Under the guidance of the learning theory of constructivism,the mode of curriculum educational reform is designed and experimented on the"acupuncturology" on-line study website using the method of action research.The action experiment contains 3 kinds of different teaching modes: the teaching center mode,the study center mode and teacher donimated-students centered mode.A whole process intervention to question senses is carried on.The relative theoretical basis and problem-solving research methods are found out during the experiment.Phase summary is formed and the teaching project is constantly revised and become perfect.

Objective To explore the dynamic spiral CT findings of adrenal ganglioneuromas and to evaluate its clinical value.Methods All 7 cases patients with adrenal ganglioneuromas confirmed by surgical pathology underwent spiral CT plain scanning and two phases dynamic enhancement scanning before operation.The CT images were reviewed and analysed retrospectively in comparison with surgical and pathological results.Results Six of 7 lesions were located in the right adrenal gland,1 in the left.The diameter of the tumors was 3.7—7.5cm,with a mean diameter of 4.6cm.The CT value of the plain scans, AP phases and PVP phases was 16.2—31.7 HU(with a mean value of 24.3 HU),20.9—36.6 HU(with a mean value of 30.2 HU),and 27.4—45.5 HU(with a mean value of 36.0 HU),respectively.The masses were well defined and showed a tendency of wedging into the space between the adjacent organs and structures and encasing the large vessels such as IV,but didn't compress or occlude them.Conclusion The dynamic SCT features of adrenal ganglioneuromas were obvious,dynamic SCT scans could suggest the diagnose.

Actins ; immunology ; metabolism ; Antibodies, Monoclonal ; metabolism ; Child ; Diagnosis, Differential ; Fibroma ; metabolism ; pathology ; surgery ; Follow-Up Studies ; Gastrointestinal Neoplasms ; metabolism ; pathology ; Gastrointestinal Stromal Tumors ; metabolism ; pathology ; Humans ; Leiomyoma ; metabolism ; pathology ; Male ; Pyloric Antrum ; pathology ; Stomach Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

ObjectiveTo investigate the correlationship between clinical and histopathological results of adrenocortical hyperplasia,adenoma and adenocarcinoma in the adrenocortical glomerular,fascicular and reticular zones. MethodsA total number of 167 702 surgical specimens were collected by the Department of pathology at the General Hospital of Tianjin Medical University from 1993 -2008.Of these,there were 631 adrenocortical specimens.Statistic analysis was done with Run test,t or t'test and x2 test on data in the aspects of proportion rate,mean age,sex proportion and relationship between clinical and pathological results of adrenocortical diseases.ResultsThe total number of adrenal diseases and adrenocortical diseases were 910 cases (0.54％) and 631 cases (0.38％),respectively.The number of adrenocortical glomerular,fascicular,reticular diseases were 310 cases (49.13％),319 cases (50.55％) and 2 cases (0.32％),respectively.The rate of adrenal diseases and adrenocortical diseases specimens did not change during the 16 year study period.The trend in proportion of hyperplasia,adenoma,adenocarcinoma in adrenocortical glomerular,fascicular and reticular zones did not change as well.The proportion pattern showed that there were more cases of adenoma than of hyperplasia and adenocarcinoma.The functional diseases of adrenocortical glomerular,fascicular and reticular zone (90.97％,79.00％,100.00％ ) were higher than nonfunctional diseases in the corresponding zones (9.03％,21.00％,0％ ) and both were higher in female patients.The mean age of nonfunctional patients with adenoma,glomerular zone adenocarcinoma and hyperplasia,adenoma of fascicular zone was higher than that in functional diseases.Interestingly,the mean age of glomerular zone adenocarcinoma patients (62.7 yrs) was higher than that in hyperplasia patients (47.8 yrs) and in adenoma patients (44.8 yrs).The mean and male diagnostic ages of adenocarcinoma of fascicular (44.3 yrs,50.0 yra) were higher than that in adenoma (44.0 yrs,49.1 yrs) and hyperplasia (41.5 yrs,40.9 yrs) respectively.But the female mean diagnostic age of fascicular adenocarcinoma (38.7 yrs) was lower than that in adenoma (42.4 yrs) and hyperplasia (41.9 yrs) respectively and the lowest average age was for nonfunctional adenocarcinoma (34.4 yrs).The diameters of the functional and nonfunctional adenocarcinoma were large (4.3 cm and 4.0 cm in glomerular zone,7.1 cm and 8.0 cm in fascicular zone).The carcinoma cells were in serious atyrpia,haemorrhage,necrosis and capsular or vascular infiltration.The rates of functional hyperplasia,adenoma with hypertension in Conn,Cushing or adrenogenital syndrome of adrenocortical glomerular,fascicular,reticular zone were higher than that without hypertension,but their tumor diameters were similar.The diameters of functional adenoma in glomerular or fascicularer ( 1.7 cm,2.3 cm ) were lower than that of nonfunctional adenoma (2.3 cm,2.4 cm ) and the diameters of glomerular tumors were smaller than that of fascicular tumors.Nonfunctional adenoma ( 2.5 cm,2.0 cm ) of glomerular or fascicular by check up finding were bigger than that of non-endocrine adenoma ( 2.5 cm,2.3cm).There were seven cases with adrenogenital syndrome (2 male cases,5 female cases ),among these,there were 4 fascicularer adenoma cases,1 adenocarcinoma case,1 network hyperplasia case and 1 adenoma case.ConclusionsGenetic abnormality plays an important role in pathogenesis of adrenocortical disease and environment had less influence.Radiological examinations (CT and MRI) of adrenocortical diseases are the first choice and have important roles in evaluating tumor characteristics.There is close relationship between clinical manifestation and pathology.However,the exact diagnosis of definite type of disease and nature of tumor needs to be made by pathologic examination.

