Virtual reality simulators and surgical demonstration were used in laparoscopic teaching combining teacher' guiding with students' practice to improve the teaching effectiveness hecause of the limitations of the traditional apprenticeship teaching methods.The new method was applied for 2 cycles and for 6 weeks.The results showed that the teaching methods of virtual reality simulators combined with surgical demonstration can significantly improve the effectiveness of laparoscopic teaching and shorten the initial learning curve,therefore it is worth promoting in laparoscopic operation training and teaching.

Objective To investigate the diagnostic value of heart-type fatty acid binding protein (H-FABP) versus cardiac trofonin I (cTnI) and creatinekinase-MB (CK-MB) in early diagnosis of acute myocardial infarction (AMI) in elderly patients.Methods 67 patients with acute chest pain were selceted sequentially and divided into AMI group (n＝30) and non-AMI group (n=37).Plasma H-FABP level was rapidly detected by using colloidal gold reagent plate and solid phase immunochromatographic assay for qualitative determination within and after 6 hours of AMI onset.Plasma levels of cTnI and CK-MB were determined within and after 6 hours of onset.The diagnositic value of H-FABP,cTnI and CK-MB in AMI was compared within and after 6 hours of onset.Results The sensitivity of H-FABP was better than that of cTnI and CK-MB within 6 hours of onset (93.3％ vs.46.6％,23.3％,both P＜0.05).The negative predictive value of H-FABP was better than that of cTnI and CK-MB within 6 hours of onset (94.7％ vs.69.8％,61.1％,both P＜ 0.05) While,positive predictive value and specificity were basically the same between H-FABP,versus cTnI and CK-MB.H-FABP and cTnI levels had significant differences between AMI and non AMI group after 6 hours of onset (all P＜0.05).Plasma levels of cTnl and CK-MB were higher after 6 hours than within6 hours [cTnI (4.10±1.79) mg/L vs.(1.45±1.31) mg/L,CK MB(180.52± 158.70) U/L vs.(20.02± 7.97) U/L,both P＜0.05].Conclusions As compared with cTnI and CK-MB,within 6 hours after AMI onset,H-FABP as a new myocardial necrosis marker has higher sensitivity,specificity,positive and negative predictive values in the diagnosis of AMI.While,after 6 hours of AMI onset,H-FABP has the same diagnostic value as cTnI and CK-MB.

Objective To investigate the changes in the concentration of myocardin in children with lupus nephritis (LN) under different degree of vessel damage.Methods Forty-nine children diagnosed with LN by routine tissue immunolfuorescence, light microscope, and electron microscope were included, and 30 healthy children were included as control group. The pathological classiifcations were performed according to the ISN/RPS 2003 LN pathological classiifcation criterion. According to the Katafuchi evaluation method, the semi quantitative assessment of glomerular and kidney tubule damage was carried out, and the degree of vascular damage was evaluated at the same time. Double antibody sandwich method was used to detect the concentration of serum myocardin.Results The glomerular and kidney tubules damage in children with LN were signiifcantly aggravated with higher pathological classification (P<0.05). Glomerular damage was positively correlated with renal interstitial damage (r=0.96, P<0.01). The degree of vascular damage was related to the degree of glomerular injury and renal interstitial injury, while it was no related with the results of clinical tests. There were different concentrations of myocardin among mild-, moderate-, severe-vessel damage and control groups (F=378.61,P<0.001), and the concentration of myocardin in moderate- and severe-vessel damage groups were obviously lower than those in control group and mild-vessel damage group (P<0.01) while there was no difference between control group and mild-vessel damage group (P>0.05). According to pathological type, there were signiifcant differences in the concentration of myocardial between control group and different pathological types (F=626.793,P<0.01). FromⅡ,Ⅲ,Ⅲ+Ⅴ,Ⅳ toⅣ+Ⅴ, the concentrations of myocardial were decreased systematically, and there were statistic differences between groups (P all<0.05).Conclusion The concentration of myocardin in children with LN can relfect the renal vascular damage to a certain extent. Elevation of myocardin concentration may be helpful for the repair of vascular damage.

