Objective: To explore the application of photodynamic therapy (PDT) combined with orally administered retinoic acid in the treatment of proliferative verrucous leukoplakia (PVL) and provide a reference for clinical practice. Methods: A case of sequential treatment of PVL with PDT and orally administered retinoic acid was reported. The characteristics, diagnosis, treatment of PVL, and the application of PDT and retinoic acid in oral leukoplakia were retrospectively analyzed based on the literature. Results: After four PDT sessions, a majority of the oral lesions were eliminated in a patient clinically diagnosed with PVL, but the lesions recurred two months later. Subsequently, the patient was treated with retinoic acid at a dose of 10 mg, once a day, orally before bedtime. After continuous treatment for 2 weeks, the oral lesions were significantly reduced. The dose was then adjusted to 10 mg, twice a day, and the treatment was extended for 3 months until the lesions completely disappeared. Following this, a periodic regimen was adopted to continue the administration of retinoic acid at a dose of 10 mg, twice a day (3 weeks of treatment followed by 1 week of drug withdrawal as one cycle), for a total of 6 cycles. No recurrence was observed during the 5-month follow-up after drug withdrawal. A review of the literature indicates that PVL is an oral potentially malignant disorder (OPMD) characterized by multifocality, high recurrence rate, and high malignant transformation rate. Currently, there is no ideal treatment method for PVL. PDT is advantageous because of its low toxicity. Furthermore, it is strongly selective, minimally invasive, and patients experience no scarring. Thus, it has been recommended as the first-line therapy for PVL. However, due to the limitations of local application of photosensitizers in terms of effectiveness, targeting, and penetration depth, the efficacy of PDT in treating PVL remains uncertain. There are a few reports on the treatment of oral leukoplakia with retinoic acid given by oral, but no literature has reported the combination of PDT and retinoic acid given by oral for PVL. Conclusion The sequential combination of PDT and oral retinoic acid therapy is an effective treatment for PVL.

Objective:To evaluate the effectiveness of a Feynman learning method based on ICARE (integrity, compassion, accountability, respect, and excellence) in the standardized training of spinal surgery residents.Methods:A total of 60 spinal surgery residents at The Second Affiliated Hospital of Naval Medical University (Shanghai Changzheng Hospital) were enrolled between May 2022 and May 2024 and randomly assigned to an experimental group or a control group with 30 residents in each group. The experimental group received dual-spiral teaching integrating ICARE with the Feynman learning method (concept explanation, simplified reconstruction, practical application, and teaching output). The control group underwent standard theoretical instruction and clinical skill training. Evaluations were performed using theoretical examinations, clinical operation, the Caring Ability Inventory, and a teaching satisfaction questionnaire. SPSS 26.0 was used for t test. Results:The experimental group scored significantly higher than the control group on the case analysis section of the theoretical examination [(15.17±2.33) vs. (12.38±2.08), P<0.001] and on clinical operation [(85.90±4.80) vs. (77.51±5.20), P=0.006]. Regarding humanistic care, the experimental group outperformed the control group in the cognition dimension [(87.75±9.43) vs. (81.10±9.56), P=0.009] and courage dimension [(77.43±9.57) vs. (72.37±9.23), P=0.042]. In teaching satisfaction assessment, the experimental group scored higher than the control group in curriculum design rationality and teaching philosophy recognition. Conclusions:The ICARE-Feynman integrated teaching method significantly enhances the clinical competence, humanistic care ability, and teaching satisfaction among spinal surgery residents. This approach provides an effective pathway for the integrated development of values and professional competencies in medical education.

Objective:To evaluate the effectiveness of a Feynman learning method based on ICARE (integrity, compassion, accountability, respect, and excellence) in the standardized training of spinal surgery residents.Methods:A total of 60 spinal surgery residents at The Second Affiliated Hospital of Naval Medical University (Shanghai Changzheng Hospital) were enrolled between May 2022 and May 2024 and randomly assigned to an experimental group or a control group with 30 residents in each group. The experimental group received dual-spiral teaching integrating ICARE with the Feynman learning method (concept explanation, simplified reconstruction, practical application, and teaching output). The control group underwent standard theoretical instruction and clinical skill training. Evaluations were performed using theoretical examinations, clinical operation, the Caring Ability Inventory, and a teaching satisfaction questionnaire. SPSS 26.0 was used for t test. Results:The experimental group scored significantly higher than the control group on the case analysis section of the theoretical examination [(15.17±2.33) vs. (12.38±2.08), P<0.001] and on clinical operation [(85.90±4.80) vs. (77.51±5.20), P=0.006]. Regarding humanistic care, the experimental group outperformed the control group in the cognition dimension [(87.75±9.43) vs. (81.10±9.56), P=0.009] and courage dimension [(77.43±9.57) vs. (72.37±9.23), P=0.042]. In teaching satisfaction assessment, the experimental group scored higher than the control group in curriculum design rationality and teaching philosophy recognition. Conclusions:The ICARE-Feynman integrated teaching method significantly enhances the clinical competence, humanistic care ability, and teaching satisfaction among spinal surgery residents. This approach provides an effective pathway for the integrated development of values and professional competencies in medical education.

