Modern medical staff are facing the challenge to survive in competitions and develop through cooperation.Thus it is of great importance for the future medical staff,that is,medical students to cultivate and enhance their teamwork for future demand.Cultivating approaches mainly include creating a collaborative environment,carrying out cooperative scientific research,creating teamwork in the curriculum,and launching community service activities.

Objective To evaluate the expression of interleukin-6 (IL-6) on peripheral blood and adenoid in children with chronic rhinosinusitis (CRS) and adenoidal hypertrophy ,to investigate the mechanism of IL-6 on the occurrence and development of CRS .Methods A total of 216 cases of hypertrophic adenoids were collected ,including 95 CRS children with hypertrophic adenoid (CRS group) ,70 children with allergic rhinitis and hypertrophic adenoid (AR group)and 51 children with hypertrophic adenoid (control group) .The plasma IL-6 concentrations were detected by ELISA ,and the expression and distribution of IL-6 in adenoid tissue was detected by immunohistochemistry .Results The plasma IL-6 level in CRS group was (49 .8 ± 8 .3)pg/mL ,significantly higher than that of in control group (33 .6 ± 6 .9)pg/mL and in AR group (35 .9 ± 5 .6)pg/mL ,differences had statistic significance ( P< 0 .05) .However ,there was no statistically significant difference between AR group and control group .Meanwhile ,the presence of IL-6 in adenoid tissue was mainly seen in inflammation cells and fibroblasts while less in mesenchymal cells ,there were statistical differences between CRS group and control group/AR group (P< 0 .05) ,but no statistical difference between AP group and control group(P> 0 .05) .Conclusion Among children with CRS ,expression of IL-6 whether in peri-plasma or in focal tissue was higher than those without CRS ,demonstrating that IL-6 may play an important role in the pathogenesis and developemnt of CRS in chil-dren .

Objective: To investigate the clinical effect of Xinqingning (XQN), a preparation of rhubarb, combined with low dose continuous gastrointestinal dialysis in treating uremia. Methods: Patients of uremia were divided into three groups at random, 18 patients in group A were treated with 1000 ml gastrointestinal dialysate (non-absorbed mannitol solution) orally 2-3 times a day, 20 patients in group B treated with the same therapy as that in group A, also combined with XQN 5-10 tablets 3 times per day and 19 patients in group C treated with orally taken coated aldehyde oxystarch 5-10 g, 3 times a day. The therapeutic course for the three groups was 11 months. The changes in clinical manifestation, renal function, nutritional condition, and electrolytes before and after treatment were observed. Results: After treatment, significant improvement was revealed in aspects of uremic symptoms, quality of life, nutritional condition, serum creatinine, urea nitrogen, serum phosphate, uric acid, CO2 combining power, creatine clearance, body weight and arm muscular circumference in group A and B, as compared with those in group C. In comparison of group A with B, group B showed a lower serum triglyceride and a slower progression of chronic renal failure (CRF). All the criteria were not improved in group C and with serum creatinine being raised significantly. Conclusion: XQN combined with low dose continuous gastrointestinal dialysis therapy was definitely effective in treating uremia. It provides a new therapeutic means of non-replacement therapy for CRF with uremia.

Eleven type 1 diabetic patients who received fixed regime of insulin Glargine were included in the study.The levels of fasting serum insulin were measured for each subject at 6:00 in three consecutive mornings.The variability of mean fasting serum insulin in each subject was 3.3%-41.5% (mean 15.4%).The variability did not correlate with the dose of Glargine statistically.

