Objective To evaluate the effectiveness of clinical rotation training in pain department for general practitioner.Methods Totally 31 general practitioners of 3 years program in the First Affiliated Hospital of Chongqing Medical University were involved in clinical rotation training in pain department form August 2008 to December 2011.Training lasted for one month.Clinical rotation training in pain department was conducted for general practitioners by studying rules and regulations,treatment methods,imaging data and clinical practice.Evaluation was made according to the treatment,theoretical knowledge,interpersonal skill and professional competency of general practitioners.Measurement data were expressed as mean ± standard deviation ((-x) ± s) while enumeration data were expressed as rate.Descriptive analysis of the data was used.Results Average total number of patients managed by 31 general practitioners was (15 ± 2),average total number of disease species was (5 ±2),average number of case discussion and small lecture participated was 1 ～2,average number of nerve block participated as assistant was (40 ± 5) and average number of minimally invasive surgery visited and studied was (2 ± 2).Residency duties were skillfully completed and assessment score was (85 ± 4.50).Conclusions Through clinical rotation training,general practitioners can understand common disease diagnosis and treatment category; familiarize clinical evaluation methods and master standards of diagnosis and treatment in pain department.Meanwhile,they would learn doctor-patient communication to establish a good therapeutic relationship with patients.

Objective To study the methods and value of emergency interventional therapy in digestive tract bleeding.Methods 61 cases with digestive tract bleeding accepted emergency angiography.According to find out positions and causes of bleeding during angiography,these patients accepted arterial embolization and /or perfusion of vasoconstrictor substance.Results In 29 cases accepted arterial embolization and 32 cases accepted perfusion of vasoconstrictor substance,the stoped bleeding immediately occured in 100% and 82.7% respectively.Bleeding recurrence was 3 cases in the patients with arterial embolization one week later and 25 cases of the patients with perfusion of vasoconstrictor substance forty-eight hours later.Conclusion To treat the digestive tract bleeding by arterial embolization or vasoconstrictor substance perfusion are safe and effective hemostatic ways during emergency angiography.Though the bleeding recurrent rate is high after vasoconstrictor substance perfusion,these ways can race against time for surgical operation.

Objective: To investigate the effect of trastuzumab combined with endocrine therapy on hormone receptor (HR) and human epidermal growth factor receptor-2 (HER-2) positive advanced breast cancer. Methods: From January 2001 to March 2017, 88 patients with HR and HER-2 positive advanced breast cancer were selected.The patients were divided into two groups according to the random number method, with 44 cases in each group.All the patients were treated with routine chemotherapy, radiotherapy and biology therapy.The control group was treated with tamoxifen, and the observation group was treated with trastuzumab on the basis of the control group.All the patients were followed up for 6 months.The changes of serum E2 and quality of life were compared before and after intervention.The clinical effects of the two groups were compared. Results: The serum E₂ of the observation group was (15.3±0.5)pmol/L, which was lower than that before intervention [(65.4±2.0)pmol/L]and that of the control group after treatment [(36.9±1.9)pmol/L](t=70.109, 0.240, all P<0.05). After the intervention, the quality of life score of the observation group was (35.3±1.1)points, which was higher than that before intervention[(81.5±2.3)points]and that of the control group after treatment [(56.6±1.7)points](t=114.608, 66.530, all P<0.05). The effective rate of the observation group was 31.8%, which was higher than 9.1% of the control group (χ²=5.657, P<0.05). Conclusion Trastuzumab combined with endocrine maintenance therapy can effectively regulate the endocrine level of patients with HR and HER-2 positive advanced breast cancer, improve the quality of life and clinical therapeutic effect.

Objective To assess the value of a fibrin-targeted contrast agent (EP-2104R) for MR detection of thrombus, and to compare this modality with non-contrast-enhanced (NCE) MRI and Gd-DTPA injection at acute period after thrombus generation. Methods Thrombus was induced with external injury and stasis in 5 rabbits. MRI was performed before and after contrast agent injection at 6.0 h after injury, and the MRI findings were compared with that of histopathologically examinations. Results EP-2104R enhanced MRI accurately detected thrombus, which was superior to both NCE and Gd-DTPA injection (P<0.001). Gd-DTPA injection was not associated with improvement of thrombus detection. Conclusion Being a fibrin-targeted MR contrast agent for in vivo detection of acute thrombus, EP-2104R is superior to NCE MRI and Gd-DTPA injection.

