By inquiring the medical students under the background of grouping teaching between the mainland students and the oversea Chinese students,we have got something about their attitude toward the credit system.The result will help us to improve the teaching renovation in medical education.The questionnaire including implementing of credit system,standard credit system, grouping teaching,curriculum,tutor system of the undergraduates,the administration of education,and so on.Then we analyze and get the result.

Objective To evaluate the efficacy and adverse effects of gefitinib in the treatment of fe- male patients with advanced adenocarcinoma of lung who had failed to previous chemotherapy.Methods These patients received 250mg of gefitinib orally,once daily until disease progression or development of intol- erable toxic reaction.They were evaluated one month after treatment and every other month thereafter.Results Among the 27 evaluable patients,there were 1 CR(3.7%),11 PR(40.8%),10 SD(37.0%)and 5 PD(18.5%). The overall response rate was 44.5%(95% CI 29%～68%);and 22 patients(81.5%)gained profit(CR+PR+ SD)from the clinical therapy(95% CI 62%～94%);the mean TTP was 7.2 months.Symptomatic improvement rate was 80.0%.The main adverse effects were mild rash and diarrhea.Conclusion gefitinib has significant efficacy in the treatment of female patients with advanced tung cancer who had failed to previous chemother- apy.Adverse effects are mild.gefitinib is a suitable therapy for these patients.

OBJECTIVETo investigate DNA aneuploid and P16 expression in biopsy specimens from lung cancer, and to study genetic instability and the application of flow cytometry in lung cancer pernicious degree diagnosis.

METHODSBlood cells and cancer cells in biopsy specimens were marked simultaneously with anti-CD45 and anti-P16 fluorescent antibody, and the ratio of CD45+ P16+ cells and CD4- P16+ cells was compared. DNA content in biopsy specimens from lung cancer was detected by flow cytometry.

RESULTSAmong the 74 cases of lung cancer, there are 46 cases of DNA aneuploid (62.2%). Thirty-seven cases of lung cancer expressed P16 lowly (50%). Twelve cases of lung cancer only expressed P16 lowly (16.22%), 21 cases of lung cancer only expressed DNA aneuploid (28.38%), and 25 cases not only expressed P16 lowly but also expressed DNA aneuploid (33.78%). Indexes of malign degree, such as P16 low expression or DNA aneuploid could be detected in 58 cases among the 74 cases (78.38%) by flow cytometry.

CONCLUSIONP16 low expression and DNA aneuploid are the indexes of lung cancer malign degree, and flow cytometry can be used to study genetic instability and evaluate biopsy specimens from lung cancer.

Aneuploidy ; Animals ; Biopsy ; Chromosomal Instability ; genetics ; DNA ; genetics ; Female ; Flow Cytometry ; Gene Dosage ; Gene Expression Regulation, Neoplastic ; Genes, p16 ; Humans ; Leukocyte Common Antigens ; genetics ; Lung Neoplasms ; diagnosis ; genetics ; pathology ; Male ; Mice ; Middle Aged

Cardiac Catheterization ; Heart Septal Defects, Ventricular ; therapy ; Humans ; Prosthesis Implantation ; instrumentation ; Septal Occluder Device

OBJECTIVETo study the reconstructive effect of the dissociate bone flap to repair the macrosis depressed skull fracture on the frontal and orbit part.

METHODSThe coronal scalp flap was elevated and dissociate bone flap was expanding to the 2cm width beside the edge of depressed skull fracture. The first step was to extract the dissociate bone flap and make there is an area for operating . Then extract free bone fragments, and elevate the depressed orbital lamina and use the biological glue to stick it to its position. The free fragments extracted were stacked into a whole one and it to its position in use of the biological glue on the dissociate bone flap. The uneven inner table should was smoother with bon-wax. The prosthetic dissociate bone flap was put back on its position and fixation.

RESULTSFrom January 2000 to December 2004, 17 cases of the macrosis depressed skull fracture on the frontal and orbit part undertaken plastic surgery by the dissociate bone flap to treat the macrosis depressed skull fracture and obtained excellent curative effect.

CONCLUSIONSUsing dissociate bone flap to treat the mocrosis depressed skull fracture on the frontal and orbit part can avoid the complication of the traditional operation, and make the method become a plastic surgical operation.

