Objective To cultivate the ability of laboratory resident physicians in multiple aspects and enhance their post-competence for laboratory medicine.Methods The residents recruited into the Cancer Hospital of China Academy of Medical Sciences Laboratory Base were divided into junior residents and senior residents.According to the different training contents and objectives,the exploration of the hierarchically progressive training model was carried out,which mainly included three aspects:training plan,process training and process assessment.Results After the implementation of the hierarchical progressive training model,the average theoretical score and the average score in the skill operation examination of the residents increased to over 90 and 95,respectively.Meanwhile,the comprehensive clinical ability was also improved.Breakthroughs of teaching,scientific research and honor were achieved from"nothing"before the implementation to"something"after the implementation,and it actively promoted the improvement of the post-competency of the residents in laboratory medicine.Conclusion The application of the hierarchically progressive training mode in standardized training of residents in laboratory medicine could play a good role in promoting the training of post-competence for residents.

Purpose/Significance To explore the feasibility of applying blockchain technology to the current healthcare system of hos-pitals,and to achieve the purpose of protecting patients'privacy to the greatest extent possible at a lower cost.Method/Process 505 questionnaires are randomly distributed and collected from people of different age groups in Beijing,Tianjin,Shanghai and Shenzhen who have a certain degree of understanding of blockchain technology,and the results are analyzed.Result/Conclusion Different age groups are highly concerned about personal privacy and privacy protection,and are willing to accept blockchain as an emerging technology.There is a greater demand and acceptance for the application of blockchain technology in the primary health care systems.

Objective:To investigate the effects of different feeding formulas on the feeding and growth and metabolism of premature infants in the early postnatal period.Methods:Eligible premature infants with the gestational age of ≤ 34 weeks hospitalized from March 2023 to March 2024 were selected as per inclusion criteria, excluding those with congenital metabolic diseases, severe congenital heart disease and developmental malformations of digestive tract. According to the feeding formulas within 2 weeks after birth, premature infants were divided into three groups, namely donor human milk (DHM) group, preterm formula (PF) group and extensively hydrolyzed formula (eHF) group. The characteristics of premature infants, perinatal condition, feeding formulas, milk intake on the 7th and 14th day, the time to the daily milk intake of 120ml/kg and 150ml/kg respectively, the time on parenteral nutrition, the length of hospitalization, feeding intolerance, cholestasis, extrauterine growth retardation and biochemical metabolic indexes at 7 days, 14 days and discharge were collected. The differences of feeding and biochemical metabolic parameters were compared across the three groups.Results:A total of 108 cases were enrolled ,of whom 39 were in DHM group, 37 in PF group and 32 in eHF group. There was no significant difference in gestational age, birth weight, head circumference and maternal complications across the three groups. The milk intake in the DHM group was (50.7±29.1) ml/(kg·d) on the 7th day, compared with (34.2±27.3) ml/(kg·d) in PF group ( P=0.031), and (103.1±36.7) ml/(kg·d) on the 14th day, compared with (73.9±39.2) ml/(kg·d) in the PF group. Compared with the PF group, the DHM group reached the daily milk intake of 120 ml/(kg·d) earlier [(18.5±10.4) days vs. (24.1±10.3) days, P=0.020], had shorter duration of parenteral nutrition [(17.9±10.9) days vs. (23.2±11.2) days, P=0.042], and lower incidence of feeding intolerance (28.2% vs. 48.6%). The length of hospitalization in DHM group was shorter than that in PF group [(33.8±15.5) days vs. (37.8±17.6) days], but there was no significant difference ( P>0.05). There was no significant difference between the DHM group and the eHF group in terms of the milk intake on the 7th and 14th day, the time to the daily milk intake of 120 ml/(kg·d), the time on parenteral nutrition, the length of hospitalization and feeding intolerance. At 1 and 2 weeks after birth, alkaline phosphatase in DHM group was higher than that in PF group and eHF group ( P<0.05), but there was no significant difference in biochemical nutritional metabolism parameters (hemoglobin, urea nitrogen, albumin, prealbumin, alkaline phosphatase and total bile acid) across the three groups at discharge( P>0.05). Conclusion:Early use of DHM in premature infants is better tolerated than PF and can help achieve complete enteral nutrition earlier and shorten the use of parenteral nutrition, while not affecting the growth and development of premature infants.

