Objective To screen the differentially expressed proteinin the livetissue of the drug-induced acute hepatifail-ure rat.MethodTwenty-foumale SD ratwere randomly divided into two group,the experimental group (12 cases) wagiven D-galactosamine10g/L by intraperitoneal injection and the control group (12 cases) wagiven normal saline by intraperitoneal injec-tion .The total proteinin the livetissue samplewere extracted ,quantitated ,and subjected to separate by the two-dimension elec-trophoresis(2-DE) of isoelectrifocusing (IEF) and SDS-PAGE ,found outhe discrepanprotein spotby the software and per-formed the identification by MALDI-TOF-M.Result27 differential protein spotwere successfully identified ,and 15 up-regula-ted and 12 down-regulated proteinexpressionwere obtained in the experimental group compared with the control group .Conclu-sion The significandifferencein the expressionof protein,such acasein kinase I(CKⅠα) ,tyrosine protein kinase(PTK) ,pro-liferating cell nucleaantigen(PCNA) ,et.in the liveexisbetween the acute hepatifailure model ratand the normal one.

Objective To investigate the effects of baicalin on serum progesterone and related hormones in female normal and cerebral ischemia rats; To explore whether baicalin plays a role in cerebral protection of neurological functions by regulating progesterone levels.Methods With vaginal smear method, the adult estrus female SD rats were selected and divided into normal group, baicalin normal group, and molding groups. The left side of the middle cerebral artery of rats in the molding groups was blocked to establish the permanent middle cerebral artery occlusion (pMCAO). After modeling, the rats were randomly divided into model group, baicalin treatment group, progesterone treatment group and progesterone inhibitor group. The baicalin normal group and baicalin treatment group were given intraperitoneal injection of baicalin solution; the normal group and model group were given normal saline of the same quantity; progesterone treatment group was given intramuscular injection of progesterone; progesterone inhibitor group was given intraperitoneal injection of baicalin solution and intragastric administration of mifepristone solution.The neurological function deficit scores were evaluated and rat forelimb holding power was detected by Grip Strength Meter respectively at different time points. Serum was taken from the rats and the progesterone and related hormones levels in the serum of every group were measured by ELISA. Results Compared with normal group, neurological functions of rats in molding groups were damaged, and neural functional behavior scores of different time points were the most strongly increased (P<0.001), and rat forelimb holding power was the most strongly reduced (P<0.001). 5 days after treating, baicalin showed the trend of improvement of neurological functions (P>0.05) and more significant improvement of the forelimb holding power (P<0.01); 10 days after modeling, baicalin treatment group significantly increased neural functional behavior scorce (P<0.001) and the most significantly improved the forelimb holding power (P<0.001). Compared with baicalin treatment group, the progesterone inhibitor group had a significant inhibitory effect on neural functional recovery (P<0.05) 10 days after modeling, and the group also had a significant inhibitory effect on the recovery of holding power (P<0.05) 5 days and 10 days after treating. At the same time, compared with the model group, progesterone level in baicalin treatment group increased significantly (P<0.05), and FSH and LH decreased (P>0.05).Conclusion After applying mifepristone to block progesterone, baicalin neurologic protection is significantly inhibited. The results demonstrated that baicalin may play a role in cerebral protection via up-regulating serum progesterone level.

Objective To evaluate the anxiety and depression status of the liver transplant recipients and to investigate the related impact factors.Method Forty-two liver transplant recipients were under survey by General Information Questionnaire (GIQ),Social Support Rating Scale (SSRS),Self-rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) before and 1,6,12,24 and 36 months after operation.Result The mean anxiety scores before and 1,6,12,24 and 36 months after operation were 37.2 ± 5.3,32.2 ± 6.2,32.1 ± 6.6,31.9± 5.1,30.1 ± 4.6 and 28.5 ± 4.1,respectively.The mean depression scores at those 6 time points were 46.7 ± 7.1,37.9 ± 10.7,36.7 ±7.9,37.1 ± 6.4,34.3 ± 5.8 and 32.1 ± 5.6,respectively.Both the anxiety and depression scores showed statistically significant difference (P＜0).001) before and after operation (all time points).Also there was statistically significant difference (P＜0.001) between post-operative month 36 and other post-operative time points.The impact factors for anxiety of liver transplant recipients were subjective supports and the utilization level of the supports.The impact factors of depression of liver transplant recipients were pre-operative depression score,objective support,subjective supports and the utilization level of the supports.Conclusion Liver transplant recipients suffer less anxiety and depression after operation.The anxiety status can be further improved from 24 to 36 months postoperation.

