Objective To detect the feasibility of patients with specific behaviors in the facial trauma clinical teaching. Method 47 medical students were randomly divided into experimental group ( n = 22 ) and control group(n=25). Students from experimental group at least dealed with 5 ～ 10 facial trauma patients with specific behaviors, while specific behaviors patients in control group were not more than 2. Teaching results were compared. Results There was no significant difference in operation test scores between the two groups ( (84.68 ±3.41 ) vs ( 83.96 ± 3.46 ), P = 0. 476 ). Composite score of teachers in the experimental group was significantly higher than that in control group( (90.09 ± 5.69 ) vs (83.48 ± 5.19), P ＜ 0.01 ). The results of questionnaire survey showed that two in five self-assessment results were higher in the experimental group(P ＜ 0. 01 ). Conclusion Medical students are more appropriately involved in treating special behaviors patients, which can improve the overall quality of students. Teaching with special behaviors patients has good effect, and is feasible.

Objective To investigate the changes of soluble CD105,transforming growth factor-beta1(TGF-β1) and vascular endothelial growth factor(VEGF) in esophageal cancer(EC) patients,analyzing its clinical significance.Methods Collecting 56 cases of gastric cancer(observation group) and 49 cases of healthy people(control group)from Nov.2014 to Jan.2016 as the research objects.The levels of soluble CD105,TGF-β1 and VEGF were detected in EC patients pre-and post-operation and healthy subjects.The data of soluble CD105,TGF-β1 and VEGF were analyzed in the two groups.Results The pre-operation levels of soluble CD105,TGF-β1 and VEGF in EC patients were significantly higher than those in the control group,the difference was statistically significant(P<0.05).The pre-operation levels of soluble CD105,TGF-β1 and VEGF in EC patients were significantly higher than post-operation levels,the difference was statistically significant(P<0.05).The post-operation levels of soluble CD105,TGF-β1 and VEGF in EC patients were not statistically different with control group(P>0.05).Conclusion The levels of soluble CD105,TGF-β1 and VEGF could be abnormal in patients with EC,which might be the index for monitoring the clinical disease condition and judging the prognosis of the EC.

Objective To observe the effect of dexmedetomidine on plasma SDF-1 level in in hepatic portal occlusion operation.Methods Fifty patients with live cancer undergoing elective partial hepatectomy were selected,no gender limitation,aged 42 to 71,body mass index(BMI) 18.5 ～ 26.0 kg/m2,ASA grade Ⅱ or Ⅲ.The patients were randomly divided into 2 groups(n=25):control group and dexmedetomidine group.The dexmedetomidine group was performed the pump injection of dexmedetomidine 1 μg/kg at 15 min before induction of anesthesia.After induction the rate was changed to 0.4μg · kg-1 · h-1 until 15 min before the end of operation;the control group adopted the same method for conducting continuous intraverous infusion of the same capaci ty of 0.9％ sodium chloride.The peripheral venous blood was collected in 2 groups at preoperative 1 h (T0),postoperative 1 h (T1),postoperative 1 d (T2),postoperative 3 d(T3).The plasma SDF-1 level was detected by using enzyme-linked immunosorbent assay(ELISA).Results There was no statistically significant difference in liver resection range,blood loss,first porta hepatis vessel occlusion time,anesthesia time and plasma SDF-1 level before surgery between the two groups (P＞0.05).Compared with pre-operation,plasma SDF-11evel at T1,T2,T3 time point was significantly increased (P＜0.05).The plasma SDF-1 level at T1,T2,T3 time point in the dexmedetomidine group was lower than that in the control group(P＜0.05).Conclusion SDF-1 expression is significantly increased during perioperative period in the patients with hepatic portal occlusion operation,and intraoperative continuous dexmedetomidine can significantly reduce the SDF-1 level,which inhibits the chemotaxis and accumulation of inflammatory ceils to some extent.

Objective To study the hepatocyte cells infected by hepatitis C virus (HCV) positive serum. Methods Human hepatocyte 7701 was incubated with HCV RNA-positive and HCV antibody(Ab) negative sera BP52. Then, the expression of HCV antigen and the presence of HCV-RNA in cell and supernatant were assayed by RT-PCR, sequence analysis, immunofluorescent staining, Western blot, confocal laser microscopy. The ultrastructural changes of infected cells were observed by electro-microscopy. Results Plus-strand RNA and minus-strand RNA were intermittently detected in cell and/or supernatant on day 7-45 after infection. Sequence analysis demonstrated that the positive DNA nucleic acids were identified with HCV 5′-non-coding region(NCR) sequence. HCV core and NS3 protein were expressed in cytoplasm of infected cells. After 2 or 3 weeks, obvious intracellular ultrastructural changes and virus-like particles were observed. Conclusion human hepatocyte 7701 could support replication of HCV in vitro, which could be a useful tool for setting up cell model of HCV infection and studying the mechanism of HCV infection.

