Information literacy is the essential literacy in medical education and training of information analysis ability is the difficulty in information literacy education .Described in this paper is the trial to help postgraduates and long-term schooling undergraduates select their study orientation and topics in ChinaMedical University , including their course targets, contents and teaching outcomes.

Objective To summarize the clinical features and vascular lesions in patients who suffered from cerebellar infarction with vertebral artery hypoplasia(VAH). Methods Retrospective analysis was used in the research. The selected patients suffered from cerebellar infarction with VAH or stenosis (stenosis rate≥50%). Seventy-one patients with cerebellar infarction were enrolled. There were 34 patients in VAH group and 37 patients in vertebral artery stenosis group. The age, sex, risk factors, clinical manifestations and characteristics of vascular examination were compared. Results The age, sex, risk factors between two groups had no significant differences (P>0.05). The scores of National Institutes of Health Stroke Scale (NIHSS) between two groups had no significant difference (P>0.05). The proportion of early neurological deterioration in VAH group (41.2%, 14/34) was higher than that in vertebral artery stenosis group (18.9%, 7/37), χ2=4.21, P<0.05. There were more patients with anterior circulation artery stenosis in the VAH group (35.3%, 12/34), compared with that in artery stenosis group (13.5%, 5/37),χ2=4.62, P<0.05. Except the ipsilateral vertebral artery, other arteries stenosis in VAH group (44.1%, 15/34) was significantly higher than that in vertebral artery stenosis group (13.5%, 5/37),χ2=8.20, P<0.05. Conclusions Cerebellar infarction with vertebral artery hypoplasia is more likely to have multiple cerebral arterial stenosis (stenosis rate ≥50%). The patients who suffered from cerebellar infarction with vertebral artery hypoplasia might be prone to early neurological deterioration.

Objective To evaluate the efficacy of self?made breathing circuit joint for intermittent positive pressure ventilation ( IPPV) in patients with central airway obstruction undergoing interventional fi?beroptic bronchoscopy ( FOB) . Methods Sixty?two patients of both sexes with central airway obstruction requiring tracheal intubation, aged 60-80 yr, with body mass index of 20-26 kg∕m2 , of American Society of Anesthesiologists physical status Ⅲ or Ⅳ and Medical Research Council dyspnea scale grade Ⅲ or Ⅳ, undergoing interventional FOB under general anesthesia, were divided into 2 groups ( n=31 each) using a random number table:high frequency jet ventilation ( HFJV) group and IPPV group. The patients were tra?cheally intubated after induction of general anesthesia. The self?made breathing circuit joint was connected, then the anesthesia machine was connected to perform IPPV, and the ventilator settings were adjusted to maintain the end?tidal pressure of carbon dioxide 35-45 mmHg in group IPPV, and HFJV was used in group HFJV. Before induction ( baseline) , at 10, 20, 30 and 40 min after start of operation, and at the end of operation, arterial blood samples were collected for blood gas analysis, the pH value, arterial oxy?gen partial pressure, and arterial carbon dioxide partial pressure were recorded. The development of hyper?capnia was recorded. Results Hyoxemia was not found in the two groups. The incidence of hypercapnia was 74%, and in addition the incidence of severe hypercapnia was 10% in group HFJV. The incidence of hypercapnia was 16%, and all the patients presented with permissive hypercapnia in group IPPV. Com?pared with group HFJV, the incidence of hypercapnia was significantly decreased, and the pH value and arterial oxygen partial pressure were increased, and arterial carbon dioxide partial pressure was decreased from 10 min after start of operation to the end of operation in group IPPV (P<0.05). Conclusion The self?made breathing circuit joint provides better efficacy than HFJV when used for IPPV in the patients with central airway obstruction undergoing interventional FOB.

