Our university actively carried out the reform and innovation of the training mode of clinical medicine postgraduates . We implemented the standardized training of resident physicians throughout postgraduate training process , and carried out the comprehensive reform of the training mode of cultivating master degree students of clinical medicine and the standard training of resident doctors. Meanwhile, we trained the master degree students with the synergy of medical education and strengthened the cultivation of students' clinical practice ability, to cultivate qualified doctors for the country, and to improve the quality of postgraduate training.

OBJECTIVE: To assess the effect of disinfectant (Cavicide) with benzethon chloramine and isopropanol as main active ingredients disinfectant on dental impression accuracy. METHODS: The effect of Cavicide on three impression materials (alginate, polyether and vinylpolysiloxane) were assessed using a standard model. The standard model was digitized by an extraoral scanner (IScan D103i, Imetric). For each kind of impression materials, thirty impressions were taken following the manufactures' instruction in the same conditions. Subsequently, the impressions were randomly divided into three groups, with ten impressions in each group. After the impression taking was completed, the three groups underwent pure water rinse for 1 min (blank control, BC), 2% glutaraldehyde solution immersion disinfection for 30 min (glutaraldehyde, GD), and Cavicide solution spray disinfection for 5 min (Cavicide, CC), respectively. All the impressions were digitized by the extraoral scanner (IScan D103i, Imetric) after disinfection and exported to a dedicated three-dimensional analysis software (Geomagic Qualify 2014, Geomagic, USA). In the software, the digital models of the impressions were trimmed to teeth and then superimposed with the digitized standard model via best-fit alignment. Root mean square (RMS) was used to evaluate the deviations between the impression and the standard model. The deviation in the anterior and posterior regions was evaluated respectively. One-way ANOVA test and the LSD post-hoc test were used to compare the deviations between the three groups (P < 0.05). The color map of each superimposition was saved for visual analysis. RESULTS: For the polyether and vinylpolysiloxane materials, the difference between the three groups was not statistically significant (P=0.933, P=0.827). For the alginate material, the difference in posterior region between group GD and group BC, as well as group GD and group CC were statistically significant (GD vs. BC, P=0.001; GD vs. CC, P=0.002), while the difference between group BC and group CC was not statistically significant (P=0.854). The visual analysis showed an obvious deviation in the buccal-lingual direction in group GD. CONCLUSION Disinfectant (Cavicide) with benzethon chloramine and isopropanol as main active ingredients using spray disinfection has no effect on the accuracy of the alginate, polyether and vinylpolysiloxane impressions.
2-Propanol ; Chloramines ; Dental Impression Materials ; Dental Impression Technique ; Disinfectants ; Disinfection ; Models, Dental

This study is to investigate the anti-tumor effect in vitro of methotrexate modified by LH-RH peptide (LH-RH-MTX). LH-RH receptors highly expressing MCF-7 human breast carcinoma cell line and lowly expressing K562 human erythroleukemia cell line were served as the tested cells. The cell proliferation inhibition rates of LH-RH-MTX were detected by MTT colorimetric assay. The effects of LH-RH-MTX on the cell cycle and apoptosis rates were detected by flow cytometry. The inhibition rate of LH-RH-MTX on MCF-7 cells was much higher than that on K562 cells, and the inhibition rate of LH-RH-MTX on MCF-7 cells was much higher than that of free MTX at the same concentration. The inhibition rate of LH-RH-MTX on rat bone marrow mononuclear cells was less than that of free MTX. The number of MCF-7 cells in S phase increased after administration of LH-RH-MTX. The apoptosis rate of LH-RH-MTX group significantly increased compared with that of the control group and MTX group. The relative expression of LHRHR mRNA of LH-RH-MTX group markedly decreased compared with that of the control group and MTX group. LH-RH-MTX is realizable to reduce drug side effects, increase the therapeutic index and achieve tumor-targeted therapy.
Animals ; Antimetabolites, Antineoplastic ; chemical synthesis ; pharmacology ; Apoptosis ; drug effects ; Bone Marrow Cells ; cytology ; Cell Cycle ; drug effects ; Cell Proliferation ; drug effects ; Cells, Cultured ; Drug Delivery Systems ; Gonadotropin-Releasing Hormone ; chemistry ; pharmacology ; Humans ; K562 Cells ; Leukocytes, Mononuclear ; MCF-7 Cells ; Methotrexate ; chemical synthesis ; pharmacology ; RNA, Messenger ; metabolism ; Rats ; Receptors, LHRH ; biosynthesis ; genetics

OBJECTIVETo assess the preventive effect of sodium valproate on early posttraumatic seizures in traumatic brain injury (TBI) patients.

