AIM:To enhance the doctors` ability of disease diagnosis and treatment by using standardized patients in neuro-ophthalmology teaching.METHODS: Graduated students and visiting students accepting neuro-ophthalmology training courses in Department of Ophthalmology during 2014-2016 were enrolled as the research objects.Two groups were randomized allocated and 20 students each group.One group of students was applied standardized patients teaching method and the other group of students was applied traditional teaching method.A questionnaire and exam after the teaching were evaluated.The data were analyzed by SPSS 20.0.RESULTS: The data of questionnaire included content interest improving,satisfaction for teaching,the key points understanding,theory with practice effective linking,future practice instruction.Comparison questionnaire data between two groups were of statistical significance (P<0.05).The test scores of case analysis of two groups were statistically significant also(P<0.001).CONCLUSION: Standardized patients teaching method is helpful for students` training on the ability of clinical diagnosis and treatment.

Objective To investigate MRI examination methods and imaging manifestations of primary ureteral carcinoma, and to evaluate its clinical values when comparing with other diagnostic imaging facilities. Methods Eighty-seven cases of primary ureteral carcinoma who were operated within recent 8 years came into the study, among which, 35 cases had MRI examinations. For MRI examination, coronal heavy T2WI (water imaging) was performed to show the dilated ureter, then axial T2WI and T1WI were scanned at the obstruction level. 11 cases underwent additional Gd-DTPA dynamic contrast enhanced scans. The original pre-operative diagnostic reports of various imaging facilities were analyzed comparing with the results of operation and pathology. Results MRI showed ureteral dilatation in 33 of 35 cases, no abnormal appearance in 1 case, and only primary kidney atrophy post renal transplantation in 1 case. Among the 33 cases with ureteral obstruction, soft mass at the obstruction level was detected on axial scans in 32 cases. The lesions showed gradual and homogeneous mild to moderate enhancement on contrast MRI. The overall employment rate of imaging facilities was as follows: ultrasound (94. 3% ) , IVU (59. 8% ) , CT (52. 9% ) , MRI (40. 2% ) , and RUP (35. 6% ). The accurate diagnostic rate was as follows: MRI (91. 4% ) , RUP (80. 6% ) , CT (63. 0% ) , ultrasound (47. 6% ) , and IVU (11. 5% ). Conclusion Combination of MR water imaging and conventional sequences can demonstrate most primary ureteral carcinoma lesions and has a highest diagnostic accuracy among the current diagnostic imaging facilities. It should be taken as the first diagnostic imaging method of choice when primary ureteral carcinoma is suspected after ultrasound screening.

Objective To assay the level of neutrophil extracellular traps (NETs) in systemic lupus erythematosus (SLE) patients and healthy controls and compare the difference between SLE group and control group, and to analyze between the level of NETs and related laboratory parameters. Methods Forty-four females patients with SLE were recruited as research subjects, with 24 cases in the active stage and 20 in stable stage. Forty-two healthy female volunteers matched in age were enrolled as control subjects. The fluorescence intensity of NETs in neutrophils was detected by fluorospectrophotometry. The concentration of neutrophil elastase in plasma was quantitatively detected. Statistical analysis of the difference of level of NETs between the SLE group and control group was conducted. Then the correlation between the fluorescence intensity of NETs and erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), and anti-double-stranded DNA (dsDNA), and anti-histone, and anti-nucleosome, and systemic lupus erythematosus disease activity index (SLEDAI) was analyzed respectively. The same tests were conducted for the level of NE. The results of the two groups were compared using analysis of variance and the relevance was analyzed using Spearman correlation analysis. NETs morphosis was observated by immunoflurescence method, and the difference of NETs between SLE group and control group was analyzed. Results ① The fluorescence intensity of NETs was significantly increased in SLE group(241±139) than that in the control group (173±135), (t=2.31, P<0.05).②The concentration of NE in the SLE group (102±47) was significantly higher than that in the control group (62±22), t= 4.38, P<0.01. No difference of NETs [(274±168) vs (211±102), t=1.52, P>0.05] and NE concentration [(104±43) vs (96±48), t=0.50, P>0.05] between SLE active stage and stable stage was detected. ③ The fluorescence intensity of NETs in SLE patients was positively correlated with SLEDAI, but had no obvious correlation with anti-dsDNA, anti-histone, anti-nucleosome, CRP or ESR, respectively. ④Images under confocal microscope showed that more NETs generated by PMN from SLE patients than that from controls. Conclusion The generation of NETs is enhanced in female patients with SLE. And NETs may relate to disease activity. However, NETs may not induce the production of autoantibodies.

