Objective:To study the enhancing effect of bFGF-targeted antisense phosphorothioate oligonucleotide (APO)on the chemosensitivity of human laryngeal squamous carcinoma cell line Hep2 to Doxorubicin,5-Fluorouracil, and Cisplatin.Methods:bFGF-specific APO was designed,constructed and transfected into Hep2 cells with jetPEI (polyethyleneimine).Expression of bFGF mRNA was evaluated by semi-quantitative RT-PCR after transfection;immuno- cytochemical method was used to examine the expression of bEGF expression before and after transfection of Hep2;the in- duction of cell apoptosis was analyzed by flow cytometry;cell proliferation was then analYzed by MTT assay after treatment with bFGF-specific APO or chemotherapeutic drugs,or a combination of both.Results:bFGF-specific APO inhibited the growth of Hep2 cells in a dose-and time-dependent manner,with the peak inhibitory rate being 25.5%.The expression of bFGF mRNA and protein decreased by 52.0% and 41.1%,respectively.The apoptosis rate of Hep2 cells was 20.5% after transfection,bFGF-specifie APO reduced the 50% inhibitory concentration of Doxorubicin,5-Fluorouracil,and Cis- platin in Hep2 cells by 75.5%,83.5% and 65.4%,respectively.Conclusion:bFGF-specific APO can enhance the chemosensitivity of Hep2 cells,which paves a new way for potential biologic chemotherapy of laryngeal squamous carcino- ma.

Objective To explore the clinical outcome of improved technique of Gamma nail in the treatment of intertrochanteric hip fracture of the elderly patients. Methods From March 2002 to October 2006.39 patients with intertrochanteric hip fracture were operated by improved technique of Gam-ma nail.There were 18 males and 21 females at average age of75.7 years(67_98 years).There were 6 patients with type A1 fracture,24 with type A2 fracture and 9 with type A3 fracture according to AO/ASIF classification.Of all.36 patients(92.3%)had osteoporosis.The operation improvements included the following points:(1)The patients were placed at the lateral decubitus position with the fractured limb on the uppermost,with flexion of knee and hip of 60°.The normal hip and knee were flexed as possible.(2)One-off indirect traction reduction was used after general anesthesia. no requirement of continuous mechanical traction.(3)C-arm image intensifier was employed to obtain normal and lateral projections.Results Of all,35 patients were followed up for a mean period of3 years and 2 months, ranging from 6 months to 5 years and 2 months.Operation data showed incision length of(4.3±1.2)cm,mean opera-tion time of(46±10)minutes,intraoperative bleeding volume of(65±26)ml and intraoperative X-ray exposure of(3.0±2.1)times.Postoperative recovery data showed survival in one-year follow up,with ambulation time of(10.5±3.6)days and fracture union time of(10.9±2.1)weeks.Mean Parker's score wag(6.9±3.2)points 6 months after operation. Conclusions Improved technique of Gamma nail can shorten operation duration,reduce operative trauma and bleeding,reduce X-ray exposure and im-prove success rate of surgery.as facilitates early pest-operative recovery and reduces the perioperative mortality rate of the elderly.

navirus disease 2019 (COVID-19) in the patients younger than 18 years old infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant, and to provide a basis for determining the chest CT changes and efficacy of COVID-19 caused by Omicron virus variant in patients younger than 18 years old. Methods　The clinical and imaging data of 30 cases of patients younger than 18 years old infected with COVID-19 Omicron variant, who admitted to the Third People's Hospital of Shenzhen from February 11 to March 26, 2022 were collected and retrospectively analyzed. The clinical manifestations, imaging features and dynamic changes of lesions were summarized. Results A total of 41 intrapulmonary lesions in 30 patients with COVID-19 caused by SARS-CoV-2 Omicron variant. The main manifestations were patchy or nodular ground-glass opacities and/or consolidation, with focal subpleural distribution, lesions mainly occur in the right lung (70.73%, 29/41). There were 42 lesion morphologies, with 22 (52.38%) striped shadows and 16 (38.10%) nodular shadows, with small lamellar and patchy shadows predominating. There were 36 lesion density variations, with ground glass shadows being the most common, with a total of 24 ground glass shadows (66.66%) in each lobe of the lung, and also 6 consolidation lesions (16.67%) and 6 mixed ground glass opacity and consolidation lesions (16.67%). With the progression of the disease, lesions gradually enlarged, appeared on the 2nd day (312.93 mm3), peaked on the 9th day (1 837.18 mm3). The average absorption time of the lesions was (16±3) days, and there was no significant difference between the absorption time of patchy and nodular lesions (ground glass and/or consolidation) (t=0.853, P>0.05). The lesions showed focal ground-glass opacity in the early stage, 77.78% lesions were absorbed after treatment in the late stage. Inflammatory nodules were absorbed slowly (9-19 days), without residual fibrotic changes. Conclusions　The imaging manifestations of COVID-19 in patients younger than 18 years old infected with SARS-CoV-2 Omicron variant have certain characteristics, showed patchy or nodular ground glass opacities and/or consolidation, mainly distributed in the subpleural area, with small and few lesions and slow change, didn't remain fibrosis. Being familiar with its clinical and imaging manifestations can assist in early diagnosis, but confirming the diagnosis requires a combination of epidemiological history, clinical symptoms, SARS-CoV-2 nucleic acid and radiological manifestations.

