Objective:To explore the effects of teaching with standardized patients and trauma simulators in surgical debridement training.Methods:Forty-two undergraduate medical students were randomly divided into research group ( n=21) and control group ( n=21) during surgical debridement training in clinical skills simulation training courses. The research group received training using standardized patients combined with trauma simulators, while the control group received training using the simulated teaching method. After training, an examination test and a questionnaire survey were conducted to investigate whether the teaching method under study improved students' doctor-patient communication skills, humanistic care skills, and clinical operational skills. SPSS 20.0 was used to perform the t test and chi-square test. Results:The research group had significantly higher scores in debridement procedures [(65.63±2.58) vs. (62.92±3.88)], communication [(18.62±0.67) vs. (12.71±1.89)], and humanistic care [(8.52±0.51) vs. (6.33±1.11)] than the control group (all P<0.05). The survey results showed that medical students were more satisfied with the teaching method with standardized patients and trauma simulators, believing that it could improve doctor-patient communication skills, humanistic care skills, and clinical practice levels ( P<0.05). Conclusion:The teaching method with standardized patients and trauma simulators can improve training effects, which is worth promotion.

Objective:To analyze the relationship between ataxia telangiectasia mutated (ATM) single nucleotide polymorphism (SNP) at rs1801516 and rs1800054 and sporadic breast cancer (SBC) in Inner Mongolia.Methods:A total of 102 patients with SBC (72 Han and 30 Mongolian) who were admitted to the Affiliated Hospital of Inner Mongolia Medical University from January 2018 to September 2019 were prospectively collected as case group and 102 healthy women (72 Han and 30 Mongolian) during the same period as control group. 2 ml of venous blood was collected to extract DNA. According to the Single Nucleotide Polymorphism Database (dbSNP), the highly polymorphic sites rs1801516 and rs1800054 of ATM gene were selected. The polymerase chain reaction (PCR) and direct sequencing were used to detect the polymorphism of the two sites, and the correlation between the single nucleotide polymorphism of the two sites and the susceptibility of SBC in Inner Mongolia was analyzed. The potential association between clinicopathological factors and ATM gene polymorphism in patients with SBC in Inner Mongolia were explored.Results:GG, GA and AA genotypes were detected in rs1801516 locus of ATM gene. Only CC genotype was detected in the rs1800054 locus of ATM gene. There was no significant difference in the distribution of genotype frequency and allele frequency between Mongolian breast cancer group and Han breast cancer group, Mongolian control group and Han control group, Mongolian breast cancer group and Mongolian control group, Han breast cancer group and Han control group (all P>0.05). Logistic regression analysis showed that allele G was the susceptibility gene of SBC in Inner Mongolia ( OR: 1.775, 95% CI: 1.04-3.03, P=0.04). ATM rs1801516 polymorphism may be associated with increased risk of breast cancer in patients with mass diameter ≤2 cm and/or without lymph node metastasis (all P<0.05). Conclusions:The polymorphism of ATM gene rs1801516 and rs1800054 may not be significantly correlated with the risk of SBC in Inner Mongolia. The rs1801516 locus may be associated with increased risk of breast cancer in patients with mass diameter ≤2 cm and/or without lymph node metastasis. Gene G may be one of the susceptible genes of SBC in Inner Mongolia.

