Objective:To construct evaluation indicators for the effectiveness of curriculum ideology and politics education in medical colleges and universities based on the Center for the Study of Evaluation (CSE) model.Methods:Based on the CSE-based theoretical framework of "needs evaluation, program evaluation, formative evaluation, and summative evaluation", semi-structured interviews were conducted to select indicators. The Delphi method was used to conduct two rounds of questionnaire-based consultation with 29 experts to establish a set of indicators for evaluating the effects of curriculum ideology and politics teaching of medical colleges and universities. The priority diagram was used to calculate and determine the weight of each index.Results:The authority coefficient of the 29 experts included in this study was 0.85. The Kendall's coefficients of concordance for the two rounds of expert consultation were 0.361 and 0.577 ( P<0.05), respectively. Finally, an evaluation system for the effectiveness of curriculum ideology and politics teaching was formed, including 4 first-level indicators, 9 second-level indicators, and 18 evaluation observation points. The 4 first-level indicators were "implementation objectives", "implementation plans", "implementation process", and "implementation effects". Conclusions:The CSE model is suitable as a theoretical framework for constructing the evaluation system of curriculum ideology and politics teaching in medical schools, which employs scientific indicator construction methods, follows the basic principles of course evaluation, and conforms to the current concept of ideological and political construction of medical curricula, showing certain feasibility and guiding significance.

Objective:To investigate the efficacy of different laparoscopic surgeries for gastrointestinal stromal tumors (GIST) of gastric cardia and fundus.Methods:The retrospective cohort study was conducted. The clinicopathological data of 251 patients with GIST of gastric cardia and fundus who underwent laparoscopic radical resection in 14 medical centers, including Guangdong Provincial People′s Hospital et al, from December 2007 to December 2021 were collected. There were 123 males and 128 females, aged 58(24,87)years. Observation indicators: (1) treatment; (2) clinicopathological data of patients undergoing different laparoscopic surgeries; (3) subgroup analysis for special laparoscopic techniques. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test or ANOVA. Measure-ment data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the Mann-Whitney U test or Kruskal-Wallis H test. Count data were described as absolute numbers or percentages. Comparison of ordinal data was conducted using the rank sum test. Results:(1) Treatment. Of the 251 patients,202 cases underwent gastric wedge resection, 26 cases underwent special laparoscopic techniques including 10 cases with serotomy and dissection and 16 cases with transluminal gastrectomy, 23 cases underwent structural gastrectomy including 6 cases with total gastrectomy and 17 cases with proximal partial gastrectomy. There were 24 patients had postoperative complications after surgery. (2) Clinicopathological data of patients undergoing different laparoscopic surgeries. The gender (male, female), age, tumor diameter, operation time, volume of intraoperative blood loss, length of incision, time to postoperative initial whole liquid food intake, time to postoperative initial semi-liquid food intake, duration of postoperative hospital stay, cases with perioperative complications, cases with mitotic count as ≤5/50 high power field, 6?10/50 high power field, >10/50 high power field, cases be classified as very low risk, low risk, medium risk, high risk according to the National Institutes of Health risk classification, cases with tumor located at fundus and gastric cardia were 93, 109, (59±11)years, 3.50(0.40,10.00)cm, 88.00(25.00,290.00)minutes,20.00(25.00,290.00)mL, 4.00(2.00,12.00)cm, 3.00(1.00,9.00)days, 4.00(1.00,16.00)days, 5.00(1.00,18.00)days, 14, 164, 31, 7, 47, 83, 50, 22, 30, 172 in patients undergoing gastric wedge resection, respectively. The above indicators were 19, 7, (49±14)years, 2.55(0.20,5.00)cm, 101.00(59.00,330.00)minutes, 27.50(2.00,300.00)mL, 4.50(0,6.00)cm, 2.50(1.00,10.00)days, 4.00(1.00,16.00)days, 6.00(1.00,18.00)days, 3, 20, 5, 1, 15, 5, 2, 4, 24, 2 in patients undergoing special laparos-copic techniques, and 11, 12, (52±10)years, 5.00(0.80,10.00)cm, 187.00(80.00,325.00)minutes, 50.00(10.00,300.00)mL, 6.00(4.00,12.00)cm, 4.00(2.00,8.00)days, 6.00(3.00,14.00)days, 8.00(2.00,18.00)days, 7, 11, 5, 7, 2, 6, 6, 9, 13, 10 in patients undergoing structural gastrectomy. There were significant differences in the above indicators among the three groups of patients ( χ2=6.75, F=10.19, H=17.71, 37.50, 35.54, 24.68, 16.09,20.20, 13.76, χ2=13.32, Z=28.98, 32.17, χ2=82.14, P<0.05). (3) Subgroup analysis for special laparoscopic techniques. The time to postoperative initial whole liquid food intake, time to postoperative initial semi-liquid food intake, classification of tumor location (endophytic type, exophytic type, parietal type) were 4.50(1.00,10.00)days, 8.00(3.00,12.00)days, 0, 8, 2 in patients undergoing serotomy and dissection, versus 2.00(1.00,4.00)days, 3.00(1.00,6.00)days, 16, 0, 0 in patients undergoing transluminal gastrectomy. There were significant differences in time to postoperative initial whole liquid food intake, time to postoperative initial semi-liquid food intake between them ( Z=-2.65, -3.16, P<0.05); and there was a significant difference in classification of tumor location between them ( P<0.05). Conclusions:Gastric wedge resection is the most commonly used laparoscopic technique for GIST of gastric cardia and fundus. The application of special laparoscopic techniques is focused on the GIST of cardia to preserve the function of the cardia.

