complete resection in the Union Hospital of Tongji Medical College of Huazhong University of Science and Technology from January 2005 to June 2018, and were diagnosed as intermediate- or high-risk based on modified NIH classification by postopertive pathology, were retrospectively analyzed. Cox regression model was used to idenitify independent risk factors of recurrence, and a recurrence risk scoring model was established. The receiver operating characteristic curve (ROC curve), consistency index (C-index) and calibration curve were used to evaluate the accuracy of the scoring model in predicting the recurrence of moderate-risk and high-risk GIST patients.Results:Among 432 GIST patients, 332 were diagnosed as high-risk and 100 as moderate-risk; 237 were males and 195 females with average age of (57.4±12.4) years. Of 432 patients, 211 cases (48.8%) had fibrinogen (FIB) >3.5 g/L; 85 cases (19.7%) had platelet to lymphocyte ratio (PLR)>272.5; 122 cases (28.2%) had neutrophil to lymphocyte ratio (NLR) > 4.2; 102 cases (23.6%) had systemic inflammatory reaction index (SIRI)> 2.7; 198 cases (45.8%) had tumor long diameter >8 cm and 108 cases (25.0%) had mitotic counts > 8/50 HPF. Cox multivariable analysis showed that FIB (HR=1.789, 95% CI: 1.058-3.027, P=0.030), PLR (HR=1.862, 95% CI: 1.067-3.249, P=0.029), SIRI (HR=1.790, 95% CI: 1.039-3.084, P=0.036), tumor long diameter (HR=1.970, 95% CI: 1.105-2.925, P=0.017) and mitotic counts (HR=2.187, 95% CI:1.211-3.950, P=0.009) were independent risk factors for recurrence in patients with middle-risk and high-risk GIST. These 5 factors were included in the risk scoring model, which was given a weight score of 58 points, 62 points, 58 points, 63 points, and 78 points, respectively. Patients with a total score of ≤ 78 points were classified as moderate-risk recurrence (group I), those of 78 to 136 points as high-risk recurrence (group II) and those of >136 points as very high-risk recurrence (group III). ROC curve showed that the area under the curve (AUC) of the scoring model was 0.730 and the C-index was 0.724 (95% CI:0.687-0.787). The calibration curves and the Kaplan-Meier curves of patients in the three groups revealed that this model had a good predictive accuracy. Conclusions:For intermediate-risk and high-risk GIST patients, the preoperative FIB >3.5 g/L, PLR > 272.5 and SIRI > 2.7 are independent risk factors of recurrence after surgery. The recurrence risk scoring model established by combining tumor long diameter, mitotic counts, FIB, PLR and SIRI can effectively predict the risk of postoperative recurrence and metastasis in moderate-risk and high-risk GIST patients.

Objective:At present, the modified NIH classification commonly used in clinical practice is still insufficient for assessing the risk of postoperative recurrence in some patients with intermediate-high risk gastrointestinal stromal tumors (GIST). Through exploring risk factors for recurrence of intermediate-high risk GIST, this study establishes a predictive model for recurrence with more convenience and more precision in order to guide adjuvant therapy for intermediate-high risk GIST patients.Methods:A retrospective case-control study was carried out. Clinical and pathological data of 432 GIST patients who did not receive preoperative targeted treatment, underwent complete resection in the Union Hospital of Tongji Medical College of Huazhong University of Science and Technology from January 2005 to June 2018, and were diagnosed as intermediate- or high-risk based on modified NIH classification by postopertive pathology, were retrospectively analyzed. Cox regression model was used to idenitify independent risk factors of recurrence, and a recurrence risk scoring model was established. The receiver operating characteristic curve (ROC curve), consistency index (C-index) and calibration curve were used to evaluate the accuracy of the scoring model in predicting the recurrence of moderate-risk and high-risk GIST patients.Results:Among 432 GIST patients, 332 were diagnosed as high-risk and 100 as moderate-risk; 237 were males and 195 females with average age of (57.4±12.4) years. Of 432 patients, 211 cases (48.8%) had fibrinogen (FIB) >3.5 g/L; 85 cases (19.7%) had platelet to lymphocyte ratio (PLR)>272.5; 122 cases (28.2%) had neutrophil to lymphocyte ratio (NLR) > 4.2; 102 cases (23.6%) had systemic inflammatory reaction index (SIRI)> 2.7; 198 cases (45.8%) had tumor long diameter >8 cm and 108 cases (25.0%) had mitotic counts > 8/50 HPF. Cox multivariable analysis showed that FIB (HR=1.789, 95% CI: 1.058-3.027, P=0.030), PLR (HR=1.862, 95% CI: 1.067-3.249, P=0.029), SIRI (HR=1.790, 95% CI: 1.039-3.084, P=0.036), tumor long diameter (HR=1.970, 95% CI: 1.105-2.925, P=0.017) and mitotic counts (HR=2.187, 95% CI:1.211-3.950, P=0.009) were independent risk factors for recurrence in patients with middle-risk and high-risk GIST. These 5 factors were included in the risk scoring model, which was given a weight score of 58 points, 62 points, 58 points, 63 points, and 78 points, respectively. Patients with a total score of ≤ 78 points were classified as moderate-risk recurrence (group I), those of 78 to 136 points as high-risk recurrence (group II) and those of >136 points as very high-risk recurrence (group III). ROC curve showed that the area under the curve (AUC) of the scoring model was 0.730 and the C-index was 0.724 (95% CI:0.687-0.787). The calibration curves and the Kaplan-Meier curves of patients in the three groups revealed that this model had a good predictive accuracy. Conclusions:For intermediate-risk and high-risk GIST patients, the preoperative FIB >3.5 g/L, PLR > 272.5 and SIRI > 2.7 are independent risk factors of recurrence after surgery. The recurrence risk scoring model established by combining tumor long diameter, mitotic counts, FIB, PLR and SIRI can effectively predict the risk of postoperative recurrence and metastasis in moderate-risk and high-risk GIST patients.

