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Objective:To explore the application effects of a neurosurgical mixed-reality distance teaching (NMDT) model in standardized residency training in neurosurgery.Methods:We built an NMDT system using mixed-reality technology and remote interaction technology, and designed the implementation procedure according to the teaching objectives. After the teaching activities were completed, a teaching satisfaction questionnaire survey was conducted among 20 neurosurgery resident trainees, in which they provided satisfaction scores for the same teaching content with different teaching models (i.e., the NMDT model and traditional teaching model). SPSS 22.0 software was used to perform the t test for data analysis. Results:There were significant differences between the NMDT model and the traditional teaching model in key indicators including the score for "completion of teaching objectives" (9.20±0.68 vs. 8.25±0.70, P<0.001) and the score for "satisfaction with learning gains" score (8.95±0.67 vs. 8.05±0.92, P=0.001). The NMDT model also outperformed the traditional teaching model in the other individual scores and the total score. Conclusions:The NMDT model can improve teaching quality, increase training efficiency, and enrich teaching content, which is worthy of promotion.
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Epigenetics refers to heritable changes in gene expression and function without alterations in gene sequences,including DNA methylation,histone modification,and non-coding RNAs.Endometriosis is a benign gynecological disease that affects the fertility and health of reproductive-age women,the etiology of which remains unclear.The recent studies have demonstrated that epigenetics plays a key role in the occurrence and development of endometriosis.This article reviews the research progress in the regulatory mechanism and application of epigenetics in endometriosis.
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Femenino , Humanos , Endometriosis/genética , Epigénesis Genética , Metilación de ADN , Procesamiento Proteico-PostraduccionalRESUMEN
OBJECTIVE@#To observe the effect of electroacupuncture (EA) on neuronal apoptosis in rats with traumatic brain injury (TBI), and to explore the action mechanism of EA on improving the brain nerve function of TBI.@*METHODS@#A total of 88 6-week-old SD rats were randomly divided into a sham operation group, a model group, an EA group and a LY294002+EA group, 22 rats in each group. The TBI model on the left side was established by the improved Feeney's free fall method. After modeling for 24 h, the rats in the EA group and LY294002+EA group were treated with acupuncture at "Baihui" (GV 20) for 10 min and pricking acupuncture at "Shuigou" (GV 26) for 20 s; EA was applied at "Neiguan" (PC 6) and "Zusanli" (ST 36) on the right side (discontinuous wave, 2 Hz of frequency, 1 mA of intensity) for 10 min, once a day for 3 days. After 3 days of intervention, the TUNEL method was used to detect the level of neuron apoptosis in left cerebral cortex; the Western blot method was used to detect the expression of Akt, p-Akt, Bcl-2, Bax, Cyt-C and Caspase-9 in the left cerebral cortex.@*RESULTS@#After 3-day treatment, compared with the sham group, the number of neuronal apoptosis in the left cortex was increased in the model group (<0.01), and the expression of Bax, Cyt-C and Caspase-9 protein was increased (<0.01), and the expression of p-Akt/Akt, Bcl-2 was decreased (<0.01). Compared with the model group, the number of neuronal apoptosis in the left cortex was decreased in the EA group (<0.01), and the expression of Bax, Cyt-C and Caspase-9 was decreased (<0.01), and the expression of p-Akt/Akt and Bcl-2 was increased (<0.01). Compared with the LY294002+EA group, the number of neuronal apoptosis in the left cortex was decreased in the EA group (<0.01), and the expression of Bax, Caspase-9 and Cyt-C was decreased (<0.01, <0.05), and the expression of p-Akt/Akt and Bcl-2 was increased (<0.01).@*CONCLUSION@#EA could significantly reduce the neuronal apoptosis in rats with TBI, and its mechanism may be related to the activation of PI3K/Akt signaling pathway.