OBJECTIVETo evaluate the creativity of medical students and study their personality characteristics using personality questionnaires.

METHODSThis investigation was conducted among 310 medical students using 16 Personality Factor Questionnaire (16PF) and Eysenck Personality Questionnaire (EPQ).

RESULTSA total of 302 students completed the questionnaires. The male and female students showed significant differences in two sub-factors with similar creativity. Four subfactors were identified to positively or inversely correlate to the creativity. The number of male students without either high or low scores was greater than that of female students. The incidences of abnormal scores in 16PF showed significant difference between students with typical EPQ scores and those with atypical scores for introversion-extroversion.

CONCLUSIONSThese medical students do not show high creativity in this study. Compared with the male medical students, the female students are more likely to have extroverted personality, and their scores for 16 basic personality factors easily exceed the normal ranges, suggesting the necessity of mental health education. The students with at least 5 abnormal scores in 16PF may show a typical introversion-extroversion personality, and individual psychological counseling can be considered when necessary.

China ; Creativity ; Female ; Humans ; Male ; Personality ; Students, Medical ; psychology ; Surveys and Questionnaires ; Young Adult

OBJECTIVETo study the effect of peroxisome proliferator activated receptor γ (PPAR-γ) agonist on the angiotensin converting enzyme 2 (ACE2) mRNA expression in monocyte-derived macrophages of essential hypertensive patients.

METHODSTotally 57 essential hypertensive patients were randomly divided into three groups: conventional treatment group (n=18), telmisartan group (n=19), and benazepril group (n=20); 20 patients with normal blood pressure were also selected as the control group. Monocyte-derived macrophages were isolated from blood samples of patients in all four groups. The expression of ACE2 mRNA in monocyte-derived macrophages was detected by RT-PCR before treatment and 4 and 12 weeks after treatment.

RESULTSFour and 12 weeks after treatment, the systolic pressure and diastolic pressure of telmisartan group and benazepril group were significantly lower than that of the conventional treatment group (all P<0.01), and the systolic pressure and diastolic pressure of telmisartan group were significantly lower than that of the benazepril group(both P<0.01) .The expression of ACE2 mRNA in monocyte-derived macrophages were significantly lower in essential hypertensive patients than that in control group (P<0.01). After having been treated for 4 weeks and 12 weeks, the expression of ACE2 mRNA in monocyte-derived macrophages of hypertensive patients in telmisartan and benazepril groups were significantly higher than that in conventional treatment group (all P<0.01), and the expression of ACE2 mRNA in telmisartan group was significantly higher than that in benazepril group (both P<0.01).

CONCLUSIONPPAR-γ agonist could increase the ACE2 mRNA expression in monocyte-derived macrophages of essential hypertensive patients.

Aged ; Benzazepines ; pharmacology ; Benzimidazoles ; pharmacology ; Benzoates ; pharmacology ; Female ; Humans ; Hypertension ; drug therapy ; enzymology ; Macrophages ; enzymology ; Male ; Middle Aged ; PPAR gamma ; agonists ; Peptidyl-Dipeptidase A ; genetics ; metabolism ; RNA, Messenger ; genetics

This paper introduces the familiar mothed for standard clinic novitiate, lecture compiling, preparation before the classes and concrete execution. By compiling standard lecture, training the teaches, regulating the novitiate teaching quality for practical curricula can be improved.

Adult ; Diagnostic Errors ; Female ; Glioma ; diagnosis ; Humans ; Male ; Middle Aged

BACKGROUNDIn order to make posterior fossa decompression for the management of Chiari I malformation simple and less invasive while using direct visualization, a novel solely endoscopic procedure has been employed for the decompression of Chiari malformation type I. The objective of this study was to present neural endoscopic posterior fossa decompression and atlas laminectomy for Chiari type I patients.

