Abstract:Objective To introduce the hydro-dissection technique and its application in ultrasound-guided percutaneous thermal ablation therapy of neck nodular lesions. Methods A total of 1 126 patients suffering from neck nodular diseases received percutaneous thermal therapy using radiofrequency ablation or microwave ablation from May 2005 to April 2013. As a part of the treatment procedure, ultrasound-guided injection of separating liquid was performed into between the target nodules and surrounding structures to form a separating zone prior to ablation. The roles of hydro-dissection technique in improving the safety of puncture route, reducing the thermal injury to normal tissues, and enhancing the curative effects of ablation were analyzed. Results Hydro-dissection technique was successfully performed in as many as fourteen parts related to the thyroids, parathyroids, submandibular glands and lymph nodes. The key points and ultrasonic characteristics of this maneuver were well established and understood. Compared with those not receiving the technique, those receiving the technique had significantly reduced heat damage to lesion-adjacent structures (0.7% vs 15%, P<0.01) and decreased incomplete ablation rate of the first try (0.29% vs 7.4%, P<0.01). Conclusion Hydro-dissection technique under ultrasound-guidance is easy to perform, has good repeatability and reliable effect; it may serve as a safe and effective supplementary measure for thermal ablation of various neck nodular lesions.

Abstract:Objective To investigate the effect of miRNA-144 on cytokine secretion by dendritic cells (DCs) during their maturation and the related mechanism. Methods miRNA chip results showed markedly down-regulated miRNA-144 during DCs maturation. The miR-144 level was also observed in DCs before and after treatment with lipopolysaccharide(LPS). The changes of related cytokines (TNF-α,IL-1β,IL-6 and IL-23)and the activation of signaling pathway(NF-_κB and MAPK)were detected in DCs after the transfection of miR-144. TargetScan was used to predict the target spot of miR-144 and double fluorescence reporting system was used for verification. Furthermore, we established DC2.4 cell line stably overexpressing the target gene, and detected the TNF-α secretion after transfecting miR-144 mimics. Results The miR-144 expression was significantly down-related in DCs stimulated with LPS(P<0.01). After the miR-144 mimics were transfected into DCs,expressions of TNF-α,IL-1β,IL-6 and IL-23 mRNA were significantly reduced(P<0.05, P<0.01), and NF-_κB phosphorylation level was reduced as well. Bioinformatics analysis hinted that receptor activator of NF-_κB ligand gene (RNAKL) was the potential target of miR-144, which was also validated by double fluorescence reporting system. Moreover,transfecting miR-144 mimics into DC2.4 cells stably overexpressing RANKL resulted in no change of TNF-α mRNA expression. Conclusion miR-144 can regulate DCs cytokine secretion by targeting RANKL.

Abstract:Objective To explore the role of sphingosine kinase 2 (SphK2) in 5-fluorouracil (5-FU)-induced apoptosis in human colon cancer HCT116 cells. Methods Hoechst33342 staining was used to examine the apoptosis morphological changes of HCT116 cells 48 h after treatment with 5-FU; flow cytometry was used to detect the apoptotic ratio of HCT116 cells and the effects of SphK2 (down-regulation and over-expression) on 5-FU-induced apoptosis were analyzed. Western blotting analysis was used to examine the changes in the activated forms of SphK2 and apoptotic marker protein in HCT116 cells after exposure to 5-FU. Results 5-FU induced significant apoptosis in HCT116 cells as reflected by apoptosis characteristics-condensation and fragmentation of chromatin. Interference of SphK2 significantly increased 5-FU-induced apoptosis in HCT116 cells compared with non-interfered group (P<0.01), accompanied by increased apoptotic marker protein. On the contrary, the apoptosis ratio of the cells with SphK2 over-expression was significantly decreased compared with vehicle plasmid-transfected group (P<0.01), accompanied by decreased apoptotic marker protein. Moreover, 5-FU greatly increased activated SphK2. Conclusion SphK2 negatively regulates 5-FU-induced apoptosis in HCT116 cells.