Objective To investigate domestic child abuse within one year before the survey being conducted in Grades 4-6 preliminary school students and explore the relationship between domestic child abuse and mental health problems including prevalence of mental disorders,anxiety,depression as well as children's selfawareness in this sample.Methods Screen Questionnaire of Child Abuse was used to screen all the students participated in the survey.For those students whose screen results were positive,further face to face interview was needed to verify the abuse history.Once a child was identified as abused one,a student without abuse history would be matched by sex and the same age.Both groups with abused history and without abuse history over past year were evaluated by the two child psychiatrists with diagnostic an statistical manual of mental disorder (DSM-Ⅳ) and mental health scales.Results 1500 10-13 year-old children received child abuse screening.23.73％ students surveyed over the past year suffered child abuse in the family.The proportion of boys who were victims of domestic child abuse was 30.44％ while 17.44％ to girls (x2 =5.95,P ＜ 0.01).The proportion of male students who were victims of domestic abuse was two times that of female students.For all participants,14.6％ had been suffered one-way abuse,5％ for two-way abuse,and 3％ for three-way abuse.Prevalence of anxiety disorder in abused students was higher than in non-abused ones (9.26％ vs 3.45％,x2 =3.19,P=0.0015).Similarly,the rate of disruptive behavior disorder in abused students was higher than in non-abused ones(18.53％vs 9.22％ x2 =3.61,P=0.0001).The total scores of The Screen for Child Anxiety Related Emotional Disorder was higher in abused students group than in non-abused students group while the total scores of Piers-Harris Children's self-concept Scale was lower in abused student group than in non-abused student group.Conclusion Domestic child abuse in 10-13 old-age students is a widespread phenomenon and abuse history over last year is associated with current mental health level.

OBJECTIVETo compare the differences in the clinical efficacy on Alzheimer's disease between acupuncture and medicine.

METHODSOne hundred and forty-one patients were randomized into an acupuncture group (72 cases) and a medicine group (69 cases). In the acupuncture group, the needling technique for benefiting qi, promoting blood circulation, regulating mind and improving intelligence was used at Shenting (GV 24), Baihui (GV 20), Fengchi (GB 20), Wangu (GB 12), Danzhong (CV 17), Zhangwan (CV 12), Qihai (CV 6), Xuehai (SP 10) and Zusanli (ST 36). The supplementary acupoints were selected according to the symptoms and physical signs. Acupuncture was given once a day and 6 treatments were required for a week. In the medicine group, the choline sterase inhibitor, donepezil (aricept) was prescribed for oral administration, 1 tablet (5 mg) each time, once every night. Four weeks later, the dose was increased to 2 tablets (10 mg) each time. In the two groups, the treatment of 4 weeks made one session and 4 sessions were required. The changes of scores before and after treatment in the minimum mental state examination (MMSE), the activity of daily living scale (ADL), Alzheimer's disease assessment scale-cognition (ADAS-cog) and the digit span (DS) were observed.

RESULTSAfter treatment, scores of MMSE and DS were increased as compared with those before treatment (both P < 0.05) and scores of ADL and ADAS-cog were reduced as compared with those before treatment. The score differences in MMSE, ADL, ADAS-cog and DS before and after treatment were significant in the two groups (all P < 0.01).

CONCLUSIONThe needling technique for benefiting qi, promoting blood circulation, regulating mind and improving intelligence significantly improves the overall function, cognition and activity of daily life in the patients of Alzheimer's disease and the efficacy is better than donepezil.

Activities of Daily Living ; Acupuncture Points ; Acupuncture Therapy ; Aged ; Aged, 80 and over ; Alzheimer Disease ; psychology ; therapy ; Cognition ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome

Objective To find a selection method system appropriate for China's essential drug list.Methods Collection and analysis of technical paper literature on essential drug list developement,adjustment technical papers,and literature on evidence-based medicine,pharmacoeconomics evaluation,and medical insurance budget analysis from WHO and other countries.On such basis,a method system for selecting China's essential medicine list can be proposed,with its feasibility analyzed and demonstrated.Results The GRADE assessment proposed by WHO was used to evaluate the efficacy and safety of the drug;the pharmacy economics evaluation is added to assess the economic efficiency;these were aided by the pharmacoeconomics evaluation for a comprehensive evaluation of the pharmacoeconomics of the drug in question,supplementing analysis of the medical insurance,and ensuring its affordability of essential medicine so selected.The theory of this system is well developed,and supporting software ready for application.Examples in Zhejiang Province regarding essential medicine for diabetes have proved this method feasible.Data acquisition constitutes a major roadblock for scientific selection due to barriers against medical insurance data sharing.Conclusions Theoretic basis and method tools are fully available for essential medicine selection,and the selection method system as proposed in this study prove feasible to some extent.Decision makers are recommended to scientifically select the essential drugs,and to encourage data sharing,in order to make the list more scientific and pragmatic.