The p75 neurotrophic factor receptor is a low affinity receptor for neurotrophic factors and plays an important role in nerve growth, development and function integrity. It is closely related to dental development, oral and maxillofacial tumor, nerve repair and tissue engineering. It shows good prospect for application. In this paper, the research progress of p75 neurotrophic factor receptor in Stomatology is reviewed.

OBJECTIVETo explore the risk factors and prognosis of No.8p lymph node metastasis in cases with advanced gastric cancer.

METHODSClinicopathological and follow-up data of 790 cases with advanced gastric cancer undergoing gastrectomy (including No.8p lymphadenectomy) from October 2003 to October 2013 in Fujian Provincial Tumor Hospital were analyzed retrospectively. Patients receiving neoadjuvant chemotherapy were excluded. Associations of No.8p lymph node metastasis with clinicopathological characteristics and metastasis in other regional lymph node were analyzed. Prognostic difference between positive No.8p group and negative No.8p group was examined.

RESULTSPositive No.8p lymph node was found in 93 cases (11.8%) among 790 cases with advanced gastric cancer. Univariate analysis showed that gender [male 9.8%(56/572) vs. female 17.0%(37/218), P=0.005], preoperative CEA level [<5 μg/L 28.0%(61/218) vs. ≥5 μg/L 5.6%(32/572), P=0.005], tumor size[diameter <5 cm 3.8%(13/346) vs. ≥5 cm 18.0%(80/445), P=0.000], tumor location [gastric fundus and cardiac 10.7% (26/244) vs. gastric body 13.5% (30/222) vs. gastric antrum 10.1% (31/308) vs. total gastric 37.5%(6/16), P=0.007], Borrmann staging [type II( 1.9%(4/211) vs. type III( 11.6% (54/464) vs. type IIII( 30.4%(35/115), P=0.000], tumor differentiation [high 0/8 vs. moderate 6.7%(25/372) vs. low 16.6%(68/410), P=0.000], T staging [T2 2.4%(4/170) vs. T3 13.1%(35/267) vs. T4 15.3%(54/353), P=0.000], N staging [N0 0 (0/227) vs. N1 2.2%(5/223) vs. N2 15.2%(26/171) vs. N3 36.7%(62/169), P=0.000] were closely associated with the No.8p lymph node metastasis. Multivariate analysis that revealed gender (OR=1.762, 95%CI: 1.020-3.043), tumor size (OR=1.107, 95%CI: 1.020-1.203), N staging (OR=4.093, 95%CI: 2.929-5.718), tumor differentiation (OR=1.782, 95%CI:1.042-3.049), and metastasis in No.8a(OR=5.370, 95%CI: 3.425-8.419), No.3(OR=1.127, 95%CI:1.053-1.206), No.6(OR=1.221,95%CI: 1.028-1.450), No.7(OR=2.149, 95%CI: 1.711-2.699), No,11p(OR=2.085, 95%CI: 1.453-2.994), No.14v(OR=2.604, 95%CI: 1.038-6.532) group lymph nodes were the independent risk factors of No.8p lymph node metastasis. One-year, 3-year and 5-year survival rates in positive No.8p group were 85.7%, 47.5% and 22.6%, and those in negative No.8p group were 96.2%, 82.5% and 70.3% respectively, whose differences were significant (χ=109.767, P<0.05).