Abstract:Objective To study the anti-arrhythmic and anti-oxidative stress effects of n-3 polyunsaturated fatty acids (PUFAs) in a canine sterile pericarditis model. Methods A total of 20 dogs were randomly assigned to two groups: a control group (10 dogs) and a PUFAs treatment group (10 dogs), with sterile pericarditis created by open-chest operation in both groups. PUFAs was administered orally (2 g/d) 4 weeks before the operation until the end of the study. The inducibility and maintenance of atrial fibrillation (AF), atrial effective refractory period (AERPs), and intra-atrial conduction time were determined before and 2 days after the operation. And the level of 3-nitrotyrosine in the atrial tissue was determined by Western blotting analysis. Results The electrophysiology parameters were similar between the two groups. On day 2 after operation, the PUFAs group compared with the control group had a significantly lower AF inducibility ([11.0±7.4]% vs [28.0±10.3]%, P<0.001) and maintenance (median AF duration: 1 105 [655.8-1 406.5] s vs 2 516.5 [1 187-3 361] s, P<0.05), a significantly longer AERP ([133.4±4.1] ms vs [129.8±4.3] ms, P<0.05), and a significantly shorter intra-atrial conduction time ([46.6±4.4] vs [51.9±4.8] ms, P<0.05). Western blotting analysis showed that 3-nitrotyrosine level in the atrial tissue of PUFAs group was significantly lower than that of the control group (P<0.000 1). Conclusion Dietary PUFAs supplementation can reduce the risk of AF after operation, and its anti-oxidative stress effect might be one of the mechanisms.

Abstract:Objective To investigate the neuroprotective effects of low dose intravenous minocycline against ischemia reperfusion injury in rats after focal cerebral ischemia reperfusion and to explore the possible mechanism. Methods Seventy-two rats were randomly divided into sham-operated group(S group), cerebral ischemia/reperfusion group (I/R group), and minocycline intervention group (I/R+MC group). Focal cerebral ischemia was induced by filament medial cerebral artery occlusion method. Minocycline (3 mg/kg) in saline was administered intravenously via the caudal vein twice a day for 14 days in the I/R+MC group. At 2 days after ischemia reperfusion, the infarct volume was evaluated using TTC staining, the permeability of blood-brain barrier was assessed by Evan's blue (EB) dye extravasation, and the expressions of high mobility group box-1 protein (HMGB1) and Iba1, a marker of activated microglia, were analyzed by using Western blotting analysis. The neurological function recovery was evaluated using the modified neurological severity score (mNSS) at 2 d, 7 d, and 14 d after ischemia/reperfusion. Results Two days after cerebral ischemia reperfusion, the brain infarction volume and the extravasations of EB were significantly increased and the expressions of HMGB1 and Iba1 were significantly up-regulated in I/R group compared with sham group(P<0.05). Compared with I/R group, minocycline at 3 mg/kg via the caudal vein significantly reduced the infarct volume in ischemic brain(P<0.05), extravasation of EB and expressions of HMGB1 and Iba1 (P<0.05). Additionally, the rats in I/R+MC group exhibited a significantly decreased neurological severity score compared with I/R group (P<0.05). Conclusion Minocycline exerts a neuroprotective effect in rats with cerebral ischemia reperfusion injury, which may be related to decrease of infarct size, inhibition of EB extravasation and microglia activation.