Objective To observe the protective effect of?-asarone,the active components from Rhizoma Acori Tarinowii,on human umbilical venous endothelial cell strain ECV304 injury induced by oxidized low-density lipoprotein(ox-LDL)and to investigate its influence on proliferation of vascular smooth muscle cells(VSMC). Methods The well-grown ECV304 cells were randomized into 5 groups:normal group,control group,high-, middle-and low-dose?-asarone groups.Except the normal group,ECV in the other groups were co-cultured with ox-LDL 25?g/mL,and the?-asarone groups were additionally with?-asarone 30,15 and 7.5?g/mL added respectively.Flow cytometry was used to detect the cell apoptotic rate and the mitochondrial membrane potential (MMP)of ECV304 as well as the proliferation index and the DNA content in different cell phases of VSMC. Results In the model group,the apoptotic rate of ECV was increased,MMP was decreased,and VSMC proliferation was promoted(P

Abstract: Schistosomiasis is a serious major parasitic disease that threatens human life and health. A better understanding of the mechanism of host-schistosome interactions is the key to designing new prevention and control strategies. MicroRNAs (miRNAs) are endogenous small non-coding RNA molecules, which lead to the degradation of the target messenger RNA (mRNA) or inhibition of its translation in a sequence-specific manner. Both schistosome and its host produce miRNAs, which can be secreted by extracellular vesicles (EVs). There is accumulating evidence that miRNAs from schistosome can be taken up by host cells, and finely manipulate the phenotype of host cells for their survival or pathogenesis in a cross-species manner, even inhibiting the growth and metastases of hepatoma cells. It is still unknown whether host free miRNAs can be taken up by schistosome, but this phenomenon is highly probable. miRNA-mediated cross-species regulation has emerged as a novel mechanism for host-schistosome interactions, and this review summarizes the advances in this regard.

China ; epidemiology ; Humans ; Influenza, Human ; epidemiology ; Population Surveillance ; methods ; Time Factors

Objective To analyze the clinical characteristics of twin reversed arterial perfusion sequence (TRAP),and investigate its prenatal evaluation and clinical management.Methods Karyotype results and ultrasound data of 25 TRAP cases were retrospectively reviewed,including estimated weight and umbilical blood flow of acardiac twin,cardiac function and middle cerebral artery peak systolic velocity of pump twin.Various managements and the outcomes were analyzed.Results (1) Karyotype of amniotie fluid were tested in 16 pump twins.Mosaicism was found in 1 case (46,XX[36]/46,XY [14]).(2) According to the ultrasound evaluation,large acardia accounted for 87.0％ (20/23) cases.Abundant blood perfusion (inter-twin difference of umbilical resistance index ≤0.20) was indicated in 86.4％ (19/22) cases.Decompensation of cardiac function was suggested in 66.7％ (10/15) pump twins.Fetal anemia of pump twin indicated by middle cerebral artery peak systolic velocity＞1.5 multiples of the median was diagnosed in 75.0％ (12/16) cases.(3) The acardiac twin with abundant blood perfusion was more likely to be a large acardia than those without [94.7％(18/19) vs 1/3,Fisher exact test,P=0.04]; More pump twin with large acardia tended to have cardiac decompensation than non-large acardia pump twins [83.3 ％ (10/12) vs 0/3,Fisher exact test,P=0.02].(4) Eleven patients chose to terminate their pregnancies after being diagnosed.In 14 cases who continue the pregnancies,the survival rate of pump twin was 64.3％ (9/14).In 3 cases of non-large acardia without cardiac decompensation of pump twin,the patients selected conservative observation resulting in 2 term deliveries and 1 termination of pregnancy due to for exacerbation.Among 11 cases with large acardia,which the pump twins were complicated by cardiac decompensation or anemia,five cases selected conservative observation.One ended in spontaneous abortion; three exacerbated (one termination and two cesarean section before term with living births) ; one was stable until delivery.Another 6 cases received bipolar cord coagulation,and successful interruptions of acardiac blood flow were achieved in 5 cases among which 4 pump twins survived.Conclusions Prenatal diagnosis,cardiac function and fetal anemia of pump twin,together with the growth and blood supply of acardia are important indexes for prenatal evaluation of TRAP,on which our prompt management should be based.