Objective:To investigate the application value of carbon nanoparticle tracer in lymph node dissection for Siewert type Ⅱ and Ⅲ adenocarcinoma of esophagogastric junction (AEG).Methods:The retrospective cohort study was conducted. The clinicopathological data of 147 patients with Siewert type Ⅱ and Ⅲ AEG who were admitted to Shengli Petroleum Central Hospital from June 2015 to July 2020 were collected. There were 109 males and 38 females, aged (65±9)years. All the patients underwent laparoscopic-assisted radical resection of AEG via esophageal hiatus. Of 147 patients, 61 cases not injected with carbon nanoparticle tracer preoperatively were allocated into control group and 86 cases injected with carbon nanoparticle tracer preoperatively were allocated into experimental group. Observation indicators: (1) surgical and postoperative situations; (2) influencing factors analysis of No.10 lymph nodes metastasis. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. Count data were represented as absolute numbers or percentages, and comparison between groups was analyzed by the chi-square test. Univariate analysis was conducted by statistic methods based on data type, and multivariate analysis was conducted by the Logistic step-wise regression model. Results:(1) Surgical and postoperative situations. Patients of the experimental group and control group completed laparoscopic-assisted radical resection of AEG via esophageal hiatus successfully. There was no significant difference in the operation time, volume of intraoperative blood loss, the total number of lymph node dissection, the number of the first station, the second station and positive lymph nodes between the two groups ( P>0.05). For the experimental group, the black staining rate of lymph nodes was 57.937%(1 365/2 356), the black staining rate of the first station and second station lymph nodes was 77.989%(1 024/1 313) and 43.691%(232/531), the black staining rate of Siewert type Ⅱ and Ⅲ AEG patients was 56.855%(423/744) and 58.437%(942/1 612), respectively. The lymph node metastasis rate was 19.091%(815/4 269) of 147 patients, 18.573%(242/1 303)of Siewert type Ⅱ AEG patients and 19.319%(573/2 966) of Siewert type Ⅲ AEG patients. For Siewert type Ⅱ AEG patients, the metastasis rate of No.1, 2, 3, 4sa, 4sb, 7, 8a, 11p lymph nodes was more than 10%, the metastasis rate of No.4d, 5, 6, 9, 10, 11d, 12a lymph nodes was lower than 10%. For Siewert type Ⅲ AEG patients, the metastasis rate of No.1, 2, 3, 4sa, 4sb, 7, 8a, 10, 11p and lower mediastinal lymph nodes was more than 10%, the metastasis rate of No.4d, 5, 6, 9 11d, 12a and lower mediastinal lymph nodes was lower than 10%. There was no significant difference in the Clavien Dindo classification of postoperative complications between the two groups ( P>0.05). (2) Influencing factors analysis of No.10 lymph nodes metastasis. Results of multivariate analysis showed that tumor T staging and degree of tumor differention was an independent influencing factor for No.10 lymph nodes metastasis ( P<0.05). Conclusions:For Siewert type Ⅱ and Ⅲ AEG patients, the application of carbon nano-partide tracer can not increase the number of lymph node dissection. The second station lymph node dissection should be paid attention for Siewert type Ⅱ AEG. Tumor T staging and degree of tumor differentiation are independent influencing factors for No.10 lymph nodes metastasis.

Objective:To investigate the diagnostic value of ultrasonography in Poland′s syndrome.Methods:From February 2016 to December 2020, the ultrasonographic images of 15 patients with Poland′s syndrome diagnosed by Provincial Hospital Affiliated to Shandong First Medical University were retrospectively analyzed, and the ultrasonographic features were summarized.Results:High-frequency ultrasound could clearly show the anatomical structures of each layer of the chest wall of the patients with Poland′s syndrome. The sonogram of Poland′s syndrome mainly showed the absence of all or part of the pectoralis major on the affected side, some of which were combined with the absence of pectoralis minor. The difference between the thickness of the affected chest wall and the healthy side was statistically significant ( P<0.01). Among the 15 cases of Poland′s syndrome, 11 cases had brachydactyly or syndactyly. Ultrasound showed that the bifurcation position of the common palmar digital artery of the middle finger was lower than that of the healthy side. Conclusions:The ultrasonography is an effective imaging method for diagnosis of Poland′s syndrome.