METHODSTwenty-one patients with Chiari type I underwent neural endoscopic posterior fossa decompression and atlas laminectomy. We described the procedure for neural endoscopic posterior fossa decompression and atlas laminectomy. All patients in this series demonstrated cerebellar tonsil herniation below the foramen magnum in addition to syringomyelia. All patients in the reviewed study underwent preoperative MRI as well as 3-month postoperative MRI. Additional follow-up MRI varied but was usually repeated 12 months to 18 months after surgery. Postoperative MRI studies were retrospectively reviewed and compared with preoperative studies.

RESULTSAll patients showed clinical improvements, and none had any complications. Patients with syringomyelia had symptoms entirely disappear. Eleven patients (52.4%) experienced radiographic improvement in syringomyelia (decreased size or resolution) during the follow-up period. Nine patients (42.8%) demonstrated decreased syrinx size and four (19%) demonstrated resolved syrinx. Of the 15 patients with symptomatic syringomyelia, 11 (73.3%) experienced symptomatic improvement. The median time to symptom improvement was four months after surgery. Post surgical MRI examinations indicated complete and sufficient decompression of foramen magnum region.

CONCLUSIONSEndoscope atlanto-occipital decompression surgery is an innovative, safe and effective surgical procedure. It has similar results compared to traditional surgery, however with the added advantages of being minimal invasive, having fewer complications, decreased influence on stability of occipital bony structure, and a faster recovery as well as reduced hospital stay and expenses.

Adolescent ; Arnold-Chiari Malformation ; surgery ; Child ; Decompression, Surgical ; methods ; Endoscopy ; methods ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Minimally Invasive Surgical Procedures ; methods ; Retrospective Studies ; Syringomyelia ; surgery

OBJECTIVETo identify prognostic factors predicting survival after radical resection of ampullary carcinoma.

METHODSClinical data of sixty- five patients with cancer of the ampulla of Vater underwent pancreaticoduodenectomy and regional lymphadenectomy were analyzed retrospectively.

RESULTSA total of 1380 lymph nodes dissected from the resected specimens was examined to detect the presence of metastasis. The median follow- up period was 83 months. Univariate analysis revealed that factors associated with poor survival included the number and the location of positive nodes. Thirty- three of the 65 patients had a total of 116 positive lymph nodes, of whom 20 had 1- 3 positive regional nodes lymph and 13 had > or = 4 positive regional lymph nodes. Multivariate analysis revealed that the number of positive nodes lymph was an independent prognostic factor (P=0.007), while the locations of lymph nodes failed to remain as an independent variable. The survival rate in patients with > or = 4 positive lymph nodes was significantly lower than that in those with 1- 3 positive lymph nodes. The median survival time was 49 months with a 5- year survival rate of 43% in patients with 1- 3 positive lymph nodes, whereas all patients with > or = 4 positive nodes died of the disease within 23 months after resection (P=0.0001).

CONCLUSIONThe number of positive regional lymph nodes is an independent prognostic factor in patients with ampullary carcinoma after resection.

Adult ; Aged ; Ampulla of Vater ; pathology ; Carcinoma ; pathology ; Common Bile Duct Neoplasms ; pathology ; Duodenal Neoplasms ; diagnosis ; secondary ; Female ; Humans ; Lymph Node Excision ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Postoperative Period ; Prognosis ; Retrospective Studies

Objective To evaluate the value of heart rate variability (HRV ) and sympathetic skin response (SSR) in differential diagnosis of Parkinson's disease (PD) .Methods We selected 36 PD ,17 essential tremor (ET) and 59 Parkinsonism-Plus (PD-plus) patients diagnosed in our department .We recorded HRV during the period of quiet breath ,deep breath and Vasaval as well as SSR incubation period of the upper limbs and lower limbs . Results ① During the period of quiet breath ,HRV decreased significantly in PD group compared with that in ET group (P< 0 .05) ,and abnormality rate of HRV in PD group was higher than that in ET group .HRV did not significantly differ between PD and PD-plus .HRV did not significantly differ among the three groups during the period of deep breath and Vasaval .② SSR incubation period showed no significant difference among PD ,PD-plus and ET groups .③ The specificity and sensibility of HRV in PD and PD-plus differential diagnosis were 22 .8% and 82 .6% , while for PD and ET differential diagnosis the values were 66 .9% and 82 .6% . The specificity and sensibility of SSR in PD and PD-plus differential diagnosis were 39 .0% and 52 .6% , 29 .4% and 52 .6% , respectively ,for PD and ET differential diagnosis .Conclusion Compared with those in ET patients ,HRV in PD patients decreases and HRV abnormality rate increases .HRV is of great value in differential diagnosis of PD and ET but not in differential diagnosis of PD and PD-plus .Determining SSR incubation period does not have much value in differential diagnosis of PD ,PD-plus and ET .