Objective To prepare a radiofrequency (RF) ablation probe guided by endoscopic ultrasonography (EUS) and to evaluate its efficacy and safety. Methods A modified 19-gauge needle ( Olympus) was used, which was electrically insulated with shrink tubing, with the tip of lcm naked. The insulation was tested, and the current signal was stable. Three rabbits were anesthetized with 8% chloral hydrate ( 3 ml/kg) intraperitoneally, fixed on the dissecting table. A standard neutral pad was applied to the thigh of the rabbit to complete the electrical circuit, both the pad and the needle electrode connected with RF generator. After anesthesia was ready, the needle was advanced through the gastric wall into the liver. Ablations were performed three times in the same zone. Extent and tissue lesion were measured after ablation. Results Ablation could be successfully performed by the needle electrode, with brown lesions surrounded by normal hepatic tissue. The mean diameter of the ablated zone in the liver was 1.0 cm× 1.2 cm. After ablation,specimens along the passage were subjected to NADH staining, and no lesions were found. HE and NADH staining showed no viable cells in the central ablation area. Conclusion With the advance of the technology and selection of materials, an EUS-guided needle electrode can be made. This preliminary animal trial demonstrates that radiofrequency ablation can be performed effectively and safely by using this EUS-guided needle electrode.

Objective To investigate the relation between activator protein-1(AP-1)and coronary atheroselerotic changes and the potential role of AP-1 in the stabilization of atherosclerotic plaques in patients with coronary heart disease(CHD).Method 142 patients were included in this study and divided into CHD group(107)and control group(35)according to coronary angiography(CAG).The CHD group was further divided into a stable angina pectoris(SAP)group(32)and all acute coronary syndrome(ACS)group (75)according to the clinical manifestations.In addition,the CHD group was divided into A type group,B type group and C type group according to the standard of ACC/AHA coronary change in 1988.Meanwhile,the CHD group was further divided into light stenosis group,moderate stenosis group and severe stenosis group according to the degree of coronary lesion.The lysate of cells was obtained through lysis of the leucocyts from peripheral blood with cell lysis buffer.The amount of Phospho.c-Jun in lysate was measured with enzyme-linked immunosorbent assay(ELISA).The results were demonstrated with absorbance,which reflects the amount of AP-1.Results The main coronary changes in the SAP group were A type(68.7%)and the changes were mainly of light degree(53.1%);the main coronary changes in the ACS group were B type(52.0%)or C type(37.3%)and the changes were mainly of heavy degree(66.7%).The absorbance of Phospho-c-Jun in CHD group was significantly higher than that in the control subjects (1.43±0.33 vs 0.71±0.13,P＜0.001).The absorbance of Phospho-c-Jun in the ACS group was significantly higher than that in the SAP group(1.56±0.28 vs 1.14±0.25,P＜0.001).The absorbance of Phospho-c-Jun increased gradually from A type group to C type group(1.18±0.27 vs 1.42±0.26 vs 1.71±0.27,P＜0.001)and from light stenosis group to severe stenosis group(1.09±0.20 vs 1.37±0.26 ys 1.60±0.29,P＜0.001).Conclusion There is a significant relationship between AP-1 and coronary atherosclerotic changes.AP-1 may be a factor that can predict coronary arteriosclerotic progression and stability of the plaque.

Objective To investigate the relationship between the plasma adiponectin concentration and coronary arteriosclerosis change in patient with coronary heart disease(CHD).Method 142 patients were divided into CHD group and control group according to the Coronary Angiography(CAG).CHD group were further divided into stable angina pectoris(SAP)subgroup and acute coronary syndrome (ACS)subgroup according to the clinical property.According to the type of coronary change,CHD group wag divided into A type group, B type group and C type group,meanwhile according to the degree of coronary lesion,CHD group was divided into light stenosis group, moderate stenosis group and severe stenosis group.The plasma adiponectin concentration was measured by ELISA.Results The plasma adiponectin concentration in CHD group was significant lower than that in control group.The plasma adiponectin concentration in ACS subgroup was significant lower than that in SAP subgroup.The plasma adiponectin concentration decreased gradually from A type group to C type group and from light stenosis group to severe stenosis group(P＜0.001).Conclusions Adiponectin is a negative regulatory factor of coronary atherosclerosis,and Hypoadiponectin may be used to predict the change of coronary arteriosclerosis and the stability of plaque.