Objective:To conduct a preliminary investigation on the establishment of a three-dimensional measurement database of upper lip-related indicators in the normal young Han population in Chengdu, and to establish reference values.Methods:A simple random sampling method was used to recruit 150 volunteers who visited Sichuan Provincial People’s Hospital between September 2012 and December 2019. The facial multi-slice spiral CT (MSCT) data were collected, and the image data was obtained to generate a three-dimensional model, which was analyzed by applying 3-matic Medical 13.0 software. The linear and proportional indices of upper lip correlation were measured including the crista philtra, right side point-the crista philtra, left side point (CphR-CphL), the right cheilion point- the left cheilion point (ChR-ChL), the middle point of crista philtra, right side point-the middle point of crista philtra, left side point (MphR-MphL), the apex of philtral column, right side point-the apex of philtral column, left side point(SbalR-SbalL), the stomion point-the sublabiale point (Sto-Sl)], ratio index [Ls-Sto/Sto-Li, MphR-MphL/ChR-ChL, MphR-MphL/CphR-CphL, Ls-Sto/Sn-Sto, Sto -Li/Sto-Sl]. In addition, the angle of the nasolabial angle was measured, and the radian of the upper lip was measured by the lip bead-bilateral angle three-point fitting circle method. The t test was used to compare the differences of the above indicators in different genders and ages (18-24, 25-30 years old). For the ChR-Ls-ChL, the Mphr-the middle point of subnasale and labrale-mphl(MphR-A-MphL), the SbalR-Sn-SbalL different radian position indexes were compared by ANOVA and SNK- q method. Results:A total of 150 volunteers were included in this study, including 68 males (45.3%) and 82 females (54.7%), ranging in age from 18 to 30 years old, with an average age of 24 years. Between different genders: the differences in linear indicators Ls-Sto, Sto-Li, Sn-Sto, Sn-Ls, Ls-Li, CphR-CphL, ChR-ChL, SbalR-SbalL, Sto-Sl were statistically significant ( P<0.05), there was no significant difference in MphR-MphL ( P>0.05); there were significant differences in Ls-Sto/Sn-Sto, Sto-Li/Sto-Sl in the ratio indicators ( P<0.01), Ls -Sto/Sto-Li, MphR-MphL/ChR-ChL, MphR-MphL/CphR-CphL had no significant difference ( P>0.05). There was no significant difference in nasolabial angle ( P>0.05); the difference in radian index ChR-Ls-ChL was statistically significant( P<0.05), there was no significant difference in MphR-A-MphL, SbalR-Sn-SbalL in radian index ( P>0.05). Between different age groups: there was no significant difference in each linear index, proportional index, angle index and radian index. ( P>0.05) Between different radian positions: the radian values of 3 different radian positions were significantly different ( P<0.01). ChR-Ls-ChL was compared with MphR-A-MphL, SbalR-Sn-SbalR the difference in SbalL was statistically significant ( P<0.01), but there was no significant difference between MphR-PoinA-MphL and SbalR-Sn-Sbal ( P>0.05). Conclusions:Based on the MSCT image data, this paper completed the preliminary survey of the three-dimensional measurement database of the upper lip-related indexes of the normal young Han population in Chengdu area, and established the reference value. The obtained data set can provide an intuitive reference for clinical evaluation and design. In addition, evaluating the upper lip by measuring the curvature of the upper lip is a new measurement method that can effectively reflect the physiological curvature of the upper lip.

