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Objective:To explore the impact of King's theory of goal attainment combined with goal setting on the effect of standardized training of general practitioners.Methods:A total of 39 general practitioners who underwent the standardized training in The Fifth Affiliated Hospital of Xinjiang Medical University from January 2019 to January 2020 were classified as control group, and traditional teaching was adopted. Another 42 general practitioners who underwent the training in The Sixth Affiliated Hospital of Xinjiang Medical University during the same period were classified as a research group, and the teaching based on King's theory of goal attainment combined with goal setting was adopted. The theoretical knowledge and operational skills scores, changes in clinical comprehensive ability before and after the training, and teaching recognition were compared between the two groups. SPSS 25.0 was used for t test and chi-square test. Results:After the training, the scores of theoretical knowledge and operation skills of the research group were both higher than those of the control group [(92.83±5.62) vs. (85.47±12.11); (90.15±7.22) vs.(83.36±11.24)]. There was no significant difference between the two groups in the scores of inquiry and communication ability, problem-solving ability, general medical thinking ability, interpretation ability of auxiliary examination results, clinical analysis and decision-making ability, team cooperation ability, community common disease diagnosis and treatment ability and humanistic care ability before the training ( P>0.05); the above scores were all improved after the training ( P<0.05), and the above scores of the research group were significantly higher than those of the control group ( P<0.05). The total recognition of teaching in the research group was 95.24%(40/42), which was significantly higher than that 76.92%(30/39) in the control group ( P<0.05). Conclusion:The application of King's theory of goal attainment combined with goal setting in standardized training of general practitioners can effectively improve the level of general practitioners' theoretical knowledge, operational skills, clinical comprehensive ability and recognition of teaching.
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Objective To evaluate the application value of low-dose CT (LDCT) in physical examination for coal miners with different exposure time.Methods The consecutive three-year imaging data of 972 coal miners with over 20-year exposure were retrospectively reviewed.All miners were divided into 3 groups according to different exposure time,including 317 cases with less than 10 years,299 cases with 10-20 years and 356 cases with more than 20 years.All subjects underwent LDCT examination every year during three consecutive years.Results Baseline LDCT:As the exposure time was prolonged (with less than 10 years,10-20 years and more than 20 years),the number of coal miners has increased with non-calcified pulmonary nodules,interstitial pulmonary lesions,clinically cured or stable stage of pulmonary tuberculosis,pulmonary calcification and pulmonary fibrous stripes,but without statistically significant difference.The detection rates of lung bullae,aorta and coronary artery sclerosis were also increased mildly,with the prolonged exposure time.There was no significant correlation between exposure time and detection rates of bronchiectasis,pulmonary inflammatory lesions,lymph node enlargement or calcification,pleural lesions.The exposure time of 6 cases of malignant nodules and 2 cases of active tuberculosis was more than 10 years.During a two-year follow-up using LDCT scan,there were no significant changes in most of intrapulmonary,pleural and mediastinal lesions.Neither were in pulmonary nodules less than or equal to 4 mm.Three pulmonary nodules with 4-8 mm diameters were enlarged.Most of the inflammatory lesions have changed in size.Conclusion The LDCT scan has a certain value for chest physical examination of the coal miners with different exposure time.It is very necessary to screen the high-risk population of coal miners with exposure time of more than 10 years using LDCT.LDCT reexamination has significant value for pulmonary nodules and inflammatory lesions with diameter of more than 4 mm.Most of intrapulmonary,pleural and mediastinal lesions have no obvious change in the short term,and make an annual reexamination unnecessary,neither does a negative baseline LDCT.
