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Evidence-based medicine (EBM) is an emerging subject which allows us to make health-related policy based on evidence, and is also an important course in medical colleges and universities. Given the current educational objectives and characteristics of evidence-based medicine, this paper proposed an online and offline integrated teaching model of evidence-based medicine based on online platform for medical undergraduates. Online teaching was conducted using online platform which focus on the cultivation of evidence-based thinking and scientific research quality. Offline teaching was in-classroom teaching which focus on basic knowledge and skill learning. Practice of this model not only enriches teaching methods, but also improves the learning effect, thus this model needs to be explored and perfected in the future.
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Objective:To investigate the effect of Xuebijing injection combined with low-molecular-weight heparin on the immune function and inflammatory factors in patients with sepsis.Methods:The clinical data of 60 patients with sepsis admitted in the department of intensive care unit of Changzhou Wujin Hospital of Traditional Chinese Medicine from January 2018 to December 2019 were analyzed. The patients were randomly divided into observation group (30 cases) and control group (30 cases). The control group was treated with low-molecular-weight heparin sodium; the observation group was given Xuebijing injection combined with low-molecular-weight heparin. The course of treatment was 1 week in both groups. Heart rate (HR), body temperature, respiratory rate and white blood cell count (WBC), systemic infection related organ failure scale (SOFA) score, acute physiology and chronic health evaluation (APACHE) Ⅱ score, immune function and inflammatory factors tumor necrosis factor-α (TNF-α), C-reactive protein (CRP) and interleukin-6 (IL-6) were compared between the two groups before and after treatment for 1 week.Results:After treatment, the levels of HR, body temperature, respiratory rate and WBC in the observation group were lower than those in the control group [(83.22 ± 4.34) beats/min vs. (89.14 ± 3.67) beats/min, (37.02 ± 0.37)℃ vs.(37.81 ± 0.4) ℃, (86.83 ± 4.56) times/min vs. (97.32 ± 6.17) times/min, (10.85 ± 1.28) × 10 9/L vs. (12.29 ± 1.34) × 10 9/L], and the differences were statistically significant ( t = 5.705, 7.330, 7.489, 4.256, P < 0.05). After treatment, the scores of SOFA and APACHEⅡ in the observation group were lower than those in the control group [(8.93 ± 1.42) scores vs. (13.24 ± 1.98) scores, (12.13 ± 2.19) scores vs. (15.52 ± 1.98) scores], and the differences were statistically significant ( t = 9.689, 6.289, P < 0.05). After treatment, the levels of CD 3+, CD 3+ CD 4+ and CD 4+/CD 8+ in the observation group were higher than those in the control group [(62.31 ± 5.21)% vs. (54.68 ± 3.75)%, (35.38 ± 2.98)% vs. (29.39 ± 3.10)%, 1.15 ± 0.24 vs. 1.47 ± 0.18], and the differences were statistically significant ( t = 6.510, 7.630, 7.050, P < 0.05). After treatment, the levels of TNF-α, CRP and IL-6 in the observation group were lower than those in the control group [(23.94 ± 4.63) μg/L vs. (37.91 ± 3.6) μg/L, (43.17 ± 9.93) mg/L vs. (75.23 ± 15.42) mg/L, (34.21 ± 4.28) μg/L vs. (48.93 ± 5.12) μg/L], and the differences were statistically significant ( t = 12.978, 9.574, 12.082, P < 0.05). Conclusions:Xuebijing injection combined with low-molecular-weight heparin on sepsis patients can reduce the HR, body temperature, respiratory rate and WBC, reduce the patient's condition and organ damage, improve the immune function of the body, and reduce the inflammatory reaction in the body.
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BACKGROUND: Studies have reported that platelet-rich plasma (PRP) can promote accelerated healing of pressure injury. OBJECTIVE: To explore the effect of PRP on pressure injury of patients with spinal cord injury. METHODS: From July 2017 to December 2019, 40 patients with spinal cord injury complicated by stage 3 and stage 4 pressure ulcers were randomly divided into a PRP group (n=20) and a control group (n=20) using a random number table. Patients in the control group were given routine wound care and standardized rehabilitation treatment, whereas those in the PRP group received PRP treatment based on routine wound care and standardized rehabilitation treatment once a week. The surface area, wound type and exudate volume were assessed by pressure ulcer scale for healing (PUSH) before treatment and 2, 4, 6, 8 weeks after treatment. The total PUSH score, score of each item in the PUSH scale, and clinical efficacy were compared between the two groups. An ethical approval was obtained from the Biomedical Ethics Committee of West China Hospital of Sichuan University, with an approval No. 2019(622). RESULTS AND CONCLUSION: The total PUSH score and scores in terms of wound area, type, and exudate volume were significantly reduced after treatment in the PRP group (P < 0.01), while those scores in the control group were also significantly reduced at 6 and 8 weeks after treatment (P < 0.01). Compared with the control group, the total PUSH score and scores on exudate volume were significantly lower in the PRP group at 4, 6, and 8 weeks after treatment, and the scores on wound type were significantly lower in the PRP group at 6 and 8 weeks after treatment. The healing rate in the PRP group was 100% after treatment, which was significantly higher than that in the control group (35%; P < 0.001). These findings indicate that PRP treatment contributes to the recovery of pressure injury in patients with spinal cord injury.
