ABSTRACT
Objective:To compare the ability of triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio and triglyceride-glucose index (TyG) in identifying nonalcoholic fatty liver disease (NAFLD).Methods:A total of 11 524 eligible subjects who underwent physical examination in the Affiliated Hospital of Qingdao University from January to December in 2018 were selected in this research. The correlation between TG/HDL-C, TyG and NAFLD was analyzed by using binary logistic regression. The receiver operating characteristic (ROC) curves of TyG and TG/HDL-C were drawn for identifying NAFLD in male and female, and their diagnostic value for NAFLD was compared.Results:The prevalence of NAFLD increased with TG/HDL-C and TyG. After adjusting for confounding factors, when compared with that in the first quartile group of TG/HDL-C, the odds ratios (OR) and 95% confidence intervals ( CI) of NAFLD risk in the second, third and fourth quartile groups of TG/HDL-C was 2.380 (2.039-2.779), 3.902 (3.342-4.555) and 7.903 (6.745-9.259), respectively. Compared with that in the first quartile group of TyG, the OR (95% CI) of NAFLD risk in the second, third and fourth quartile groups of TyG was 2.243 (1.923-2.617), 3.918 (3.363-4.565) and 9.002 (7.676-10.559), respectively. The area under the curve (AUC) of TG/HDL-C and TyG in identifying NAFLD in male was 0.746 and 0.744, respectively, and there was no significant difference between the two indexes ( P=0.509 1). The AUCs of TG/HDL-C and TyG in identifying NAFLD in female was 0.785 and 0.799, respectively, and the difference was statistically significant ( P<0.001). The cut-off point of TG/HDL-C for identifying NAFLD in male was 1.02, and the cut-off point of TyG for identifying NAFLD in female was 8.55. Conclusions:TG/HDL-C and TyG are closely related to NAFLD in adults. There is no difference between TG/HDL-C and TyG in evaluating NAFLD in male, while TyG is better than TG/HDL-C in evaluating NAFLD in female.
ABSTRACT
Objective:To understand the current situation of smartphone addiction and mental health of medical freshmen, and conduct research on the relationship between smartphone addiction and mental health, so as to provide evidence for the prevention and intervention of smartphone addiction among medical freshmen.Methods:A stratified random sampling method was used to select 279 freshmen in the medical profession of Binzhou Medical University as the research objects, and the revised smartphone addiction scale (SAS-C) and mental health symptom self-rating checklist scale (SCL-90) were selected for testing. SPSS 19.0 was used for t test. Results:A percentage of 29.71 medical freshmen had smartphone addiction problems, which was generally above average. The SCL-90 total scores and the scores of somatization, interpersonal sensitivity, depression, anxiety, hostility, psychosis and other factors in the smartphone addiction group were significantly higher than those in non-smartphone addiction group. The total score of smartphone addiction in medical professional freshmen was significantly correlated with the total score of SCL-90. In addition to the interference factors of daily life, other factors had positive correlation with various factors of SCL-90. Interpersonal sensitivity and obsessive-compulsive symptoms had a significant predictive effect on smartphone addiction (β=0.24, 0.26, P < 0.01), which were important variables affecting mobile phone addiction of medical freshmen. Conclusion:Many medical freshmen have the problem of smartphone addiction, which may cause a series of psychological problems, especially obsessive-compulsive symptoms, interpersonal sensitivity, anxiety and psychosis.