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Objective To investigate the role of GABAAα3and GABAB receptors in the ventrolateral periaqueductal gray in the development of paw acute pain in rats.Methods Twelve male SD rats, weighing 280~320 g, were randomly divided into two groups: normal saline group (group NS), formaldehyde-induced pain group (group F), 6 rats in each group.In group F, rats were subcutaneously injected with 2% formaldehyde 50 μl into the ventral surface of right hind paw to induce periphery inflammatory pain.In group NS, rats were subcutaneously injected with normal saline into the ventral surface of right hind paw.Mechanical threshold was assessed using von Frey hairs for every ten minutes.The rat pain behavior scores were recorded for every five minutes.The thickness of skin and skin temperature were recorded for every fifteen minutes.Results Mechanical hyperalgesia were induced in group F after formalin injection into right hind paw.Compared with group NS, rat pain behavior scores were increased significantly in group F at all time points after injection, mechanical threshold were decreased significantly in group F at 10-60 min after injection, the temperature of the skin and the skin thickness were increased significantly in group F at 15-60 min after injection (P<0.05), the levels of the expression of GABAAα3 and GABAB were significantly increased in group F (P<0.05).Conclusion GABAAα3and GABAB receptors mediates formalin-induced hyperalgesia at ventrolateral portion of the PAG (vlPAG) of rats.
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Objective To investigate the effect of cannabinoid receptor 1 ( CBR1 ) on spatial learning and memory function of neuropathic pain ( NP ) model rats and the expression of N-methyl-D-aspartic acid receptor 1(NR1) subunit in medial prefrontal cortex (mPFC).Methods Thirty-six healthy male Wistar rats were randomly divided into 4 groups, with 9 rats in each group: the sham operated group (SO group), the neuropathic pain model group (NP group), the NP model group with an mPFC injection of saline ( NS group ) , and the NP model group with an mPFC injection of the CBR 1 antagonist AM251 ( AM251 group).The NP model was prepared using the operation of chronic constriction injury ( CCI) of the right sciatic nerve.The mechanical withdrawal threshold ( MWT ) and the thermal withdrawal latency (TWL) of the rats in each group were detected at 3, 7, 14, 21 and 28 days after the operation.At 29 days after the operation , 18 rats of NP model were randomly selected and given an mPFC injection of saline or AM251 using a three-dimensional brain puncture.At days 30-37 after operation , the eight-arm maze test was performed to detect the spatial learning and memory function of the rats , and the rats were sacrificed immediately after this test.The expression levels of CBR1, NR1 and phosphorylated-N-methyl-D-aspartic acid receptor 1 ( p-NR1 ) ( Ser896 ) in the mPFC brain region were detected by Western blotting , RT-PCR and immunofluorescence.Results Compared with the SO group , the pain thresholds and the spatial learning and memory function of the rats in the NP group were significantly lower ( both P <0.05 ).Compared with the NS group , the rats in the AM251 group showed improvement about spatial learning and memory function ( P<0.05).Compared with the SO group ( the mRNA and protein level of CBR 1:0.23 ± 0.06,0.42 ±0.03), the mRNA(0.43 ±0.12) and protein (0.53 ±0.05) level of CBR1 in NP group increased (both P<0.05).Compared with the NS group (the mRNA and protein level of CBR1:0.42 ± 0.11,0.52 ±0.10), the mRNA (0.53 ±0.05) and protein (0.98 ±0.17) level of CBR1 in AM251 group increased (both P<0.05).Compared with the SO group (the mRNA and protein level of NR1 and the protein level of p-NR1:1.50 ±0.15,0.65 ±0.05,0.79 ±0.15), the mRNA (0.94 ±0.07) and protein (0.24 ±0.05) level of NR1 in NP group decreased (both P<0.05), the protein level of p-NR1 (0.33 ± 0.04) decreased (P<0.05).Compared with the NS group (the mRNA and protein level of NR1 and the protein level of p-NR1:1.09 ±0.14,0.26 ±0.06,0.31 ±0.08), the mRNA(1.58 ±0.10) and protein (1.42 ±0.10) level of NR1 in AM251 group increased (both P<0.05), the protein (0.95 ±0.15) level of p-NR1 increased ( P<0.05).Conclusion CBR1 can decrease the expression level of NR 1 and p-NR1 in the mPFC brain region of NP model rats and induce the spatial learning and memory impairment.