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OBJECTIVE@#To observe the impacts of electroacupuncture (EA) on neurological function, the pathological morphology in brain tissue, apoptosis level and the protein expressions of apoptosis-related cytochrome C (Cyt-C) and cysteine aspartic acid protease-9 (Caspase-9) in the rats with traumatic brain injury (TBI) and explore the potential mechanism of EA in treatment of TBI.@*METHODS@#A total of 70 clean-grade SD mice were randomized into a blank group (8 rats), a sham-operation group (8 rats), a model group (27 rats) and an EA group (27 rats). In terms of interventions of 3, 7 and 14 days, 3 subgroups were divided in the model group and the EA group successively, 9 rats in each subgroup. The modified Feeney free-fall percussion method was adopted to establish TBI models of rats. In the sham-operation group, only the skull was exposed and drilled and no free-fall percussion was exerted. One day after modeling, EA was given in the rats of EA group at "Shuigou" (GV 26), "Baihui" (GV 20) and "Neiguan" (PC 6) and "Zusanli" (ST 36) on the affected side, with intermittent wave, 2 Hz in frequency, once daily, 10 min each time, for 3, 7 and 14 days successively. Separately, on the day 3, 7 and 14 of intervention, the modified neurological severity scale (mNSS) was used to evaluate the degree of neurological function injury in the rats, HE staining and Nissl staining were to observe the pathological and morphological changes in brain tissue, TUNEL method was to observe the level of apoptosis in brain tissue and immunohistochemistry (IHC) method and Western blot were to determine the protein expressions of Cyt-C and Caspase-9 in brain tissue.@*RESULTS@#Compared with the sham-operation group, on the day 3, 7 and 14 of intervention, mNSS scores were increased obviously in the rats of the model group respectively (<0.01). Compared with the model group, on the day 3, 7 and 14 of intervention, mNSS scores were reduced in the rats of the EA group respectively (<0.05). On day 3 of intervention, in brain injury region of the rats in the model group and the EA group, gross tissue necrosis, nuclear fragmentation, consolidation and obvious vacuolar changes, reduced Nissl bodies and scattered arrangement were found. On day 7 and 14 of intervention, in the model group and the EA group, the new connective tissue filling and normal cells were visible and Nissl bodies increased. The overall repair and Nissl body quantity in the EA group were better than the model group. Compared with the sham-operation group, on day 3, 7 and 14 of intervention, the numbers of apoptotic cells were increased obviously in the model group (<0.01) and they were reduced in the EA group as compared with the model group (<0.05). Compared with the sham-operation group, on day 3, 7 and 14 of intervention, the protein expressions of Cyt-C and Caspase-9 in damaged brain tissue were all increased obviously in the model group (<0.01) and they were all reduced in the EA group as compared with the model group successively (<0.05).@*CONCLUSION@#Electroacupuncture remarkably improves the condition in the neurological function injury and reduces apoptosis degree in TBI model rats, which is likely related to the down-regulation of the protein expressions of Cyt-C and Caspase-9 in damaged brain tissue and further to bring the impacts on mitochondria mediated apoptosis process.
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Animales , Ratas , Apoptosis , Lesiones Traumáticas del Encéfalo , Terapéutica , Caspasa 9 , Metabolismo , Citocromos c , Metabolismo , Electroacupuntura , Distribución Aleatoria , Ratas Sprague-DawleyRESUMEN
Ventricular arrhythmias in pregnancy is a common disease of cardiovascular disease during pregnancy which can cause adverse outcomes in severe state,such as maternal heart failure,sudden death,fetal hypoxia,premature delivery and stillbirth.The management of ventricular arrhythmias requires multidisciplinary participation,including obstetrics,cardiology,anesthesiology and neonatology.This article discusses how to manage the ventricular arrhythmias from the following aspects:pre-pregnancy counseling and assessment,treatments,managements during pregnancy and managements of delivery in order to reduce the occurrence of maternal and fetal complications,and emphasizes the significance of multidisciplinary collaborative management to the prognosis of disease.