Abstract:Objective To analyze the correlation between catechol-O-methyltransferase (COMT) gene polymorphism and cerebral vasospasm (CVS) in early period after subarachnoid hemorrhage (SAH). Methods The clinical data of 167 patients with spontaneous SAH, who were treated in our hospital from Jan. 2008 to Dec. 2008, were collected for this study. COMT genotyping was performed by means of polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The degree of CVS was identified by transcranial Doppler (TCD). Hunt-Hess classification was used to evaluate the severity of the patients' condition. The bleeding amount was evaluated by means of Fisher classification of head CT. χ² test (SPSS13.0 software) and logistic regression were adopted to analyze the correlation of COMT gene polymorphism and other clinical data with early CVS after SAH. Results The distribution of each allele matched with Hardy-Weinberg law and the research samples were heredity equilibrium population. Early CVS incidence of patients with COMT A allele was significantly higher than those with COMT G allele (51.7% vs 38.5%, P<0.01). Early CVS incidence of patients with COMT A/A genotype was significantly higher than those with COMT G/G genotype (66.7% vs 35.9%, P<0.05). Univariate logistic regression demonstrated that COMT A allele, A/A genotype and Grade 3-5 of Hunt-Hess classification were all associated with early CVS. After adjustment of general information, further multivariate logistic regression demonstrated that COMT A allele, A/A genotype were the risk factors of early CVS after SAH. Conclusion COMT A allele and A/A genotype might be risk factors of early CVS after SAH.

Abstract:Objective To prepare angiopep-2 and transferrin co-modified liposomes (ANG/TF-LPs) and to observe their property of passing the blood-brain barrier (BBB). Methods ANG/TF-LPs were prepared by film-ultrasonic method. The particle size, Zeta potential and stability in fetal bovine serum (FBS) of ANG/TF-LPs were evaluated. The cellular uptake of ANG/TF-LPs by bEnd.3 cells in vitro was observed to evaluate the targeting efficiency. The in vitro BBB model was used to evaluate the ability of liposomes passing the BBB. Results The diameter of the prepared ANG/TF-LPs was (93.2±13.5) nm, the Zeta potential was (7.55±1.85) mV, and they were stable in FBS within 24 h. It was found that the uptake of ANG/TF-LPs by bEnd.3 cells was 2.9, 2.4 and 4.8 folds those of transferrin modified liposomes (TF-LPs), angiopep-2 modified liposomes (ANG-LPs) and liposomes (LPs), respectively (P<0.01). The efficiency of ANG/TF-LPs passing the BBB was 3.1, 2.9 and 5.4 folds those of TF-LPs, ANG-LPs and LPs, respectively (P<0.01). Conclusion The angiopep-2 and transferrin co-modified liposomes are easy to prepare, and the modification can enhance the BBB passing ability, making the prepared liposomes a promising brain drug delivery system.

Abstract:Objective To modify polyargine (PLR) with polyethylene glycol (PEG) and to observe the effect of PEG modification on PLR cytotoxicity and efficiency of PLR-mediated RNA interference. Methods ¹HNMR was used to characterize PLR-PEG and gel electrophoresis was adopted to determine the siRNA-packing capacity of PLR-PEG. The cytotoxicity of PLR-PEG, cellular uptake and RNA interference efficiency of PLR-PEG/siRNA complexes were investigated using prostate cancer stem-like cells(RC-92a/hTERT). Results ¹HNMR results showed the successful synthesis of PLR-PEG.It was found that PEG modification decreased cytotoxicity of PLR and reduced cellular uptake of PLR/siRNA complexes, but the reduction of cellular uptake was limited when N/P was high. The modification also inhibited the efficiency of PLR-mediated RNA interference, but the influence of PEG modification was not notable within a certain range. Conclusion PEG -modified PLR may be a promising vector for gene therapy targeting prostate cancer stem cells.

