The case is the cornerstone of case teaching. The construction of case database can support case teaching and its orderly development. The clinical cases of gynecology of Chinese medicine were collected, sorted and processed in combination with the teaching syllabus and teaching objective. Operating platform was based on the Excelltable. The column was divided into overview, menstrual disorders, leukorrhoeal diseases, pregnancy disease, postpartum disease and miscellaneous diseases of gynecology with hierarchical set of 15 modules per column, including basic information, complaints, history, symptoms, physical examination, diagnosis, application purpose and context and so on. And the corresponding search term was also selected. Cases can be divided into introduction cases and improvement ones according to their easiness and difficulty , into typical cases and atypical ones according to their feature types. Case database content also needs to be constantly revised by teaching activities to make it more suitable for clinical teaching.

Objective To screen the peripheral blood circRNA differently expressed in patients with rheumatoid arthritis (RA) and to explore the pathogenetic role of peripheral blood cicRNA in RA by analyzing the data with bioinformatics.Methods The study was performed in 3 RA cases and 3 healthy controls,using circRNA microarrays to screen the circRNA in peripheral blood of patients with RA.The data were normalized and analyzed by R soft package,screening by fold change and P value and searching the differently expressed circRNAs between the two samples by t test.Bioinformatics was performed to analyze the differently expressed circRNAs.Results The results from circRNA microarrays revealed that 36 circRNAs were significantly al-tered in RA patients (P ＜0.05) compared with the control group.Among them,22 were significantly up-regulated,and the other 14 were down-regulated.The GO analysis of the genes involved in the circRNA showed that these genes participated in the progress of biological regulation,cell differentiation,and metabolism.We predicted the target miRNA of all the differently expressed circRNAs,among the results there was a miRNA (hsa-miR-125a-3p) targeted by a circRNA(hsa_circ_0005397) experimentally confirmed by other studies.The relationships among circRNA-miRNA-Gene were predicted by Cytoscape software.Conclusion There are many differently expressed cireRNAs in peripheral blood of patients with RA,and the circRNAs maybe involved in the regulatory mechanisms of Rheumatoid Arthritis.

ObjectiveTo explore the imaging of the thrombosis after pharmacological triggering of plaque rupture in atherosclerotic rabbit model by using 3.0 T high-resolution magnetic resonance imaging.MethodsTwenty male New Zealand white rabbits were divided into an experimental group (n = 16) and a control group (n = 4).The aortic wall injuries were induced by an intravascular balloon in experimental group rabbits after high cholesterol diet.The pharmacological triggering with Russell's viper venom and histamine was performed after 3 months of establishment of model.All of the animals underwent pre-trigger and post-trigger MR examinations including 3D time of fight (3D TOF),T1 WI,T2WI and post contrast T1 WI.Euthanasia was performed in all rabbits and gross anatomy and histological specimen of aorta were obtained.Comparing the location and length of the thrombus between MRI images and histopathology was used Pearson test.Comparing the calculated indexes of abdominal aorta between rabbits with and without thrombosis was used AVONA test and LSD-t test.Results After triggering,8 in 14 survived rabbits developed thrombosis in experimental group,meanwhile,no thrombus was found in control group.The accuracy of multi-sequences MRI for detecting of thrombus was 87.1％ (27/31).MRI data correlated with the histopathology regarding thrombus length ( r = 0.85,P ＜ 0.01 ) and thrombus location ( r = 0.94,P＜0.01 ).Compared with rabbits without thrombosis,the rabbits with thrombosis had narrower lumen of abdominal aorta in the pre-triggered MR images [ ( 5.71 ± 2.38 )mm2 vs.( 8.93 ± 5.36) mm2,P ＜ 0.01 ].ConclusionMRI is useful tool to determine the thrombosis and plaque rupture in atherosclerotic rabbit model.

