Objective To evaluate the clinical training outcomes from two clinical practice modes for undergraduate students. Methods Total two grades 2009 and 2010,150 undergraduate students were randomly divided into two groups: 69 students in group A and 81 students in group B. The synthetic teaching mode was applied in group A,and group B received the traditional teaching mode. The Objective Structure Clinical Examination (OSCE)and a written comprehensive examination were used to evaluate the training outcomes by T test analyzed by SPSS 17.0(α= 0.05). Results The theoretical level of 2009 grade students was better than that of 2010 grade (P < 0.05). The clinical practice skills of the two groups had no significant difference(P > 0.05). There were no significant differences between two groups in theoretical and clinical training(P > 0.05). Comparing with the 2010 grade,the theoretical level of the 2009 was better,but the clinical skill level was weaker. Conclusion Synthetic teaching mode and traditional teaching mode both achieved good outcomes. In order to obtain better comprehensive progresses,the two teaching modes need to be combined. The orientation by following the requirements of oral practicing qualification examination may enhance the clinical skills of the students.

OBJECTIVETo study the X-ray and CT findings of traumatic bronchial rupture for early radiographic diagnosis and treatment.

METHODSThe chest plain X-ray films and CT images of 21 patients with traumatic bronchial rupture confirmed by operations or bronchoscopy were retrospectively analyzed.

RESULTSThe main radiographic findings of traumatic bronchial rupture included interrupted tracheobronchial air column, atelectasis, lung ptosis, pneumomediastinum and subcutaneous emphysema, pneumothorax or hydropneumothorax. CT scanning also revealed tracheobronchial wall defect, bronchostenosis, and bronchial occlusion, displacement and angulation.

CONCLUSIONChest plain X-ray film combined with CT scanning has important values for early diagnosis of traumatic bronchial rupture.

Adolescent ; Adult ; Aged ; Bronchi ; injuries ; surgery ; Bronchoscopy ; Early Diagnosis ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Rupture ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo analyze the radiological parameters of the conservatively in treating distal radius fracture and investigate whether the final re-displacement can be predicted after primary reduction.

METHODSFrom January 2013 to June 2014,212 patients with distal radial fracture conservatively were treated in our hospital, 107 patients of them were excluded because of their incomplete radiological parameters;the remaining 105 patients were available for radiological were assessed after injury, there were 56 male patients and 49 female patients in this study, the average age of the patients was 51 years old (ranged from 22 to 80 years). According to AO classification, there were 47 cases of type A2 and C1, and 58 cases of type A3, C2, C3. All patients were treated by closed reduction and below-elbow cast immobilization for 4 to 6 weeks. All patients were followed up for 3 to 6 months (means 4.5 months) by X-ray, all fractures were healed. Standard AP and lateral radiographic examination was conducted before reduction and after reduction and bony consolidation,the dorsal angulation and the radial angle were measured at each time point. The linear regression was used for the analysis to find out whether the final re-displacement can be predicted after primary reduction.

RESULTSAmong 105 patients,the significant correlations were found for the dorsal angulation between the reduction time and the end time (r = 0.82) and for the radial angulation between the reduction time and end time (r = 0.85).

CONCLUSIONThe dorsal angulation and the radial angulation after complete healing can be predicted from linear the regression functions. Due to the possibility of predicting the end result, whether the fracture should receive further conservative treatment or surgical treatment can be decided immediately.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Radiography ; Radius Fractures ; diagnostic imaging ; therapy

Objective To investigate the clinical effect ofstereotactic operation on treatment of hypertensive cerebral hemorrhage.Methods One hundred and sixty patients with hypertensive cerebral hemorrhage,admitted to our hospital from February 2010 to February 2013,were chosen;according to the different treatment methods,they were divided into treatment group (n=100,treated by stereotactic operation) and control group (n=60,performed conventional treatment).Their clinical data were retrospectively analyzed,and the hematoma elimination time,mortality rate and treatment efficacy were compared between the two groups.Results As compared with that in the control group,the hematoma elimination time was significantly shorter in the treatment group (P＜0.05).Nineteen patients (19％) in the treatment group died and 20 patients (33.33％) in the control group died with significant differences (P＜0.05).Good recovery/mild disability was noted in 39 patients of the treatment group,counting for 39％,and that was noted in 16 patients of the control group,counting for 26.67％.The curative effect of treatment group was significantly better than that of the control group (P＜0.05).Conclusion Stereotactic operation in treatment of hypertensive cerebral hemorrhage enjoys clinical curative effect,which can improve the quality of life and reduce the mortality rate; its clinical curative effect is better than that of conservative treatment of hypertensive cerebral hemorrhage in the Department of internal medicine.

BACKGROUNDHepatitis B virus infection is closely related to hepatocellular carcinoma (HCC). Cyclooxygenase-2 (COX-2) is overexpressed in HCC and considered to play a role in hepatic carcinogenesis. In this study, we analyzed the polymorphism of COX-2 promoter -899G/C in healthy controls, chronic hepatitis B (CHB) patients, liver cirrhosis patients, and hepatocellular carcinoma (HCC) patients, to investigate the relationship between COX-2 -899G/C polymorphism and the risk for hepatitis B-related liver cancer in a Chinese population from Gansu province.

