There has been existing problems such as teaching method and test pattern in construction of medicine mathematical statistic curriculum in the medicine colleges. In combination with the teaching practice and the theory pondered,the article has elaborated several views to medicine mathematical statistic educational reform.

Objective To analyze CD+4 CDHi25 CDLo127 regulatory T cells (Treg) in peripheral blood of patients with thyroid nodules and differentiated thyroid cancer and their change regularity, and to investigate the immunosuppression mechanism. Methods The peripheral blood was collected from 175 patients with thyroid nodules, including 43 patients with differentiated thyroid cancer and 132 patients with nodular goiter.By using monoclonal antibodies, the blood samples were evaluated with the flow cytomertry for lymphocyte subsets and Treg cells. Results The results showed the prevalence of the CD+4 CDHi25 CDLo127 Treg in differentiated thyroid cancer group [(6.48±1.49) %] and nodular goiter group [(6.23+1.67) %] was higher than those in the healthy group [(5.62±1.48) %], and the difference was significant(P < 0.005), but there was no significant difference between the nodular goiter group and differentiated thyroid cancer group (P >0.005).Conclusion It is concluded that the relative increase of CD+4 CDHi25 CDLo127 Treg in peripheral blood of patients with nodular goiter and differentiated thyroid cancer may be related to immunosuppression and tumor progression.

Objective To investigate the role of renal nerve in cardioprotection provided by renal ischemic preconditioning(RIP).Methods The effects of ischemia-reperfusion and RIP on the hemodynamics, myocardial oxygen consumption, epicardial electrography and infarct size were examined in anesthetized rabbit.Results During the 45 min of myocardial ischemia and 180 min of reperfusion, all hemodynamic parameters and myocardial oxygen consumption decreased progressively significantly. Epicardial electrographic ST-segment was elevated significantly during myocardial ischemia and return to baseline progressively in the course of reperfusion. The myocardial infarct size occupied 55.80±1.25% of area at risk,and RIP significantly reduced the myocardial infarct size to 36.51±2.80%(P＜0.01). The renal nerve section (RNS) per se didn't affect myocardial infarct size produced by ischemia-reperfusion, while cardioprotection afforded by RIP was completely abolished by RNS.Conlusion RIP have the protective effect on heart, and activation of renal afferents by transient ischemia-reperfusion play an important role in such a cardioprotection.

Objective NKT cells are very important as a kind of non-specific immune cells. Much attention in antitumor significance has been received in the study of its effect on malignant diseases. The aim of this study was to detect the expression of NKT cells and its CD+8 NKT subsets in peripheral blood of esophageal patients and normal person, and to analyze the changes in the expression of NKG2D and NKG2A receptorsand its clinical pathological factors. Methods By flow cytometric analysis, 53 patients with esophageal carcinoma and 39 normal controls were analysed for peripheral blood of NKT cells and CD+8 NKT subsets, and the expression of NKT cells NKG2A and expression of NKG2D receptor. The clinical pathological factors were collected for the comparative analysis. Results Compared with the normal control group, the expression of NKT cells in peripheral blood of esophageal patients increased [(4.32±0.73) %, (5.97±1.29) %] (t =3.562, P <0.01), and the expression level of its surface receptor NKG2D reduced [(17.56±5.92) %, (15.12±1.56) %] (t =3.892, P <0.05), but the express levels of NKG2A [(4.02±1.41) %, (5.99±4.59) %] in creased (r = 4.015, P <0.05), those expression change with the development of the esophageal cancer. Conclusion The increased expression of NKT cells and CD+8 NKT subsets in the peripheral blood of patients with esophageal carcinoma refletcs that the immune feedback of patients' antineoplastic effect is strengthened. The decresed expression of the active receptor NKG2D and the increased expression of the inhibitory receptor NKG2A on NKT cells might be one of mechanisms leading to the reduction of NKT cell activity and immune escape of patients with esophageal carcinoma. The changes of surface receptors of NKT cells may be associated with the development of the esophageal cancer.

ObjectiveTo evaluate the clinical value of infrahyoid myocutaneous flap in the reconstruction of mouth floor tissue defects. MethodsInfrahyoid myocutaneous flap was made including stenohyoid,thyrohyoid,omohyoid and the affiliated skin based on the axis of superior thyroid artery,vein and ansa cervicalis. The clinical data of 11 patients with reconstruction of mouth floor tissue defects using infrahyoid myocutaneous flap (maximum area was 8 cm × 3 cm) from Match 1993 to June 2009 were retrospectively reviewed.ResultsSeven infrahyoid myocutaneous flaps which reserved platysma branch of superior thyroid artery were all alive, while 2 patients presented epidermal necrosis of 4 un-protected patients. The follow-up period was range from 24 months to 195 months, one patient received salvage surgery for local regional lymphatic recurrence in level Ⅰ,which survived without diseases until now.The rest cases had turned out a success.No dysphagia,dysphonia,and tongue extension difficulty was reported in any patient.ConclusionInfrahyoid myocutaneous flap is one of the valuable donor sites for the reconstruction of mouth floor tissue defects after radical oncologic operations,especially for those with early stage carcinoma of the mouth floor.

