Case based learning ( CBL ) teaching method was applied to the experiment group in radiology internship teaching,and conventional teaching in control group.Two mentors would evaluate and score their radiological case analysis.The aim of this research was to explore the application and effect of case-based learning ( CBL ) teaching method in radiology internship teaching.

Objective To study the application value of parathyrod in situ exposure and protection in differentiated thyroid cancer thyroid carcinoma (DTC) surgery. Methods 500 cases of DTC admitted from Jan. 2012 to Dec. 2014 were selected for the research. According to whether the parathyroid was anatomically exposed during the surgery, the patients were divided into experimental group (exposed group) and the control group (un-exposed group). Then, depending on tumor extent and risk factors, the experimental group were divided into group E1 (lateral affected glandular lobe, isthmus lobe resection and unilateral VI lymph node dissection )and E2 (total or subtotal thyroidectomy and bilateral VI lymph node dissection), while the control group were divided in-to group C1 (surgical treatment same as E1)and group C2 (surgical treatment same as E2). Patients’ postopera-tive nerve and muscle symptoms were observed, such as clinical manifestations of face, lips, hand and foot numb-ness or convulsions. Both preoperatively and postoperatively, patients’ parathyroid hormone (PTH) and serum calcium level indicators were detected before surgery and at the 1st, 3rd, 5th, 7th, 14th and 28th day after surgery. Results The lymph node metastasis rate and number between experimental group and the control group had statistical insignificance (χ2=1.02, 0.79, P=0.14, 0.96). The recurrence rate of the 2 groups had no significant difference during the follow-up (χ2=0.23, P=0.65). Group E1 was significantly lower than Group C1 in postopera-tive parathyroid function decline rate, incidence of hypocalcemia and parathyroid mistakenly cut rate. Group E2 was also obviously lower than Group C2 in all these aspects. The difference had statistical significance (P<0.05). Conclusion Parathyrod in situ exposure and protection assisted by direct vision of the magnifying glass can re-duce the mistakenly cut rate of parathyroid and the temporary hypoparathyroidism, which can effectively avoid the adverse effects caused by total thyroidectomy.

Objective: Fetal monitoring is extremely important in perinatal care. Analysis of cardiotocogragh(CTG) can suppose if the fetus is lack of oxygen, distressed, acidosis, etc. in order to take measures timely. Methods: We have designed Meticare analysis software package to analyze 867 pieces of CTG data, and researched the relationship between short term variation (STV) and basal heart rate(BHR) by statistics, and short time monitoring analysis based on STV. Results: The amplitude of fetal heart rate curve variation(long term variation) tended to decrease when BHR increasing, with the negative correlation and regression equation STV = 9.866-0.02×BHR. Positive correlation exists between 5 and 10 mimute-STV, with the regression equation STV_(10min)=2.861-0.596×STV_(5min).Conclusion: STV calculated by 5 minutes CTG data can forecast the one by 10 minutes data as a reference demanded by Dawes & Redman criterion. If fetal doppler contains STV analysis function, out-patient fetal heart auscultation will be more significant. After 30 weeks pregnancy, with the STV decreasing, fetal distress, asphyxia, low birth weight, and even mortality increasing. BHR increasing should cause attention that STV might decrease, when monitoring with no analysis functional devices or fetal dopplars.

Objective To compare the prognosis and life quality of patients with early-stage breast cancer(stage I or II)undergoing breast-conserving surgery or modified radical mastectomy.Methods 180 cases with early-stage breast cancer were divided into 2 groups:breast-conserving surgery group(BCS)and modified radical mastcctomy group(MRM),with 90 cases in each group.The 2 groups were all given radiotherapy,chemotherapy and endocrine therapy according to indications.The prognosis and life quality in the 2 groups were compared.Results The 5-year-postoperative follow-up showed there was no significant difference in duration of disease-free survival(DFS)of the 2 groups.However,life quality of BCS patients was significantly better than that of MRM patients in terms of general health,physical function,pain,vitality,social functioning,emotion and mental health.Conclusion Breast-conserving surgery is highly recommended for patients with early-stage breast cancer.