A mouse-anti-human monoclonal antibody was produced by using the membrane proteins of human lung carcinoma cell line A549 as the immunogen to generate monoclonal antibodies against lung carcinoma with the use of hybridoma techniques. McAb4E7 was prepared successfully. To identify its antigen, proteomic technologies such as two-dimenstional electrophoresis, western blotting and mass spectrometry were employed. The targeting antigen of McAb4E7 expressed positive in human lung cancer cell lines A549 and human hepatocarcinoma cell line HepG2, moreover, the expression of the antigen was stronger in A549 cells. Finally, we obtained one positive protein in A549 cell line that has strong affinity and specificity for McAb4E7, which was identified to be ATP synthase beta subunit. We identified ATP synthase beta subunit as the targeting antigen of lung carcinoma special monoclonal antibody McAb4E7.
Animals ; Antibodies, Monoclonal ; biosynthesis ; chemistry ; immunology ; Antibodies, Neoplasm ; immunology ; Antibody Specificity ; Antigens, Neoplasm ; genetics ; immunology ; Cell Line, Tumor ; Humans ; Lung Neoplasms ; immunology ; Membrane Proteins ; immunology ; Mice ; Mice, Inbred BALB C ; Mitochondrial Proton-Translocating ATPases ; immunology

Objective: To investigate the clinical effect of posterior unilateral short segment screw fixation and bone graft fusion in the treatment of special upper cervical spine injuries. Methods: A retrospective case series study was conducted to analyze the clinical data of 15 patients with upper cervical spine injury admitted to Shanxi Bethune Hospital from July 2012 to May 2017. There were nine males and six females, aged 10-69 years [(41.9±20.9)years]. There were eight patients with traumatic atlantoaxial dislocation, one with congenital atlantoaxial dislocation, two with atlantoaxial dislocation with nonunion of odontoid process, three with Anderson type II odontoid process fracture, and one with old odontoid process fracture. All patients had cervico-occipital pain to different degrees, slender unilateral pedicle and distinct stenosis of vertebral artery. All patients were treated with posterior unilateral screw fixation and bone graft fusion. The injury of spinal cord and vertebral artery, operation time and intraoperative blood loss were recorded. Visual analogue scale (VAS) was used to evaluate pain before and after operation, and Japanese Orthopaedic Association (JOA) score was used to evaluate spinal cord function and postoperative improvement rate before and at the last follow-up. The position of internal fixation and fusion of bone graft were observed by X-ray after operation. Results: All 15 patients were followed up for 6-36 months [(20.4±8.6)months]. All the screws were implanted successfully at the first time, without spinal cord or vertebral artery injury. The operation time was 100-210 minutes [(131.3±32.0)minutes], and the intraoperative blood loss was 100-450 ml [(203.1±104.0)ml]. Preoperative VAS score was (7.9±0.9)points, and postoperative VAS score was (3.7±0.8)points (P<0.01). Preoperative JOA score was (12.1±4.4)points, and the JOA score at postoperative follow-up was (16.1±1.4)points, with the improvement rate of 68%. Postoperative X-ray showed good recovery of cervical spine sequence. One patient developed loosened internal fixation after the neck brace protection was removed one month after surgery, and the patient recovered after timely second surgical fixation and fusion. The remaining 14 patients did not have loosened internal fixation, fracture or loss of reduction, with bone fusion 6-12 months after surgery. Conclusion Posterior cervical unilateral short-segment screw fixation and bone graft fusion can restore cervical stability, relieve pain, and improve function recovery, which can be used as a complementary procedure to treat upper cervical spine injury with anatomic structure variation.

OBJECTIVE: To assess the value of Improved Mayo Endoscopic Score (IMES) for evaluation of treatment efficacy for active ulcerative colitis (UC). METHODS: We retrospectively analyzed the clinical and endoscopic data of 103 patients diagnosed with active UC in Beijing Tsinghua Changgung Hospital from January, 2015 to December, 2020. The severity of endoscopic lesions was determined by Mayo Endoscopic Score and the Ulcerative Colitis Endoscopic Index of Severity (UCEIS), and the area of the endoscopic lesions was evaluated based on the Montreal classification system. The IMES was established by combining the MES with the Montreal classification. RESULTS: Univariate analysis suggested that young patients (<40 years old), patients with extensive disease type (E3), patients with high endoscopic scores (MES=3, UCEIS>4, and IMES>4), and patients receiving advanced drug therapy (with systemic hormones, immunosuppressants, immunomodulators, and biological agents, etc.) had lower clinical and endoscopic remission rates. COX survival analysis showed that IMES≤4 was an independent risk factor for clinical and endoscopic remission. ROC curve indicated that the predictive value of IMSE≤4 for clinical and endoscopic remission (AUC=0.7793 and 0.7095, respectively; P<0.01) was better than that of Montreal (AUC=0.7357 and 0.6847, respectively; P<0.01), MES=2 (AUC=0.6671 and 0.5929, respectively; P<0.01), and UCEIS≤4 (AUC=0.6823 and 0.6459, respectively; P<0.01); IMES=5 had a better predictive value for patients with active UC undergoing colectomy tham E3 and MES=3. CONCLUSION IMES has good value in evaluating treatment efficacy for active UC.
Humans ; Adult ; Colitis, Ulcerative ; Retrospective Studies ; Endoscopy ; Immunosuppressive Agents ; Treatment Outcome