ABSTRACT
Objective:To study the effect of sublingual immunotherapy on children with mite allergic rhinitis.Methods:Four hundred and ninety patients with mite allergic rhinitis have been recruited by Beijing Children′s Hospital from March 2014 to September 2019 and divided into 4 groups of young children group, different treatment duration group, individualized dose adjustment group and multiple allergy evaluation group, the clinical scores of total nasal symptoms score (TNSS), visual analogue scale scores (VAS) and total medication score were recorded at the first visit, 12 months, 24 months and 36 months after treatment, and the combined symptom and medication score(CSMS) score was calculated.Results:A total of 374 patients (76.32%) completed this study.Among them, the CSMS(2.20±1.61, 2.50±1.78), TNSS(2.80±2.32, 3.60±2.71) and VAS(3.50±1.16, 3.90±1.43) in ≤3-year-old group and children over 3-year-old group of young children set after use of 12 months were significantly lower than the score at the first time of diagnosis (respectively CSMS: 4.50±1.44, 5.30±1.32; TNSS: 6.20±1.89, 7.50±2.19; VAS: 5.40±2.33, 5.90±1.61). In addition, in the duration and efficacy set, the patients who completed the immunotherapy for 36 months can only be observed in the 3-year group, the scores were TNSS(0.90±0.97), VAS (1.30±1.19), CSMS (1.70±1.28); the scores of patients who completed the immunotherapy for 24 months in 2-year group and 3-year group were TNSS (2.10±0.95, 2.00±0.97), VAS (3.00±1.56, 3.10±1.68) and CSMS (3.10±1.15, 2.90±1.19) and the patients who completed 12-month immunotherapy were scored in 1-year group, 2-year group and 3-year group with TNSS(3.20±1.27, 3.10±1.41, 3.20±1.41), VAS(4.50±2.11, 4.70± 2.19, 4.50±2.17) and CSMS(4.20±1.39, 3.70±1.32, 4.10±1.39) respectively; patients with poor efficacy in sublingual immunotherapy achieved a score similar to the control group after 6 months of dose adjustment (equals to 12 months after treatment), that were CSMS(2.90±1.56, 2.90±1.88, 2.40±1.69), TNSS(4.70±2.98, 3.90±2.77, 3.80±2.45) and VAS(4.20±1.29, 4.50±1.65, 4.20±1.14) of 4 drops group, 5 drops group and control group; sublingual immunotherapy for patients with multiple allergens for 2 years finally achieved similar efficacy to patients with single allergen, with CSMS (2.30±0.50, 2.10±1.01, 1.90±1.01), TNSS (3.50±2.62, 3.70±2.62, 3.20±2.82) and VAS (4.50±1.00, 4.10±1.57, 3.80±1.54) in single allergen group, combined with 1-2 allergens group and combined with 3+ allergens group.Conclusions:Sublingual immunotherapy plays a corresponding role in the treatment of low-age children, multiple allergy children, and some children get better after dose adjustment.
ABSTRACT
Objective@#To analyze the characteristics distribution of falls among students aged 6-17 in 2018, and to provide data support for preventing falls among students and formulating the corresponding policies.@*Methods@#Data of falls among students aged 6-17 in China in 2018 were collected from the the National Injury Surveillance System (NISS) for analyzing its demographic characteristics, injury occurrence and clinical traits of falling.@*Results@#In total, 42 735 cases of fall aged 6-17 were collected from the NISS in China in 2018, which accounted for 54.03% of all cases, with a sex ratio of 2.34∶1, the proportion of students aged 6-11 was the highest(53.78%). The proportion of falls from March to June was the highest(42.12%), and the peak time when falls occurred was forenoon 10:00-10:59(8.40%). School and school-related area(40.40%), home(18.96%) and public residential institution (15.35%) were the sites where falls mainly occurred. The top three activities when falls occurred were leisure activities(47.41%), sports activities(23.90%) and walking(9.77%). Bruise/scrape(54.49%), sprain/strain(21.98%) and fracture(12.69%) were the major nature of injury. The most common body parts falls involved were lower limbs(34.71%), head(29.85%) and upper limbs(25.10%). The injury of falling was mainly characterized by mild ones(83.44%).@*Conclusion@#There were more cases of falls on students aged 6-17 from the NISS in China in 2018, mainly males. The epidemiological characteristics were relatively variable, so targeted prevention program of falls should be conducted.
ABSTRACT
Objective:To study the utilization of massive open online courses (MOOCs) learning and the satisfaction with the learning effect of MOOCs.Methods:A questionnaire survey was formulated for residents' cognition of MOOCs in standardized residency training, and 133 valid questionnaires were collected. Descriptive statistical analysis, chi-square test and logistic regression were used to analyze the influencing factors of residents' learning satisfaction with MOOCs.Results:The influencing factors of standardized residency training trainees' satisfaction with MOOCs were the flexibility of learning time, the setting of discussion area, the interaction with teachers and the learning enthusiasm of the trainees.Conclusion:Standardized residency training trainees are satisfied with the learning effect of MOOCs. In the future, the construction of MOOCs will focus on formulating regular learning plan and supervision mechanism, increasing communication and feedback between teachers and trainees, improving the learning enthusiasm of residential trainees and enriching the content of MOOCs.