Objective To discuss the regulatory effect of 5-aza-2 ,-deoxycytidine on P16 and MGMT in cervical cancer cells. Methods After four kinds of cervical cancer cells (HeLa, SiHa, C33A and CaSki) were treated with 5-Aza-dC , MSP was used to detect the methylation variation of P16 and MGMT , and fluorogenic quantitative PCR and Western blot were employed for determination of P16 and MGMT expression. MTT and Annexin V-FITC/PI double staining were adopted for detection of cell proliferation and apoptosis. Results Both P16 and MGMT exhibited methylation in four kinds of cervical cancer cells , and after treatment with 5-Aza-dC ,their methylation levels were reversed. 5-Aza-dC was able to inhibit p16 and MGMT expression in the cervical cancer cells, and can also suppress cell proliferation and promote apoptosis. Conclusions Although methylation of P16 and MGMT are present in cervical cancer cells, their expression level was still high. Therefore, regulation of P16 and MGMT expression may be affected by other factors. 5-Aza-dC can suppress the growth of cervical cancer cells. Although 5-Aza-dC reverse the methylation levels of P16 and MGMT, it inhibits their gene expression. More experiments are needed to verify the hidden reasons and mechanisms.

In response to viral infection, RIG-I-like RNA helicases detect viral RNA and signal through the mitochondrial adapter protein VISA. VISA activation leads to rapid activation of transcription factors IRF3 and NF-κB, which collaborate to induce transcription of type I interferon (IFN) genes and cellular antiviral response. It has been demonstrated that VISA is activated by forming prion-like aggregates. However, how this process is regulated remains unknown. Here we show that overexpression of HSC71 resulted in potent inhibition of virus-triggered transcription of IFNB1 gene and cellular antiviral response. Consistently, knockdown of HSC71 had opposite effects. HSC71 interacted with VISA, and negatively regulated virus-triggered VISA aggregation. These findings suggest that HSC71 functions as a check against VISA-mediated antiviral response.
Adaptor Proteins, Signal Transducing ; biosynthesis ; chemistry ; genetics ; metabolism ; Cell Aggregation ; genetics ; GPI-Linked Proteins ; metabolism ; Gene Knockdown Techniques ; HEK293 Cells ; HSC70 Heat-Shock Proteins ; genetics ; metabolism ; Heat-Shock Response ; genetics ; Humans ; Interferon Regulatory Factor-3 ; genetics ; metabolism ; Interferon-beta ; genetics ; NF-kappa B ; genetics ; Prions ; metabolism ; Receptors, Retinoic Acid ; metabolism ; Viruses ; drug effects ; metabolism ; pathogenicity

ObjectiveTo analyze the clinicopathologic features of hereditary cutaneomucosal venous malformation (VMCM) in a Chinese family.MethodsFamily history was investigated in a family with VMCM,and tissue specimens were obtained from the lesions of the proband and subjected to histopathological analysis.ResultsAmong 65 members from 5 generations of the family,19 were affected by VMCM,hinting an autosomal dominant inheritance.None of the family members experienced gastrointestinal bleeding,central nervous system disorders,or cardiac defects.Affected individuals usually presented with multiple irregularly sized,blue-violet,elevated and slightly indurated masses located in the oral mucosa and subcutaneous tissue of the extremities.Pathological analysis showed malformed veins with abnormally dilated cavities and irregularly thickened walls.Although small veins were abnormally proliferating and clustered,there was no endothelial discontinuity.The smooth muscle layer was thickned in a varying degree or absent.ConclusionA diagnosis of VMCM is made according to the inheritance manner,clinical manifestation and pathological findings.

Objective To evaluate the clinical characteristics and pathological features of Meckel's diverticulum(MD) in children.Methods 244 MD cases admitted between January 2010 and December 2014 were retropectively analyzed.Results In fifty patients,MD was an incidental finding at laparotomy or laparoscopy for unrelated entities.Among the remaining 194 symptomatic patients,there were 76 patients presenting GI bleeding,forty eight patients were identified with perforated Meckel's diverticulum,thirty six patients suffered from intestinal obstruction.34 patients had MD caused severe complications such as volvulus and intestinal necrosis,diverticular perforation and peritonitis.61 out of 76 GI bleeding patients underwent a 99mTc scan,and positive tracer was found in 42 patients.Among the 19 negative 99mTc scan patients,8 received capsule endoscopy and only 3 patients were suspected of diverticulum.242 patients underwent one stage resection of the diverticulum.Histology revealed ectopic gastric mucosa or ectopic pancreatic tissue in 128 patients.One patient died of volvulus and intestinal necrosis postoperatively,and two suffered from adhesive intestinal obstruction during one to five year's follow up.Conclusions It is necessary to maintain a high suspicion of MD in the pediatric age group with symptoms of abdominal pain,gastrointestinal hemorrhage or intestinal obstruction.Ectopic mucosa assumes the ultimate responsibility for major complications of MD.