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Objective To investigate the value of procalcitonin in guiding the antibiotic use in acute exacerbation of chronic ob-structive pulmonary disease(AECOPD) .Methods A total of 184 patients with AECOPD in our hospital from March 2014 to Sep-tember 2015 were selected and divide into two groups by the random number table method .Ninety-two cases in the control group received the antibiotic therapy according to clinical experience .Ninety-two cases in the observation group was implemented the anti-biotic therapy according to serum procalcitonin level .Results Compared with before treatment ,the procalcitonin level after treat-ment in the observation group was decreased significantly (P0 .05) .Conclusion Serum procalcitonin is significantly increased in the patients with AECOPD .Procalcitonin can be used for the optimized use of antibiotics .
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Objective To summarize the nursing for acute epididymitis within intermittent catheterization. Methods From August, 2013 to February, 2016, twelve patients suffering acute epididymitis within intermittent catheterization after spinal cord injury were reviewed. Re-sults Epididymitis was cured in all the patients after retention catheterization, psychological nuring, diet and drinking guide, reasonable drug use, etc. Conclusion Acute epididymitis within intermittent catheterization can be controlled by appropriate medication and nursing.
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Objective To explore the effectiveness of plan-do-check-action (PDCA) cycle in the management of teaching quality of reha-bilitation nurse. Methods From March, 2014 to March, 2015, 108 nurses were recruited in three terms. PDCA cycle was applied in the man-agement. Problems existing in their nursing work and nursing continuing education were investigated and analyzed, then improved in the next term. Results The teaching satisfactions were 86.12%, 90.13%, and 93.32%, respectively. The scores of theoretical examination, opera-tion examination and Power Point report gradually increased in nurses of three terms. Conclusion The application of PDCA cycle is effec-tive in the management of teaching quality of rehabilitation nurse.
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Objective To investigate the effect of depression on the incidence of osteoporosis in patients with maintenance peritoneal dialysis (MPD).Methods We enrolled 80 MPD patients,who underwent peritoneal dialysis in our dialysis center.The clinical data and biochemical parameters of all patients were collected,bone mineral density was detected and the Self-rating depression scale was used to evaluate depression state.Results Among the 80 enrolled MPD patients,34 patients had osteoporosis (42.5％),48 patients had the presence of depression (60％).Logistic regression analysis showed that age,dialysis age,gender,diabetes history and depression state were the risk factors for osteoporosis in MPD patients,the depression state was negatively correlated with BMD of lumbar and femoral neck (r=-0.347,r=0.426,P＜0.05).Conclusion Depression state may be a risk factor for osteoporosis in clinic,it is of great significance to focus on the psychological state of MPD patients in the prevention and treatment of osteoporosis.
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Objective To investigate the effectiveness of bone marrow mesenchymal stem cell (MSC) and different transplantation methods of MSC on adriamycin (ADR) model of nephropathy in rats. Methods The ADR model of nephrop-athy was induced by left nephrectomy plus injection of ADR (2.5 mg/kg) in Sprague-Dawley (SD) rats, once a week for two weeks. The model rats with nephropathy were randomly divided into three groups: adriamycin nephropathic model control group (ADR, n=12), MSCs transplantation through right renal artery group (M-A, n=12) and MSCs transplantation through peripheral veins group (M-V, n=12). Another 12 SD rats were served as normal controls (N, n=12). MSCs were cultured, transplanted via right renal artery (2×106/mL) to rats in M-A group, and were transplanted via peripheral veins 2×106/mL) to rats in M-V group. The same procedure was repeated in two weeks. The blood urea nitrogen, serum creatinine, 24 h urine protein and 24 h uromicroprotein were detected before transplantation and in one and two weeks after the second transplanta-tion. The renal morphology and labeled cells were examined in the kidney one week after the second transplantation. Results The values of blood urea nitrogen, serum creatinine, 24 h urine protein and 24 h uromicroprotein were significant-ly higher in M-A group, M-V group and ADR group than those of N group (P<0.01). The level of 24 h uromicroprotein was significantly lower before the second transplantation in M-A group than that of ADR group (P<0.01). The serum level of cre-atinine was significantly decreased in M-A group than that of ADR group and M-V group (P<0.01). The levels of 24 h urine protein and 24 h uromicroprotein were significantly lower after one week transplantation in M-A group than those of M-V group (P<0.01). The serum level of creatinine was significantly lower two weeks after the second transplantation in M-A group than that of ADR group and M-V group (P<0.01), but no significant differences in the levels of urine protein and uro-microprotein between M-A group and M-V group. Conclusion Transplantation of MSCs can alleviate renal damage of chronic ADR-induced nephropathy, which is more effective in rats with MSCs transplantation via renal artery than that in rats with MSCs transplantation via peripheral vein.