Objective To determine the frequency of depression in patients with Parkinson' s disease(PD) and healthy controls over 50 years of age and to analyze the characteristics and influencing factors of PD with depression(PDD) in Nanjing.Methods One hundred and twenty-six PD patients were diagnosed and assessed using Self-rating Depression Scale (SDS) and Hamilton Depression Scale (HAMD).The frequency,characteristics and influencing factors of depression were statistically analyzed,and the factor analysis of HAMD was carried out.Also,one hundred and twenty-four healthy subjects over the age of 50 were selected as the control group.Ressults The incidence of depression in PD group was 48.4％ ( 61/126):15.1％ (19/126) for mild depression,27.8％ (35/126) for moderate depression,5.6％ (7/126) for severe depression.The incidence of depression in the control group was 9.7％ (12/124):5.7％ (7/124) for mild depression,2.4％ (3/124) for moderate depression,1.6％ (2/124) for severe depression.There was a significant difference between these two groups( x2 =45.36,P ＜ 0.01 ).Univariate and Logistic regression analysis revealed that a high frequency of depression occurred in patients with long PD duration,high H-Y stage and UPDRS Ⅲ.According to each factor analysis of HAMD,the scores of cognitive impairment,tardiness,anxiety and sleep disturbances of the PD patients with depressive syndromes were higher than that of the control group.Conclusion Depression is a relatively common complication of PD in Nanjing which is associated with long PD duration,severity of motor disturbances and increasing H-Y stage.

Objective To investigate the effects of ropivacaine infiltration combined with dezocine on the agitation during recovery from general anesthesia in the patients undergoing cerebral surgery.Methods Sixty patients of both sexes,aged 18-64 yr,of ASA physical status Ⅰ or Ⅱ,undergoing elective neurosurgery under general anesthesia,were randomly divided into 4 groups (n =15 each) using a random number table:control group (group C),ropivacaine group (group R),dezocine group (group D),and ropivacaine + dezocine group (group RD).Group C received local infiltration with normal saline 20 ml at 10 min before skin incision,and normal saline 2 ml was injected intravenously at 30 min before the end of operation.The patients received local infiltration with 0.5％ ropivacaine 20 ml at 10 min before skin incision,and normal saline 2 ml was injected intravenously at 30 min before the end of operation in group R.Group D received local infiltration with normal saline 20 ml at 10 min before skin incision,and dezocine 10 mg was injected intravenously at 30 min before the end of operation.The patients received local infiltration with 0.5％ ropivacaine 20 ml at 10 min before skin incision,and dezocine 10 mg was injected intravenously at 30 min before the end of operation in group RD.The time for recovery from anesthesia,extubation time,and development of agitation after extubation in PACU were recorded.Agitation was assessed and scored.Ramsay sedation score and VAS score were recorded immediately after extubation.The development of cardiovascular events and respiratory depression was recorded within 10 min after extubation.Before induction of anesthesia (T0),at the end of surgery (T1) and immediately after extubation (T2),blood samples were collected from the dorsal artery of foot for deter mination of the levels of blood glucose,plasma cortisone,epinephrine and norepinephrine.Results Compared with group C,the agitation score,incidence of agitation,VAS score,and incidence of postoperative hypertension were significantly decreased in R,D and RD groups,especially in R and D groups.The time for recovery from anesthesia and time for extubation were significantly shorter in R and RD groups than in group C.Ramsay sedation scores were significantly higher at the onset of extubation in R,D and RD groups than in group C.Ramsay sedation scores were significantly higher in D and RD groups than in group R.Compared with group C,the levels of blood glucose,plasma cortisone,epinephrine and norepinephrine were significantly decreased in R,D and RD groups,especially in group RD.Conclusion Ropivacaine infiltration combined with dezocine can reduce the agitation during recovery from general anesthesia in the patients undergoing cerebral surgery.