ABSTRACT
Objective@#To understand the epidemiology characteristics of child injury aged 6-17. Data was from the National Injury Surveillance System (NISS) and the results of the study would provide corresponding intervention strategies and decision-making for child injury prevention.@*Methods@#Descriptive analysis was applied to depict the general information, injury event and clinical characteristics of child injury aged 6-17 from 2015 to 2018.@*Results@#A total of 331 663 child injury cases aged 6-17 were reported, with the male and female ratio appeared as 2.19∶1. 15:00-18:59 was the peak time of injury cases from 2015 to 2018. The majority of the injuries occurred unintentional(94.85%). The top three causes of injury cases were falling(51.38%), blunt injury (12.50%)and road traffic injury(11.27%). The injuries occurred mainly at home(28.23%), in schools/public places (27.70%) and on the road/street(20.35%). The main activities were leisure activities (46.67%) and sports activities(14.36%). 49.06% cases were bruise. 31.18% of the injury involved with head, but 83.32% of injuries were minor, while 90.05% left hospital after the treatment.@*Conclusion@#Falls, blunt injury and road traffic injury are the key causes of children aged 6-17 to go to the outpatient /emergency department for treatment. Prevention and control should be carried out according to the epidemic characteristics of injuries among children of different genders and ages.
ABSTRACT
A questionnaire survey on the perception of general practice and career intention was conducted among 365 undergraduates in Harbin Medical University in May 2018. Among all participants 71 (19.45%) had studied the course of Introduction to General Medicine, and 289 did not (79.18%). Twenty one students well knew general practice (5.78%), 189 knew (51.78%) and 155 students did not know (42.47%); 164 (44.93%) would pursue a master degree study in general practice after graduation, 216 people (59.18%) were willing to attend standardized residency training after graduation, and 147 (40.27%) choose to be a general practitioner after graduation. The proportion of students willing to pursue a master degree study in general medicine and to receive standardized resident training of general practice in students who had studied "Introduction to General/Family Medicine" was lower than that in hose did not studied (χ2=7.46, 7.14, both P<0.05). The top three reasons for becoming a general practitioner were more chance for career development (70.15%, 109/147), loving the subject (52.38%, 77/147), and difficulty to be employed for other specialties (27.21%, 40/147). The first three reasons for not being a general practitioner were less chance for career development (52.17%, 133/138), less interesting specialty (47.10%, 65/138), unfamiliar with grassroots work (39.86%, 55/138). The survey indicates that medical colleges should continue to strengthen the education of general practice, and constantly improve its curriculum system to attract more medical students to join the team of general practitioners after their graduation.
ABSTRACT
Multidisciplinary therapy is considered as an acceptable option for gastric cancer patients with liver metastases currently, while the effectiveness of surgery is still controversial. Although there was no improved survival for cytoreductive surgery, some evidences showed that some selected patients with the combination surgery of gastric cancer and liver metastases could benefit from curative resection. Compared to cytoreductive surgery for gastric cancer patients with liver metastasis, curative resection did not increase the incidence of complications or mortality. Therefore, surgery-based multidisciplinary therapy would be appropriate for some seleted gastric cancer patients with liver metastasis. In highly selected patients with neoadjuvant chemotherapy, curative resection with both primary and metastatic tumor could improve long-term survival benefits. Furthermore, the long-term survival and quality of life should be considered of equal importance in future studies.