CONCLUSIONSMetastasis in Np.8p lymph nodes is an important factor affecting the prognosis of patients with advanced gastric cancer. In patients with female gender, tumor diameter ≥5 cm, preoperative late N staging, low tumor differentiation or metastasis in No.8a, No.3, No.6, No.7, No.11p, No.14v group lymph nodes, thorough clean rance of No.8p group lymph node should be considered.

Carcinoembryonic Antigen ; blood ; Female ; Gastrectomy ; Humans ; Lymph Node Excision ; methods ; Lymph Nodes ; physiopathology ; surgery ; Lymphatic Metastasis ; diagnosis ; pathology ; physiopathology ; Male ; Multivariate Analysis ; Neoplasm Grading ; statistics & numerical data ; Neoplasm Staging ; statistics & numerical data ; Prognosis ; Retrospective Studies ; Risk Factors ; Sex Factors ; Stomach Neoplasms ; diagnosis ; mortality ; surgery ; Survival Rate

Objective To analyze the relationship of lymphovascular invasion (LVI) and the clinical pathological feature of gastric cancer and impact on the prognosis in gastric cancer patients.Methods The clinical and pathological data of 1 482 gastric cancer patients undergoing gastrectomy were analyzed retrospectively.The relationship between LVI and the prognosis was evaluated.Results LVI was found in 606 patients (40.9％),which was in significant correlations with tumor size,tumour location,Borrmann type,tumor differentiation status,operative method,tumor invasion,lymph node involvement,and TNM stage (P ＜ 0.05).The five-year survival of patients with LVI was significantly shorter than that of the LVI-negative patients (55.0％ vs.73.1％,x2 =45.15,P =0.00).By multivariate analysis,LVI was an independent prognostic factor (HR =1.592,95％ CI:1.329-1.907,P =0.00).Conclusion LVI is au important indicator for poor prognosis of gastric cancer,suggesting a more aggressive postoperative therapies.

