Objective:To explore the role and mechanism of Talin-1 in mouse aortic dissection.Methods:Sixty male FVB mice were evenly divided into groups of blank, model, Talin-1 up-regulation, Talin-1 up-regulation control, Talin-1 down-regulation, and Talin-1 down-regulation control. Except mice in the blank group, mice were treated with β-aminopropionitrile (BAPN) combined with angiotensin to construct a mouse aortic dissection model. Hematoxylin-eosin and vascular elastic fiber staining (EVG) were used to observe the aorta and elastic fiber morphology and structure. Western blot was used to detect the phosphorylation levels of FAK and ERK1 / 2 in mouse aortic tissue.Results:The success rate of aortic dissection in model mice was 70%, and there was no aortic dissection appeared in the blank group.No mice died during the experiment. The incidence of aortic dissection in the Talin-1 down-regulated group was 100%, which was significantly higher than that in the Talin-1 down-regulated control group( P<0.05). The incidence of aortic dissection in the Talin-1 up-regulated group was 20%, significantly lower than that in the Talin-1 up-regulated control group. The wall thickness of the aorta of mice in the Talin-1 down-regulated group was accompanied by hematoma or pseudocavity formation. The median elastic fiber content was higher than that in the Talin-1 downregulation control group( P<0.05). The content of elastic fibers in the blood vessel wall of mice in the Talin-1 up-regulation group was significantly higher than that in the Talin-1 up-regulation control group.The down-regulation of Talin-1 significantly inhibited FAK phosphorylation, and instead promoted ERK1/2 phosphorylation( P<0.05). Conclusions:Down-regulation of Talin-1 may reduce the elastic fiber content in the aorta of mice by activating the ERK1/2 signaling pathway, leading to vascular remodeling of the aortic wall and promoting the occurrence of aortic dissection.

Objective:To investigate the outcomes of surgical treatment for carotid body tumor(CBT) without preoperative embolization at our institution.Methods:101 patients undergoing surgical treatment for CBT without preoperative embolization from 2011 to 2016 were followed-up for 2 years.Results:Complete resection of the CBT was achieved in all 101 cases(100%). Post-operative adverse events(AEs) mostly observed during hospitalization were as tongue bias(Ⅰ: 4, 36.4%; Ⅱ: 8, 19.5%; Ⅲ: 13, 26.5%), hoarseness(Ⅰ: 1, 9.1%; Ⅱ: 4, 9.8%; Ⅲ: 7, 14.3%), dysphagia (Ⅰ: 0; Ⅱ: 2, 4.9%; Ⅲ: 7, 14.3%) and local hematoma(Ⅰ: 0; Ⅱ: 0; Ⅲ: 1, 2.0%). No other serious AEs were observed. The total incidence of AEs was 5(45.5%) in type Ⅰ patients, 14(34.1%) in type Ⅱ, and 28(57.1%) in type Ⅲ. At the end of 2 years of follow-up, there was no AEs in type Ⅰ patients. The number of patients with adverse events in type Ⅲ was greater than that in type Ⅱ ( P>0.05). Three most frequently injured cranial nerves were hypoglossal nerve(21.9%), vagus nerve(20.3%), and recurrent laryngeal nerve(18.8%). Conclusion:Surgical management without preoperative embolization for CBT patients does not increase the risk of complications nor is it related to prognosis.

Objective:To explore the effect and value of the active learning mode based on mind mapping in the teaching of medical service support for major disasters.Methods:A total of 90 undergraduate students of 2016 Clinical Medicine of Naval Medical University were randomly selected as research objects, and they were randomly divided into observation group and control group. The 45 students in the control group used the traditional teaching mode, and the 45 students in the observation group used the mind mapping-based active learning mode for major disaster rescue and medical survice. The teaching time of the two groups was 12 h. The theoretical examination of knowledge and practical skills of the two groups of students were compared after teaching, and the students' satisfaction with the application of mind mapping-based teaching model in the teaching of medical service support for major disaster rescue was investigated. EmpowerStats and R softwares were used for t test and Chi-square test. Results:There were 24 males and 21 females in the observation group, with an average age of (21.40±0.69) years old. There were 22 males and 23 females, with an average age of (21.71±0.55) years old. The theoretical performance of the observation group (91.38±4.37) was significantly higher than that of the control group (84.91±3.98) ( P<0.001), and the practical skill performance of the observation group (92.98±3.24) was significantly higher than that of the control group (87.38±3.80) ( P<0.001). At the same time, the students' satisfaction with teaching effect in the observation group was 82.2% (37/45), which was significantly higher than that in the control group (37.8%, 17/45). Conclusion:The active learning mode based on mind mapping focuses on cultivating students' independent learning, interactive exploration and clinical thinking ability, and has a broad application prospect in the teaching of medical service support for major disasters.

Objective: To investigate the relationship between the maximum thickness of carotid atherosclerotic plaque and the incidence of complications after carotid stenting in patients with severe carotid stenosis. Methods: The clinical data of 85 patients with severe carotid stenosis undergoing CAS were analyzed. The maximum thickness of carotid plaque was evaluated according to ultrasound imaging data.Patients were divided into two groups according to the optimal threshold value: 0.435 mm, which calculated in the ROC curve of plaque thickness. The incidence of complications within two years after CAS was analyzed. Results: 85 patients were followed up for 2 years: restenosis occurred in 12 cases, the incidence rate was 14.1%, which was significantly correlated with the maximum thickness of atherosclerotic plaque(P=0.002). Postoperative restenosis occurred in 2 cases (3.70%) in group A and 10 cases (32.26%) in group B(P<0.001); Three cases (9.68%) suffered from relapsing cerebral infarction in group B compared to none in group A(P=0.020). Conclusion With the carotid plaque growing thicker, the incidence of restenosis after CAS in patients with carotid stenosis increases. Especially in patients whose maximum plaque thickness is more than 0.435 mm, the incidence of restenosis postoperative increases remarkably.