Objective To evaluate the clinical significance of prostatic hypoechoic lesions on transrectal ultrasound(TRUS) for prostate cancer detection Methods 438 patients referred to our hospital between August 1999 and August 2006 for biopsy of the prostate.Every patient received 6～13 biopsy cores of the prostate.If a hypoechoic was identified,the biopsy was taken from this lesion.Correlation between hypoechoic lesions,isoechoic areas and cancer detection for each core was performed.Results Among 438 patients,cancer was detected in 112(25.6%) patients.Hypoechoic lesions were seen in 75(67%)patients with prostate cancer,the isoechoic areas in 37(33%).A total of 3504 biopsy cores were obtained from 438 patients.Among them,636 biopsy cores were taken from hypoechoic lesions.163(25.6%)biopsy cores taken from hypoechoic lesions harbored cancer and 473(74.4%) had no cancer.The cancer detection rate was similar in patients with hypoechoic lesions on TRUS or not,25.4%(75/298)and 26.4%(37/140)respectively.The difference was not statistically significant(P

Objective To investigate the effect of ischemic preconditioning ( IP) on the content of myocardial mitochondria cardiolipin and the heart function in isolated rat hearts. Methods Seventy-two healthy SD rats of both sexes ( 36 males,36 females) weighing 200 to 300 g were randomly divided into 4 groups ( n =18 for each group) : normal group,control group,IP group ( IP) and 5-hydroxydecanoate ( 5-HD) plus IP group ( HD) . Langendorff apparatus were used to establish the model of ischemia/reperfusion in isolated rat hearts. The hearts were perfused for 20 min to get stabilization followed by continuous perfusion in normal group for 100 min. In control group,after perfusing of 20 min for stabilization followed by continuous perfusion for 30 min,the hearts were then reperfused for 30 min after 40 min ischemia. In IP group,the hearts were given a 5-minute ischemia and 5-minute reperfusion for twice in order within a brief intermittent period,and ischemia reperfusion was carried out in the same way as that in control group. In HD group,the hearts were perfused with 100 ?mol/L 5-HD before IP,and the following procedures were carried out as those in IP group. HR,left ventricular end-diastolic pressure ( LVEDP) ,left ventricular developed pressure ( LVDP) were recorded at the end of stable perfusion ( T1) ,immediately before ischemia ( T2) and at the end of reperfusion ( T3) in all the groups. The content of myocardial mitochondria cardiolipin was measured with HPLC. Results When theparameters at T3 were compared with those at T1 and T2,HR and LVDP were decreased,LVEDP was increased and the content of myocardial mitochondria cardiolipin was decreased. All these changes were significant ( P

To intensify the medical students' clinical skills training is the main objective of medical education,and it can promote the reform of clinical teaching.In the whole process of clinical practice,we have adopted means of teaching before receiving clinical practical training,estimating indexes of examine,making use of diversified clinical skill training,supervising clinical practical quality.The operation ability of medical students has greatly increased.

Objective Structured Clinical Examination(OSCE) is a model of clinical skills examination.We have applied OSCE in the graduate examination of medical colleges for three years.There are different requests for training teachers and Standardized Patients(SP),setting exam place,examiners and students and so on.OSCE is worth spreading as clinical ability examination in other medical education.

