ABSTRACT
In the context of a healthy China, strengthening humanistic literacy education for general medical students reflects the demands of the times, promotes the transformation of medical models, and has important practical significance in reducing the work burnout of general practitioners in practice. Integrating narrative medicine into general practice student education is conducive to implement the patient-centered concept of general practice, provide continuous and systematic medical services, and further improve the humanistic literacy of general practitioners. Based on these, this paper proposed the relevant paths of integrating narrative medicine into student education in general medicine, including changing educational concepts and integrating educational resources, boldly carrying out curriculum reforms and innovating educational methods, fully utilizing parallel medical records and reflective writing, as well as cultivating the habit of lifelong learning.
ABSTRACT
OBJECTIVE@#To screen potential pan-cancer biomarkers based on The Cancer Genome Atlas (TCGA) database, and to provide help for the diagnosis and prognosis assessment of a variety of cancers.@*METHODS@#"GDC Data Transfer Tool" and "GDCRNATools" packages were used to obtain TCGA database. After data sorting, a total of 13 cancers were selected for further analysis. False disco-very rate (FDR) < 0.05 and fold change (FC) >1.5 were used as the differential expression criteria to screen genes and miRNAs that were up- or down-regulated in all the 13 cancers. In the receiver operating characteristic curve (ROC curve), the area under the curve (AUC), the best cut-off value and the corresponding sensitivity and specificity were used to reflect diagnostic significance. The Kaplan-Meier method was used to calculate the survival probability and then the log-rank test was performed. Hazard ratio (HR) was calculated to reflect prognostic evaluation significance. DAVID tool were used to perform GO (Gene Ontology) and KEGG (Kyoto Encyclopedia of Genes and Genomes) enrichment analysis for differentially expressed genes. STRING and TargetScan tools were used to analyze the regulatory network of differentially expressed genes and miRNAs.@*RESULTS@#A total of 48 genes and 2 miRNAs were differentially expressed in all the 13 cancers. Among them, 25 genes were up-regulated, 23 genes and 2 miRNAs were down-regulated. Most differentially expressed genes and miRNAs had good ability to distinguish between the cases and controls, with AUC, sensitivity and specificity up to 0.8-0.9. Survival analysis results show that differentially expressed genes and miRNAs were significantly associated with patient survival in a variety of cancers. Most up-regulated genes were risk factors for patient survival (HR>1), while most down-regulated genes were protective factors for patient survival (0 < HR < 1). The enrichment analysis of GO and KEGG showed that the differentially expressed genes were mostly enriched in biological events related to cell proliferation. In the regulatory network analysis, a total of 13 differentially expressed genes and 2 differentially expressed miRNAs had regulatory and interaction relationships.@*CONCLUSION@#The 48 genes and 2 miRNAs that were differentially expressed in 13 cancers may serve as potential pan-cancer biomarkers, providing help for the diagnosis and prognosis evaluation of a variety of cancers, and providing clues for the development of broad-spectrum tumor therapeutic targets.
Subject(s)
Humans , Biomarkers, Tumor/genetics , Early Detection of Cancer , Gene Expression Profiling , Gene Expression Regulation, Neoplastic , MicroRNAs/genetics , Neoplasms/genetics , PrognosisABSTRACT
Many studies indicated that with the rise of cardiac function class in patients with heart failure (HF), serum CA125 concentration gradually rose, and it's significant positively correlated with BNP level and NYHA class. It 's reported that in HF patients with pleural effusion, serum CA125 level significantly increases, and rehospitalization rate and mortality of HF patients rise along with CA125 level. Therefore, the present article made a discussion on relationship between serum CA125 level and HF.
ABSTRACT
Coronary heart disease has become a major threat of human health, and its incidence rate remains surprisingly high.In recent years, technology on its diagnosis and treatment has developed greatly.The present article made a review on related new diagnosis and treatment so as to provide reference for clinical diagnosis and treatment of coronary heart disease.