Objective To establish a stable model of rat orthotopic left lung transplantation using direct suture of vessels and bronchi. Methods Ten Sprague Dawley (SD) rats weighted 250 to 350 g were used as lung donors and recipients respectively. Airway and pulmonary vessels were reconstructed microsurgically using continuous running suture technique. Survival time were recorded and donor lungs were checked by autopsy. Results All 10 rats received left lung transplantation were weaned from ventilator successfully. Both of cold ischemia time and warm ischemia time were about 40 minutes. The total procedure took about 130 minutes. Autopsy was used to check the patency of anastomotic sites. No thrombosis or air leak was found. Conclusions Direct microsurgical surture can be used to establish an experimental model of orthotopic left allograft lung transplantation in rats. This method is proved to be stable, reliable and similar to clinical practices.

Objective To explore the effect of nurse-social worker-college student volunteer team guide on care-giving competence of the primary caregivers for the long-term bedridden elderly. Methods The research was conveniently focused on a total of 60 long-term bedridden elderly and 30 primary caregivers, pension caregiver in welfare home from March to May 2015. The nurse-social worker-college student volunteer team guide for the primary caregivers included distributing health manual, training skill, psychological support, respite care and so on. The intervention lasted for 3 months, twice a month, 150 minutes each time. This was a self comparison study. The care competence for the primary caregivers and self-care ability of daily activities for the long-term bedridden elderly were conducted before and after intervention. Results Before intervention, the total score of care-giving competence was 59.07 ± 13.42. After intervention, the total score was 66.64 ± 14.16. Before intervention, the scores of caring knowledge, operation technique, behavior and attitudes, decision-making and self-efficacy were as follows:18.48±3.46, 17.95±3.98, 12.16±3.08, 7.98±2.56. Whereas, after intervention, the scores were as follows:20.32±3.58, 20.48±2.74, 14.29±3.03, 9.65±2.07. Each dimension score after intervention was significantly higher than that before intervention (t=-2.87--2.02, P<0.01). For bathing, dressing, indoor transferring and eating in self-care ability of daily activities, the numbers of people in 60 long-term bedridden elderly were 8, 13, 21, 18 before intervention and 17, 24, 43, 29 after intervention. The self-care ability of daily activities of the primary caregivers such as bathing, dressing, indoor transferring and eating after intervention were significantly higher than that before intervention (χ2=4.093-4.857, P<0.05). Conclusions Nurse-social worker-college student volunteer team guide can enhance the care-giving competence of the primary caregivers as well as improve the self-care ability of daily activities for the long-term bedridden elderly.

Objective To analyze the results of the Objective Structured Clinical Examination(OSCE) of medical interns in Department of Gynecology and Obstetrics,and to assess the role of OSCE in clinical teaching and practice. MethodsAtolal of 104 medical interns of five-year education program in 2002 and seven-year education program in 2003 in School of Medicine had taken part in OSCE of gynecology and obstetrics.The OSCE consisted of six stations: gynecologic examination,obstetric examination,oral test,interrogation of standardized-patients(SP),drawing partogram,and non-stress test(NST) explanation.After gathering the data of each station,the software of SPSS 11.0 was used to make statistical analysis. Results The median scores were as follows: 92.0 for gynecologic examination,91.0 for obstetric examination,83.5 for oral test,80.0 for interrogation of SP,80.0 for drawing partogram,and 70.0 for NST explanation.There was no significant impact of familiarity to OSCE on the results of the test.The results showed that medical interns did good job in basic performance,but lack of clinical practice skills in some complicated practice of gynecology and obstetrics.Conclusion The grading system and stations setup of OSCE in Department of Gynecology and Obstetrics in Shanghai Sixth People's Hospital show objectivity and equity.The OSCE can be widely applied in the after-department examination and even graduation examination.