Objective:To analyze the clinical features, imaging findings and gene test of patients with type Ⅱ Alexander disease.Methods:All the clinical data of three cases with type Ⅱ Alexander disease from August 2018 to June 2020 in the Department of Neurology, Qilu Hospital of Shandong University (Qingdao) and Qilu Hospital of Shandong University were collected, and their clinical and imaging findings were analyzed retrospectively.Results:All the three patients were middle aged and old men with a chronic progressive course, beginning with weakness of one or both lower limbs, followed by dizziness, dysarthria, dysphagia, sphincteral disturbances, constipation and orthostatic hypotension. Three patients all experienced misdiagnosis (hydrarthrosis, cerebral vascular disease, alcoholism, respectively) at early stage of the disease. Cranial magnetic resonance imaging (MRI) showed mild supratentorial periventricular leukodystrophy, which was not specific. Sagittal cranial MRI demonstrated medulla oblongata and upper cervical cord atrophy called “tadpole atrophy”, which had high suggestive value. The results of gene analysis showed heterozygous mutation of glial fibrillary acidic protein gene, which had been reported as pathogenic gene; c.1091C>T (p.A364V) in exon 6, c.722C>T (p.R258C) in exon 4 and c.197G>A (p.R66Q) in exon 1, respectively.Conclusions:Type Ⅱ Alexander disease is an autosomal dominant disease, most with point mutations, rarely with deletion mutations. Type Ⅱ Alexander disease should be suspected when a patient had signs of lower brainstem involvement such as dizziness, ataxia, pyramidal sign, autonomic dysfunction, especially when cranial MRI showed mild supratentorial leukodystrophy, and medulla oblongata and upper cervical cord atrophy.

OBJECTIVETo evaluate the early clinical and radiographic outcome of scaphoid non-unions treated with Acutrak headless compression screw.

METHODSFrom January 2008 to July 2011,21 patients with scaphoid non-union were treated in our department. There were 18 males and 3 females with a mean age of (23.6 +/- 4.6) years; 12 cases were on right hand and 9 were on left. According to Herbert-Fisher classification, there were 10 cases with type D1, 7 cases with type D2, 3 cases with type D3, and 1 case with type D4. The mean time from injury to operation was (12.4 +/- 2.7) months. All patients were treated with Acutrak headless compression screw fixation (6 cases received 2 screws fixation, 15 cases received 1 screw fixation, and Matti-Russe bone grafting was applied in 7 cases). The carpal height, the scaphoid index and changes of the scapholunate angle were assessed before and after the operation. Range of motion and grip strength were recorded and the wrist function was assessed according to the Patient-Rated Wrist Evaluation (PRWE).

RESULTSAverage duration of follow-up was (21.3 +/- 3.6) months. All the patients attained radiological union in a mean time of (13.3 +/- 2.4) weeks following the operation. No obvious complications were recorded. The surgical treatment allowed the preoperative mean scaphoid index of 0.61 +/- 0.13 and the preoperative mean scapholunate angle of (59.4 +/- 6.8) degree to be improved to 0.69 +/- 0.10 and (44.3 +/- 8.2)degree postoperatively, respectively. There was a substantial improvement in grip strength and pain amelioration after surgery. The preoperative mean PRWE score of 45.2 +/- 4.7 was improved to 76.1 +/- 5.2 postoperatively. All patients returned back to the original work,the average time from surgery to work was (6.0 +/- 1.1) months.

CONCLUSIONFor scaphoid non-unions, Acutrak headless compression screw fixation can provide anatomical reduction, provide satisfactory results with a high union rate, well return of function and minimal complications in the early stage.

Adolescent ; Adult ; Bone Screws ; Female ; Fracture Fixation, Internal ; Fractures, Ununited ; surgery ; Humans ; Male ; Range of Motion, Articular ; Scaphoid Bone ; injuries ; physiopathology ; surgery ; Treatment Outcome ; Wrist Injuries ; physiopathology ; surgery ; Wrist Joint ; physiopathology ; surgery ; Young Adult

OBJECTIVETo investigate the early clinical efficacy of induced membrane technique for reconstruction of large bone defects after debridement in adults with chronic osteomyelitis of limbs.

METHODSFrom March 2010 to March 2012,a total of 23 adult patients with chronic osteomyelitis of limbs were treated in our department. There were 15 males and 8 females, with a mean age 35.2 years old (ranged from 26 to 49 years old). Sixteen patients had open fracture history. According to the lesion site, there were 12 cases of tibia, 7 cases of femur, 3 cases of humerus, and 1 case of both radius and ulna. Among them, 19 patients had diseases in diaphysis and 4 patients in the metaphysis. The mean interval from infection to operation was 6.9 months (ranged from 4 to 13 months). All the patients were treated by using induced membrane technique. The follow-up evaluation included clinical complications, time of bone healing and limbs function. The Chinese version of SF-36 scores was used in the assessment of quality of life pre- and post-operation.