AIM: To analyze the effect of compound xuesaitong combined with conbercept on central macular retinal thickness (CMT), fluorescein fundus angiography and best corrected visual acuity(BCVA) in pathological patients with choroidal neovascularization (CNV).METHODS:A total of 60 cases (60 eyes) with pathological myopia and CNV who were admitted to our hospital during January to October 2016 were enrolled in the study.They were divided into observation group and control group, 30 cases in each group.Observation group was treated with compound xuesaitong combined with conbercept.Control group was treated with conbercept only.Changes of CMT, intraocular pressure (IOP), area of CNV, BCVA and serum vascular endothelial growth factor (VEGF) before surgery, 4 and 12wk after surgery were compared.Complications during follow-up were statistically analyzed.RESULTS: At 12wk after surgery, the total effective rate was 97% in observation group, 80% in control group and the difference was significant (P<0.01).The CMT, IOP, area of CNV and serum VEGF levels were significantly lower or smaller than those before surgery while BCVA was significantly higher than that before surgery (P<0.01).There were no local complications of systematic severe complications.CONCLUSION: Compound xuesaitong combined with conbercept can effectively reduce CMT and IOP, reduce the area of CNV and significantly improve visual acuity.Its anti-VEGF effect is obvious, safe and feasible.

Objective To summarize our preliminary experience of selective fetieide with bipolar coagulation in complicated monochorionie twins(MCT),and discuss the clinical application of feticide in discordant MCT.Methods Three MCT with one twin anomaly.in which 2 had severe twin-twin transfusion syndrome(TTTS),stage Ⅳ ,and 1 had acardiac twin,were identified in the second trimester of pregnancy.To terminate the abnormal twin and isolate the co-twin's circulation completely.selective feticide was performed by umbilical cord occlusion with bipolar coagulation under guidance of ultrasound and fetoscopy.After each invasive procedure,serial monitoring was performed,including procedural complications,Doppler of fetal middle cerebral artery and umbilical artery.Pregnancies were followed up every 2 weeks for fetal growth until delivery.After birth the placentas and the terminated fetuses were examined.Result Cord occlusion was successfully accomplished in all 3 targeted fetuses,at 21,22 and 24 weeks of gestation respectively.One case with TTTS was complicated with rupture of the membrane in the terminated fetus at the 7th day after the procedure.and a healthy baby was born at 32 weeks.The other case with TTTS delivered a boy by cesarean section at 38 weeks.The third case with TRAP is at 35 weeks of gestations and under regular follow-up.Monochorionicity was confirmed by placental examination after delivery.and the effects of bipolar coagulation were observed at the,cord of terminated fetuses.Conclusions Umbilical cord occlusion witll bipolar coagulation is an effective procedure for selective feticide in MCT with one twin anomaly.The outcome of normal fetus can be favorable.

Objective To study the effect of Jieyuyubao prescription on endometrial pinopodes and HOXa-10 mRNA in chronic stress rats , and reveal the regulatory mechanisms of the endometrial receptivity. Methods Totally 48 SPF SD rats were randomly divided into three groups with weight stratified: normal control group (group A), model control group (group B) and experimental drug group (group C). Rat model of chronic stress was established in group B and group C. On the first day of stimulation, Jieyuyubao solution (1 g·mL-1 ) was intragastrically administered (11. 8 mL·kg-1 ) to the rats of group C at 9:00 am, once daily, and stopped giving at the fourth day of pregnancy (pd4) after being confirmed by vaginal smears. Purified water (11. 8 mL·kg-1 ) was intragastrically administered to the rats of group A and group B at 9:00 am. All the rats were mated at the sex ratio of female:male = 2:1 at 16:00 pm on the 21st day. The rats were sacrificed at the pd4. Maturity of endometrium pinopodes was assessed under transmission electron microscope. HOXa-10 mRNA content was evaluated by real-time fluorescence-PCR. Results The maturity of pinopodes was as follows: the maturity score of normal control group, model control group and experimental group was (2. 7 ± 0. 3), (1. 3 ± 0. 3), and (2. 1 ± 0. 2), respectively, with significant difference between experimental drug group and model control group (P<0. 05). HOXa-10 mRNA expression was significantly decreased in model control group (0. 658±0. 031) as compared with normal control group (0. 965±0. 102) (P<0. 05). Conclusion Jieyuyubao prescription maybe increase the number and maturity of pinopodes through promoting HOXa-10 mRNA expression in endometrial epithelium cells, and then improve endometrial receptivity.