Objective To investigate the relationship between perineural invasion and clinicopathological factors of gastric cancer or prognosis of patients.Methods The retrospective case-control study was conducted.The clinicopathological data of 1 801 patients with gastric cancer who were admitted to the Affiliated Tumor Hospital of Fujian Medical University between March 1999 and November 2015 were collected.All the patients received surgery in order to the radical resection of gastric cancer,and total gastrectomy or two-thirds and above of gastrectomy and D2 lymph node dissection were performed.Patients with preoperative stage Ⅲ of clinical staging underwent neoadjuvant chemotherapy.Patients with T3-T4 of histopathologic stage,T1-T2 of positive lymph nodes and T2N0 of high risk factors (low differentiated tumor,lymphovascular invasion,perineural invasion and age ＜ 50 years) underwent postoperative chemotherapy.Observation indicators:(1) treatment situations;(2)pathological characteristics;(3) follow-up results;(4) prognostic factors.Follow-up using outpatient examination and telephone interview was performed once within 1 month postoperatively,once every 3 months within 2 years postoperatively and once every 6 months from 3 to 5 years postoperatively up to February 2016.Follow-up included inquiry,physical examination,routine blood test,biochemical test,carcinoembryonic antigen (CEA),CA19-9,color Doppler ultrasound or computed tomography (CT) and endoscopy.Measurement data with normal distribution were represented as (x)±s and comparison between groups was analyzed using the t test.Measurement data with skewed distribution were described as M (range).Ordinal data was analyzed by the nonparametric test.The univariate analysis and multivariate analysis were done using the COX regression model.The hazard ratio (HR)and 95％ confidence interval (CI) were calculated.The survival curve and survival analysis were respectively drawn and done by the Kaplan-Meier method and Log-rank test.Result (1) Treatment situations:all the 1 801patients underwent traditional open surgery,including 1 570 undergoing radical resection and 231 undergoing palliative surgery.Of 1 801 patients,1 029 received total gastrectomy,540 received distal gastrectomy,201 received extended gastrectomy and 31 received resection of residual stomach.Operation time,volume of intraoperative blood loss,number of lymph node dissected and duration of hospital stay were (173±40) minutes,(224-±91) mL,30± 13 and (15±9) days,respectively.Of 1 801 patients,79 underwent preoperative neoadjuvant chemotherapy and 906 underwent postoperative adjuvant chemotherapy.(2) Pathological characteristics:results of pathological examinations of 1 801 patients showed that 509 had positive perineural invasion and 1 292 had negative perineural invasion.Tumors located in the upper region,middle region and lower region of stomach,whole stomach and stump stomach were respectively detected in 173,189,123,12,12 patients with positive perineural invasion and 395,417,428,29,23 patients with negative perineural invasion.Type Ⅰ,Ⅱ,Ⅲ and Ⅳ of Borrmann type were respectively detected in 13,213,244,39 patients with positive perineural invasion and 92,511,629,60 patients with negative perineural invasion.The good and poor tumor differentiations and tumor diameter ＜5 cm and ≥5 cm were respectively detected in 172,337,244,265 patients with positive perineural invasion and 536,756,833,459 patients with negative perineural invasion.Stage Ⅰ,Ⅱ,Ⅲ,Ⅳv of histopathologic stage,T1,T2,T3,T4 of invasive depth,NO,N1,N2,N3 of lymph node metastasis and positive and negative lymphovascular invasion were respectively detected in 27,54,346,82,17,24,26,442,77,84,109,239,383,126 patients with positive perineural invasion and 263,283,623,123,188,169,289,646,409,219,312,352,437,855 patients with negative perineural invasion,with statistically significant differences in above indexes between positive and negative perineural invasion patients (X2 =14.142,Z =-2.098,X2 =9.061,41.536,Z=-10.389,-13.824,-8.638,X2 =252.624,P＜ 0.05).(3) Follow-up results:1 629patients were followed up for 1.0-99.0 months,with a median time of 37.3 months.The 5-year overall survival rate was 58.5％.(4) Prognostic factors:results of univariate analysis showed that tumor location,Borrmann type,degree of tumor differentiation,tumor diameter,histopathologic stage,invasive depth,lymph node metastasis,lymphovascular invasion and perineural invasion were factors affecting prognosis of patients with gastric cancer (HR=1.209,1.303,1.496,2.303,3.368,2.057,1.812,2.013,1.332,95％ CI:1.123-1.301,1.171-1.449,1.290-1.736,2.001-2.649,3.012-3.767,1.856-2.279,1.694-1.939,1.749-2.317,1.126-1.576,P＜0.05).Resuhs of multivariate analysis showed that tumors located in the upper and middle of stomach,whole stomach and stump stomach,tumor diameter ≥ 5 cm,stage Ⅱ-Ⅳ of histopathologic stage,T2-T4 of invasive depth,N1-N3 of lymph node metastasis,positive lymphovascular invasion and positive perineural invasion were independent risk factors affecting prognosis of patients with gastric cancer (HR =1.087,1.234,2.663,1.174,1.136,1.254,1.272,95％ CI:1.008-1.172,1.063-1.432,2.292-3.095,1.035-1.332,1.044-1.236,1.064-1.501,1.066-1.516,P＜0.05).The 5-year survival rate was 49.1％ in 509 patients with positive perineural invasion and 60.7％ in 1 292 patients with negative perineural invasion,respectively,with a statistically significant difference (X2 =11.270,P＜0.05).The 5-year overall survival rate was 41.1％ in 383patients with positive perineural invasion and lymphovascular invasion,77.1％ in 126 patients with positive perineural invasion and negative lymphovascular invasion,49.1％ in 437 patients with negative perineural invasion and positive lymphovascular invasion and 92.1％ in 855 patients with negative perineural invasion and lymphovascular invasion,respectively,with a statistically significant difference (X2=244.368,P＜0.05).Conclusion Perineural invasion is a high risk factor affecting prognosis of patients with gastric cancer,and it may be useful in evaluating prognosis of patients with gastric cancer.