PurposeTo study the MRI and pathological features of ovarian endometrioid adenocarcinoma (OEC) in order to evaluate the value of MRI in diagnosing OEC. Materials and Methods The MRI imaging features of 8 patients confirmed by surgery and pathology were analyzed retrospectively and were compared with the results of surgery and pathology. The MRI outcome and the related histological findings were further analyzed.Results Six out of the eight patients had unilateral tumor, 3 tumors in the left and the other 3 in the right; 2 patients had masses in the both ovaries. The total number of masses was ten.The diameters of the tumors ranged from 3.5 to 16.5 cm, with the average size of (10.5±4.1) cm. The border of 2 tumors was partially fuzzy and that of the other 6 was clear. The MRI scans showed that 8 tumors were cystic-solid and the other 2 were solid with heterogeneous signals. The solid components mainly presented slightly short T1 signals and long T2 signals; the cystic ones revealed long T1 and T2 signals. The enhanced scanning showed that the solid components of 8 tumors were patchy and obviously enhanced and the other 2 had mild or moderate enhancement. The cystic components were not hyper-intense. The enhanced MRI scans of two cases of primary endometrial carcinoma with metastases to the ovaries showed thickened endometrium and mild hyper-intense.Conclusion MRI can reveal the pathological features of OEC and clearly presents the forms, components and the relationship with its surroundings of tumors. Therefore, MRI is of great importance to the clinical diagnosis of OEC.

Objective To observe the influence of trastuzumab on DNA break repair and Her-2 nuclear import after radiation in breast cancer cell line SKBR3,and discuss the radiosensitivity mechanism of trastuzumab.Methods Clone formation assay was used to analyze the difference of survival fractions between radiation group and radiation plus trastuzumab group.Confocal microscopy was applied to observe the influence of trastuzumab in the nuclear import process of Her-2 and the expression of γH2AX after radiation,which is considered as the marker of DNA double strand break.Western blotting was used to detect the expression of Her-2 and DNA-PKcs in nuclei after radiation.Results The result of clone formation assayshowed that the SF2 in radiation group was 0.547±0.046 and 0.321±0.022 in the radiation plus trastuzumab group were significantly decreased,the results of confocal microscopy showed that trastuzumab postponed the nuclear import process of Her-2 (52.80±19.74 in radiation group,21.41±10.55 in the radiation group),and increased expression of γH2AX after radiation (85.40±25.63 in radiation group,18.53±44.32 in the radiation group),and western blotting revealed trastuzumab reduced the expression of Her-2,DNA-PKcs in nuclei.Conclusion Trastuzumab can inhibit the radiation induced nuclear import of Her-2,and decrease Her-2,DNA-PKcs in nuclei to increase the DSB on early stage after radiation.

This study examined the radiation-induced ERBB2 nuclear transport in the BT474 breast cancer cell line and the relationship between caveolin-1 and radiation-induced ERBB2 nuclear transport. The BT474 cells were treated with herceptin (200 nmol/L), PP2 (a caveolin-1 inhibitor, 100 nmol/L) and irradiation combined or alone. Confocal microscopy was used to observe the nuclear import of ERBB2 and caveolin-1 after irradiation. Western blotting was employed to detect the expression of ERBB2, caveolin-1 and DNA-PKcs after irradiation, and immunoprecipitation to identify the ERBB2 and caveolin-1 complex before perinuclear ERBB2 localization. Confocal microscopy showed the transport of ERBB2 and caveolin-1 from the cell membrane to the nucleus 15 min after irradiation and the proteins accumulated at the perinuclear region within 45 min. Western blotting revealed that the expression levels of ERBB2, caveolin-1 and DNA-PKcs were increased after irradiation and reached a peak 45 min later. Both herceptin and PP2 treatments were found to decrease ERBB2 expression. An immune complex composed of ERBB2 and caveolin-1 was found in the herceptin group after irradiation. It was concluded that after irradiation, ERBB2 may be transported from the cell membrane to the nucleus and activate DNA-PKcs to trigger DNA double-strand break (DSB) repair; caveolin-1 may participate in this process. Treatments involving the downregulation of caveolin-1 may increase the radiosensitization of breast cancer cells.