Humans ; MicroRNAs ; Muscle, Smooth, Vascular ; Myocytes, Smooth Muscle ; Phenotype

Background A main cause of visual impairment in proliferative diabetic retinopathy (PDR) is vitreous hemorrhage and retinal detachment due to contraction of fibrovascular membrane.To explore the pathogenic mechanism of fibrovascular membrane is a new target for the prevention and management of PDR.Objective This study was to determine the change in expression of vascular endothelial growth factor (VEGF),connective tissue growth factor(CTGF) and pigment epithelium derived factor(PEDF) in the proliferative membranes of patients with PDR after intravitreal injection of avastin,an anti-VEGF agent.Methods This study was approved by the Medical Ethic Committee of Tianjin Medical College,and written informed consent was obtained from each patient before enrollment.A prospective randomized-controlled study was designed.Twenty-six eyes of 24 patients with PDR scheduled for surgery were enrolled from January to June,2008 in Tianjin Medical College Eye Hospital.The patients were randomized into the simple vitrectomy group and avastin injection combined with vitrectomy group,with matched gender,age and disease duration.1.25 mg (0.05 ml) of avastin was intravitreally injected prior to surgery,and vitrectomy was performed 10 days after injection in the avastin injection combined with vitrectomy group,and only vitrectomy was given in the simple vitrectomy group.Preretinal membrane was collected during the surgery.Expression of VEGF,CTGF and PEDF in the preretinal membranes was assayed by immunochemistry.Results VEGF,CTGF and PEDF were expressed in the cytoplasm.The rate of VEGF expression in the preretinal membranes was 30.77％ in the avastin injection combined with vitrectomy group,showing a significant reduction in comparison with the simple vitrectomy group(100.00％)(U =4.000,P＜0.01).The rate of expression CTGF was remarkable elevated in the avastin injection combined with vitrectomy group compared with the simple vitrectomy group (92.31％ vs.62.54％)(U=7.500,P=0.048).However,no significant difference was found in the expression rate of PEDF between the two groups(100.00％ vs.92.31％) (U =65.500,P =0.299).Conclusions The results suggest that intravitreal injection of anti-VEGF drugs resulted in the decrease of VEGF expression and increased CTGF expression in proliferative membranes from patients with PDR.

AIMTo investigate the liver X receptors agonists T0901317's effect on expression of FAT/CD36 gene mRNA in adult human skeletal muscle cell.

METHODSMyotubes from humans were exposed to different T0901317 concentrations (0, 0.5, and 1.0 micromol/L) for 24 hours before experiments were performed. Then the expression of FAT/CD36 mRNA in skeletal muscle cell of each experimental group was detected by SYBR Green I real-time quantitative polymerase chain reaction. The relative data were compared among groups by 2-delta delta Ct method.

RESULTS(1) The Ct mean of control group, T0901317 (0.5 micromol/L) group, T0901317 (1 micromol/L) group were analyzed and there was significant difference (P < 0.01). (2) The expression of FAT/CD36 mRNA with liver X receptors agonists T0901317 in human skeletal muscle cell in the T0901317 (0.5 micromol/L) group and T0901317 (1 micromol/L) group were 2.91 times and 3.03 times than the control group.

CONCLUSIONThe expression of FAT/CD36 mRNA in human skeletal muscle cell afer the treatment of liver X receptors agonists T0901317 is increased, so we may propose that T0901317 may increase the risk of resistance in adult human skeletal muscle.