Adult ; Bone Transplantation ; methods ; Female ; Humans ; Male ; Orbit ; Orbital Fractures ; surgery ; Reconstructive Surgical Procedures ; methods ; Skull Fracture, Depressed ; surgery ; Surgical Flaps ; Young Adult

OBJECTIVETo investigate the clinical safety and effects of auto-dendritic cells pulsed with HLA-A201-binding peptides prostate-specific antigen (PSA) , prostate-specific membrane antigen (PSMA) and prostatic acid phosphatase (PAP) in the treatment of hormone-refractory metastatic prostate cancer (HRPC).

METHODSSixteen HRPC patients with positive HLA-A201 were enrolled and their monocytes isolated and induced into dendritic cells with the combination of rhGM-CSF and rhIL4. The patients were inoculated subcutaneously near the inguinal region with auto-DCs pulsed with peptides PSA (KLQCVDLHV) , PSMA (ALDVYNGL L) and PAP (LLHETDSAV) every 2 weeks for 4 times, and the immunological and clinical responses were examined within 1 -2 weeks after the final vaccination.

RESULTSVaccination of dendritic cells was well tolerated and no toxicity was observed. The cytokine levels in the serum such as IL-2, IL-12 and IFN-gamma were significantly increased after the vaccination (P < 0.01). The delayed type hyper- sensitivity (DTH) test was positive in 4 of the patients (4/11), the percentage of antigen-special IFN-gamma+ CD8+ T increased in 5 (5/11), the level of the tumor marker PSA decreased in 6 (6/16) , hydrops abdominis reduced in 1 (1/16), and the size of the cervical lymph node lessened in 1 (1/16). Three patients showed partial remission (PR), 7 stability of the disease (SD), and the other 6 progression of the disease (PD).

CONCLUSIONAuto-DC vaccines loaded with PSA, PSMA and PAP peptides, capable of eliciting specific immune responses in HRPC patients, is a safe and effective option for the treatment of advanced HRPC.

Acid Phosphatase ; Aged ; Antigens, Surface ; immunology ; CD8-Positive T-Lymphocytes ; immunology ; Cancer Vaccines ; immunology ; Cytokines ; blood ; Dendritic Cells ; immunology ; Glutamate Carboxypeptidase II ; immunology ; HLA-A2 Antigen ; immunology ; Humans ; Male ; Middle Aged ; Prostate-Specific Antigen ; immunology ; Prostatic Neoplasms ; therapy ; Protein Tyrosine Phosphatases ; immunology ; Treatment Outcome

Objective To analyze the epidemiological characteristics of food poisoning deaths in Wenshan Prefecture of Yunnan Province from 2010 to 2019, so as to provide the basis for formulating the strategies and measures for prevention and control of food poisoning deaths in Wenshan Prefecture. Methods The data of food poisoning deaths in Wenshan Prefecture from 2010 to 2019 were collected and analyzed by Excel software. Results From 2010 to 2019, 65 food poisoning deaths were reported, accounting for 7.5% of the food poisoning incidents in the same period.The fatality rate of food poisoning deaths was 36.7%, and the mortality rate of food poisoning events in the same period was 2.1%.The high incidence of food poisoning deaths occurred in summer and autumn, with the highest in June and July.Wild mushroom poisoning was the main cause of death in food poisoning, and the incidence was mainly in rural families. Conclusion Wild mushroom poisoning should be the focus of controlling food poisoning deaths in Wenshan Prefecture.It is necessary to strengthen public education, improve people′s ability to identify edible wild mushrooms, strengthen the building of capacity of medical institutions in towns and villages, and establish a long-term mechanism for food safety management.