Objective To estimate the value of detection of Merkel cell carcinoma polyomavirus (MCPyV)in the diagnosis of Merkel cell carcinoma (MCC).Methods Two cases of MCC were studied using light microscopy and immunohistochemistry.PCR was performed to detect DNA sequences encoding MCPyV large T antigen(LT)and viral protein 1 (VP1) in paraffin-embedded tissue specimens from the two patients with MCC,five patients with T cell lymphoma,two normal human controls,as well as in two T cell lymphoma cell lines MAC 1 and MAC2.DNA sequencing was also carried out.Results Both of the patients with MCC were male.The patient 1 presented with a mass in the right anterior shin for more than one year,and the patient 2 had a mass in the left knee for more than six months.Skin examination revealed densely distributed pink nodules in the right anterior shin,with confluence into an indurated plaque which measured 10 cm × 8 cm with superficial erosion,exudates and crusts and was surrounded by multiple irregularly sized erythematous nodules with limited mobility in the patient 1,as well as a royal blue,hard,poorly marginated nodular mass measuring 5 cm × 4 cm in the left medial knee with limited mobility in the patient 2.Pathological manifestations were similar in the two patients.Tumor cells were uniform with large hyperchromatic nuclei,eosinophilic and sparse cytoplasm,and fine chromatin.Mitotic figures were easily seen.Immunohistochemistry revealed that the tumor cells stained positive for pan-cytokeratin,synuclein (Syn),neuron-specific enolase (NSE),chromogranin (CgA),CK20,and Ki-67 (＞ or =60％),but negative for S100 protein,HMB45,CD34,thyroid transcription factor 1 (TTT-1),CK7 and leukocyte common antigen (LCA).MCPyV DNA was detected in both MCC specimens,but absent in the other skin specimens or T cell lymphoma cell lines.Conclusions MCC has distinctive clinical and pathological appearance.Immunohistochemistry and detection of MCPyV DNA sequences using PCR may be beneficial to the definitive diagnosis of MCC.

Objectives To study the age and gender distribution of clinical and non-clinical depressive symptoms in chil-dren, and the potential link between non-clinical and clinical depressive symptoms. Methods 4520 children aged 8-15 years old were screened for mental disorders by Strength and Dififculties Questionnaire (SDQ) and the Development and Well Being Assessment (DAWBA), and further assessed by the Depression Self-Rating Scale for Children (DSSC). Fifty-three children diagnosed as depressive disorder were included in clinical group and 1504 children without depression disorders whose DSSC scores≥14 were included in non-clinical group. The relationship between gender, age and DSSC scores was analyzed. Results Interaction effect on DSSC scores between gender and age was found in clinical group (F=4.40, P=0.049), but not found in non-clinical group (F=1.04, P=0.409). DSSC scores of girls were higher than that of boys in clinical group (t=2.16, P=0.048). There was no statistically signiifcant main effect of gender in non-clinical group (F=0.21, P=0.646). No signiifcant difference in DSSC scores existed among different age groups in clinical group (F=0.82, P=0.573). There was signiifcant main effect of age in non-clinical group (F=1.96, P=0.048). Conclusions There were different age and gender distribution of clinical and non-clinical depressive symptoms in children.

OBJECTIVE: To observe the time-course expression of calcium-calmodulin dependent protein kinase II delta (CaMK II delta) in cerebral cortex after traumatic brain injury (TBI). METHODS: The TBI rat model was established. The expression of CaMK II delta in cerebral cortex around injured area was tested by Western blotting and immunohistochemical staining. RESULTS: Western blotting revealed expression of CaMK II delta in normal rat brain cortex. It gradually increased after TBI, peaked after 3 days, and then returned to normal level. The result of immunohistochemical staining was consistent with that of Western blotting. CONCLUSION The expression of CaMK II delta around injured area after TBI increased initially and then decreased. It could be used as a new indicator for wound age determination following TBI.
Animals ; Blotting, Western ; Brain Injuries/metabolism* ; Calcium-Calmodulin-Dependent Protein Kinase Type 2/metabolism* ; Cerebral Cortex/metabolism* ; Forensic Medicine ; Immunohistochemistry ; Rats ; Time Factors