OBJECTIVE: To describe five rare cases of bilateral olfactory clefts respiratory epithelial adenomatoid hamartoma (REAH), and investigate the clinicopathologic features in REAH. METHOD: Five cases with REAH were reported and the relevant literatures were reviewed. All the cases were confirmed by pathology. RESULT: The chief complaint in 4 cases when visited was nasal obstruction and rhinorrhea, with or without hyposmia and headache. Another was discomfortable of head-facial region, sometimes with pus discharge and blood in nasal discharge. Polypoid neoplasms can be seen in nasal meatus of the 5 cases. Endoscopic sinus surgery was utilized to eliminate foci in 5 cases. All REAH foci located in bilateral olfactory clefts areas, four of which appeared polypoid changes,one appeared obvious inflammatory edema. All of them presented as wide-based lesion with tenacious quality compared to polyps. Histologically, these lesions were characterized by a glandular proliferation lined by ciliated respiratory epithelium originated from the surface epithelium, and the glands surround into round or oval, with various sizes and separated by stromal tissue. CONCLUSION It is possible to continue developing after operation, if REAH is not completely resected. Complete resection of lesions is the key to treatment success for this entity in endoscopic sinus surgery. Although REAH arising from the rhino sinusal region is very rare, rhinolaryngologists must know this entity in order to differentiate it from inverted papilloma and adenocarcinoma.
Adult ; Female ; Hamartoma ; pathology ; Humans ; Male ; Middle Aged ; Nasal Cavity ; pathology ; Nose Diseases ; pathology ; Olfactory Mucosa ; pathology ; Respiratory Mucosa ; pathology

OBJECTIVETo study genetic mutations and clinical features of a pedigree affected with MYH9-related disorders from Guangxi.

METHODSBlood platelets were counted with a hemocytometer. Blood smear was carried out to detect the inclusion body in peripheral blood neutrophils. DNA and mRNA samples were extracted from blood samples from the members of the pedigree. Fragments of the MYH9 gene were amplified with PCR and directly sequenced.

RESULTSThe affected individuals presented with a triad of giant platelets, decreased platelet count and inclusion bodies in the neutrophils with variable expressivity. A heterozygous deletional mutation (c.5803delG) in exon 41 of the MYH9 gene was found in all of the 8 affected individuals, which led to a frame-shift and change of 26 amino acids at the C-end of the tail domain of nonmuscle myosin heavy chain IIA (NMMHC-IIA) (p.Ala1935Profs*12). The same mutation was not found among healthy members of the pedigree.

CONCLUSIONThe c.5803delG mutation probably underlies the MYH9-related disorders in this pedigree. The mutation has altered the C-end of the tail domain of the NMMHC-IIA protein, resulting in mild clinical symptoms in the affected individuals.

Adult ; Base Sequence ; China ; Female ; Humans ; Male ; Molecular Motor Proteins ; genetics ; Molecular Sequence Data ; Myosin Heavy Chains ; genetics ; Pedigree ; Sequence Deletion ; Thrombocytopenia ; diagnosis ; genetics

Objective To explore associated factors of cerebral microbleeds (CMBs) in patients with intracerebral hemorrhage (ICH).Methods A total of 161 ICH patients were detected by 1.5T magnetic resonance imaging.Patients were divided into different groups according to ICH location (58 cases with lobar ICH,103 cases with non-lobar ICH).Results Eighty-eight (55％) patients hadCMBs at ICH onset,and 76 (47％) had CMBs during follow-up.Predictors of incident CMBs were ≥ 1 CMBs at ICH onset and old radiological macrohemorrhage.In the patients with nonlobar hemorrhage,CMBs was associated with lacunar state and antiplatelet drug use.In patients with lobar hemorrhage,CMBs was associated with large brain hemorrhage showed by imaging display.Conclusion The prognosis and related factors of CMBs are different according to the location of hemorrhage.