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<p><b>OBJECTIVE</b>To investigate the imaging features of burst injury of the lung in coal miners and to provide reference for clinical diagnosis and treatment.</p><p><b>METHODS</b>A retrospective analysis was performed on the clinical data and imaging findings of 78 patients with burst injury of the lung.</p><p><b>RESULTS</b>The imaging findings of burst injury of the lung were variable and complex, and they varied over time. Eleven cases showed no abnormalities on X-ray and CT within 24 h, but abnormalities appeared within 3 d; 53 cases showed abnormalities on X-ray and CT and had an exacerbation within 3 d; 8 cases showed improvements when reexamined. Among the 78 patients examined by X-ray and (or) CT, ground glass-like shadows were noted in 15 cases, interstitial changes in 13 cases, segmental consolidation in 24 cases, and diffuse consolidation in 26 cases. The complications included pneumothorax (n = 35), hemothorax (n = 28), costal fracture (n = 24), and pulmonary infection (n = 27).</p><p><b>CONCLUSION</b>X-ray plain film and CT offer a reliable basis for early diagnosis of burst injury of the lung. CT is superior to X-ray plain film in detecting lesions, so chest CT should be performed as early as possible to remedy burst injury of the lung.</p>
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Adult , Humans , Male , Middle Aged , Young Adult , Acute Lung Injury , Diagnostic Imaging , Blast Injuries , Diagnostic Imaging , Occupational Injuries , Diagnostic Imaging , Retrospective Studies , Tomography, X-Ray ComputedABSTRACT
<p><b>OBJECTIVE</b>To observe oxygen uptake efficiency plateau (OUEP, i.e.highest V˙O2/V˙E) and carbon dioxide output efficiency (lowest V˙E/V˙CO2) parameter changes during exercise in normal subjects.</p><p><b>METHODS</b>Five healthy volunteers performed the symptom limited maximal cardiopulmonary exercise test (CPET) at Harbor-UCLA Medical Center. V˙O2/V˙E and V˙E/V˙CO2 were determined by both arterial and central venous catheters. After blood gas analysis of arterial and venous sampling at the last 30 seconds of every exercise stage and every minute of incremental loading, the continuous parameter changes of hemodynamics, pulmonary ventilation were monitored and oxygen uptake ventilatory efficiency (V˙O2/V˙E and V˙E/V˙CO2) was calculated.</p><p><b>RESULTS</b>During CPET, as the loading gradually increased, cardiac output, heart rate, mixed venous oxygen saturation, arteriovenous oxygen difference, minute ventilation, minute alveolar ventilation, tidal volume, alveolar ventilation and pulmonary ventilation perfusion ratio increased near-linearly (P < 0.05-0.01, vs.resting); arterial oxygen concentration maintained at a high level without significant change (P > 0.05); stroke volume, respiratory rate, arterial partial pressure of carbon dioxide, arterial blood hydrogen ion concentration and dead space ventilation ratio significantly changed none-linearly (compare resting state P < 0.05-0.01).OUE during exercise increased from 30.9 ± 3.3 at resting state to the highest plateau 46.0 ± 4.7 (P < 0.05 vs.resting state), then, declined gradually after anaerobic threshold (P < 0.05-0.01, vs.OUEP) and reached 36.6 ± 4.4 at peak exercise. The V˙E/V˙CO2 during exercise decreased from the resting state (39.2 ± 6.5) to the minimum value (24.2 ± 2.4) after AT for a few minutes (P > 0.05 vs.earlier stage), then gradually increased after the ventilatory compensation point (P < 0.05 vs.earlier stage) and reached to 25.9 ± 2.7 at peak exercise.</p><p><b>CONCLUSIONS</b>Cardiac and lung function as well as metabolism change during CPET is synchronous.In the absence of pulmonary limit, appearing before and after anaerobic threshold, OUEP and lowest V˙E/V˙CO2 could be used as reliable parameters representing the circulatory function.</p>
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Humans , Arteries , Blood Gas Analysis , Blood Pressure , Carbon Dioxide , Metabolism , Cardiac Output , Exercise , Physiology , Exercise Test , Heart , Heart Rate , Hemodynamics , Lung , Oxygen , Metabolism , Oxygen ConsumptionABSTRACT
The article presents the contents of marketing of medical information services,explores the model of the marketing of medical information services suitable for the Medical Library of Chinese PLA,discusses the meaning of the marketing of medical information services,the status in this field in China and other countries,and the efforts we need to make next.The purpose is to match the information services to the information needs,support the innovation of medical science.