Objective To evaluate the CT findings of pancreatic carcinoid tumors.Methods The CT imaging data of five patients with pancreatic carcinoid tumors confirmed by pathology were retrospectively analyzed.Results The tumors ranged in maximum diameter from 2.0 to 11.0 cm with a mean of 6.4 cm. On unenhanced CT,the tumors were slightly hypodense relative to the pancreatic parenchyma,homogenous in 2 cases,and heterogenous in 3 cases.One tumor showed calcification.After contrast material injection, the solid component of the tumor showed marked heterogenous enhancement on the arterial phase scanning in 3 cases,and mild heterogenous enhancement in 2 cases.The degree of tumor enhancement was less intense than the surrounding pancreatic parenchyma due to necrosis of various degree,which led to the cystic appearance of the tumor in 1 ease.On the portal phase scanning,all tumors showed marked enhancement similar to that of the pancreatic parenchyma.On the delayed phase scanning,the degree of enhancement was more intense than the surrounding pancreatic parenchyma in 1 case.Liver metastases with retroperitoneal lymphadenopathy and peripancreatic vessels invasion were seen in 1 case.No dilatation of the biliary tract or pancreatic duct was present.Conclusion The CT features of pancreatic carcinoid tumors included infrequent dilatation of the biliary tract or pancreatic duct and unusual vascular involvement,calcification within the mass,marked enhancement similar to that of the surrounding pancreatic parenchyma during the portal phase scanning and more intense during the delayed phase scanning.

Child ; Child, Preschool ; China ; epidemiology ; Female ; Hand, Foot and Mouth Disease ; epidemiology ; Humans ; Infant ; Male ; Seasons

This paper reports the diagnosis and therapy of one case of Dipylidium caninum infection in an infant.

Retinoic acid-inducible gene I (RIG-I) is an important pattern recognition receptor that detects viral RNA and triggers the production of type-I interferons through the downstream adaptor MAVS (also called IPS-1, CARDIF, or VISA). A series of structural studies have elaborated some of the mechanisms of dsRNA recognition and activation of RIG-I. Recent studies have proposed that K63-linked ubiquitination of, or unanchored K63-linked polyubiquitin binding to RIG-I positively regulates MAVS-mediated antiviral signaling. Conversely phosphorylation of RIG-I appears to play an inhibitory role in controlling RIG-I antiviral signal transduction. Here we performed a combined structural and biochemical study to further define the regulatory features of RIG-I signaling. ATP and dsRNA binding triggered dimerization of RIG-I with conformational rearrangements of the tandem CARD domains. Full length RIG-I appeared to form a complex with dsRNA in a 2:2 molar ratio. Compared with the previously reported crystal structures of RIG-I in inactive state, our electron microscopic structure of full length RIG-I in complex with blunt-ended dsRNA, for the first time, revealed an exposed active conformation of the CARD domains. Moreover, we found that purified recombinant RIG-I proteins could bind to the CARD domain of MAVS independently of dsRNA, while S8E and T170E phosphorylation-mimicking mutants of RIG-I were defective in binding E3 ligase TRIM25, unanchored K63-linked polyubiquitin, and MAVS regardless of dsRNA. These findings suggested that phosphorylation of RIG inhibited downstream signaling by impairing RIG-I binding with polyubiquitin and its interaction with MAVS.
Adaptor Proteins, Signal Transducing ; metabolism ; Adenosine Triphosphate ; metabolism ; DEAD Box Protein 58 ; DEAD-box RNA Helicases ; chemistry ; genetics ; metabolism ; Dimerization ; Humans ; Mutagenesis, Site-Directed ; Phosphorylation ; Polyubiquitin ; metabolism ; Protein Binding ; Protein Structure, Tertiary ; RNA, Double-Stranded ; metabolism ; Recombinant Proteins ; biosynthesis ; chemistry ; genetics ; Signal Transduction ; Transcription Factors ; metabolism ; Tripartite Motif Proteins ; Ubiquitin-Protein Ligases ; metabolism ; Ubiquitination