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Objective@#To investigate the application of free medial plantar flap for reconstruction of plantar defects, so as to restore cosmetic and functional sole.@*Methods@#19 Patients(16 males and 3 females) with soft tissue defects at the plantar feet, aged from 6 to 53 years old, were treated in our department, including 5 forefoot defects and 14 heel defects. Free medial plantar flaps at the contraside were used to repair the defects. The size of the flap ranged from 4 cm×5 cm to 6.5 cm×12 cm.@*Results@#All the flaps and skin grafts survived without complications. Nine patients underwent follow-up for 3 to 12 months, the contour and walking function were satisfactory with no ulcers.@*Conclusions@#Free medial plantar flap for reconstruction of plantar defect provides a long-term favorable functional and aesthetic outcome, indicating its' feasibility and efficiency for weight-bearing plantar foot reconstruction.
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<p><b>OBJECTIVE</b>To investigate the effects of Dragon' s blood extract on proliferation and secret extracellular matrix function of fibroblasts in vitro.</p><p><b>METHODS</b>Dragon' s blood was extracted by chloroform, acetoacetic ester, alcohol. Human fibroblast were cultured in vitro in media containing gradient dilutions of Dragon' s blood extracts (0.002, 0.02, 0.2, 2, 20 mg/ml) , which was followed by cell proliferation assessed with MTT assay on 0, 12, 24, 36, 48, 60, 72 h. Under the optimal concentration, the cell growth curves were drawn and the flow cytometry (FCM) was used to determine the changes of cell cycle. On 0, 12, 24, 36, 48, 60, 72 h, the concentration of hyaluronic acid in the supernatant of fibroblast culture was measured by radioimmunoassay.</p><p><b>RESULTS</b>0.2-2 mg/ml Dragon' s blood extracts enhanced the proliferation of fibroblasts in a dose-dependent manner. 2 mg/ml was the optimal dilution of Dragon's blood extract, and it increased the ratio of S cells in cell cycle [(25.80 ± 3.10)%] than control group [(7.50 ± 0.70)%, P < 0.01]. From 12 h to 72 h, in 2 mg/ml Dragon's blood group, concentration of Hyaluronic acid secreted by fibroblasts gradually increased, but were less than control (P < 0.01).</p><p><b>CONCLUSIONS</b>Dragon's blood acetoacetic ester extract improved the proliferation of cultured human fibroblasts in vitro, might be beneficial to promote wound healing.</p>
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Humanos , Ciclo Celular , Proliferación Celular , Medios de Cultivo , Química , Relación Dosis-Respuesta a Droga , Matriz Extracelular , Fibroblastos , Biología Celular , Secreciones Corporales , Citometría de Flujo , Ácido Hialurónico , Secreciones Corporales , Extractos Vegetales , Farmacología , Resinas de Plantas , Factores de TiempoRESUMEN
BACKGROUND:Dragon’s blood is the main ingredient of traditional medicine prescription for promoting granulation, which has been used in clinical treatment of a variety of refractory wounds and achieved the exact effects. But the Dragon’s blood effect on colagen secretion from normal fibroblasts has not been reported. OBJECTIVE: To investigate the effects of Dragon’s blood extract on the proliferation and secret function of fibroblastsin vitro. METHODS: Dragon’s blood was extracted by extracts chloroform, acetoacetic ester, and alcohol in turn. Normal human fibroblasts were respectively cultured in Dragon’s blood extracts of chloroform, acetoacetic ester, and alcohol, DMEM containing 1% dimethyl sulfoxide, and normal culture medium. Then, the fibroblasts were cultured in vitro in different media containing gradient dilutions of Dragon’s blood extracts (0.002, 0.02, 0.2, 2, 20 g/L), which was folowed by cel proliferation determination assessed with MTT assay. Under the optimal concentration, the cel growth curves were drawn and the flow cytometry was used to determine the changes of cel cycle. The concentration of procolagen type III in the supernatant of the fibroblast culture systems was measured by radioimmunoassay. RESULTS AND CONCLUSION:0.2 g/L-2 g/L dilution of Dragon’s blood extracted by acetoacetic ester enhanced the proliferation of fibroblasts in a dose-dependent manner. The 2 g/L was the optimal dilution of Dragon’s blood extracted by acetoacetic ester, and it increased the ratio of S cels in cel cycle than control group and decreased procolagen type III. These findings indicate that Dragon’s blood acetoacetic ester extract can improve the proliferation of cultured human fibroblastsin vitro, and decrease the secretion of procolagen type III of fibroblasts, and it can be beneficial to improve wound healing and inhibit hypertrophic scar.