Objective To summarize the clinicopathological characteristics and analyze the prognostic factors of young gastric cancer patients.Methods Data of 1 801 gastric cancer patients (divided into ≤45 years of age group,n =230 cases,and ＞ 45 years old group,n =1 571 cases) undergoing gastrectomy in Department of Gastrointestinal Surgery,Fujian Provincial Cancer Hospital,from June 1999 to November 2015 were retrospectively analyzed.Results Compared with the elderly patients,those ≤45 years old were more female with higher percentage of signet ring cell carcinoma,M1 and non radical resection while less in the upper stomach area (P ＜ 0.05),but there was no statistical difference in tumor size,depth of invasion,lymph node metastasis,Borrmann type,TNM stage,peripheral nerve involvement,cancer embolus,positive margin.Prognostic analysis showed the difference of 5-years survival rate was not statistically significant between young and elderly patients.But the 5-year survival rate in young patients with signet ring cell carcinoma undergoingt radical gastrectomy was better than that of elderly patients (P =0.047,0.038).Multivariate regression analysis showed that M staging and surgical modality were independent prognostic factors for these ≤ 45 years old patients.Conclusion Although there are special clinicopathological features of gastric cancer in young patients,but the postoperative prognosis is relatively the same as those elderly patients.

Objective To investigate the mineralized capacities of ectomesenchymal stem cells (EMSC) from facial process of Sprague Dawley(SD) rat embryo of different age in vitro and the expression of p75 neurotrophin receptor(p75NTR) in this process.Methods The stem cell surface antigens of EMSC from 12.5 d,15.5 d and 18.5 d SD rat embryonic facial process were tested by flow cytometry technology.E12.5 d EMSC,E15.5 d EMSC and E18.5 d EMSC were incubated under mineralization induction and analysed by alkaline phosphatase(ALP) staining on day 7(d7) and alizarin red staining on day 21(d21).Expression changes of Runt-related transcription factor-2(RUNX2),collagen Ⅰ (Col Ⅰ) and p75NTR in each group were measured using Western blotting and real time(RT)-PCR on day 0(d0),day 7(d7),day 14(d14) and day 21(d21).Results The expression of the special substances CD29,CD146 and p75NTR in E12.5 d EMSC,E15.5 d EMSC and E18.5 d EMSC were positive,and the expression of CD45 was negative.The expression level of p75NTR in E18.5 d EMSC(84.04％) was much higher than that of E12.5 d EMSC (22.53％) and E15.5 d EMSC(81.43％).The mineralized capacities of E18.5 d EMSC was stronger than that of E12.5 d EMSC and E15.5 d EMSC.The higher expression of RUNX2,Col Ⅰ in E18.5 d EMSC(RUNX2:1.92±0.20,Col Ⅰ:1.85±0.66) was found compared with E12.5 d EMSC(RUNX2:0.38±0.02,Col Ⅰ:0.33±0.94)and E15.5 d EMSC(RUNX2:0.72±0.22,Col Ⅰ:0.64±0.07)(P＜0.05),and p75NTR in the E18.5 d EMSC experimental group(E12.5 d:0.79±0.23,E15.5 d:0.84±0.29,E18.5 d:1.35±0.22) was significantly higher than the in control group(E12.5 d:0.42±0.12,E15.5 d:0.43±0.13,E18.5 d:0.48±0.15)(P＜0.05).RTPCR further proved the results of the Western blotting.Conclusions p75NTR participated in the mineralization differentiation of EMSC.E18.5 d EMSC had a higher expression of p75NTR and stronger mineralization capacity and was the ideal engineering seed cells.