Abstract:Objective To understand the mother-to-child transmission rate of human immunodeficiency virus (HIV) and the use of drugs to prevent the transmission in China from 2004 to 2010. Methods English and Chinese databases including PubMed, Chinese Biomedical Literature database (CBM), etc. were searched to retrieve the relevant references from the start to May 2013. Quality evaluation of the included studies was performed with four criteria which was compiled according to AHRQ cross-sectional study evaluation standards and the STROBE statement. The sample size, recruitment venue and study year were taken as the main source of heterogeneity in meta regression analysis. The data was analyzed by Comprehensive Meta-Analysis V2.0 software. Results A total of 2 356 references were retrieved, and 51 of them were finally included in meta-analysis. In 2004-2010, the mother-to-child transmission rates of HIV were 12.90%(95% CI: 7.48%-21.36%),16.35%(95% CI: 10.41%-24.73%),6.45%(95% CI: 3.73%-10.93%),6.25%(95% CI: 2.39%-15.36%),5.56%(95% CI: 2.79%-10.76%),3.10%(95% CI: 1.59%-5.97%), and 2.29%(95% CI: 1.36%-3.83%), respectively. Meanwhile, From 2004 to 2010, the drug use rates for HIV antiretroviral prophylaxis among pregnant women were 70.39%(95% CI: 24.42%-94.59%),71.99%(95% CI: 61.49%-80.54%),78.79%(95% CI: 70.19%-85.43%), 86.84%(95% CI: 79.24%-91.94%), 82.71%(95% CI: 76.62%-87.48%), 81.85%(95% CI: 75.55%-86.80%), and 86.16%(95% CI: 53.20%-97.15%), respectively. And in 2005-2010, the drug use rates for HIV antiretroviral prophylaxis among infants were 80.72%(95%CI: 72.89%-86.70%), 81.84%(95% CI:71.55%-88.98%), 85.43%(95% CI: 80.99%-88.97%), 89.75%(95% CI: 81.82%-94.45%), 92.39%(95% CI: 84.97%-96.31%), and 90.34%(95% CI: 85.50%-93.68%), respectively. Conclusion The HIV mother-to-child transmission rate is decreasing in China in recent years, and the drug use rates of HIV antiretroviral prophylaxis are increasing among HIV-infected pregnant women and their infants.

Abstract:Objective To evaluate the effects of allogeneic blood transfusion (ABT) on long-term prognosis in colorectal cancer (CRC) patients undergoing surgery. Methods PubMed, EMbase, The Cochrane Library and China Biology Medicine disc(CBMdisc) were searched for studies on the correlation between ABT and clinical outcomes of colorectal cancer patients,and relevant articles were also retrieved from references. All the searches were done from inception to March, 2014.Two reviewers independently screened the literature,extracted the data and evaluated the quality of the data.Then the meta-analysis was performed by using Stata12.0 software. Results Finally 8 studies involving 5 479 patients were included.The results of meta-analysis showed that, compared with non-transfusion group,the transfusion group had significantly increased risks of overall survival (by 21%, HR=1.21;95% CI: 1.09-1.33;P<0.001) and disease-specific survival (by 47%, HR=1.47; 95% CI: 1.17-1.84;P=0.001);whereas the risks of disease free survival,local recurrence or distant metastasis were not significantly different between the 2 groups. Conclusion ABT can increase the risks of overall survival and disease-specific survival in CRC patients undergoing surgery; therefore, it is of great clinical significance to take active perioperative blood conservation strategies to decrease ABT rate.

Abstract:Objective To analyze the status of systematic review(SRs)/meta-analyses(MAs) of endoscopic ultrasound (EUS) diagnosis. Methods We searched PubMed, EMBASE, Cochrane Library, Web of Science, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang Database, and Chinese Scientific Journals Database from the starting to July, 2013 for related publications. Based on the inclusion and exclusion criteria, SRs/MAs of EUS for diagnosis were collected. Articles were screened by two reviewers and the process of extraction was done by pre-designed table. Results A total of 72 SRs/MAs were included in the present paper. The number of papers ranged from one in 1998 to 16 in 2012. The fields of disease were mainly related to digestive system (54/72,75.0%) and respiratory system (6/72,8.3%). Most of the papers (65/72,90.3%) were published in English and the rest (9.7%[7/72]) in Chinese. Totally 87.5%(63/72) of the papers were published in journals indexed by Science Citation Index. The majority of papers (67/72,93.1%) had their authors from the same country. The first authors of the included papers were mainly from China(23/72,31.9%) and the United States (22/72,30.6%), only with 5 studies done with international cooperation; and 77.8% (56/72) of the papers were completed by one institution (such as a hospital, a college or an institute). The characteristics table of included studies (61/72,84.7%) and forest plot (52/72,72.2%) were most frequently used. The number of references in English literature was about 2.5 times that of Chinese one, and the English papers had more references of the latest five years than the Chinese one. The average cites of SRs/MAs was only 36.3 in our study. It was found that 54.2% (39/72) SRs/MAs used QUADAS standard for assessing the quality of original research, which was recommended by Cochrane Handbook 5.1; there were still 38.9% (28/72) SRs/MAs did not report their quality assessment tool. No included Chinese paper reported fund support. Conclusion SRs/MAs of EUS for diagnosis is increasing on an annual basis. International cooperation should be improved among researchers for SRs/MAs studies and methodology researchers should be included for the study. QUADAS as diagnostic quality assessment tool should be encouraged. Flow chart and funnel plot should be strictly applied according to PRISMA statement.