Objective To compare short-term therapeutic outcomes and the safety of percutane-ous radiofrequency ablation (PRFA) with left single lung ventilation (LSLV) for liver cancer of the hepatic dome (LCHD) and that of PRFA for right liver carcinoma in favorable location. Methods Thirty one patients with hepatocellular carcinoma (belonging to LCHD) receiving PRFA with LSLV (Group LCHD) between January 2006 and January 2009 in our hospital were selected, and 45 control patients with right lobe HCC ≥1 cm away from the liver capsule, gallbladder, and main portal bran-ches were also included. One month after PRFA, residual tumors were followed up with contrast en-hanced CT and alpha fetal protein and PRFA was repeated in the presence of residual foci. Tumor-free survival time was defined as the duration from complete ablation to diagnosed local tumor progression.The Mann-Whitney test was used to compare age, tumor diameter, and average number of punctures between LCHD patients and controls. A χ2 test was used for comparison of the incidence of complica-tions and incomplete tumor ablation rate. The Kaplan-Meier's method was used for calculation of local tumor-free survival rate compared with a log-rank test. Results The incidence of right shoulder pain was significantly higher in LCHD patients than in controls (87. 1% vs 11. 1%, P<0. 01). LCHD pa-tients showed no difference from controls in the average number of punctures (2. 8±. 5 vs 3. 2±. 5,P>0. 05). Meanwhile, there was no difference between the 2 groups in average duration of treatment and hospitalization, and the complete tumor ablation rate at first PRFA. No differences were observed in the 1-, 2- and 3-year local tumor-free survival rates between LCHD patients (85. 5% , 65. 8% , and 36. 4% ,respectively) and controls (87.7%, 62. 3% , and 34.0% , respectively). Conclusion PRFA with LSLV for LCHD seems to promise comparable short-term outcomes and safety to PRFA for right liver carcinoma of fa-vorable location and should be preferred as one of the therapeutic options for LCHD patients with tumor di-ameters≤5 cm regardless of its unique location.

Objective To investigate the expressions of carbohydrate antigen 19-9(CA19-9), carbohydrate antigen 15-3(CA15-3) and carbohydrate antigen 125(CA125) and their clinical significance in papillary thyroid carcinoma (PTC). Methods The expressions of CA19-9, CA15-3 and CA125 were detected by immunohistochemical MaxVision method in 80 cases of PTC and 80 cases of benign thyroid lesions (BTL), including 34 cases of nodular goiter, 26 cases of Hashimoto's thyroiditis and 20 cases of follicular adenoma. The relationship between expressions of CA19-9, CA15-3 and CA125 and the clinical pathological characteristics were analyzed. Results The expression rates of CA19-9, CA15-3 and CA125 in 80 cases of PTC were 85%, 100%and 43.8%respectively, compared with BTL, the difference was statistically significant (P < 0.01). There was no significant correlation between expressions of CA19-9, CA15-3 and CA125 and age, gender, number and diameter of tumor nodules, lymph node metastasis, and TNM staging (P > 0.05). The sensitivity of CA19-9, CA15-3 and CA125 in the differential diagnosis of PTC and BTL were 85%, 100% and 43.8% respectively, and the specificity were 91.3%, 36.3%and 91.3%, respectively. Conclusion The expressions of CA19-9, CA153 and CA125 are helpful for the differential diagnosis of PTC and BTL.

OBJECTIVETo evaluate masticatory performance and life quality of children with ectodermal dysplasia (ED) after prosthetic rehabilitation.

METHODSSix children with ED received denture restoration and 18 healthy children were involved in this study. The surface electromyography (EMG) of masseter (MM) and anterior temporalis (TA) during clenching and chewing movement were recorded. The EMG amplitude, area, asymmetry index of total and activity index of MM/TA were compared at each stage. The masticatory efficiency was measured with spectrophotometer. The life quality was assessed using visual analogue scale questionnaire.

RESULTSThe EMG amplitude of MM and TA during chewing in ED Group were 41.7% and 45.6% of the control group respectively, the area were 35.9% and 36.0% respectively. Significant difference in asymmetry index of total during clenching was observed between the two groups (P < 0.05) but not during chewing (P > 0.05). The differences of activity index of MM/TA during clenching and chewing between the two groups were not detected (P > 0.05). The masticatory efficiency of ED group was 67.2% of the control group. The score of chewing function in children with ED after prosthetic rehabilitation was three times higher than before, and no difference was present between the two groups (P > 0.05).

CONCLUSIONSEarly prosthetic rehabilitation can significantly improve the masticatory performance and life quality of children with ED.

Case-Control Studies ; Child ; Dental Prosthesis ; Ectodermal Dysplasia ; physiopathology ; rehabilitation ; Electromyography ; Humans ; Masseter Muscle ; physiology ; Mastication ; physiology ; Quality of Life ; Temporal Muscle ; physiology