ABSTRACT
Objective To understand the status quo of stressors and mental health of undergradu-ates of local medical colleges in internship and provide relevant countermeasures so as to provide scientific reference for psychological health counseling for them. Methods The stress source scale and mental health symptom self-rating scale for medical students in internship (SCL-90) coded by Chang Lirong et al was adopted to investigate. The questionnaire survey was conducted on the stress and mental health status of 390 interns in Binzhou Medical College, and 384 valid questionnaires were collected, with the effective rate of recovery as 98.46%. The questionnaire results were analyzed by sample t test, variance analysis and Pearson correlation analysis. Results A total of 24.1% of students in local medical schools were under moderate pressure (1.17±0.63). The highest pressure source was examination and employment (1.58±0.74), and the other followed were knowledge and skills (1.43 ±0.68), interpersonal relationships (1.11 ±0.54), patients (1.06±0.53), medical conditions (1.00±0.53) and work load (0.95±0.52) respectively. The scores of various stressors were significantly and positively correlated with most of the mental health factors. Conclusion The undergraduates of local medical colleges and universities are generally under stress in internship, which would affect their mental health. It is suggested that the interns should be guided from the aspects of employment, study and psychology so as to help them relieve their stress and develop good psychological qualities.
ABSTRACT
In order to improve the quality of standardized training in department of orthopedics, it is necessary to ensure and strengthen the discipline management of standardized training. According to management experience of the standardized trainees in the department of orthopedics in the past years, this paper analyzes present situation of standardized training in orthopedics department, including the composi-tion and characteristics of the students and the structure of existing management staff and discusses the management measures, such as the establishment of electronic supervision system and the establishment of a new management structure. By doing so, we hope to achieve the institutionalization and normalization of the discipline management of standardized training and provide valuable experience in discipline manage-ment for other bases.
ABSTRACT
The number of lymph node dissection and positive lymph nodes are the necessary guarantees for patients to achieve accurate staging after gastric cancer surgery. On the basis of the minimum number of lymph nodes dissection recommended by the NCCN guidelines, as many as possible lymph node yields will be most likely to benefit patients. Many factors can influence the number of lymph node yields including surgery, patient, tumor pathology and postoperative sorting factors. Compared with traditional manual nodal dissection method, fat-clearing technique and methylene blue staining method can improve the number of lymph nodes detection, while lymphatic tracers, such as carbon nanoparticles, are conducive to show lymphatic vessels, contributing to the dissection of small lymph nodes. The initial results from People′s Liberation Army General Hospital show that lymph node packet submission after isolation by surgeon yields more lymph nodes. For the establishment of standards, lymph node retrieval-related procedures need further in-depth exploration and investigation.
ABSTRACT
Objective To explore the clinical phenotype of 22q11.2 deletion syndrome with imperforate anus. Methods The clinical diagnosis and treatment of one case of 22q11.2 deletion syndrome complicated with anal atresia were retrospectively analyzed. Gene and phenotype of this disease were analyzed, and the related literature was reviewed. Results An elder male test tube infant of twins, born to a G2P2 mother were found to have special facial features, cleft palate, congenital heart disease, and imperforate anus after birth. A genome-wide microarray scan revealed 22q11.2 deletion syndrome. In related literatures, 22q11.2 deletion syndrome could be affected by TBX1 gene, histone modification, Ranbp1 gene, and even microRNA; while imperforate anus were influenced by multiple elements such as genetic, maternal, and environmental factors and multiple embryonic developments related genes could be involved in its pathogenesis. Conclusions Congenital imperforate anus and 22q11.2 deletion syndrome are mostly sporadic cases in epidemiology and are incidental accidents in development. Whether there is a common interaction factor between them needs to be further studied and defined.
ABSTRACT
OBJECTIVE To discuss the diagnosis and endoscopic treatment of congenital basal encephaloceles in infants.METHODS We retrospectively reviewed the clinical data of 6 infants with congenital basal encephaloceles in Beijing Children's Hospital between January 2014 to September 2016. CT and MRI were performed routinely. All patients underwent endoscopic resection of encephaloceles and repair of skull base defects. RESULTS Five patients presented with transethmoidal encephaloceles and one transsphenoidal encephaloceles. All patients underwent endoscopic procedure successfully. There were no complications except for one 7-month old girl who got purulent meningitis. All patients had favorable clinical outcomes during a follow-up of 3 to 29 months.CONCLUSION For infants with persistent nasal obstruction and nasal neoplasms, congenital basal encephaloceles should be considered. Nasal coronary CT and sagital MRI are of paramount importance in the diagnosis of congenital basal encephaloceles in infants. The endoscopic procedure is the safe and effective method for the management of congenital basal encephaloceles in infants.