Abstract:Long noncoding RNAs (lncRNAs),contraining more than 200 nucleotides,are RNA transcripts without protein-coding capacity.It has been reported that lncRNAs regulate gene expression at the epigenetic,transcriptional and post-transcriptional levels,and are deeply involved in various biological processes.Many diseases are found related to lncRNAs and they have become a focus of studies.According to recent evidences,a number of lncRNAs are changed in lung cancer,and they play a significant part in the development,progression and prognosis of lung cancer.This review focuses on the definition and functional mechanism of lncRNAs and their relation with lung cancer.

Abstract:Alveolar epithelial apoptosis and injury induced by oxidative stress in pulmonary diseases have drawn great attention from researchers. Peroxiredoxin 6 (Prdx6), endowed with the activities of both glutathione (GSH) peroxidase and phospholipase A₂ (PLA₂), can effectively fight against oxidative stress and alleviate oxidative stress-induced lung injury, and therefore plays an important role in pulmonary diseases. This review focuses on the structure, function, distribution and expression regulation of Prdx6, and summarizes the role of Prdx6 in pulmonary antioxidant defense and its regulatory mechanism based on experimental studies.

Abstract:The indigenous populations of high altitude, physiologically with lower concentration of hemoglobin and higher level of nitric oxide, can be well-adapted to hypoxia and cold environment. Recent studies have revealed that these adaptive highland population possessed genetic bases, which involved a number of genes, such as EPAS1, EGLN1, CBARA1, VAV3, PPARA, and eNOS, associating with hypoxia-inducible pathway, production of red blood cells and vasodilator substances, etc. These findings provided new insights and strategies from genetics to uncover the unique natural environment selection, to understand the mechanisms of plateau diseases, finally to better prevent and treat them.

Abstract:Objective To establish an animal model with more serious ischemic brain damage by combining unilateral carotid artery ligation with double injection model of cisterna magna. Methods Thirty New Zealand rabbits were evenly randomized into sham group, subarachnoid hemarrhage (SAH) group, and SAH + carotid artery occlusion (CAO) group. Double blood injection was performed in SAH group and SAH CAO group; right carotid artery ligation was also performed in the SAH CAO group. All the animals were sacrificed at day 5 after the first blood injection, and then H-E and TUNEL staining were performed for the brain tissue sections. The diameter of the basilar artery was measured and the neuronal apoptosis was counted at the hippocampus region. Results The survival rate for the sham group, SAH group, and SAH CAO group were 100%, 90%, and 70%, respectively. Compared with the sham group, SAH group and SAH CAO group had significant basilar artery vasospasm and neural apoptosis(P<0.001). The diameters of basilar artery were not significantly different between SAH group and SAH CAO group (P=0.342); however, the neuronal apoptosis count in hippocampal region was significantly higher in SAH CAO group than in SAH group (P=0.005). Conclusion Unilateral carotid artery ligation combined with double injection model of cisterna magna can be used to establish a more serious cerebral vasospasm model.