ABSTRACT
Many researches proved that inflammation plays a decisive role in occurrence, development and prognosis of acute coronary syndrome (ACS).Atorvastatin possesses many other effects besides lipid regulation, and anti-inflammatory effect is the most significant one.Some studies indicated that atorvastatin can reduce levels of high sensitive C reactive protein (hsCRP), interleukin (IL)-6 and tumor necrosis factor (TNF)-α in ACS patients, then inhibit postoperative inflammation, improve postoperative blood flow perfusion and reduce occurrence of acute coronary events.The present article made a review on influence of atorvastatin on levels of hsCRP, IL-6 and TNF-α in ACS patients.
ABSTRACT
Objective To observe the action ofFu Liu Zhen (acupuncture at the six abdominal points) plus moxa-box moxibustion at umbilicus on a community population of qi and yang deficiency.Method Two hundred subjects diagnosed with qi deficiency and/or yang deficiency were randomized into a treatment group and a control group, 100 cases in each group. The two groups both received constitution-associated health education, and the treatment group was additionally intervened byFu Liu Zhen plus moxa-box moxibustion at umbilicus, while the control group didn’t receive any other intervention. The Score of Constitution in Traditional Chinese Medicine (TCM) and the number of people of each constitution were observed prior to the intervention, right after the intervention, 6 months after the intervention and 12 months after the intervention.Result In the treatment group, the scores of qi deficiency and yang deficiency after the intervention, 6 months after the intervention and 12 months after the intervention were significantly different from that prior to the intervention (P<0.01). The scores of the corresponding constitution types (qi deficiency, yang deficiency) after the intervention, 6 months after the intervention and 12 months after the intervention were significantly different from that before the intervention (P<0.01). The proportions of subjects with harmonious constitution, qi deficiency, and yang deficiency in the treatment group after the intervention, 6 months and 12 months after the intervention were significantly different from that prior to the intervention (P<0.01). The proportions of subjects with harmonious constitution, qi deficiency, and yang deficiency in the treatment group after the intervention, 6 months and 12 months after the intervention were significantly different from that in the control group (P<0.01).ConclusionFu Liu Zhen plus moxa-box moxibustion at umbilicus can improve the qi-deficiency and yang-deficiency constitutions in the community population.
ABSTRACT
Objective:To explore the correlation between serum level of matrix metalloproteinase 2 (MMP-2)and se-verity of coronary artery disease in aged patients with acute coronary syndrome (ACS)complicated hyperhomocys-teinemia (HHCY).Methods:According to serum level of homocysteine (Hcy),a total of 105 aged ACS patients were selected and divided into ACS+HHCY group (n=56)and pure ACS patients (n=49),another 65 healthy in-dividuals were enrolled as healthy control group.The severity of coronary artery disease was showed by Gensini score ;enzyme linked immunosorbent assay was used to measure serum MMP-2 level in each group.Results:Com-pared with healthy control group,there were significant rise in MMP-2 level [(140.8±50.1)ng/ml vs.(442.5± 98.2)ng/ml,(297.9±86.3)ng/ml]in ACS+HHCY group and pure ACS group,P <0.01. Gensini score in ACS+HHCY group was significantly higher than that of pure ACS group [(1.9±0.2)scores vs.(1.1±0.3)scores,P<0.01].Pearson correlation analysis indicated that Gensini score was positively correlated with MMP-2 level in ACS+HHCY group (r =0.424,P <0.05).Conclusion:The serum MMP-2 level is significantly positively correla-ted with severity of coronary artery disease in aged patients with ACS complicated HHCY.
