Objective To understand awareness of basic knowledge on control and prevention for chronic obstructive pulmonary disease (COPD) among general practitioner in community health service centers. Methods Questionnaire survey was conducted among 593 general practitioners at 15 community health service centers in a district of Shanghai in the morning of February 26, 2008. Results Five hundred and forty-two of 593 ( 91.4% ) general practitioners surveyed knew that chronic obstructive pulmonary disease can be abbreviated as COPD, and 315 of them (53.1%) thought they knew the main contents of the "Guidelines for Prevention and Control of Chronic Obstructive Pulmonary Disease". No pulmonary function instrument was equipped at all 15 community health service centers surveyed, and 501 of 593 ( 84.5% ) general practitioners knew spirometry is gold standard for diagnosis of COPD. Only 115 ( 19.4% ) general practitioners knew that COPD can be categorized as acute exacerbation and stable stage. One hundred and sixty-three of them (27.5%) knew that drug therapy should be maintained in COPD patients for long term following effective treatment, 328 (55.3%) recognized that treatment for COPD patients was still needed in their stable stage, and 312 (52.6%) believed that antibiotics may not be necessary and 465 (78.4%) thought that inhalation therapy was the choice of treatment for acute exacerbation of COPD. Two hundred and thirty-five of them (39.6%) knew that oxygen inhalation should be more than 15 hours per day in regular family therapy. The investigation showed that 365 (61.6%) general practitioners had participated in training for COPD-related knowledge, only one or two times a year. Awareness of COPD knowledge was significantly poorer in rural practitioners than that in urban community ones. Conclusions Basic knowledge of prevention and treatment for COPD was seriously lack in general practitioners, so it is a necessity to strengthen training for them.

It is known that ischemic cerebrovascular disease is causing enormous harm to human health on account of the resultant high morbidity and disability rate. In this connexion, the anticipated target is to control the size of focal ischemic cerebral infarction, which is also an important method for judgment of therapeutic efficacy. The key question is to survey the size accurately and objectively; at the same time, the quantitative analysis of focal ischemic cerebral infarction is the pivotal question affecting the experiment conclusion and the reliability level. In this paper are introduced and summarized the methods being recently and commonly used in survey and computation, and the studies made on quantitative analysis of focal ischemic cerebral infarction by 2, 3, 5-triphenyltetrazolium chloride (TTC) staining method. Also are summarized the principles of dyeing in TTC method, the preparatory work, and the commonly used method of surveying and computation. It is the intent of this review to provide relevant data and suggestion for research workers.
Animals ; Brain Ischemia ; pathology ; Cerebral Infarction ; pathology ; Coloring Agents ; Humans ; Reperfusion Injury ; pathology ; Tetrazolium Salts

AIM:To explore the preliminary mechanism of senegenin ( Sen) on inhibiting hypoxia/reoxygenation ( H/R)-induced apoptosis of primary cortical neurons .METHODS:The cultured cortical neurons were randomly divided in-to normal group (control group), model group (H/R group), Sen+H/R group and Sen group.Flow cytometry was used to evaluate the effect of Sen on H/R-induced cell apoptosis .The protein levels of JNK , p-JNK, c-Jun, p-c-Jun, Bcl-2 and Bax were assessed by Western blotting .RESULTS:The apoptotic rate in H/R group was obviously higher than that in control group (P<0.05), while the apoptotic rate in Sen +H/R group was obviously lower than that in H/R group (P<0.05), suggesting that the model of apoptosis was established successfully .The results of Western blotting showed that Sen increased the expression of JNK and c-Jun, inhibited the phosphorylation of JNK and c-Jun (P<0.05), increased the protein level of Bcl-2 and inhibited the protein level of Bax in H/R treated primary cortical neurons (P<0.05).CONCLUSION:Sen has a protective effect against H/R-induced neuronal apoptosis by increasing the expression of JNK and c-Jun, inhibiting the phosphorylation of JNK and c-Jun, increasing the protein level of Bcl-2 and decreasing the protein level of Bax .