Objective:To discuss how to make the surgical strategy for tibial tubercle fracture associated with bicondylar tibial plateau fracture.Methods:Data of thirty-five patients of tibial tubercle fractures associated with bicondylar tibial plateau fractures who were treated from October 2014 to May 2018 were retrospectively analyzed. There were 26 males and 9 females with an average age of 37.6 years (range, 21-68 years). According to Schatzker classification in tibial plateau fracture, 16 cases were type V and 19 cases were type VI. According to the integrity of tibial tubercle fracture and cortical bone of the proximal tibia in bicondylar tibial plateau fracture, they were divided into four types: type A, tibial tubercle fracture fragment and cortical bone of the proximal tibia are both complete; type B, tibial tubercle fracture fragment is complete but cortical bone of the proximal tibia is comminuted; type C, tibial tubercle fracture fragment is comminuted but cortical bone of the proximal tibia is complete; type D, both of them are comminuted. The surgical approaches and fixation methods of all the tibial tubercle fractures were according to the four different types. There were 22 cases with type A and B that were treated via an anterolateral and a medial incision, 13 cases with type C and D were treated via an anterior midline and a medial incision. There were 4 cases belonging to type A fixed with lag screws singly, 18 cases with type B fixed with 1/4 tubular plates, 7 cases with type C and 6 cases with type D fixed by 1/4 tubular plates combined with lag screws.Results:Thirty-five patients were followed up for 16.8 months (range, 12-24 months). All fractures healed with an average time of 4.7 months (range, 3-6 months). Loss of reduction didn’t occur in 34 cases except one. According to Rasmussen radiographic evaluation, the average score was 14.1 (range, 10-18) and clinical outcomes were rated with excellent in 11 cases, good in 19, fair in 5. The excellent and good rate was 85.7% (30/35) . The mean Hospital for Special Surgery (HSS) scores of all cases were 86.8 (range, 64-98) and the functional scores were excellent in 22 cases, good in 10 cases and fair in 3 cases with the excellent and good rate of 91.4% (32/35) . Surgical complications included fat liquefaction in 2 cases, superficial wound infection in 1, loosening of implant in 1and traumatic arthritis in 1.Conclusion:This kind of tibial tubercle fracture associated with bicondylar tibial plateau fracture is rare and special. Therefore, the preoperative plan should be made by considering the morphological features of the tibial tubercle fragments and the cortical bone of the proximal tibia. The middle longitude approach is the best way to expose tibial tubercle fragments which should be fixed with 1/4 tubularplate and/or lag screws.

Objective: To investigate the safety and efficacy of haploidentical hematopoietic stem cell transplantation with different intensity conditioning regimen in the treatment of childhood aplastic anemia (AA) . Methods: Thirty-seven AA patients who underwent haploidentical transplantation in BaYi Children's Hospital Affiliated to PLA Army General Hospital from January 2013 to January 2017 were enrolled. According to the dosage of conditioning regimen, 34 patients excluding 3 other conditioning regimens were divided into high-dosage group (regimen 2, 22 cases) and low-dosage group (regimen 3, 12 cases). The data of Engraftment, graft-vs-host disease (GVHD), hematopoietic reconstitution, relapse, infection, overall survival (OS) were analyzed. The comparison between the two groups was tested by χ² test. Results: A total of 35 of 37 patients achieved primary engraftment; 2 cases died of regimen-related toxicity and severe infection before the infusing of the grafts. The activation rate of CMV and EBV was 60% (21/35) . Post-transplant lymphocyte disease (PTLD) of lung occurred in one case. The cumulative incidences of acute GVHD grade Ⅰ-Ⅳ and chronic GVHD were 29% (10/35) and 34% (12/35) respectively and the incidence of extensive chronic GVHD was 6% (2/35) . The median follow-up time was 18.8 (2.9-44.1) months, the OS was 92% (34/37) .All survived patients were no longer dependent on blood transfusion and none of them had recurrence. Comparing the rates of overall survival(86%(19/22) vs.100%(12/12)) and rates of chronic GVHD(40%(8/20) vs. 17%(2/12)) in regimen 2 and regimen 3 group, there were no significant difference (χ²=1.742, 1.841, all P>0.05) . Significant difference was found at the incidence of Ⅰ-Ⅳ acute GVHD (10% (2/20) vs. 50% (6/12) ,χ²=6.200, P=0.013). Conclusions Haploidentical hematopoietic stem cell transplantation is effective and safe. It is suitable for patients who are not eligible for matched donor transplantation. Application of reduced dose preconditioning in haploid transplantation is worth exploring.