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<p><b>OBJECTIVE</b>To verify the feasibility and safety of the vascular interventional vascular interventional surgical robot system applied to vascular interventional operation.</p><p><b>METHODS</b>From March to September 2013, 10 patients had undergone robot-assisted cerebral angiography. There were 6 male and 4 female patients; aged from 19 to 58 years, with an average age of 38.4 years. The operation were carried out by neurosurgeons and vascular interventional robot. After successfully implanted of femoral artery sheath by hand, the catheter was fixed on the robot, under the guidance of navigation image the surgeon manipulate the master part and control the slave part of robot by sending command through network transmission, finally finished the whole cerebral angiography. The operation time was recorded from placing the sheath into femoral artery to finishing cerebrovascular selective angiography, simultaneously the time of staff under exposure of X ray was recorded, and the position difference between the setted targets and the actual position(positioning accuracy).</p><p><b>RESULTS</b>It took 25-41 minutes to finish the cerebral angiography, the average time was (31 ± 5) minutes, and the robot-assisted angiography went quickly and smoothly without surgical complications. The remote positioning accuracy was (1.03 ± 0.23) mm. The time of staff under exposure of X ray was 0 minute, the entire experimental process was basically implemented mechanization and automation.</p><p><b>CONCLUSION</b>This system basically achieves initial medical purposes, such as reducing the radiation, facilitating interventional procedures on the basis of enhancing the image navigation, shorting the operation time, and improve the quality of operation.</p>
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Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Procedimientos Quirúrgicos Robotizados , Procedimientos Quirúrgicos VascularesRESUMEN
<p><b>OBJECTIVES</b>To investigate the methodology of diversified advanced image-guided stereotactic biopsy for the brain lesions, and its diagnostic significance and experience in nervous system diseases.</p><p><b>METHODS</b>Retrospectively reviewed 1187 cases of brain lesions underwent image-guided stereotactic biopsy from December 1987 to January 2009. There were 694 male (58.5%) and 493 female (41.5%) patients, aged from 1 to 85 years (average 39.7 years). There were 607 cases in CT-guided, including positron emission computed tomography (PET) guided stereotactic biopsy; 580 cases in MRI-guided, including proton magnetic resonance spectroscopy ((1)H-MRS) guided stereotactic biopsy. Routine frame was used in 726 cases and frameless stereotactic biopsy in 461 cases, including neuroendoscopic biopsy in 28 cases, guided by computer assisted surgery (CAS) computer-assistant robot. In the early 450 cases, CT/MRI images films were employed to measure the coordinates of the target by hand, while in the late 737 cases, computer-assistant planning software rebuilt the CT/MRI images and figured out the optimal neurosurgical path for biopsy.</p><p><b>RESULTS</b>The positive diagnosis rate of biopsy was 97.4%, 983 (82.8%) cases were diagnosed pathologically as brain tumors, and 173 (14.6%) cases as non-tumor diseases. The tumors mainly including neuroglioma, metastatic tumor, primary central nervous system lymphoma and germ cell tumors. In non-tumor diseases, mainly including multiple sclerosis, tumefactive demyelinating lesion, neurodegenerative disease, inflammation and parasite. The biopsy operation caused small hematoma without neurological deficits in 20 cases (1.7%), and caused large hematoma (> 10 ml) which need neurosurgical treatment (catheterization or craniotomy evacuation of hematoma) in 9 cases (0.8%). Hemorrhage associated with biopsy caused 3 cases (0.3%) death. There were no severe intracranial infection cases.</p><p><b>CONCLUSIONS</b>The stereotactic biopsy with advanced image-guided technique represents a safe, reliable and minimally invasive method for pathological diagnosis of intracranial lesions. Moreover, the developments of biochemical imaging gives a new concept to the stereotactic biopsy.</p>