Objective To discuss the method of the surgical treatment for retained and regenerate hepaticolithiasis, and to improve the theraputic level. Methods In recent 5 years,in our hospital,136 cases of retained and regenerate hepaticolithiasis were treated by combination of hepatolobectomy with other operation, and these cases were analyzed retrospectivly. Results One patient died after operation (0. 7%),8 patients had other complications including: biliary fistuta(6 cases, 4.4%), subphrenic abscess (2 cases,1.5%). All cases were visited for 2.5 - 8.3 years, 115 (84.6%) cases had not any symptom, 6 (4.4%)cases had infection of biliary tract, 6(4.4%) cases had retained calculus, 9(6.6%) cases recurred calculus 2 -5 years after operation. Conclusion Retained and regenerate hepaticolithiasis should be treated by combination of hepatolobectomy with other operation and fiber choledochoscope and B ultrasound of operation, which can increase therapeutic effect.

OBJECTIVETo study the relationship between TCM syndrome type and HBV-DNA in serum and peripheral blood mononuclear cells (PBMCs) in chronic hepatitis B (CHB) patients.

METHODSThe serum HBV markers,HBV-DNA levels in serum and PBMCs, were quantitatively detected in 220 CHB patients by PCR method, and TCM syndrome type of 205 patients were differentiated.

RESULTSArranged from low to high, the percentages of CHB patients with the serum HBV-DNA > or = 1.0 x l0(5) copy/mL (high viral loading) in the five syndrome types were as follows: damp-heat retention in middle-jiao syndrome (DHRS, 55.2%), blood stasis blocking collateral syndrome (BSBC), Gan-Shen yin deficiency syndrome (GSYS), Pi-Shen yang deficiency syndrome (PSDS) and Gan stagnation with Pi deficiency syndrome (GSPS, 82.5%), the difference was significant between DHRS and GSPS; those with HBV-DNA in PBMCs infection were: GSYS (27.3%), DHRS (34.3%), BSBC (53.1%) and GSPS (77.2%). The percentage in GSPS was the highest, which was significantly different to that in other syndromes.

CONCLUSIONAmount of serum HBV-DNA and PBMCs HBV-DNA infection has certain correlation with the TCM syndrome type of CHB. The highest percentage of patients with HBV-DNA > or = 1.0 x l0(5) copy/mL and PBMCs HBV-DNA infection presented in CHB patients of GSPS type. We should pay more attention to strengthen genuine qi to eliminate pathogenic factors in treatment of CHB.

Adolescent ; Adult ; Aged ; DNA, Viral ; blood ; Diagnosis, Differential ; Female ; Hepatitis B virus ; genetics ; Hepatitis B, Chronic ; pathology ; therapy ; virology ; Humans ; Leukocytes, Mononuclear ; virology ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Syndrome ; Young Adult

Objective To investigate the impairment and the effect factors of encoding of episodic memory in patients with cerebral infarction. Methods 112 cases cerebral infarction patients and 115 healthy elders as controls were tested for episodic memory encoding with episodic pictures accomplished in computer, and compare the differences of encoding of episodic memory between the two groups. Results The remember indexes ( REM )of encoding memory test in patient group was significantly lower than that in control group( (70.81 ± 6.08 )vs (84.67 ± 4.49), P ＜ 0.01 ). The REM in patients with different impaired areas was significantly different ( (65.88 ± 5.73 ), (68.92 ± 4.65 ), (73.39 ± 6.20), ( 73.53 ± 3.44), P ＜ 0. 01 ). The REM in frontal lobe infarction group was significantly lower than that in temporal lobe infarction group (P ＜ 0.05 ), and in temporal lobe infarction group was significantly lower than that in basal ganglia infarction group and corona radiate infarction group (P＜0.05, P＜0. 01). The REM in cortex infarction group was significantly lower than that in under cortex group ( ( 67.37 ± 5.40 ), ( 73.46 ± 4.99 ), P ＜ 0.01 ). The REM in small cerebral infarction group was significantly higher than that in large cerebral infarction group( (72.67 ±4.47 ), (67.56 ± 6.18 ), P＜0.01 ). The size of cerebral infarction diameter was related with the REM( r= -0.39, P＜0. 01 ). The REM among control group,infarction with atrophy group, and infarction without atrophy group were significantly different( (67.03 ± 6. 17 ),( 72.84 ± 5. 00 ), ( 84.67 ± 4.49 ), P ＜ 0. 01 ). The REM in infarction with atrophy group was significantly lower than that in infarction without atrophy group and control group( both P＜0.01 ) ,The REM in infarction without atrophy group was significantly lower than that in control group (P ＜ 0.01). Conclusion The encoding of episodic memory was impaired in cerebral infarction patients. The infarction parts,size of infarction area and atrophy was related with the impairment of encoding of episodic memory.