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Objective To investigate the impact of initial dialysis dose on residual renal function of peritoneal dialysis patients. Methods Clinical data of 178 consecutive patients on initial peritoneal dialysis received follow-up for 3 months in our department were analyzed retrospectively. According to urinary volume after peritoneal dialysis, patients were divided into three groups: lower urine group (LU, n=97), decreased urine group (DU, n=19), and normal urine group (NU, n=62). Their dialysate volume, dialysate glucose content, uhrafiltration, weekly renal urea clearance normalized to total body water (Kt/V), body weight, edema degree and daily urinary volume were recorded and association among these parameters were examined. Results There were no significant differences in age, gender, serum albumin and total Kt/V among three groups. One month after dialysis, body weight and edema degree in DU group were significantly higher than those in LU and NU groups (all P<0.05); the dialysate volume, dialysate glucose content, ultrafiltration and renal Kt/V in DU group were significantly higher than those in LU group (all P<0.05), but were not significantly different from NU group. Three months after dialysis, in DU group, dialysate volume, ultrafiltration and urinary volume decreased significantly (P<0.05) as compared with LU and NU groups, but body weight and edema degree were still higher, and Kt/V decreased significantly as well. Conclusions The residual renal function (urinary volume and Kt/V value) of initial patients will be deteriorated by over ultrafihration in early stage of peritoneal dialysis. Excess uhrafiltration should be avoided for the initial peritoneal dialysis patients.
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The completion of many malaria parasite genomes provides great opportunities for genomewide characterization of gene expression and high-throughput genotyping. Substantial progress in malaria genomics and genotyping has been made recently, particularly the development of various microarray platforms for large-scale characterization of the Plasmodium falciparum genome. Microarray has been used for gene expression analysis, detection of single nucleotide polymorphism (SNP) and copy number variation (CNV), characterization of chromatin modifications, and other applications. Here we discuss some recent advances in genetic mapping and genomic studies of malaria parasites, focusing on the use of high-throughput arrays for the detection of SNP and CNV in the P. falciparum genome. Strategies for genetic mapping of malaria traits are also discussed.
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Animals , Chromosome Mapping , DNA, Protozoan/genetics , Gene Dosage , Microarray Analysis , Plasmodium falciparum/genetics , Polymorphism, GeneticABSTRACT
Objective: To seek a treatment that can improve the effect on dysphagia following post-stroke pseudobulbar palsy. Methods: Sixty patients were randomly allocated into observation and control groups, 30 cases each. The observation group was treated with Western drugs plus acupuncture at Tiantu (CV 22) and other three acupoints around Lianquan (CV 23) and the control group with simple Western drugs. Results: The effective rate was 86.7% in the observation group and 30.0% in the control group. Conclusion: Acupuncture can improve the curative effect of Western drugs on dysphagia following post-stroke pseudobulbar palsy.
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Objective To investigate the effects of different tidal volume ventilation on acute lung injury in rats. Methods Thlrty-two normal Wistar rats were randomly divided into four groups:control group,low tidal volume group(L- V_T),conventional tidal volume group(C-V_T)and high tidal volume group(H-V_T).The pathologic changes of the lungs were observed under macrography,light and electron microscope.The blood gas analysis(PaO_2),the counts of neutrophils (PMN),the levels of protein and the myloperoxidase(MPO)activities in bronchoalveolar lavage fluid(BALF)were measured by biochemical methods respectively.Results There were no distinct pathological differences between L-V_T group and control group under macrography,light and electron microscope.In the C-V_T and H-V_T groups,there were different degree of lung injuries under light and electron microscope,their PMN,MPO activity and protein level in BALF were significantly higher than those of control and L-V_T groups and their PaO_2 were significantly lower than those of control and L- V_T groups(P＜0.01,P＜0.05).The MPO activity and the protein level in BALF were also significantly higher than those of C-VT group(P＜0.01)Of the above indexes,there were no statistical differences between L-V_T group and control group(P＞0.05).Conclusion Conventional tidal volume ventilation alone,without any lung-protective strategy, could produce injuries to the normal lung tissues,while low tidal volume ventilation hadn't effects on them.The injury effects produced by mechanical ventilation was closely related to the recruitment and activation of neutrephils in the lung.
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0 05, The reference inteval ( ?2s ) was 0 70～1 15 mmol/L ( n =67) Conclusions This method is simple, sensitive, rapid and accurate,and suitable for the routine manual or automatic analysis of magnesium in serum