METHODSThe retrospective study was based on 159 patients with TBI treated at Department of Neurosurgery, Nanjing General Hospital of Nanjing Command enrolled between January 1, 2008 and December 31, 2009. The in-hospital section of the retrospectively collected database includes information on age, sex, initial Glasgow Coma Score (GCS), results of CT scanning, operation, usage of sodium valproate, seizures in the first week after injury and outcome.

RESULTSSeven patients (4.4%) showed early posttraumatic seizures. Although the incidence was zero in patients who received sodium valproate treatment, the difference between the treatment and control groups was not statistically significant. Of the 87 severe TBI patients (GCS 3-8), 6 patients in the control group (6.9%) suffered from early seizures during the first week after TBI and no patient who received preventive therapy suffered from seizures. The difference between the treatment and the control groups was still not statistically significant. Of the 72 mild and moderate TBI patients (GCS 9-15), only 1 patient in the control group suffered from seizures and no patient in the treatment group suffered.

CONCLUSIONSAlthough the results suggest that the study is not sufficiently powerful to detect a clinically important difference in the seizure rates between the treatment and control groups, sodium valproate is effective in decreasing the risk of early posttraumatic seizures in severe TBI patients. Further prospective studies are recommended.

Adolescent ; Adult ; Aged ; Anticonvulsants ; therapeutic use ; Brain Injuries ; complications ; Epilepsy, Post-Traumatic ; prevention & control ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Valproic Acid ; therapeutic use

OBJECTIVEThis is a preliminary study of the endoscopic technique on open surgery. The purpose of this study is to introduce the use of endoscopic technique for the reconstruction of the condyle with costochondral graft through a preauricular incision.

METHODS33 patients of temporomandibular joint diseases (n=49) underwent reconstruction of mandibular condyle with costochondral graft. After preparation of the recipient site through a preauricular incision, maxillo-mandibular fixation, and preparation of the costochondral graft, the graft was fixed to the lateral side of the mandible ramus under the supervision of arthroscope.

RESULTSAll the patients had successful reconstruction of the condyle with costochondral graft without any severe bleeding or craniocerebral injury.

CONCLUSIONThis case series demonstrates the feasibility of endoscopic technique for the reconstruction of the condyle through a preauricular incision. It has the advantage of high efficiency, minimal postoperative morbidity, great patient comfort, and little appearance impairment. The endoscopic technique has a promising future.

Adult ; Arthroscopes ; Endoscopy ; Female ; Humans ; Male ; Mandible ; Mandibular Condyle ; Reconstructive Surgical Procedures ; Temporomandibular Joint Disorders

Objective To clarify the depression status of empty-nest elderly in Shanxi Province, to explore the related influencing factors by structural equation model, and to provide scientific basis for the prevention and intervention of depression for empty nesters. Methods A questionnaire survey was conducted among 4 901 empty-nest elderly in Shanxi Province by self-rating depression scale and general situation questionnaire, and the model was established. Results The prevalence of depressive symptoms among empty nesters in Shanxi Province was 64.21%. The model demonstrated that health status had a direct impact on depressive symptoms (P=0.028), the total effect was -0.978; the effect of economic status on depressive symptoms was 0.086 (P=0.030), and social function had no significant impact on depressive symptoms (P=0.173), which could affect depressive symptoms through affecting health status and economic status. There was a significant correlation between the three latent variables (P<0.05). Health status had the strongest correlation with social function (r=0.942), followed by economic status (r=0.718), and the correlation between social function and economic status was 0.683. Conclusions In this research, most of the empty-nest elderly suffer from depressive symptoms. Health status is the most direct and important influencing factor of depressive symptoms in empty nesters. Social function affects depressive symptoms through influencing health status and economic status.

Objective To analyze the stage characteristics in the exercise behavior improvement of college students and explore the role of Process in the exercise behavior change based on the transtheoretical model, providing basis for the stage-matched intervention for the exercise behavior of college students. Methods There were 932 students who completed the questionnaires, from 5 universities in Shanxi Province were selected by using a stratified random cluster sampling method. Descriptive analysis was used to describe the exercise behavior of college students. Variance analysis and multivariate Logistic regression model were used to analyze the difference of the process of with stage of change among college students’ physical exercise. Multivariate variance analysis was used to analyze how personal characteristics affect process of change. Results Among all participants, 89.4% students knew the importance of physical exercise, and 29.4% students were satisfied with their physical exercise condition. The distribution of students’ physical exercise stage showed an inverted U-shape with left-side peak, and there was a significant difference between gender( 2=54.657, P<0.001). There were significant stage characteristics in the process of students' exercise behavior, gender had a significant main effects on mutual aid relation(F=7.400, P=0.07)and conscious control (F=7.778, P=0.005), gender and grade had interaction effects on social release (F=3.614, P=0.013). Conclusions The college students' exercise behavior showed the characteristics of “knowing but not to do”, which conformed to the Transtheoretical model. It is essential to develop targeted phased exercise intervention strategies according to the relationship between change of phase and change of procedure.

