Application of three-dimensional image reconstruction combined with problem-based learning in the teaching of physicians receiving continuing education in thoracic surgery / 中华医学教育探索杂志

Objective:To investigate the application of three-dimensional image reconstruction combined with problem-based learning (PBL) in the teaching of physicians receiving continuing education in thoracic surgery.Methods:A total of 68 physicians who received continuing education in Department of Thoracic Surgery in our hospital were selected as research subjects, and they were divided into control group and observation group using a random number table, with 34 physicians in each group. The physicians in the control group received traditional teaching, while those in the observation group received three-dimensional image reconstruction combined with PBL teaching. A questionnaire survey, theoretical assessment, and assessment of practical skills were performed to evaluate the effect of teaching. SPSS 22.0 was used to perform the t-test. Results:Compared with the control group, the observation group had significantly higher degrees of satisfaction with each item of the questionnaire survey ( P<0.05). Compared with the control group, the observation group had significantly higher scores of theoretical assessment [(94.07±6.03) vs. (86.34±5.46), P<0.001] and the assessment of practical skills [(95.20±5.48) vs. (84.71±6.14), P<0.001]. Conclusion:The application of three-dimensional image reconstruction combined with PBL teaching can help to improve the comprehensive ability of physicians receiving continuing education.

Practice and application of "artificial intelligence + big data" in the construction of thoracic surgery golden course / 中华医学教育探索杂志

Objective:To discuss the practice and application of "artificial intelligence + big data" in the construction of thoracic surgery golden course.Methods:The intern students of the Department of Thoracic Surgery in Harbin Medical University Cancer Hospital were selected as the research objects, and they were randomly divided into 2 groups with 36 cases in each group. The control group was taught with regular courses, and the observation group was taught by the golden course system under "artificial intelligence + big data". After the course, self-made assessment forms were used to assess the academic performance (theoretical knowledge assessment results and skill operation assessment results) of the two groups of medical students. The excellent and good rate of knowledge mastery and the mastery of clinical operation techniques were scored by the teachers, and the evaluation was made from the aspects of learning attitude, the mastery degree of theoretical knowledge and clinical operational techniques, etc. In addition, self-made innovative thinking ability scale was used to assess the medical students. SPSS 22.0 was used for independent samples t test and chi-square test. Results:There was no statistically significant difference between the two groups of theoretical knowledge assessment scores and skill operation assessment scores before the teaching; after the course, the theoretical knowledge assessment scores and skill operation assessment scores of the control group were higher than those before the teaching, with statistically significant differences ( t=5.37, 4.17, P<0.05). After the course, the theoretical knowledge assessment scores and skill operation assessment scores of the observation group were higher than those before the teaching, with significant differences ( t=10.93, 8.24, P<0.05). The results of theoretical knowledge assessment and skill operation assessment in the observation group were significantly higher than those in the control group after the course ( t=7.10, 5.77, P<0.05). In the control group, 17 cases were excellent in knowledge mastery, accounting for 47.22%, and the rate of knowledge mastery was 83.33% (30/36); in the observation group, 26 cases were excellent in knowledge mastery, accounting for 72.22%, and the excellent and good rate of knowledge mastery was 100% (36/36), and the difference was statistically significant ( χ2=4.55, P=0.033). After the course, the innovative thinking ability of the control group was higher than that before the teaching, the innovative thinking ability of the observation group was higher than that before the teaching, and the innovative thinking ability of the observation group was higher than that of the control group, and the difference was statistically significant ( t=7.07, P<0.001). Conclusion:The use of the "artificial intelligence + big data" golden course to build a teaching system can improve the academic performance, knowledge mastery and innovative thinking ability of medical students.

Effect of tamoxifen on invasiveness of breast cancer SK-BR-3 cells and its mechanism / 中华内分泌外科杂志

Objective To investigate the effect of tamoxifen (TAM) on the invasiveness of breast cancer SK-BR-3 cells and its mechanism.Methods The SK-BR-3 breast cancer cells in logarithmic growth period were cultured for 24 h by theserum-free RPMI 1640 culture medium,and then were divided into control group (serumfree RPMI 1640 medium) and TAM group(serum-freeRPMI 16400.5,2.5,12.5 mol·L-1TAM).Western blot was used to detect matrix metalloproteinase-9 (MMP-9),matrix metalloproteinase-2 (MMP-2),and vascular endothelial growth factor (VEGF) in groups.Scratch and transwelhests were used to detect the invasiveness of SK-BR-3 cells.Results The results of scratch test and Transwell experiment showed that the relative invasive ability of SKM-BR-3 cells in TAM (0.5,2.5,12.5 mol/L) group was significantly higher than that in the control group,and the difference was statistically significant (P＜0.05).The invasive ability of SK-BR-3 cells increased with the increase of TAM con centration.The results of Western blot showed that the expression levels of VEGF,MMP-9 and MMP-2 in SK-BR-3 cells of TAM group were average.It was significantly higher than the control group,and the expression levels of VEGF,MMP-9 and MMP-2 in SK-BR-3 cells increased gradually with the increase of TAM concentration.Conclusion Tamoxifen may play the role of estrogens and promote the invasiveness of SK-BR-3 breast cancer cells,via increasing the expression levels of VEGF,MMP-9 and MMP-2.