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Objective To analyze Candida species causing vulvovaginal candidiasis in Qingdao and surrounding areas.Methods Vaginal discharge specimens were collected from 362 patients with suspected vulvovaginal candidiasis in the Affiliated Hospital of Qingdao University Medical College from May 2011 to November 2011,and subjected to routine fungal culture.The Candida isolates were identified by using Sabouraud dextrose agar,CHROMagar medium,germ tube test with serum,and API 20C AUX Clinical Yeast System.Results Totally,313 (86.46％) Candida strains were isolated from the specimens of 362 patients.Of these Candida strains,275 were identified as Candida albicans,38 as non-albicans Candida species,including 13 Candida glabrata strains,8 Candida parapsilosis strains,7 Candida tropicalis strains,5 Candida krusei strains,1 Candida lusitaniae strain,1 Candida dubliniensis strain,1 Rhodotorula mucilaginosa strain,1 Pichia ohmeri strain and 1 Trichosporon mucoides strain.Conclusions As far as vulvovaginal candidiasis is concerned,Candida albicans is still the most prevalent pathogen,and Candida glabrata appears to be the predominant species in pathogenic non-albicans Candida species.
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Objective To evaluate the clinical pathology meaning of atypical squamous cell of undetermined significance (ASCUS) in cervical cytology. Methods The clinical data of 2118 cases who underwent cervical liquid thin-prep cell test (TCT) were analyzed retrospectively, ASCUS and squamous epithelium (SIL) were diagnosed according to the classification of the data TBS cytology, the histopathological examination results were tracked. Results The incidence of ASCUS was 3.4% (72/2218), and the ratio for SIL ( 1.2%, 25/2118) was 2.9. In the cellular pathology of ASCUS, there were four aspects, atypical surface cells and atypical hollowed cells in 16 cases (22.2%), atypical atrophy of the squamous epithelial cells in 11 cases (15.3%), atypical mature or immature metaplastic cells 28 cases (38.9%), atypical cells less influence diagnosis 17 cases (23.6%). Tracking the histologic findings in 43 cases with chronic cervicitis 22 cases (51.2%), low level squamous epithelium neoplasia in 12 cases (27.9%), high levels of squamous epithelial change in 8 cases (18.6%), squamous cell carcinoma 1 case(2.3%). Conclusion ASCUS exists within the risk of squamous lesions, management should be strengthened.
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<p><b>OBJECTIVE</b>To investigate the chemical constituents of Hypericum petiolulatum.</p><p><b>METHOD</b>The chemical constituents were isolated and purified by column chromatography on silica gel, macroporous adsorbent resin, Sephadex LH-20, and preparative HPLC. Structures of the compounds were identified by NMR and MS spectroscopic methods.</p><p><b>RESULT</b>Nine lignans were obtained and their structures were elucidated as (-)-(2R, 3R)-1-O-feruloyl-8,8'-bisdihydrosiringenin (1), (-) -secoisolariciresinol 4-O-beta-D-glucopyrano-side (2), isolariciresinol-beta-4'-O-beta-D-glucopyranoside (3), 5-methoxy-9beta-xylopyra-nosyl-(+) -isolariciresinol (4), (+) -lyoniresinol 2alpha-O-beta-D-xylopyranoside (5), 5-methoxy-9-beta-xylopyranosyl-(-) -isolariciresinol (6), isolariciresinol 6a-O-beta-D-gluco-side (7), (+)-lyoniresinol 3alpha-O-beta-D-xylopyranoside (8) and 7-methoxy-5-benzofuranpropanol 4'-O-beta-D-glucopyranoside (9).</p><p><b>CONCLUSION</b>Coupound 1 was new and compounds 2-9 were obtained from the genus Hypericum for the first time.</p>
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Drugs, Chinese Herbal , Chemistry , Hypericum , Chemistry , Lignans , Chemistry , Magnetic Resonance Spectroscopy , Mass SpectrometryABSTRACT
Objective To approach the correlation between the bone density measured by quantitative CT and the blood sugar level of the aged patients with non-insulin-dependent diabetes mellitus,and observe the effects of the blood sugar level on the bone density.Methods The lumbar bone densities and the blood sugar levels of 160 aged patients with non-insulin-dependent diabetes mellitus (hyperglycemia group 80 cases,euglycemia group 80 cases ) and the healthy aged people (80 cases) were detected by quantitative CT and serum biochemical detection; the correlation between the blood sugar level and the bone density and the osteoporosis occurrence status of aged people in various groups were analyzed.Results The bone density in the non-insulin-dependent diabetes and hyperglycemia group was lower than those in normal(control) group and non-insulin-dependent diabetes and euglycemia group (P