ABSTRACT
Clinical novitiate is not only a significant part in the training of basic comprehensive ability of clinical medicine students,but also a weak link in current teaching practice link. This research is guided by the educational reform of the"5+3"talent training mode and it carries out reforms by constructing three-stage novitiate mode, realizing curriculum integration and PBL teaching as well as multi-dimensional performance appraisal etc.It is student-centered and lays emphasis on developing students' autonomous learning ability,basic clinical skills and thinking ability,so as to improve the training quality of the medical professionals and provide a referable novitiate teaching mode for the training of medicine professionals under the new situation.
ABSTRACT
Aiming at the existing problem of inequality and being unscientific in the evaluation of comprehensive quality of medical students, through literature research and expert opinion method, and from multi angles , the author constructed the evaluation index system of comprehensive quality of scientific medicine, using AHP to determine the weights of evaluation indexes, and established a fuzzy evaluation model of the comprehensive quality of medical students, and on this basis, improved the calculation method of fuzzy evaluation and the maximal subjection degree of the evaluation result. The specific examples of the evaluation results showed that the method was effective and could reflect the comprehensive quality of med-ical students in a comprehensive and objective way, and it had great significance to the comprehensive quality evaluation of medical students.
ABSTRACT
OBJECTIVE To investigate the short-term clinical efficacy of sublingual immunotherapy in children with allergic rhinitis. METHODS Forty-four patients, from 3-14 years of age, with mite-sensitive allergic rhinitis were treated sublingually with standardized dermatophagoidesfarinae extract. After treatment of 3 or 6 months using the dermatophagoidesfarinae extract, the total nasal symptoms score(including nasal congestion, nasal itching, rhinorrhea and sneezing scores), total rhinitis medicine scores, visual analog scale scores and the percentage of blood eosinophilic granulocyte(Eos%) before and after treatment were evaluated. SPSS 20.0 software was used to analyze the data. RESULTS After 3 or 6 months' treatment,thenasal symptoms score(including nasal congestion, nasal itching, rhinorrhea and sneezing scores), total rhinitis medicine scores and visual analog scale scoreshad significantly reduced,comparing with that before treatment(all P0.05), while nasal itching scores had significantly reduced(Z=-4.185, P<0.05). After 6 months' treatment, the percentage of Eos% had significantly reduced compared with that before treatment(Z=-4.544, P<0.05). CONCLUSION SLIT could be an effective treatment in patients with allergic rhinitis sensitive to house dust mite. It would have effect after3 months treatment and Eos%reduced significantly after 6 months treatment.
ABSTRACT
Objective To discuss pathogens findings in children with severe pneumonia.Methods Bacteria was detected by using sputum culture and blood culture in sterile culture media.Viruses and atypical pathogenic antibodies were detected by using indirect immunofluorescence.Influenza A (H1N1) virus RNA were tested using RT-PCR.According to the results of bacterial culture and drug sensitive test,we can guide the use of antibiotics,and individualize treatment was carried out,including anti-inflammatory,organ function support.Results Bacteria was found in 69 children by using sputum culture.Gram negative bacteria accounted for 57.47％.Gram positive bacteria accounted for 42.53％.Escherichia coli(14.94％),Haemophilus influenzae (20.96％) and klebsiella pneumoniae(13.79％) were the main strains of Gram negative bacteria,Staphylococcus aureus (21.84％)and Streptococcus pneumonia(16.1％)were the main strains of Gram positive bacteria.Bacteria was found in 7 (8.00％) children by using blood culture.Virus were identified in 11 out of 123 patients,including 2 cases of respiratory syncytial virus antibody positive,2 cases of adenovirus antibodies positive,4 cases of influenza B virus antibody positive,2 cases of parainfluenza virus antibody positive and influenza A(H1N1) virus from only one case,Mycoplasma pneumonia agents were identified in 8 patients.Eighty-nine children (72.36％) complicated with sepsis,85 children (69.11％) with respiratory failure,48 children (39.02％) with gastrointestinal dysfunction,32 children (26.02％) with heart failure,18 children(14.63％) with septic shock,13 cases (10.57％) with toxic encephalopathy,5 children (4.07％) with disseminated intravascular coagulation.Among them,17 children (13.82％) complicated with multiple organ dysfunction syndrome.In the 123 children with severe pneumonia,46 cases (37.4％) were cured,73 cases (59.35％) improved,and 4 cases died (3.25％) with critical multiple organ dysfunction syndrome.Conclusion The detection rate of pathogen is high in this study.We should pay more attention to individualize therapy for complication,so that the cure rate could be increased.