Treatment of symptomatic cerebral artery stenosis and occlusion with Xenon CT guided cerebral revascularization / 中国脑血管病杂志

Objective To investigate the roles of Xenon-CT cerebral blood flow perfusion imaging in cerebral revascularization before surgery and efficacy evaluation.Methods The clinical data of 15 patients with symptomatic cerebral artery stenosis/occlusion of anterior circulation were analyzed retrospectively.Eight patients were treated with endovascular stenting,1 was treated with internal carotid endarterectomy,and 6 were treated with superficial temporal artery-middle cerebral artery bypass grafting.The regional cerebral blood flow (rCBF) detected by Xenon CT within 2 weeks before and after procedure and the modified Ranking scale (mRS) scores at 6 months after procedure were compared.Results (1) The mean rCBF value of 12 patients with abnormal blood perfusion of target vessels before procedure was 30±10 ml/(100 g·min) and that was 32±14 ml/(100 g·min) after procedure.Compared with before procedure,the difference was statistically significant (P0.05).(2) The postoperative mRS score was decreased in 8 cases and stable in 7 cases.Compared with before procedure,there were significant differences in mRS scores after procedure in 15 cases (P<0.05).During the follow-up period,none of the patients had new neurological impairment.Conclusion Revascularization can improve the presence of hemodynamic disorders in patients with symptomatic anterior circulation cerebral artery stenosis or occlusion of the target blood vessels in the distal local cerebral perfusion and neurological deficit symptoms.The patients with abnormal perfusion of preoperative Xenon-CT cerebral blood flow perfusion imaging may be more beneficial than those with normal perfusion.

Evaluating the relationship between intracranial atherosclerotic plaque stability and stroke recurrence risk with high-resolution MRI / 中国脑血管病杂志

Objective To investigate the relationship between intracranial atherosclerotic plaque stability and stroke recurrence risk.Methods Forty-eight patients with acute ischemic stroke caused by intracranial atherosclerosis in Guangdong Province Hospital of TCM were analyzed retrospectively.After the Essen Stroke Risk Scale (ESRS) was used to assess the risk factors for the patients,they were divided into either an ESRS ≥3 group (n=21 in the high-risk recurrence group) or an ESRS <3 group (n=27 in the low-risk recurrence group).Both groups of patients underwent high-resolution MR imaging (HR-MRI) examinations of the intracranial guilty vessels (basilar artery or unilateral middle cerebral artery).According to the signal intensity of HR-MRI on the T1-weighted imaging,T2-weighted imaging,and T1 fat suppression sequences,the intracranial atherosclerotic stable plaques and unstable plaques were distinguished.The stabilization of intracranial atherosclerotic plaques was compared in patients of both groups.Results There were significant differences in the age and incidences of hypertension,diabetes mellitus,and unstable plaques in patients of both groups (P<0.05).Further multivariate logistic regression analysis of the four factors showed that the age,hypertension,diabetes,and intracranial atherosclerotic unstable plaques were the high-risk factors for recurrent ischemic stroke (ORs,87.114,159.423,8.942,and 11.551,respectively;95%CIs 4.218-1 799.078,3.235-7 855.957,1.054-75.857,and 1.011-132.043,respectively;all P<0.05).Conclusion In addition to the traditional risk factors such as age,hypertension,and diabetes,the intracranial atherosclerotic unstable plaque is an independent risk factor for high-risk recurrence of ischemic stroke.

Role of balloon occlusion test in the treatment of permanent internal carotid artery occlusion / 局解手术学杂志

Objective To investigate the relation between the balloon occlusion test ( BOT) and the anatomy of the circle of Willis ( CW) , and to explore the role of balloon occlusion test in the treatment of internal carotid artery permanent occlusion. Methods Selected the clinical data of 49 patients (52 sides) who had BOT in our hospital from October 2009 to June 2015,and analyzed the relationship be-tween the occurrence rate of anterior communicating artery ( AcoA) / posterior communicating artery ( PcoA) and the positive rate of BOT retrospectively. Results The occurrence rate of the AcoA was 97. 9%, and the occurrence rate of PcoA in one side was 82. 7%. Negative rate BOT accounted for 92. 3% and AcoA occurred in all, while the positive rate accounted for 7. 7%, including 2 cases of right superior ar-teria cerebri anterior combined with ipsilateral PcoAs absence, 1 case of left superior arteria cerebri anterior combined with ipsilateral PcoAs absence, and 1 case of AcoA and PcoAs absence. Conclusion Before the permanent occlusion of the internal carotid artery, it’ s necessary to clarify the redistribution of the compensatory way of blood flow in the AcoA-absent cases. Implementing permanent occlusion for cases with complete circle of Willis would cause less ischemic risk.