Abstract:Objective To study the protective effect of lycopene (LP) against diabetic retinopathy (DR) in rats and its related mechanism. Methods A single dose of streptozotocin (56 mg/kg) was injected intraperitoneally in SD rats to induce diabetes retinopathy (DR), and the 20 successful DR models were equally randomized into DR group and LP treatment group. Meanwhile, 10 normal rats served as normal control group (NC). LP group received LP gavage (60 mg/kg) once a day; NC and DR groups were gavaged with equivalent saline daily for 8 weeks. The serum levels of endothelin(ET) and calcitonin gene related protein(CGRP) were detected by using radioimmunoassay(RIA), and the expression of vascular endothelial growth factor (VEGF) in the retina was determined by immunohistochemistry and Western blotting analysis. Results The serum levels of ET and expression of VEGF in the retina were significantly increased in DR groups when compared with NC group (P<0.05), and the serum CGRP was significantly decreased (P<0.05); Compared with DR group, LP group had significantly lower VEGF expression and ET levels and significantly higher level of CGRP (P<0.05). Conclusion LP can protect against DR in rats by decreasing serum ET, increasing serum CGRP, and subsequent down-regulating VEGF expression.

Abstract:Objective To apply 3.0 T MRI(3-dimensional time-of-flight and high-resolution MRI vessel wall imaging) technique for analyzing atherosclerotic middle cerebral stenosis, location of the plaque and remodeling of the middle cerebral artery. Methods 3.0 T MRI was used to examine 64 patients with middle cerebral atherosclerotic stenosis, determining the plaque location and thickness. The plaque area ratio was defined as plaque area/cross-sectional area of the vessel(VA); remodeling ratio was defined as VA/average of the proximal and distal normal artery; and the luminal area of the vessel (LA) ratio was defined as LA/average of the proximal and distal normal artery. Results The atherosclerotic plaque of middle cerebral artery (M1 segment) most frequently formed annular plaque and was located at the ventral and inferior wall, with the plaque thickness being 0.5-1.5 mm (72.5%).The middle cerebral atherosclerotic plaque remodeling modes were mainly positive (outward) remodeling. Conclusion 3.0 T MRI can help to demonstrate the distribution of the middle cerebral atherosclerotic plaque and the remodeling of the middle cerebral artery, which is worth further studying.

Abstract:Objective To evaluate the value of Dynesys dynamic fixation for treatment of lumbar degenerative disease by comparing with lumbar spinal fusion. Methods The clinical data of 60 patients with lumbar degenerative disease, who were treated in Changhai Hospital from June 2009 to June 2010, were retrospectively analyzed. Twenty-six patients, including 15 males and 11 females, with age ranging 32-56 years (average [42.45±10.12] years), received Dynesys implantation for segments L₄-L₅ (13 cases) and L₅-S₁ (13 cases). Thirty-four patients, including 20 males and 14 females, with age ranging 38-60 years(average [45.24±12.15] years), received fusion implantation for segments L₄-L₅ (18 cases) and L₅-S₁ (16 cases). The following parameters were observed and compared between the two groups: operation time, blood loss, hospital stay, preoperative Oswestry disability index (ODI), ODI at last follow-up, low back and leg pain visual analogue scale (VAS), results of health status questionnaire (SF-36), segmental angulation degree of lumbar spine, and intervertebral height. Results All the 60 patients were followed up for 3-4 years (average [3.2±0.2] years). The operation time and intra-operative blood loss were significantly different between the two groups (P<0.05), and no difference was found for average hospital days. The ODI, VAS, and SF-36 clinical scores at last follow-up were significantly improved compared with those before operation in the two groups (P<0.01), with the improvement in Dynesys group being more significant than the fusion group (P<0.01). The segmental angulation degree of lumbar spine had no noticeable improvement in the two groups at last follow-up, and there were no significant differences between the two groups. There was no intervertebral height loss at the last follow-up in the two groups, and there was no significant difference in intervertebral heights between the two groups. Conclusion Dynesys dynamic lumbar fixation shows no more advantages in terms of radiological results compared with the fusion group. Moreover, fusion fixation is not suggested to have more adjacent segment degeneration(ASD) than Dynesys dynamic lumbar fixation. But clinically Dynesys dynamic lumbar fixation yields a greater improvement, with the advantages of less bleeding and shorter operation time. In middle-aged and elderly patients with degenerative diseases, Dynesys dynamic lumbar fixation is an acceptable choice.