Objective To evaluate the effectiveness of using high-fidelity simulator (HFS) in medical training of cardiopulmonary resuscitation (CPR).Methods The randomized controlled trials (RCTs),quasi-randomized controlled trials (q-RCTs) about comparing HFS with traditional teaching methods in medical training of CPR were searched from Cochrane Library,Pubmed,Web of Knowledge,CNKI,CBM and Wanfang Data.The methodological quality of the included studies was assessed and the valid data were extracted.Meta-analysis was conducted with the Cochrane Collaboration RevMan 5.0.Results Ten q-RCTs and one RCT were included.The quality of the studies were relatively low.Meta-analysis showed that compared with the traditional teaching method,high-fidelity simulation in medical training of CPR had no statistically significant differences in mastering the theoretical knowledge,but had statistically significant differences in mastering the CPR skills.Conclusions HFS in medical training of CPR skills is positive and effective,superior to the traditional teaching methods,but in terms of theoretical knowledge and satisfaction,self-confidence,more researches still need to be further confirmed.

Objective To estimate the safety,feasibility and generalization of three point single-incision laparoscopic cholecystectomy (SILC).Methods The clinical data of 1 126 patients who underwent three-point SILC at the second department of Hepatobiliary Surgery of Zhu Jiang Hospital,Southern Medical University From January 1,2011 to December 30,2015 was analyzed retrospectively.The patient who were indicated for conventional laparoscopic cholecystectomy were included,but those suspected malignant diseases of gallbladder were excluded.Results Of the 1126 patients,the surgery was performed successfully in 923 patients,and 192 patients need extra ports due to the adhesion and difficulty of exposing the Calots triangle,and 11 were converted to open surgery due to severe adhesion,with the success rate being 81.9％.The operating time was (29.5 ± 12.2) min (from the entrance of laparoscope to the removing of gallbladder),the blood loss was (8.7 ± 7) ml,and the hospital stay time was (1.4 ± 0.7) d (after surgery).There were three cases of bile duct injury:two of them were bile leak of aberrant duct,one of them was bile leak of cystic duct damaged by heat.And there was one case of injury of duodenum,22 cases of umbilicus hematoma,13 cases of hematoma of thorax,and 2 cases of thoracic hemorrhage who required surgery.There were no hernia,aerothorax and so on.Conclusion Three point SILC is a technology that is safe,maneuverable and suitable for being carried out in clinical practice.

OBJECTIVEUsing the health economics methodology to assess the screening program on gastric cancer in Zhuanghe high risk area for gastric cancer, from 2001 to 2003 and to assess the feasibility on cost of the screening program and to provide a basis for the popularization of the two-time gastric cancer screening methodology.

METHODSThree major techniques of medical economics namely cost-effective analysis (CEA), cost-benefit analysis (CBA) and cost-utility analysis (CUA) were used to assess the screening program. The screening program was composed of two steps: (1) epidemiological survey and detection of blood pepsinogen; (2) gastroscopy and biopsy of membrane. 'Number of deaths reduced' was used to evaluate the effect during cost-effective analysis while cost-benefit analysis would include the evaluation on the direct cost and indirect cost, direct benefit and indirect benefit as well as the cost-benefit ratio (CBR). During CUA, a questionnaire of WHOQOL-BREF was used to assess the value of the utility while the number of quality adjusted life year (QALY) saved by the screening program was also computed. The direct cost of per saved QALY was also calculated.

RESULTSDada from CEA showed that: investing every 8448 Yuan on screening program and treatment in Zhuanghe high risk area of gastric cancer, one gastric cancer patient could be avoided. Results from CBA showed that: direct cost was 1,260,000 Yuan while indirect cost was 40 621 Yuan with direct benefit as 101 500 Yuan and indirect benefit as 1 540 979 Yuan. The total cost however, was 1,300,621 Yuan with total benefit as 2,555,979 Yuan and CBR was 1:1.97. Data from CUA showed that: a total number of 331.44 QALY was saved, 11.43 QALY was saved by reducing one death, 3802 Yuan per QALY was saved in high risk area of gastric cancer, through this screening program.

CONCLUSIONThe screening program of gastric cancer appeared to be an economic and society-beneficial measure regarding primary prevention in high risk area of gastric cancer. We also suggested that in the future, evaluations through health economics methodologies on different screening programs be carried out in the same population to solve the problem of comparability.