ABSTRACT
Carbon monoxide has been proved to be an important signal molecule in body. Transition metal carbonyl compounds are solidified form of carbon monoxide. Numerous studies have shown that Ruthenium carbonyl carbon monoxide releasing molecules have a strong pharmacological activity. In this paper, five Ruthenium (II) carbonyl CORMs 1-5 were synthesized and their toxicology, tissue distribution and interaction with blood endogenous substances were investigated. The results showed CORMs' IC50 to fibroblasts are ranged from 212.9 to 2089.2 micromol x L(-1). Their oral LD50 to mouse is between 800 to 1600 mg x kg(-1). After repeated administration, CORMs 1 and CORMs 5 haven't shown an obvious influence to rats' liver and kidney function, but caused the injury to liver and kidney cells. The in vivo distribution result revealed the majority of CORMs were distributed in blood, liver and kidney, only a small part of CORMs distributed in lung, heart and spleen. They could scarcely cross the blood-brain barrier and distribute to brain. The non-CO ligands in structure have an obvious relevance to their in vivo absorption and distribution. Interestingly, CORMs could enhance the fluorescence of bovine serum albumin, and this enhancement was in direct proportion with the concentration of CORMs. Under different conditions, interaction of CORMs with glutathione got different type of products, one is Ruthenium (II) tricarbonyl complexes, and Ruthenium (II) dicarbonyl complexes.
ABSTRACT
Objective To examine the role of c-Jun NH2-terminal kinase(JNK) 1 in cytolytic T lymphocyte (CTL) responses against virus infection.Methods Wild-type (WT) and JNK1-knockout (JNK1-/-) mice were infected with ectromelia virus(ECTV) through hind footpads.Survival and virus titers in the target organs (liver and spleen) were analyzed.Effector T cells in the spleen and popliteal lymph nodes were determined on day 3 and 7 post-infection.Proliferation and INF-γ production of CTL were also detected.Results JNK1 deficiency caused an increased susceptibility to ECTV infection in mice,indicated by higher case fatality and viral burden in target organs.The decrease in CTL response correlated with a defect in CTL proliferation and INF-γproduction.Conclusion The data suggest that JNK1 is involved in expansion of activated CTL during ECTV infection,and plays an important antiviral role in regulating the proliferation and effector function of CTL.
ABSTRACT
Objective To observe the effect of ulinastatin on the expression of interleukin 15 (IL-15), connective tissue growth factor (CTGF) and malondialdehyde (MDA) in rat peritoneal mesothelial cells (RPMCs) induced by high glucose. Methods RPMCs were isolated, cultured and passaged by trypsin, then identified. The third generation of cultured RPMCs were used in the experiment. RPMCs were divided into normal control group, high glucose (1.5%, 2.5%, 4.25%) for 6 hours and 12 hours, high glucose (2.5%) for 3, 6, 12, 24 hours or ulinastatin (160, 320, 640U/ml) for 12 hours. IL-15 mRNA was detected by real-time PCR. IL-15 and CTGF protein in supernatants was detected by ELISA. MDA protein was detected by TBAS. Results Compared with the control group, the expression of IL-15, CTGF and MDA was significantly increased in the groups stimulated by high glucose (P＜0.05) in dose- and time-dependent manner. Ulinastatin could significantly decrease the expression of IL-15, CTGF and MDA induced by high glucose in dosedependent manner both in protein and gene levels (P＜0.05). Conclusions High glucose can up-regulate the expression of IL-15, CTGF and MDA in RPMCs. Ulinastatin can reverse these changes.