ABSTRACT
<p><b>BACKGROUND</b>Several studies have demonstrated that primary percutaneous coronary intervention (PCI) can result in reperfusion injury. This study aims to investigate the effectiveness of liposomal prostaglandin E1 (Lipo-PGE1, Alprostadil, Beijing Tide Pharmaceutical Co., Ltd.) for enhancing microcirculation in reperfusion injury. In addition, this study determined the optimal administration method for acute ST elevation myocardial infarction (STEMI) patients undergoing primary PCI.</p><p><b>METHODS</b>Totally, 68 patients with STEMI were randomly assigned to two groups: intravenous administration of Lipo-PGE1 (Group A), and no Lipo-PGE1 administration (Group B). The corrected thrombolysis in myocardial infarction (TIMI) frame count (cTFC) and myocardial blush grade (MBG) were calculated. Patients were followed up for 6 months. Major adverse cardiac events (MACE) were also measured.</p><p><b>RESULTS</b>There was no significant difference in the baseline characteristics between the two groups. The cTFC parameter in Group A was significantly lower than Group B (18.06 ± 2.06 vs. 25.31 ± 2.59, P < 0.01). The ratio of final MBG grade-3 was significantly higher (P < 0.05) in Group A (87.9%) relative to Group B (65.7%). There was no significant difference between the two groups in final TIMI-3 flow and no-reflow. Patients were followed up for 6 months, and the occurrence of MACE in Group A was significantly lower than that in Group B (6.1% vs. 25.9% respectively, P < 0.05).</p><p><b>CONCLUSIONS</b>Myocardial microcirculation of reperfusion injury in patients with STEMI, after primary PCI, can be improved by administering Lipo-PGE1.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Administration, Intravenous , Alprostadil , Therapeutic Uses , Microcirculation , Myocardial Infarction , Drug Therapy , Percutaneous Coronary Intervention , MethodsABSTRACT
<p><b>BACKGROUND</b>Transradial approach catheterization is now widely used in coronary angiography and angioplasty. The ulnar artery, which is one of the two terminal branches of the brachial artery, may be a potential approach for cardiac catheterization. The aim of this study was to evaluate the safety and feasibility of a transulnar approach for coronary catheterization in non-selective patients.</p><p><b>METHODS</b>A total of 535 consecutive patients were randomly assigned to transulnar approach (TUA) group (n = 271) or transradial approach (TRA) group (n = 264) upon arrival at the catheterization laboratory. Allen's test and inverse Allen's test were not routinely performed. Ultrasound-Doppler assessment of the forearm artery was performed before the procedure, two days after the procedure, and 30 days after the procedure. The primary endpoints of study were the rate of successful artery cannulation and the access-site related complications. The secondary endpoints included the number of needle punctures, total time for the procedure, and major adverse cardiac events (MACE).</p><p><b>RESULTS</b>Successful puncture of the objective artery was obtained in 91.5% of the patients in the TUA group, and 95.1% of the patients in the TRA group (P > 0.05). There was no significant difference in hematoma complications between the two groups (7.7% vs. 4.2%, P = 0.100). A motor abnormality of the hand was observed in one patient in the TUA group. There were no arteriovenous fistula or pseudoaneurysm observed in our study. Three (1.1%) patients in the TUA group and 8 (3.0%) patients in the TRA group had occlusion of the access artery (P = 0.137), but none of the patients had symptoms or signs of hand ischemia. There were no significant differences in MACE between the two groups during follow-up.</p><p><b>CONCLUSION</b>The transulnar approach is an effective and safe technique for coronary catheterization in non-selective patients.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Cardiac Catheterization , Methods , Coronary Angiography , Methods , Radial Artery , General Surgery , Ulnar Artery , General SurgeryABSTRACT
<p><b>OBJECTIVE</b>To explore the clinical outcome of floating knee injury treated by open reduction and internal fixation.</p><p><b>METHODS</b>The course of treatment of floating knee in 78 cases by open reduction and internal fixation were reviewed. There were 59 males and 19 females, aged from 17 to 58 years old, with an average age of 37.5 years. Intramedullary nail, pressure plate hollow screw, multi-function single side external fixation holder and other internal fixature were used in the operation. Early exercises were followed postoperatively.</p><p><b>RESULTS</b>All patients were followed-up for 8 to 35 months (mean 18.6 months). According to the criterion of Karlström, of the 48 cases with femoral shaft fracture, 45 were excellent and 3 were good. In the 11 cases of bimalleolar fracture, 5 were excellent, 3 good, 1 fair and 2 bad. Of the 19 cases of mixed fracture, 9 were excellent,6 good, 3 fair and 1 bad.</p><p><b>CONCLUSION</b>Strict sterilization, non-invasion and standard internal and external fixation could make the fracture anatomical reduction and firm fixation. It is beneficial to early rehabilitation exercise. Complications such as malunion, and stiff joint could be avoided. The clinical outcome were satisfactory.</p>