RESULTSThe average duration of follow-up was (27.6 ± 5.3) months (ranged from 18 to 43 months). Two patients had postoperative flap edge necrosis, 1 patient had superficial iliac incision infection, no obvious complications were recorded. Twenty patients obtained radiological union at a mean time of 4.6 months (ranged from 3 to 7 months). Among them, 16 patients treated with lower limbs surgery achieved full weight-bearing at about 5.2 months (ranged from 4 to 8 months) postoperatively. Four patients suffered from reinfection during follow-up, but 3 of them achieved complete bone healing after the second surgeries with induced membrane technique. At the final follow-up, there was a substantial improvement in each dimension scores and total scores of SF-36 as compared with those before surgery.

CONCLUSIONWhen treating with adult chronic osteomyelitis of limbs, the induced membrane technique can effectively reconstruct large bone defects after debridement, significantly shorten treatment cycle, provide satisfactory results with minimal complications, promote good recovery of limbs function and require relatively simple operation technique.

Adult ; Chronic Disease ; Extremities ; surgery ; Female ; Humans ; Male ; Middle Aged ; Osteomyelitis ; surgery ; Reconstructive Surgical Procedures ; methods

Objective To explore the effects of Ad-hIFN-λ1 recombinant adenovirus on prolifera-tion of gastric adenocarcinoma cell line SGC-7901 and its mechanism .Methods Ad-hIFN-λ1 recombinant adenovirus and empty plasmid Ad-LacZ were respeetively transfated to human gastric adenocarcinoma SGC-7901 cells.The proliferation of transfected cells was detected by MTT assay .IFN-λ1 gene expression at mR-NA and protein levels in the cells were measured by RT-PCR analysis and immunofluorescence assay , re-spectively .Tunel assay and flow cytometry were used to analyze the rate of cell apoptosis .Results The proliferation of gastric adenocarcinoma SGC-7901 cells were significantly inhibited with Ad-hIFN-λ1 inter-vention in accordance with highly expressed IFN-λ1 at mRNA and protein levels , respectively .The apoptosis rate of Ad-hIFN-λ1 transfected cells was markedly higher than that of the empty plasmid Ad-LacZ group and PBS blank control group .Conclusion The expression of hIFN-λ1 could be detected after transfection of Ad-hIFN-λ1 recombinant adenovirus into gastric adenocarcinoma SGC-7901 cells.Ad-hIFN-λ1 could signifi-cantly inhibit the proliferation of gastric adenocarcinoma SGC-7901 cells by promoting the apoptosis of cancer cells.

Conditions about protoplast preparation and regeneration of Streptococcus zooepidemicus,which could produce hyaluronic acid, were studied , including the concentration of lysozyme, lytic time, different osmotic stabilizers and the preculture under the high osmotic pressure . As a result, the formation and regeneration rate of protoplasts could reach up to 94.6% and 18.5% respectively under the optimum conditions, before the digestion of lysozyme (50U/mL,39℃, 60 min) the strain was cultured for 2 hours in 0.6 mol/L NaCl high osmotic pressure liquid medium containing 1.2% Gly. Among different treatments of various laser power and irradiating time, He-Ne laser which acted for 300 seconds with 40mW /cm 2 caused lethality rate as high as 99.88%. Finally, a mutated strain was gained, whose production of HA is 2.21g/L, just 4.5 times as much as the original strain.

The vip3A gene of Bt9816C was cloned and the sequencing result was submitted to GenBank (accession no.AY945939). The gene was identified as a novel vip3Aa gene, which was assigned name vip3Aa18 by the Bacillus thuringiensis delta-endotoxin nomenclature committee. Subsequently, vip3Aa18 was expressed in Escherichia coli BL21 and bioassay demonstrated that the purified recombinant Vip3Aa18 had high toxicity against Helicoverpa armigera and Spodoptera exigua. The results of sequence analysis revealed that a carbohydrate binding domain exists on the C-termini 536 to 667 residues of Vip3Aa18,which maybe participate in binding to midgut receptors in susceptible insects. Moreover, a transmembrane helices located on N-termini 272 to 292 residues was proposed responding for pore formation. Furthermore, a putative disulfide bond was found in the Vip3Aa18 sequence. The specific structures and sites of Vip3Aa18 sequence imply potential function.