OBJECTIVETo compare the consistency of root canal configuration types of mandibular first premolar by using micro-CT and radio visio graphy (RVG).

METHODSOne hundred extracted mandibular first premolars with complete dental root and apex which received no endodontic treatment were randomly selected. Each tooth was radiographed with RVG through a buccolingual and mesiodistal direction, and then scanned with micro-CT and reconstructed. The classifications of the root canal types according to Vertucci's type with the two methods were compared.

RESULTSThe canal patterns were classified as type I (67%), type III (3%), type V (18%), type VII (2%), additional type (10%) with micro-CT and canal patterns as type I (71%), type III (2%), type V (23%), type VII (1%), additional type (3%) with RVG. 63% of teeth showed one canal in both micro-CT and RVG. Only 25% of teeth were diagnosed as complex canal by the same canal type in both micro-CT and RVG. The Kappa value between micro-CT and RVG was 0.541 which suggested that the two kinds of methods had intermediate consistency. 82.8% of the premolars with root groove had two or more than two canals.

CONCLUSIONAlthough RVG can basically reflect the root canal system type of the mandibular first premolars in vitro, it offers poor accuracy images to complex root canals. Micro-CT three-dimensional images could clearly and precisely display the root canal system morphology of the mandibular first pre-molars in vitro.

Bicuspid ; Dental Pulp Cavity ; Humans ; Mandible ; Molar ; Root Canal Therapy ; Tooth Root ; X-Ray Microtomography

AIM: To investigate the influence of serum apolipoprotein (apo) CII concentrations on the distribution of serum high-density lipoprotein (HDL) subclasses. METHODS: Serum HDL subclasses in 247 subjects were determined by two dimensional gel electrophoresis-immunodetection. RESULTS: With the increase in serum apolipoprotein CII levels, age, BMI, the contents of TG, TC, apoB100, apoCII, apoCIII, apoE, preβ_1-HDL, preβ_2-HDL, HDL_3b and HDL_3a increased significantly, but the contents of HDL-C, HDL_(2a) and HDL_(2b) decreased remarkably. The contents of preβ_1-HDL increased with the rise in apoCII and apoA I levels, whereas the content of HDL_(2b) increased with the rise in serum apoA I level in the same apoC II group, but decreased with the increase in serum apolipoprotein CII level in the same apoA I group. With the increase in the ratio of apoCII/ apoCIII, the content of preβ_1-HDL elevated, but the content of HDL_(2b) decreased. The correlation analysis illustrated that the apoCII level was positively correlated with preβ_1-HDL (r=0.186, P<0.01), but inversely correlated with HDL_(2b) (r=-0.149, P<0.05). The apoA I level was positively associated with all HDL subclasses (r in the range of 0.349-0.587, P<0.01). In addition, the apoCIII level was positively correlated with preβ_1-HDL (r=0.184, P<0.01) and preβ_2-HDL (r=0.178, P<0.01), while the apoE level was positively correlated with HDL_(3a) (r=0.040, P<0.05). The apoB100 level was inversely correlated with HDL_(2a) (r=-0.102, P<0.05). CONCLUSION: The particles of HDL show a general shift towards smaller size with the increase in apoCII levels, indicating that the maturation of HDL is abnormal. Whereas the contents of apoA I level correct the effect of apoCII on the distribution profile of HDL subclasses. The ratio of apoCII/apoCIII might also been taken as one of the indexes reflecting the distribution profile of serum HDL subclasses.