Objective To develop a clinically applicable approach to enhance repair of cartilage defects by constructing an in vivo non-viral gene transfer system targeting chondrocytes. Methods High molecular weight chitosan (HMWC) was degraded to produce low molecular weight chitosan (LM-WC) that was combined with transforming growth factor-β1 (TGF-β1) plasmid to form stable nano-sizc complexes. After being tested in vitro firstly, these nano-size complexes were injected into the knee joint of New Zealand white rabbit models with full-thickness cartilage defects to detect their feasibility of delive-ring the growth factor gent in vivo. Results The results showed that LMWC/DNA nano-sizc comple-xes could deliver the gone into the cultured chondroeytes and cartilage tissue efficiently in vitro. When used in vivo, LMWC/TGF-β1 gene nano-size complexes could enhance the transfection efficiency and prolong the expression of TGF-β1 gone. In the animal models of articular osteechondral defect of rabbits, better healing and gentler degeneration could be observed in comparison with the control. Conclusion In vivo transfection of LMWC/TGF-β1 nano-size complexe is a safe and effective method to early promote the repair of osteochondral defects.

Objective To investigate the quality of life(QOL)of patients with stroke and its related factors.Methods The QOL of eighty-two stroke survivors was assessed in terms of SF-36 scores,motor impairment (Fugl-Meyer),disability[Barthel index(BI)]and depression(HAMD)more than one year after their first episode.Their social demographic characteristics such as age,gender,education and income were recorded,as were the characteristics of their disease and any complications.Multiple regression analysis was used to analyse the related factors.Results The average age of the 82 subjects was 61.89 + 9.81 years(range,33-81).56 of them were male (68.2％).Scores on all items of the SF-36 for these subjects were lower than those of a normal population.Correlation analysis showed income,cost for medical care,regular exercise,movement function,ability in the activities of daily living,depression,hypertension and shoulder pain were significantly correlated with most of the SF-36 domain scores.Motor function,income and cost for medical care explained 34％ of the variance in SF-36 scores.Motor function was the single most important factor.Conclusion The major factors affecting the QOL of stroke patients are motor function,level of income and cost for medical care.Paying more attention to rehabilitation treatment,taking regular exercise and more income could help improve the QOL of stroke survivors.

Objective To investigate the feasibility of laparoscopic-assisted transanal pull-through resection and anastomosis in the treatment of ultra-low rectal cancer.Methods From November 2005 to December 2006,21 patients with ultra-low rectal cancer had undergone laparoscopic-assisted transanal pull-through resection and anastomosis in Southwest Hospital.The perioperative condition,postoperative complications and the result of follow-up were retrospectively analyzed.Results The operation was successfully performed on all the patients.The mean operation time and postoperative hospital stay were(216±25)minutes(170-260 minutes)and(9.4±1.0)days(7-11 days),respectively.The time needed for the recovery of gastrointestina]function was(65±14)hours(38-88 hours).The mean perioperative blood loss was(140±49)ml(80-250 ml).All the patients were followed up for(22±4)months(15-28 months),and no anastomotic bleeding or fistula was observed.Six patients developed mild to moderate anastomotic striclure,1 local recurrence and 1 liver metastasis.Conclusions Laparoscopic-assisted transanal pull-through resection and anastomosis for ultra-low rectal cancer is safe and feasible,and the short-term effect is satisfactory.

Objective To explore the protective effects of GYY4137, a new hydrogen sulfide donor, on intestinal mucosa in a neonatal rat model of necrotizing enterocolitis (NEC), and its potential mechanism.Methods Sixty SD rats were randomly assigned into 4 groups: group A (control group), group B (NEC group), group C (NEC with GYY4137 treatment, H2S donor group), and group D (NEC with GYY4137 and Znpptreatment, HO-1 inhibitor group). The SD rat models of NEC were established using simulated milk feeding-hypoxia-cold stress-Lipopolysaccharides. The injury degree of intestinal mucosa was evaluated using HE-staining, and its mechanisms were investigated using biochemical indicators and Western blotting. Results Compared with control group, the pathology score and the total superoxide dismutase (T-SOD) in the NEC group was significantly higher, the concentrations of methane dicarboxylic aldehyde (MDA) and necrosis factor α (TNF-α) were lower(P<0.05). Compared with those in NEC group, the pathology score and the concentration of MDA and TNF-α in the H2S donor group were signiflcantly lower, the T-SOD, and the HO-1 expression was higher. The pathology score and the level of MDA and TNF-α were signiflcantly increased after treated with HO-1 inhibitor Znpp, and T-SOD was signiflcantly decreased.. Conclusions The GYY4137, as a new H2S donor, could attenuate the injury of intestinal mucosa in a neonatal rat model of NEC by upregulating the expression of HO-1.