Objective To construct and identify lentiviral vectors carrying the connexin43 (CX43) gene. Methods Plasmids containing the CX43 gene and lentiviral vectors were digested using EcoRI/XbaI restriction enzymes, and the target gene fragments were cloned into the lentival vectors to result in CX43 recombinant lentiviral vectors (pHBLV-CMVIE-IRES-ZsGreen-CX43). CX43 recombinant lentiviral vectors were identified by restriction enzyme digestion and electrophoresis, and sequencing was carried on only for correct vectors after identification. The successfully-constructed CX43 recombinant lentiviral vectors and packaging plasmids were mixed and contransfected into 293FT cell for packaging and producting virus. Then the virus was collecting, concentrated and titrated in 293FT cells. Finally, the expression of CX43 gene was assessed by real-time polymerase chain reaction(PCR). Results The restriction enzyme digestion and electrophoresis and sequencing results proved that CX43 recombinant lentiviral vectors were constructed correctly. Lentiviral concentrated virus suspension titer was 1× 108/ml. The up-regulation expression of CX43 was detected correctly by real-time PCR in 293FT cells. Conclusions Stable lentiviral vectors expressing CX43 gene is constructed successfully.

By formulating the standard operating procedures for clinical skills, and standardizing the operation steps, the Affiliated Hospital of Inner Mongolia Medical University further refines and quantifies the scoring criteria, and this is also applied in the teaching practice of medical students' clinical skills. The two operations of clean wound dressing and diagnostic peritoneal puncture are taken as an example for description. The assessment results shows that the level of medical students' clinical skills has improved significantly. Questionnaire survey also shows that teachers' training efficiency and students' learning effi-ciency have been improved , indicating that clinical skills standard operation procedures have achieved good teaching results in clinical skills teaching practice.

Objective To observe the bacteriostasis of herba houttuyniae liquid in bladder irrigation for treatment of rabbit bladder infection model, and to offer a new way for prevention and treatment of urinary tract infection.Methods Twenty male New Zealand long-eared white rabbits were divided into gentamicin control group and three different concentrations herba houttuyniae groups according to random number table method, each group 5 rabbits. The rabbit bladder infection model was replicated by injecting coli liquid 1 mL (105 cfu/mL) into the urinary bladder through a urethral catheter, and clipping the catheter for 1 hour. After model establishment for 3 days, in the three herba houttuyniae groups, 0.25, 0.50, 1.00 g/mL herba houttuyniae liquid 50 mL were injected into the bladder respectively, and in the gentamicin control group, 160 kU gentamicin was injected into the bladder. Before molding and after molding for 3, 5, 7, 9 days, ear blood in rabbit was taken, and white blood cell (WBC) count and neutrophil percentage (N%) were tested; at the same time, the middle segment morning urine was taken to detect bacteriuria and urine WBC positive rates; after the experiment, the animals were sacrificed, the urinary bladder tissues were taken, and the pathological changes in urinary bladder tissue were observed by a light microscope.Results Before molding, the bacteriuria in animals of each group was negative and the results of urine WBC, blood WBC and N% were within normal range. After molding for 3 days, bacteriuria and urine WBC positive rates reached 100%; with the prolongation of treatment after molding, the above two rates in each group were gradually decreased, and herba houttuyniae 0.50 g/mL and 1.00 g/mL groups appeared statistical significance on the 5th day (bacteriuria positive rate was 60% and 40%, urine WBC positive rate was 60% and 40% respectively, while the gentamicin control group and herba houttuyniae 0.25 g/mL group was still 100% positive, allP < 0.01); on the 9th day, the bacteriuria positive rate in both higher dosage herba houttuyniae groups was 0, in 0.25 g/mL group, it still had the positive rate 20%, showing herba houttuyniae 0.50 g/mL and 1.00 g/mL had stronger inhibitory effect than herba houttuyniae 0.25 g/mL. WBC and N% were increased in each group after molding, and on the 3rd day, WBC and N were significantly higher in each group than those before molding [WBC (×109/L): gentamicin control group 13.00±5.23 vs. 8.95±2.69, herba houttuyniae 0.25 g/mL group 14.52±10.28 vs. 8.73±3.16, herba houttuyniae 0.50 g/mL group 12.97±11.33 vs. 7.83±4.51, herba houttuyniae 1.00 g/mL group 13.03±9.17 vs. 6.45±3.85. N%: gentamicin control group 80.99±14.93 vs. 63.41±7.96, herba houttuyniae 0.25 g/mL group 89.62±9.41 vs. 70.01±9.13, herba houttuyniae 0.50 g/mL group 87.69±11.34 vs. 67.75±8.91, herba houttuyniae 1.00 g/mL group 85.67±12.81 vs. 65.12±4.63]. On the 7th day, WBC and N% fell, and on the 9th day, the WBC and N% were restored to normal range in herba houttuyniae 0.50 g/mL and 1.00 g/mL groups [WBC (×109/L): herba houttuyniae 0.50 g/mL group 8.56±5.38, herba houttuyniae 1.00 g/mL group 7.93±4.82. N%: herba houttuyniae 0.50 g/mL group 65.97±8.35, herba houttuyniae 1.00 g/mL group 65.57±9.12]. Under light microscopy, it was shown that the morphological appearances of tissue cells in various layers of bladder mucosa were normal in herba houttuyniae group, demonstrating that herba houttuyniae fluid in bladder did not cause allergic inflammatory reaction, etc.Conclusion The bacteriostatic action of herba houttuyniae liquid for bladder irrigation in treatment of rabbits with urinary tract infection is better than that of gentamicin.