Objective To study of short-term rehabilitation index and its relationship with medium-term function in male rectal cancer after laparoscopic surgery. Methods A retrospective analysis was made of 60 cases with rectal cancer who received laparoscopic radical resection in our hospital. In the observation group,the pelvic autonomic nerves were retained in 30 cases,and 30 cases in the control group were not retained. The levels of se-rum prealbumin(PA),C reactive protein(CRP),white blood cell count(WBC)and blood cortisol(Cor)were compared between the 2 groups. The independent influence factors of erectile and ejaculatory disorder were fol-lowed up at 6 months after operation. Results Postoperative exhaust time,defecation time,postoperative extuba-tion time,ambulation time,postoperative hospitalization time in the observation group were significantly shorter than those in the control group(P < 0.05). The level of serum CRP,WBC and Cor in the observation group was significantly lower than those of the control group at 3 d after operation,and the level of PA was significantly high-er than that of the control group(P < 0.05).The independent influence factors of erectile dysfunction were the level of PA and CRP at 3d after operation(P < 0.05).The independent influence factors of ejaculatory dysfunction were PA level at 3D after operation(P < 0.05). Conclusion Pelvic nerve protection in laparoscopic surgery is helpful to promote the postoperative recovery. High PA at short term after operation may be one of the medium-term protec-tion mechanisms for sexual function.

Objective To evaluate effectiveness of prevention and treatment for patients with chronic obstructive pulmonary disease (COPD) for one year at community health-care service (CHS)centers. Methods A quasi-experiment design was used to evaluate effectiveness of community management for patients with COPD who visited and registered at Xiaokunshan and Xinbang CHS centers in Songjiang district of Shanghai in 2008, with COPD patients from Xiaokunshan community CHS center as management group and those from Xinbang as control. Measures for community management included training for local general practitioners in essential knowledge of COPD prevention and treatment, allocation of necessary drugs for COPD treatment, and health education for COPD patients and their family members. No special measures were taken for control group except routine treatment. Results A total of 132 patients were diagnosed as COPD according to their pulmonary function on 2008, 61 at Xiaokunshan and 71 at Xinbang CHS canters.One hundred and two patients, 47 at Xiaokunshan and 55 at Xinbang, finished one-year follow-up. Five patients from Xiaokunshan who were smokers at their first visits and three of them quitted smoking after oneyear management. Meanwhile, none of nine smoked patients from Xinbang quitted smoking in the same period. There was no statistically significant difference in symptom scores, pulmonary function, and forced expiratory volume at the first second (FEV1) between patients in the two groups during one-year follow-up.Average score of quality of life in patients at Xiaokunshan dropped to 39. 12 after one-year management from 46. 96 at their first visits, and that in patients at Xinbang increased to 62. 11 from 56. 55 (P＜0.01).Average six-minute walking distance (6-MWD) in patients at Xiaokunshan reduced to 354. 26 meters after one-year management from 361.66 meters at their first visits, meanwhile that in patients at Xinbang reduced to 351.18 meters from 398.07 meters (P =0. 008). Scores of functional dyspnea in patients at Xiaokunshan fell to 0.34 from 0.40 at their first visit, meanwhile that in patients at Xinbang increased to 1.00 from 0.95(P =0.038). During the one-year follow-up, 13 patients at Xiaokunshan and 53 at Xinbang visited emergency departments for treatment, and four at Xiaokunshan were hospitalized and none died, and five at Xinbang were hospitalized due to acute exacerbation of COPD and four of them died. Conclusions The study suggests that strengthening prevention and treatment for COPD patients at community level by general practitioners, patients themselves and their family members can improve their quality of life, reduce emergency visits and hospitalization, alleviate dyspnea symptoms and delay the decline of 6MWD.

uate and should be standardized.

Objective: To study the feasibility of using a double purse-string bridging pancreaticojejunostomy in total laparoscopic pancreaticoduodenectomy (TLPD). Methods: A database of 35 patients who underwent TLPD using a double purse-string bridging pancreaticojejunostomy from January 2016 to January 2019 in Jinhua Hospital of Zhejiang University was retrospectively reviewed. The perioperative outcomes were analyzed. Results: All the 35 patients underwent TLPD successfully. The surgery time was (370.2±33.5) min, and the time of constructing the pancreaticojejunostomy was (28.4±12.6) min. The hospital stay after surgery was (14.2±6.9) days. Five patients developed postoperative complications, including pancreatic fistula in 3 patients, bile leakage in 1 patient, gastroparesis (complicated with abdominal infection) in 1 patient, and abdominal infection in 3 patients (2 patients with pancreatic fistula, and 1 patient with gastroparesis). All the patients with complications responded well to conservative treatment. Conclusions A double purse-string bridging pancreaticojejunostomy was simple and widely applicable. It is safe and feasible in total laparoscopic pancreaticoduodenectomy and should be promoted in clinical practice.