AIM: To screen the lentiviral vector carrying siRNA with higher efficiency of suppressing the sphingosine-1-phosphate receptor 2 (S1P2) gene expression in the primarily cultured corpus cavernosum smooth muscle cells of spontaneously hypertensive rats (SHR).METHODS: SHR and SD rats (n=5 each) were used for primarily culturing corpus cavernosum smooth muscle cells.The cells were randomly divided into 6 groups: SHR siRNA-1, SHR siRNA-2, SHR siRNA-3, SHR GFP, SHR control (SHR non-transfection group), and SD control (SD rat control group).Each group had 5 samples with 1.0×105 cells of each sample.At 72 h after transfection (MOI=60) with lentiviral vectors carrying S1P2 siRNA into the SHR corpus cavernosum smooth muscle cells, the expression of GFP was observed under fluorescence microscope.The protein expression of S1P2, ROCK1, ROCK2 and eNOS in the corpus cavernosum smooth muscle cells, and the mRNA expression of S1P2, ROCK1 and ROCK2 were determined by by Western blot and RT-PCR.RESULTS: The transfection efficiency of the corpus cavernosum smooth muscle cells in SHR siRNA-1, SHR siRNA-2, SHR siRNA-3 and SHR GFP groups were>80%.Compared with SHR control group, the mRNA levels and the protein expression of S1P2, ROCK1 and ROCK2 in SHR GFP group showed no remarkable changes, while those in SHR siRNA-1, SHR siRNA-2, SHR siRNA-3 and SD control groups were significantly lower than those in SHR control group (P<0.05).The protein expression of eNOS in SHR siRNA-1, SHR siRNA-2, SHR siRNA-3 and SHR GFP groups were not significantly changed as compared with SHR control group, but that in SD control group was significantly higher than that in SHR control group.CONCLUSION: Three groups of siRNA lentiviral vectors targeting S1P2 inhibit the expression of S1P2 in the corpus cavernosum smooth muscle cells of SHR, and by silencing the S1P2 expression, the expression of ROCK1 and ROCK2 is inhibited.Among them, siRNA-1 has the highest inhibitory efficiency.

Objective To investigate effects of low shear stress on atherosclerosis,the development of atherosclerosis and expression of ?actin and cMyc proteins were studied in VSMC of common carotid artery under low shear stress. Methods We established the atherosclerotic model of left common carotid artery that presented low shear stress by the operation of ligating the left external carotid artery in rabbits.The histomorphology of the carotid arteries was examined by light microscopy.The expression of ?actin and cMyc was studied by immunohistochemistry. Results The typical atherosclerosis was observed and the atherosclerotic lesion was obviously accelerated under low shear stress.The expression of ?actin was downregulated and the phenotype of VSMC converted from contractile phenotype into synthetic phenotype,and expression of cMyc increased in VSMC of the artery under low shear stress.Conclusion This new model of atherosclerosis under low shear stress was successfully established,which provides a new tool for studying the effects of low shear stress on atherosclerosis.The results show that the atherosclerotic lesion is obviously accelerated and VSMC tends to proliferate in response to low shear stress.

Objective To explore role of functional neck dissection for lower collar-shaped incision at hair margin behind ear in the treatment of differentiated thyroid cancer. Methods The clinical data of 11 patients with thyroid papillary carcinoma who underwent func-tional neck dissection for lower collar-shaped incision at hair margin behind ear were retrospectively analyzed. Results The incisions of all patients were unseen in daily life and patients were satisfied with the postoperative appearances. No case of shoulder syndrome,postoperative local recurrence and distant metastasis was observed. Conclusion Functional neck dissection for lower collar-shaped incision at hair margin behind ear is effective in the treatment of differentiated thyroid cancer. Meanwhile it can obviously improve patients’ postoperative appearance and life quality,therefore it is worth clinical application.

Objective To investigate the clinical biomarkers of acute lung injury(ALI) after the Stanford A aortic dissection.Methods Thirty patients underwent Stanford A aoatic dissection were selected as subjects,who hospitalized from January 2006 to March 2013.Of which,21 patients underwent total arch replacement with stented elephant trunk procedure and 9 patients underwent triple-branched stent graft placement.The general information of patients,preoperation echocardiogram data,and arterial partial pressure of oxygen (PaO2),partial pressure of carbon dioxide (PaCO2) and fraction of inspired oxygen(FiO2) were recorded before,after the operation and entering ICU.Alveolar-arterial oxygen difference (A-aDO2),oxygenation index (OI) were calculated.Results A-aDO2 and OI at preoperation,postoperative and entering ICU point were (112.47 ±41.06) mmHg,(136.13 ± 29.51) mmHg and (141.37 ± 25.94) mmHg; (535.23 ± 70.15) mmHg; (491.50 ± 73.12) mmHg and (387.33 ± 91.32) mmHg respectively,and the differences were significant (F=35.926,323.742;P =0.000).The levels of A-aDO2 and OI at entering ICU were significant different from that of pre-operation and post-operation (P ＜ 0.01,P ＜ 0.05).Conclusion Early postoperative oxygenation and switching functions of patients with Stanford A aortic dissection are subject to damage to some degree.The A-aDO2 and OI might be sensitive biomarkers of the diagnosis for early acute lung injury of aortic dissection patients.