Adult ; China ; Cost-Benefit Analysis ; Feasibility Studies ; Female ; Health ; Humans ; Male ; Quality-Adjusted Life Years ; Risk ; Stomach Neoplasms ; diagnosis ; economics

Objective:To compare acetyltransferase MORF level in periodontal ligament stem cells( PDLSCs) derived from healthy individuals ( H-PDLSCs) with those derived from the individuals with periodontitis ( P-PDLSCs ) . And to determine the effect of MORF on the osteogenic differentiation potential of PDLSCs. Methods: Human H-PDLSCs and P-PDLSCs were cultured and cloned with limited dilution method. H-PDLSCs were stimulated by LPS, TNF-α, IL-β and the mix of the 3 inflammatory factors to imitate inflammatory environment ( IP-PDLSCs ) . Quantitative RT-PCR and Western Blot were applied to examine different expression of MORF in H-PDLSCs and P-PDLSCs. Western Blot was applied to detect expression of MORF in IP-PDLSCs. Quantitative RT-PCR, Western Blot and alizarin red staining were applied to determine osteogenic differentiation potential of H-PDLSCs with MORF knock-down. Results:Quantitative RT-PCR and Western Blot showed lower expression of MORF in P-PDLSCs compared with H-PDLSCs( P<0. 05). Western Blot revealed lower expression of MORF in IP-PDLSCs. Quantitative RT-PCR, Western Blot and alizarin red stai-ning indicated osteogenic differentiation potential was inhibited in H-PDLSCs with MORF knockdown(P<0. 05). Conclusion: Peri-odontitis can suppress the expression of MORF in PDLSCs and inhibite the osteogenic differentiation potential of PDLSCs.

ObjectiveTo explore the application and significance of assisted laparoscopic hepatectomy (ALH) in living-donor-hepatectomy.MethodsWe successfully performed 7 cases of ALH of right hepatectomy on living donor from 30/5/2011 to 1/9/2011.ResultsThe donors recovered well with ratio of remnant lver:32.10％ ～38.31 ％,good liver fuction,little pain and no surgical complications.All the wound sutured intracuteneously was taken out stitches 7 days after operation and healed perfectly.Liver function got normal 2 weeks after operation.Conclusions ALH,which gives the consideration to both the minimal invasion of laparoscopic surgery and safe of open surgery,can be applied safely in hepatectomy of living donor and highly acceptible for donor and receptor.

Objective:To explore the application effect of case-based learning (CBL) and lecture-based learning (LBL) in the teaching of image post-processing course in the standardized training system of medical imaging technology.Methods:A total of 34 trainees in the standardized training of imaging technology of Batch 2018 in West China Hospital of Sichuan University were divided into the experimental group and the control group according to their student numbers, with 17 students in each group. CBL teaching was carried out in the experimental group, and LBL teaching was carried out in the control group. According to the standardized training course design, after one year of image post-processing course teaching, the teaching effect was evaluated through closed-book examination, questionnaire survey and post-processing test. SPSS 20.0 was used for t-test and Mann-Whitney U test. Results:The scores of closed-book examinations (74.42±6.10) and post-processing test (73.47±6.03) in the experimental group were higher than those in the control group [(69.11±3.70) and (69.08±6.51)], and the difference was statistically significant ( P<0.05). The questionnaire survey showed that the students in the experimental group recognized CBL teaching in terms of learning interests stimulation, classroom atmosphere mobilization, clinical thinking cultivation, self-study ability training, and analysis of difficult and rare cases, etc. Conclusion:In the image post-processing course of standardized training of medical imaging technology, the rational application of CBL teaching mode is helpful to improve students' learning enthusiasm, self-learning ability, comprehensive analysis of clinical ability, practical ability, innovation consciousness and so on.

Follicular dendritic cell (FDC) sarcoma is rare and is classified either as conventional type or inflammatory pseudotumor (IPT)-like variant. Extranodal presentation is uncommon and nearly all gastrointestinal FDC tumors are of the conventional type. IPT-like variant tumors occur almost exclusively in the liver and spleen and are consistently associated with Epstein-Barr virus (EBV). Here we report the case of a 78-year-old woman with an IPT-like FDC sarcoma presenting as a pedunculated colonic polyp. Histologically, scanty atypical ovoid to spindle cells were mixed with a background of florid lymphoplasmacytic infiltrate, which led to an initial misdiagnosis of pseudolymphoma. These atypical cells expressed CD21, CD23, CD35, and D2-40, and were positive for EBV by in situ hybridization, confirming the diagnosis. The patient was free of disease five months after polypectomy without adjuvant therapy. Although extremely rare, the differential diagnosis for colonic polyp should include FDC sarcoma to avoid an erroneous diagnosis. A review of the 24 cases of IPT-like FDC sarcoma reported in the literature reveal that this tumor occurs predominantly in females with a predilection for liver and spleen, and has a strong association with EBV.
Aged ; Colonic Polyps* ; Dendritic Cell Sarcoma, Follicular* ; Dendritic Cells, Follicular ; Diagnosis ; Diagnosis, Differential ; Diagnostic Errors ; Female ; Granuloma, Plasma Cell ; Herpesvirus 4, Human ; Humans ; In Situ Hybridization ; Liver ; Pseudolymphoma ; Sarcoma ; Spleen ; Taiwan