BACKGROUND:Our previous studies have shown that a soft substrate has a significant effect on morphology and cytoskeleton of rat bone marrow mesenchymal stem cel.
OBJECTIVE:To explore the effect of polyacrylamide gels as soft substrates with different elastic moduli on the chondrogenic differentiation of human synovial-derived mesenchymal stem cels.
METHODS:The synovium was harvested from patients with osteoarthritis under sterile conditions, and primary human synovial-derived mesenchymal stem cels were separated using limiting dilution assay. The flow cytometry and multi-directional differentiation experiments were used to identify the cel surface markers and function of the human synovial-derived mesenchymal stem cels, respectively. The polyacrylamide gels with the elastic modulus of 0.4, 6, 30 kPa, which were made using various amounts of acrylamide and bis-acrylamide, were used to culture human synovial-derived mesenchymal stem cels under induction with transforming growth factor-β1 for 7 and 14 days. RT-PCR was used to test the expression of chondrogenic genes, type II colagen gene and cartilage acidic protein 1. The 6-wel cel culture plates served as controls.
RESULTS AND CONCLUSION: The human synovial-derived mesenchymal stem cels showed different cel morphology in the different elastic modulus of polyacrylamide gels. The expression of type II colagen gene and cartilage acidic protein 1 were affected by the different elastic modulus of polyacrylamide gels and culture time, and there was an interaction between these two factors. At 7 days of induction, the expression of cartilage acidic protein 1 gene on 6 kPa polyacrylamide gels was the highest (F=44.350,P=0.000); meanwhile, the expression of type II colagen gene on 0.4 kPa polyacrylamide gels was the highest (F=6.384,P=0.005). These findings indicate that polyacrylamide gels with lower elastic modulus are superior to routine culture plates to promote the chondrogenic differentiation of human synovial-derived mesenchymal stem cels.

Objective:To demonstrate the relationship between the Th 1/Th2/Th17/Treg paradigm and the bone loss induced by estrogen deficiency and looking for potential target for clinical treatment.Methods:30 BALB/c mice were divided randomly into the normal control group , the sham operation group , and the ovariectomy group.The serum estradiol ( E2 ) was assessed by ELISA.Bone mineral density (BMD) of thigh bone was measured with dual energy X ray absorptiometry.Meanwhile,the T-cell subsets (Th1:CD4+TNFα+, Th2: CD4+IL-4+, Th17: CD4+IL-17 A+, Treg: CD4+CD25+Foxp3+) in spleen lymphocytes were analyzed by flow cytometry.Results:Compared with the normal group and the sham operation group , both E2 and BMD in the ovariectomy group decreased significantly ( P<0.05 ).The percentage of Th 1 and Th17 subset increased while the percentage of Th 2 and Treg decreased significantly in ovariectomy mice compared with sham operation mice.Correlation analysis showed that BMD was positively related to E 2 level and the percentage of Th 2 and Treg subset;however ,BMD was negatively related to the percentage of Th 1 and Th17 subset ( P<0.05 ).Conclusion: Conclusion: T-cell paradigm was involved in the bone loss induced by estrogen deficiency.Modifying T-cell paradigm may become a potential target for reducing bone loss induced by estrogen deficiency .

Breast Neoplasms ; complications ; epidemiology ; Eye Neoplasms ; diagnosis ; epidemiology ; secondary ; Female ; Humans