Adult ; CD36 Antigens ; genetics ; metabolism ; Cells, Cultured ; Female ; Humans ; Hydrocarbons, Fluorinated ; pharmacology ; Liver X Receptors ; Male ; Muscle, Skeletal ; cytology ; metabolism ; Orphan Nuclear Receptors ; agonists ; RNA, Messenger ; genetics ; metabolism ; Sulfonamides ; pharmacology

Aim Kadsuraheteroclita ( Roxb ) Craib ( Schizandraceae) is a medicinal plant termed Xuetong in Chinese Tujia ethnomedicine. Xuetong possesses therapeutic effects of, in the terms of Chinese medical theories, reinforcing vital energy, promoting blood cir-culation, expelling wind-evil, and removing damp-e-vil, and has been long used for the prevention and treatment of rheumatic and arthritic diseases, especial-ly in the southern China. The HPLC analysis has iden-tified that the ethanol extract of Xuetong contains large-ly biologically active lignans and triterpenoids. Our previous studies have shown that KHS exhibits very fa-vorable safety profile and potent anti-inflammatory and analgesic activities. In the present study, we investiga-ted anti-arthritic effects and the possible mechanisms of Xuetongon adjuvant-induced arthritis ( AIA ) in rats. Methods AIA was established in male Sprague-Daw-ley ( SD ) rats as described previously, and animals were daily treated by gavage with Xuetong ethanol ex-tract ( 1. 0 g · kg-1 ) or vehicle ( 0. 3% CMC-Na ) throughout the 30-day experiment. The incidence and severity of arthritis were evaluated using clinical pa-rameters. On day 30, bone destruction of the arthritic joints was assessed by computed tomography( CT) and histopathological analyses. The serum levels of pro-in-flammatory cytokines TNF-α, IL-1β, and IL-6 were measured by ELISA. Results Treatment with 1. 0 g/kg Xuetong significantly inhibited the onset and pro-gression of AIA. The vehicle-treated rats all developed severe arthritis, while the incidence of AIA in the Xue-tong-treated rats was as low as 55%( P=0. 035 ) . The Xuetong -treated rats exhibited 1. 8 to 2. 3 fold reduc-tion of paw swelling, and gained 10 to 20% more body weight than the vehicle-treated AIA rats throughout the experiment. CT and histopathological examinations re-vealed that Xuetong markedly protected AIA rats from cartilage and bone destruction of joints. Moreover, the serum levels of TNF-α, IL-1β, and IL-6 were signifi-cantly decreased in the Xuetong-treated rats than the vehicle-treated AIA rats. Conclusions These data strongly support the clinical use of Xuetong for rheu-matic and arthritic diseases, and suggest that Xuetong is a valuable candidate for further investigation to be a new anti-arthritic drug with favorable safety profile.

Objective:The standard treatment for inoperable locally advanced esophageal cancer is concurrent chemoradiotherapy, but the survival was not satisfied. Nituzumab is a humanized IgG monoclonal antibody against EGFR. The purpose of this study is to investigate the toxicity and efficacy of concurrent chemoradiotherapy combined with nituzumab for locally advanced esophageal cancer.Methods:We retrospectively reviewed the clinical data of locally advanced esophageal cancer who were treated with concurrent chemoradiotherapy combined with nituzumab in Peking University Cancer Hospital from June 2015 to June 2020. Kaplan- Meier method was used for analysis. Results:Thirty Patients were enrolled this study.After a median follow-up of 22.5 months, The objective response rate was 93%. The 1-year, 2-year, 3-year overall survival rates were 83%, 57% and 41%, with the progression-free survival rates 75%, 47% and 32%, with the local-recurrence free survival rates 83%, 53% and 37%, with the metastasis-free survival rates 75%, 51% and 36%, respectively.The incidence of grade≥3 hematological toxicity was 32%. There were 16% patients experiencing grade≥3 esophagitis.Conclusion:The preliminary result of concurrent chemoradiotherapy combined with nituzumab is effective and safe for patients with locally advanced esophageal cancer.

OBJECTIVE: To select specific DNA aptamer for determining ketamine by FluMag-SELEX. METHODS: Based on magnetic beads with tosyl surface modification as solid carrier and ketamine as target, a random ssDNA library with total length of 78 bp in vitro was compounded. After 13 rounds screening, DNA cloning and sequencing were done. Primary and secondary, structures were analyzed. The affinity, specificity and Kd values of selected aptamer were measured by monitoring the fluorescence intensity. RESULTS: Two ssDNA aptamers (Apt#4 and Apt#8) were successfully selected with high and specific abilities to bind ketamine as target with Kd value of 0.59 and 0.66 μmol/L. The prediction of secondary structure was main stem-loop and G-tetramer. The stem was the basis of stability of aptamer's structure. And loop and G-tetramer was the key of specific binding of ketamine. CONCLUSION FluMag-SELEX can greatly improve the selection efficiency of the aptamer, obtain the ketamine-binding DNA aptamer, and develop a new method for rapid detection of ketamine.
Aptamers, Nucleotide/metabolism* ; DNA ; DNA, Single-Stranded/genetics* ; In Vitro Techniques ; Ketamine/metabolism* ; Oligonucleotides ; SELEX Aptamer Technique/methods*