Child ; Hemorrhagic Fever with Renal Syndrome ; Humans

Since 1988,our school has been enrolling in increasing numbers students in 7-year programs of clinical medicine and stomatology. During the period, we have accumulated some experience, which can be embodied in five major points. On this basis, we have, starting from this year, enrolled students working on doctoral degree in 8-year programs with candidates who have completed 4-year undergraduate programs of science and engineering, designed to further intensify reforms in medical education programs.

OBJECTIVETo study the results of arthroscopic partial meniscectomy for medial meniscal tear in late middle-aged adults.

METHODSFrom October 2010 to October 2012,49 patients meeting inclusion criteria were treated with arthroscopic partial meniscectomy for medial meniscal tear. There were 31 males and 18 females,with an average age of (55.3±2.8) years old. There were 22 left knees and 27 right knees. The average flexion angle was (116.01±12.03)°. The pre-operative HSS Knee Score was 48.73±8.43, and the Lysholm score was 63.95±5.45. The patients were followed up and evaluated. All the patients received a standard surgery, in which the torn tissue was removed, and the anterior part of the meniscus was left in situ.

RESULTSAll the surgeries were successful with no serious complications. All the patients were followed up,and the duration ranged from 12 to 36 months. All the patients had 5 degrees of muscle strength. The average flexion angle was (136.77±18.56)°. There was significant difference between the two angles before operation and after operation. The pre-operative HSS Knee Score was 90.17±4.10, and the Lysholm score was 87.84±5.16. Statistically, the difference between preoperative score and the postoperative score was significant.

CONCLUSIONArthroscopic partial meniscectomy is a good option for medial meniscal tear in late middle-aged adults. Operative indication is crucial and the excellent surgical technique is also critical for the good clinical outcome. All the patients could get good clinical results, although there are some patients with motion restrictions in the early stage after operation.

Arthroscopy ; methods ; Female ; Humans ; Knee Injuries ; surgery ; Male ; Menisci, Tibial ; physiopathology ; surgery ; Middle Aged ; Tibial Meniscus Injuries

Background and purpose:Gene therapy is a novel approach for the treatment of the patients with breast cancer. One of the effective ways is to direct transgenic expression to specific tissues or tumors with the use of tissue-specific-promoters (TSP). hTERT (human telomerase reverse transcriptase) is highly expressed in many types of cancers including breast cancer. Thus, we hypothesized that the hTERT promoter targeting with gene therapy vectors could be exploited for breast cancer. In this study, we amplified hTERT gene promoter and cloned it into the reporter vector pEGFP and pGL3-Basic. Afterwards, the specific transcription of hTERT promoter in MCF7 cells was evaluated. Methods:hTERT gene minimal promoter was PCR amplified and cloned into the reporter plasmid pEGFP-1 and pGL3-Basic.The constructs pEGFP/TERT and pGL3/TERT were transfected into MCF7 breast cancer cells and HBL100 human epithelial cells, respectively.The expression of EGFP and luciferase were investigated, respectively..Results:pEGFP/TERT and pGL3 /TERT bearing hTERT gene promoter were constructed. The specific expression of EGFP was detected in MCF7 cells while little expression of EGFP was seen in HBL100 cells.In accordance with EGFP, luciferase driven by hTERT also showed specific and high activity in MCF7 cell (RLU/U: 33784), which is 15 times higher than in HBL100 (RLU/U: 2400).Conclusions:The high transcriptional activity of hTERT gene promoter in MCF7 cell indicates its potential utility as a novel candidate for transcriptional targeting of breast cancer.