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Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Adulto Joven , Biopsia con Aguja , Métodos , Encéfalo , Patología , Encefalopatías , Diagnóstico , Patología , Imagen por Resonancia Magnética , Estudios Retrospectivos , Técnicas Estereotáxicas , Tomografía Computarizada por Rayos XRESUMEN
Objective To evaluate a therapeutic strategy using aromatase inhibitors and TAM in postmenopausal Luminal B breast cancer patients. Methods The clinical data of 733 primary breast cancer cases receiving postoperative endocrine thempy from July 2002 to Mar 2005 in Tianjin Cancer Hospital were retrospectively analyzed.Diagnosis was confirmed by pathology in all the cases.All patients were post-menopausal and ER-positive.501 patients were given tamoxifen(TAM 2.5 mg qd,po),232 patients were given aromatase inhibitors(Letrozole 10 mg bid,po).The follow-up time ranged from 36 to 90 months.Median follow-up time was 46 months.Results The disease-free-survival(DFS)rate of Luminal B breast cancer patients in aromatase inhibitors(AIS)group was higherthan that in TAM group(90.6% vs.88.6%,P=0.038).In TAM group,subgroup analysis showed 3-year DFS of node-positive with HER2(+)is lower than that of node-positive with Her-2-negative(88.2% vs.90.4%,P=0.037);3-year DFS of ER+/PR+ group in HER2(+) patients was higher than that of ER+/PR-group(90.8% vs.89.5%.P=0.032).In AIs group,in spite of the axillary lymph node status,there was no significant difference of 3-year DFS between HER2(+)patients and HER2(-)ones(P>0.05).3-year DFS of ER+/PR+with HER2(+) patients was higher than that of ER+/PR-ones with HER2(+)(91.9% vs.90.5%,P=0.029).Hot flush,vaginal bleeding and thromboembolics in AIS group is less frequent,but muscle pain and bone fracture is more common than that in TAM group(P<0.05).Conclusion Compared to TAM, AIs is more effective and safer with postmenopausal Luminal B patients,and the effect is independent on node stams.
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<p><b>OBJECTIVE</b>To evaluate the clinical outcome of posterior total vertebral resection in treating thoracic vertebrae tumor in order to provide a safe and effective method in rebuilding spine stability.</p><p><b>METHODS</b>From 2002.1 to 2007.12, 18 patients with thoracic spine tumor underwent posterior total vertebral resection and internal fixation. Among the patients, 10 patients were male and 8 patients were female, ranging in age from 45 to 78 years, with an average of 56 years. The course of the diseases ranged from 2 to 13 months. After the operation, the tumor reccurence was monitored by X-ray, and the tumor markers were detected.</p><p><b>RESULTS</b>All the patients were followed up for a period ranging from 12 to 60 months, averaged 29 months. All the patients showed a postoperative neurologic improvement, as well as showed radiographic evidence of solid fusion in the follow-up examinations during 3 to 9 months, with an average of (8 +/- 1.4) months.</p><p><b>CONCLUSION</b>Posterior total vertebral resection for the treatment of thoracic spine tumor is safe and effective.</p>
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Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Fijación Interna de Fracturas , Métodos , Neoplasias de la Columna Vertebral , Patología , Cirugía General , Vértebras Torácicas , Patología , Cirugía General , Resultado del TratamientoRESUMEN