METHODSPatients were divided into four groups: 300 patients with CHB, 300 patients with liver cirrhosis, 300 patients with HCC, and 300 healthy controls. The polymorphism of COX-2 -899G/C was detected by PCR-TaqMan probes. The results were analyzed by SPSS 17.0.

RESULTSThe COX-2 -899G/C genotypes were GG, GC, and CC. Frequencies in CHB were 87.00%, 12.67%, 0.33%; in liver cirrhosis were 85.33%, 14.00%, 0.67%; in HCC were 77.00%, 21.67%, 1.33%; and in healthy controls were 90.67%, 9.00%, 0.33%, respectively. COX-2 -899C carriers may have an increased risk for hepatitis B-related liver cancer. Compared with the frequency of GG genotype, there were significant differences in the frequency of GC genotype between HCC and healthy control groups (OR = 2.835, 95%CI: 1.751 - 4.589); HCC and CHB groups (OR = 1.933, 95%CI: 1.248 - 2.994); and HCC and liver cirrhosis groups (OR = 1.175, 95%CI: 1.119 - 2.628). Stratification analyses showed that COX-2 -899C allele carriers with a drinking history are more susceptible to develop HCC.

CONCLUSIONCOX-2 -899C genotype may increase the susceptibility of individuals to hepatitis B-related liver cancer in Gansu province, China.

Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Carcinoma, Hepatocellular ; etiology ; genetics ; Cyclooxygenase 2 ; genetics ; Female ; Genetic Predisposition to Disease ; Hepatitis B ; etiology ; genetics ; Humans ; Liver Neoplasms ; etiology ; genetics ; Male ; Middle Aged ; Polymorphism, Genetic ; genetics ; Promoter Regions, Genetic ; genetics

OBJECTIVETo evaluate the value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in diagnosis of mediastinal lesions and to discuss its optimal indication.

METHODSOne hundred and twenty three patients with mediastinal lesions who underwent EBUS-TBNA were included in this study. The accuracy, sensitivity, specificity, positive and negative predictive value of EBUS-TBNA in diagnosis of mediastinal lesions were analyzed according to the final diagnosis and evaluate its value and the optimal indication.

RESULTSIn the 123 patients, EBUS-TBNA was successfully performed to obtain samples from 286 stations of lymph nodes (2.33 stations/per patient). The puncture success rate was 100%. The procedure was uneventful without complications. Final diagnosis indicated that there were 83 positive and 40 negative patients. EBUS-TBNA had a sensitivity of 95.2%, specificity of 100%, positive predictive value of 100%, negative predictive value of 90.0%, and overall accuracy of 96.8%. For diagnosis of the epithelial cancer, EBUS-TBNA had an accuracy of 98.8%, sensitivity of 98.8%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 100%. EBUS-TBNA failed to reveal three lymphomas. For diagnosis of benign mediastinal diseases, EBUS-TBNA had a diagnosis rate of 47.2% which had a confirmed clinical application value.

CONCLUSIONSEBUS-TBNA may be expected to replace the mediastinoscopy as a superior choice for diagnosis of mediastinal epithelial cancers. EBUS-TBNA can not replace mediastinoscopy but being a promising tool for diagnosis of benign mediastinal lesions including granulomas. For certain special diseases such as lymphoma, mediastinoscopy cannot be replaced. However, EBUS-TBNA can be a potentially favorite choice for early stage screening.

Adult ; Aged ; Aged, 80 and over ; Biopsy, Needle ; methods ; Bronchoscopy ; Female ; Granuloma ; pathology ; Humans ; Lung Neoplasms ; pathology ; Lymphatic Metastasis ; Lymphoma ; pathology ; Male ; Mediastinal Diseases ; pathology ; Mediastinoscopy ; Middle Aged ; Predictive Value of Tests ; Sarcoidosis ; pathology ; Sensitivity and Specificity ; Ultrasonography, Interventional ; Young Adult

BACKGROUNDNeural tube defects are the most common human birth defects. The causes are multifactorial with complex genetic and environmental factors, although the exact genetic causes are unknown. This research was conducted to study the frequency of Msx2 gene polymorphisms in 59 women with a history of pregnancy with a neural tube defect and in 73 healthy controls. We aimed to determine the effect of this genetic polymorphism on the incidence of neural tube defects in the Han Chinese population.

METHODSWe studied 59 mothers with at least one previous child with a neural tube defect (the case group) and 73 case-control subjects during the same period, from Shanxi Province, China. We analyzed the genotypic distributions and allele frequencies of Msx2 C386T polymorphisms in DNA samples from the case and control groups. A three-dimensional protein model was predicted using Swiss-Pdb Viewer software version 4.0. Disease association was analyzed using chi-square tests.

