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 .

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

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.

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 investigate the inhibitory effects of a recombinant adenovirus vector ex-pressing human IFN-λ1 ( r-Ad-hIFN-λ1) on the growth of orthotopic gastric cancer and to analyze its possi-ble mechanism in a nude mice model of orthotopic human gastric carcinoma .Methods Orthotopic trans-plantation was performed to establish the nude mice model of orthotopic gastric cancer .Thirty mice were ran-domly divided into three groups including PBS control group , Ad-Lac Z empty vector group and r-Ad-hIFN-λ1 experiment group .The mice in each group were given the corresponding interventions once a week for three times.The sizes of tumor were detected by using B-mode ultrasound at different time points to draw growth curves .The expression of IFN-λ1 at mRNA level in skeletal muscle tissues was analyzed by RT-PCR.Western blot assay and immunohistochemical staining were used to detect IFN-λ1 protein in gastric tumor samples .The apoptosis of cells in paraffin-embedded tumor tissues was detected by TUNEL .The per-centages of natural killer ( NK) cells in spleen tissues were analyzed by flow cytometry .Results Compared with control group and empty vector group , the mice in r-Ad-hIFN-λ1 experiment group showed the smallest tumor size [(331.25±6.00) mm3, (322.92±5.92) mm3 vs (248.39±7.60) mm3; P<0.05].hIFN-λ1 was transfected into skeletal muscle successfully and expressed in gastric cancer tissue .Highly expressed hIFN-λ1 was observed in cytoplasm of tumor cells from experiment group by immunohistochemical staining . The apoptotic index of tumor tissues for experiment group was 0.700±0.059 which was significant different from that of control group (0.271±0.026, P<0.05) and empty vector group (0.333±0.028, P<0.05). The percentage of NK cells in spleens from mice in experiment group [(26.49±1.89)%] was significantly higher than that of control group [(13.94 ±1.31)%, P<0.05)] and empty vector group [(19.12 ±1.69)%, P<0.05)].Conclusion Transfection of r-Ad-hIFN-λ1 and expression of hIFN-λin skeletal muscle could significantly inhibit the growth of gastric cancer by inducing tumor cells ′apoptosis and enhan-cing NK cells.

Objective To evaluate image quality of 640-slice coronary CT angiography by combined anesthesia in Tibet minipigs. Methods Tibet minipigs underwent 640-slice coronary CT angiography after anesthesia with xylazine hydrochloride and pentobarbital sodium. The effect of anesthesia was observed and the image quality was evaluated.Results The anesthesia maintained in 40 minutes.The heart rate was (66.66±6.62)beat per minutes.The respiratory frequency was (15.62±1.53)beat per minutes.The revived time was 30 -60 minutes. All of images were good enough to be diagnosed.Conclusion Combined anesthesia with xylazine hydrochloride and pentobarbital sodium has excellent anesthetic effect.It is also simple,convenient and safe.Therefore,it is one of ideal anesthetic methods on such study for 640-slice coronary CT angiography in Tibet minipigs.