Objective To investigate the effect of hydrogen sulfide postconditioning on the systolic function of left ventricle during myocardial ischemia-reperfusion (IR) in rats. Methods Part Ⅰ Adult male SD rats weighing 200-250 g were anesthetized with pentobarbital 40 mg/kg and heparin 250 U/kg. Their hearts were excised and perfused in a Langendorff apparatus with K-H solution saturated with 95% O2-5% CO2 at 37 ℃. Forty isolated rat hearts were randomly divided into 5 groups ( n = 8 each) after 20 min of equilibration: control group (group C); IR group; sodium hydrosulfide 1,10, 100 μmol/L postconditioning group (group SP1, SP10, SP100 ).In group Cthe hearts were perfused continuously for another 100 min. In group IR, the hearts were reperfused for 60 min after 40 min ischemia induced by 10 ml/kg ST. Thomas solution. In group SP1 , SP10 and SP100 the hearts were perfused with K-H solution containing sodium hydrosulfide 1, 10, 100 μmol/L for 2 min before reperfusion.LVDP and ± dp/dtmax were recorded at the end of equilibration and reperfusion. Part Ⅱ Cardiomyocytes were isolated from the male SD rats (weighing 200-250 g) and then cultured in CO2 incubator for 4 h. Sixty-four dishes of cultured myocytes were randomly divided into 4 groups( n = 16 each): control group (group C), hypoxia/reoxygenation group (group HR), hydrogen sulfide postconditioning group (group SP) and hypoxia postconditioning group (group HP). Group C were cultured continuously for 2 h. Group HR, SP and HP were exposed to 1 h hypoxia (95%N2-5%CO2 ) followed by 1 h reoxygenation. In group SP 10 μmol/L sodium hydrosulfide was added and the myocytes were then incubated for 2 min before reoxygenation. In group HP the cultured myocytes were expased to 3 min reoxygenation followed by 3 min hypoxia for 3 times before the 1 h reoxygenation. Mitochondrial membrane potential and F-actin expression were determined. Results Part Ⅰ Compared with group C, LVDP and ± dp/dtmax were significantly decreased at the end of reperfusion in group IR (P ＜ 0.05), while no significant difference was found in group SP1 , SP10 and SP100(P ＞0.05). Compared with group IR, LVDP and ± dp/dtmax were significantly increased in group SP ( P ＜ 0.05). There was no significant difference in LVDP and ± dp/dtmax among group SP1, SP10 and SP100(P ＞0.05). Part H Compared with group C, the mitochondrial membrane potential was significantly decreased in group HR and HP, and the expression of F-actin was significantly up-regulated in group HR, SP and HP ( P ＜ 0.05). Compared with group HR, the mitochondrial membrane potential was significantly increased and the expression of F-actin up-regulated in group SP and HP ( P ＜ 0.05 ). There were no significant difference in the mitochondrial membrane potential and expression of F-actin between group SP and HP ( P ＞0.05).Conclusion Hydrogen sulfide postconditioning can improve left ventricular systolic function during IR in rats by stabilizing mitochondrial membrane potential and promoting aggregation of F-actin.

Objective To evaluate the effectiveness and safety of ultrasound-enhanced thrombolysis for acute ischemic stroke.Methods Fifty stroke patients with acute middle cerebral artery occlusion were randomly divided into either a ultrasound-enhanced thrombolysis group (recombinant tissue-plasminogen activator [rtPA] +2 MHz ultrasound monitoring for 2 h) or a standard thrombolysis group (rtPA alone).The demographic characteristics,vascular risk factors,blood pressure before treatment,thrombolysis in brain ischemia (TIBI) grade before thrombosis,and vascular occlusion site of the patients were collected.The primary outcome endpoint was the good outcome rate (defined as the modified Rankin Scale score 0-1) at 3 months.The secondary outcome endpoints were complete recanalization at 2 h after thrombolysis,sustained complete recanalization,symptomatic intracerebral hemorrhage,and mortalitY.Results The good outcome rate of the ultrasound-enhanced thrombolysis group at 3 months after treatment was significantly higher than that of the standard thrombolysis group (64％ vs.36％;P=0.011).The sustained complete recanalization rate (40％ vs.8％;P =0.018) and complete recanalization rate (48％ vs.12％;P =0.012) of the ultrasound-enhanced thrombolysis group were significantly higher than those of the standard thrombolysis group,but there were no significant differences in the reocclusion rate (8％ vs.12％;P =0.637),incidence of symptomatic intracerebral hemorrhage (4％ vs.4％;P=1.000),and mortality (4％ vs.4％;P=1.000) compared with the standard thrombolysis group.Conclusions Ultrasoundenhanced thrombolysis can improve the sustained complete recanalization rate,complete recanalization rate,and good outcome rate after using rtPA within 2 h,and it does not increase the risks of symptomatic cerebral hemorrhage and death.It is a safe and effective adjunctive thrombolytic therapy.

Objective To investigate the effect of hypoxic postconditioning and diazoxide postconditioning on the calreticulin expression during hypoxia/reoxygenation (H/R) in rat cardiomyocytes. Methods Primary cultured male SD rat cardiomyocytes were randomly divided into 6 groups (n = 8 each): control group (group C),H/R group; hypoxic postconditioning group (group HP) and diazoxide postconditioning group (group DP). Group C were cultured continuously for 2 h. Group H/R, Hp and DP were exposed to 45 min hypoxia (95% N2-5% CO2)followed by 1 h reoxygenation. In group HP, the cells were subjected to three cycles of 3 min hypoxia at 3 min intervals at the end of 45 min hypoxia before 1 h reoxygenation. In group DP, diazoxide 50 μmol/L was giyen at the end of hypoxia. Caspase-3 activity, calreticulin expression and intracellular free calcium ion concentrations were determined. Results Compared with group C, caspase-3 activity was significantly increased in the other groups,the calreticulin expression was up-regulated in group HP and DP, and the free calcium ion concentrations were increased in group H/R (P ＜ 0.05 or 0.01). Compared with group H/R, caspase-3 activity was significantly decreased in HP and DP, the calreticulin expression was up-regulated and the free calcium ion concentrations were decreased in group HP and DP (P ＜ 0.01). Conclusion Hypoxic postconditioning and diazoxide postconditioning attenuate H/R injury in rat cardiomyocytes through up-regulating the expression of calreticulin and reducing intracellular calcium overload.