OBJECTIVETo investigate the manifestation and diagnostic value of multislice spiral CT (MSCT) and MRI imaging in detection of tumor recurrence after liver transplantation for hepatocellular carcinoma (HCC).

METHODSThe clinical data of 161 consecutive HCC patients who underwent orthotopic liver transplantation were retrospectively reviewed. Twenty-nine HCC patients were classified by pTNM according to the "Pittsburgh criteria". MSCT and MRI findings of tumor recurrence after liver transplantation were evaluated retrospectively in 29 stage II-IVb HCC patients. The recurrence site and relapse interval between liver transplantation and recurrence were analyzed.

RESULTSLung tumor recurrence were found in 21 cases, presented as cotton-like lesions in a diameter of 2 - 3 cm, with a clear margin and homogeneous density. Pleural tumor recurrence was detected in 4 cases. Liver tumor recurrence were found in 9 cases, which can be divided into four subtypes: multinodular in 4 cases, diffuse lesion in 2 cases, huge mass in 2 cases, and uninodular in 1 case. Two cases showed tumor thrombus in the inferior vena cava and portal vein. Lymph node tumor recurrence was found in 9 cases, presented as multiple nodules at hepatic hilum, lesser peritoneal sac, posterior mediastinum, retroperitoneum, or around pancreatic head, and accompanied with merging and necrosis in one case. Bone tumor recurrence were found as osteolytic destruction in 4 cases, and accompanied with adjacent soft-tissue mass in 2 cases. The recurrence sites of the 29 cases were as following: lung (21 cases, 72.4%), liver (9 cases, 31.0%), lymph nodes (9 cases, 31.0%), bone (4 cases, 13.8%) and other sites (3 cases, 10.3%). Lung tumor recurrence was found in all the 10 stage IVb patients with tumor recurrence after liver transplantation, significantly more frequent than that in stage IVa patients (P = 0.023). After liver transplantation, all 25 patients with stage III approximately IVb HCC developed recurrence within one year, but in the 4 cases with stage II HCC at one year later (P = 0.009).

CONCLUSIONThe results of our study show that in hepatocellular carcinoma patients after liver transplantation, the lung and pleura are the most frequent site of recurrence, followed by liver, lymph node and bone as the second and third sites. The Stage IVb hepatocellular carcinoma should be regarded as a contradiction for liver transplantation due to rapid recurrence. Tumor recurrence occurs later in stage II HCC than in stage III approximately IVb patients. MSCT and MRI are of significant importance in diagnosis and formulating operation plan in HCC patients with recurrence after liver transplantation.

Adult ; Carcinoma, Hepatocellular ; diagnosis ; diagnostic imaging ; secondary ; surgery ; Female ; Follow-Up Studies ; Humans ; Liver Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; surgery ; Liver Transplantation ; Lung Neoplasms ; diagnosis ; diagnostic imaging ; secondary ; Lymphatic Metastasis ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; diagnosis ; diagnostic imaging ; Neoplastic Cells, Circulating ; Pleural Neoplasms ; diagnosis ; diagnostic imaging ; secondary ; Retrospective Studies ; Tomography, Spiral Computed ; methods

OBJECTIVETo explore the influence of compound whole grain complex antioxidant chain on oxidative stress to the hyperlipidemia population.

METHODSFrom March 2008 to March 2009, 418 hyperlipemia residents (45 to 75 years of age) of Han group were screened from 3 main districts in Nanjing, according to the community, blood lipids and oxidative indicators, stratified into intervention and control group by quasi-experimental design. The intervention group (212 individuals) were provided with compound whole grain and health education while only health education was provided for the control group (206 individuals). Body mass index (BMI), waist-to-hip ratio (WHR), total cholesterol (TC), triglyceride (TG) and high density lipoprotein cholesterol (HDL-C) and oxidative indicators (including T-AOC, MDA, SOD, GSH-Px) were measured before and after the one-year intervention period. Analyses of the correlation between posture, biochemical markers and oxidative stress indicators before and after intervention were carried out.