Abstract:Objective To compare the therapeutic outcomes of standard laparoscopic and laparoendoscopic single-site (LESS) nephrectomy for benign nonfunctioning kidney. Methods From September 2009 to August 2013, a single urologist group in our center performed 72 transperitoneal laparoscopic nephrectomies for benign nonfunctioning kidney, with 50 undergoing LESS (group A) and 22 undergoing standard laparoscopic surgery (group B). The clinical data of the two groups were analyzed and the therapeutic outcomes were compared between the two groups. Results The operation was successfully performed in all cases,with no conversion to open surgery. Compared with standard laparoscopic group, the LESS group had significantly lower postoperative pain score (4.3±1.0 vs 3.7±0.8, P=0.015),quicker bowel function recovery ([58.1±16.1] h vs [49.2±14.0] h,P=0.032),shorter drainage duration ([3.9±1.5] d vs [2.8±1.1] d,P=0.003),shorter post-operative hospital stay ([7.3±3.1] d vs [6.3±3.4] d,P=0.048), and a better cosmetic satisfaction score (7.4±0.9 vs 8.0±0.6, P=0.001). The operative time and intraoperation blood loss were not significantly different between the two groups. Conclusion Compared to standard laparoscopic nephrectomy, transumbilical LESS nephrectomy offers a quicker recovery of bowel function,shorter drainage duration,a better postoperative pain control,and a better cosmetic satisfaction for benign nonfunctioning kidney,but its long-term therapeutic effect needs to be further verified.

Abstract:Objective To explore the teaching method for transrectal ultrasound guided prostate biopsy, so as to shorten the learning curve and reduce the complications during the study period. Methods Six residents of urology, who had 2-3 years experience of urology and had no experience in transrectal ultrasound biopsy, were randomly divided into two groups: experimental group and control group (n=3). All the members were trained to perform transrectal ultrasound-guided 12 needle biopsy of the prostate. The experimental group received the modularized step-by-step training mode; and the control group received the traditional method, which included operation teaching and independent operation of the whole process. Fourteen days later,all the members were tested for manipulation and surveyed by questionnaires on the training. Results All the 3 residents in the experimental group were capable to perform the operation successfully after 14 days, while only 1 resident in the control group can do it smoothly. The questionnaire survey showed that, all the 3 residents in the experimental group thought that the training procedure was easy and interesting, and they were not nervous during the operation. In the control group, only 1 resident felt it was easy, and the other 2 felt it was difficult and boring, and they were liable to be nervous and forgetful in clinical practice. Conclusion The modularized step-by-step training mode can greatly improve the learning efficiency of training for transrectal ultrasound guided prostate biopsy, making the learning process simple and interesting.