Objective To evaluate the efficacy of small dose of dexmedetomidine for prevention of the adverse effects caused by carboprost in the patients undergoing caesarean section.Methods Forty parturients,of ASA physical status Ⅰ or Ⅱ,aged 26-30 yr,weighing 63-71 kg,scheduled for elective caesarean section under epidural anesthesia,were equally and randomly divided into control group (C group) or carboprost group (D group) by using a random number table.After delivery of the fetus,all the patients received iv infusion of 20 U oxytocin and carboprost 250 μg was injected into the myometrium simultaneously.In group D,after a loading dose of dexmedetomidine 0.1 μg/kg,dexmedetomidine was infused at a rate of 0.4 μg· kg-1 · h-1 starting from 1 min prior to carboprost injection until the end of surgery,while the equal volume of normal saline was given in group C.Adverse effects such as dyspnea,facial flushing,nausea,vomiting,hypertension and tachycardia were recorded.The OAA/S scores and time for breastfeeding initiation were also recorded at the end of surgery and 2 h after surgery.Results Compared with group C,the incidence of dyspnea,facial flushing,nausea,vomiting,hypertension and tachycardia was significantly decreased in D group.There was no significant difference in OAA/S score and the time for breastfeeding initiation after surgery between the two groups.Conclusion Small-dose dexmedetomidine (loading dose 0.1 μg/kg,followed by infusion at 0.4 μg· kg-1 · h-1 until the end of surgery) infused before carboprost administration is helpful in preventing the adverse gastrointestinal and cardiovascular reactions caused by carboprost in the patients undergoing caesarean section.

Objective To investigate the effect of up-regulation of tetraspanin-5 (Tspan-5) expression on the metastatic ability of colorectal cancer (CRC) cells. Methods The coding sequence of Tspan-5 mRNA was amplified from total RNA of LoVo cells by RT-PCR and cloned into pEGFP-C1 to construct Tspan-5/pEGFP-C1,a eukaryotic expression vector. The expression of Tspan-5 in LST-R1 cells was up-regulated by gene tranfection. Western blotting was used to detect the expression level of Tspan-5/EGFP fusion protein,and laser scanning confocal microscopy (LSCM) was used to observe the distribution of Tspan-5/EGFP in LST-R1 cells. The changes in adhesion,migration and invasion ability of LST-R1 cells were determined by adhesion,migration and invasion experiment in vitro,respectively. Liver metastasis model of nude mice was used to test the changes in liver metastasis ability of LST-R1 cells in vivo. Results The Tspan-5/EGFP fusion protein could be detected by Western blotting in Tspan-5/pEGFP-C1 transfectants. LSCM showed that Tspan-5/EGFP protein located in cell membrane. Adhesion and migration assays showed that up-regulation of Tspan-5 expression level significantly promoted the adhesion and migration ability of LST-R1 cells on a series of extracellular matrix (ECM) components,including collagen IV,FN,LN and VN (P

Objective To investigate the clinical features of patients with recurrent epithelial ovarian cancer (EOC),and explore the factors that can prolong the disease-free interval(DFI) after primary treatment.Methods We retrospectively reviewed the medical records of 54 patients with recurrent EOC and analyzed the clinical stage,histological subtypes,primary treatments,DFI,recurrent site,secondary treatment,and the response after secondary treatment.By Mann-Whitney test and T test,factors influent the DFI were analyzed,the relationship between DFI and the response after secondary treatment were analyzed also.Results The mean DFI for all 54 patients was 19.07 months.The DFI of patients received optimal cytoreductive surgery was longer than those received non-optimal cytoreductive surgery [(32 ± 19.10) months vs (18.77 ± 7.80) months,P ＜ 0.01];The DFI of patients with serous,mucous and clear cell tumor was [(20.16 ± 14.63) months,(14.00 ± 4.73) months and (16.67 ± 13.03) months,respectively],suggesting patients with mucous tumor might have shorter DFI.The DFI of patients with low tumor grade was longer than those with high tumor grade [(28.18 ± 16.97) months vs (16.52 ±9.46) months,respectively];The DFI of patients with stage Ⅰ and Ⅱ disease was [(19.60 ± 12.89)months],was compared to the DFI of patients with stage Ⅲ,stage Ⅳ disease,which was [(19.22 ± 12.38) months] and [(11.67 ±5.39) months],respectively.When disease recurred,the most frequent recurrent site was pelvic (50％,n =27),with upper abdominal (29.6％) and lymph node(29.6％) followed.When recurrence was found in lymph node,the most frequent site was pelvic and para-arotic lymph node.In our study,when disease recurred,response of the tumor after the secondary treatment has no relationship with the DFI.Conclusions Patients received optimal cytoreductive surgery,patients with low tumor grade and early stage have longer DFI.Retroperitoneal lymphadenectomy might be chosen during the primary cytoreductive surgery in some selected patients.