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Objective To investigate the levels of complement and activated complement factors in peripheral blood and skin in patients with psoriasis and their significance in the development of psoriatic lesion.Methods Enzyme linked immunosorbent assay (ELISA) and immuno turbidi metric analysis were used to determine the levels of C3d, sC5b-9, C3 and C4 in sera from 57 patients with psoriasis vulgaris.Immunohistochemistry was employed to assess in situ expression of SC5b-9 in lesional and non lesional skin of 37 patients.Results There was a significant decrease of C3 and C4, and increase of C3d and sC5b-9 in patients with psoriasis in comparison with those of normal controls (t=10.88～ 24.80, P<0.01).The levels of C3 and C4 were significantly lower, while the levels of C3d and sC5b-9 were significantly higher in progressive stage than those in static stage (t=4.55～ 6.77,P< 0.01).In situ expression of sC5b-9 was significantly higher in stratum corneum and dermo epidermal junction of lesional skin than that in non lesional skin and normal controls (χ2=62.90,45.45;P< 0.01).There was no significant difference of C5b-9 expression in stratum corneum and dermoepidermal junction of lesional skin between progressive and static stage.Conclusions There is significant correlation between the development of psoriatic lesion and local deposit of activated complement factors.
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Objective: The purpose of this tudy was to dynamicly observe the weight and the bone mineral density (BMD) of the unsexed rabbits with a few self-made standardized phantoms. Methods:The eighteen healthy adult female rabbits were measured for their weight and BMD in preunsexed and postunsexed 5 months, 10 months with quantitative CT(QCT). Results:There were 61.1% of rabbits whose weight and BMD decreased after 5 months of the postunsexed and 100% of rabbits whose weight and BMD decreased after 10 months of the operation. Conclusion:QCT can be used to dynamicly observe curative effect of drugs in various periods as well,and it is a good method to study osteoporosis.
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Objective To investigate the levels of p27kip1 and ki-67 of psoriatic lesions in patients with psoriasis vulgaris. Methods The expression of p27kip1 and ki-67 in psoriatic lesions was determined by immunohistochemistry. Results The level of p27kip1 expression was significantly lower in the plaque-form lesions of the patients with psoriasis than that in the normal controls(P 0.05). The expression level of ki-67 was significantly higher in plaque-form lesions than that in the normal controls(P
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Objective To investigate the levels of complement and activated co mplement factors in peripheral blood and skin in patients with psoriasis and the ir significance in the development of psoriatic lesion. Methods Enzyme linked im munosorbent assay (ELISA) and immuno turbidi metric analysis were used to dete rmine the levels of C3d, sC5b－9, C3 and C4 in sera from 57 patients with psori asis vulgaris. Immunohistochemistry was employed to assess in situ expression of SC5b－9 in lesional and non lesional skin of 37 patients. Results There was a significant decrease of C3 and C4, and increase of C3d and sC5b－9 in patient s with psoriasis in comparison with those of normal controls (t=10.88～ 24.80, P
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Objective To explore the correlation between the leukocyte rheology, cell adhesion molecule(CAM) expression and psoriasis. Methods Enzyme linked immunosorbent assay(ELISA), erythrocyte deformability apparatus and in vitro thrombus and platelet adhesion dual purpose apparatus were used to determine the changes of leukocyte CD18 expression, levels of serum soluble intercelular adhesion molecule 1(sICAM 1), and the changes of leukocyte filtration index(LFI) and leukocyte adhesion rate(LAR). Results The leukocyte CD18 expression, sICAM 1 level, LFI and LAR were significantly increased in patients with psoriasis than those in controls(P