Acute Disease ; Allografts ; Humans ; Kidney ; Kidney Transplantation ; Nephritis ; Pyelonephritis ; Transplantation, Homologous

For many years, studies on cholesteryl ester transfer protein inhibitors(CETP) have not been interrupted, intending to achieve further cardiovascular protection through increasing the level of HDL-C on the basis of statin-lowering LDL-C. However, the failure of large clinical studies of CETP inhibitors represented by torcetrapib has caused continuous controversy in this area of research. The 2017 European Society of Cardiology Annual Conference published the results of Phase 3 clinical trials on Anacetrapib, which regained significant attention to CETP inhibitors. Based on these, this article reviewed the development of the four major CETP inhibitors, and briefly discusses their clinical effects and differences.

OBJECTIVETo establish a computer-assisted screening system for individualized treatment of type 2 diabetes mellitus.

METHODSThe clinical data of the diabetic patients were retrospectively analyzed, and the regression equation for the affecting factors and therapeutic effect was established. With computer-aided programming, a computer-assisted screening system was established.

RESULTSA computer-assisted screening system for individualized treatment type 2 diabetes was established, which showed a concordance rate was 98% in clinical verification.

CONCLUSIONUsing epidemiological methods and assistance by computer technique, a computer-assisted screening system for individualized prescription can be established for selecting therapeutic regimen for type 2 diabetes.

Adult ; Aged ; Decision Support Systems, Clinical ; Diabetes Mellitus, Type 2 ; therapy ; Drug Therapy, Computer-Assisted ; methods ; Female ; Humans ; Male ; Middle Aged ; Patient-Centered Care ; methods ; Retrospective Studies

OBJECTIVETo culture rat corpus cavernosum smooth muscle cells in vitro using a modified tissue culture method.

METHODSFifteen male rats were randomized into 3 equal groups, namely enzyme digestion group, tissue culture group, and modified tissue culture group. The penis of the rats was separated carefully and cut into small pieces, and seeded onto culture flasks and cultured in complete medium consisting of DMEM containing 20% fetal calf serum at 37 degrees C; in a humidified atmosphere with 5% carbon dioxide. The cells growth was observed under phase contrast microscope and the smooth muscle cell specific proteins alpha-SM-actin and desmin were identified immunohistochemically.

RESULTSThe alpha-SM-actin-positive cell rate was 96.3% in rat corpus cavernosum smooth muscle and 23.8% in the fibroblasts, and the corpus cavernosum smooth muscle contained 74.4% desmin-positive cells while the fibroblasts showed no desmin positivity. Significant difference was found in the positive cell rate for desmin among the 3 groups, with the highest positive cell rate occurred in modified tissue culture group.

CONCLUSIONDesmin may serve as a marker for identifying corpus cavernosum smooth muscle cells. The modified tissue culture method can result in highly purified corpus cavernosum smooth muscle cells with intact structure and functions.

Actins ; analysis ; Animals ; Biomarkers ; analysis ; Cell Proliferation ; Desmin ; analysis ; Male ; Muscle, Smooth ; cytology ; Penis ; cytology ; Rats ; Rats, Sprague-Dawley ; Tissue Culture Techniques

OBJECTIVETo investigate the method for culturing corpus cavernosum smooth muscle cells (CCSMs) derived from diabetic rats with erectile dysfunction (ED) for the study of ED caused by diabetes.

METHODSCCSMs were isolated from the corpus cavernosum of diabetic rats with ED and cultured using a modified method of adherent tissue culture. The cultured cells were identified by immunohistochemistry and the cell morphology and proliferation were observed.