Objective:To conduct a preliminary investigation on the establishment of a three-dimensional measurement database of upper lip-related indicators in the normal young Han population in Chengdu, and to establish reference values.Methods:A simple random sampling method was used to recruit 150 volunteers who visited Sichuan Provincial People’s Hospital between September 2012 and December 2019. The facial multi-slice spiral CT (MSCT) data were collected, and the image data was obtained to generate a three-dimensional model, which was analyzed by applying 3-matic Medical 13.0 software. The linear and proportional indices of upper lip correlation were measured including the crista philtra, right side point-the crista philtra, left side point (CphR-CphL), the right cheilion point- the left cheilion point (ChR-ChL), the middle point of crista philtra, right side point-the middle point of crista philtra, left side point (MphR-MphL), the apex of philtral column, right side point-the apex of philtral column, left side point(SbalR-SbalL), the stomion point-the sublabiale point (Sto-Sl)], ratio index [Ls-Sto/Sto-Li, MphR-MphL/ChR-ChL, MphR-MphL/CphR-CphL, Ls-Sto/Sn-Sto, Sto -Li/Sto-Sl]. In addition, the angle of the nasolabial angle was measured, and the radian of the upper lip was measured by the lip bead-bilateral angle three-point fitting circle method. The t test was used to compare the differences of the above indicators in different genders and ages (18-24, 25-30 years old). For the ChR-Ls-ChL, the Mphr-the middle point of subnasale and labrale-mphl(MphR-A-MphL), the SbalR-Sn-SbalL different radian position indexes were compared by ANOVA and SNK- q method. Results:A total of 150 volunteers were included in this study, including 68 males (45.3%) and 82 females (54.7%), ranging in age from 18 to 30 years old, with an average age of 24 years. Between different genders: the differences in linear indicators Ls-Sto, Sto-Li, Sn-Sto, Sn-Ls, Ls-Li, CphR-CphL, ChR-ChL, SbalR-SbalL, Sto-Sl were statistically significant ( P<0.05), there was no significant difference in MphR-MphL ( P>0.05); there were significant differences in Ls-Sto/Sn-Sto, Sto-Li/Sto-Sl in the ratio indicators ( P<0.01), Ls -Sto/Sto-Li, MphR-MphL/ChR-ChL, MphR-MphL/CphR-CphL had no significant difference ( P>0.05). There was no significant difference in nasolabial angle ( P>0.05); the difference in radian index ChR-Ls-ChL was statistically significant( P<0.05), there was no significant difference in MphR-A-MphL, SbalR-Sn-SbalL in radian index ( P>0.05). Between different age groups: there was no significant difference in each linear index, proportional index, angle index and radian index. ( P>0.05) Between different radian positions: the radian values of 3 different radian positions were significantly different ( P<0.01). ChR-Ls-ChL was compared with MphR-A-MphL, SbalR-Sn-SbalR the difference in SbalL was statistically significant ( P<0.01), but there was no significant difference between MphR-PoinA-MphL and SbalR-Sn-Sbal ( P>0.05). Conclusions:Based on the MSCT image data, this paper completed the preliminary survey of the three-dimensional measurement database of the upper lip-related indexes of the normal young Han population in Chengdu area, and established the reference value. The obtained data set can provide an intuitive reference for clinical evaluation and design. In addition, evaluating the upper lip by measuring the curvature of the upper lip is a new measurement method that can effectively reflect the physiological curvature of the upper lip.

Objective:To evaluate the role of high frequency ultrasonography in diagnosis of closed volar plate injury of proximal interphalangeal joint.Methods:From May 2015 to may 2021, 41 patients with acute closed volar plate injury confirmed by Department of Hand and Foot Surgery of the Provincial Hospital Affiliated to Shandong First Medical University were examined by high frequency ultrasonography. The sonographic features were analyzed and classified.Results:High frequency ultrasonography could not only clearly show the thickness, shape and echo of volar plate, but also the degree of injury and avulsion fracture of volar plate, according to which the closed volar plate injury could be divided into three types: A, B and C. Type A(13 cases): Avulsion fracture of the middle phalangeal base was found with volar plate rupture, the sonogram showed that the continuity of the volar plate attachment of the middle phalangeal base was interrupted, and avulsion fracture was found at the distal end of the volar plate. Type B(11 cases): Complete rupture of the volar plate attachment of the middle phalangeal base was found without avulsion fracture, the sonogram showed that the continuity of the volar plate attachment of the middle phalangeal base was interrupted, and the end of the volar plate contracted and thickened. Type C(17 cases): Tear of the volar plate was found, the sonogram showed enlarging volar plates, heterogeneous internal echo, and liquid dark area was visible in some cases. The average thickness of the three types of closed volar plate injury of the proximal interphalangeal joint measured by ultrasound was (0.33±0.05)cm, and the average thickness of the volar plate at the same position of the corresponding finger on the opposite side was (0.22±0.03)cm. There was significant difference between the two groups ( t=7.864, P=0.006). Conclusions:High frequency ultrasonography is the preferred imaging examination method for the diagnosis of closed volar plate injury in proximal interphalangeal joint, which has an important guiding significance for the selection of clinical treatment.