AlM: To analyze, summarize and describe ophthalmic imaging features of posterior scleritis.
METHODS: Clinical data of 16 patients ( 21 eyes ) with posterior scleritis diagnosed in our hospital from October 2008 to June 2013 were retrospectively analyzed. The results of type-B ultrasonic, fundus chromophotograph, fundus fluorescein angiography, CT were recorded for comprehensive evaluation and analysis of ophthalmic imaging features of posterior scleritis.
RESULTS: All patients underwent type-B ultrasonic examination and manifested as diffuse and nodular types. The diffuse type showed diffusely thickened sclera and a dark hypoechoic area that connected with the optic nerve to form a typical “T”-shaped sign. The nodular type showed scleral echogenic nodules and relatively regular internal structure. FFA showed that relatively weak mottled fluorescences were visible in the arterial early phase and strong multiple needle-like fluorescences were visible in the arteriovenous phase, which were then progressively larger and fused; fluorescein was leaked to the subretinal tissue in the late phase;varying degrees of strong fluorescences with less clear or unclear boundaries were visible in the optic disk. CT results showed thickened eyeball wall.
CONCLUSlON: Posterior scleritis is common in young female patients, whose ophthalmic imaging features are varied and more specific in type-B ultrasonic. Selection of rational ophthalmic imaging examination method, combined with clinical manifestations, can accurately diagnose posterior scleritis and avoid the incidence of missed and delayed diagnosis.

Objective The purpose of this study is to evaluate Surgical Procedure and Prognosis for elderly stage 1NSCLC patients above 70 years old.Methods The patients who were stage Ⅰ non-small cell lung cancer from 2003 to 2007were enrolled ( n =71 ).The median age was 74 years ( ranged from 70 to 84 years).The median follow-up of patients was 30months( ranged from 2 to 81 months).Results The percentages of postoperative complications after sublobar resection and lobectomy patients were 36.4％ and 46.9％,respectively.The period in hospital were 11.36 days and 12.24 days.The 3 year survival was 85.9％ for patients undergoing sublobar resection and 78.8％ for lobectomy.The 5 year survival was 56.4％ and 56.9％ respectively.No significant difference was observed between two types of surgical procedure in the elderly.Staging is the independent factor of prognosis.Conclusion Lobectomy is still the main therapy method for elderly stage Ⅰ NSCLC patients.Especially,for those who can undergo radical resection.But sublobar resection also appears to be a viable surgical treatment for patients with cardiopulmonary physiologic impairment.

Objective To study the curative effect of ZeGuiLongShuang capsules combined with naftopidil on benign prostatic hyperplasia(BPH).Methods 140 cases with BPH were randomly divided into treatment group and control group.The patients in treatment group were given ZeGuiLongShuang capsules(once 2 tablets,3 times a day) combined with naftopidil(once 25 mg,once a day before sleeping).The patients in control group were given only naftopidil(once 25 mg,once a day before sleeping).Internatianal-prognosic-scoring-system(IPSS),uroflowmetry-max(Qmax),Quality-of-life(QOL),residual urine and weight of prostate before and after treatment were detected.Results IPSS,Qmax,QOL and residual urine changed in two groups.IPSS,Qmax,QOL and residual urine in treatment group were more significant than those in control group(P

Objective To construct S6K1 shRNA gene recombinant adenovirus(S6K1 Ax)and evaluate its gene silencing effects on mouse cell lines and C57 BL/6J mice level.Methods Three S6K1 shRNA gene sequences were designed and spliced from pcPUR plasmid,pcDNA3.1 plasmid to cosmid plasmid and transfected into adenovirus.S6K1 Ax which has best gene silencing effect was selected and proliferated in 293 cell.Silencing effect of S6K1Ax was checked on mice AML12,C2C12,3T3-L1 cell lines.C57BL/6J liver was obtained after S6K1 Ax was injected into mice tail vein six days later.S6K1 was evaluated by qRT-PCR and Western blot.Alanine transferanse(ALT)was examined before and after S6K1 Ax injected.Results S6K1Ax can silence S6K1 expression of mouse AML12,C2C12 and 3T3-L1 cell lines and liver of C57 BL/6J mice on Western blot.S6K1 mRNA expression of C57BL/6J liver were control group 1.39±0.21 vs S6K1Ax group 0.63±0.09,t=6.132.P<0.01.ALT of mice hepatic function did not change after S6K1Ax injected:before(15.15±4.43)U/L,after(17.32±4.22)U/L,t=1.451,P>0.05.Conclusion Construction of shS6K1 Ax can knockdown S6K1 gene on mice cell lines and C57BL/6J mice liver,it provides a good tool to study the function of S6K1.