<p><b>OBJECTIVE</b>To evaluate tolerance and toxicity of high-dose epirubicin regimen CEF-100 as adjuvant therapy for breast cancer.</p><p><b>METHODS</b>From March 2005 to October 2006, 98 patients with stage I - III a breast cancer were randomly assigned to receive postoperative chemotherapy with CEF-100 regimen (epirubicin 100 mg/m2, dl per 21 days for 6 cycles, n =48) or CEF-60 regimen (epirubicin 60 mg/m2, dl per 21 days for 6 cycles, n = 50). Blood routine test were done every cycle, liver and kindey function were examined and adverse effects were recorded after every cycle.</p><p><b>RESULTS</b>No difference of average leucocyte or neutrophil count (P >0.05) was observed in every cycle. Adverse effects of digestive tract and damage of liver function in CEF-100 group were more severe than that in CEF-60 group (P <0.05), but all adverse effects could be relieved by treatment. No severe non-hematological toxicity and cardiac toxicity in both groups were observed (P <0.05). There was no death caused by chemotherapy.</p><p><b>CONCLUSION</b>Our data shows that high dose epirubicin-containing CEF regimen is safe and tolerable for postoperative chemotherapy of breast cancer patient, and the adverse effects could be relieved by marrow support and liver-protection therapy. Further observation and longer follow-up is still needed in order to evaluate the efficacy of this high dose regimen.</p>
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Adulto , Femenino , Humanos , Persona de Mediana Edad , Alanina Transaminasa , Sangre , Protocolos de Quimioterapia Combinada Antineoplásica , Usos Terapéuticos , Aspartato Aminotransferasas , Sangre , Neoplasias de la Mama , Quimioterapia , Cirugía General , Carcinoma Ductal de Mama , Quimioterapia , Cirugía General , Carcinoma Lobular , Quimioterapia , Cirugía General , Quimioterapia Adyuvante , Ciclofosfamida , Usos Terapéuticos , Epirrubicina , Usos Terapéuticos , Fluorouracilo , Usos Terapéuticos , Estudios de Seguimiento , Leucopenia , Neutropenia , VómitosRESUMEN
<p><b>OBJECTIVE</b>To study the efficacy and complications of the method for reduction mammaplasty in patients with breast benign diseases.</p><p><b>METHODS</b>From November 1980 to December 2001, reduction mammaplasty was performed in 27 patients with breast hypertrophy, ptosis and benign diseases. The operation methods were selected according to the characters of the diseases and the extent of breast hypertrophy and ptosis. 9 patients received reduction mammaplasty using an inferior pyramidal pedicle technique; 16 patients received Mckissock vertical bipedicle technique and 2 patients received the bicyclic incision technique.</p><p><b>RESULTS</b>The successful rate was 94.2%. Three breasts developed areola necrosis in Mckissock. Symptoms caused by breast hypertrophy and benign diseases were improved apparently.</p><p><b>CONCLUSION</b>Reduction mammaplasty is the best option for the treatment of breast hypertrophy and ptosis with benign diseases. The method of reduction mammaplasty should be taken individually.</p>
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Anciano , Femenino , Humanos , Mama , Patología , Cirugía General , Enfermedades de la Mama , Cirugía General , Hipertrofia , Cirugía General , Mamoplastia , MétodosRESUMEN
<p><b>OBJECTIVE</b>To explore the effects of lead on the thyroid function of occupationally exposed workers.</p><p><b>METHOD</b>157 workers occupationally exposed to lead in a smelting factory were investigated. The concentration of lead in air at workshop was measured by flame atomic absorption spectrophotometry (FAAS) and the levels of blood lead (PbB) by atomic absorption spectrophotometry (AAS), zinc protoporphyrin (ZPP) by ZnPP meter, as well as the indexes of thyroid function, thyroid-stimulating hormone (TSH), triiodothyronine (T(3)), thyroxin (T(4)), free T(3) (FT(3)), and free T(4) (FT(4)) in serum by radioimmunoassay.</p><p><b>RESULTS</b>The workers with higher level of blood lead (> 2.88 micro mol/L) showed lower levels of T(3) [(1.54 +/- 0.39) nmol/L] and FT(3) [(5.50 +/- 1.26) pmol/L] than those with lower blood lead level [PbB: (1.92 approximately 2.88) micro mol/L group, T(3): (1.71 +/- 0.45) nmol/L, FT(3): (6.12 +/- 1.64) pmol/L, P < 0.05]. There was no obvious effect of length of service on thyroid hormone of exposed workers.</p><p><b>CONCLUSION</b>Higher level of blood lead may cause certain damage to thyroid function by inhibiting deiodination of T(4). No obvious relation between length of service and thyroid function was found.</p>