Objective:To investigate the clinical manifestation and management strategy of intraparotid facial nerve schwannoma.Methods:The clinical data of 12 patients with parotid schwannoma treated in Henan Cancer Hospital from January 2009 to January 2019 were analyzed retrospectively, including 5 males and 7 females, aged from 23 to 72 years. All the 12 patients complained of a mass in the parotid region, of whom 4 patients had local discomfort and pain, and 6 patients had varying degrees of pain during palpation. Ultrasound examination showed solid mass in parotid region in 8 cases and mixed mass in 4 cases. The treatment methods, the relationship between tumor and facial nerve, the modes of treatments and the nerve functions before and after operation were analyzed and summarized with House-Brackmann grade.Results:All 12 patients received surgical treatment: 8 patients underwent tumor resection plus partial or total superficial parotidectomy, 1 patient underwent tumor resection and total parotidectomy, and 3 patients underwent tumor resection, with 1 patient in whom tumor could not be removed completely due to tumor extention to the skull base. In 9 cases, the tumor occurred in the trunk or main branch of the facial nerve, and there was no facial nerve injury occurred after surgery; in 1 case, the tumor occurred in the terminal branch of the facial nerve, and part of the severe small branches of adhesion were cut off during the operation; in 1 case, the total trunk of the facial nerve was not found and the broken end of the nerve could not be found during the operation, so the nerve transplantation was not performed. In 1 case, nerve grafting was performed after nerve transection because it was impossible to separate the trunk of the facial nerve from the tumor during the operation. Preoperatively, House-Brackmann grade (H-B)Ⅰfacial nerve function was shown in 10 patients, H-BⅡ in 1 patient and H-B Ⅴin 1 patient. Postoperatively, the facial nerve function recovered to H-B Ⅰfor 7 patients, H-B Ⅱfor 2 patients, H-B Ⅲ for 1 patient, grade Ⅳ for 1 patient with nerve transplantation, and H-B Ⅴfor 1 patient with a revised surgery due to tumor recurrence.Conclusions:The intraparotid facial nerve schwannoma is rare, and it is easy to be misdiagnosed before operation. Surgery is a main treatment for intraparotid facial nerve schwannoma. Attention should be paid to the protection of facial nerve during operation.

BACKGROUND: Lung cancer is one of the common malignant tumors that impair human health. With the development of epigenetics, the researchers found that enhancer of Zeste homolog 2 (EZH2) is highly expressed in lung cancer tissue and its expression is closely related to the prognosis. EZH2 inhibitor can also enhance the sensitivity of tumor cells to a variety of anti-tumor drugs. The purpose of this study is to investigate the effect of combination of EZH2 inhibitor and gefitinib on the proliferation, apoptosis and migration of Gefitinib-resistant lung cancer cells. METHODS: PC9 and PC9/AB2 cells were used for this study. CCK-8 and EdU experiment were used to detect combined treatment on cell viability and proliferation activity; Wound healing assay and Transwell chamber experiment were used to determine the effects of combination therapy on cell migration ability; Flow cytometry was used to detect the effect of combination therapy on EZH2 and apoptosis; Western blot was used to observe the effect of combination therapy on epidermal growth factor receptor (EGFR) signaling pathway-related proteins expression. RESULTS: In gefitinib-resistant cell line PC9/AB2, gefitinib combined with EZH2 inhibitor GSK343 can significantly inhibit cell viability, reduce cell migration and increase cell apoptosis. At the same time, combination therapy can significantly inhibit the expression of EZH2 and phosphorylation EGFR proteins. CONCLUSIONS The combination of EZH2 inhibitor GSK343 and gefitinib sensitize PC9/AB2 cell to gefitinib response. This study also suggests that synergistic therapy plays a role in the reversal of EGFR-tyrosine kinase inhibitor (EGFR-TKIs) resistance in lung cancer.
Antineoplastic Agents ; pharmacology ; Cell Line, Tumor ; Cell Movement ; drug effects ; Cell Proliferation ; drug effects ; Cell Survival ; drug effects ; Drug Resistance, Neoplasm ; drug effects ; Drug Synergism ; Enhancer of Zeste Homolog 2 Protein ; antagonists & inhibitors ; ErbB Receptors ; antagonists & inhibitors ; Gefitinib ; pharmacology ; Humans ; Lung Neoplasms ; pathology ; Protein Kinase Inhibitors ; pharmacology