Objective To investigate the effects of functional electrical stimulation (FES) on endogenous proliferation of the neural stem cells within the brain and the behaviors in rats with acute cerebral infarction and explore the FES therapeutic mechanism on improving the neural function after the cerebral infarction. Methods Fifty-four SD adult male rats were randomly allocated into FES treatment group, placebo stimulation group and sham-operated group (n=18). Focal cerebral infarction models were induced by the performent of middle cerebral artery occlusion (MCAO) in rats; the FES treatment group began receiving the FES (10 min/d, once dairy) and the placebo stimulation group did not give any special treatment since the 3rd day of the successful model inducement. The expression of nestin positive cells in the hippocampus subgranular zone and subventricular zone was examined by immunohistochemistry staining and the expression of nestin protein at ischemia side was detected by Western blot analysis on the 3rd, 7th and 14th d after MCAO; meanwhile, the behavior functions of rats at various time points were evaluated. Results The number of nestin positive cells in the hippocampus subgranular zone and subventricular zone and the expression of nestin protein from ischemia side brain in the FES treatment group significantly increased than those in the placebo stimulation group on the 7th and 14th d after MCAO (P<0.05). And statistical difference was noted on the 14th d on the behavior functional evaluation between the FES treatment group and the placebo stimulation group (P<0.05). Conclusion FES may enhance the endogenous proliferation of the neural stem cells within the brain in rats with acute cerebral infarction and improve the behavior function in rats, which may be one of the mechanisms of FES on improving the neural function after cerebral infarction.

OBJECTIVETo assess the medical community's awareness and practice regarding delirium in the intensive care unit (ICU).

METHODSOne hundred and ten predesigned questionnaires were distributed to ICU practitioners in the affiliated hospitals of Zhejiang University.

RESULTSA total of 105 valid questionnaires were collected. Totally, 55.3% of the clinicians considered that delirium was common in the ICU. Delirium was believed to be a significant or serious problem by 70.5% of respondents, and under-diagnosis was acknowledged by 56.2% of the respondents. The incidence of ICU delirium is even more under-estimated by the pediatric doctors compared with their counterparts in adult ICU (P less than 0.05). Primary disease of the brain (agreed by 82.1% of the respondents) was believed to be the most common risk factor for delirium. None of the ICU professionals screened delirium or used a specific tool for delirium assessment routinely. The vast majority (92.4%) of respondents had little knowledge on the diagnosis and the standard treatment of delirium.

CONCLUSIONSAlthough delirium is considered as a serious problem by a majority of the surveyed ICU professionals, it is still under-recognized in routine critical care practice. Data from this survey show a disconnection between the perceived significance of delirium and the current practices of monitoring and treatment in ICU in China.

Attitude of Health Personnel ; Delirium ; diagnosis ; epidemiology ; therapy ; Humans ; Incidence ; Intensive Care Units ; Risk Factors ; Surveys and Questionnaires

OBJECTIVETo investigate the correlation between expression of A-kinase anchoring protein 95 (AKAP95) and protein expression of cyclin E1 and cyclin D1 in lung cancer tissue.

METHODSFifty-one cases of lung cancer were included in the study. The protein expression of AKAP95, cyclin E1, and cyclin D1 were measured by immunohistochemistry.

RESULTSThe protein expression of cyclin E1 in lung cancer tissues was significantly higher than that in para-cancerous tissues (positive rate: 75.56%vs 20%, P < 0.01); its expression showed no relationship with histopathological type, lymph node metastasis, and cellular differentiation (P > 0.05). The protein expression of cyclin D1 in lung cancer tissues was higher than that in para-cancerous tissues (positive rate: 69.39% vs 14.29%); its expression showed a significant relationship with histopathological type (P < 0.05). The expression of AKAP95 was correlated with the protein expression of cyclin E1 and cyclin D1 in lung cancer tissues (P < 0.01).

CONCLUSIONCyclin E1 and cyclin D1 are highly expressed in lung cancer tissue, suggesting that they play an important role in the development and progression of lung cancer. The protein expression of cyclin E1 has no relationship with cellular differentiation, lymph node metastasis, and histopathological type of lung cancer, and the protein expression of cyclin D1 has a significant relationship with histopathological type. The expression of AKAP95 is correlated with the protein expression of cyclin E1 and cyclin D1 in lung cancer tissue.

A Kinase Anchor Proteins ; metabolism ; Adult ; Aged ; Cyclin D1 ; metabolism ; Cyclin E ; metabolism ; Humans ; Lung ; metabolism ; pathology ; Lung Neoplasms ; metabolism ; pathology ; Middle Aged ; Oncogene Proteins ; metabolism