RESULTSAfter intervention, BMI ((25.53 ± 2.77) kg/m(2)), WHR (0.82 ± 0.03), TC ((4.60 ± 0.98) mmol/L), TG ((1.26 ± 0.88) mmol/L) in the intervention group were decreased significantly compared to the levels of BMI ((26.60 ± 3.18) kg/m(2)), WHR (0.93 ± 0.05), TC ((4.97 ± 1.02) mmol/L), TG ((1.98 ± 1.11) mmol/L) in the control group (all P values < 0.05); while HDL-C ((1.34 ± 0.26) mmol/L) in the intervention group was increased significantly compared to the level of HDL-C ((1.18 ± 0.17) mmol/L) in the control group (P < 0.05); After intervention, levels of T-AOC (19.52 ± 0.81), SOD ((85.42 ± 21.65) U/ml) and GSH-Px ((128.26 ± 33.65) µmol/L) were increased significantly compared to the levels of T-AOC (11.11 ± 1.30), SOD ((78.68 ± 30.48) U/ml) and GSH-Px ((118.48 ± 24.19) µmol/L) in the control group (all P values < 0.05); while MDA ((1.78 ± 1.16) nmol/ml) decreased significantly compared to the level of MDA ((2.12 ± 1.37) nmol/ml in the control group (P < 0.05); Pearson product moment correlation analysis showed that: T-AOC with TC, TG, BMI showed a negative correlation (r values were -0.258, -0.266, -0.230, respectively, all P values < 0.05), while with HDL-C was a positive correlation (r values was 0.194, P < 0.05); SOD with TC, TG, BMI showed a negative correlation (r values were -0.282, -0.311, -0.217, respectively, all P values < 0.05), while with HDL-C was a positive correlation (r values was 0.169, P < 0.05).

CONCLUSIONCompound whole grain could improve lipid metabolism to the hyperlipidemia population. There was a correlation between common human metabolism and the levels of oxidative stress.

Aged ; Aged, 80 and over ; Antioxidants ; China ; epidemiology ; Diet ; Diet Surveys ; Edible Grain ; Female ; Health Education ; Humans ; Hyperlipidemias ; epidemiology ; metabolism ; prevention & control ; Lipid Metabolism ; Male ; Middle Aged ; Oxidative Stress

OBJECTIVETo investigate the effects of losartan, a specific angiotensin II receptor blocker, on slowing progression of renal insufficiency in patients with biopsy-proven chronic allograft nephropathy (CAN) and the molecular mechanism of the therapy.

METHODSTwenty-two renal transplant recipients with biopsy-proven CAN (group A) were treated with losartan within two months after renal dysfunction for at least one year. Losartan was administered at a dose of 50 mg/d. Twenty-four recipients in the same fashion (group B) who never received angiotensin II receptor antagonist were studied as control. The investigation time for each patient lasted one year. Renal functions and concentrations of plasma and urine transforming growth factor-beta1 (TGF-beta1) were compared between the two groups at the initiation and end of the study. In group A, expressions of TGF-betal mRNA and immunofluorescence intensity of TGF-betal protein and pathological alterations in renal biopsy specimens were compared between before losartan therapy and after one year of the therapy.

RESULTSAt the initiation of the investigation, no significant differences were found between group A and group B in clinical data such as donor age, cold-ischemia time, HLA mismatch, levels of creatinine clearance (Ccr), plasma and urine TGF-beta1 concentrations. One year later, 14 of 22 (63.6%) patients showed stable or improved graft functions in group A, and 4 of 24 (16.7%) in group B. The difference was significant (P < 0.05). At the end of the study, urine TGF-betal concentration was 273.8 +/- 84.1 pg/mg x Cr in group A and 457.2 +/- 78.9 pg/mg x Cr in group B. During one year study period, loss of Ccr was 6.6 +/- 5.4 mL/min in group A and 16.2 +/- 9.1 mL/min in group B. Both of the differences were significant between the two groups (P < 0.01). No significant differences were found in plasma TGF-betal concentrations between the four values determined at the initiation and end of the study in the two groups (F = 2.56, P > 0.05). After one year losartan therapy, group A showed a significant decrease in expressions of TGF-beta1 mRNA and TGF-betal protein in renal biopsy specimens [from 1.59 +/- 0.35 to 0.96 +/- 0.27 and from (10.83 +/- 2.33) x l0(6) to (6.41 +/- 1.53) x 10(6), respectively; both P < 0.01], but in light microscopy the histological changes were similar to the first renal biopsy. Losartan was excellently tolerated in all patients in group A. No cases with losartan therapy showed too low blood pressure and other side effects.

CONCLUSIONThis study suggests that losartan have an effect on slowing progression of CAN. Reducing production of intrarenal TGF-betal may play a decisive role in the efficacy of losartan.

Adolescent ; Adult ; Aged ; Angiotensin II Type 1 Receptor Blockers ; pharmacology ; Creatinine ; blood ; urine ; Disease Progression ; Female ; Humans ; Kidney ; pathology ; Kidney Transplantation ; adverse effects ; Losartan ; pharmacology ; Male ; Middle Aged ; Postoperative Complications ; metabolism ; pathology ; RNA, Messenger ; biosynthesis ; genetics ; Renal Insufficiency, Chronic ; drug therapy ; pathology ; surgery ; Transforming Growth Factor beta1 ; biosynthesis ; genetics