RESULTSThe primary culture of CCSM was performed successfully, and the cells were seen to migrate from the small tissue pieces 3 days later, reaching nearly confluence in 16-18 days. A typical "hill-valley" growth pattern was noted in the cell passaging. Immunohistochemical staining for alpha-smooth muscle actin (alpha-SM-actin) and desmin yielded positive results in the cells.

CONCLUSIONThe modified method for adherent tissue culture is convenient and reliable in establishing the in vitro cell culture model of CCSMs from diabetic rats with ED, and the cultured CCSMs display a faster proliferation than normal CCSMs. No obvious differences in the cell morphology can be found between diabetic and normal CCSMs under light microscope.

Animals ; Cell Culture Techniques ; Cells, Cultured ; Diabetes Mellitus, Experimental ; complications ; pathology ; physiopathology ; Erectile Dysfunction ; etiology ; pathology ; physiopathology ; Male ; Models, Biological ; Myocytes, Smooth Muscle ; cytology ; physiology ; Penile Erection ; Penis ; cytology ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo study the immunosuppressive effect of the interleukin-2-pseudomonas exotoxin 66(IL-2-PE66) on murine corneal allograft rejection.

METHODSThirty-six recipient female BALB/c mice received corneal allografts from C57BL/6 mice and were divided randomly into treatment and control groups. The condition of the grafts was observed twice a week. On days 10, 15, 25 and 35 after the transplantation, the operated eyes were removed for pathological examinations. Peripheral blood samples were also collected for analysis of T cell subsets and T lymphocyte colony forming unit (T-CFU) assay.

RESULTSThe survival time of corneal allograft averaged 15.8-/+2.1 days in the control group and 31.2-/+2.9 days in the treatment group. The CD(4)(+)/ CD(8)(+)/ of the T cell subsets 15 days after the operation was 1.26-/+0.23 in the treatment group and 2.01-/+0.23 in the control group, with T-CFU of 201-/+18.2 and 286-/+16.8, respectively.

CONCLUSIONIL-2-PE66 can delay the development of corneal graft rejection, significantly reduce the percentage of T helper cells, and weaken the aggregation of the peripheral T cells.

Animals ; Bacterial Proteins ; therapeutic use ; Corneal Transplantation ; adverse effects ; Cytotoxins ; therapeutic use ; Exotoxins ; therapeutic use ; Female ; Graft Rejection ; drug therapy ; Graft Survival ; drug effects ; Immunosuppressive Agents ; therapeutic use ; Interleukin-2 ; therapeutic use ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Random Allocation ; Recombinant Fusion Proteins ; therapeutic use

OBJECTIVETo validate the hypothesis that the phenotypic transformation occurs in the smooth muscle cells in the corpus cavernosum of hypertensive rat and explore its impact on the erectile function of rats.

METHODSEighteen 16-week-old male spontaneously hypertensive rats (SHR) and 10 syngeneic normotensive rats (WKY) were used in this experiment. After measurement of systolic blood pressure of the caudal artery and examination of the erectile function with subcutaneous injection of apomorphine (APO), the rats were divided into 3 groups, namely hypertensive with erectile dysfunction (HBP-ED) group (n=6), hypertensive (HBP) group (n=12) and control group (n=10). Immunohistochemical staining and color image analysis system were used to observe expression of calponin 1 and osteopontin (OPN) in rat corpus cavernosum. Real-time quantitative RT-PCR was used to determine the expression of calponin 1 and OPN mRNAs in different groups.

RESULTSThe expressions of calponin 1 protein and mRNA were the highest in the control group and the lowest in HBP-ED group, while the expressions of OPN protein and mRNA were the highest in HBP-ED group and the lowest in the control group.

CONCLUSIONThe smooth muscle cells may transform from the contractile phenotype into synthetic phenotype in the corpus cavernosum of the hypertensive rats, resulting ultimately in erectile dysfunction.

Animals ; Calcium-Binding Proteins ; genetics ; metabolism ; Erectile Dysfunction ; etiology ; pathology ; Hypertension ; complications ; pathology ; Male ; Microfilament Proteins ; genetics ; metabolism ; Myocytes, Smooth Muscle ; pathology ; Osteopontin ; genetics ; metabolism ; Penis ; pathology ; Phenotype ; RNA, Messenger ; genetics ; metabolism ; Rats ; Rats, Inbred SHR