Objective To investigate the effects of menaquinone-4(MK4)on the activation and function of CD8+T cells.Methods An in vitro culture system for primary mouse CD8+T cells was established by isolating these cells from the spleen using CD8a T cell isolation kit.The isolated CD8+T cells were then incubated and activated in a 96-well plate coated with anti-CD3/CD28 antibodies.The impact of MK4 on the activation and cytokine secretion of CD8+T cells was explored by quantifying the expression levels of CD8+T cell activation receptors and cytokines using flow cytometry.Additionally,the concentrations of these cytokines in the culture supernatant were measured by enzyme-linked immunosorbent assay(ELISA).The influence of MK4 on the anti-tumor function of CD8+T cells was evaluated by co-culturing colorectal cancer MC38 cells of mice with CD8+T cells at different ratios,and the effect of MK4 was assessed by detecting tumor cell apoptosis.Results High-purity primary CD8+T cells of mice(97.5％)were isolated using the magnetic bead,which could be activated by pre-coated CD3/CD28 antibodies and showed proliferation.Compared with the control group,the MK4-treated group exhibited increased expressions of CD25,CD69 and CD44 on CD8+T cells,as well as higher production and secretion levels of interleukin-2(IL-2),interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α)and granzyme B.In addition,CD8+T cells in the MK4-treated group induced a higher percentage of tumor cell apoptosis(36.7％)compared with the control group(29.1％).Conclusion MK4 can enhance the activation of CD8+T cells and promote anti-tumor functions.

Purpose To investigate the clinicopathological and molecular of embryonal tumor with multilayered rosettes(ETMR).Methods The clinical data and follow-up data of 9 cases of ETMR were collected,and the expression of Syn,LIN28A,vimentin,GFAP,Olig2,S-100,INI1,H3K27me3,and Ki67 was detected by immunohistochemistry EnVision two-step method.The amplification genes of C19MC were detected by fluorescence in situ hybridization(FISH).And relevant lit-eratures were reviewed.Results There were 6 males and 3 fe-males with 2∶1 of M:F;seven cases were located supratentorial-ly and two cases located subratentorially,one of the case located to the brainstem was resemble of diffuse intrinsic pontine glioma in imaging.Histopathologically,there 9 cases were diagnosed as embryonal tumor with abundant neuropil and true rosettes(four cases),ependymoblastoma(three cases),or medulloepithelio-ma(two cases).Immunohistochemistry showed that LIN28A,Syn and vimentin were positive,GFAP was variable,BRG1,INI1 and H3K27me3 were retained.The Ki67 proliferation index rangeed from 40％to 70％.C19MC amplification were detected in 8 samples by FISH.In all 9 cases,four cases had undergone gross total tumor resection,two cases only subtotal tumor re-moved,one patient was underwent biopsy,two patients were un-known.Seven patients were adjuvant therapy.Four patients had CSF seeded,but without extraneural metastases.The follow-up time ranged from 0 to 36 months.The overall survival(OS)was 36 months and the median survival was 10 months.Eight pa-tients died within 3 years after their initial diagnosis.Conclu-sion ETMR almost occurs in the cerebral hemisphere,and a few cases can occur in the brainstem and show the imaging char-acteristics of DIPG.ETMR have highly aggressive and poor prognosis.The combination of histological,LIN28A immunohis-tochemistry,and C19MC tests is helpful for diagnosis and differ-ential diagnosis.

Objective To compare the dose distribution of postoperative plans with preoperative plans of 3D-printing template (coplanar and non-coplanar) assisted and CT-guided 125I seed implantation for the treatment of soft tissue sarcoma,and to explore the accuracy of treatment at dosimetry level.Methods From December 2015 to July 2017,19 patients with soft tissue sarcoma (a total of 25 lesions)were treated with 3D printing template assisted and CT-guided 125I seed implantation in Peking University Third Hospital.All patients underwent preoperative assessment,CT simulation orientation,preoperative planning,3D-template printing,3D-template reduction,needle and seed implantation,postoperative dosimetry assessment,postoperative care and follow-up.The preoperative and postoperative dosimetric parameters were conpared.Ten cases of soft tissue sarcoma in superficial trunk or limbs were screened.Preoperative planning of coplanar template and non-coplanar template were designed respectively.The dosimetric parameters of preoperative planning guided of two templates were compared.Results Twentyfive 3D-printing templates were designed and constructed,and 25 lesions were totalled.There was no statistical difference between preoperative and postoperative dosimetric parameters.There was no statistical difference of the preoperative plan's dosimetric parameters between coplanar and non-coplanar in soft tissue sarcoma of superficial trunk/limbs.Conclusions The validation of actual dose distribution in postoperative plans assisted by 3D-printing template in 125I seed implantation showed that most of parameters could meet the expectation of preoperative plans,which indicated the improvement in accuracy for this new modality.For soft tissue sarcoma located in the superficial trunk/limbs,it was recommended to select the 3D-printing coplanar template firstly.