Objective To investigate the clinical features of kidney transplantation of small pediatric donors to pediatric recipients.Method A retrospective analysis of 48 kidney transplants from small pediatric donors into pediatric recipients was performed.Result Based on the transplantation types,the patients were divided into two groups:the single kidney transplantation (SKT) group and the en bloc kidney transplantation (EBKT) group.SKT was performed on 36 patients and EBKT on 12 patients.In the SKT group,postoperative complications included vascular thrombosis in 1 case (2.8％),primary disease recurrence in 1 case (2.8％),ureteral stenosis in 1 case (2.8％),delayed graft function in 17 cases (47.3 ％) and acute rejection in 4 cases (11.1 ％).In the EBKT group,postoperative complications included vascular thrombosis in 4 cases (33.3％),urine leak in 2 cases (16.7％),delayed graft function in 2 cases (16.7％) and acute rejection in 2 cases (16.7％).At last follow-up,patient survivals were 100％ in both groups,whereas graft survival was 94.4％ (34/36) in the SKT group and 75％ (9/12) in the EBKT group.The mean serum creatinine in the SKT and EBKT group was (68.4 ± 22.1) and (55.8 ± 16.7) μmol/L,respectively.Conclusion Favorable outcomes can be obtained from transplantation from small pediatric donors.The use of this donor population for pediatric recipients should be encouraged.

Objective To evaluate the value of increased threshold of SUVmax and delayed imaging on diluted and filled bladder for improving the detection of bladder cancer with 18F-FDG PET/CT.Methods From July 2007 to October 2012,18 F-FDG PET/CT was performed on 63 suspected or treated (with bladder preserved) bladder cancer patients (55 males,8 females,average age 69.1 years).After routine imaging,all patients were given 1 500-2 000 ml of water orally three times and voided three times.Then they underwent delayed pelvic imaging at a full bladder status.The routine images were reanalyzed with increased SUVmax threshold (from 6-8 to 8-20).The final diagnosis was confirmed by pathology or follow-up (＞6 months).The differences of SUVmax in urine,18 F-FDG metabolism in lesions between routine and delayed imaging were compared.Paired t test was used to compare their differences.Results The SUVmax of urine on routine and delayed imaging was 15.11±11.11 and 4.73±2.00 respectively (t=4.15,P＜0.01).Among the 63 patients,there were 15 malignant and 3 benign cases confirmed by pathology,and 45 patients without obvious abnormality during follow-up.All 18 cases were detected by 18F-FDG PET/CT including the 3 benign false positive cases (2 were positive by CT though negative by PET,and 1 FDG-avid cystitis).All 15 true positive cases were confirmed as primary or recurrent bladder carcinoma and 1 false positive case as inflammation.The detection rates of early imaging with routine and increased display threshold of SUVmax were 18.8％(3/16) and 43.8％(7/16),respectively.Conclusion Increased SUVmax threshold for display and delayed imaging with diluted urine under full bladder status could effectively improve the detection rate of primary or recurrent bladder cancer with 18F-FDG PET/CT.

The radial support capacity of intravascular stent is usually evaluated by the planar compression or the radial compression methods. Based on FEM simulation, the planer and radial compression methods are compared, and the agreement of the evaluation for the radial support capacity between these two methods is found. Moreover, the planer compression method is used to study the geometric parameters' effect on the radial support capacity by numerical simulations and experiments. Results show that, at the beginning of the compression process, the radial support capacity is mainly influenced by the metal-to-artery surface ratio; at large compression rate, the radial support capacity will decrease sharply with the increment of post-expansion diameter and decrement of the thickness and metal-to-artery surface ratio. The results provide guidance to the design and test of stents.
Computer Simulation ; Models, Cardiovascular ; Prosthesis Design ; Software ; Stents