ObjectiveTo investigate the application value of narrative medical model in communication with cancer patients with low education level. MethodsRetrospective analysis was performed on 80 cancer patients with low education level who were hospitalized in West China Hospital of Sichuan University from March 2019 to April 2020. They were randomly divided into control group （n=40） and observation group （n=40）. The control group received conventional nursing intervention， while the observation group received narrative medical nursing mode intervention. Both groups received intervention for 6 months. The Self-rating Anxiety Scale （SAS）， Self-rating Depression Scale （SDS）， Morisky Medication Adherence Scale （MMAS-8）， Social Support Rating Scale （SSRS） and self-designed knowledge of the disease and cognition questionnaire were used for evaluation before and after intervention. ResultsAfter intervention， the SAS and SDS scores of observation group were lower than those of control group （t=7.493， 8.314， P<0.01）. After intervention， medication compliance of observation group was higher than that of control group （χ²=4.012， P=0.045）. SSRS subscale score and total score were higher than those in control group （t=2.198， 7.548， 2.664， 4.248， P<0.05 or 0.01）. After intervention， the mastery rate of knowledge about the disease and the excellent and good rate of cognitive behavior in observation group were higher than those in control group （χ²=4.588， 5.541， P<0.05）. ConclusionThe narrative medical model is of certain application value in communication with cancer patients with low education level. It can better improve the patients’ negative emotions， social support， and knowledge and cognition of the disease.

Irreversible destruction of bronchi and alveoli can lead to multiple incurable lung diseases. Identifying lung stem/progenitor cells with regenerative capacity and utilizing them to reconstruct functional tissue is one of the biggest hopes to reverse the damage and cure such diseases. Here we showed that a rare population of SOX9 basal cells (BCs) located at airway epithelium rugae can regenerate adult human lung. Human SOX9 BCs can be readily isolated by bronchoscopic brushing and indefinitely expanded in feeder-free condition. Expanded human SOX9 BCs can give rise to alveolar and bronchiolar epithelium after being transplanted into injured mouse lung, with air-blood exchange system reconstructed and recipient's lung function improved. Manipulation of lung microenvironment with Pirfenidone to suppress TGF-β signaling could further boost the transplantation efficiency. Moreover, we conducted the first autologous SOX9 BCs transplantation clinical trial in two bronchiectasis patients. Lung tissue repair and pulmonary function enhancement was observed in patients 3-12 months after cell transplantation. Altogether our current work indicated that functional adult human lung structure can be reconstituted by orthotopic transplantation of tissue-specific stem/progenitor cells, which could be translated into a mature regenerative therapeutic strategy in near future.
Bronchiectasis ; genetics ; metabolism ; Humans ; Pulmonary Alveoli ; cytology ; metabolism ; SOX9 Transcription Factor ; genetics ; metabolism ; Stem Cell Transplantation ; methods ; Stem Cells ; cytology ; metabolism