Objective To study clinical value of percutaneous intrabiliary expandable metallic biliary stenting (EMBS) for treatment of malignant obstructive jaundice. Methods One hundred and sixty patients with malignant obstructive jaundice were treated with EMBS ( EMBS group) . Thirty patients underwent only external drainage by PTCD were recruited as control. The patency rate of stent,decline of bilirubin and the complication were analyzed retrospectively. Both groups were followed up for three months. The Kaplan-Meier method (log-rank test) was used to compare the survival period between the two groups. Results Anorexia,skin pruritus and color of urine alleviated at a certain degree in both groups.In the EMBS group,plasma total bilirubin was(218. 78 ±2. 29) μmol/L pre-stent,and decreased to (134. 90 ±2. 34), (83. 18 ±2.40) , (40. 74 ±2. 29) μmol/L at the 7,14,21 days after the stenting, respectively; direct bilirubin was (128.82 ±2.40) μmol/L pre-stent, and decreased to (81.28 ± 2. 34), (51. 29 ±2. 45) and (25. 70 ±2.40)μmol/L at the 7,14,21 days after the stenting ( P =0. 000). In the PTCD group,plasma total bilirubin was (223. 57 ± 2. 58) μmol/L pe-stent, and decreased to ( 145. 68 ± 2. 57 ) ,(87.57 ±2.58) ,(38.65 ±2. 20) μmol/L at the 7,14,21 days after the stenting,respectively;direct bilirubin was (127. 6 ±2. 59)μmol/L pre-stent,and decreased to (79. 78 ±2. 70) ,(58. 36 ±2. 46) and (29.46 ±2. 20)μmol/L at the 7,14,21 days after the stenting,respectively ( P <0.001 ). No significant difference was found between the two groups at any time point ( P > 0. 05). Complications occurred in 34 patients in the EMBS group and the incidence rate was 20. 62% . Two or more complications occurred in 9 patients. In the PTCD group, complications occurred in 60.00% of the patients. In the EMBS group, 14 patients were failed to follow up, and 136 died. The median length was 214 days. In the PTCD group,all patients were followed up and all died,with a median length of survival of 75. 5 days. The survival analysis showed that the EMBS group survived longer than the PTCD group (P =0. 000). Conclusions EMBS placement showed better effect than PTCD. Compared to PTCD, internal drainage of metallic stents lead few complications and faster recover, and can improve the life quality and prolong survival time of patient with malignant obstructive jaundice. The placement of metallic stents is recommended as a preference for palliative therapy of malignant biliary obstruction.

Objective To analyze the distribution and drug resistance characteristics of pathogenic bacteria isolated from blood cultures in the infected patients in our hospital during 2009-2013 to provide the newest evidence for the clinical anti-infection ther-apy.Methods The bacterial identification and drug susceptibility test were performed by applying the VITEK-32 System.The dis-tribution situation and the drug susceptibility test results of pathogens isolated from blood culture specimens in our hospital during this period were analyzed.Results 2 301 strains of positive bacteria were isolated from 14 006 cases of blood culture during these five consecutive years.The positive rate was 16.4%.Among them,1 303 strains were Gram positive bacteria(56.6%),954 strains of Gram negative bacilli(41.5%)and 44 strains of fungi(1.9%).Gram-positive bacteria were mainly Staphylococcus aureus,coagu-lase negative staphylococci(CNS),etc.Gram-negative bacteria were mainly E.coli,Klebsiella pneumoniae,etc.E.coli and Klebsiella pneumoniae were highly sensitive to carbapenem,amikacin,cefoxitin and antibacterial drugs containing enzyme inhibitor.The detec-tion rates of extended-spectrumβ-lactamase(ESBL)-producing Escherichia coli and Klebsiella pneumoniae were 55.8% and 18.4%respectively.Acinetobacter baumannii in blood culture had serious resistance to most of antibacterial drugs.Conclusion The kinds of pathogens isolated from blood culture are complex with different sensitivity to antibacterial drugs.Timely understanding the re-sults of blood culture has the important significance to adjust the treatment scheme in clinic and timely discover drug-resistant strains for serve clinic better.