Abstract:Objective To explore the association of testosterone (T), testosterone receptor (AR), and heat shock protein 90 (HSP90) levels in the peripheral blood with those in the testicular tissue of azoospermia patients. Methods A total of 45 azoospermia patients were selected in this study. Their blood levels of luteotropic hormone (LH), follicle-stimulating hormone (FSH), T, AR, and HSP90 were measured. The testicular tissues were biopsied to observe the presence of sperm under microscope. Then the biopsied tissues were ground, centrifuged to obtain the supernatant, which was then subjected to detection of T, AR, and HSP90 levels. According to the biopsied results and FSH value, the patients were divided into three groups: group A (had sperm, FSH<8 IU/L), B (no sperm, FSH<8 IU/L), and C (no sperm, FSH>8 IU/L). The blood and testicular levels of T, AR, and HSP90 were compared between the three groups, and the relationship between FSH, LH, T, AR, and HSP90 levels was analyzed. Results There were significant differences between the three groups regarding the levels of AR (F=5.478,P=0.026) and HSP90 (F=5.972,P=0.019) in the blood samples, and levels of T (F=6.757,P=0.006) and AR (F=4.988,P=0.047) in the testis tissue samples. We also found that FSH level was positively correlated with blood HSP90 level (r=0.729,P=0.001) and testicular T level (r=0.722,P=0.002); LH level was positively correlated with blood (r=0.629,P=0.012) level and testicular T levels (r=0.610,P=0.016); blood T level was negatively correlated with blood AR level (r=-0.665,P=0.005) while testicular T level was positively correlated with testicular AR level (r=0.544,P=0.029); and blood (r=0.559,P=0.042) and testicular (r=0.803,P=0.000) AR levels were positively correlated with their corresponding HSP90 levels. Conclusion Azoospermia patients with normal testicular volume have increased blood HSP90 and AR levels, and it has a feedback effect upon FSH and LH levels, with gradually increased testicular T and AR levels and unchanged HSP90 level.

Abstract:Objective To examine the reliability and validity of Chinese Military Job Burnout Scale (CMJBS). Methods A test with CMJBS was carried out on 1 292 armymen chosen by stratified cluster sampling, and 130 of them were also tested by Chinese Military Occupational Stress Scale (CMOSS). SPSS17.0 and Amos7.0 were used to examine the reliability and validity of CMJBS. Results The Cronbach's α coefficient of total scale of CMJBS was 0.844, and those of subscales of CMJBS were 0.683-0.800 (P<0.01); the split-half reliability of total scale was 0.834, and those of the subscales were 0.575-0.758 (P<0.01). The correlation coefficients between factors and total scale score were 0.655-0.809 (P<0.01); the correlation coefficients between total scale score of CMJBS and CMOSS was 0.538(P<0.01). The results of exploratory factor analysis showed that the scale of the entries in the collation and factors named were consistent. The results of confirmatory factor analysis showed a higher degree of accordance between the sample data and the hypothesized structure of factors, with the χ² statistic being 1 465.447 and RMSEA (root mean square error of approximation) being 0.060, and with TLI (Tucker-Lewis index), CFI (comparative fit index), IFI (incremental fit index) and GFI (goodness of fit index) being 0.949, 0.895, 0.915, and 0.893, respectively. Conclusion The reliability and validity of CMJBS meet standards for scale designing and can serve as a tool for measuring the job burnout of Chinese armymen.

Abstract:Objective To conduct a meta-analysis on the sensitivity and specificity of neutrophil CD64 and C-reactive protein (CRP) for diagnosing neonatal sepsis by retrieving all the relevant high quality publications, so as to provide evidences for clinicians to select diagnosis indicators. Methods The publication about the sensitivity and specificity of neutrophil CD64 and CRP for diagnosing neonatal sepsis were searched in PubMed, EMBASE and Science Citation Index Expanded from the set-up time to Oct. 15, 2013. All the trials were evaluated strictly and the included trials were analyzed by meta-analysis. The odds radio (OR) for the sensitivity and specificity of CD64 and CRP for diagnosing neonatal sepsis was calculated. Results Eight studies were included for analysis. Totally 578 cases were positive and 854 cases were negative according clinical diagnosis. Meta analysis showed that the sensitivity of CD64 for diagnosing neonatal sepsis was significantly higher than that of CRP (OR=2.79,95%CI [1.59,4.92], P=0.000 4), while the specificities of CD64 and CRP for diagnosing neonatal sepsis had no significant difference (OR=0.81,95%CI [0.50,1.30],P=0.37). Conclusion This meta-analysis shows that CD64 is more sensitive than CRP for diagnosing neonatal sepsis, but the specificities of CD64 and CRP are similar for diagnosing neonatal sepsis.

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