Prevention of the superior laryngeal nerve injury at endoscopic thyroidectomy through subclavicular approach / 中国医师进修杂志

Objective To discuss the methods of the prevention of the superior laryngeal nerveinjury at endoscopic thyroidectomy through subclaviclar approach.Methods The clinical data of 100 patients with thyroid diseases received endoscopic thyroidectomy through subclavicular approach were analyzed retrospectively.Nodular goiter in 69 cases,adenoma in 18 cases,simple goiter in 13 cases.Line side lobe resection in 35 cases,the side lobe subtotal in 8 cases,the side lobe resection + subtotal contralateral lobe in 48 cases,bilateral subtotal gland in 9 cases.Results All 100 patients after surgery pronounced normal,no tone deep,choking water,etc,patients 7-30 d laryngoscope review found no abnormalities.Conclusion Thyroidectomy through subclavicular approach under endoscope is calleidic thyroidectomy,effectively avoid permanent superior laryngeal nerve injury.

Expression of MAGE genes peripheral blood of gastric cancer patients and its relation to lymph node metastasis and prognosis / 中国基层医药

Objective In the detection of peripheral blood in patients with gastric cancer the melanoma antigen A1 (MAGEA1) and the melanoma antigen A3 (MAGEA3) gene expression,combined with the conditions of patients with postoperative follow-up analysis MAGE gene expression and the relationship between gastric cancer metastasis and prognosis.Methods Peripheral blood was obtained from 40 patients with gastric carcinoma and 20 patients with benign diseases.The mRNA of the MAGEA1 and MAGEA3 genes in the peripheral blood mononuclear cells(PBMC) was detected by RT-PCR,meanwhile the MAGEA1 and MAGEA3 transcripts in gastric carcinoma tissues and corresponding nomal tissue were detected.In contrast with CEA gene,we detected its expression by nested RT-PCR.Results Of the 40 gastric carcinoma patients,MAGEA1 and MAGEA3 mRNA were positive in 47.5％ (17/40) and 25.0％ (10/40) of PBMC,respectively,and in 65.0％ (26/40) and 30.0％ (12/40) of gastric carcinoma tissues,the corresponding paracancerous gastric tissues were not expressed,of which 4 cases of peripheral blood both expression.In the PBMC of 40 gastric carcinoma patients,62.5％ (25/40) samples were detected to express at least one type of MAGE mRNA,the detection of CEA gene mRNA in peripheral blood of the patients in PBMCwas 65.0％ (26/40),20 patients with non neoplastic diseases of PBMC were not detected in the MAGE gene mRNA.There were 22.5％ (9/40) of 40 gastric carcinoma patients with CEA gene expression in PBMC.The detection rate of the MAGE gene of mRNA PBMC in patients with gastric cancer was not related with the lymph node metastasis,TNM stage,and the degree of tumor differentiation,depth of invasion,tumor size,distant metastasis.Conclusion Gastric cancer patients with peripheral blood MAGE gene expression is closely related to the tumor lymph node metastasis,TNM staging,express positive patients with poor prognosis.

Advanced oxidation protein products inhibit proliferation and differentiation of rat osteoblasts through oxidative stress / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of advanced oxidation protein products (AOPP) on proliferation, differentiation, and oxidative stress in rat osteoblasts.</p><p><b>METHODS</b>The cell proliferation and differentiation of osteoblasts isolated from neonatal SD rat skull were evaluated following treatment with different concentrations (50, 100, 200, and 400 µg/ml) of AOPP using CCK-8 kit and ALP assay kit, respectively. The levels of reactive oxygen species (ROS) in the treated cells were analyzed using 2', 7'-dichlorofluorescin diacetate, and the transcription levels of ALP, collagen I and RAGE were assessed using real-time PCR.</p><p><b>RESULTS</b>Compared with the control group, AOPP-treated osteoblasts showed obviously inhibited proliferation and differentiation with down-regulated expressions of ALP and collagen I and increased ROS production and RAGE expression.</p><p><b>CONCLUSION</b>AOPP can inhibit the proliferation and differentiation of rat osteoblasts partially by up-regulating RAGE and inducing ROS production.</p>