Objective To compare radiation doses to patients between rotational angiography and standard angiography.Methods According to different modes,our experiment was divided into RA (Dual-axis Rotational Angiography) group and SA (Standard Angiography) group.The latter was divided into 3 subgroups (SA1,SA2 and SA3) in terms of different time of cine.The procedure time and the position were controlled by the order preset into the machine.Each group consisted of 10 repeated operations with a unique phantom to simulate the true patients.The radiation doses were measured by using dose meter provided by the machine and TLD system; the means of the data were compared.Results The mean of total accumulated DAP and AK in group RA were 3 061.6 mGy·cm2 and 64.2 mGy,respectively,compared with group SA1 (4 213.9 mGy·cm2 and 85.5 mGy),SA2 (6 436.0 mGy·cm2 and 112.2 mGy),SA3 (12 810.4 mGy·cm2 and 243.7 mGy).The mean of accumulated dose in group RA was 37.70 mGy,higher than group SA1 (26.56 mGy) but lower than group SA2 (46.86 mGy) and SA3 (77.79 mGy).The gap between highest dose and lowest dose in RA group was insignificant whereas significant in the subgroups of SA.Conclusions In comparison with conventional angiography,the dual-axis rotational angiography has the potential to reduce radiation exposure of patients significantly so as to prevent skin radiation injures.

Objective To investigate the effect of α7 nicotinic acetylcholine receptor(α7nAChR) agonist agent PNU282987 on bone cement particles stimulated secretion of inflammatory cytokines in peripheral blood monocytes and its molecular mechanism.Methods Mouse peripheral blood monocytes were isolated and the inflammatory response were induced by PMMA particles.TNF-α, IL-1β and IL-6 concentration in culture supernatant were measured by ELISA.TNF-α, IL-1β and IL-6 mRNA expression were measured by RT-PCR.p-p65, p65, p-JAK2, JAK2, p-STAT3, STAT3, and β-actin expression were detected by Western blot.NF-κB DNA binding activity were measured by ELISA.ResultsAfter stimulation of PMMA particles, TNF-α, IL-1β and IL-6 concentration in culture supernatant was significantly increased(P<0.05), TNF-α, IL-1β and IL-6 mRNA expression was significantly increased (P<0.05), p-p65, p-JAK2 and p-STAT3 expression and NF-κB DNA binding activity was also increased significantly (P<0.05).However, after PNU282987 treatment, TNF-α, IL-1β and IL-6 concentration in culture supernatant decreased(P<0.05), TNF-α, IL-1β and IL-6 mRNA expression decreased in a concentration gradient way(P<0.05), p-p65, p-JAK2 and p-STAT3expression and NF-κB p65 DNA binding activity was also decreased(P<0.05).Conclusions α7nAChR agonist PNU282987 significantly inhibites PMMA bone cement particles induced secretion of inflammatory cytokines in peripheral blood monocytes of mice.

Objective:To evaluate the efficacy and safety of multimodal endovascular therapy for acute ischemic stroke in elderly patients.Methods:A total of 263 elderly patients with acute ischemic stroke were enrolled as research subjects from January 2017 to December 2018.Patients were divided into two groups: the intravenous thrombolytic therapy group and the endovascular therapy group.Treatment outcomes were compared by using the National Institutes of Health Stroke Scale(NIHSS)and the modified Rankin Scale(mRS).Results:Of 263 patients, 125 were in the intravenous thrombolytic therapy group and 138 were in the intravascular therapy group.The rate of good/excellent outcomes was higher in the endovascular treatment group than in the intravenous thrombolytic therapy group(97.8% vs.91.2%, χ2=5.713, P<0.05). The NIHSS score and mRS score were lower in the endovascular treatment group than the in intravenous thrombolytic therapy group[(2.3±0.3) vs.(6.0±1.8), (1.1±0.1) vs.(2.3±0.3), t=9.067 and 16.970, P<0.05]. There was no significant difference in the incidence of adverse reactions between the two groups(8.6% vs.8.0%, χ2=0.041, P>0.05). Conclusions:Multimodal mechanical thrombus retrieval is a safe and effective treatment for intracranial large vessel occlusion in acute ischemic stroke patients and should be recommended and promoted.