RESULTSSignificant differences were observed in the genotypes and allele frequencies of the Msx2 C386T allele between the case and control groups (CT: 32% vs. 15%, P = 0.0073 and TT 15% vs. 4%, P = 0.013, respectively). Logistic regression analysis showed that the C386T mutation is a potential risk factor for neural tube defects (P < 0.05; OR: 3.466; 95%CI: 1.831 - 6.560). Three-dimensional structure prediction revealed that the Msx2 C386T mutation results in a threonine substitution for methionine at position 129 of exon 2, which might lead to structural mutations or dysfunctions in the protein encoded by Msx2.

CONCLUSIONMaternal Msx2 C386T gene polymorphisms were associated with fetal neural tube defects in Han Chinese women in Shanxi Province.

Adult ; Asian Continental Ancestry Group ; genetics ; China ; Female ; Homeodomain Proteins ; chemistry ; genetics ; metabolism ; Humans ; Neural Tube Defects ; epidemiology ; genetics ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide ; genetics ; Pregnancy ; Protein Structure, Secondary ; Young Adult

This study was aimed to investigate the effects of different stimulatory factors on proliferation and function of cytokine induced killer (CIK) cells. Peripheral blood mononuclear cells (PBMNC) were separated by Ficoll-Hypacue gradient. According to supplement of different stimulatory factors (CD28 mAb, IL-15 and IL-21), the experiment was divided into five groups:control group (CIK), CB28+IL-15+IL-21 group, IL-15+IL-21 group, CD28+IL-15 group and CD28+IL-21 group. Effects of different stimulatory factors on the proliferation of CIK cells were assayed by an automated hematology analyzer. Changes of granzyme B,perforin and CD107a were detected by flow cytometry. IL-10, IL-12, INF-γ and TNF-α were quantified by ELISA. Cytotoxicities on lung cancer cell line A549, breast adenocarcinoma cell line MFC-7 and human melanoma cell line HME1 were examined by lactate dehydrogenase release method. The results showed that there were significant differences among different groups. The highest proliferation index on days 10 was observed in group CD28mAb, IL-15 and IL-21(255.3 ± 6.3), which was higher than control group, IL-21+IL-15 group and CD28 mAb+IL-21 group (166.6 ± 13.5, 199.4 ± 15.0 and 228.8 ± 16.6) (P < 0.05). The expression of perforin in CD28 mAb+IL-15 group was higher than the other groups. The expression of perforin,GranB and CD107a of costimulatory groups was higher than control group. The cytotoxicities of CD28 mAb+IL-15 group on A549, MFC-7 and HME1 cells (82.2%, 59.3% and 70.6%) were much higher than that of control group (60.9%, 49.6% and 48.4%) (P < 0.05). The highest IFN-γsecretion was found in CD28 mAb, IL-15 and IL-21 groups. It is concluded that there are significant difference of proliferative capacity, cytokine secretion and cytotoxicity after being activated by different stimulatory factors. Adding corresponding stimulatory factors into the culture system displays a great value for target cells culture.
Cell Line, Tumor ; Cell Proliferation ; drug effects ; Cytokine-Induced Killer Cells ; cytology ; drug effects ; Humans ; Interferon-gamma ; metabolism ; Interleukin-10 ; metabolism ; Interleukin-12 ; metabolism ; Interleukin-15 ; pharmacology ; Interleukins ; pharmacology ; Tumor Necrosis Factor-alpha ; metabolism

BACKGROUNDQacA, a main exporter mediating the multidrug-resistance of Staphylococcus aureus to a variety of antiseptics and disinfectants, possesses a topology of 14 alpha-helical transmembrane segments (TMS). Our study aimed to determine the importance and topology of amino acid residues in and flanking the cytoplasmic end of TMS5.

METHODSSite-directed mutagenesis was used to mutate 5 residues, including L146, A147, V148, W149 and S150, into cysteine. A minimum inhibitory concentration (MIC) and transport assay with or without N-ethylmaleimide (NEM) were performed to analyse the function of these mutants.

RESULTSAll of the mutants showed comparable protein expression levels. MIC analysis suggested that mutant W149C showed low resistance levels to the drugs, but the mutations at L146, A147, V148, and S150C had little or no effect on the resistance level. And the results of the fluorimetric transport assay were in agreement with those of MIC analysis, that is to say, W149C did not allow transport to the substrates to be tested, while the other mutants retained significant transport ability. The reaction of the different mutant proteins with Fluorescein-NEM revealed that the mutant L146C was highly reactive with NEM; the W149C and S150C mutants were moderately reactive; A147C was barely reactive and V148C showed no reactivity.

CONCLUSIONSThe study identified that residues W149 and S150 situated at the interface of the aqueous: lipid junction as functionally important residues, probably involved in the substrate binding and translocation of QacA.

Bacterial Proteins ; chemistry ; physiology ; Drug Resistance, Bacterial ; Ethylmaleimide ; pharmacology ; Indoles ; metabolism ; Membrane Transport Proteins ; chemistry ; physiology ; Structure-Activity Relationship